[Clinical features of intestinal polyps and risk factors for secondary intussusception in children: an analysis of 2 669 cases]. / 2 669ä¾‹å„¿ç«¥è‚ æ¯è‚‰çš„ä¸´åºŠç‰¹å¾åŠç»§å‘è‚ å¥—å çš„å±é™©å› ç´ åˆ†æž.

OBJECTIVES: To study the clinical features of intestinal polyps and the risk factors for secondary intussusception in children. METHODS: A retrospective analysis was performed for the medical data of 2 669 children with intestinal polyps. According to the presence or absence of secondary intussusception, they were divided into two groups: intussusception (n=346) and non-intussusception (n=2 323). Related medical data were compared between the two groups. The multivariate logistic regression analysis was used to identify the risk factors for secondary intussusception. RESULTS: Among the children with intestinal polyps, 62.42% were preschool children, and the male/female ratio was 2.08∶1; 92.66% had hematochezia as disease onset, and 94.34% had left colonic polyps and rectal polyps. There were 346 cases of secondary intussusception, with an incidence rate of 12.96% (346/2 669). Large polyps (OR=1.644, P<0.001), multiple polyps (≥2) (OR=6.034, P<0.001), and lobulated polyps (OR=93.801, P<0.001) were the risk factors for secondary intussusception. CONCLUSIONS: Intestinal polyps in children often occur in preschool age, mostly in boys, and most of the children have hematochezia as disease onset, with the predilection sites of the left colon and the rectum. Larger polyps, multiple polyps, and lobulated polyps may increase the risk of secondary intussusception, and endoscopic intervention is needed as early as possible to improve prognosis.

[Clostridium difficile infection and its susceptibility factors in children with inflammatory bowel disease].

OBJECTIVE: To investigate the incidence rates of Clostridium difficile colonization and Clostridium difficile infection (CDI) in children with inflammatory bowel disease (IBD) and the susceptibility factors for CDI in children with IBD. METHODS: A total of 62 children diagnosed with IBD were enrolled as the IBD group. Forty-two children who attended the hospital due to persistent or chronic diarrhea and were excluded from IBD were enrolled as the non-IBD group. The incidence rate of CDI was compared between the two groups. According to the presence or absence of CDI, the IBD group was subdivided into two groups:IBD+CDI (n=12) and non-CDI IBD (n=50), and the clinical data were collected from the two groups to analyze the susceptibility factors for CDI. RESULTS: The IBD group had a significantly higher incidence rate of CDI[19% (12/62) vs 2% (1/42); P < 0.05] than the non-IBD group (P < 0.05). Compared with the non-CDI IBD group, the IBD+CDI group had a significantly longer disease course (P < 0.05), and a significantly higher proportion of children with fever, diarrhea, or abdominal pain (P < 0.05). The IBD+CDI group had significantly higher activity indices of pediatric Crohn's disease, C-reactive protein levels and erythrocyte sedimentation rate than the non-CDI IBD group (P < 0.05). The univariate analysis showed that compared with the non-CDI IBD group, the IBD+CDI group had a significantly higher proportion of children with moderate-to-severe disease, use of glucocorticoids, or treatment with broad-spectrum antibiotics for more than 14 days before diagnosis (P < 0.05). CONCLUSIONS: The children with IBD have a higher incidence of CDI than those without IBD. Severe disease conditions and use of broad-spectrum antibiotics or glucocorticoids may be associated with an increased incidence of CDI in children with IBD.

Traditional Tibetan medicine: therapeutic potential in lung diseases.

Lung diseases have become a major threat to human health worldwide. Despite advances in treatment and intervention in recent years, effective drugs are still lacking for many lung diseases. As a traditional natural medicine, Tibetan medicine has had a long history of medicinal use in ethnic minority areas, and from ancient times to the present, it has a good effect on the treatment of lung diseases and has attracted more and more attention. In this review, a total of 586 Tibetan medicines were compiled through literature research of 25 classical works on Tibetan medicine, drug standards, and some Chinese and English databases. Among them, 33 Tibetan medicines have been studied to show their effectiveness in treating lung diseases. To investigate the uses of these Tibetan medicines in greater depth, we have reviewed the ethnomedicinal, phytochemical and pharmacological properties of the four commonly used Tibetan medicines for lung diseases (rhodiola, gentian, sea buckthorn, liexiang dujuan) and the five most frequently used Tibetan medicines (safflower, licorice, sandalwood, costus, myrobalan). It is expected to provide some reference for the development of new drugs of lung diseases in the future.

Single-cell landscape of the cellular microenvironment in three different colonic polyp subtypes in children.

BACKGROUND: The understanding of the heterogeneous cellular microenvironment of colonic polyps in paediatric patients with solitary juvenile polyps (SJPs), polyposis syndrome (PJS) and Peutz-Jeghers syndrome (PJS) remains limited. METHODS: We conducted single-cell RNA sequencing and multiplexed immunohistochemistry (mIHC) analyses on both normal colonic tissue and different types of colonic polyps obtained from paediatric patients. RESULTS: We identified both shared and disease-specific cell subsets and expression patterns that played important roles in shaping the unique cellular microenvironments observed in each polyp subtype. As such, increased myeloid, endothelial and epithelial cells were the most prominent features of SJP, JPS and PJS polyps, respectively. Noticeably, memory B cells were increased, and a cluster of epithelial-mesenchymal transition (EMT)-like colonocytes existed across all polyp subtypes. Abundant neutrophil infiltration was observed in SJP polyps, while CX3CR1hi CD8+ T cells and regulatory T cells (Tregs) were predominant in SJP and JPS polyps, while GZMAhi natural killer T cells were predominant in PJS polyps. Compared with normal colonic tissues, myeloid cells exhibited specific induction of genes involved in chemotaxis and interferon-related pathways in SJP polyps, whereas fibroblasts in JPS polyps had upregulation of myofiber-associated genes and epithelial cells in PJS polyps exhibited induction of a series of nutrient absorption-related genes. In addition, the TNF-α response was uniformly upregulated in most cell subsets across all polyp subtypes, while endothelial cells and fibroblasts separately showed upregulated cell adhesion and EMT signalling in SJP and JPS polyps. Cell-cell interaction network analysis showed markedly enhanced intercellular communication, such as TNF, VEGF, CXCL and collagen signalling networks, among most cell subsets in polyps, especially SJP and JPS polyps. CONCLUSION: These findings strengthen our understanding of the heterogeneous cellular microenvironment of polyp subtypes and identify potential therapeutic approaches to reduce the recurrence of polyps in children.

Antitumor effects of polysaccharides from medicinal lower plants: A review.

Cancer is one of the leading causes of death worldwide, yet the drugs currently approved for cancer treatment are associated with significant side effects, making it urgent to develop alternative drugs with low side effects. Polysaccharides are natural polymers with ketone or aldehyde groups, which are widely found in plants and have various biological activities such as immunomodulation, antitumor and hypolipidemic. The lower plants have attracted much attention for their outstanding anticancer effects, and many studies have shown that medicinal lower plant polysaccharides (MLPPs) have antitumor activity against various cancers and are promising alternatives with potential development in the food and pharmaceutical fields. Therefore, this review describes the structure and mechanism of action of MLPPs with antitumor activity. In addition, the application of MLPPs in cancer treatment is discussed, and the future development of MLPPs is explored.

Deep polyp image enhancement using region of interest with paired supervision.

Endoscopic medical imaging in complex curved intestinal structures are prone to uneven illumination, low contrast and lack of texture information. These problems may lead to diagnostic challenges. This paper described the first supervised deep learning based image fusion framework to enable the polyp region highlight through a global image enhancement and a local region of interest (ROI) with paired supervision. Firstly, we conducted a dual attention based network in global image enhancement. The Detail Attention Maps was used to preserve more image details and the Luminance Attention Maps was used to adjust the global illumination of the image. Secondly, we adopted the advanced polyp segmentation network ACSNet to obtain the accurate mask image of lesion region in local ROI acquisition. Finally, a new image fusion strategy was proposed to realize the local enhancement effect of polyp image. Experimental results show that our method can highlight the local details of the lesion area better and reach the optimal comprehensive performance with comparing with 16 traditional and state-of-the-art enhancement algorithms. And 8 doctors and 12 medical students were asked to evaluate our method for assisting clinical diagnosis and treatment effectively. Furthermore, the first paired image dataset LHI was constructed, which will be made available as an open source to research communities.

Spectrum-Effect Relationship in Chinese Herbal Medicine: Current Status and Future Perspectives.

The quality of Chinese herbal medicine (CHM) directly impacts clinical efficacy and safety. Fingerprint technology is an internationally recognized method for evaluating the quality of CHM. However, the existing quality evaluation models based on fingerprint technology have blocked the ability to assess the internal quality of CHM and cannot comprehensively reflect the correlation between pharmacodynamic information and active constituents. Through mathematical methods, a connection between the "Spectrum" (fingerprint) and the "Effect" (pharmacodynamic data) was established to conduct a spectrum-effect relationship (SER) of CHM to unravel the active component information associated with the pharmacodynamic activity. Consequently, SER can efficiently address the limitations of the segmentation of chemical components and pharmacodynamic effect in CHM and further improve the quality evaluation of CHM. This review focuses on the recent research progress of SER in the field of CHM, including the establishment of fingerprint, the selection of data analysis methods, and their recent applications in the field of CHM. Various advanced fingerprint techniques are introduced, followed by the data analysis methods used in recent years are summarized. Finally, the applications of SER based on different research subjects are described in detail. In addition, the advantages of combining SER with other data are discussed through practical applications, and the research on SER is summarized and prospected. This review proves the validity and development potential of the SER and provides a reference for the development and application of quality evaluation methods for CHM.

Expanding the mutational spectrum of ZTTK syndrome: A de novo variant with global developmental delay and malnutrition in a Chinese patient.

BACKGROUND: Zhu-Tokita-Takenouchi-Kim (ZTTK, OMIM 617140) syndrome is a severe multisystem developmental disorder characterized by intellectual disability, developmental delay, cortical malformations, epilepsy, visual problems, musculoskeletal abnormalities, and congenital malformations. ZTTK syndrome is caused by a heterozygous pathogenic variant of the SON gene (NM_138927) at chromosome 21q22.1. The purpose of this study was to investigate the pathogenesis of a 6-month-old Chinese child who exhibited global developmental delay, muscle weakness, malnutrition, weight loss, and strabismus, brain abnormality, immunological system abnormalities. METHODS: The little girl was tested for medical exome sequencing (MES) and mtDNA sequencing in trio. And, the mutation was validated by Sanger sequencing. RESULTS: A novel de novo frameshift variant, c.1845_1870del26 (p.G616Sfs*61), in the SON gene was found in the proband. CONCLUSION: We described a 6-month-old Chinese child with global developmental delay caused by pathogenic de novo mutation c.1845_1870del26 (p.G616Sfs*61) in the SON. Apart from a founder mutation, we reviewed the phenotypic abnormalities and genotypes in 79 individuals. The data showed that global developmental delay is accompanied by other system disorders. Our findings expanded the mutational spectrum of ZTTK syndrome and provide genetic counseling of baby with global developmental delay.

Lane-GAN: A Robust Lane Detection Network for Driver Assistance System in High Speed and Complex Road Conditions.

Lane detection is an important and challenging part of autonomous driver assistance systems and other advanced assistance systems. The presence of road potholes and obstacles, complex road environments (illumination, occlusion, etc.) are ubiquitous, will cause the blur of images, which is captured by the vision perception system in the lane detection task. To improve the lane detection accuracy of blurred images, a network (Lane-GAN) for lane line detection is proposed in the paper, which is robust to blurred images. First, real and complex blur kernels are simulated to construct a blurred image dataset, and the improved GAN network is used to reinforce the lane features of the blurred image, and finally the feature information is further enriched with a recurrent feature transfer aggregator. Extensive experimental results demonstrate that the proposed network can get robust detection results in complex environments, especially for blurred lane lines. Compared with the SOTA detector, the proposed detector achieves a larger gain. The proposed method can enhance the lane detail features of the blurred image, improving the detection accuracy of the blurred lane effectively, in the driver assistance system in high speed and complex road conditions.

A low-light image enhancement method with brightness balance and detail preservation.

This paper proposes a new method for low-light image enhancement with balancing image brightness and preserving image details, this method can improve the brightness and contrast of low-light images while maintaining image details. Traditional histogram equalization methods often lead to excessive enhancement and loss of details, thereby resulting in an unclear and unnatural appearance. In this method, the image is processed bidirectionally. On the one hand, the image is processed by double histogram equalization with double automatic platform method based on improved cuckoo search (CS) algorithm, where the image histogram is segmented firstly, and the platform limit is selected according to the histogram statistics and improved CS technology. Then, the sub-histograms are clipped by two platforms and carried out the histogram equalization respectively. Finally, an image with balanced brightness and good contrast can be obtained. On the other hand, the main structure of the image is extracted based on the total variation model, and the image mask with all the texture details is made by removing the main structure of the image. Eventually, the final enhanced image is obtained by adding the mask with texture details to the image with balanced brightness and good contrast. Compared with the existing methods, the proposed algorithm significantly enhances the visual effect of the low-light images, based on human subjective evaluation and objective evaluation indices. Experimental results show that the proposed method in this paper is better than the existing methods.

Efficient adaptive feature aggregation network for low-light image enhancement.

Existing learning-based methods for low-light image enhancement contain a large number of redundant features, the enhanced images lack detail and have strong noises. Some methods try to combine the pyramid structure to learn features from coarse to fine, but the inconsistency of the pyramid structure leads to luminance, color and texture deviations in the enhanced images. In addition, these methods are usually computationally complex and require high computational resource requirements. In this paper, we propose an efficient adaptive feature aggregation network (EAANet) for low-light image enhancement. Our model adopts a pyramid structure and includes multiple multi-scale feature aggregation block (MFAB) and one adaptive feature aggregation block (AFAB). MFAB is proposed to be embedded into each layer of the pyramid structure to fully extract features and reduce redundant features, while the AFAB is proposed for overcome the inconsistency of the pyramid structure. EAANet is very lightweight, with low device requirements and a quick running time. We conducted an extensive comparison with some state-of-the-art methods in terms of PSNR, SSIM, parameters, computations and running time on LOL and MIT5K datasets, and the experiments show that the proposed method has significant advantages in terms of comprehensive performance. The proposed method reconstructs images with richer color and texture, and the noises is effectively suppressed.

A retrospective study on the characteristics of renal pathological grades in HSPN children with mild to moderate proteinuria.

Objective: To investigate the characteristics of renal pathological grades in Henoch-Schönlein purpura nephritis (HSPN) children with mild to moderate proteinuria and the correlation between pathological grade and severity of proteinuria among this population. Methods: HSPN children who were presented with mild (150 mg <24 h urinary protein <25 mg/kg) to moderate (25 mg/kg ≤24 h urinary protein <50 mg/kg) proteinuria and performed renal biopsy without steroid ± immunosuppressant treatment in the Second Xiangya Hospital between January 2010 and March 2021 were involved. We retrospectively analyzed the correlation between age, disease course, degree of proteinuria, type of immunoglobulin deposits, C3 deposits in glomeruli and renal pathological grade. Results: (1) 72 HSPN children including 46 boys and 26 girls were included, with a mean age of onset of 9.01 ± 2.65 years old. The majority of these patients (62.5%) had a disease course between 1 week to 1 month. 51 patients presented with mild proteinuria and 21 patients with moderate proteinuria. (2) Renal biopsy results showed that ISKDC Grade IIIa were both predominant in mild proteinuria group (25, 49%) and moderate proteinuria group (11, 52.4%). 32 patients had grade II (44.4%), 2 had grade IIIb (2.8%), 1 had grade IV (1.4%), and 1 had grade VI (1.4%). There was no correlation between age, disease course and renal pathological grade (p > 0.05). (3) In patients with mild proteinuria (n = 51), 27 (52.9%) HSPN children had a pathological grade ≥ grade III. In patients with moderate proteinuria (n = 21), 13 (61.9%) HSPN children had grade ≥ III. There was no significant difference in the proportion of renal pathological grade between the 2 groups (p > 0.05). (4) There was no significant correlation between glomerular C3 deposits or immunoglobulin deposit types and renal pathological grade (p = 0.776 and p = 0.056 respectively). Conclusion: In HSPN children with mild to moderate proteinuria, longer disease course or heavier urinary protein level is not completely parallel with higher renal pathological grade. ISKDC grade IIIa is the most common pathological grade. Clinicians should pay great attention to the renal injury in patients with mild to moderate proteinuria.

Predictability of Urinary CD80 in the Relapse of Primary Nephrotic Syndrome.

PURPOSE: The current study is aimed at investigating whether urinary CD80 is reliable to predict the recurrence of pediatric PNS. MATERIALS AND METHODS: A total of 128 children, 105 males and 23 females, were enrolled in this study. Urinary samples were collected from SSNS and SRNS patients and 25 healthy children as controls. Urinary CD80 was measured by ELISA and adjusted for urinary creatinine excretion. RESULTS: Urinary CD80 in relapse stage of SSNS was significantly higher, and the urinary CD80 of paired relapse and remission stages of each SSNS patient were also significantly different. No significant difference was found between the urinary CD80 in SRNS relapse group, SRNS remission group, and the control group. Similarly, there was no significant difference between frequent SSNS and not frequent SSNS in remission group, as well as the relapse group. There is no correlation between urinary CD80 and 24-hour urinary protein. CONCLUSION: The increase of urinary CD80 was closely associated with the relapse of SSNS but was not related to the frequency of relapse. The urinary CD80 changes of concentration were reliable to predict the recurrence of SSNS. However, it cannot be used to predicate the frequent recurrence of PNS.