[Feasibility multi-center study of artificial intelligence assistance in cervical fluid-based cytology diagnosis].

Objective: To propose a method of cervical cytology screening based on deep convolutional neural network and compare it with the diagnosis of cytologists. Method: The deep segmentation network was used to extract 618 333 regions of interest (ROI) from 5, 516 cytological pathological images. Combined with the experience of physicians, the deep classification network with the ability to analyze ROI was trained. The classification results were used to construct features, and the decision model was used to complete the classification of cytopathological images. Results: The sensitivity and specificity were 89.72%, 58.48%, 33.95% and 95.94% respectively. Among the smears derived from four different preparation methods, this algorithm had the best effect on natural fallout with a sensitivity of 91.10%, specificity of 69.32%, positive predictive rate of 41.41%, and negative predictive rate of 97.03%. Conclusion: Deep convolutional neural network image recognition technology can be applied to cervical cytology screening.

A targetable HB-EGF-CITED4 axis controls oncogenesis in lung cancer.

Aberrant epidermal growth factor (EGF) receptor (EGFR) signaling contributes to neoplastic initiation and progression in lung. Mutated EGFR has become as an important therapeutic target in lung cancer, whereas targeted treatment is not available for wild-type EGFR or its ligands. In this study, we found that heparin-binding (HB)-EGF, a member of the EGF family, was highly expressed in a subset of lung cancer, proliferation of which was dependent on HB-EGF signaling. Silencing of HB-EGF with RNA interference inhibited cell cycle progression in lung cancer cells. We observed that, upon HB-EGF induction, CITED4 was induced through a signal transducer and activator of transcription 3 (STAT3)-dependent pathway, regulating cell proliferation. CITED4 interacted with MYC and potentiated MYC-mediated transactivation of the CCND1 promoter, leading to cell cycle progression. Correlation analysis revealed that HB-EGF and CITED4 were significantly positively associated in primary lung tumors, and expression of HB-EGF predicted a poor survival outcome in patients. In vitro and in vivo experiments revealed that pharmacological inhibition of HB-EGF with CRM197 significantly attenuated tumor cell growth. Thus, CITED4 functions as a molecular switch in HB-EGF-induced growth control, and HB-EGF provides a novel therapeutic target for lung cancer intervention.

Carp cDNA sequence encoding a putative diazepam-binding inhibitor/endozepine/acyl-CoA-binding protein.

A full-length cDNA coding for common carp diazepam-binding inhibitor (DBI)/endozepine (EP)/acyl-CoA-binding protein (ACBP) was isolated and sequenced. The deduced DBI/EP/ACBP is comprised of 87 amino acids (including initiating methionine) without possessing a signal peptide. Common carp DBI/EP/ACBP displays 77%, 78%, 70%, 63%, 61% and 45% identity with human, bovine, rat, frog, duck and yeast DBI/EP/ACBP, respectively.

A second type of rod opsin cDNA from the common carp (Cyprinus carpio).

A second type of rhodopsin cDNA from carp (cRh-II) shared 97.2% polynucleotide identity with the previously reported cRh-I. The deduced amino acid sequences of cRh-I and cRh-II exhibited 98.6% identity. The key difference between these two types of cRh is that valine at position 169 of cRh-I was replaced by glutamic acid in cRh-II. Southern blot analysis of genomic DNA showed that there were two types of cRh gene. These two rod opsin genes were proven to be expressed in carp retinas by using RT-PCR with type-specific primers.

Cycle-averaged dynamics of a periodically driven, closed-loop circulation model.

Time-varying elastance models have been used extensively in the past to simulate the pulsatile nature of cardiovascular waveforms. Frequently, however, one is interested in dynamics that occur over longer time scales, in which case a detailed simulation of each cardiac contraction becomes computationally burdensome. In this paper, we apply circuit-averaging techniques to a periodically driven, closed-loop, three-compartment recirculation model. The resultant cycle-averaged model is linear and time invariant, and greatly reduces the computational burden. It is also amenable to systematic order reduction methods that lead to further efficiencies. Despite its simplicity, the averaged model captures the dynamics relevant to the representation of a range of cardiovascular reflex mechanisms.

Comparative pathogenicity of Coxsackievirus A16 circulating and noncirculating strains in vitro and in a neonatal mouse model.

An enterovirus 71 (EV71) vaccine for the prevention of hand, foot, and mouth disease (HMFD) is available, but it is not known whether the EV71 vaccine cross-protects against Coxsackievirus (CV) infection. Furthermore, although an inactivated circulating CVA16 Changchun 024 (CC024) strain vaccine candidate is effective in newborn mice, the CC024 strain causes severe lesions in muscle and lung tissues. Therefore, an effective CV vaccine with improved pathogenic safety is needed. The aim of this study was to evaluate the in vivo safety and in vitro replication capability of a noncirculating CVA16 SHZH05 strain. The replication capacity of circulating CVA16 strains CC024, CC045, CC090 and CC163 and the noncirculating SHZH05 strain was evaluated by cytopathic effect in different cell lines. The replication capacity and pathogenicity of the CC024 and SHZH05 strains were also evaluated in a neonatal mouse model. Histopathological and viral load analyses demonstrated that the SHZH05 strain had an in vitro replication capacity comparable to the four CC strains. The CC024, but not the SHZH05 strain, became distributed in a variety of tissues and caused severe lesions and mortality in neonatal mice. The differences in replication capacity and in vivo pathogenicity of the CC024 and SHZH05 strains may result from differences in the nucleotide and amino acid sequences of viral functional polyproteins P1, P2 and P3. Our findings suggest that the noncirculating SHZH05 strain may be a safer CV vaccine candidate than the CC024 strain.

Estrogen-induced gonadotropin surges in decerebrated female rhesus monkeys with medial basal hypothalamic peninsulae.

Hypothalamic peninsulae, posteriorly continuous with the brain stem, were produced in ovariectomized rhesus monkeys by aspiration of the cerebral hemispheres and all brain structures anterior and dorsal to the optic chiasm. These preparations were sustained for 52 to 60 h postoperatively by maintaining blood gases and pH within physiological limits and by supporting arterial blood pressure, when necessary, with infusions of rhesus monkey blood and norepinephrine. The sc injection of estradiol benzoate (EB) to such animals upon completion of the ablation procedure was followed 18-24 h later by unambiguous surges of serum LH and FSH with durations in the excess of 24 h. These findings are consonant with the view that the central components of the control system that initiates the preovulatory gonadotropin surge in the rhesus monkey are resident within the medial basal hypothalamic-hypophysial apparatus.

Effect of exercise on cation transport in human red cells.

To test the hypothesis that environmental as well as genetic factors are important determinants of monovalent cation transport systems in humans, and to explore potential basic mechanisms of the alleged antihypertensive effects of habitual exercise, we studied the effects of a 12-week exercise program (45 minutes, 3-5 times per week) upon several membrane transport parameters in erythrocytes from a population of 63 adult men (30 normotensive subjects and 33 essential hypertensive patients). Subjects were randomly assigned into either an exercise group or a sedentary control group, and clinical and membrane transport parameters were measured at baseline and after 3 months. Exercising subjects demonstrated increases in maximal treadmill work capacity (p less than 0.001) and high-density lipoprotein cholesterol levels (p = 0.009) as well as decreases in heart rate at a fixed submaximal workload (p less than 0.05) and body weight (p less than 0.001) relative to the sedentary group. In conjunction with these well-described effects of exercise conditioning, the exercise group demonstrated a significant decrease in Na+-Li+ countertransport (p = 0.002), without significant changes in any other transport parameters measured. Blood pressure was not significantly altered in either group. We conclude that powerful environmental influences such as exercise training may act in concert with genetic factors to influence monovalent cation transport in humans and must be considered in further investigations of the pathophysiological linkage between altered monovalent cation transport and essential hypertension.

Analysis and comparison of venous air embolism detection methods.

Changes in precordial ultrasonic Doppler patterns in dogs were compared with changes of end-tidal carbon dioxide (EtCO2) and pulmonary arterial pressure (PAP). Possible mechanisms of pulmonary arterial hypertension after air embolism in dogs are discussed. After the injection of air, an immediate change in the Doppler ultrasonic pattern was detected, including a shift of the base line. The duration of change of Doppler patterns varied depending upon the length of time that trapped air remained in the right heart. There was a delay of 15 to 30 seconds before the EtCO2 and PAP responded. In a group of dogs pretreated with 0.3 mg of propranolol per kg, there was a significant decrease in the PAP response due to induced air embolism compared to the control group (P < 0.05). We found that the Doppler ultrasonic device was the most sensitive for detecting venous air embolism at a level as low as 0.05 ml of air per kg compared to 0.25 ml/kg for the PAP and EtCO2 responses.

Osteoid osteoma of the os calcis in a teenage athlete.

Osteoid osteomas are small, benign bone tumors most commonly located in the proximal femur or tibia. The classic presentation is localized pain increasing in severity at night, and relieved by the use of anti-inflammatory medications. In a young athlete complaining of foot pain, many conditions should be included in the differential diagnosis. A case of osteoid osteoma of the os calcis in a teenage basketball player is presented.

Acute fracture bipartite patella: case report and literature review.

Disorders of the patella are the most common cause of anterior knee pain. The etiologies of anterior knee pain are reviewed. A case report of an acute displaced patella fracture in a bipartite union is presented. Bipartite patellar development, incidence, radiographic findings, and clinical symptoms follow. Treatment of excision of displaced fragment provides an excellent result.

Jet ventilation for operative laryngoscopy.

High pressure oxygen jet ventilation via a small bore endotracheal tube has been found to be a very effective method for operative laryngoscopy and bronchoscopy under general anesthesia. Advantages of this technique include easily visualization of the larynx and good access for surgical manipulations and bronchoscopic procedures while maintaining excellent patient oxygenation and ventilation. There are few contra-indications for this procedure. Over the past 7 years we have done several thousand operative laryngoscopies using high pressure oxygen jet ventilation with few complications and excellent anesthetic and surgical results.

Nonflammable endotracheal device for CO2 laser ablation of benign laryngeal and proximal tracheal tumors.

A Holinger aspirating tube may be utilized as a nonflammable endotracheal device during CO2 laser ablation of benign laryngeal and proximal tracheal tumors. Adequate jet ventilation may be performed through this small diameter (3.0 mm), metallic device while providing an unobstructed view of the surgical lesion. This technique was well-accepted by surgeons during the clinical trials. Because the 3.0 mm outside diameter was significantly smaller than the smallest flexible, uncuffed metal endotracheal tube currently available (6.9 mm), the rigid structure facilitated atraumatic insertion past the surgical lesion. Both the use of this device and the required anesthetic technique are described in three CO2 laser ablative procedures. The authors consider that this device increases safety during this potentially hazardous procedure by eliminating the flammable polyvinyl chloride endotracheal tube and cottonoid packings most frequently used during this procedure.

Stress-strain relationship and neurological sequelae of uniaxial elongation of the spinal cord of cats.

An in vivo experimental method was developed to measure the mechanical or rheological properties of the spinal cord of anesthetized cats. This novel approach resulted in measurements of the tensile force in the cord and the modulus of the spinal cord tissue under longitudinal elongation. Both sensory and motor function of the cats recovered within a week after a spinal cord segment had been stretched by a 50% elongation.

[Primary small cell carcinoma of the kidney: report of a case].

Primary small cell carcinoma (SCC) of the kidney is an extremely rare neoplasm. The morphological, immunohistological and ultrastructural features are closely akin to primary SCC of the lung. The case of a 38-year-old married male, nonsmoker, with primary small cell carcinoma of the kidney and associated multiple bony metastases is reported. Roentgenographic studies exhibited a tumor mass 3 cm in diameter over the middle portion of the left kidney. A CT scan of the cervical and thoracic spines, and a whole body bone scan displayed multiple osteolytic lesions suggesting multiple bony metastatic lesions. A chest X ray and CT scan of the nasopharynx demonstrated no significant lesions. A complete workup was performed followed by a left nephrectomy. Histologically, the tumor revealed SCC of the kidney. Immunohistochemically, the tumor cells demonstrated immunoreactivity to cytokeratin (CK), neuron-specific enolase (NSE) and produced negative stains to argentaffin, argyrophil, S-100 and chromogranin A. Ultrastructurally, these neoplastic small cells revealed a few cytoplasmic dense-core neuroendocrine-type differentiated secretory granules, measuring 110 to 115 nm in size. Thus, adjuvant therapy, supplemented with chemotherapy and radiotherapy, was employed. The patient was alive and well 6 months after surgery. To the best of our knowledge, there are four documented cases of primary SCC of the kidney. In this article, the light microscopic, immunohistochemical and ultrastructural studies of renal SCC are presented and suggest a renal pelvic epithelial origin of renal SCC. Cognitively renal SCC appears to be an aggressive tumor, regardless of the degree of neuroendocrine differentiation.

The impact of simulated distal interphalangeal joint fusion on grip strength.

This study assessed the impact of distal interphalangeal (DIP) joint fusion on grip strength and how this may be related to a profundus quadriga. Nineteen adults (12 men and 7 women) with an average age of 32.6 years (range: 24-61 years) underwent a series of grip strength measurements with simulation of DIP arthrodesis to the index, long, and index and long (index-long) fingers. The nondominant hand served as a control for the testing. All participants were tested in the same manner: baseline dominant and nondominant hands without DIP block followed by blocking of DIP flexion on the dominant hand only for index, index-long, and long finger alone. Nondominant hands also were tested each time, but without blocking to serve as a control for normal changes in grip strength with repeated testing. Grip strength values were compared to baseline for each trial using the Student's t test. Significant decreases in grip strength were seen for all DIP blocking compared with baseline, but no significant differences were noted in the equivalent trial in the nondominant, nonblocked hand. These findings may have clinical relevance when performing DIP arthrodesis.

Case report: increased myocardial irritability with halothane and aminophylline.

Increased cardiac sensitivity to epinephrine during halothane anesthesia has been well documented; however, there are few reports of increased cardiac irritability due to interaction between halothane anesthesia and aminophylline. The following case report is suggestive of such an interaction resulting in ventricular tachycardia.

Enflurane-induced grand mal seizures during otic microsurgery.

Abnormal electroencephalographic seizure-like activity and myoclonic movements have been recognized during enflurane anesthesia. This is most commonly seen in the presence of respiratory alkalosis and high concentrations of enflurane. Immediate and delayed postoperative generalized tonic-clonic convulsions have also been reported after enflurane anesthesia. Experimental studies have shown that auditory stimuli could facilitate seizure activity during deep enflurane anesthesia. Here we report a case of intraoperative generalized tonic-clonic convulsion during low concentrations of enflurane without evidence of hyperventilation and the presence of auditory stimulation.