[Hematoma Segmentation of Spontaneous Intracerebral Hemorrhage Based on Watershed and Region-Growing Algorithm].

Objective: To establish a brain hematoma CT image segmentation method based on watershed and region-growing algorithm so as to measure hematoma volume quickly and accurately, to explore the consistency between the results of this segmentation method and those of manual segmentation, the clinical gold standard, and to compare the results of this method with the calculation of the two Tada formulas commonly used in clinical practice. Methods: The preoperative CT images of 152 patients who were treated for spontaneous cerebral hemorrhage at the Department of Neurosurgery, West China Hospital, Sichuan University between January 2018 and June 2019 were retrospectively collected. The CT images were randomly assigned, by using a random number table, to the training set, the test set and the validation set, which contained 100 patients, 22 patients and 30 patients, respectively. The labeling results of the training set and the test set were used in algorithm training and testing. Four methods, namely, manual segmentation, algorithm segmentation, i.e., segmentation calculation based on watershed and regional growth algorithm, Tada formula, i.e., the traditional Tada formula calculation, and accurate Tada formula, i.e., accurate Tada formula calculation based on 3D-Slicer, were applied on the validation set to measure the hematoma volume. The Digital Imaging and Communications in Medicine (DICOM) data of subjects meeting the selection criteria of the study were manually segmented by two experienced neurosurgeons. The hematoma segmentation model was built based on watershed algorithm and regional growth algorithm. Seed point selected by neurosurgeons was taken as the starting point of growth. Regional grayscale difference criterion combined with manual segmentation validation were adopted to determine the regional growth threshold that met the segmentation precision requirements for intracranial hematoma. Using manual segmentation as the gold standard, Bland-Altman consistency analysis was used to verify the consistency of the three other methods for measuring hematoma volume. Results: With manual segmentation as the gold standard, among the three methods of measuring hematoma volume, algorithm segmentation had the smallest percentage error, the narrowest range of difference, the highest intra-group correlation coefficient (0.987), good consistency, and the narrowest 95% limits of agreement ( LoA). The percentage error of its segmentation was not statistically significant for hematomas of different volumes. Conclusion: The segmentation method of spontaneous intracerebral hemorrhage based on watershed and regional growth algorithm shows stable measurement performance and good consistency with the clinical gold standard, which has considerable clinical significance, but it still needs further validation with more clinical samples.

Effect of microwave radiation on antioxidant capacities of Tartary buckwheat sprouts.

This study aimed to investigate the effects of different microwave radiation power and treatment time on the antioxidant enzyme activities and radical scavenging potency in Tartary buckwheat sprouts. The results indicated that the optimal microwave irradiation conditions for superoxide dismutase, catalase, peroxidise and ascorbate peroxidise antioxidant enzymes was the power 300 W for 75 s, and their activities were all higher than those of the control and the ungerminated seeds. In addition, under the above microwave conditions, the total reducing power and the ability to scavenge DPPH, ABTS, O2- and •OH were also optimal. These results indicated that suitable microwave treatment could effectively improve the antioxidant enzyme activity in Tartary buckwheat sprouts and enhance the antioxidant capacity of sprouts.

Tracheoplasty should be proactively considered within the surgical strategy for treating the ring-sling complex.

BACKGROUND: To examine the safety and effectiveness of proactive tracheoplasty for pediatric ring-sling complexes. METHODS: We retrospectively collected the data from 304 children who were diagnosed with a ring-sling complex and underwent surgery at three cardiac centers in China between January 2010 and June 2023. Children were categorized into three surgical groups: concurrent sling and tracheal surgery (Group A, n=258), staged sling and tracheal surgery (Group B, n=25), and sling-only surgery (Group C, n=21). We compared perioperative clinical characteristics, tracheal morphology changes, and outcomes across the groups. RESULTS: The median age of the children was 1.2 (IQR: 0.7-1.9) years. The anomalous tracheobronchial arborization rates were higher in Groups A (52.5%) and B (60.0%) than in Group C (15.0%). The preoperative narrow-wide ratio (NWR) was lower in Groups A and B than in Group C, with values of 0.44 (IQR: 0.35-0.52), 0.44 (0.33-0.59), and 0.68 (0.54-0.72), respectively (P<0.001). Preoperative subcarina angles were similar among the groups (P=0.54). After specific surgeries, the NWR and subcarina angle significantly improved in Groups A and B but not in Group C. There were seven in-hospital deaths and two post-discharge deaths. Respiratory symptoms improved in Groups A and B but seven children in Group C remained respiratory dysfunction. Six children presented with residual stenosis of the left pulmonary artery. CONCLUSION: Concurrent sling and tracheal surgeries for children with the ring-sling complex are safe and effective and are especially preferable for those with NWR ≤0.6, long-segment or diffuse tracheal stenosis, anomalous tracheobronchial arborization, and pronounced respiratory symptoms.

Tricuspid mechanical valve replacement for severe tricuspid stenosis in a child who underwent surgical correction of complete atrioventricular septal defect, a rare long-term complications.

BACKGROUND: Complete atrioventricular septal defect is a complicated congenital heart malformations, and surgical correction is the best treatment, the severe tricuspid stenosis is a rare long-term complication after the surgery. CASE PRESENTATION: We report a case with the complication of severe tricuspid stenosis 7 years after the surgical correction of complete atrioventricular septal defect in a child. Then the patient underwent tricuspid mechanical valve replacement, Glenn, atrial septostomy, and circumconstriction of the right pulmonary artery. CONCLUSIONS: The patient recovered successfully with good short-term.

Evaluating interhemispheric synchronization and cortical activity in acute stroke patients using optical hemodynamic oscillations.

Objective.An understanding of functional interhemispheric asymmetry in ischemic stroke patients is a crucial factor in the designs of efficient programs for post-stroke rehabilitation. This study evaluates interhemispheric synchronization and cortical activities in acute stroke patients with various degrees of severity and at different post-stroke stages.Approach.Twenty-three patients were recruited to participate in the experiments, including resting-state and speed finger-tapping tasks at week-1 and week-3 post-stroke. Multichannel near-infrared spectroscopy (NIRS) was used to measure the changes in hemodynamics in the bilateral prefrontal cortex (PFC), the supplementary motor area (SMA), and the sensorimotor cortex (SMC). The interhemispheric correlation coefficient (IHCC) measuring the synchronized activities in time and the wavelet phase coherence (WPCO) measuring the phasic activity in time-frequency were used to reflect the symmetry between the two hemispheres within a region. The changes in oxyhemoglobin during the finger-tapping tasks were used to present cortical activation.Main results.IHCC and WPCO values in the severe-stroke were significantly lower than those in the minor-stroke at low frequency bands during week-3 post-stroke. Cortical activation in all regions in the affected hemisphere was significantly lower than that in the unaffected hemisphere in the moderate-severe stroke measured in week-1, however, the SMC activation on the affected hemisphere was significantly enhanced in week-3 post-stroke.Significance.In this study, non-invasive NIRS was used to observe dynamic synchronization in the resting-state based on the IHCC and WPCO results as well as hemodynamic changes in a motor task in acute stroke patients. The findings suggest that NIRS could be used as a tool for early stroke assessment and evaluation of the efficacy of post-stroke rehabilitation.

High-Definition Transcranial Direct Current with Electrical Theta Burst on Post-Stroke Motor Rehabilitation: A Pilot Randomized Controlled Trial.

BACKGROUND: High-definition transcranial electrical theta burst superimposing direct current stimulation (HD-tDCS-eTBS) not only incorporates the therapeutic advantages of tDCS and TBS but enhances stimulation focality and practicality. However, the applicability of this innovative neuromodulatory device in post-stroke rehabilitation remains uncertain. OBJECTIVE: This study aimed to assess the efficacy and safety of the HD-tDCS-eTBS on upper extremity (UE) motor function in patients with chronic stroke. METHODS: A patient-blinded, randomized controlled study was conducted. Twenty-four participants were randomly assigned into either the active HD-tDCS-eTBS group or sham HD-tDCS-eTBS group. Both groups received 20 minutes of active/sham HD-tDCS-eTBS combined with 30 minutes of conventional UE rehabilitation each time, 3 times a week for 4 weeks. Outcome measures including the Fugl-Meyer Assessment of Upper Extremity, Wolf Motor Function Test, Jebsen-Taylor Hand Function Test, Finger-Nose Test, and Modified Ashworth Scale were assessed before and immediately after the intervention period. RESULTS: Spasticity of shoulder adductor (P = .05), elbow extensor (P = .04), and thumb flexor (P < .01) were significantly reduced in the active HD-tDCS-eTBS group versus the sham group. Nonsignificant trends in the improvements of most other outcome measures were in favor of the active HD-tDCS-eTBS group with moderate to large effect sizes (P = .06-.26, ηp2 = 0.06-0.16). No severe adverse events except for slight skin redness under the stimulus electrode was detected after the HD-tDCS-eTBS. CONCLUSIONS: Our findings support that HD-tDCS-eTBS is safe and has therapeutic potential for post-stroke UE motor rehabilitation. TRIAL REGISTRATION: ClinicalTrials.gov (ID: NCT04278105).

Experimental investigation of the reliability issue of RRAM based on high resistance state conduction.

In this paper, reliability issues of robust HfO(x)-based RRAM are experimentally investigated in terms of cycling ageing, temperature impact and voltage acceleration. All reliability issues can be estimated by the conduction of the high resistance state (HRS). The conduction current of the HRS exponentially increases as the square root of the applied voltage, which is well explained by 'quasi-Poole-Frenkel-type' trap assistant tunneling. Further experiments on HRS conduction at different temperatures show that the depth of the potential well of the trap in HfO(x) film is about 0.31 eV. The degradation induced by the cycling ageing is possibly ascribed to the increase of the amount of oxygen ions in the TiO(x) layer of the TiN/TiO(x)/HfO(x)/TiN device. The retention times with various stress voltages at different temperatures also exhibit an exponential relationship to the square root of the applied voltage, indicating that stress current plays a dominant role for the degradation of the HRS. An oxygen-release model is proposed to explain the relationship of retention time to HRS conduction current.

Designing and pilot testing a novel high-definition transcranial burst electrostimulation device for neurorehabilitation.

Objective.Non-invasive brain stimulation has been promoted to facilitate neuromodulation in treating neurological diseases. Recently, high-definition (HD) transcranial electrical stimulation and a novel electrical waveform combining a direct current (DC) and theta burst stimulation (TBS)-like protocol were proposed and demonstrated high potential to enhance neuroplastic effects in a more-efficient manner. In this study, we designed a novel HD transcranial burst electrostimulation device and to preliminarily examined its therapeutic potential in neurorehabilitation.Approach.A prototype of the transcranial burst electrostimulation device was developed, which can flexibly output a waveform that combined a DC and TBS-like protocol and can equally distribute the current into 4 × 1 HD electrical stimulation by automatic impedance adjustments. The safety and accuracy of the device were then validated in a series ofin vitroexperiments. Finally, a pilot clinical trial was conducted to assess its clinical safety and therapeutic potential on upper-extremity rehabilitation in six patients with chronic stroke, where patients received either active or sham HD transcranial burst electrostimulation combined with occupational therapy three times per week for four weeks.Main results.The prototype was tested, and it was found to comply with all safety requirements. The output parameters were accurate and met the clinical study needs. The pilot clinical study demonstrated that the active HD transcranial burst electrostimulation group had greater improvement in voluntary motor function and coordination of the upper extremity than the sham control group. Additionally, no severe adverse events were noted, but slight skin redness under the stimulus electrode immediately after stimulation was seen.Conclusions.The results demonstrated the feasibility of incorporating the HD electrical DC and TBS-like protocol in our device; and the novel neuromodulatory device produced positive neurorehabilitation outcomes in a safe fashion, which could be the basis for the future clinical implementation for treating neurological diseases.Trial registration:ClinicalTrials.gov Identifier: NCT04278105. Registered on 20 February 2020.

MiR-499a-5p suppresses apoptosis of human nucleus pulposus cells and degradation of their extracellular matrix by targeting SOX4.

Emerging evidence suggests that microRNAs (miRNAs, miRs) play important roles in the development of intervertebral disc degeneration (IVDD). Nonetheless, the expression level and biological function of miR-499a-5p in IVDD are still unclear. In this study, we found that miR-499a-5p was significantly downregulated in degenerative tissues of the human nucleus pulposus (NP) compared with healthy tissues. Knockdown of miR-499a-5p promoted NP cell (NPC) apoptosis, stimulated caspase activation, enhanced MMP3 and MMP13 expression, and downregulated aggrecan and type II collagen. Furthermore, TNF-α-treated NPCs showed increased apoptosis and induced an imbalance between anabolism and catabolism of the extracellular matrix (ECM); these changes were attenuated by miR-499a-5p overexpression. Research into possible mechanisms revealed that miR-499a-5p suppressed the expression of SOX4 both at mRNA and protein levels and directly bound to the 3' untranslated region of SOX4 mRNA. Ectopic expression of SOX4 attenuated the negative effect of miR-499a-5p on NPC apoptosis and the positive effect on ECM synthesis. Taken together, these results indicate that miR-499a-5p may attenuate TNF-α-induced NPC apoptosis and an imbalance between anabolism and catabolism of the ECM by downregulating SOX4.

Near-infrared spectroscopy monitoring of brain oxygen in infant cardiac surgery.

The use of near-infrared spectroscopy for monitoring cerebral oxygenation during different types of cardiopulmonary bypass was evaluated in 24 patients aged 5 to 13 months. They underwent open-heart surgery under cardiopulmonary bypass with moderate hypothermia, deep hypothermia with low flow, or deep hypothermia with circulatory arrest. Near-infrared spectroscopy data were compared with electroencephalography and biochemical indicators (neuron-specific enolase, lactate). Near-infrared spectroscopy data showed no correlation with biochemical indicators in patients undergoing cardiopulmonary bypass with moderate hypothermia or deep hypothermia with low flow. In the deep hypothermia with circulatory arrest group, the oxygenated hemoglobin signal declined to a nadir during circulatory arrest. The period from reaching the nadir until reperfusion and the minimum values of oxygenated hemoglobin correlated closely with increases in neuron-specific enolase and lactate. All patients with an oxygenated hemoglobin-signal nadir time < 35 min were free from behavioral evidence of brain injury. The oxygenated hemoglobin-signal nadir time may be useful in predicting the safe duration of circulatory arrest.