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In order to address the issues of spatial induction bias and lack of effective representation of global contextual information in colon polyp image segmentation, which lead to the loss of edge details and mis-segmentation of lesion areas, a colon polyp segmentation method that combines Transformer and cross-level phase-awareness is proposed. The method started from the perspective of global feature transformation, and used a hierarchical Transformer encoder to extract semantic information and spatial details of lesion areas layer by layer. Secondly, a phase-aware fusion module (PAFM) was designed to capture cross-level interaction information and effectively aggregate multi-scale contextual information. Thirdly, a position oriented functional module (POF) was designed to effectively integrate global and local feature information, fill in semantic gaps, and suppress background noise. Fourthly, a residual axis reverse attention module (RA-IA) was used to improve the network's ability to recognize edge pixels. The proposed method was experimentally tested on public datasets CVC-ClinicDB, Kvasir, CVC-ColonDB, and EITS, with Dice similarity coefficients of 94.04%, 92.04%, 80.78%, and 76.80%, respectively, and mean intersection over union of 89.31%, 86.81%, 73.55%, and 69.10%, respectively. The simulation experimental results show that the proposed method can effectively segment colon polyp images, providing a new window for the diagnosis of colon polyps.
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Humans , Colonic Polyps/diagnostic imaging , Computer Simulation , Electric Power Supplies , Semantics , Image Processing, Computer-AssistedABSTRACT
The existing retinal vessels segmentation algorithms have various problems that the end of main vessels are easy to break, and the central macula and the optic disc boundary are likely to be mistakenly segmented. To solve the above problems, a novel retinal vessels segmentation algorithm is proposed in this paper. The algorithm merged together vessels contour information and conditional generative adversarial nets. Firstly, non-uniform light removal and principal component analysis were used to process the fundus images. Therefore, it enhanced the contrast between the blood vessels and the background, and obtained the single-scale gray images with rich feature information. Secondly, the dense blocks integrated with the deep separable convolution with offset and squeeze-and-exception (SE) block were applied to the encoder and decoder to alleviate the gradient disappearance or explosion. Simultaneously, the network focused on the feature information of the learning target. Thirdly, the contour loss function was added to improve the identification ability of the blood vessels information and contour information of the network. Finally, experiments were carried out on the DRIVE and STARE datasets respectively. The value of area under the receiver operating characteristic reached 0.982 5 and 0.987 4, respectively, and the accuracy reached 0.967 7 and 0.975 6, respectively. Experimental results show that the algorithm can accurately distinguish contours and blood vessels, and reduce blood vessel rupture. The algorithm has certain application value in the diagnosis of clinical ophthalmic diseases.
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Algorithms , Fundus Oculi , Optic Disk , ROC Curve , Retinal Vessels/diagnostic imagingABSTRACT
Objective To explore the diagnosis and treatment of non-tuberculosis mycobacteria (NTM) infection after cosmetic injection via scientific debridement surgery combined with regular application of anti-NTM drugs.Methods 14 patients who were infected with NTM after cosmetic injection and were not cured over a long period of time in other hospitals from 2012 to 2016.The patients were treated with VSD thorough surgical debridement,the bacterial type of NTM was identified by bacterial culture and PCR identification and anti-NTM drugs were systematically used according to the results of drug sensitivity.Results Fourteen patients who were treated with scientific debridement surgeries combined with regular anti-NTM drug treatment in our hospital for 2-4 months were discharged after their skin lesions were cleared and healed and they were continually treated with antiNTM drugs for 12 months.Fourteen patients were completely cured by using the above treatments without severe side effects,such as liver and kidney dysfunction,nervous system disorders and so on.Only colpitis mycotica occurred in 3 patients.In addition,one patient presented the decrease of leukopenia after using anti-NTM drugs for 2 months and continued to complete the treatment after we adjusted the treatment plan to returning the level of leukopenia to the normal.These 14 patients were followed up for 1-5 years with no recurrence of the lesion.The facial appearance of 12 patients were almost normal with slight scars.The facial surgery area of 2 patients were uneven and nearly recovered to normal facial appearance by tissue transplantation and photoelectric therapy.Conclusions For the NTM patients caused by invasive procedures such as injection,the comprehensive treatment program,which combined scientific debridement surgery and systematically targeted drug treatment,not only can effectively cure NTM infection,but also minimize secondary injury and restore the patients' appearance,which is worthy of clinical application.
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Objective@#To explore the association between DNA methylation and body mass index (BMI) using Mendelian randomization analysis.@*Methods@#A total of 469 participants were selected from the Chinese National Twin Registry in 2013, who were living in Shandong, Jiangsu, Zhejiang, and Sichuan provinces, and at least 18 years of age. A questionnaire survey and physical examination were conducted to collect demographic, clinical, and behavioral information. Peripheral blood cells were collected to detect genotype and methylation status. Association analyses between DNA methylation and BMI and between CpGs and cis-SNP were conducted. With rs748212 as the instrumental variable, the association between cg15053022 and BMI was explored using the Mendelian randomization method.@*Results@#A total of 469 participants were selected. The mean age of participants was (44.8±13.2) years and the BMI was (25.0±3.8) kg/m2. Nine BMI-related DNA methylation sites were found and DNA methylation site cg15053022 in the ATP4A gene was negatively associated with cis-SNP rs748212 (β=-0.020); the mean methylation level of AA, AC, and CC were 0.212±0.025, 0.242±0.024, and 0.264±0.028, respectively. rs748212 was associated with BMI (β=0.04, P=0.007) and closely related to cg15053022 (F=237.66, P=0.143). Mendelian randomization analysis showed lower methylation levels at cg15053022 were associated with higher BMI (β=-1.97, P<0.001).@*Conclusion@#This study supported the impact of cg15053022 methylation in the ATP4A gene on BMI using Mendelian randomization analysis and provided the basis for using Mendelian randomization analysis in methylation studies.
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<p><b>OBJECTIVE</b>To screen SNP information of keloid pedigrees through whole genome sequencing.</p><p><b>METHODS</b>We Collected information and clinical data of the keloid pedigree and constructed charts of the pedigree. The DNA was extracted from peripheral venous blood samples of the pedigree to sequence the whole genome.</p><p><b>RESULTS</b>27 SNP and 8 disease-associated genes were screened out.</p><p><b>CONCLUSIONS</b>Whole genome sequencing technology can select new genetic mutations associated with keloid, and provide a new way for the research of keloid.</p>
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Humans , China , Ethnology , Genome, Human , Keloid , Genetics , Mutation , Pedigree , Polymorphism, Single Nucleotide , Sequence Analysis, DNAABSTRACT
Objective To study the clinical and genetic characteristics of keloid through investigating on four Han Chinese pedigrees.Methods The pedigree information and clinical data from Han Chinese keloid pedigrees were collected,which consisted of 22 patients in 127 family members,and then the charts of these pedigrees were constructed according to the data.Using the genetic model and pedigree analyses we summarized the clinical features of the disease in the families.Results Four Han Chinese keloid pedigrees were discovered.The three pedigree spans included 3 generations and one was 4 generations.Incidence of KD in the consanguinity family member was 23.7％ (23/93),and 20.8％ (11/53) in male KD,and 27.5％ (11/40) in female.Incidence of anterior chest KD was 40.9 ％.The inheritance pattern observed in these pedigrees was consistent with an autosomal dominant inheritance multi-gene hereditary disease with incomplete penetrance,and its nonpenetrance of KD gene carriers was 12％ (3/25).Conclusions The pattern of inheritance observed in these four Han Chinese keloid pedigrees is similar to previous reports and no gender differences are found in the incidence of disease,but differences in pathogenic site.Pedigree investigation helps to reveal the genetic characteristics of keloid.
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Teaching information retrieval course in two phases for students of 8-year clinical medicine was de-scribed in aspects of its contents, organization, teaching material construction and examination methods.Its results were analyzed according to the written examination score, report on a special topic, group report and feedback of students.Measures were put forward for further improving the classroom teaching results, namely effective linking of teaching contents, careful section of retrieval topics, selection and training of teachers.
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Combining the two novelty search work workshops with recent published papers on novelty search in Universities and Colleges,new progresses for science & technology (ST) novelty search in Universities and Colleges have been comprehensive summarized,and some enlightenments have been probed into seminar:a new novelty search experience communication mode and fast development of college ST novelty search work to ST novelty search and innovation.
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<p><b>OBJECTIVE</b>To investigate the effects of botulinum toxin type A (BTXA) on the expression of alpha smooth muscle actin(alpha-SMA) and myosin-II of fibroblasts in scars. Methods Fibroblasts were isolated from tissue specimens of scars contracture. Cells from passages 3-5 were randomly divided into 3 groups (control group, low BTXA group (1 U/10(6) Cells), and high BTXA group (2.5 U/ 10(6)Cells)). Growth condition of fibroblasts was observed at 1 , 4, 7 day after BTXA treated. Changes of alpha-SMA and myosin-II in fibroblasts were detected by Western blot.</p><p><b>RESULTS</b>Fibroblasts grew well in control group. The proliferation was decreased 4 days later in BTXA groups. Lots of apoptotic cells were seen in high BTXA group at 7th day. Proteins of alpha-SMA and myosin-II in fibroblasts were statistically different between BTXA group and control groups at 4th day (P < 0.05). The expression of alpha-SMA and myosin-II in low BTXA group was higher than that in high BTXA group at 7th day (P < 0.05).</p><p><b>CONCLUSIONS</b>BTXA could induce the apoptosis of fibroblasts and decrease the expression of alpha-SMA and myosin-II in fibroblasts. The inhibitory effect was strengthened with BTXA concentration increase within a certain range.</p>
Subject(s)
Humans , Actins , Metabolism , Botulinum Toxins, Type A , Pharmacology , Cicatrix , Fibroblasts , Metabolism , Muscle, Smooth , Metabolism , Myosin Type II , Metabolism , Random AllocationABSTRACT
Objective To explore influencing factors of the individual entrepreneurship from as-pects of entrepreneurial intention, entrepreneurial cognition and entrepreneurship education. Methods Questionnaire of entrepreneurial cognition was conducted for 1860 students in Southern Medical Universi-ty. SPSS was used to analyze the data. Results ①Entrepreneurship intention among university students were strong.②There was a lack of awareness of college students entrepreneurship policy among college students. ③Students never receiving entrepreneurship education accounted for 65%, but 89%students held that entrepreneurial education courses was necessary. Conclusions Due to arduous professional tasks, medical students have compelling and demanding need for personalized entrepreneurship educa-tion. Initiative participation of library in integrating of entrepreneurship education information by using advantageous resources plays a important role in entrepreneurship education.
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Objective To evaluate the validity of botulinum toxin type A (BTXA) injections for the treatment of scar contracture.Methods 26 patients with scar contracture were randomly assigned into BTXA group and triamcinolone acetonide (TAC) group.Pinpoint tattooing was performed on each side of each scar in the plane of its longest axis.A template was used to ensure consistent length.These two tattoo points were measured to assess scar contraction at baseline,at every month for a total of 6 months.Histological analysis was conducted to study the physiological environment and immunohistochemistry to detect the expression of α-SMA and myosin-Ⅱ at different groups.Results Scar contraction was more relaxed in BTXA group than that in TAC group after 1 month (P＜0.05),especially in the 6th month (the D value in BTXA group and TAC group was (1.23±0.42) cm,and (0.56±0.33) cm respectively).For immunohistochemistry,the expression of α-SMA and myosin-Ⅱ also decreased in BTXA group (P＜0.05).Conclusions The treatment of scar contracture by suitable BTXA injections is safe and effective.
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This paper is to introduce our experiences in treating 2 batches of 13 burn victims transferred from remote areas on postburn days 3 and 4. Methods Thirteen burn victims of 2 mass casualties were transferred to our burns institute from remote areas on postburn days 3 and 4 on June 27, 2001 and June 2, 2002, respectively. There were 4 males and 9 females, age ranged from 20 to 43 years, with a mean age of 31.1±6.2 years. The mean total burn area was 74.3%±24.7% TBSA (range, 25% to 97%). Among them, 10 patients suffered from serious burn with mean total burn area involving 86.0%±11.5% TBSA (range, 60% to 97%), and mean full-thickness burn of 63.9%±26.3% TBSA. Four patients also manifested signs of severe inhalation injury, and 6 patients with moderate inhalation injury. In three patients with mean total burn area covering 35.5%±10.0% TBSA (range, 25% to 45%), with mean full-thickness burn of 15.3%±5.0%, were al having moderate inhalation injuries. Among these 13 patients, 3 were having high body temperature (39℃), while 3 manifested hypothermia. The heart rate was 140-160/min, and respiratory rate 26 to 32/min in 6 patients. Abdominal distension or loss of bowel sound were found in 4 patients. Low white cell and platelet count were found in some patients. In 13 cases, liver function, renal function, myocardiac enzyme, and coagulation function were abnormal. Results Among 13 burn victims, one patient died of myocarditis on postburn day 29, and another one died of hepatic failure (history of chronic hepatitis B) on postburn day 45 with only 2% TBSA of burn wound remained open. Conclusion Burns victims occurred in mass casualties who were transferred from remote areas to our Burns Institute were all in critical condition, usually with multiple complications, demanding most meticulous care. Our strategies in this regard consisted of dispatch of experienced surgeons and nurses to the referring hospitals and the airport to receive the patients to offer appropriate care to them during the journey,organization of the medical staff so that each of them was ordained specific function, thus conditions of the patients were evaluated immediately and appropriate treatment started expeditiously for those lethal complications on arrival. Timely and exact comprehensive treatments were prerequisite to save the patients’ life. Adequate metabolic support should be emphasized, and coagulant of anticoagulant treatment should be carried out when indicated.
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Objective To introduce a method of comprehension correction for secondary lip-nasal deformities after operation of the completely unilateral cleft lip. Methods The correction consisted of the following procedures: reposition of the columella and nasal alar crus by one tractional suture with nostril base narrowing; modification of flat nostril by a MT-plasty at the edge of naris; arising of the nasal alar and nasal dorsor by ePTFE implantation; reconstruction of the Cupid's bow by M type incision and vermilion advancement; repair of the vermilion deficit with the hinge mucosal flap and bipedicle mucosal flaps of the lower lip. Results Twenty-one cases with secondary lip-nasal deformities were successfully corrected by these comprehensive methods. Ten of them were followed-up for three months to 1 year with satisfactory effects. Conclusion The comprehensive methods can be used to correct satisfactorily the secondary lip-nasal deformities after operation of the completely unilateral cleft lip.
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Objective To prepare porcine acellular dermal matrix(PADM) without cytotoxicity,to evaluate its biological safety,and investigate its end result in vivo.Methods A piece of porcine split-thickness skin of 0.3-0.4mm was obtained,the epidermis was removed by hypertonic saline immersion,and then the skin was immersed in sodium hydroxide solution,and dermal cells were removed by shaking water bath at normal temperature to harvest PADM.After cross-linking and sterilization,bacteria and porcine virus were examined in the PADM.The PADM were embedded beneath the Sprague-Dawley(SD) rat's skin,and then the general and histological changes were observed after transplantation.Result The obtained PADM was soft and elastic,easy to be moulded,and convenient for operation.No cellular component was found in PADM,the collagen was regularly arranged and elastic fibers were abundant.Bacteria and virus examination of all specimens was negative.No immunologic rejection of PADM was found after being embedded beneath the skin of SD rat.The PADM adhered to the wound firmly,and it was difficult to detach 3 weeks after implantation,and the general structures of PADM beneath rat skin were discernible 24 weeks after implantation.The PADM was infiltrated by inflammatory cells in the early stage,fibroblasts and capillary vessels increased in number along with the time,and collagen fibers gradually gained a regular and compact arrangement in PADM.Conclusions The PADM prepared by hypertonic saline/sodium hydroxide method is a simple preparation process,and there is no cytotoxicity.It has a high biological safety and can be used as dermal scaffold with long-term existence in vivo.
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Objective To explore the diagnosis and topical treatment of diabetic foot in patients with burns.Methods Sixty-five patients with burns complicated with diabetic foot were admitted from Jan.2002 to Dec.2006.Bacterial culture of wound excretion,peripheral nerve electromyography and vascular ultrasonography of both lower extremities were performed in a part of patients.Twenty-four patients received topical treatment,including immersion bath with hypertonic saline solution and the application of epidermal growth factor,fibroblast growth factor and complex lysozyme disinfectant.Forty-one patients underwent surgical treatment.The operation methods,surgical treatment included debridement followed by direct closure,split-thickness skin grafting,repair with local skin flap or cross leg skin flap,or amputation of foot,as determined according to the condition of the wound.Results The positive rate of bacterial culture of wound excretion was 88.7%(47/53)on admission and 30.2%(16/53)one week after topical treatment.There were abnormal findings of peripheral nerve electromyography in all 31 cases.Vascular ultrasonography revealed pathological findings in both lower extremities of all 12 patients with vascular lesion,and 9 in 16 cases without vascular lesion.The lesions in all patients except 2,who were discharged in advance,healed and the cure rate was 96.9%.Conclusion Peripheral nerve electromyography and vascular ultrasonography of both lower extremities are promising auxiliary examinations for the diagnosis of diabetic foot in patients with burns.Topical treatment,which includes immersion bath with hypertonic saline solution and the application of growth factors and complex lysozyme disinfectant,as well as appropriate surgical management,plays an important role in the wound healing.