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This paper provides a comprehensive review of deep learning models for ischemic stroke lesion segmentation in medical images. Ischemic stroke is a severe neurological disease and a leading cause of death and disability worldwide. Accurate segmentation of stroke lesions in medical images such as MRI and CT scans is crucial for diagnosis, treatment planning and prognosis. This paper first introduces common imaging modalities used for stroke diagnosis, discussing their capabilities in imaging lesions at different disease stages from the acute to chronic stage. It then reviews three major public benchmark datasets for evaluating stroke segmentation algorithms: ATLAS, ISLES and AISD, highlighting their key characteristics. The paper proceeds to provide an overview of foundational deep learning architectures for medical image segmentation, including CNN-based and transformer-based models. It summarizes recent innovations in adapting these architectures to the task of stroke lesion segmentation across the three datasets, analyzing their motivations, modifications and results. A survey of loss functions and data augmentations employed for this task is also included. The paper discusses various aspects related to stroke segmentation tasks, including prior knowledge, small lesions, and multimodal fusion, and then concludes by outlining promising future research directions. Overall, this comprehensive review covers critical technical developments in the field to support continued progress in automated stroke lesion segmentation.
Subject(s)
Deep Learning , Ischemic Stroke , Humans , Ischemic Stroke/diagnostic imaging , Magnetic Resonance Imaging/methods , Tomography, X-Ray Computed/methods , Image Processing, Computer-Assisted/methods , Image Interpretation, Computer-Assisted/methods , Stroke/diagnostic imaging , AlgorithmsABSTRACT
BACKGROUND AND OBJECTIVE: Recurrent major depressive disorder (rMDD) has a high recurrence rate, and symptoms often worsen with each episode. Classifying rMDD using functional magnetic resonance imaging (fMRI) can enhance understanding of brain activity and aid diagnosis and treatment of this disorder. METHODS: We developed a Residual Denoising Autoencoder (Res-DAE) framework for the classification of rMDD. The functional connectivity (FC) was extracted from fMRI data as features. The framework addresses site heterogeneity by employing the Combat method to harmonize feature distribution differences. A feature selection method based on Fisher scores was used to reduce redundant information in the features. A data augmentation strategy using a Synthetic Minority Over-sampling Technique algorithm based on Extended Frobenius Norm measure was incorporated to increase the sample size. Furthermore, a residual module was integrated into the autoencoder network to preserve important features and improve the classification accuracy. RESULTS: We tested our framework on a large-scale, multisite fMRI dataset, which includes 189 rMDD patients and 427 healthy controls. The Res-DAE achieved an average accuracy of 75.1 % (sensitivity = 69 %, specificity = 77.8 %) in cross-validation, thereby outperforming comparison methods. In a larger dataset that also includes first-episode depression (comprising 832 MDD patients and 779 healthy controls), the accuracy reached 70 %. CONCLUSIONS: We proposed a deep learning framework that can effectively classify rMDD and 33 identify the altered FC associated with rMDD. Our study may reveal changes in brain function 34 associated with rMDD and provide assistance for the diagnosis and treatment of rMDD.
Subject(s)
Depressive Disorder, Major , Humans , Depressive Disorder, Major/diagnostic imaging , Magnetic Resonance Imaging/methods , Brain Mapping , Algorithms , Brain/diagnostic imagingABSTRACT
OBJECTIVE@#To analyze the results of activated partial thromboplastin time (APTT) mixing test in coagulation factor Ⅷ inhibitor-positive hemophilia patients, so as to increase the value of APTT mixing test in the screen of factor Ⅷ inhibitor.@*METHODS@#Eighty plasmas samples with different titers of coagulation factor Ⅷ inhibitors had been collected and diluted for routine immediate APTT mixing test and at 37 ℃ 2 hours incubation APTT mixing test. Fifteen samples were selected for immediate and normal temperature incubation for 15 min, 30min, 1 hour, 2 hours and 37 ℃ for 30 min, 1 hour, 2 hours APTT mixing test.@*RESULTS@#The results of APTT mixing test were significantly correlated with the titers of coagulation factor Ⅷ inhibitors. The ROC curve result showed that the best diagnostic cut-off value for 2 hours incubation APTT mixing test at 37 ℃ to determine the presence or absence of coagulation factor Ⅷ inhibitors was 43.8 s (sensitivity and specificity was 85.90% and 100%, respectively), while the best diagnostic cut-off value for distinguishing high-titer and low-titer Ⅷ inhibitors was 52.4 s (sensitivity and specificity was 98.18% and 95.65%, respectively). The critical coagulation factor Ⅷ inhibitor titer that could not be corrected by immediate APTT was 5.14 BU/ml, while that could not be corrected by 37 ℃ 2 hours incubation APTT was 1.31 BU/ml. Paired samples t -test was performed on the APTT mixing test results at different times and temperatures, and the differences were statistically significant (P < 0.05).@*CONCLUSIONS@#The APTT mixing test can be used as a screening index for coagulation factor Ⅷ inhibitors. APTT mixing test result shows a significant time-temperature dependence with lower titers of coagulation factor Ⅷ inhibitor. Patients with hemophilia who cannot be corrected by immediate APTT mixing test should be alert to the possibility of high titer of coagulation factor Ⅷ.
Subject(s)
Humans , Factor VIII , Hemophilia A/diagnosis , Blood Coagulation Tests/methods , Partial Thromboplastin Time , Blood Coagulation FactorsABSTRACT
Objective@#The Chinese version of the Multidimensional Bullying Victimization Scale (MBVS) was revised, and its reliability, validity and cross gender equivalence were tested in Chinese adolescents.@*Methods@#A total of 2 279 adolescents were investigated by using convenient cluster sampling method from April to May 2021, 1 500 adolescents were followed to complete the retest of Chinese version of MBVS after 4-6 weeks. Olweus Bully/Victim Questionnaire Victim (OBVQ-V) and Center for Epidemiologic Studies Depression Scale (CES-D) were used as the criterion related validity instrument.@*Results@#Exploratory factor analysis extracted 4 factors with a cumulative variance interpretation rate of 58.34%. Results of CFA supports the hypothesis of 4 factor model( χ 2/df=8.64, CFI=0.93, TLI=0.92, RMSEA =0.06), and the 4 dimensions included direct bullying, indirect bullying, evaluative bullying and relationship bullying. The correlation coefficient between MBVS and OBVQ-V was 0.59, between MBVS and CES-D was 0.32. The internal consistency reliability was 0.92 and the test retest reliability was 0.72. The cross gender equivalence hypothesis of the scale was valid.@*Conclusion@#The Chinese version of MBVS has good reliability and validity, as well as gender equivalence and could be recommended for adolescent bullying screening.
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Objective:To observe the effects of Scutellariae Radix-Hedyotidis Herba on the proliferation of human lung adenocarcinoma A549 cells and the expression of interleukin-6(IL-6), phosphatidylinositol 3-kinase (PI3K),protein kinase B (Akt), p-protein kinase B (p-Akt), mechanistic target of rapamycin (mTOR), hypoxia-inducible factor-1<italic>α </italic>(HIF-1<italic>α</italic>), and Cyclin D<sub>1</sub> at the cellular level, and to explore their molecular mechanism. Method:Following the set-up of the blank group (complete medium), low-, moderate-,and high-dose (20, 40, and 60 mg·L<sup>-1</sup>) Scutellariae Radix-Hedyotidis Herba groups, and low-, moderate-, and high-dose (5, 10, and 20 mg·L<sup>-1</sup>) cisplatin groups, the cell were treated with the corresponding drugs for 24, 48, and 72 h for detecting their viability by tetrazolium bromide (MTT) colorimetry. A549 cells were then divided into the blank group, Scutellariae Radix-Hedyotidis Herba group, cisplatin group, and combined medication group and intervened with the<sup> </sup>complete medium, 40 mg·L<sup>-1 </sup>Scutellariae Radix-Hedyotidis Herba, 10 mg·L<sup>-1</sup> cisplatin, and 40 mg·L<sup>-1 </sup>Scutellariae Radix-Hedyotidis Herba + 10 mg·L<sup>-1 </sup>cisplatin, respectively, for 24, 48 and 72 h, followed by the measurement of inhibitory effects against the proliferation of A549 cells in each experimental group. The level of IL-6 in cell culture supernatant was determined by enzyme-linked immunosorbent assay (ELISA) after 72 h. The mRNA expression levels of HIF-1<italic>α</italic> and Cyclin D<sub>1</sub> in each group were assayed by real-time polymerase chain reaction (Real-time PCR), and the protein expression levels of PI3K, Akt, p-Akt, mTOR, HIF-1<italic>α</italic>, and Cyclin D<sub>1</sub> by Western blot. Result:After 24 h intervention, Scutellariae Radix-Hedyotidis Herba did not significantly inhibit the proliferation of A549 cells. However, 48 h later, the inhibitory effect in Scutellariae Radix-Hedyotidis Herba groups were significantly enhanced in comparison with that in the blank group (<italic>P</italic><0.05), exhibiting a time-dependent response. After 72 h of action, no significant change was present in the inhibitory effect of each Scutellariae Radix-Hedyotidis Herba group, so the optimal concentration of Scutellariae Radix-Hedyotidis Herba was set at 40 mg·L<sup>-1</sup> for follow-up experiments. As demonstrated by the comparison with the blank group, cisplatin at each concentration inhibited the cell proliferation in a time-dependent manner (<italic>P<</italic>0.05). Considering the cell survival rate, the best concentration of cisplatin was set at 10 mg·L<sup>-1</sup>. Compared with the blank group, Scutellariae Radix-Hedyotidis Herba combined with cisplatin remarkably inhibited the proliferation of A549 cells in a time-dependent manner (<italic>P<</italic>0.05), and the differences between the combined medication group and the other two groups became more significant after 72 h of medication (<italic>P<</italic>0.01). The IL-6 level in each experimental group, especially in the combined medication group, significantly declined in contrast to that in the blank group (<italic>P<</italic>0.01). The mRNA expression levels of HIF-1<italic>α</italic> and Cyclin D<sub>1</sub> in all experimental groups were obviously lower than those in the blank group, with the most significant changes observed in the combined medication group (<italic>P</italic><0.05,<italic>P</italic><0.01). The protein expression levels of PI3K, p-Akt, mTOR, HIF-1<italic>α</italic>, and Cyclin D<sub>1</sub> in each experimental group was significantly down-regulated(<italic>P</italic><0.05,<italic>P</italic><0.01), and the levels in the combined medication group were even lower than those in the cisplatin group (<italic>P<</italic>0.01). Conclusion:Scutellariae Radix-Hedyotidis Herba has an inhibitory effect on the proliferation of A549 cells, which may be related to its inhibition against the expression and secretion of IL-6/PI3K/Akt/mTOR-HIF-1<italic>α</italic> axis.
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Objective:To explore the performance and clinical application value of a rapid detection method for the hematopoietic stem/progenitor cell of peripheral blood using the automated hematology analyzer.Methods:Methodology validation and retrospective study. Collected sample from Fujian Medical University Union Hospital from January 2015 to December 2018, the peripheral blood of 4 patients with acute myeloid leukemia was first treated, and one healthy donor′s peripheral blood stem cell collection 5 times diluent, for the methodology validation. And the peripheral venous blood and 5-fold dilutions of peripheral blood stem cell collection, from 23 patients with hematopoietic stem cell transplantation and 22 healthy donors of allogeneic peripheral blood stem cell transplantation, used for consistency retrospective analysis. In the linear test, each of the peripheral blood and HPC collecting solutions from blood cell separator, which known CD34 +cell concentration, that was high-value samples for the expected upper limit (H) . Another low-value sample is normal saline (L) . According to the multiple proportion dilution, HPC was detected and regressed consistency test specimens were 126, EDTA-K 2 anticoagulant venous blood 78 and peripheral blood stem cell 48. Venous blood was collected at the same time, one tube of blood routine and HPC detection, the other tube flow cytometry (FCM) detection of CD34 +cells. Stem cell collection was diluted 5 times with sterilized saline and divided into two tubes. One tube was used to count whole blood cells and HPC, the other tube was used to detect CD34 +cells by FCM. The test results of the two instruments were compared, and the deviation was evaluated. Results:The background counting was 0×10 9/L and the carryover rate was 0.1%, conformed to the quality requirements of hematology analyzer, and the repeatability study imprecision ranged between 4.7%-18.8%. HPC of peripheral venous blood linear range (0-27.201×10 9/L), Stem cell collection was diluted 5 times linear range (0-0.878×10 9/L). The results of 126 samples detected by the hematology analyzer and FCM were compared. The correlation coefficient r2=0.960 1. When WBC>10×10 9/L, the results of the two instruments have a good consistency. The slope is between 0.95 and 1.05, and the relative bias is less than 30%. Conclusions:This study suggests that the hematology analyzer has a good linear range for detecting HPC, and has a good correlation with FCM. The hematology analyzer has the advantages of no pretreatment, convenient operation, a wide range of applications in detecting HPC specimens.
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Objective: To observe changes of variation of red blood cell distribution width-coefficient (RDW-CV), levels of matrix metalloproteinase (MMP)-2, MMP-9 and tissue inhibitor of metalloproteinases (TIMP)-1 in patients with essential hypertension (EH) of different risk stratification.Methods: A total of 105 EH patients treated in our department from Oct 2015 to Sep 2016 were regarded as EH group.According to hypertension risk stratification, they were divided into low risk group (n=34), medium risk group (n=38) and high-and extremely high risk group (n=33).Another 105 subjects with corresponding age and gender were selected as healthy control group during the same period.RDW-CV, serum levels of MMP-2, MMP-9 and TIMP-1 were measured and compared among all groups.Multivariate Logistic regression analysis was used to analyze relationship among above indexes and hypertension.Results: Compared with healthy control group, there were significant rise in RDW-CV [(12.57±1.46) vs.(14.54±1.82)], serum levels of MMP-2 [(121.71±18.86)ng/ml vs.(155.43±40.81)ng/ml], MMP-9 [(109.72±21.80)ng/ml vs.(191.23±53.05)ng/ml] and TIMP-1 [(59.42±9.41)ng/ml vs.(83.64±15.82)ng/ml] in EH group, P<0.05 or <0.01.Compared with low risk group, there were significant rise in RDW-CV [(13.35±1.54) vs.(14.43±1.17) vs.(15.90±1.81)], serum levels of MMP-2 [(131.21±35.24) ng/ml vs.(152.16±33.15)ng/ml vs.(184.16±37.14)ng/ml], MMP-9 [(163.95±38.61) ng/ml vs.(198.70±43.52)ng/ml vs.(232.83±54.12)ng/ml] and TIMP-1 [(73.15±13.12)ng/ml vs.(83.78±10.22) ng/ml vs.(94.27±16.77)ng/ml] in medium risk group, high-and extremely high risk group, and those of high-and extremely high risk group were significantly higher than those of medium risk group, P<0.05 or <0.01.Multivariate Logistic regression analysis indicated that RDW-CV, MMP-2, MMP-9 and TIMP-1 were independent risk factors for hypertension (OR=2.248~2.725, P<0.05 or <0.01).Conclusion: RDW-CV,MMP-2,MMP-9 and TIMP-1 are independent risk factors for hypertension, active monitoring and intervention should be given for these risk factors.
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OBJECTIVE:To provide reference for TCM in the treatment of coronary heart disease (CHD) unstable angina and new drug research and development.METHODS:TCM inheritance auxiliary platform software was adopted to build prescription database of TCM in the treatment of CHD unstable angina.The software function of clinical collection,platform management,information management,knowledge retrieval,statistics,data analysis were adopted to analyze prescription database in respects of four properties,five tastes,channel tropism distribution,frequency statistics,rules of prescriptions and potential new prescriptions,etc.RESULTS:Through analyzing 178 prescriptions of CHD unstable angina,152 ingredients were involved.Top 3 in the list of distribution frequency of four properties were warm (617),cold (474) and mild (288).Top 3 in the list of distribution frequency of five tastes were bitter (750),sweet (732) and pungent (497).Top 3 in the list of distribution frequency of channel tropism were liver (860),heart (573) and spleen (549).A total of 40 ingredients were used more than 10 times,and top 5 were Ligusticum chuanxiong,Salvia miltiorrhiza,Astragalus membranaceus,Angelica sinensis and Carthamus tinctorious.According to the frequency of the drug combination,top 5 in descending order were L.chuanxiong-S.miltiorrhiza,L.chuanxiong-A.sinensis,L.chuanxiong-A.membranaceus,C.tinctorious-L.chuanxiong and S.miltiorrhiza-A.membranaceus.A total of 8 new prescriptions were obtained after evolution.CONCLUSIONS:Main prescriptions for CHD unstable angina included in CNKI are mild drug property,sweetness and bitterness in taste.Main selected ingredients can promote blood circulation,remove blood stasis and relieve pain,relieve restlessness and tranquilize the mind.It embodies the CHD unstable angina treatment principles of "treat both the incidental and fundamental aspects,tonification and purgation in combination".
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Objective To assess the safety, immunogenicity and efficacy of group A and C meningococcal polysaccharide vaccine (A/C MPV) in response to an outbreak of group C meningococcal disease. Methods A vaccination campaign with A/C MPV was prompted 6 weeks after the use of group A MPV in Laibin city, Guangxi, where an outbreak of group C meningococcal meningitis occurred in 2002.Vaccinees were observed for local and systemic reactions after the vaccination and followed up for the meningococcal disease for 5 years. Blood samples were collected from 71 people in the epidemic and 43 in the non-epidemic areas before and 1 month after the vaccination and examined by ELISA to detect IgG antibodies to group A and C polysaccharides. Results The vaccination coverage was 97%. No significant adverse reactions were observed. The positive rates of group C antibodies after vaccination was between 97.67% and 100% among the populations in the epidemic and non-epidemic areas, as well as among those negative and positive for group C antibodies prior to the vaccination.The geometric mean anti-C concentrations ranged 30.81 μg/ml to 37.44 μg/ml, showing no significant difference between groups. The incidence rate of meningococcal disease in students with timely immunization (218.58/100 000) dropped by 69.02% , when compared to that in those with delayed immunization (705.72/100 000). No clinical cases were identified during the follow-up period of 15 760 person-years. Conclusion The vaccination campaign with the Chinese group A/C MPV seemed successful in controlling the group C meningococcal outbreak.The vaccine was shown to be safe even administered after the group A vaccine only 6 weeks apart. It could induce high levels of antibodies in vulnerable population and significantly increase antibody levels in seropositive individuals, thus providing a protection of at least 5 years.
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<p><b>OBJECTIVE</b>To evaluate the safety of a group A + C meningococcal polysaccharide vaccine as part of a phase IV clinical trial.</p><p><b>METHODS</b>The study area was divided into 108 clusters according to the principle of cluster randomization, stratified and paired sampling methods. 54 out of 108 clusters served as observation groups were administered A + C vaccine, while the rest 54 groups were administered Vi polysaccharide vaccine. An adverse event surveillance system was established to monitor the adverse events following the vaccination campaign. Identical form and methods were used for data collection to investigate the adverse events following the vaccination of both A+ C vaccine and Vi vaccine.</p><p><b>RESULTS</b>34,543 people were vaccinated, including 18,167 of whom received A + C vaccine, while the other 16,376 received Vi vaccine. The rates of immediate injection reaction and unsolicited non-serious adverse events from A + C vaccine group were 0.44% and 0.38% while of Vi vaccine group were 0.79% and 0.73% respectively. At the solicited adverse event survey on 3-day-post-vaccination, 1239 vaccinees were followed-up including 771 received A + C vaccine and 468 received Vi vaccine. The local injection reaction rate of A + C vaccine group on the 1st day was significantly higher (X2 = 13.98, P = 0.0002) than that of Vi vaccine group. Neither the local injection reaction rate nor the system reaction rate between both groups was significantly different on 2nd and 3rd day, post vaccination. It was not statistically different when comparing fever onset rate between those who received vaccine and those who did not, in each vaccine group. There were no serious adverse events observed.</p><p><b>CONCLUSION</b>Results showed that the side effects of A + C vaccine and the Vi vaccine were mild and safe for vaccination campaigns targeting on populations at different age.</p>
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Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Age Distribution , Meningococcal Vaccines , Allergy and Immunology , Polysaccharides, Bacterial , Allergy and Immunology , Sex DistributionABSTRACT
<p><b>OBJECTIVE</b>To describe the design and application of cluster randomized controlled method on typhoid Vi vaccine trial, and to assess the effect of implementation.</p><p><b>METHODS</b>Simple size calculation of cluster-randomized trial was used to determine the sample size of the two groups and a vaccination campaign was conducted. The study group was given typhoid Vi vaccine and the control group was given meningococcal A vaccine.</p><p><b>RESULTS</b>According to sample size calculation, a total sample of 96,121 participants was required and the study areas were divided into 108 clusters. In practice, 53 study clusters with 44,054 participants and 54 control clusters with 48,422 participants were stratified and matched according to size, location (urban or rural), characteristics (school, department, factory, demography) were randomized respectively. Confounding factors of two groups including age, sex, resident area, income, level of education were compared. It was found that the ratio of all confounding factors between the two groups were comparable and balanced.</p><p><b>CONCLUSION</b>Confounding factors can be better controlled between study group and the control group by applying cluster-randomized method on vaccine trail which enabled the intervention to be more scientifically evaluated; The implementation of cluster randomization trial was simple and easy to be accepted.</p>
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , China , Cluster Analysis , Mass Vaccination , Polysaccharides, Bacterial , Allergy and Immunology , Typhoid Fever , Typhoid-Paratyphoid Vaccines , Allergy and Immunology , VaccinationABSTRACT
<p><b>OBJECTIVE</b>To characterize the incidence, epidemiologic features, etiologic agents and sequelae of bacterial meningitis in children under 5 years of age in Nanning, Guangxi.</p><p><b>METHODS</b>A population-based surveillance was conducted to evaluate children with signs and symptoms of meningitis. All hospitals, township health centers and village clinics in the surveillance area were structured to participate in the case referral and evaluation. Cerebrospinal fluid (CSF) and blood specimens were obtained and processed using standardized microbiologic methods.</p><p><b>RESULTS</b>During the 26-month surveillance period, among the children under 5 years old, a total of 1272 cases who met the screening criteria of meningitis were studied. 265 of 1272 cases were identified as clinically diagnosed meningitis, with an incidence rate of 86.36 per 100 000 population. The annual incidence rate under the 38 cases of confirmed bacterial meningitis appeared to be 12.38/100 000. Staphylococcus species accounted for the largest proportion of laboratory-confirmed bacterial meningitis, followed by E. coli and S. pneumoniae. The highest attack rate occurred in neonates < 1 month, followed by children aged 1 - 12 months in the confirmed patients. Meningitis caused by Sp and Hi mainly occurred in children aged 1 - 12 months. All cases of meningitis due to Hi and Sp were children aged 1 - 24 months. 13.16% and 0.00% of the cases survived with complications and sequelae, and the case-fatality rate was 18.42%. 40 bacterial isolates were identified from 1193 blood cultures and 23 from 1211 cerebrospinal fluid samples, but no Neisseria meningitidis was found.</p><p><b>CONCLUSION</b>Meningitis due to Hi was first confirmed in Guangxi with the incidence of 0.98 per 100 000 population. The annual incidence rate of confirmed bacterial meningitis was 12.38 per 100 000, which was considered an important public health problem in children. Staphylococci was the predominant pathogen in confirmed bacterial meningitis.</p>