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Objective To observe the value of preoperative CT enterography(CTE)for predicting the necessity of enterectomy in ovarian cancer(OC)patients for achieving optimal debulking surgery(ODS).Methods Preoperative CTE data of 49 patients with pathologically confirmed OC were retrospectively analyzed,including 13 cases received neoadjuvant chemotherapy(NACT)and 36 cases did not.The length(L)and circumference(C)of muscular involvement shown on CTE were taken as criteria for judging the necessity of enterectomy in OC patients([degree 0:no muscular involvement,degree 1:L<3.0 cm and C<1/3,degree 2:L≥3.0 cm[A]or C≥1/3[B]).The patients were followed up for at least 1 year after surgery,and the actual operation results were recorded to estimate the ideal surgical strategy.The consistency of CTE evaluated necessity of enterectomy and the ideal surgical strategy was analyzed.Results For patients not undergoing NACT,according to degree 2 A or B showed on CTE,predicted results had excellent agreement with the ideal surgical strategy(Kappa=0.852,P<0.001),while those according to degree 1 or 2,2 A,2 B were all in good agreement with the ideal surgical strategy(Kappa=0.684-0.771,all P<0.001).For patients undergoing NACT,the predicted results of degree 2 muscular involvement showed on CTE before NACT had excellent consistencies with the ideal surgical strategy(all Kappa=0.806,all P=0.003).The predicted results of degree 2 muscular involvement showed on CTE after NACT had moderate consistencies with the ideal surgical strategy(all Kappa=0.581,all P=0.021).Conclusion Preoperative CTE could be used to predict the necessity of enterectomy in OC patients for achieving ODS.
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Objective To explore the impact of temperature and environmental factors on the risk of deaths from cardiovascular and cerebrovascular diseases (CVD) in Wuhan during the course of high temperature. Methods The daily CVD death data and meteorological and atmospheric pollutant concentration data during the high temperature process in Wuhan from 2014 to 2019 were collected. The generalized additive models (GAM) were used to obtain the characteristics of meteorological factors, atmospheric pollutant concentrations, high impact factors and thresholds affecting the relative risk of CVD death. Results The analysis results showed that: (1) When the maximum temperature reached 36.7°C and the lowest temperature reached 25.3°C, the relative risk of CVD death increased significantly; (2) The risk of CVD death during the first high temperature process was the largest, and the average CVD excess mortality rate during the first high temperature process from 2014 to 2019 reached 21.7%; and (3) The average temperature, maximum temperature and PM10 during the course of high temperature were important environmental factors that increased the risk of CVD deaths, and the relative risks were 1.14 (95% confidence interval (95% CI): 1.11-1.17), 1.11 (95% confidence interval (95% CI): 1.08-1.15, and 1.06 (95% confidence interval (95% CI): 1.02-1.09), respectively. Conclusion Temperature and PM10 are important environmental factors that increase the risk of death from CVD during the high temperature process in Wuhan from 2014 to 2019, with the first annual high temperature process having the greatest impact on the risk of CVD death.
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ObjectiveTo investigate the survival and adverse reactions of patients with unresectable cholangiocarcinoma after stereotactic body radiation therapy (SBRT). MethodsA total of 27 patients with unresectable solitary cholangiocarcinoma without metastasis who underwent SBRT in The Fifth Medical Center of Chinese PLA General Hospital from February 2012 to July 2020 were enrolled. The prescribed dose to planning target volume was 42-60 Gy in 5-8 fractions, with 5-11 Gy/fraction. Among these patients, five patients were also treated with chemotherapy and transcatheter arterial chemoembolization. The 6-, 12-, 18-, and 24-month overall survival (OS) rates, progression-free survival (PFS) rates, and local control (LC) rates were used as the assessment indices for treatment outcome; Common Terminology Criteria for Adverse Events v.4.03 was used to evaluate adverse reactions; the Kaplan-Meier method was used to calculate OS, PFS, and LC rates. ResultsThe median follow-up time was 17 months. For all 27 patients, the 6-, 12-, 18-, and 24-month OS rates were 100%, 88%, 57.5%, and 47.9%, respectively; the 6-, 12-, 18-, and 24-month PFS rates were 74.1%, 58.6%, 47.9%, and 35.9%, respectively; the 6-, 12-, 18-, and 24-month LC rates were 96.3%, 91.9%, 84.8%, and 76.4%, respectively. No grade 3 or above toxic reactions were observed. Five patients were diagnosed with radiation-induced liver injury, but there was no death due to radiation-induced liver injury. ConclusionSBRT is safe and effective in the treatment of unresectable cholangiocarcinoma, with relatively high survival rate, PFS rate, and LC rate and low toxicity, and therefore, SBRT can be used as an alternative treatment method for patients with cholangiocarcinoma who are not candidates for surgery.
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Accurate segmentation of retinal blood vessels is of great significance for diagnosing, preventing and detecting eye diseases. In recent years, the U-Net network and its various variants have reached advanced level in the field of medical image segmentation. Most of these networks choose to use simple max pooling to down-sample the intermediate feature layer of the image, which is easy to lose part of the information, so this study proposes a simple and effective new down-sampling method Pixel Fusion-pooling (PF-pooling), which can well fuse the adjacent pixel information of the image. The down-sampling method proposed in this study is a lightweight general module that can be effectively integrated into various network architectures based on convolutional operations. The experimental results on the DRIVE and STARE datasets show that the F1-score index of the U-Net model using PF-pooling on the STARE dataset improved by 1.98%. The accuracy rate is increased by 0.2%, and the sensitivity is increased by 3.88%. And the generalization of the proposed module is verified by replacing different algorithm models. The results show that PF-pooling has achieved performance improvement in both Dense-UNet and Res-UNet models, and has good universality.
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Algorithms , Retinal Vessels , Image Processing, Computer-AssistedABSTRACT
Objective:To investigate the application value of mixed reality (MR) technology in reconstruction of soft tissue defect of extremities with free anterolateral thigh flap(ALTF).Methods:From December 2019 to November 2021, a retrospective analysis was performed on 10 patients who had undergone ALTF reconstruction of soft tissue defects in extremities in Department of Orthopaedics, the First People's Hospital of Yunnan Province. Four patients had the defects in hand and 6 patients in foot and ankle. For the 6 patients in emergency surgery, the time from injury to admission was 4.0-15.0 hours, with an average of 7.3 hours. Four patients with soft tissue defects caused by chronic infection and ulcers were given debridement, and the soft tissue defects were reconstructed by flap transfer at the second stage. The defect area were from 8.0 cm×5.0 cm to 22.0 cm×8.0 cm. Preoperatively, 3D bone-vessel-flap model was established based on the lower extremity CTA scans. Intraoperatively, MR technology was used to project the 3D model on the flap donor site to observe the virtual profile of vessel shape in real time, to locate the perforator and the course of the perforator, and observe the consistency between the virtual image and the actual anatomy of the perforator. The appearance, texture and colour of the flap were recorded at the last follow-up. Hand function was evaluated by the total activity movement (TAM), and foot and ankle function was evaluated by the American Orthopaedic Foot and Ankle Society (AOFAS).Results:The position location and course of perforator vessels were reconstructed successfully in all patients before surgery. The MR technology was used to locate the perforator, and the course of the virtual perforator was consistent with the actual anatomy, and the matching reached 100%. The length of vascular pedicle measured before surgery was at 11.02 cm±1.37 cm. And that measured during surgery was at 11.21 cm±1.23 cm ( P=0.748, t=-0.326). The difference was not statistically significant ( P>0.05). The flap area was at 9.0 cm×6.0 cm to 23.0 cm×9.0 cm. The donor site was sutured directly in one stage. All patients were entered postoperative followed-up for 1 to 24 months, with an average of 13.5 months. All the flaps survived after surgery. The flap with good appearance, colour and texture, and only one linear scar was left in the donor site. According to the TAM of the hand function, 3 cases were excellent and 1 was fair. Foot and ankle function were evaluated according to the AOFAS, 5 cases were in excellent and 1 was good. Conclusion:MR technology applied to the surgery of ALTF can locate the course of the flap vessels in real time, guide the operation, improve the operation efficiency and reduce the risk in surgery.
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China boasts for its abundant resources of Trapa L.The fruit of Trapa has been given high edible and medicinal values so far.Trapa L.plants mainly contain terpenoids,sterols,phenolic acids and flavonoids.Current studies profotmdly analyzed the biological activities on hypoglycemic,anti-oxidation,anti-tumor,antibacterial and immunomodulatory effects of it.Some preliminary studies over biological activities included the effects on reducing the expression of vascular endothelial growth factor (VEGF),the inhibition of H2O2-induced injury of human umbilical vein endothelial cells,inducing HeLa cell apoptosis,analgesia,liver protection,anti-atherosclerosis and deworming.This paper reviewed literature on the chemical constituents and biological activities of Trapa L for the provision of a reference for the exploration and utilization of Trapa L.
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This study aimed at identifying pig-hide gelatin from tortoise shell glue using ultra-performance liquid chromatography-electrospray-time of flight mass spectrometry(UPLC-ESI-QTOF-MS/MS).The samples of tortoise shell glue were digested by trypsin before the analysis on UPLC coupled with QTOF mass spectrometry.The ions at m/z 925.4 were selected as the marker peptides of pig-hide gelatin.It was found that the test results of the ions at m/z 925.4 were positive in the samples with low contents of the marker peptides of tortoise shell glue,indicating the existence of pig-hide gelatin.However,the result of bovine-hide gelatinordonkey-hide gelatin was negative,while negative results were detected in tortoiseglue standard.The finding was in conformity with previous references over the fragmentation regularity of MS/MS.In conclusion,the method can be adopted to identifying the pig-hide gelatin from tortoise shell glue and applied to the quality control of tortoise shell glue with high specificity and sensibility.
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This study aimed at developing an ultra-performance liquid chromatography electrospray time of flight-mass spectrometry (UPLC-ESI-QTOF-MS) method for the identification of bovine hide gelatine from the shell glue of the red-eared slider.Tortoise shell glue was made from the shell of red-eared slider or Reeves' turtle (Chinemys reevesii).The samples were analyzed on UPLC-ESI-QTOF-MS after being digested by trypsin,and the ions at m/z 604.8,m/z 641.3,m/z 790.8 of the marker peptides of bovine hide gelatin were detected.As a result,it was found that the test results of the ions made from the shell of red-eared slider at m/z 641.3 were positive,taking the same fragmentation regularity of MS/MS as the standard of bovine-hide gelatine,while negative results were detected from the ions made from the shell of Reeves' turtle.In conclusion,the method was simple and accurate provided a basis for distinguishing the tortoise shell glue from bovine hide,which could be also used for the quality control of tortoise shell glue.
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This study was aimed to reveal the medication patterns of Chinese patent medicine in the treatment of breast hyperplasia based on association rules and clustering of data mining technology. Articles on Chinese patent medicine in the treatment of breast hyperplasia were retrieved from databases. External formulas or those mixed with western drugs were excluded. Terminologies in the selected formulas were standardized. Information was extracted to build excelltables. Association rules analysis and cluster analysis were used to reveal the medication patterns of Chi-nese patent medicine in the treatment of breast hyperplasia with software R2.15.2 and Cytoscape 2.8.3. The results showed that Chinese medicinals with higher frequency in 195 formulas were Radix bupleuri, Rhizoma cyperi, Chinese Angelica, Selfheal, White Peony Root, Trichosanthes kirilowii Maxim et al. Chinese medicinals with lower frequency were Chinese Alangium leaf, Rhinacanthus nasutus et al. The commonly used herbal pairs were Radix bupleuri -Chinese A ngelica, Rhizoma curcumae - Rhizoma sparganii, frankincense - myrrh et al. The strong association rules indicated that Xiaoyaosan, which takes Radix bupleuri and Chinese A ngelica as its core, is the key character of Chinese patent medicine in the treatment of breast hyperplasia. The cluster analysis revealed several Chinese medicine functional modules, such as Fructus forsythiae - Rhizoma smilacis glabrae - Evodia lepta - Chinese mahonia stem - Lignum millettiae et al. It was concluded that the herbal frequency, herbal pairs, strong associa-tion rules and cluster analysis can reveal the medication patterns of Chinese patent medicine in the treatment of breast hyperplasia in order to provide reference evidences in the optimization of clinical treatment for mula and im-provement of therapeutic efficacy.
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In this paper, the preliminary study on antioxidant, enhancement of antioxidant enzymes activity, reducing the content of oxygen free radicals, delaying skin aging of the recombination cytoglobin (rCygb) purified by our lab were investigated through human keratinocyte cell line (HaCAT) H2O2 oxidative stress model, mouse skin aging model caused by continuous subcutaneous injection D-gal, rat acute liver injury model induced by CCl4 and rat skin wound healing model. The results showed that rCygb improved the activities of total superoxide dismutase (T-SOD), glutathione peroxidase (GSH-Px) and catalase (CAT), reduced the activities of lactate dehydrogenase (LDH) and alanine aminotransferase (ALT) as well as decreased the content of malondialdehyde (MDA). Skin biopsy showed that rCygb promoted angiogenesis, increased expression of collagen and improved the anti-inflammatory ability. All results displayed that rCygb improved the oxygen free radical scavenging ability, delayed skin aging and promoted wound healing.
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BACKGROUND: There is a great debate but little research addressing the cell suspension obtained from the digested mantle tissues can effective amplify and form pearl sac in vitro, thus producing pearl. OBJECTIVE: To establish an effective technique and method of in vitro separation and culture of mantle of the pearl oyster (Pinctada martensii), and to determine the optimal method of forming pearl sac with the intact structure and secretion function, thus producing pearl. DESIGN, TIME AND SETTING: Single sample observation was performed at the School of Basic Medicine, Guangxi Traditional Chinese Medical University, between August and December in 2008. MATERIALS: Pearl oyster (Pinctada martensii) aged 1.0 2.0 years, were offered by Yingpan Pearl Industrial Co., Ltd. Of Beihai City, China; the self-modified marine shellfish balanced salt solution; the self-prepared concha pteriae serum and concha pteriae body fluid; keratinocyte growth factor was purchased from Sigma, USA. METHODS: The mantle of pearl oyster (Pinctada martensii) was digested with 2.5 g/L trypsin, the harvested cells were cultured using M199 medium containing 10% fetal bovine serum and supplemented with 10 μg/L keratinocyte growth factor, 10% self-prepared concha pteriae serum and concha pteriae body fluid. The cultivation was performed for 30 days. MAIN OUTCOME MEASURES: Cell growth characteristics and growth state. RESULTS: The pearl mantle epithelial cells cultured in vitro were shown to proliferate rapidly, secrete productively, and the muscle cells showed a great proliferation, finally encapsulated the mantle epithelial cells to form pear sac with the intact structure and strong secretion function. CONCLUSION: Using the modified culture technology and culture system, the addition of keratinocyte growth factor can obtain the well growing and secreting pearl sac during in vitro culture of mantle cells.
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Objective To further study the blood supply mechanism of blocking flap and establish the standard of transferring the flap.Methods 7 groups of flap were made on 5 mini-Banna pigs.For each group,we had research flap and control flap on the right side and left side of each pig.After flap blocking operation,we detected the skin temperature of the flap on the 3rd,7th and 10th day.Results There was no statistic difference between each group before operation,but there was statistic difference after operation.Conclusion Temperature detecting may help choose the right time(32.5~33.5℃) for transferring the blocking flap.