Brain tumor feature extraction and edge enhancement algorithm based on U-Net network.

Background: Statistics show that each year more than 100,000 patients pass away from brain tumors. Due to the diverse morphology, hazy boundaries, or unbalanced categories of medical data lesions, segmentation prediction of brain tumors has significant challenges. Purpose: In this thesis, we highlight EAV-UNet, a system designed to accurately detect lesion regions. Optimizing feature extraction, utilizing automatic segmentation techniques to detect anomalous regions, and strengthening the structure. We prioritize the segmentation problem of lesion regions, especially in cases where the margins of the tumor are more hazy. Methods: The VGG-19 network structure is incorporated into the coding stage of the U-Net, resulting in a deeper network structure, and an attention mechanism module is introduced to augment the feature information. Additionally, an edge detection module is added to the encoder to extract edge information in the image, which is then passed to the decoder to aid in reconstructing the original image. Our method uses the VGG-19 in place of the U-Net encoder. To strengthen feature details, we integrate a CBAM (Channel and Spatial Attention Mechanism) module into the decoder to enhance it. To extract vital edge details from the data, we incorporate an edge recognition section into the encoder. Results: All evaluation metrics show major improvements with our recommended EAV-UNet technique, which is based on a thorough analysis of experimental data. Specifically, for low contrast and blurry lesion edge images, the EAV-Unet method consistently produces forecasts that are very similar to the initial images. This technique reduced the Hausdorff distance to 1.82, achieved an F1 score of 96.1%, and attained a precision of 93.2% on Dataset 1. It obtained an F1 score of 76.8%, a Precision of 85.3%, and a Hausdorff distance reduction to 1.31 on Dataset 2. Dataset 3 displayed a Hausdorff distance cut in 2.30, an F1 score of 86.9%, and Precision of 95.3%. Conclusions: We conducted extensive segmentation experiments using various datasets related to brain tumors. We refined the network architecture by employing smaller convolutional kernels in our strategy. To further improve segmentation accuracy, we integrated attention modules and an edge enhancement module to reinforce edge information and boost attention scores.

Association of anxiety, depression symptoms and sleep quality with chronic kidney disease among older Chinese.

This study aimed to explore the association of anxiety, depression symptoms and sleep quality with chronic kidney disease (CKD) among older Chinese adults. A total of 1025 participants from the Chinese Longitudinal Healthy Longevity Survey (CLHLS, 2011-2012) were included in our study. The Generalized Anxiety Disorder scale was used to assess anxiety and the Center for Epidemiologic Studies Depression Scale was used to evaluate depressive symptoms. Logistic regression models were conducted to explore the odds ratios (ORs) and 95% confidential intervals (CIs). We found that anxiety, depression symptoms and poor sleep quality were positively associated with albuminuria, impaired estimated glomerular filtration (eGFR) and CKD, after adjusting for other covariates. For anxiety symptom, the ORs and 95% CIs were 1.20 (1.15-1.38) for albuminuria, 1.16 (1.12-1.35) for impaired eGFR and 1.18 (1.12-1.36) for CKD, respectively. For depression symptom, the ORs and 95% CIs were 1.15 (1.05-1.23) for albuminuria, 1.14 (1.05-1.20) for impaired eGFR and 1.14 (1.05-1.22) for CKD, respectively. Compared with good sleep quality, the OR and 95% CI of poor sleep quality were 1.12 (1.04-1.35) for albuminuria, 1.10 (1.02-1.30) for impaired eGFR and 1.11 (1.03-1.32) for CKD, respectively. And the positive association was more evident among females, body mass index ≥ 28, smoking and drinking adults. Anxiety, depression symptoms and poor sleep quality are positively associated with CKD. Future cohort studies are needed to confirm the results.

Foreign Body Granuloma Originating From the Lateral Process of Malleus: A Case Series of 19 Children.

OBJECTIVE: A special presentation of foreign body granuloma originating from the lateral process of the malleus (FBGLP) was noted in the absence of a history of foreign body entry into the external auditory canal (EAC). This study reported the clinical features, pathology, and prognosis of patients with FBGLP. DESIGN: Retrospective study. SETTING: Shandong Provincial ENT Hospital. PATIENTS: Nineteen pediatric patients (age, 1-10 yr) with FBGLP. INTERVENTIONS: Clinical data were collected from January 2018 to January 2022. MAIN OUTCOME MEASURES: Clinicopathologic characteristics of the patients were analyzed. RESULTS: All patients had an acute course, and were within 3 months of ineffective medical treatment. The most common symptoms were suppurative (57.9%) and hemorrhagic (42.1%) otorrhea. FBGLP imaging examinations demonstrated a soft mass blocking the EAC without bone destruction and occasionally concomitant effusion in the middle ear. The most common pathologic findings were foreign body granuloma (94.7%,18/19), granulation tissue (73.7%, 14/19), keratotic precipitate (73.7%, 14/19), calcium deposition (63.2%, 12/19), hair shafts (47.4%, 9/19), cholesterol crystals (5, 26.3%), and hemosiderin (15.8%, 3/19). Foreign body granuloma and granulation tissue showed higher expression levels of CD68 and cleaved caspase-3 than did the normal tympanic mucosa, whereas Ki-67 levels were similarly low in all tissues. The patients were followed up for 3 months to 4 years without recurrence. CONCLUSION: FBGLP is caused by endogenous foreign particles in the ear. We recommend the trans-external auditory meatus approach for FBGLP surgical excision, as this shows promising outcomes.

Clinical observation of posterior scleral reinforcement in the treatment of progressive high myopia in Chinese children: a retrospective study.

OBJECTIVE: To observe the efficacy and safety of posterior sclera reinforcement over time. METHODS: This retrospective single-arm cohort study included children with high myopia who underwent the modified Snyder-Thompson type posterior sclera reinforcement surgery from 03/2015 to 08/2018 at Fuzhou Children's Hospital of Fujian Medical University. Axial length (AL), corneal radius of curvature (CRC), AL/CRC, refractive error, and best-corrected visual acuity (BCVA) were observed from 1 year before the operation to 2 years after. RESULTS: Nineteen children (33 eyes) with high myopia were included. The patients were 4.9 ± 2.7 (range, 2-10) years of age (three patients were 10 years old, all others were ≤ 7 years old). AL increased from 1 year before surgery to 2 years after surgery (from 25.31 ± 1.59 to 26.76 ± 1.52, P < 0.001). The refractive error was smaller 1 year before surgery than at the other timepoints (all P < 0.05). BCVA improved over time (P < 0.001). Changes over time were also observed in horizontal CRC (hCRC), AL/hCRC, AL/vertical CRC (vCRC), and AL/CRC (all P < 0.001), but not in vCRC (P = 0.304). The increase of AL at 2 years after surgery was smaller than at 1 year before surgery and 1 year after surgery (both P < 0.001). The increase of AL/CRC at 2 years after surgery was smaller than at 1 year before surgery (0.04 ± 0.04 vs. 0.07 ± 0.04; P = 0.008). CONCLUSION: In the short term, posterior scleral reinforcement surgery can delay the increase of AL of progressive high myopia.

The effect of balloon dilatation eustachian tuboplasty combined with grommet insertion on the structure and function of the eustachian tube in patients with refractory otitis media with effusion.

BACKGROUND: The treatments for refractory secretory otitis media with effusion usually choose long-term grommet insertion. This study evaluated the effect of balloon eustachian tuboplasty combined with grommet insertion on the function and the opening length of the eustachian tube in patients with refractory otitis media with effusion. METHODS: Fifty-seven patients with refractory otitis media with effusion were enrolled. A three-dimensional reconstruction of an iohexol-enhanced computed tomography image was applied to evaluate the structural and length changes of the eustachian tube at both resting and Valsalva maneuver states. The grommet was removed 3 months after the operation and postoperative follow-up was carried out from 3 to 12 months. We performed pre- and post-operative observation of the following: appearance of the tympanic membrane, pure-tone audiometry threshold, eustachian tube score, seven-item Eustachian Tube Dysfunction Questionnaire scores (ETDQ-7), quantitative examination of eustachian tube function dynamic observation of tympanogram peak pressure point, and computed tomography examination of the eustachian tube. RESULTS: The pure-tone audiometry at 1, 3, 6, 9, and 12 months postoperatively were all significantly lower compared to the preoperative value (all P<0.05). There was no significant difference between the pure-tone audiometry at 6 and 9 months postoperatively, neither was for the air-bone conduction gap at these time points. The quantitative examination peak pressure deviation was markedly increased at 6 months postoperatively compared with that before the operation (all P<0.05). The peak pressure deviation of tympanometry at 6 and 9 months postoperatively were both higher than the value at 12 months after surgery (P<0.05). The eustachian tube score at 1, 3, 6, 9, and 12 months postoperatively were notably higher than that before the operation (all P<0.05). A significant difference was also observed between the 6- and 12-month postoperative eustachian tube score (P<0.05). There was a significant difference in the ETDQ-7 scores at 6- and 12-month postoperatively (P<0.05). The quantitative examination peak pressure deviation and eustachian tube score were both correlated with development length of the eustachian tube after three-dimensional computed tomography reconstruction (P<0.05). CONCLUSIONS: Eustachian tube balloon dilatation combined with grommet insertion is an effective treatment for refractory otitis media with effusion.

Platelet-rich plasma can release nutrient factors to promote facial nerve crush injury recovery in rats.

OBJECTIVES: To evaluate the effects of platelet-rich plasma (PRP) on promoting neural repair after facial nerve compression in rats and the mechanism by which this occurs.  Methods: Adult Wistar rats (n=100) were divided into 3 groups: healthy controls, surgery-only, and surgery+PRP groups. The rats underwent nerve crush injury to establish a facial palsy model. The blood from the rats was used to prepare the PRP for application to the injury site. The evaluation methods included vibrissae movement, eyelid closure, and electrophysiology. Electron microscopy, immunohistochemistry, and real-time polymerase chain reaction (PCR) were used to detect nutrient factor expression in the brain and nerve sections. This study was conducted in Shandong Provincial ENT Hospital Affiliated to Shandong University,  Shandong, China between January and November 2018.  Results: Platelet-rich plasma promotes the recovery of vibrissae movement, eyelid closure, and electrophysiological function in a rat model of nerve crush injury. Hematoxylin and eosin staining, toluidine blue staining, and electron microscopy showed significant recovery of Schwann cells and axons in the PRP group. Polymerase chain reaction results showed that PRP releases growth factors, which include nerve growth factor and brain-derived neurotrophic factor. Immunohistochemistry also demonstrated higher levels of S-100 protein expression in the PRP group compared to the other groups.  Conclusions: Platelet-rich plasma releases nutrient factors in the brainstem, and the use of PRP can promote injury recovery.

Examining the Effect of Fish Oil Supplementation in Chinese Pregnant Women on Gestation Duration and Risk of Preterm Delivery.

BACKGROUND: Intervention studies have shown that long-chain (LC) n-3 PUFA intake can prolong gestation but the dose-time-effect relations remain unresolved. OBJECTIVES: We examined the effect on gestation duration of 2 doses of supplemental LC n-3 PUFAs. METHODS: We undertook a 3-group parallel randomized controlled trial in areas of China with low (median: 2.1 g/d) and higher (14.3 g/d) fish intake. Unselected women (median: age, 26.2 y; BMI, 20. kg/m2) were randomly assigned at midgestation to take four 0.72-g identical gelatin capsules per day until the last day of the preterm period (<259 days of gestation), when they were asked to stop. Capsules contained fish oil [high fish oil (HFO) group (60% w/w LC n-3 PUFAs)], a 1:3 mixture of fish oil to olive oil [low fish oil (LFO) group (20%)], or olive oil [control (CON) group (0%)], providing 2.0, 0.5, and 0 g/d of LC n-3 PUFAs, respectively. Habitual fish intake was recorded at baseline. Hazard rate ratios (HRRs) for spontaneous delivery <259 days of gestation and <273 days of gestation across groups were estimated by Cox regression. RESULTS: Among 5531 women randomly assigned, 92.5% were included in analyses (1706/1825, 1695/1851, and 1717/1855, respectively). The groups were similar with respect to hazard rates <259 days of gestation [HRR: 1.04 (95% CI: 0.70, 1.53) for LFO compared with CON and 0.90 (95% CI: 0.60, 1.35) for HFO compared with CON], hazard rates <273 days of gestation [HRR: 1.00 (95% CI: 0.86, 1.18) and 0.91 (95% CI: 0.77, 1.07), respectively], and mean gestation durations [differences: 0.2 d (95% CI: -0.5, 0.8) and 0.6 d (95% CI: -0.06, 1.2), respectively]. Inspection of pregnancy survival curves suggested that LC n-3 PUFAs delayed delivery in low fish consumers by 5-10 d and that this effect ceased rapidly after stopping taking the capsules. CONCLUSION: This trial could not substantiate that fish oil prevents preterm birth in Chinese women, possibly because statistical power was too low. This trial was registered at clinicaltrials.gov as NCT02770456.

Targeted deletion of Sox10 by Wnt1-cre defects neuronal migration and projection in the mouse inner ear.

Sensory nerves of the brainstem are mostly composed of placode-derived neurons, neural crest-derived neurons and neural crest-derived Schwann cells. This mixed origin of cells has made it difficult to dissect interdependence for fiber guidance. Inner ear-derived neurons are known to connect to the brain after delayed loss of Schwann cells in ErbB2 mutants. However, the ErbB2 mutant related alterations in the ear and the brain compound interpretation of the data. We present here a new model to evaluate exclusively the effect of Schwann cell loss on inner ear innervation. Conditional deletion of the neural crest specific transcription factor, Sox10, using the rhombic lip/neural crest specific Wnt1-cre driver spares Sox10 expression in the ear. We confirm that neural crest-derived cells provide a stop signal for migrating spiral ganglion neurons. In the absence of Schwann cells, spiral ganglion neurons migrate into the center of the cochlea and even out of the ear toward the brain. Spiral ganglion neuron afferent processes reach the organ of Corti, but many afferent fibers bypass the organ of Corti to enter the lateral wall of the cochlea. In contrast to this peripheral disorganization, the central projection to cochlear nuclei is normal. Compared to ErbB2 mutants, conditional Sox10 mutants have limited cell death in spiral ganglion neurons, indicating that the absence of Schwann cells alone contributes little to the embryonic survival of neurons. These data suggest that neural crest-derived cells are dispensable for all central and some peripheral targeting of inner ear neurons. However, Schwann cells provide a stop signal for migratory spiral ganglion neurons and facilitate proper targeting of the organ of Corti by spiral ganglion afferents.

Conformational transition and energy landscape of ErbB4 activated by neuregulin1ß: one microsecond molecular dynamics simulations.

ErbB4, a receptor tyrosine kinase of the ErbB family, plays crucial roles in cell growth and differentiation, especially in the development of the heart and nervous system. Ligand binding to its extracellular region could modulate the activation process. To understand the mechanism of ErbB4 activation induced by ligand binding, we performed one microsecond molecular dynamics (MD) simulations on the ErbB4 extracellular region (ECR) with and without its endogenous ligand neuregulin1ß (NRG1ß). The conformational transition of the ECR-ErbB4/NRG1ß complex from a tethered inactive conformation to an extended active-like form has been observed, while such large and function-related conformational change has not been seen in the simulation on the ECR-ErbB4, suggesting that ligand binding is indeed the active inducing force for the conformational transition and further dimerization. On the basis of MD simulations and principal component analysis, we constructed a rough energy landscape for the conformational transition of ECR-ErbB4/NRG1ß complex, suggesting that the conformational change from the inactive state to active-like state involves a stable conformation. The energy barrier for the tether opening was estimated as ~2.7 kcal/mol, which is very close to the experimental value (1-2 kcal/mol) reported for ErbB1. On the basis of the simulation results, an atomic mechanism for the ligand-induced activation of ErbB4 was postulated. The present MD simulations provide a new insight into the conformational changes underlying the activation of ErbB4.