HGCMorph: joint discontinuity-preserving and pose-learning via GNN and capsule networks for deformable medical images registration.

Objective.This study aims to enhance medical image registration by addressing the limitations of existing approaches that rely on spatial transformations through U-Net, ConvNets, or Transformers. The objective is to develop a novel architecture that combines ConvNets, graph neural networks (GNNs), and capsule networks to improve the accuracy and efficiency of medical image registration, which can also deal with the problem of rotating registration.Approach.We propose an deep learning-based approach which can be utilized in both unsupervised and semi-supervised manners, named as HGCMorph. It leverages a hybrid framework that integrates ConvNets and GNNs to capture lower-level features, specifically short-range attention, while also utilizing capsule networks (CapsNets) to model abstract higher-level features, including entity properties such as position, size, orientation, deformation, and texture. This hybrid framework aims to provide a comprehensive representation of anatomical structures and their spatial relationships in medical images.Main results.The results demonstrate the superiority of HGCMorph over existing state-of-the-art deep learning-based methods in both qualitative and quantitative evaluations. In unsupervised training process, our model outperforms the recent SOTA method TransMorph by achieving 7%/38% increase on Dice score coefficient (DSC), and 2%/7% improvement on negative jacobian determinant for OASIS and LPBA40 datasets, respectively. Furthermore, HGCMorph achieves improved registration accuracy in semi-supervised training process. In addition, when dealing with complex 3D rotations and secondary randomly deformations, our method still achieves the best performance. We also tested our methods on lung datasets, such as Japanese Society of Radiology, Montgoermy and Shenzhen.Significance.The significance lies in its innovative design to medical image registration. HGCMorph offers a novel framework that overcomes the limitations of existing methods by efficiently capturing both local and abstract features, leading to enhanced registration accuracy, discontinuity-preserving, and pose-learning abilities. The incorporation of capsule networks introduces valuable improvements, making the proposed method a valuable contribution to the field of medical image analysis. HGCMorph not only advances the SOTA methods but also has the potential to improve various medical applications that rely on accurate image registration.

Associations of Insomnia With Hypertension and Coronary Artery Disease Among Patients With Type 2 Diabetes Mellitus.

Purpose: This study aimed to determine whether insomnia is associated with hypertension (HBP) and coronary artery disease (CAD) in a hospital-based sample of patients with type 2 diabetes mellitus (T2DM). Methods: Our present study included 354 patients with T2DM. According to the diagnostic criteria of insomnia, the participants were assigned to three groups based on the duration of T2DM and insomnia diagnosis. Patients with T2DM alone were placed in group A; patients with T2DM longer than insomnia were placed in group B; and patients with insomnia longer than T2DM were placed in group C. Medical history was collected from all the patients in detail. Besides, the participants underwent thorough physical examinations and laboratory measurements. Propensity score matching (PSM) was applied to evaluate the associations of insomnia with HBP and CAD. The univariate and multivariate logistic regression analysis was used to explore whether insomnia was a risk factor for HBP and CAD in patients with T2DM. Results: Of 354 patients, 225 patients were included in group A, 62 patients were included in group B, and 67 patients were included in group C. Compared with groups B and C, group A showed a lower prevalence of HBP and CAD (p < 0.05). In addition, compared with group B, group C showed no difference in the prevalence of HBP and CAD (p > 0.05). After PSM was performed, groups B and C had a higher prevalence of HBP and CAD (p < 0.05) than group A with no significant difference between groups B and C (p > 0.05). In the univariate and multivariate logistic regression analysis, insomnia was a risk factor for HBP [univariate: odds ratio (OR) = 3.376, 95% CI 2.290-6.093, p < 0.001; multivariate: OR = 2.832, 95% CI 1.373-5.841, p = 0.005] and CAD (univariate: OR = 5.019, 95% CI 3.148-8.001, p < 0.001; multivariate: OR = 5.289, 95% CI 2.579-10.850, p < 0.001). Conclusion: T2DM combined with insomnia was related to HBP and CAD and insomnia was a risk factor for HBP and CAD in patients with T2DM. However, larger, prospective studies are required to confirm our findings.

Complement C7 is Specifically Expressed in Mesangial Cells and is a Potential Diagnostic Biomarker for Diabetic Nephropathy and is Regulated by miR-494-3p and miR-574-5p.

BACKGROUND: Diabetic nephropathy (DN) is the leading cause of end-stage renal disease, but it remains relatively underdiagnosed. OBJECTIVE: In this study, we aimed to explore the key regulatory pathways and potential biomarkers related to DN using integrated bioinformatics analysis and validation. METHODS: First, the microarray data of the GSE30528 and GSE96804 datasets were downloaded from the Gene Expression Omnibus (GEO) database, and differentially expressed genes (DEGs) were screened. Then, weighted gene coexpression network analysis (WGCNA), gene ontology (GO) annotation, gene set enrichment analysis (GSEA) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed to identify key pathways and genes. qRT-PCR and receiver operating characteristic (ROC) curves were used to validate our results. Furthermore, single-cell RNA sequencing (scRNA-seq) data were reanalyzed to investigate the expression specificity of C7 in DN cells. An online database search and luciferase reporter assay identified the target relationship between miRNAs and C7. RESULTS: The "complement and coagulation cascades" were significantly enriched, and complement C3 and C7 were candidate markers. The receiver operating characteristic (ROC) curve revealed that C7 had significant diagnostic value (AUC=0.865) in DN. Through scRNA-seq reanalysis, we found that C7 was specifically elevated in mesangial (MES) cells of DN. Moreover, we found that the expression of C7 was regulated by miR-494-3p and miR-574-5p. CONCLUSION: This is the first study to reveal that C7 is specifically expressed in mesangial cells, is a potential diagnostic biomarker for diabetic nephropathy, and is regulated by miR-494-3p and miR-574-5p.

Angelica Dahurica Regulated the Polarization of Macrophages and Accelerated Wound Healing in Diabetes: A Network Pharmacology Study and In Vivo Experimental Validation.

Diabetic wounds exhibit retarded and partial healing processes. Therefore, patients are exposed to an elevated risk of infection. It has been verified that Angelica dahurica (Hoffm.) Benth. and Hook. f. ex Franch. and Sav (A. dahurica) is conducive for wound healing. However, the pharmacological mechanisms of A. dahurica are yet to be established. The present study uses network pharmacology and in vivo experimental validation to investigate the underlying process that makes A. dahurica conducive for faster wound healing in diabetes patients. 54 potential targets in A. dahurica that act on wound healing were identified through network pharmacology assays, such as signal transducer and activator of transcription 3 (STAT3), JUN, interleukin-1ß (IL-1ß), tumor necrosis factor (TNF), and prostaglandin G/H synthase 2 (PTGS2). Furthermore, in vivo validation showed that A. dahurica accelerated wound healing through anti-inflammatory effects. More specifically, it regulates the polarization of M1 and M2 subtypes of macrophages. A. dahurica exerted a curative effect on diabetic wound healing by regulating the inflammation. Hence, pharmacologic network analysis combined with in vivo validation elucidated the probable effects and underlying mechanisms of A. dahurica's therapeutic effect on diabetic wound healing.

Associations of Thyroid Hormone Levels and Macrovascular Complications in Euthyroid Type 2 Diabetic Patients.

PURPOSE: The purpose of this study is to evaluate whether thyroid hormone in euthyroid patients with type 2 diabetes mellitus (T2DM) is associated with macrovascular complications. PATIENTS AND METHODS: The authors examined 311 patients enrolled from February 2019 to December 2019 in Tianjin Medical University Chu Hsien-I Memorial Hospital. A medical record review enabled the collection of demographic and anthropometric information. We classified the patients into two groups based on the echocardiography and vascular ultrasonography results, namely, non-macrovascular complications (n=131) group and macrovascular complications (n=180) group. Odds ratios (OR) and 95% confidence intervals (CI) were calculated, adjusting for potential confounders, the prevalence of macrovascular complications was determined using multivariate logistic regression. RESULTS: A significant association was observed for diabetic macrovascular complications with normal free triiodothyronine (FT3) (OR=0.534, 95% CI 0.358-0.796, p = 0.002) and free thyroxine (FT4) (OR= 0.844, 95% CI 0.760-0.937, p = 0.001). Nevertheless, there was no evidence of any association between thyroid-stimulating hormone (TSH) and the development of diabetic macrovascular complications. When stratified by the body mass index (BMI), a similar relationship existed with the overall results. The positive association remained in restricted analyses involving only patients with HbA1c abnormalities. CONCLUSION: Overweight or obese T2DM patients are at high risk due to the implicit association between low but clinically normal thyroid hormone levels and elevated risk of macrovascular complications. However, there were no statistically significant associations between TSH and diabetic macrovascular complications.

Effect of transsphenoidal surgery and standard care on fertility related indicators of patients with prolactinomas during child-bearing period.

OBJECTIVE: To explore the surgical therapeutic effects in the endocrine and reproductive system of women with prolactinoma at child-bearing age, and to investigate the potential influencing factors for therapeutic outcome. METHODS: This retrospective study was performed using the medical records of 99 cases of female patients with pituitary PRL adenomas at child-bearing age, who underwent transsphenoidal surgery and took standard perioperative care from January, 2013 to June, 2013 in Huashan hospital, in which micro adenoma (≤1 cm) of 68 cases, large adenomas (> 1 cm) of 31 cases, 88 cases were total resection, 9 cases were subtotal resection, and 2 cases were massive resection. Retrospective study on the preoperative serum level of PRL, menstruation, galactorrhea and reproductive function, etc. Patients were followed up in 1, 3, 6 and 12 months after operation for endocrine indicators, the situation of menstruation and pregnancy. RESULTS: Overall, 88.9%, 9.1%, and 2% patients underwent total, subtotal, and massive resection of prolactinoma in 99 cases of patients. Before accepting transsphenoidal surgery and standard care, all 99 cases with serum PRL level higher than normal 25 ng/ml, 71.7% (71 cases, all total resection) patients had their serum PRL < 25 ng/ml on the first day after surgery, and micro adenomas remission rate of 80.9% (55 cases) was significantly higher than 51.6% of large adenomas (16 cases) (P < 0.05); the postoperative PRL of 11 cases of total or massive resection in patients were not back to normal, Chi-square test results showed that the PRL remission rate after total resection were significantly higher than that of subtotal or massive resection (P < 0.01). 67.3% (66/98) irregular menstruation patients had menstruation recovery after surgery, in addition, total resection of the tumor, micro- adenoma, preoperative PRL < 200 ng/ml and first day of postoperative PRL ≤25 ng/ml were favorable factors for menstrual improvement (P < 0.05). 83.6% (51/61) of patients with galactorrhea symptoms got alliviated after surgery, but had no association to the types of tumor (P > 0.05). 14 patients out of 17 infertility patients got pregnant after surgery. CONCLUSION: Transsphenoidal operation combining standardized nursing measures is an effective way to treat pituitary PRL adenoma, and it has high cure rate on abnormal menstruation caused by pituitary PRL adenoma which can recover the fertility of female patients. The preoperative serum level of prolactin could be used as an indicator for postoperative improvement in the endocrine system. The serum level of prolactin on the first day after operation could accurately reflect prognosis, so be regarded as one of the assessment factors for surgical therapeutic effect.

Prevalence, risk factors and recognition rates of depressive disorders among inpatients of tertiary general hospitals in Shanghai, China.

OBJECTIVE: To investigate the prevalence, risk factors and recognition rates of depressive disorders among inpatients of tertiary general hospitals in Shanghai, China. METHODS: A total of 784 inpatients were randomly selected from three tertiary general hospitals and evaluated with a Chinese version of the Mini International Neuropsychiatric Interview 5.0 by ten trained psychiatrists. A questionnaire, containing socio-demographic and clinical data, and a social support scale were also administered to subjects during the course of the clinical interview. Logistic regression was used to identify factors that were associated with depression. RESULTS: The current prevalence rates (95% confidence intervals) of any depressive disorder and major depressive disorder (MDD) were found to be 13.1% (10.7%-15.5%) and 6.9% (5.1%-8.7%), respectively. The risk factors for depression included poor marital status, living alone or with others, lack of medical insurance, poor or very poor self-rated physical health, hospitalization in the internal medicine department, and a subjective support score ≤23. Only 18.5% of the patients with current MDD were detected. CONCLUSION: Depression, especially MDD, has been a major mental health problem for Chinese tertiary general hospitals. There is an urgent need for the development of efficacious hospital-based consultation-liaison psychiatry programs aimed at improving Chinese physicians' recognition and ability to manage inpatient depression.

Home visits in brain tumor patient: how nurse and family members cooperate in tumor patient's family self-care.

PURPOSES: We reported the roles and functions of nurses in home visits for brain tumor patients using the family health assessment guide in the study. METHODS: One patient of brain glioma was chosen as the case illustration. The nurses assessed the patients' situation, their families and living environment individually. All these factors were analyzed together. RESULTS: The nurses then implemented their knowledge and skills to adopt different measures in different conditions, investigated the patients' health problems and carried out personalized effective actions. CONCLUSIONS: Nurses should put effort into community nursing to allow patients to live in a safe environment, to satisfy the health needs of human being and their needs for health knowledge, and enhance their self-care abilities.

[Effects of nutritional education on improvement of nutritional knowledge of infant's mothers in rural area in China].

OBJECTIVE: To investigate the knowledge, attitude and practice (KAP) of young children's mothers on infant feeding and to evaluate the effects of nutritional education in the rural areas. METHODS: A cluster sampling method was used to select the local health station. Five hundred and fifteen mothers, who had infants with age of 4 - 6 months, were recruited for the questionnaire survey on the nutritional knowledge in rural areas of Tianjin municipality. The mothers were randomly divided into intervention group I (160), intervention group II (180) and control group (175). The mothers in the intervention group I were educated with feeding guideline on infants and young children and had had Group lectures and advisory from experts about maternal and child nutrition for teaching them how to feed their children; while, the mothers in the intervention group II were trained with feeding guideline on infants and young children by themselves; and the mothers in the control group received routine guidance at the local health station. The follow-up evaluation on nutritional knowledge of the mothers in each group was carried out after 3 and 6 months intervention, respectively. RESULTS: The educational background had significant effect on KAP scores: KAP scores of the mothers with primary education or less (8.3 +/- 2.2) were significantly lower than that of the mothers educated with high school (9.4 +/- 1.6) and university (9.6 +/- 1.8) (LSD t = 3.70, P < 0.001). After being educated with feeding guideline on infants and young children, the knowledge of infant's mothers was greatly improved and KAP scores of the mothers after intervention were higher than that of the baseline (F = 183.556, P = 0.006); the percentage of correct answer on nutrition knowledge in the intervention groups was significantly higher than that of the control group. At six months of intervention, the KAP scores of intervention group I (12.0) and intervention group II (11.6) were higher than that of the control group (10.5) (LSD t = 5.96, P < 0.001; LSD t = 4.25, P < 0.001). CONCLUSION: Providing nutritional and health education to the infant's mothers should be helpful for improving infant's feeding pattern and ensuring the adequate growth and development of infants.