Hierarchical fusion detection algorithm for sleep spindle detection.

Background: Sleep spindles are a vital sign implying that human beings have entered the second stage of sleep. In addition, they can effectively reflect a person's learning and memory ability, and clinical research has shown that their quantity and density are crucial markers of brain function. The "gold standard" of spindle detection is based on expert experience; however, the detection cost is high, and the detection time is long. Additionally, the accuracy of detection is influenced by subjectivity. Methods: To improve detection accuracy and speed, reduce the cost, and improve efficiency, this paper proposes a layered spindle detection algorithm. The first layer used the Morlet wavelet and RMS method to detect spindles, and the second layer employed an improved k-means algorithm to improve spindle detection efficiency. The fusion algorithm was compared with other spindle detection algorithms to prove its effectiveness. Results: The hierarchical fusion spindle detection algorithm showed good performance stability, and the fluctuation range of detection accuracy was minimal. The average value of precision was 91.6%, at least five percentage points higher than other methods. The average value of recall could reach 89.1%, and the average value of specificity was close to 95%. The mean values of accuracy and F1-score in the subject sample data were 90.4 and 90.3%, respectively. Compared with other methods, the method proposed in this paper achieved significant improvement in terms of precision, recall, specificity, accuracy, and F1-score. Conclusion: A spindle detection method with high steady-state accuracy and fast detection speed is proposed, which combines the Morlet wavelet with window RMS and an improved k-means algorithm. This method provides a powerful tool for the automatic detection of spindles and improves the efficiency of spindle detection. Through simulation experiments, the sampled data were analyzed and verified to prove the feasibility and effectiveness of this method.

Laparoscopic vs. open anatomical hepatectomy for intrahepatic cholangiocarcinoma: A retrospective cohort study.

Background: Intrahepatic cholangiocarcinoma is a highly malignant and invasive cancer originating from biliary epithelial cells. The current study was designed to evaluate the feasibility, safety, and clinical outcomes of laparoscopic anatomical hepatectomy in patients with intrahepatic cholangiocarcinoma. Methods: After screening, 95 patients who underwent anatomical hepatectomy for intrahepatic cholangiocarcinoma at our center were enrolled and divided into two groups according to the surgical approach; the baseline characteristics, pathological findings, surgical outcomes, and long-term outcomes were compared. Moreover, univariate and multivariate analyses were performed to identify independent prognostic factors for overall survival (OS) and disease-free survival (DFS). Results: There were no significant differences in baseline characteristics or pathological findings between the two groups. Regarding short-term outcomes, the intraoperative blood loss, incision length, and length of postoperative hospital stay were more favorable in the laparoscopic anatomical hepatectomy group than the open anatomical hepatectomy group (P < 0.05). The two groups differed significantly in the extent of liver resection, with a lower lymph node dissection rate and lymph node yield in the laparoscopic anatomical hepatectomy group (P < 0.05). Furthermore, the postoperative complication rate was similar in the two groups (P > 0.05). The median postoperative follow-up times were 10.7 and 13.8 months in the laparoscopic anatomical hepatectomy and open anatomical hepatectomy groups, respectively. Regarding the long-term follow-up results, OS and DFS were similar in the two groups (P > 0.05). On multivariate analysis, the independent prognostic factors for OS were CA-199, CEA, HGB, tumor diameter, and T stage, and those for DFS were CA-199 (P < 0.05), and T stage (P < 0.05). Conclusion: laparoscopic anatomical hepatectomy for intrahepatic cholangiocarcinoma is safe and feasible when performed by experienced surgeons. Compared with open anatomical hepatectomy, laparoscopic anatomical hepatectomy provides better short-term outcomes and a comparable long-term prognosis.

Preparation and mechanical behavior of the acellular porcine common bile duct and its immunogenicity in vivo.

The current clinical treatments for complications caused by hepatobiliary surgery still have some inevitable weaknesses. This study aimed to prepare the acellular porcine common bile duct (APCBD) for repairing biliary defects and damage. The porcine common bile duct was decellularized by the freeze-thaw method combined with nuclease treatment, and the efficacy of acellularization was confirmed by the DNA quantification and histological structure. The results showed that the residual DNA content was reduced from 854.67 ± 9.71 ng/mg to 5.43 ± 0.85 ng/mg, and the natural structure and shape of the bile duct were well preserved. The biomechanical properties such as the tensile strength, elastic modulus, and elongation-at-break of the APCBD in the transverse and longitudinal direction indicated that the APCBD meets the requirements of the biomechanical strength in replacement. In addition, the results of the immunotoxicity test showed there was no significant difference in the body weights, organ coefficient, hematology, and immune histology between the experimental groups (three subgroups) and the negative control group, which demonstrated the prepared APCBD had no obvious toxicity to the immune system in vivo and might be a suitable biomaterial for the bile duct repairing.

Enhanced recovery after surgery protocols in patients undergoing liver transplantation: A retrospective comparative cohort study.

INTRODUCTION: Enhanced Recovery after Surgery (ERAS) is a multimodal pathway to overcome the deleterious effect of perioperative stress, and has been applied to different surgeries including liver resection surgery. Explorative studies have shown the safety of some ERAS measures in liver transplantation patients, although no consensus was reached. This study aimed to evaluate the effect of ERAS protocols compared with conventional care in patients undergoing liver transplantation. METHOD: All patients (aged 16-70) undergoing liver transplantation for their first time in our centers between January 2016 and July 2019 were retrospectively reviewed and included into this cohort study. They were divided into ERAS group and conventional group depending on the perioperative protocols. Operative time, anhepatic phase time, intraoperative blood loss, intraoperative hypothermia, Surgical Intensive Care Unit (SICU) stay, postoperative complications, pain score, postoperative hospital stay, and mortality were compared between the two groups. RESULTS: A total of 40 and 53 patients were included in the ERAS and conventional groups, respectively. The ERAS group had shorter SICU stay (2 vs. 4 days, p < 0.001) and postoperative hospital stay (14.5 vs. 16 days, p < 0.001) compared with the conventional group. Intraoperative hypothermia rate, postoperative pulmonary complications rate, and postoperative pain score were lower in the ERAS group (p < 0.05). There were no differences in operative time, anhepatic phase time, blood loss, mortality, reintubation, lower extremity venous thrombosis and other complications incidence between the two groups. CONCLUSION: ERAS procedures effectively improved the patients' recovery, alleviated the suffering and pulmonary complications, and reduced SICU stay and postoperative hospital stay, without increasing incidence of other complications or reintubation. As a safe and feasible choice, ERAS protocols may also have some socioeconomic advantages, which should be addressed in further prospective cohort or clinical trial studies.

MicroRNA-138 targets SP1 to inhibit the proliferation, migration and invasion of hepatocellular carcinoma cells.

The identification of microRNAs (miRNAs/miRs) has enabled the improved understanding of the carcinogenesis and progression of hepatocellular carcinoma (HCC). miRNAs are small non-coding RNAs comprised of 19-24 nucleotides that regulate the expression of target genes. In the present study, miR-138 was demonstrated to be downregulated in human HCC tissues and cell lines. Restoration of miR-138 expression repressed the proliferation, migration and invasion of HCC cells. Furthermore, specificity protein 1 (SP1) was identified as a target gene of miR-138 in HCC using bioinformatics analysis, luciferase reporter assay, reverse transcription-quantitative polymerase chain reaction and western blot analysis. Knockdown of SP1 produced similar suppressive effects to those induced by miR-138 overexpression in HCC cells. These results indicate that miR-138 targeted SP1 to repress the growth, migration and invasion of HCC cells, and may therefore represent a therapeutic target in human HCC.

Knockdown of PFTAIRE Protein Kinase 1 (PFTK1) Inhibits Proliferation, Invasion, and EMT in Colon Cancer Cells.

PFTK1 is a member of the cyclin-dependent kinase (CDK) family and is upregulated in many types of tumors. However, its expression and role in colon cancer remain unclear. In this study, we aimed to investigate the expression and function of PFTK1 in colon cancer. Our results showed that PFTK1 was highly expressed in colon cancer cell lines. The in vitro experiments demonstrated that knockdown of PFTK1 inhibited the proliferation, migration, and invasion of colon cancer cells as well as the epithelial-to-mesenchymal transition (EMT) progress. Furthermore, knockdown of PFTK1 suppressed the expression of Shh as well as Smo, Ptc, and Gli-1 in colon cancer cells. Taken together, these results suggest that knockdown of PFTK1 inhibited the proliferation and invasion of colon cancer cells as well as the EMT progress by suppressing the Sonic hedgehog signaling pathway. Therefore, these findings reveal that PFTK1 may be a potential therapeutic target for the treatment of colon cancer.

Influence of the time of hepatocyte infusion on liver transplantation outcome.

BACKGROUND/AIMS: Donor-derived hepatocytes infused into recipient rats before liver transplantation can improve the results of liver transplantation in rats. However, the appropriate time when the hepatocytes were infused before transplantation is needed to be explored. METHODOLOGY: All the rats were randomly divided into five groups, the recipient rats were infused with donor-derived hepatocytes at different points of time before transplantation (Group A received the injection one week prior to the transplantation; group B, two weeks prior to the transplantation; group C, three weeks; and group D, four weeks; the control group did not receive hepatocytes infusion). The alanine aminotransferase (ALT), alkaline phosphatase (ALP), and albumin (ALB) levels were tested and the survival time was recorded. RESULTS: The survival times of recipient rats in group B was the longest among the five groups. The level of serum ALT and ALP in group B were the lowest and the level of ALB was the highest among the five groups. CONCLUSIONS: In order to achieve the best result following liver transplantation, infusion of hepatocytes two weeks before liver transplantation was determined to be the optimal time.