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Background and Objective: Bone age detection plays an important role in medical care, sports, judicial expertise and other fields. Traditional bone age identification and detection is according to manual interpretation of X-ray images of hand bone by doctors. This method is subjective and requires experience, and has certain errors. Computer-aided detection can effectually enhance the validity of medical diagnosis, especially with the fast development of machine learning and neural network, the method of bone age recognition using machine learning has gradually become the focus of research, which has the advantages of simple data pretreatment, good robustness and high recognition accuracy. Methods: In this paper, the hand bone segmentation network based on Mask R-CNN was proposed to segment the hand bone area, and the segmented hand bone region was directly input into the regression network for bone age evaluation. The regression network is using an enhancd network Xception of InceptionV3. After the output of Xception, the convolutional block attention module is connected to refine the feature mapping from channel and space to obtain more effective features. Results: According to the experimental results, the hand bone segmentation network model based on Mask R-CNN can segment the hand bone region and eliminate the interference of redundant background information. The average Dice coefficient on the verification set is 0.976. The mean absolute error of predicting bone age on our data set was only 4.97 months, which exceeded the accuracy of most other bone age assessment methods. Conclusion: Experiments show that the accuracy of bone age assessment can be enhancd by using the Mask R-CNN-based hand bone segmentation network and the Xception bone age regression network to form a model, which can be well applied to actual clinical bone age assessment.
RESUMEN
OBJECTIVE: To examine the expression of apoptosis-related genes c-IAP2 and caspase-4 in sinonasal squamous carcinoma. To investigate the role and mechanism of the two apoptosis-related genes in nasal cavity and sinus squamons carcinoma. METHODS: Forty-one pathologically confirmed specimens of nasal cavity and sinus squamons carcinoma were subjected for immunohistochemical staining to analyze the expression of c-IAP2 and caspase-4, in addition 10 normal nasal mucosa were used as control. RESULTS: The positive rate of c-IAP2 in sinonasal squamons carcinoma was 87.8%, among which 14 cases were strongly stained(+ + +), 15 cases were stained(+ +), 7 cases were stained (+), only 5 cases were negative. In 10 normal control tissues, no case was stained(+ + +), 2 cases were stained (+ +), 3 cases were stained(+), the other 5 cases were negative. Higher level expression of c-IAP2 protein was detected more often in squamons carcinoma specimens than that in normal nasal mucosa. There was statistically significant difference between the two groups for the staining(P < 0.05). The expression of c-IAP2 was not correlated with clinical staging (P > 0.05), but there were positive correlation with clinical prognosis (P < 0.01) and pathological classification (P < 0.01); The positive rate of caspase-4 in nasal cavity and sinus squamons carcinoma was 58.5%, among which 4 cases were strongly stained (+ + +), 7 cases were stained (+ +), 13 case was stained(+), 17 cases were negative. The expression of caspase-4 protein was more deletion in squamons carcinoma specimens than that in control group, there was statistically significant difference between the two groups for the staining (P < 0.05). The expression of caspase-4 protein was negatively correlated with clinical prognosis (P < 0.01) and pathological classification ( P < 0.01), not correlated with clinical staging(P > 0.05). The expression of c-IAP2 was negativelly correlated with the experssion of caspase-4. CONCLUSIONS: The results indicates that in sinonasal squamous carcinoma, c-IAP2 is activated, while caspase-4 is restrained, the signal transduction pathway of apoptosis is arrested, leading to surviving of tumor cells, this maybe directly associated with the development of sinonasal squamons carcinoma, and with the failure of tumor trentment.
