HGCTNet: Handcrafted Feature-Guided CNN and Transformer Network for Wearable Cuffless Blood Pressure Measurement.

Biosignals collected by wearable devices, such as electrocardiogram and photoplethysmogram, exhibit redundancy and global temporal dependencies, posing a challenge in extracting discriminative features for blood pressure (BP) estimation. To address this challenge, we propose HGCTNet, a handcrafted feature-guided CNN and transformer network for cuffless BP measurement based on wearable devices. By leveraging convolutional operations and self-attention mechanisms, we design a CNN-Transformer hybrid architecture to learn features from biosignals that capture both local information and global temporal dependencies. Then, we introduce a handcrafted feature-guided attention module that utilizes handcrafted features extracted from biosignals as query vectors to eliminate redundant information within the learned features. Finally, we design a feature fusion module that integrates the learned features, handcrafted features, and demographics to enhance model performance. We validate our approach using two large wearable BP datasets: the CAS-BP dataset and the Aurora-BP dataset. Experimental results demonstrate that HGCTNet achieves an estimation error of 0.9 ± 6.5 mmHg for diastolic BP (DBP) and 0.7 ± 8.3 mmHg for systolic BP (SBP) on the CAS-BP dataset. On the Aurora-BP dataset, the corresponding errors are -0.4 ± 7.0 mmHg for DBP and -0.4 ± 8.6 mmHg for SBP. Compared to the current state-of-the-art approaches, HGCTNet reduces the mean absolute error of SBP estimation by 10.68% on the CAS-BP dataset and 9.84% on the Aurora-BP dataset. These results highlight the potential of HGCTNet in improving the performance of wearable cuffless BP measurements.

Cuffless Blood Pressure Measurement Using Smartwatches: A Large-Scale Validation Study.

This study aimed to evaluate the performance of cuffless blood pressure (BP) measurement techniques in a large and diverse cohort of participants. We enrolled 3077 participants (aged 18-75, 65.16% women, 35.91% hypertensive participants) and conducted followed-up for approximately 1 month. Electrocardiogram, pulse pressure wave, and multiwavelength photoplethysmogram signals were simultaneously recorded using smartwatches; dual-observer auscultation systolic BP (SBP) and diastolic BP (DBP) reference measurements were also obtained. Pulse transit time, traditional machine learning (TML), and deep learning (DL) models were evaluated with calibration and calibration-free strategy. TML models were developed using ridge regression, support vector machine, adaptive boosting, and random forest; while DL models using convolutional and recurrent neural networks. The best-performing calibration-based model yielded estimation errors of 1.33 ± 6.43 mmHg for DBP and 2.31 ± 9.57 mmHg for SBP in the overall population, with reduced SBP estimation errors in normotensive (1.97 ± 7.85 mmHg) and young (0.24 ± 6.61 mmHg) subpopulations. The best-performing calibration-free model had estimation errors of -0.29 ± 8.78 mmHg for DBP and -0.71 ± 13.04 mmHg for SBP. We conclude that smartwatches are effective for measuring DBP for all participants and SBP for normotensive and younger participants with calibration; performance degrades significantly for heterogeneous populations including older and hypertensive participants. The availability of cuffless BP measurement without calibration is limited in routine settings. Our study provides a large-scale benchmark for emerging investigations on cuffless BP measurement, highlighting the need to explore additional signals or principles to enhance the accuracy in large-scale heterogeneous populations.

Multi-Sensor Fusion Approach for Cuff-Less Blood Pressure Measurement.

Ambulatory blood pressure (BP) provides valuable information for cardiovascular risk assessment. The present cuff-based devices are intrusive for long-term BP monitoring, whereas cuff-less BP measurement methods based on pulse transit time or multi-parameter are inferior in robustness and reliability by using electrocardiogram (ECG) and photoplethysmogram signals. This study examined a multi-sensor fusion-based platform and algorithm for systolic BP (SBP), mean arterial pressure (MAP), and diastolic BP (DBP) estimation. The proposed multi-sensor platform was comprised of one ECG sensor and two pulse pressure wave sensors for simultaneous signal collection. After extracting 35 features from the collected signals, a weakly supervised feature selection method was proposed for dimension reduction because the reference oscillometric technique-based BP are intermittent and can be redeemed as coarse-grained labels. BP models were then established using a multi-instance regression algorithm. A total of 85 participants including 17 hypertensive and 12 hypotensive patients were enrolled. Experimental results showed that the proposed approach exhibited good accuracy for diverse population with an estimation error of 1.62 ± 7.76 mmHg for SBP, 1.53 ± 6.03 mmHg for MAP, and 1.49 ± 5.52 for DBP, which complied with the association for the advancement of medical instrumentation standards in BP estimation. Moreover, the estimation accuracy is with random daily fluctuations rather than long-term degradation through a maximum two-month follow-up period indicated good robustness performance. These results suggest that the proposed approach is with high reliability and robustness and thus provides a novel insight for cuff-less BP measurement.

Forkhead box P3 gene silencing inhibits the expression of chemokines and chemokine receptors associated with cell growth, migration, and apoptosis in hepatocellular carcinoma cells.

The aberrant expression of forkhead box P3 (FOXP3) leads to the formation of malignant tumors. FOXP3 expression levels are also elevated in hepatocellular carcinoma (HCC). The aim of the present study was to investigate the effects of FOXP3 silencing on cell proliferation, migration, apoptosis and chemokine/chemokine receptor expression in the MHCC-97H HCC cell line. Three FOXP3 short hairpin (sh)RNA constructs were designed: Sh-FOXP3-1-pGreenPuro, sh-FOXP3-2-pGreenPuro, and sh-FOXP3-3-pGreenPuro. MHCC-97H cells were transfected with shRNA-FOXP3, and the mRNA and protein expression levels of C-X-C motif chemokine (CXC) ligand 12 (CXCL12), CXCL11, CXC receptor 4 (CXCR4) and CXCR7 were measured. Cell Counting Kit-8, terminal deoxynucleotidyl-transferase-mediated dUTP nick end labeling and Transwell assays were used to evaluate cell proliferation, apoptosis and migration, respectively. Of the three FOXP3 lentivirus carriers constructed, sh-FOXP3-1 significantly reduced FOXP3 expression levels and was chosen for further experiments. sh-FOXP3-1 inhibited cell proliferation, promoted apoptosis and inhibited cell migration compared with the negative control. The mRNA and protein expression levels of CXCL12, CXCL11, CXCR4 and CXCR7 were decreased significantly in response to FOXP3 silencing. FOXP3 silencing may therefore inhibit cell growth, induce apoptosis and inhibit migration in HCC cells, possibly by impairing the chemokine/chemokine receptor axes.

Desumoylating Isopeptidase 2 (DESI2) Inhibits Proliferation and Promotes Apoptosis of Pancreatic Cancer Cells through Regulating PI3K/AKT/mTOR Signaling Pathway.

This study aimed to investigate the effects of desumoylating isopeptidase 2 (DESI2) on tumor cell proliferation, apoptosis and invasion of pancreatic cancer, and to assess the signaling pathway involved. Overexpression and silence of DESI2 were designed and the experiments were divided into 5 groups: a normal control group, an interference control group (shRNA-NC); an interference group (sh-DESI2); an overexpression control group (NC), an overexpression group (DESI2). Quantitative real time polymerase chain reaction (qRT-PCR) was used to screen the appropriate interference sequence. The silencing and overexpression of DESI2 were confirmed by qRT-PCR and western blotting. Cell cycling, apoptosis, invasion, and the expression of phosphatidylinositol-3-kinase (PI3K)-protein kinase B (AKT)-mammalian target of rapamycin (mTOR) pathway and caspase 3 were measured. Overexpression and silence of DESI2 were successfully designed in two pancreatic cancer cells, and the interference effect of sh-DESI2-3 showed the best silencing effects. The biological activities of DESI2 were detected in both ASPC-1 and PANCE-1 cells. Our results showed that cell proliferation was significantly increased in the sh-DESI2 group, while decreased in DESI2 group compared with the control group in both cell lines. In ASPC-1 cells, the events in G1 phase decreased and in S phase increased obviously in the sh-DESI2 group, compared with control group. An opposite result was found when DESI2 was overexpressed. In PANCE-1 cells, the events in G2 phase were higher in the sh-DESI2 group, while in the DESI2 group was significantly lower than that in control group. In ASPC-1 and PANCE-1 cells, sh-DESI2 group showed decreased apoptosis, increased cell invasion and increased expression of AKT, p-Akt, PI3K, p-PI3K, p-mTOR and mTOR and decreased caspase 3 expression compared with the control group, while overexpression of DESI2 leaded to increased apoptosis, decreased cell invasion and reduced expression of AKT, p-Akt, PI3K, p-PI3K, p-mTOR and mTOR and increased expression of caspase 3. DESI2 regulates the proliferation and apoptosis of pancreatic cancer cells through PI3K/AKT/mTOR signaling pathway.

Cuffless Blood Pressure Estimation Using Pressure Pulse Wave Signals.

Pulse transit time (PTT) has received considerable attention for noninvasive cuffless blood pressure measurement. However, this approach is inconvenient to deploy in wearable devices because two sensors are required for collecting two-channel physiological signals, such as electrocardiogram and pulse wave signals. In this study, we investigated the pressure pulse wave (PPW) signals collected from one piezoelectric-induced sensor located at a single site for cuffless blood pressure estimation. Twenty-one features were extracted from PPW that collected from the radial artery, and then a linear regression method was used to develop blood pressure estimation models by using the extracted PPW features. Sixty-five middle-aged and elderly participants were recruited to evaluate the performance of the constructed blood pressure estimation models, with oscillometric technique-based blood pressure as a reference. The experimental results indicated that the mean ± standard deviation errors for the estimated systolic blood pressure and diastolic blood pressure were 0.70 ± 7.78 mmHg and 0.83 ± 5.45 mmHg, which achieved a decrease of 1.33 ± 0.37 mmHg in systolic blood pressure and 1.14 ± 0.20 mmHg in diastolic blood pressure, compared with the conventional PTT-based method. The proposed model also demonstrated a high level of robustness in a maximum 60-day follow-up study. These results indicated that PPW obtained from the piezoelectric sensor has great feasibility for cuffless blood pressure estimation, and could serve as a promising method in home healthcare settings.

LAP+CD4+ T cells are elevated among the peripheral blood mononuclear cells and tumor tissue of patients with hepatocellular carcinoma.

The purpose of the present study was to investigate the role of latency-associated peptide (LAP)+CD4+T cells in hepatocellular carcinoma (HCC) immunity. Flow cytometric analysis was performed to detect the proportion of LAP+CD4+ T cells among the peripheral blood mononuclear cells (PBMCs) of 30 HBV-infected HCC patients at the pre-operative and post-operative stages, as well as 30 hepatitis B virus (HBV)-infected volunteers as a control group. Furthermore, tumor tissues and peri-tumor tissues from 28 patients with HCC, as well as hepatic tissues from 28 HBV-infected patients with benign lesions were subjected to immunohistochemical analysis with double staining for LAP and CD4, and the average number of the LAP+CD4+T cells in each visual field was quantified. The results indicated that the proportion of LAP+CD4+ T cells in the PBMCs of patients with HCC was significantly higher than that in the control group (1.84±0.85 vs. 0.73±0.39%, P=0.019), while it was significantly reduced after the operation (1.07±0.35, P=0.021), but still slightly, if not significantly, higher compared with that in the control group (P=0.342). Furthermore, the number of LAP+CD4+ T cells per high-magnification microscopic field (magnification, ×400) in the HCC tissues was 11.25±3.00, which was significantly higher than that in the peri-cancer tissues (5.75±1.00) and that in the HBV-infected hepatic tissues around benign lesions (2.61±0.83). In peri-cancer tissues, LAP+CD4+ T cells were also significantly more abundant than in control tissues. Furthermore, in the HCC tissues, LAP+CD4+ T cells were present as clusters in the tumor stroma and closely associated with CD4+ T lymphocytes. By contrast, in the peri-cancer liver tissues and HBV-infected hepatic tissues around benign lesions, LAP+CD4+ T cells were sparsely distributed. LAP+CD4+ T cells have marked inhibitory effects, and in the peripheral blood and tumor tissues of patients with HCC, they have an important role in the suppression of anti-tumor immunity and in the immune evasion of tumor cells.

An Assisted Diagnosis System for Detection of Early Pulmonary Nodule in Computed Tomography Images.

Lung cancer is still the most concerned disease around the world. Lung nodule generates in the pulmonary parenchyma which indicates the latent risk of lung cancer. Computer-aided pulmonary nodules detection system is necessary, which can reduce diagnosis time and decrease mortality of patients. In this study, we have proposed a new computer aided diagnosis (CAD) system for detection of early pulmonary nodule, which can help radiologists quickly locate suspected nodules and make judgments. This system consists of four main sections: pulmonary parenchyma segmentation, nodule candidate detection, features extraction (total 22 features) and nodule classification. The publicly available data set created by the Lung Image Database Consortium (LIDC) is used for training and testing. This study selects 6400 slices from 80 CT scans containing totally 978 nodules, which is labeled by four radiologists. Through a fast segmentation method proposed in this paper, pulmonary nodules including 888 true nodules and 11,379 false positive nodules are segmented. By means of an ensemble classifier, Random Forest (RF), this study acquires 93.2, 92.4, 94.8, 97.6% of accuracy, sensitivity, specificity, area under the curve (AUC), respectively. Compared with support vector machine (SVM) classifier, RF can reduce more false positive nodules and acquire larger AUC. With the help of this CAD system, radiologist can be provided with a great reference for pulmonary nodule diagnosis timely.

Endoscopic sphincterotomy in the treatment of cholangiopancreatic diseases.

AIM: To investigate the therapeutic effect of endoscopic sphincterotomy (EST) in the treatment of choledocholithiasis and stenosing papillitis. METHODS: A total of 1 026 patients undergoing EST during July 1983 to May 2003 at the institute were retrospectively analyzed. Chronic pancreatitis was diagnosed in 63 (6.1%), cholecystolithiasis and choledocholithiasis in 549 (53.5%), stones in residual biliary duct in 249 (24.3%), stenosing papillitis in 228 (22.2%). In patients with simple stenosing papillitis, most incisions were within 0.5-1 cm in length. As for patients with chronic pancreatitis simultaneously, selective pancreatic sphincterotomy was performed, and incision was within 0.5-0.8 cm in length. For stones less than 1 cm, incision was from 1 to 1.5 cm, and for those larger than 1 cm, incision ranged from 1.5 to 3 cm. For stones more than 2 cm in diameter, detritus basket rather than simple incision was chosen. RESULTS: Of the 798 patients with choledocholithiasis, 764 (93.5%) had successful stone clearance, 215 (94.3%) out of 228 cases of stenosing papillitis were cured totally, while 63 had chronic pancreatitis developed from stenosing papillitis, 57 (90.1%) had sound remission of symptoms, though membranous stenosis emerged in 13 of 57 which was treated with balloon dilatation. After the operation, only 21 cases (2.1%) had complications such as severe pancreatitis and incision bleeding. None of the patients died. CONCLUSION: EST is an ideal surgical management with mini-invasion in the treatment of choledocholithiasis and stenosing papillitis.