Effects of positive psychological interventions on positive and negative emotions in depressed individuals: a systematic review and meta-analysis.

BACKGROUND: Positive psychological interventions (PPIs) are known to be effective in alleviating depression. However, the effect of PPIs on positive and negative emotions in depressed participants is not unclear. AIMS: To systematically investigate the effects of PPIs on positive and negative emotions in depressed individuals. METHODS: 6 databases were searched for randomized controlled trials of PPIs in individuals with depressive disorders or depressive symptoms. Hedges' g value was computed using a random-effects model to determine effect sizes. RESULTS: 14 trials from 13 studies were included. Our meta-analysis showed that PPIs had significant but small effects on improving positive affect (g = 0.33, p = .02), life satisfaction (g = 0.26, p = .03), happiness (g = 0.62, p = .03) and depression (g = -0.32, p = .001), and negligible effects on improving well-being (g = 0.13, p = .24) and negative affect (g = -0.15, p = .31). Subgroup analyses of depression showed that PPIs have experienced benefits in improving depression in most subgroups. In addition, none of the subgroup analyses performed for outcomes other than depression found PPIs to be more effective than controls. CONCLUSION: PPIs can improve positive affect, life satisfaction, happiness and depression in depressed individuals, but further studies are needed to validate their effects on well-being, and negative affect.

A randomized controlled trial of a nurse-led psychological pain solution-focused intervention for depressed inpatients: study protocol.

BACKGROUND: Depressed patients commonly experience psychological pain. Research pointed to positive psychological interventions as an effective means of ameliorating psychological pain, although the exact effect is unclear. Based on the hope theory and solution-focused brief therapy (SFBT), this study combines hope theory with solution-focused brief therapy to develop a nurse-led psychological pain solution-focused (PPSF) intervention in depressed patients. METHODS: This is an assessor-blinded randomized controlled trial following the SPIRIT guidance. A total of 84 depressed patients will be recruited from the inpatient wards of a psychiatric hospital and randomly assigned to the control and experimental groups. Patients in the control group will be treated as usual. In contrast, patients in the experimental group will receive 6 sessions of the PPSF intervention for two weeks on top of the routine care. Primary outcomes are psychological pain, hope, cognitive distortions. Secondary outcomes are depression and suicidal ideation. Data will be collected at 5-time points: baseline, 1 and 2 weeks (post-intervention), 1 month (follow up), and 6 months after baseline. Generalized equation evaluation will be used to assess the effectiveness of the PPSF intervention. DISCUSSION: From a positive psychology perspective, there remains much room for developing psychological pain interventions in depressed patients. SFBT and hope theory are both based on positive psychology. With hope theory as the general framework and SFBT questions as the practical guide, the PPSF intervention program is designed that nursing staff can implement. If the intervention is effective, it will advance the development of psychological pain interventions for patients with depression. TRIAL REGISTRATION: ChiCTR2100048223.

The mediating and moderating role of psychological resilience between occupational stress and mental health of psychiatric nurses: a multicenter cross-sectional study.

BACKGROUND: The particular occupational stress of psychiatric nurses has a negative impact on their mental health. There is evidence that psychological resilience can promote mental health; however, the relationship between resilience in occupational stress and mental health of psychiatric nurses is unclear, and mental health was assessed from a psychopathological perspective, neglecting the role of positive psychology. Therefore, this study was based on a dual-factor model of mental health, describing mental health in terms of both positive well-being and psychiatric symptoms. We aimed to investigate the level of psychiatric nurses' mental health and whether resilience plays a mediating or moderating role between occupational stress and mental health in psychiatry nurses. METHODS: A cross sectional survey of 450 psychiatric nurses in five hospitals in Jiangsu Province was conducted using a convenience sampling method, of which 413 were valid questionnaires with an effective rate of 91.8%. The evaluation included the Chinese Nurses' Stress Scale, the Connor-Davidson Resilience Scale, the Warwick-Edinburgh Mental Well-being Scale, and the General Health Questionnaire. Descriptive and Spearman correlation analyses were performed using SPSS25.0 while mediating and moderating effects were performed using SmartPLS3.0. RESULTS: Based on a dual-factor model of mental health, this study found that psychiatric nurses had a low general state of mental health, with 54.5% positive mental health, 7% vulnerable, 21.8% symptomatic but content, and 16.7% completely troubled. In addition, we found that resilience plays a mediating role in stress and mental health [ß = -0.230, 95% CI of (-0.310, -0.150)] and does not play a moderating role [ß = -0.018, 95%CI (-0.091, 0.055)]. CONCLUSIONS: Psychiatric nurses are in a poor state of mental health, and psychological resilience partly mediates occupational stress and mental health. This study suggests that attention should be paid to both positive and negative aspects of psychiatric nurses' mental health, and strategies should be developed to reduce occupational stress and develop psychological resilience.

Genome-wide association study reveals the genetic determinism of growth traits in a Gushi-Anka F2 chicken population.

Chicken growth traits are economically important, but the relevant genetic mechanisms have not yet been elucidated. Herein, we performed a genome-wide association study to identify the variants associated with growth traits. In total, 860 chickens from a Gushi-Anka F2 resource population were phenotyped for 68 growth and carcass traits, and 768 samples were genotyped based on the genotyping-by-sequencing (GBS) method. Finally, 734 chickens and 321,314 SNPs remained after quality control and removal of the sex chromosomes, and these data were used to carry out a GWAS analysis. A total of 470 significant single-nucleotide polymorphisms (SNPs) for 43 of the 68 traits were detected and mapped on chromosomes (Chr) 1-6, -9, -10, -16, -18, -23, and -27. Of these, the significant SNPs in Chr1, -4, and -27 were found to be associated with more than 10 traits. Multiple traits shared significant SNPs, indicating that the same mutation in the region might have a large effect on multiple growth or carcass traits. Haplotype analysis revealed that SNPs within the candidate region of Chr1 presented a mosaic pattern. The significant SNPs and pathway enrichment analysis revealed that the MLNR, MED4, CAB39L, LDB2, and IGF2BP1 genes could be putative candidate genes for growth and carcass traits. The findings of this study improve our understanding of the genetic mechanisms regulating chicken growth and carcass traits and provide a theoretical basis for chicken breeding programs.

Clinical Value and Role of miR-129-5p in Non-Alcoholic Fatty Liver Disease.

This study was to evaluate the expression of miR-129-5p in non-alcoholic fatty liver (NAFLD) patients and its clinical value and explore its regulatory effect on insulin resistance (IR). A total of 117 NAFLD patients and 110 healthy controls were included. The levels of miR-129-5p were detected by qRT-PCR. To assess the diagnostic value of miR-129-5p for NAFLD, the receiver operating characteristic curve (ROC) was established. C57Bl/6 mice were supplied with high-fat diet to establish NAFLD model. Intraperitoneal insulin tolerance test (IPITT) was carried out to evaluate the effect of miR-129-5p on IR in NAFLD animal model. miR-129-5p was highly expressed in the serum of NAFLD patients, and patients with HOMA-IR ≥2.5 had higher level of miR-129-5p than those with HOMA-IR <2.5. miR-129-5p had the ability to differentiate NAFLD patients from healthy individuals and might be associated with the development of IR. Serum miR-129-5p was positively correlated with the levels of HOMA-IR, BMI, total cholesterol (TC), and triglyceride (TG) in NAFLD patients. Downregulation of miR-129-5p regulates lipid metabolism and insulin sensitivity in NAFLD mice model. MiR-129-5p was upregulated in NAFLD patients and might be a potential diagnostic biomarker. The regulatory effect of miR-129-5p on NAFLD may function by regulating lipid accumulation and insulin sensitivity.

Haplotype genomic prediction of phenotypic values based on chromosome distance and gene boundaries using low-coverage sequencing in Duroc pigs.

BACKGROUND: Genomic selection using single nucleotide polymorphism (SNP) markers has been widely used for genetic improvement of livestock, but most current methods of genomic selection are based on SNP models. In this study, we investigated the prediction accuracies of haplotype models based on fixed chromosome distances and gene boundaries compared to those of SNP models for genomic prediction of phenotypic values. We also examined the reasons for the successes and failures of haplotype genomic prediction. METHODS: We analyzed a swine population of 3195 Duroc boars with records on eight traits: body judging score (BJS), teat number (TN), age (AGW), loin muscle area (LMA), loin muscle depth (LMD) and back fat thickness (BF) at 100 kg live weight, and average daily gain (ADG) and feed conversion rate (FCR) from 30 to100 kg live weight. Ten-fold validation was used to evaluate the prediction accuracy of each SNP model and each multi-allelic haplotype model based on 488,124 autosomal SNPs from low-coverage sequencing. Haplotype blocks were defined using fixed chromosome distances or gene boundaries. RESULTS: Compared to the best SNP model, the accuracy of predicting phenotypic values using a haplotype model was greater by 7.4% for BJS, 7.1% for AGW, 6.6% for ADG, 4.9% for FCR, 2.7% for LMA, 1.9% for LMD, 1.4% for BF, and 0.3% for TN. The use of gene-based haplotype blocks resulted in the best prediction accuracy for LMA, LMD, and TN. Compared to estimates of SNP additive heritability, estimates of haplotype epistasis heritability were strongly correlated with the increase in prediction accuracy by haplotype models. The increase in prediction accuracy was largest for BJS, AGW, ADG, and FCR, which also had the largest estimates of haplotype epistasis heritability, 24.4% for BJS, 14.3% for AGW, 14.5% for ADG, and 17.7% for FCR. SNP and haplotype heritability profiles across the genome identified several genes with large genetic contributions to phenotypes: NUDT3 for LMA, LMD and BF, VRTN for TN, COL5A2 for BJS, BSND for ADG, and CARTPT for FCR. CONCLUSIONS: Haplotype prediction models improved the accuracy for genomic prediction of phenotypes in Duroc pigs. For some traits, the best prediction accuracy was obtained with haplotypes defined using gene regions, which provides evidence that functional genomic information can improve the accuracy of haplotype genomic prediction for certain traits.

Genome­wide association study and genomic prediction for growth traits in yellow-plumage chicken using genotyping-by-sequencing.

BACKGROUND: Growth traits are of great importance for poultry breeding and production and have been the topic of extensive investigation, with many quantitative trait loci (QTL) detected. However, due to their complex genetic background, few causative genes have been confirmed and the underlying molecular mechanisms remain unclear, thus limiting our understanding of QTL and their potential use for the genetic improvement of poultry. Therefore, deciphering the genetic architecture is a promising avenue for optimising genomic prediction strategies and exploiting genomic information for commercial breeding. The objectives of this study were to: (1) conduct a genome-wide association study to identify key genetic factors and explore the polygenicity of chicken growth traits; (2) investigate the efficiency of genomic prediction in broilers; and (3) evaluate genomic predictions that harness genomic features. RESULTS: We identified five significant QTL, including one on chromosome 4 with major effects and four on chromosomes 1, 2, 17, and 27 with minor effects, accounting for 14.5 to 34.1% and 0.2 to 2.6% of the genomic additive genetic variance, respectively, and 23.3 to 46.7% and 0.6 to 4.5% of the observed predictive accuracy of breeding values, respectively. Further analysis showed that the QTL with minor effects collectively had a considerable influence, reflecting the polygenicity of the genetic background. The accuracy of genomic best linear unbiased predictions (BLUP) was improved by 22.0 to 70.3% compared to that of the conventional pedigree-based BLUP model. The genomic feature BLUP model further improved the observed prediction accuracy by 13.8 to 15.2% compared to the genomic BLUP model. CONCLUSIONS: A major QTL and four minor QTL were identified for growth traits; the remaining variance was due to QTL effects that were too small to be detected. The genomic BLUP and genomic feature BLUP models yielded considerably higher prediction accuracy compared to the pedigree-based BLUP model. This study revealed the polygenicity of growth traits in yellow-plumage chickens and demonstrated that the predictive ability can be greatly improved by using genomic information and related features.

Self-expanding metal stent insertion by colorectal surgeons using a two-person approach colonoscopy without fluoroscopic monitoring in the management of acute colorectal obstruction: a 14-year experience.

BACKGROUND: Placement of a self-expanding metal stent (SEMS) in patients presenting with an acute colorectal obstruction (ACO) may obviate emergency surgery (ES), potentially effectively palliating incurable tumors, acting as a bridge to surgery (BTS) in patients with operable or potentially operable tumors and achieving effective decompression of other ACO. We present our experience with SEMS insertion by colorectal surgeons without fluoroscopic monitoring for ACO especially for acute malignant colorectal obstruction (AMCO) for nearly a 14-year period (2007-2020). AIM: To explore the safety and effectiveness of SEMS insertion in the management of ACO by colorectal surgeons using a two-person approach colonoscopy without fluoroscopic monitoring. METHODS: We reviewed the medical records of patients retrospectively to identify all patients presenting to our unit with ACO especially with AMCO who had stenting carried out to achieve colonic decompression. All 434 procedures were performed by colorectal surgeons using a two-person approach colonoscopy without fluoroscopic monitoring. RESULTS: The overall technique success rate and clinic success rate by SEMS insertion were 428/434 (98.6%) and 412/434 (94.9%). The overall incidence of complications by SEMS insertion was 19/434 (4.4%). The complications included clinical perforation (6/434, 1.4%); stent migration (2/434, 0.5%), 1 of which re-stent; stent detachment (fell off) (3/434, 0.7%), none of them with re-stent; stool impaction (6/434, 1.4%), 1 of which re-stent; and abdominal or anal pain (2/434, 0.5%). There was no hemorrhage in any of the 434 patients. CONCLUSIONS: SEMS insertion is a relatively safe and effective technique for colonic decompression in dealing with ACO as either a BTS or as a palliative measure. It is also a solution to other causes of ACO such as recurrent tumor, benign diseases, or extra-luminal compression. Therefore, ES was largely avoided.

MicroRNA-766 promotes cancer progression by targeting NR3C2 in hepatocellular carcinoma.

MicroRNAs (miRNAs) have been reported to play important roles in tumor progression of various cancers. However, the clinical significance and biologic function of miR-766 in hepatocellular carcinoma (HCC) remain unknown. In this study, we investigated the roles of miR-766 in HCC progression using HCC cell lines and a xenograft mouse model. miR-766 expression in tumor tissues and adjacent nontumorous liver tissues of patients with HCC was evaluated by quantitative RT-PCR. Our results showed that miR-766 promoted proliferation and metastasis of HCC cells in vitro and in vivo and that NR3C2 was a direct target of miR-766 and involved in miR-766-mediated proliferation and metastasis of HCC cells. We also found that miR-766 affected the ß-catenin signaling pathway by targeting NR3C2. Furthermore, miR-766 was significantly up-regulated in HCC tissues and was correlated with the prognosis of patients with liver cancer. Taken together, our results show that miR-766 affects HCC progression by modulating NR3C2 expression and is a possible new therapeutic target for patients with HCC.-Yang, C., Ma, X., Guan, G., Liu, H., Yang, Y., Niu, Q., Wu, Z., Jiang, Y., Bian, C., Zang, Y., Zhuang, L. MicroRNA-766 promotes cancer progression by targeting NR3C2 in hepatocellular carcinoma.

Depression and Insomnia Are Closely Associated with Thyroid Hormone Levels in Chronic Hepatitis B.

BACKGROUND Depression and insomnia in chronic hepatitis B (CHB) patients affect the quality of life, disease diagnosis, and mortality. CHB patients are more likely to have psychological disorders, but the underlying mechanisms have not been elucidated. This study investigated the incidence of depression in patients with CHB and sought to identify risk factors for depression and insomnia in these patients, focusing on changes in liver function and thyroid hormone levels. MATERIAL AND METHODS This cross-sectional cohort study used the Hamilton Depression Scale and Athens Insomnia Scale to assess the depressive and insomnia states, respectively, of 209 CHB patients. Liver function, thyroid hormone levels, hepatitis B surface antigen, hepatitis B e-antigen, and hepatitis B virus-deoxyribonucleic acid load were evaluated. Liver cirrhosis was assessed by imaging (color Doppler ultrasound and computed tomography). A multivariate logistic regression model was used to analyze the correlation among various factors and depression and insomnia. RESULTS Subclinical and clinical depressive states were found in 23.9% and 5.3% and subclinical and clinical insomnia in 11% and 35.4% of patients, respectively. Depression and insomnia severity were significantly correlated with low FT3 (<3.5 mol/L). The odds ratios of low FT3 for subclinical and clinical depression and clinical insomnia were 3.07 (95% confidence interval (CI), 1.248-7.568), 7.85 (95% CI, 1.839-33.547), and 3.91 (95% CI, 1.417-10.789), respectively. CONCLUSIONS CHB patients are prone to depression and insomnia. FT3 reduction may be a risk factor for depression and insomnia. In clinical settings, more attention needs to be paid to the mental state of patients with FT3 reduction.

Knockdown long non-coding RNA ANRIL inhibits proliferation, migration and invasion of HepG2 cells by down-regulation of miR-191.

BACKGROUND: Hepatocellular carcinoma (HCC) is a common malignant tumor with high fatality rate. Recent studies reported that up-regulation of long non-coding RNA antisense non-coding RNA in the INK4 locus (lncRNA ANRIL) was found in HCC tissues, and which could affect HCC cells biological processes. However, the potential molecular mechanism of ANRIL in HCC is still unclear. The study aimed to uncover the effect of ANRIL on HepG2 cells growth, migration and invasion. METHODS: The knockdown expression vectors of ANRIL were transfected into HepG2 cells, and qRT-PCR, CCK-8, flow cytometry, Transwell and western blot assays were performed to analyze the effect of ANRIL on cell proliferation, apoptosis, migration and invasion. The relative expression of miR-191 was then examined in ANRIL knockdown vector transfected cells. These experiments were repeated again for exploring the effect of miR-191 on HepG2 cells. NF-κB and Wnt/ß-catenin signaling pathways were examined by using western blot assay. RESULTS: Knockdown of ANRIL inhibited proliferation, induced apoptosis, meanwhile suppressed migration and invasion of HepG2 cells. Additionally, the results showed that the expression level of miR-191 was down-regulated by ANRIL knockdown in HepG2 cells. Importantly, overexpression of miR-191 reversed the anti-tumor effect of ANRIL on cell proliferation, apoptosis, migration and invasion in HepG2 cells. Besides, we found that ANRIL knockdown inactivated NF-κB and Wnt/ß-catenin pathways by regulating miR-191. CONCLUSIONS: These data demonstrated that ANRIL knockdown suppressed proliferation, migration, invasion, and promoted apoptosis in HepG2 cells by down-regulating miR-191 and inactivating NF-κB and Wnt/ß-catenin signaling pathways.

Application of genomic selection in farm animal breeding.

Genomic selection (GS) has become a widely accepted method in animal breeding to genetically improve economic traits. With the declining costs of high-density SNP chips and next-generation sequencing, GS has been applied in dairy cattle, swine, poultry and other animals and gained varying degrees of success. Currently, major challenges in GS studies include further reducing the cost of genome-wide SNP genotyping and improving the predictive accuracy of genomic estimated breeding value (GEBV). In this review, we summarize various methods for genome-wide SNP genotyping and GEBV prediction, and give a brief introduction of GS in livestock and poultry breeding. This review will provide a reference for further implementation of GS in farm animal breeding.

Extracting the phase information from atomic memory by intensity correlation measurement.

We demonstrate experimentally controlled storage and retrieval of the optical phase information in a higher-order interference scheme based on Raman process in (87)Rb atomic vapor cells. An interference pattern is observed in intensity correlation measurement between the write Stokes field and the delayed read Stokes field as the phase of the Raman write field is scanned. This result implies that the phase information of the Raman write field can be written into the atomic spin wave via Raman process in a high gain regime and subsequently read out via a spin-wave enhanced Raman process, thus achieving optical storage of phase information. This technique should find applications in optical phase image storage, holography and information processing.

Evaluation of the implementation outcomes of the Essential Medicines System in Anhui county-level public hospitals: a before-and-after study.

BACKGROUND: In August 2009, China formally established the National Essential Medicines System (NEMS) and implemented this system in the government-funded primary care medical and health institutions. After nearly four years of practice, the system has already been generalized to the county-level public hospitals. This study aimed to examine the impact on the operation of the hospitals through implementing the NEMS in Anhui Province and put forward some improvement measures. METHODS: For quantitative analyses, we distributed 21 questionnaires to 21 county-level public hospitals in Anhui Province, which had implemented the national public hospital reform. Twenty valid questionnaires were returned, response rate was 95.2 %. Questions covered storage, usage and supply of essential medicines, compensation mechanisms, insurance policies, hospital incomes, service amounts and fees from January to June in each of the years from 2011 to 2013. For qualitative study, we chose three from 21 hospitals based on geographical distribution and conducted focus group interviews based on a planned interview outline centered on the implementation status of the system. RESULTS: Following implementation, the types of essential medicines stocked and the proportion of total sales that were composed of essential medicines have increased but do not yet meet the required standards issued in the government document, which was not less than 95 % and 30 % of the total, respectively. The average financial subsidies had increased by 1,665,200 yuan, and significant increases appeared in provincial financial assistance. The average inpatient fees per visit decreased by 487.41 yuan. Increases in income from medicines during hospitalization led to increases in per-visit hospitalization fees. Unexpectedly, higher financial assistance revenue also led to higher average per-visit hospitalization fees. DISCUSSION: The guiding role of the National Essential Medicines List remains to be reinforced, and specific lists for county hospitals should be developed. Supervision was required to implement the process of guaranteeing the storage and usage of essential medicines. The compensation mechanism was far from sound, and the leverage of the health insurance policies was not obvious. Regarding the reductions in the proportion of income derived from medicines and per-visit inpatient fees, the policy had been partially successful. CONCLUSIONS: Our results showed that the implementation of the Essential Medicines System do have a beneficial role in the reduction of the drug fees and further alleviates the burden of the masses. Much effort should be made to the redesign of the compensation mechanism, mainly including the government and the medical insurance compensation, emphasizing on both the fairness and the rationality of the compensation in the future.

Surveillance of influenza virus during 2010-2012 in Changsha, China.

The objective of this study was to examine the circulating influenza viruses in Changsha, China, during 2010-2012. Nasopharyngeal specimens were collected from persons with influenza-like illness (ILI) who presented for care at two hospitals. Of 2,955 patients tested, 278/(9.4%) were positive for influenza virus: 116/(41.7%) were influenza type A(H3N2), 79/(28.4%) were type A(H1N1) pandemic 2009 (pdm09) and 83/(29.9%) were influenza type B. The rates of virus detection varied by age and sex. The highest rate was in the 5-14 year old age group and females were infected more than males. After the initial 2009 A(H1N1) pdm09 outbreak, the number of cases of this virus declined and the season become shorter. Influenza A(H3N2) and B viruses occurred mainly during the spring and summer, while influenza A(H1N1)pdm09 occurred mainly during the winter and spring. Influenza A(H1N1)pdm09 replaced the usual seasonal H1N1 virus during 2010-2012. Continuing epidemiological surveillance of influenza virus is important to monitor trends in influenza infections and to develop prevention and control measures.

Mitochondria UPR stimulation by pelargonidin-3-glucoside contributes to ameliorating lipid accumulation under copper exposure.

Intensification of copper pollution in the environment has led to its excessive accumulation in humans, causing oxidative stress and lipid metabolism disorders. It is necessary to look for effective targets and safe methods to alleviate copper toxicity. Pelargonidin-3-glucoside (Pg3G) is a natural anthocyanin with metal ion chelating ability and multiple physiological activities. In this study, lipid accumulation was investigated under copper exposure in Caenorhabditis elegans which can be improved by Pg3G. Transcriptome analysis revealed that differentially expressed genes are enriched in lipid metabolism and protein folding/degradation. Pg3G activated mitochondrial unfold protein response (UPRmt) to mitigate mitochondrial damage caused by copper and regulated the expression of genes involved in lipid absorption, transport, and synthesis, thereby reducing lipid levels in C. elegans. This improvement disappeared in the ubl-5 knockout strain, indicating that ubl-5 is one target of Pg3G. Meanwhile, in HepG2 cells, Pg3G enhanced the cellular antioxidant capacity by activating UPRmt for maintaining mitochondrial homeostasis, followed by inhibition of excessive lipid accumulation. Overall, these results suggested that UPRmt activation can be a strategy for mitigating lipid disorders induced by copper and Pg3G with excellent ability to resist oxidative stress specially targeted for ubl-5 has a promising application in controlling copper contamination.

Determination of the 3'UTR region of HLA-B*53:01:03 sequence by next generation sequencing.

The 3'UTR of the HLA-B*53:01:03 allele has been determined by next generation sequencing.

Characterization of the novel HLA-DQB1*03:516 allele by next-generation sequencing.

HLA-DQB1*03:516 differs from DQB1*03:03:02:03 by one nucleotide substitution at position 197G>A in exon 2.

GraphSKT: Graph-Guided Structured Knowledge Transfer for Domain Adaptive Lesion Detection.

Adversarial-based adaptation has dominated the area of domain adaptive detection over the past few years. Despite their general efficacy for various tasks, the learned representations may not capture the intrinsic topological structures of the whole images and thus are vulnerable to distributional shifts especially in real-world applications, such as geometric distortions across imaging devices in medical images. In this case, forcefully matching data distributions across domains cannot ensure precise knowledge transfer and are prone to result in the negative transfer. In this paper, we explore the problem of domain adaptive lesion detection from the perspective of relational reasoning, and propose a Graph-Structured Knowledge Transfer (GraphSKT) framework to perform hierarchical reasoning by modeling both the intra- and inter-domain topological structures. To be specific, we utilize cross-domain correspondence to mine meaningful foreground regions for representing graph nodes and explicitly endow each node with contextual information. Then, the intra- and inter-domain graphs are built on the top of instance-level features to achieve a high-level understanding of the lesion and whole medical image, and transfer the structured knowledge from source to target domains. The contextual and semantic information is propagated through graph nodes methodically, enhancing the expressive power of learned features for the lesion detection tasks. Extensive experiments on two types of challenging datasets demonstrate that the proposed GraphSKT significantly outperforms the state-of-the-art approaches for detection of polyps in colonoscopy images and of mass in mammographic images.