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The calculation of Tumor Stroma Ratio (TSR) is a challenging medical issue that could improve predictions of neoadjuvant chemotherapy benefits and patient prognoses. Although several studies on breast cancer and deep learning methods have achieved promising results, the drawbacks that pixel-level semantic segmentation processes could not extract core tumor regions containing both tumor pixels and stroma pixels make it difficult to accurately calculate TSR. In this paper, we propose a Vague-Segment Technique (VST) consisting of a designed SwinV2UNet module and a modified Suzuki algorithm. Specifically, the SwinV2UNet identifies tumor pixels and generate pixel-level classification results, based on which the modified Suzuki algorithm extracts the contour of core tumor regions in terms of cosine angle. Through this way, VST obtains vaguely segmentation results of core tumor regions containing both tumor pixels and stroma pixels, where the TSR could be calculated by the formula of Intersection over Union (IOU). For the training and evaluation, we utilize the well-known The Cancer Genome Atlas (TCGA) database to create an annotated dataset, while 150 images with TSR annotations from real cases are also collected. The experimental results illustrate that the proposed VST could generate better tumor identification results compared with state-of-the-art methods, where the extracted core tumor regions lead to more consistencies of calculated TSR with senior experts compared to junior pathologists. The experimental results demonstrate the superiority of our proposed pipeline, which has promise for future clinical application.

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PURPOSE: The significance of neuroendocrine differentiation (NED) in gastric carcinoma (GC) is controversial, leading to ambiguous concepts in traditional classifications. This study aimed to determine the prognostic threshold of meaningful NED in GC and clarify its unclear features in existing classifications. MATERIALS AND METHODS: Immunohistochemical staining for synaptophysin, chromogranin A, and neural cell adhesion molecule was performed for 945 GC specimens. Survival analysis was performed using the log-rank test and univariate/multivariate models with percentages of NED (PNED) and demographic and clinicopathological parameters. RESULTS: In total, 275 (29.1%) cases were immunoreactive to at least 1 neuroendocrine (NE) marker. GC-NED was more common in the upper third of the stomach. PNED, and Borrmann's classification and tumor, lymph node, metastasis stages were independent prognostic factors. The cutoff PNED was 10%, beyond which patients had significantly worse outcomes, although the risk did not increase with higher PNED. Tumors with ≥10% NED tended to manifest as Borrmann type III lesion with mixed/diffuse morphology and poorer histological differentiation; the NE components in this population mainly grew in insulae/nests, which differed from the predominant growth pattern (glandular/acinar) in GC with <10% NED. CONCLUSIONS: GC with ≥10% NED should be classified as a distinct subtype because of its worse prognosis, and more attention should be paid to the necessity of additional therapeutics for NE components.

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Objective To investigate the effect of combined inhalation of ambroxol hydrochloride, intermittent tapping and sputum drainage and psychological intervention on postoperative lung cancer. Methods 68 cases of lung cancer patients treated in our hospital from January 2015 to March 2017 were selected, the control group received oxygen aerosol inhalation of ambroxol hydrochloride and intermittent beating back sputum at the early stage of the operation. The study group was treated with psychological intervention on the basis of the treatment of the control group. The postoperative pulmonary complications in two groups of patients with lung cancer were recorded. The data were input into SPSS statistical software and analyzed. Results The incidence rate of atelectasis and pulmonary infection in the study group (5.88％, 8.82％) were higher than those in the control group (The incidence of atelectasis was 32.35％, and the incidence of pulmonary infection was 38.24％) was significantly reduced, the difference was statistically significant (P<0.05). Conclusion On the basis of providing oxygen aerosol inhalation of ambroxol hydrochloride and intermittent beating back sputum for early postoperative lung cancer patients, the clinical prognosis can be significantly improved if psychological intervention is used.

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Objective To investigate influence on the quality of life of psychological intervention combined with hydrochlorothiazide on the treatment of the patients undergoing heart valve replacement. Methods The control group after heart valve replacement surgery were accepted the routine drug combined with hydrochlorothiazide, at this basis, the study group were received targeted nursing interventions. The changes of quality of life (SF-36) before and after cardiac valve replacement in the two groups were recorded. The effect in the two groups were compared. Results There was no statistically significant in SF-36 in the two groups before heart valve replacement; After treatment, the SF-36 scale scores in the 2 groups were significantly higher than that before treatment, and the SF-36 scale score in the study group was significantly higher than that in the control group (P<0.05). Conclusion The combination of hydrochlorothiazide and psychological intervention in the patients undergoing cardiac valve replacement can significantly improve the quality of life and improve the prognosis.

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Objective To investigate the pathologic morphology and immunohistochemical phenotypes of sarcomatoid carcinoma(SC) of the fallopian tube.Methods One case of SC of the fallopian tube was studied under the light microscopy for morphology.Immunohistochemistry was used to detect the expression of CK,EMA,S-100,Desmin,SMA,Leu-7,CD68,actin,and Vimentin in SC tissues.Pathologic features and biological behaviors of SC were analyzed in combination with the review of literature.Results Microscopically carcinomatous and sarcomatous elements co-existed.Usually the sarcomatous element formed the bulk of the lesion.In the sarcomatous tissues,there was no distinguishable bone,cartilage,rhadomyosarcoma,etc. Immunohistochemically the strong expression of CK7,EMA and Vimentin,and the partial expression of S-100,SMA,Leu7,CD68 and actin were detected.Conclusion SC of the fallopian tube is lack of specific symptoms,and its preoperative diagnosis is difficult.B-ultrasonography,CT and MRI are helpful to the staging of SC.Final diagnosis of SC depends on pathological examination and immunohistochemistry.SC is rare,and undergoes blood metastasis in early stage.Prognosis of SC is worst.Early detection of SC is the key to improve the prognosis.