Research progress in immunoregulation mechanism of bone trauma microenvironment / 中华创伤杂志

Trauma induces immune cells to infiltrate the fracture site, and regulates the removal of local dead bone and remodeling of new bone by secreting a variety of cytokines and inflammatory mediators. With the development of trauma immunology, the role of the immune system in the process of bone wound healing has been deeply studied in recent years. When fracture occurs, the non-specific and specific immune cells are successively attracted into the fracture site, participating in bone repair. If there was a disorder in the bone trauma microenvironment, the coordination between osteoblasts and osteoclasts will be disordered, leading to delayed or nonunion of fractures. Therefore, it is very important to systematically explore the communication between immune cells and immune cells or osteoblasts/osteoclasts in bone trauma microenvironment. The authors review the immune regulation mechanism in the process of bone clearance and repair after bone trauma, and provide a rationale for the future immunotherapy of bone trauma.

Identification of small intestinal bleeding by small intestinal capsule endoscopy with intelligent assistant system based on deep convolutional neural network / 中华消化杂志

Objective:To verify the capability of small intestinal capsule endoscopy with intelligent assistant system based on deep convolutional neural network (DCNN) in the identification and diagnosis of small intestinal bleeding.Methods:A total of 158 235 small intestinal capsule endoscopy images of 1 970 patients were collected from ESView platform (including 3 765 images of 165 patients with small intestinal bleeding) for training of DCNN-based small intestinal capsule endoscopy with intelligent assistant system. In the validation phase, the capability of the system in identification and diagnosis of small intestinal bleeding was verified by images of 100 patients with small intestinal bleeding (10 cases of active bleeding, 31 cases of blood clot and 59 cases of submucosal hemorrhage).Results:Small intestinal bleeding lesions could be identified by the DCNN-based intelligent assistant system, and also could be displayed with mark on the original capsule endoscopy images. This system also could mark multiple bleeding images of the same lesion and multiple different bleeding lesions in the same image. With this system the average reading time of 100 cases of small intestinal bleeding of images the doctors used was (5.23±1.31) minutes per case. The sensitivity of the diagnosis of small intestinal bleeding was 99.00% (95% confidence interval 93.76% to 99.95%).Conclusions:The sensitivity of small intestinal bleeding identification by small intestinal capsule endoscopy with DCNN-based intelligent assistant system is high, which can be used to assist image reading doctors to identify and diagnose of small intestinal bleeding.