Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.323
Filtrar
1.
Artigo em Inglês | MEDLINE | ID: mdl-31675348

RESUMO

In the medical ultrasound field, ultrafast imaging has recently become a hot topic. However, the diagnostic reliability of ultrafast high-frame rate plane-wave (PW) imaging is reduced by its low-quality images. The medical ultrasound equipment on the market usually adopts the line-scanning mode, which can obtain high-quality images at a very low frame rate. In addition, many proven data-driven ultrasound image processing methods are trained by line-scan images. Since the gray-level distributions of line-scan images and PW images are very different, these gray-level distribution-sensitive methods cannot be generalized to ultrafast ultrasound imaging, which limits further applications. Hence, we propose an ultrasound-transfer generative adversarial network to improve the quality of PW images and extend the existing image processing methods to ultrafast ultrasound imaging by reconstructing PW images into line-scan images. This network adopts a residual dense generator with a self-attention system that fully uses the hierarchical features and generates details from all the relevant physiological information. A projection discriminator and spectral normalization are introduced to increase the discernibility and to maintain a balance between the generator and the discriminator. Moreover, we reorganize the transmit sequence of the transducer array to eliminate the negative influence of human movements and facilitate the convergence of the proposed model. The experimental results are evaluated with five metrics, which confirm the feasibility of the proposed method to obtain a line-scan-quality image with a very high frame rate. This technology could significantly popularize ultrafast medical ultrasound imaging.

2.
Artigo em Inglês | MEDLINE | ID: mdl-31711186

RESUMO

OBJECTIVES: The study sought to test the feasibility of using Twitter data to assess determinants of consumers' health behavior toward human papillomavirus (HPV) vaccination informed by the Integrated Behavior Model (IBM). MATERIALS AND METHODS: We used 3 Twitter datasets spanning from 2014 to 2018. We preprocessed and geocoded the tweets, and then built a rule-based model that classified each tweet into either promotional information or consumers' discussions. We applied topic modeling to discover major themes and subsequently explored the associations between the topics learned from consumers' discussions and the responses of HPV-related questions in the Health Information National Trends Survey (HINTS). RESULTS: We collected 2 846 495 tweets and analyzed 335 681 geocoded tweets. Through topic modeling, we identified 122 high-quality topics. The most discussed consumer topic is "cervical cancer screening"; while in promotional tweets, the most popular topic is to increase awareness of "HPV causes cancer." A total of 87 of the 122 topics are correlated between promotional information and consumers' discussions. Guided by IBM, we examined the alignment between our Twitter findings and the results obtained from HINTS. Thirty-five topics can be mapped to HINTS questions by keywords, 112 topics can be mapped to IBM constructs, and 45 topics have statistically significant correlations with HINTS responses in terms of geographic distributions. CONCLUSIONS: Mining Twitter to assess consumers' health behaviors can not only obtain results comparable to surveys, but also yield additional insights via a theory-driven approach. Limitations exist; nevertheless, these encouraging results impel us to develop innovative ways of leveraging social media in the changing health communication landscape.

3.
ACS Nano ; 2019 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-31702885

RESUMO

The simultaneous therapy of tumor and bone defects resulted from tumor surgery is still a challenge in the clinical orthopedics. Few nanomaterials systems simultaneously possess multifunctional capacities including biodegradability, treating tumor and enhancing bone regeneration. Herein, we designed a biodegradable monodispersed bioactive glass nanoparticles (BGN) platform with multifunctional properties for enhanced colon cancer photothermo-chemotherapy and bone repair. The mussel-inspired surface assembling with BGN was established as a stable NIR-excited photothermal nanoplatform (BGN@PDA) for ablating tumor. BGN@PDA shows an ultrahigh anticancer drug (DOX) loading with on-demand (pH/NIR-responsive) drug releasing behavior and antibacterial activity for enhanced tumor chemotherapy (BGN@PDA-DOX). The growth of colon cancer cells (Hct116 cells) and cervical cancer cells (Hela cells) was significantly inhibited in vitro and superior local anti-cancer efficacy could be achieved by synergic chemo-photothermal-therapy in vivo. BGN@PDA underwent a gradual degradation in vivo during 60 days and showed negligible side toxicity effects. Meanwhile, BGN@PDA could positively induce the osteogenesis of osteoblasts in vitro and possess excellent in vivo bone repair ability in rat cranial defects. This work presents a distinctive strategy to design bioactive multifunctional nanoplatform for treating tumor disease-resulted bone tissue regeneration.

4.
Food Chem ; : 125821, 2019 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-31753687

RESUMO

The aim of this study was the fabrication of stable encapsulated cumin essential oil using ionic gelation method and its application in mayonnaise as a natural antioxidant. The obtained nanoparticles exhibited a positively charged surface with diameters ranging from 269 to 326 nm. In addition, results from encapsulation efficiency demonstrated that excess concentration of initial essential oil reduced the amount of entrapped essential oil. From the obtained observation, the optimal weight ratio of chitosan to cumin essential oil of 1:0.5 was selected. In vitro release study indicated an initial burst at all different pH, although the most release rate was related to acidic media (pH = 3). Furthermore, an improvement of thermal stability and antioxidant properties was observed. Regarding cytotoxicity results, loaded particles had a good biocompatibility, while there were slight prevention effects on breast and brain tumor at the highest concentration. Finally, the antioxidant properties of fabricated nanoparticles were investigated in mayonnaise. It significantly reduced peroxidase value (POV) and thiobarbituric acid (TBA) values during storage period. Overall, our observations showed the encapsulated cumin essential oil could be used as natural antioxidant.

5.
World Neurosurg ; 2019 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-31733392

RESUMO

BACKGROUND: Spinal angiolipomas (SALs) are benign tumors that usually present a slow progressive spinal cord or radicular compression. Acute myelopathy or acute aggravated radicular syndrome are exceedingly rare. CASE DESCRIPTION: The authors report an original case with sudden aggravated radicular pain caused by hemorrhagic SALs. A 54-year-old woman presented with a 2-month history of mild back pain, and the pain was significantly aggravated after a therapeutic back massage. Neurologic examination showed pain and hyperalgesia between T4 and T7 dermatome, from back to front, just like a band. Spinal magnetic resonance imaging (MRI) showed a dorsally located epidural lesion (T4-T6) and a small intratumoral hemorrhage at the lower part of the tumor. A bilateral T4-T6 laminectomy was performed to achieve total excision of the tumors. Histologic examination showed that the tumors were composed of mature adipose tissue and vascular tissue as angiolipomas. The postoperative course was uneventful with complete neurologic recovery 4 days after the surgery. MRI at 1-year follow-up indicated no recurrence. CONCLUSIONS: SALs are unusual benign tumors that are composed of mature fatty tissue and abnormal blood vessels; sudden aggravated spinal cord or radicular compression syndrome are rare. MRI is the best choice in the diagnosis of SALs. Surgery may be performed in different ways depending on the type of SALs, and the prognosis is generally good.

6.
Magn Reson Med ; 2019 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-31729078

RESUMO

PURPOSE: To apply deep convolution neural network to the segmentation task in myocardial arterial spin labeled perfusion imaging and to develop methods that measure uncertainty and that adapt the convolution neural network model to a specific false-positive versus false-negative tradeoff. METHODS: The Monte Carlo dropout U-Net was trained on data from 22 subjects and tested on data from 6 heart transplant recipients. Manual segmentation and regional myocardial blood flow were available for comparison. We consider 2 global uncertainty measures, named "Dice uncertainty" and "Monte Carlo dropout uncertainty," which were calculated with and without the use of manual segmentation, respectively. Tversky loss function with a hyperparameter ß was used to adapt the model to a specific false-positive versus false-negative tradeoff. RESULTS: The Monte Carlo dropout U-Net achieved a Dice coefficient of 0.91 ± 0.04 on the test set. Myocardial blood flow measured using automatic segmentations was highly correlated to that measured using the manual segmentation (R2 = 0.96). Dice uncertainty and Monte Carlo dropout uncertainty were in good agreement (R2 = 0.64). As ß increased, the false-positive rate systematically decreased and false-negative rate systematically increased. CONCLUSION: We demonstrate the feasibility of deep convolution neural network for automatic segmentation of myocardial arterial spin labeling, with good accuracy. We also introduce 2 simple methods for assessing model uncertainty. Finally, we demonstrate the ability to adapt the convolution neural network model to a specific false-positive versus false-negative tradeoff. These findings are directly relevant to automatic segmentation in quantitative cardiac MRI and are broadly applicable to automatic segmentation problems in diagnostic imaging.

7.
Exp Cell Res ; 385(2): 111691, 2019 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-31678170

RESUMO

Rafoxanide is commonly used as anti-helminthic medicine in veterinary medicine, a main compound of salicylanilide. Previous studies have reported that rafoxanide, as an inhibitor of BRAF V600E mutant protein, inhibits the growth of colorectal cancer, multiple myeloma, and skin cancer. However, its therapeutic effect on gastric cancer (GC) and the potential mechanism has not been investigated. Here, we have found that rafoxanide inhibited the proliferation of GC cells in vitro, arrested the cell cycle in the G0/G1 phase, and promoted apoptosis and autophagy in GC cells. Treatment with specific autophagy inhibitor 3-methyladenine drastically inhibited the apoptotic cell death effect by suppressing the switch from autophagy to apoptosis. Mechanistically, we found that rafoxanide inhibited the growth of GC cells in vitro by inhibiting the activity of the PI3K/Akt/mTOR signaling pathway. This process induced autophagy, which essentially resulted in the apoptosis of GC cells. Results from subcutaneous implanted tumor models in nude mice also indicated that rafoxanide inhibited the growth of GC cells in vivo. Taken together, our findings revealed that rafoxanide inhibited the growth of GC cells both in vitro and vivo, indicating a potential drug candidate for the treatment of GC.

8.
Skeletal Radiol ; 2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31773187

RESUMO

PURPOSE: Compare the diagnostic performance of saline and gadolinium shoulder magnetic resonance arthrograms (MRA) in the detection of labral and rotator cuff injury compared to arthroscopy. MATERIALS AND METHODS: Consecutive patients who underwent a gadolinium or saline MRA followed by arthroscopy were retrospectively reviewed. The reports were reviewed for injuries. A chi square or Fisher's exact test was performed to compare the MRA and surgery. Kappa values were calculated to correlate diagnosis of tear between MRA and arthroscopy. RESULTS: There were a total of 58 patients included, including 34 gadolinium arthrograms and 24 saline arthrograms. The accuracy of saline MRA was similar compared to gadolinium MRA in the diagnosis of tears of the supraspinatus (accuracy 0.88 vs 0.74, respectively) and infraspinatus (accuracy 0.88 vs 0.65, respectively) tendons and tears of the anterior/anterior inferior, posterior, and superior labrum, (accuracy 0.79 vs 0.76, 0.71 vs 0.62, and 0.58 vs 0.56), and saline vs gadolinium, respectively. Although there was a trend toward overall better saline MRA performance, a statistically significant difference in the accuracy to detect tears was only noted for the infraspinatus tendon. Interobserver agreement for rotator cuff tears was higher for saline than gadolinium MRA. CONCLUSION: Saline MRA was accurate, with no significant differences compared gadolinium arthrograms in the diagnosis of labral and rotator cuff pathology. Given expense, and the potential additional information provided by fluid sensitive sequences over T1 fat-suppressed sequences, consideration should be given to using saline for shoulder MRAs. LEVEL OF EVIDENCE: Level III, Retrospective Cohort Study.

9.
Zhen Ci Yan Jiu ; 44(11): 854-7, 2019 Nov 25.
Artigo em Chinês | MEDLINE | ID: mdl-31777238

RESUMO

Bloodletting puncture at twelve well-points is a characteristic emergency therapy in traditional Chinese medicine. This article reviewed the research advances in the clinical effect of this therapy in the treatment of acute central nervous injury and its mechanism of action over the past 30 years, and it is found that this therapy can effectively improve disturbance of consciousness, neurological defects, and cerebral edema caused by stroke, traumatic brain injury, and carbon monoxide poisoning. The mechanism involves the improvement of cerebral blood flow and tissue oxygen supply, repair of the blood-brain barrier, and regulation of local ion balance. Well-designed clinical trials and in-depth research on biological mechanisms should be performed in future to promote and guide its clinical application.

10.
Zhen Ci Yan Jiu ; 44(10): 766-71, 2019 Oct 25.
Artigo em Chinês | MEDLINE | ID: mdl-31657169

RESUMO

OBJECTIVE: To explore the rule of acupoint combination in acupuncture treatment of hiccups. METHODS: Original research articles on acupuncture treatment of hiccup were collected from databases of CNKI, Wanfang, VIP, and Pubmed by using key words of "hiccup", "acupuncture" "diaphragmatic spasm" "body acupuncture" "filiform needle" and "electroacupuncture". According to our inclusive and exclusive criteria, the collected data were extracted to establish an acupuncture prescription database for hiccup. Then, the regularities of acupoint combinations for hiccup were analyzed by using Gephi complex network analysis software. RESULTS: ;A total of 606 articles containing 634 acupoint prescriptions for acupuncture treatment of hiccups were brought into analysis. There were 133 single-acupoint prescriptions (20.98%), which was significantly lower than the multi-acupoint prescription (501, accounting for 79.02%). There were mainly acupoints in multi-acupoint prescriptions, and distal-proximal acupoint combination method were often used as the basis of acupoint selection (326, accounting for 65.07%). A total of 163 acupoints were involved, with a total frequency of 2 969. Among them, Neiguan(PC6) was used most frequently (400 times, accounting for 13.47%), followed by Zusanli (ST36), Zhongwan (CV12), Danzhong (CV17), and Taichong (LR3). The acupoints of the Conceptional Vessel(666 times, accounting for 22.43%), and Stomach Meridian, Pericardium Meridian and Liver Meridian were chiefly used. There were 67 specific acupoints, the frequency of use was 2 555 times(accounting for 86.05% of the total frequency), among which the frequency of the five Shu-points was the highest (875 times, accounting for 29.47% of the total frequency), and followed by eight confluence points. CONCLUSION: ;The core acupoints are PC6, ST36, CV12, etc. and the distal-proximal acupoint combination method found in this study are often used as the basis of acupoint selection and acupoint prescription for acupuncture treatment of hiccup.


Assuntos
Eletroacupuntura , Soluço , Meridianos , Pontos de Acupuntura , Soluço/terapia , Humanos
11.
Thorac Cancer ; 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31613427

RESUMO

BACKGROUND: Approximately 3%-5% of lung adenocarcinoma is driven by anaplastic lymphoma kinase (ALK) fusion oncogene, whose activity can be suppressed by multiple ALK inhibitors. Crizotinib and ceritinib have demonstrated superior efficacy to platinum-based chemotherapy as front-line treatment for patients with ALK-positive advanced non-small cell lung cancer (NSCLC). However, the direct comparison between them in the front-line setting remains lacking. METHODS: A total of 48 patients with ALK-positive, previously untreated advanced NSCLC, who received crizotinib and ceritinib as front-line treatment were retrospectively investigated. The efficacy and pattern of disease progression were analyzed. RESULTS: Patients receiving ceritinib treatment were significantly younger than those receiving crizotinib treatment (52.0 vs. 63.0, P = 0.016). The median progression-free survival (PFS) was significantly longer with ceritinib than with crizotinib treatment (32.3 vs. 12.9 months; log-rank P = 0.020); the hazard ratio for disease progression or death, 0.27 (95% CI, 0.08-0.90; P = 0.033). An objective response was noted in all patients in the ceritinib group and in 23 patients in the crizotinib group (74.2%; 95% CI, 59.0 to 88.5). The rate of systemic progression was significantly lower over time with ceritinib treatment compared to crizotinib treatment (cause-specific hazard ratio, 0.21; 95% CI 0.06-0.73; P = 0.014). Serious adverse events were noted in one (2.9%) patient showing elevated liver function in the crizotinib group and three (23.1%) patients showing diarrhea in the ceritinib group. Dose reduction was needed in five out of 13 (38.5%) patients receiving ceritinib treatment. CONCLUSION: Ceritinib showed higher efficacy associated with a better control of systemic progression compared to crizotinib for the front-line treatment of ALK-positive advanced NSCLCs.

12.
Free Radic Res ; : 1-11, 2019 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-31631710

RESUMO

Of all the aerobic respiration by-products, cytotoxic superoxide derived from mitochondrial-leaked electrons, is the only one known to be disposed of intracellularly. Is this fate the only destiny for mitochondrial-leaked electrons? When Cynomolgus monkeys were injected intravenously with reactive oxygen species (ROS) indicators, the connective tissues of dura mater, facial fascia, pericardium, linea alba, dorsa fascia and other body parts, emitted specific and intense fluorescent signals. Moreover, the fluorescent signals along the linea alba of SD rats, did not result from the local presence of ROS but from the interaction of ROS indicators with electrons flowing through this tissue. Furthermore, the electrons travelling along the linea alba of mice were revealed to originate from mitochondria. These data suggest that mitochondrial-leaked electrons may be transported extracellularly to a hitherto undescribed system of connective tissues, which is pervasively networked, electrically conductive and metabolically related.

13.
ChemSusChem ; 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31638336

RESUMO

The reliable and accurate quantification of ammonia in electrochemical and photochemical experiments has been a technical challenge owing to the extremely low concentration of generated ammonia, interference from trace amounts of cations and organic compounds, and ammonia contamination from various sources. As a result, overestimation and significant errors may happen in many research works. Herein, accuracy and precision of ion chromatography (IC) are evaluated at different pH; excellent performance with a low detection limit (<2 µg L-1 ) under acidic and neutral conditions is found, whereas the linearity is unsatisfactory in the low NH4 + concentration range (0-100 µg L-1 ) under alkaline conditions. High concentrations of Li+ and Na+ are difficult to separate from NH4 + in conventional IC, but this can be solved by employing a high-exchange-capacity column or gradient elution. The interference effects of 14 common transition metal cations and 6 common organic compounds on the quantification of ammonium with low-level concentration (500 µg L-1 ) using IC are systematically investigated, and the results demonstrate good robustness. The overestimation caused by ammonia contamination from reagent water, surroundings, and even the analytical grade of inorganic and organic reagents are confirmed and the results indicate the necessity to prepare and test fresh electrolyte solutions before each experiment, owing to the high sensitivity of acidic and neutral solutions to ammonia contamination from the surroundings. The ammonization of a Nafion membrane during experiments and the underestimation in quantification are also discussed. Finally, a reliable level of synthesized ammonia is identified and some recommendations are presented to improve the reliability and accuracy of ammonia quantification.

14.
J Surg Oncol ; 120(8): 1412-1419, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31621086

RESUMO

BACKGROUND: Anastomotic leakage (AL) is a serious complication after anterior resection. The purpose of this study was to determine the role of microvascular density (MVD) in AL and to develop a nomogram to accurately predict AL. METHODS: This study retrospectively enrolled 477 consecutive patients who underwent anterior resection for rectal cancer from January 2011 to January 2019. Tissue samples of the resection margins were assessed for MVD. Univariate and multivariate regression analyses were used to identify the risk factors for AL. RESULTS: The incidence of clinical AL was 6.7%. MVD in the distal margin was associated with AL (P < .001). Univariate and multivariate regression analysis identified the following variables as independent risk factors for AL: preoperative albumin ≤35 g/L (odds ratio [OR] = 2.511), neoadjuvant treatment (OR = 3.560), location of tumor ≤7 cm (OR = 3.381), blood loss ≥100 mL (OR = 2.717), and MVD in the distal margin ≤20 (OR = 4.265). Then, a nomogram including these predictors was developed. The nomogram showed good discrimination (AUC = 0.816) and calibration (concordance index = 0.816). The decision curve analysis demonstrated that the nomogram was clinically useful. CONCLUSIONS: MVD in the distal margin is closely associated with AL. The nomogram can be used for individualized prediction of AL after anterior resection for patients with rectal cancer.

15.
Zhongguo Zhen Jiu ; 39(10): 1075-80, 2019 Oct 12.
Artigo em Chinês | MEDLINE | ID: mdl-31621260

RESUMO

OBJECTIVE: To observe the effect of bloodletting acupuncture at twelve jing-well points of hand on microcirculatory disturbance in mice with traumatic brain injury (TBI), and to explore the protective effect of bloodletting therapy on TBI. METHODS: Sixty clean adult male C57BL/6J mice were randomly divided into a sham-operation group, a model group and a treatment group, 20 mice in each group. The TBI model was established by using electronic controlled cerebral cortex impact instrument in the model group and the treatment group. The mice in the treatment group were treated with bloodletting acupuncture at bilateral "Shaoshang" (LU 11), "Shangyang" (LI 1), "Zhongchong" (PC 9), "Guanchong" (TE 1), "Shaochong" (HT 9) and "Shaoze" (SI 1) immediately after trauma. The mice in the sham-operation group only opened the bone window but did not receive the strike. The regional cerebral blood flow (rCBF) was monitored by laser speckle contrast analysis (LASCA) using a PeriCam PSI System before trauma, immediately after trauma and 1, 2, 12, 24, 48, 72 h after trauma. The brain water content was measured by wet-dry weight method 24 h after trauma. The severity of functional impairment at 2, 12, 24, 48 and 72 h after trauma was evaluated by modified neurological scale scores (mNSS). RESULTS: ① 2 h after trauma, the mNSS in the model group and treatment group were >7 points, suggesting the successful establishment of model; compared with the sham-operation group, the mNSS was increased significantly from 12 to 72 h after trauma in the model group ( all P<0.01), but the mNSS in the treatment group was significantly lower than that in the model group from 2 to 24 h after trauma (P<0.01, P<0.05). ② Compared with the sham-operation group, rCBF in the model group was decreased significantly immediately after trauma (P<0.01), and the rCBF in the model group was lower than that in the sham-operation group from 1 to 72 h after trauma ( all P<0.01); rCBF in the treatment group began to rise and was significantly higher than that in the model group 1-2 h after trauma (P<0.01); 12-48 h after trauma, the increasing of rCBF in the two groups tended to be gentle until 72 h after injury, and rCBF in the model group was decreased while that in the treatment group continued to rise and was higher than that in the model group (P<0.01). ③ 24 h after trauma, the brain water content in the model group was significantly higher than that in the sham-operation group (P<0.01), and brain water content in the treatment group was significantly lower than that in the model group (P<0.01). CONCLUSION: The bloodletting acupuncture at twelve jing-well points of hand could improve microcirculation disturbance, increase microcirculation perfusion, alleviate secondary brain edema and promote the recovery of nerve function in mice with TBI.


Assuntos
Terapia por Acupuntura , Sangria , Lesões Encefálicas Traumáticas , Pontos de Acupuntura , Animais , Lesões Encefálicas Traumáticas/terapia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Microcirculação , Distribuição Aleatória
16.
Health Serv Res ; 54(6): 1156-1165, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31642066

RESUMO

OBJECTIVE: To examine whether the Wellness Incentive and Navigation (WIN) intervention can improve health-related quality of life (HRQOL) among Medicaid enrollees with co-occurring physical and behavioral health conditions. DATA SOURCES: Annual telephone survey data from 2013 to 2016, linked with claims data. STUDY DESIGN: We recruited 1259 participants from the Texas STAR + PLUS managed care program and randomized them into an intervention group that received flexible wellness accounts and navigator services or a control group that received standard care. We conducted 4 waves of telephone surveys to collect data on HRQOL, patient activation, and other participant demographic and clinical characteristics. DATA COLLECTION/EXTRACTION METHODS: The 3M Clinical Risk Grouping Software was used to extract variables from claims data and group participants based on disease severity. PRINCIPAL FINDINGS: Our results showed that the WIN intervention was effective in increasing patient activation and HRQOL among Medicaid enrollees with co-occurring physical and behavioral health conditions. Furthermore, we found that this intervention effect on HRQOL was partially mediated by patient activation. CONCLUSIONS: Providing navigator support with wellness account is effective in improving HRQOL among Medicaid enrollees. The pragmatic nature of the trial maximizes the chance of successfully implementing it in state Medicaid programs.

17.
Med Phys ; 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31663134

RESUMO

PURPOSE: To apply tracer kinetic models as temporal constraints during reconstruction of under-sampled brain tumor dynamic contrast enhanced (DCE) magnetic resonance imaging (MRI). METHODS: A library of concentration vs time profiles is simulated for a range of physiological kinetic parameters. The library is reduced to a dictionary of temporal bases, where each profile is approximated by a sparse linear combination of the bases. Image reconstruction is formulated as estimation of concentration profiles and sparse model coefficients with a fixed sparsity level. Simulations are performed to evaluate modeling error, and error statistics in kinetic parameter estimation in presence of noise. Retrospective under-sampling experiments are performed on a brain tumor DCE digital reference object (DRO), and 12 brain tumor in-vivo 3T datasets. The performances of the proposed under-sampled reconstruction scheme and an existing compressed sensing-based temporal finite-difference (tFD) under-sampled reconstruction were compared against the fully sampled inverse Fourier Transform-based reconstruction. RESULTS: Simulations demonstrate that sparsity levels of 2 and 3 model the library profiles from the Patlak and extended Tofts-Kety (ETK) models, respectively. Noise sensitivity analysis showed equivalent kinetic parameter estimation error statistics from noisy concentration profiles, and model approximated profiles. DRO-based experiments showed good fidelity in recovery of kinetic maps from 20-fold under-sampled data. In-vivo experiments demonstrated reduced bias and uncertainty in kinetic mapping with the proposed approach compared to tFD at under-sampled reduction factors >= 20. CONCLUSIONS: Tracer kinetic models can be applied as temporal constraints during brain tumor DCE-MRI reconstruction. The proposed under-sampled scheme resulted in model parameter estimates less biased with respect to conventional fully sampled DCE MRI reconstructions and parameter estimation. The approach is flexible, can use nonlinear kinetic models, and does not require tuning of regularization parameters.

18.
Chin J Integr Med ; 2019 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-31571124

RESUMO

Due to its own internal laws of development, Chinese medicine (CM) seems more inclined to empirical medicine in a relatively long historical period. It is considered to be lacking objective and unified clinical practice guidelines (CPGs), and the difficulties in diagnosis and therapeutic effect evaluation comes with it, have restricted its further inheritance, development and international communication. Over the years, our research group has been committed to improving the standardization theory and methodology of CM, also perfecting relative techniques for further application, which are all based on the stratified evidence scoring method. We have already applied this method to 45 issued guidelines, including 5 national guidelines, 3 industrial guidelines, and 37 formulation/revision social organization guidelines. The stratified evidence scoring method has been recognized and used widely. It helps scholars and applicators to study, formulate, publish and popularize the acupuncture therapy clinical practice guidelines better, thus further promotes the development of acupuncture therapy.

19.
Curr Pharm Des ; 2019 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-31663471

RESUMO

Traumatic brain injury (TBI) can cause disorders of consciousness (DOC) by impairing the neuronal circuits of the ascending reticular activating system (ARAS) structures, including the hypothalamus, which are responsible for the maintenance of the wakefulness and awareness. Current awakening therapies for TBI-induced DOC comprise, among others, the regulation of excitatory and inhibitory neurotransmitters and the stimulation of the peripheral or central nervous system (CNS). However, the effects of these awakening therapies are still not satisfactory. Hypothalamus has been identified as a sleep/wake center, and its anterior and posterior regions have diverse roles in the regulation of the sleep/wake function. In particular, posterior hypothalamus (PH) possesses several types of neurons, including the orexin neurons in the lateral hypothalamus (LH) with widespread projections to other wakefulness-related regions of the brain. Orexins have been known to affect feeding and appetite, and recently their profound effect on sleep disorders and DOC has been identified. Orexin antagonists are used for the treatment of insomnia, and orexin agonists can be used for narcolepsy. Additionally, several studies demonstrated that the agonists of orexin might be effective in the treatment of DOC, providing novel therapeutic opportunities in this field.

20.
Sleep Med ; 63: 82-87, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31606653

RESUMO

OBJECTIVE: To evaluate the effect of insomnia after acute ischemic stroke on cerebrovascular reactivity (CVR). METHODS: A total of 158 eligible patients with acute ischemic stroke were enrolled prospectively. Of these, six patients were lost to follow-up, and 152 were included in the final analysis. The patients were divided into the insomnia (N = 24) and non-insomnia (N = 128) groups based on the Athens Insomnia Scale. The insomnia group was further divided into benzodiazepine (BDZ) and non-BDZ treatment groups according to BDZ use status after ischemic stroke. The transcranial doppler ultrasound (TCD) breath-holding test was performed to calculate the breath-holding index (BHI) of the responsible cerebral middle artery, which was used to evaluate CVR. Then, univariate and multivariate linear regression analyses were carried out to determine the effect of insomnia after acute ischemic stroke on CVR. RESULTS: At one month after the onset of acute ischemic stroke, TCD-BHI was significantly higher in the non-insomnia group compared with the insomnia group (p = 0.027). In patients with insomnia, TCD-BHI was significantly higher in the BDZ treatment group compared with non-BDZ treatment group (p = 0.039). With age, hypertension, diabetes, hyperlipidemia, long-term smoking, blood homocysteine, and Athens Insomnia Scale score as independent variables, and TCD-BHI at one month after onset as a dependent variable, univariate and multivariate linear regression analyses indicated that the Athens Insomnia Scale score was an independent factor affecting TCD-BHI (regression coefficient, -0.013; 95% confidence interval (CI) -0.024 to -0.003). CONCLUSION: Insomnia after acute ischemic stroke is an independent risk factor for CVR.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA