D2D Social Selection Relay Algorithm Combined with Auction Principle.

In a D2D (device-to-device) communication system, this paper proposes a relay selection strategy based on social perception. Firstly, the social threshold is introduced into the D2D relay network to screen and filter the potential relay users, thus effectively reducing the detection cost. Then, an auction algorithm is used to motivate the relay users to increase their transmission power. The simulation results show that the algorithm not only improves the throughput but also reduces the probability of a system outage.

MASSD: Multi-scale attention single shot detector for surgical instruments.

Surgical instrument detection is a significant task in computer-aided minimal invasive surgery for providing real-time feedback to physicians, evaluating surgical skills, and developing a training plan for surgeons. In this study, a multi-scale attention single detector is designed for surgical instruments. In the field of object detection, accurate detection of small objects is always a challenging task. We propose an innovative feature fusion technique aimed at small surgical instrument detection. First, the attention map is created from high-level features to act on the low-level features and enrich the semantic information of the low-level features. The original and processed features are then fused by skip connection. Finally, multi-scale feature maps are created to predict fusion features. The experiments on the ATLAS Dione dataset yielded results with a detection time of 0.066 s per frame and a mean average precision of 90.08%. Our proposed feature fusion module can obtain more semantic information for low-level features and significantly enhance the performance of small surgical instrument detection.

A Holistically-Nested U-Net: Surgical Instrument Segmentation Based on Convolutional Neural Network.

Surgical instrument segmentation is an essential task in the domain of computer-assisted surgical system. It is critical to increase the context-awareness of surgeons during the operation. We propose a new model based on the U-Net architecture for surgical instrument segmentation, which aggregates multi-scale feature maps and has cascaded dilated convolution layers. The model adopts dense upsampling convolution instead of deconvolution for upsampling. We set the side loss function on each side-output layer. The loss function includes an output loss function and all side loss functions to supervise the training of each layer. To validate our model, we compare our proposed model with advanced architecture U-Net in the dataset consisting of laparoscopy images from multiple surgical operations. Experiment results demonstrate that our model achieves good performance.

Clinical Significance of Serum CA125, CA19-9, CA72-4, and Fibrinogen-to-Lymphocyte Ratio in Gastric Cancer With Peritoneal Dissemination.

Background: Relevant serum tumor markers have been indicated to be associated with peritoneal dissemination (PD) of gastric cancer (GC). Fibrinogen has been shown to play an important role in the systemic inflammatory response (SIR) and in tumor progression. However, the clinical significance of the fibrinogen-to-lymphocyte ratio (FLR) in GC with PD has not been studied. Methods: The clinical data of 391 patients with GC were collected, including 86 cases of PD. Then, 1:3 matching was performed by propensity score matching (PSM), and the clinical data of the matched 344 patients were analyzed by univariate and multivariate conditional logistic regression. Classification tree analysis was used to obtain the decision rules and a random forest algorithm to extract the important risk factors of PD in GC. A nomogram model for risk assessment of PD in GC was established by using the rms package of R software. Results: Univariate analysis showed that the factors related to PD in GC were: carbohydrate antigen (CA) 125 (P < 0.0001), CA19-9 (P < 0.0001), CA72-4 (P < 0.0001), FLR (P < 0.0001), neutrophil-to-lymphocyte ratio (NLR) (P < 0.0001), albumin-to- lymphocyte ratio (ALR) (P < 0.0001), platelet-to-lymphocyte ratio (PLR) (P = 0.013), and carcinoembryonic antigen (CEA) (P = 0.031). Conditional logistic regression found that CA125 (OR: 1.046; P < 0.0001), CA19-9 (OR: 1.002; P < 0.0001), and FLR (OR: 1.266; P = 0.024) were independent risk factors for GC with PD. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of the decision rules for detecting PD of GC were 89.5, 77.4, 94.0, 82.8, and 91.8%, respectively. According to the important variables identified by the classification tree and random forest algorithm, the risk assessment model of PD in GC was established. The accuracy, sensitivity, and specificity of the model were 91, 89.5, and 79.5%, respectively. Conclusion: CA125 > 17.3 U/ml, CA19-9 > 27.315 U/ml, and FLR > 2.555 were the risk factors for GC with PD. The decision rules and nomogram model constructed by CA125, CA19-9, CA72-4, and FLR can correctly predict the risk of PD in GC.

The application of polypropylene mesh for testicular prosthesis in surgical castration for patients with prostate cancer.

BACKGROUND: To explore whether a polypropylene mesh is suitable for application as a new material for testicular prostheses. METHODS: The data of 65 patients with advanced prostate cancer who underwent surgical castration in hospital were collected and analyzed. Patients who preferred to undergo traditional orchidectomy (n = 16) were assigned to the control group, and patients who underwent subcapsular orchiectomy plus implantation of a polypropylene mesh testicular prosthesis (n = 49) were assigned to the experimental group. The presence of hematoma, infection, and other complications in patients in these two groups were investigated at 3 and 12 months following the surgery. The patients were also followed up using a self-designed testicular castration satisfaction questionnaire. RESULTS: A higher score indicated greater satisfaction. The mean score was 15.33 ± 2.85 in the experimental group and 4.63 ± 1.45 in the control group at 3 months after the surgery. The mean score was 14.92 ± 1.74 in the experimental group and 4.25 ± 1.61 in the control group at 12 months after the surgery. The difference between the two groups was statistically significant at the two time points (P < 0.01). CONCLUSIONS: Compared with orchidectomy alone, patients were more satisfied with subcapsular orchiectomy plus the implantation of a polypropylene mesh testicular prosthesis for the treatment of advanced prostate cancer. Furthermore, the polypropylene mesh testicular prosthesis maintained its original character over the duration of the study, with a good long-term effect. Thus, implantation of a polypropylene mesh testicular prosthesis is indicated to be safe and effective, and polypropylene mesh is potentially useful as a new material for testicular prostheses.

[Polypropylene mesh for testicular prothesis implantation: A report of 57 cases].

OBJECTIVE: To search for an optimum method for testicular prothesis implantation in the treatment of testis loss. METHODS: We retrospectively analyzed the surgical methods and outcomes of 53 cases of terminal prostate cancer and 4 cases of unilateral testicular torsion treated by implantation of testicular prothesis with the polypropylene mesh. RESULTS: The 57 male patients all received testicular prothesis with the polypropylene mesh. All the patients were satisfied with the appearance and size of the scrotum after surgery. No scrotal hematoma, prosthesis infection, or autoimmune disease occurred postoperatively. CONCLUSION: Testis loss is not a rare condition clinically, for the treatment of which surgical implantation of testicular prothesis with the polypropylene mesh can achieve both a fine tissue compatibility and a desirable scrotal appearance.

[Treatment of erectile dysfunction by implantation of domestic made three-piece inflatable penile prosthesis, a retrospective study of 29 cases].

OBJECTIVE: To evaluate the effect of implantation of domestic made three-piece inflatable penile prosthesis on erectile dysfunction (ED). METHODS: Domestic made three-piece inflatable penile prosthesis were implanted through an incision at the border of penis and scrotum on 29 patients with ED refractory to non-operative treatment, among which 23 being with neurogenic ED, including 18 paraplegia cases and 5 cases of traumatic injury of nervi erigentes; 4 cases with ED caused by arteriovenous fistula; I case with ED caused by fibrosis of corpus cavernosum, and 1 case with ED caused by Klinefelter's syndrome. Follow-up was conducted for 3 - 36 months to survey the clinical effect. RESULTS: Operation was successfully performed upon all 29 patients. Follow-up after operation lasted 3 - 36 months, 18 months on average. Fluid exudation of penile prosthesis and localized infection occurred in 1 patient and mechanic complication occurred in 2 patients. Maintained sexual intercourse rate was 28/29. 3 ED patients with primary arteriovenous fistula made their spouses pregnant after treatment. CONCLUSION: With excellent covertness and at low cost, implantation of domestic made three-piece inflatable penile prosthesis is effective and well accepted by ED patients.