Accurate Intervertebral Disc Segmentation Approach Based on Deep Learning.

Automatically segmenting specific tissues or structures from medical images is a straightforward task for deep learning models. However, identifying a few specific objects from a group of similar targets can be a challenging task. This study focuses on the segmentation of certain specific intervertebral discs from lateral spine images acquired from an MRI scanner. In this research, an approach is proposed that utilizes MultiResUNet models and employs saliency maps for target intervertebral disc segmentation. First, a sub-image cropping method is used to separate the target discs. This method uses MultiResUNet to predict the saliency maps of target discs and crop sub-images for easier segmentation. Then, MultiResUNet is used to segment the target discs in these sub-images. The distance maps of the segmented discs are then calculated and combined with their original image for data augmentation to predict the remaining target discs. The training set and test set use 2674 and 308 MRI images, respectively. Experimental results demonstrate that the proposed method significantly enhances segmentation accuracy to about 98%. The performance of this approach highlights its effectiveness in segmenting specific intervertebral discs from closely similar discs.

Compound 5 alleviated acute kidney injury without affecting the antitumor effect after cisplatin treatment.

Despite being a powerful weapon against cancer cells, cisplatin's therapeutic potential is hampered by numerous adverse reactions, including acute kidney injury (AKI). Compound 5 has 3-SH fragments at the end of the vertical short alkyl side chain, which is an ROS scavenger synthesized. In this study, we evaluated the protective effect of compound 5 on the kidney after cisplatin administration and its mechanism. The results founded that compound 5 can alleviate serum urea nitrogen and serum creatinine induced by cisplatin administration in vivo. In addition, histopathological analysis of the kidneys showed that compound 5 significantly reduced cisplatin-induced (Cis-induced) renal toxicity compared with the cisplatin group. A mechanism study showed that compound 5 significantly reduces NOX4 levels, improves the activity of antioxidant enzymes (SOD and GSH-Px), reduces Malondialdehyde (MDA) levels, increases the total antioxidant level, reduces oxidative stress, and thus reduces kidney tissue damage. At the same time, compound 5 activated the Nrf2 signaling pathway. In addition, it can increase the expression of Bax, reduce the expression of Bcl-2 and caspase-3, a marker of apoptosis, which is beneficial to the survival of kidney cells. Additionally, compound 5 did not interfere with the antitumor effects of cisplatin in in vivo xenotransplantation models.

KZ02 enhances the radiosensitivity of BRAF-mutated CRC in vitro and in vivo.

Colorectal cancer (CRC) is a common malignant tumor with a high incidence and mortality worldwide. Preoperative chemoradiotherapy is a common treatment for patients with metastatic colorectal cancer (mCRC) as it reduces colostomy and local recurrence. The RAS (rat sarcoma)-RAF (extracellular signal-regulated kinase)-MEK (mitogen-activated protein kinase)-ERK (extracellular signal-regulated kinase) pathway regulates important cellular processes in the CRC. Abnormal ERK activation stimulates cell growth and provides a survival advantage. Our group has previously reported that the compound KZ02 has a stronger ability to inhibit tumor growth than AZD6244 (a MEK inhibitor). In this study, we evaluated the antitumor activity of KZ02 in combination with ionizing radiation (IR) and investigated its mechanism of action in BRAF-mutated colorectal cancer. Our results showed that this combination kills tumor cells better than either radiation or drugs alone, both in vivo and in vitro. Furthermore, studies have shown that KZ02 inhibits ERK overactivation. The combination resulted in a G1 phase arrest, a reduction in the radioresistant S phase, and aggravating DNA damage. It can also inhibit Pim-1 (Moloney murine leukemia virus-1), p-BAD (Bcl-2 associated agonist of cell death), Bcl-2 (B-cell lymphoma 2) and Bcl-XL (B-cell lymphoma-extra large) levels and promote apoptosis when combined with radiation. Our results suggest that KZ02 significantly increases the radiosensitivity of BRAF-mutated CRC cells by perturbing the cell cycle, increasing DNA damage, and promoting tumor apoptosis.

Automatic Segmentation of Specific Intervertebral Discs through a Two-Stage MultiResUNet Model.

The automatic segmentation of intervertebral discs from medical images is an important task for an intelligent clinical system. In this study, a deep learning model based on the MultiResUNet model for the automatic segmentation of specific intervertebral discs is presented. MultiResUNet can easily segment all intervertebral discs in MRI images; however, when only certain specific intervertebral discs need to be segmented, problems with segmentation errors, misalignment, and noise occur. In order to solve these problems, a two-stage MultiResUNet model is proposed. Connected-component labeling, automatic cropping, and distance transform are used in the proposed method. The experimental results show that the segmentation errors and misalignments of specific intervertebral discs are greatly reduced, and the segmentation accuracy is increased to about 94%. The performance of the proposed method proves its usefulness for the automatic segmentation of specific intervertebral discs over other deep learning models, such as the U-Net, CNN-based, Attention U-Net, and MultiResUNet models.

Design, Synthesis, and Biological Evaluation of a Novel Aminothiol Compound as Potential Radioprotector.

The risk of radiation damage has increased with the rapid development of nuclear technology and radiotherapy. Hence, research on radioprotective agents is of utmost importance. In the present study, a novel aminothiol compound 12, containing a linear alkylamino backbone and three terminal thiols, was synthesized. Owing to the appropriate capped groups in the chains, it has an improved permeability and oral bioavailability compared to other radioprotective agents. Oral administration of compound 12 improved the survival of mice that received lethal doses of γ-irradiation. Experimental results demonstrated that compound 12 not only mitigated total body irradiation-induced hematopoietic injury by increasing the frequencies of hematopoietic stem and progenitor cells but also prevented abdominal irradiation-induced intestinal injury by increasing the survival of Lgr5+ intestinal cells, lysozyme+ Paneth cells, and Ki67+ cells. In addition, compound 12 decreased oxidative stress by upregulating the expression of Nrf2 and NQO1 and downregulating the expression of NOX1. Further, compound 12 inhibited γ-irradiation-induced DNA damage and alleviated G2/M phase arrest. Moreover, compound 12 decreased the levels of p53 and Bax and increased the level of Bcl-2, demonstrating that it may suppress radiation-induced apoptosis via the p53 pathway. These results indicate that compound 12 has the possibility of preventing radiation injury and can be a potential radioprotector for clinical applications.

Anticancer Efficacy and Mechanism of Amentoflavone for Sensitizing Oral Squamous Cell Carcinoma to Cisplatin.

BACKGROUND/AIM: Nuclear factor kappa B (NF-κB) inactivation and apoptosis activation have been shown to enhance the anticancer effect of cisplatin in oral squamous cell carcinoma (OSCC). Amentoflavone may suppress NF-κB activity and trigger apoptosis in different types of cancer. The aim of this study was to investigate the anticancer effect and mechanism of amentoflavone in combination with cisplatin in OSCC. MATERIALS AND METHODS: We investigated the combination effect and mechanism of amentoflavone and cisplatin via cell viability analysis, flow cytometry-based apoptosis analyses, transwell migration/invasion assay, immunofluorescence staining and western blotting assay. RESULTS: Both amentoflavone and QNZ (NF-κB inhibitor) significantly increased cisplatin-induced cytotoxicity. Amentoflavone reduced cisplatin-triggered NF-κB activity and enhanced cisplatin-induced intrinsic caspase-dependent and independent apoptotic pathways. Moreover, amentoflavone augments cisplatin-suppressed invasion and migration ability of OSCC cells. CONCLUSION: Inactivation of NF-κB and induction of apoptosis through intrinsic caspase-dependent and independent apoptotic pathways are associated with amentoflavone enhanced anti-OSCC efficacy of cisplatin.

Severe Hypoglycemia as a Predictor of End-Stage Renal Disease in Type 2 Diabetes: A National Cohort Study.

Aims: This study investigated whether there is a link between severe hypoglycemia and progression into end-stage renal disease (ESRD) in patients with type 2 diabetes. Methods: Tapping into Taiwan's Health Insurance Research Database, we identified all type 2 diabetes patients between 1996 and 2013 and identified those diagnosed with a severe hypoglycemia episode during an emergency department visit and those who were not. Controls were then matched 1:1 for age, sex, index year, and medication. Results: We identified 468,421 type 2 diabetes patients diagnosed as having severe hypoglycemia in an emergency department visit. Compared with controls, these patients with SH had a higher risk of all-cause mortality (Hazard Ratio (HR), 1.76; 95% confidence interval, 1.61⁻1.94) and progressed into ESRD within a shorter period of time. Results were similar after controlling for competing risk. Conclusion: Severe hypoglycemia is significantly associated with worsening renal dysfunction in patients with type 2 diabetes and hastened progression into ESRD.

Is Bladder Training by Clamping Before Removal Necessary for Short-Term Indwelling Urinary Catheter Inpatient? A Systematic Review and Meta-analysis.

PURPOSE: Urinary catheterization is a common technique in clinical practice. There is, however, no consensus on management prior to removal of the indwelling catheter for short-term patients. This systematic review examined the necessity of clamping before removal of an indwelling urinary catheter in short-term patients. METHODS: A systematic literature review was conducted using eight databases and predetermined keywords-guided searches. Some 2,515 studies were evaluated. Ten studies that met the inclusion criteria were selected. RESULTS: The quality of the studies was assessed using the Jadad scoring system. Only 40.0% of studies were rated as high quality. This review found that catheter clamping prior to removal was not necessary for the short-term patient. When made a comparison with the unclamping group, there was no significant difference in recatheterization risk, risk of urine retention, patients' subjective perceptions and rate of urinary tract infection. CONCLUSIONS: This review indicated that bladder training by clamping prior to removal of urinary catheters is not necessary in short-term catheter patients. In addition, clamping carries the risk of complications such as prolonging urinary catheter retention and urinary tract injury. Further investigation requires higher quality methodologies and more diverse study designs.

in vitro polysaccharide extraction from Cipangopaludina cathayensis and its pharmacological potential.

Cipangopaludina cathayensis (mudsnails) is a snail-like animal. This study intends to reveal pharmacological potential of polysaccharide extracted from mudsnails. Crude soluble polysaccharide of mudsnails was extracted using hot water extraction and ethanol precipitation method. The crude polysaccharide was purified successively using Sevag method. Applying Fenton reactions, it was found that antioxidant potential efficiency of polysaccharide extracted from mudsnail was dose-dependent and reached up to 44.29% at 4 mg ml(-1) concentration. Most significantly, polysaccharide extracted from mudsnail could efficiently inhibit lung cancer cell line A-549 proliferation in vitro and over 50% cells were killed on applying 300 mg ml(-1) of polysaccharide after 24 hrs of post treatment. It implies that mudsnail polysaccharide is a potential anti-tumor agent.