Establishment of a nomogram model in predicting risk factors of post-operative complications after laparoscopic anterior resection for rectal cancer.

OBJECTIVE: We aimed to analyse the risk factors of complications after laparoscopic anterior resection of rectal cancer, and to establish a nomogram prediction model and evaluate its accuracy. PATIENTS AND METHODS: We retrospectively analysed the clinical data of 180 patients undergoing laparoscopic anterior resection of rectal cancer. Univariate analysis and multivariate logistic regression analysis were used to screen the potential risk factors of post-operative complications of Grade II and establish a nomogram model. The receiver operating characteristic (ROC) curve and Hosmer-Lemeshow goodness-of-fit test were used to evaluate the discrimination and coincidence of the model, and the calibration curve was used to internally verify. RESULTS: A total of 53 patients (29.4%) with rectal cancer had Grade II post-operative complications. Multivariate logistic regression analysis showed that age (odds ratio [OR] =1.085, P < 0.001), body mass index ≥24 kg/m 2 (OR = 2. 763, P = 0. 008), tumour diameter ≥5 cm (OR = 3. 572, P = 0.002), tumour distance from anal margin ≤6 cm (OR = 2.729, P = 0.012) and operation time ≥180 min (OR = 2.243, P = 0.032) were independent risk factors for Grade II post-operative complications. The area under the ROC was 0.782 (95% confidence interval: 0.706-0.858, sensitivity: 66.0%, specificity: 76.4%) in the nomogram prediction model. Hosmer-Lemeshow goodness-of-fit test showed χ2 = 9.350, P = 0.314. CONCLUSION: Based on five independent risk factors, the nomogram prediction model has a good predictive performance for post-operative complications after laparoscopic anterior resection of rectal cancer, which is helpful to early identify high-risk people and formulate clinical intervention measures.

A Low-Cost AI-Empowered Stethoscope and a Lightweight Model for Detecting Cardiac and Respiratory Diseases from Lung and Heart Auscultation Sounds.

Cardiac and respiratory diseases are the primary causes of health problems. If we can automate anomalous heart and lung sound diagnosis, we can improve the early detection of disease and enable the screening of a wider population than possible with manual screening. We propose a lightweight yet powerful model for simultaneous lung and heart sound diagnosis, which is deployable in an embedded low-cost device and is valuable in remote areas or developing countries where Internet access may not be available. We trained and tested the proposed model with the ICBHI and the Yaseen datasets. The experimental results showed that our 11-class prediction model could achieve 99.94% accuracy, 99.84% precision, 99.89% specificity, 99.66% sensitivity, and 99.72% F1 score. We designed a digital stethoscope (around USD 5) and connected it to a low-cost, single-board-computer Raspberry Pi Zero 2W (around USD 20), on which our pretrained model can be smoothly run. This AI-empowered digital stethoscope is beneficial for anyone in the medical field, as it can automatically provide diagnostic results and produce digital audio records for further analysis.

Towards East Asian Facial Expression Recognition in the Real World: A New Database and Deep Recognition Baseline.

In recent years, the focus of facial expression recognition (FER) has gradually shifted from laboratory settings to challenging natural scenes. This requires a great deal of real-world facial expression data. However, most existing real-world databases are based on European-American cultures, and only one is for Asian cultures. This is mainly because the data on European-American expressions are more readily accessed and publicly available online. Owing to the diversity of huge data, FER in European-American cultures has recently developed rapidly. In contrast, the development of FER in Asian cultures is limited by the data. To narrow this gap, we construct a challenging real-world East Asian facial expression (EAFE) database, which contains 10,000 images collected from 113 Chinese, Japanese, and Korean movies and five search engines. We apply three neural network baselines including VGG-16, ResNet-50, and Inception-V3 to classify the images in EAFE. Then, we conduct two sets of experiments to find the optimal learning rate schedule and loss function. Finally, by training with the cosine learning rate schedule and island loss, ResNet-50 can achieve the best accuracy of 80.53% on the testing set, proving that the database is challenging. In addition, we used the Microsoft Cognitive Face API to extract facial attributes in EAFE, so that the database can also be used for facial recognition and attribute analysis. The release of the EAFE can encourage more research on Asian FER in natural scenes and can also promote the development of FER in cross-cultural domains.

Alginate oligosaccharide alleviates D-galactose-induced cardiac ageing via regulating myocardial mitochondria function and integrity in mice.

Ageing is a crucial risk factor for the development of age-related cardiovascular diseases. Therefore, the molecular mechanisms of ageing and novel anti-ageing interventions need to be deeply studied. Alginate oligosaccharide (AOS) possesses high pharmacological activities and beneficial effects. Our study was undertaken to investigate whether AOS could be used as an anti-ageing drug to alleviate cardiac ageing. D-galactose (D-gal)-induced C57BL/6J ageing mice were established by subcutaneous injection of D-gal (200 mg·kg-1 ·d-1 ) for 8 weeks. AOS (50, 100 and 150 mg·kg-1 ·d-1 ) were administrated intragastrically for the last 4 weeks. As a result, AOS prevented cardiac dysfunction in D-gal-induced ageing mice, including partially preserved ejection fraction (EF%) and fractional shortening (FS%). AOS inhibited D-gal-induced up-regulation of natriuretic peptides A (ANP), brain natriuretic peptide (BNP) and ageing markers p53 and p21 in a dose-dependent manner. To further explore the potential mechanisms contributing to the anti-ageing protective effect of AOS, the age-related mitochondrial compromise was analysed. Our data indicated that AOS alleviated D-gal-induced cardiac ageing by improving mitochondrial biogenesis, maintaining the mitochondrial integrity and enhancing the efficient removal of impaired mitochondria. AOS also decreased the ROS production and oxidative stress status, which, in turn, further inhibiting cardiac mitochondria from being destroyed. Together, these results demonstrate that AOS may be an effective therapeutic agent to alleviate cardiac ageing.

Alginate Oligosaccharide Alleviates Monocrotaline-Induced Pulmonary Hypertension via Anti-Oxidant and Anti-Inflammation Pathways in Rats.

Pulmonary arterial hypertension (PAH) is a serious and fatal cardiovascular disorder characterized by increased pulmonary vascular resistance and progressive pulmonary vascular remodeling. The underlying pathological mechanisms of PAH are multi-factorial and multi-cellular. Alginate oligosaccharide (AOS), which is produced by depolymerizing alginate, shows better pharmacological activities and beneficial effects. The present study was undertaken to investigate the effects and potential mechanisms of AOS-mediated alleviation of pulmonary hypertension. Pulmonary hypertension was induced in Sprague-Dawley rats by a single intraperitoneal injection of monocrotaline (MCT; 60 mg/kg). Five weeks after the injection of MCT, AOS (5, 10, and 20 mg·kg-1·d-1) was injected intraperitoneally for another three weeks. The results showed that AOS prevented the development of MCT-induced pulmonary hypertension and right ventricular hypertrophy in a dose-dependent manner. AOS treatment also prevented MCT-induced pulmonary vascular remodeling via inhibition of the TGF-ß1/p-Smad2 signaling pathway. Furthermore, AOS treatment downregulated the expression of malondialdehyde, nicotinamide adenine dinucleotide phosphate oxidase, and pro-inflammatory cytokines, decreased macrophage infiltration, and upregulated the expression of anti-inflammatory cytokines. These findings indicate that AOS exerts anti-oxidative and anti-inflammatory effects in pulmonary arteries, which may contribute to the alleviation of pulmonary hypertension and pulmonary vascular remodeling.

Alginate oligosaccharide alleviates senile osteoporosis via the RANKL-RANK pathway in D-galactose-induced C57BL/6J mice.

Osteoporosis is a systemic skeletal disorder characterized by reduced bone mineral density (BMD) and bone quality and increased bone porosity, which increase the risk of bone fracture. Inflammation, one of the important mechanisms related to aging, is associated with osteoporosis. Treatment with anti-inflammatory agents is effective for alleviating senile osteoporosis. Alginate oligosaccharide (AOS) can prevent and treat diseases related to inflammation, oxidative stress, and immunity. This study evaluates the effect of AOS on osteoporosis and investigates the underlying mechanism. Osteoporosis model was induced by D-galactose (D-gal) (200 mg kg-1  day-1 ) for eight weeks. Three groups were administered via AOS (50, 100, and 150 mg kg-1  day-1 ) for four weeks, while a control group received sterile water (5 ml kg-1  day-1 ) for 8 weeks. The results showed that AOS improved bone density and bone microstructure in D-gal-induced osteoporosis mice. AOS inhibited osteoclast proliferation, probably through the suppression of receptor activator of nuclear factor-kappa B ligand (RANKL)-associated nuclear factor kappa B (NF-κB) and c-Fos signaling pathway. AOS also increased osteoprotegerin (OPG) expression and competitively inhibited the binding between RANK and RANKL in senile osteoporosis. Further, AOS decreased the secretion of serum osteocalcin and reduced bone conversion. Together, these results demonstrate the anti-osteoporosis activity of AOS in mice with osteoporosis.

Alginate Oligosaccharide Prevents against D-galactose-mediated Cataract in C57BL/6J Mice via Regulating Oxidative Stress and Antioxidant System.

PURPOSE: Alginate oligosaccharides (AOS), obtained from depolymerizing alginate, has multiple pharmacological benefits. Cataract is a common disease caused by turbidity of the lens protein due to lens metabolism disorders. This study aimed to test the effects and the underlying mechanisms of AOS on D-galactose (D-gal)-mediated cataract. MATERIALS AND METHODS: A total of 45 8-week-old C57BL/6 J male mice were randomly divided into 5 groups. After eight weeks' intervention, the score of cataract was calculated depending on the turbidity of the lens. Hematoxylin and eosin (HE) and transmission electron microscope (TEM) images were observed. Superoxide dismutase (SOD) activity and malondialdehyde (MDA) level were measured by corresponding detection kits, respectively. SOD1, SOD2, catalase (CAT) and p53 protein expressions were examined by Western blot. Nuclear factor erythroid-2 related factor (Nrf2) and heme oxygenase-1 (HO-1) mRNA expressions were examined by Quantitative Real Time-PCR (RT-qPCR). RESULTS: The score of the turbidity of the lens showed that AOS significantly delayed the cataractogenesis. HE staining and TEM imaging showed that AOS decreased the damage and senescence of lenses in D-gal-induced C57BL/6 J mice. We further detected aging marker p53 expression in crystalline lenses, and our result showed that AOS significantly inhibited p53 protein expression in D-gal-induced mice. In addition, SOD activity and MDA level detection results showed that AOS significantly increased the activity of SOD, and decreased the level of MDA in crystalline lenses homogenates of D-gal-induced aging mice. Western blot results showed that AOS attenuated the damage of D-gal in the protein expressions of antioxidative enzymes SOD1, SOD2 and CAT. RT-qPCR results showed that AOS suppressed the down-regulation of Nrf2 and HO-1 mRNA expressions induced by D-gal. CONCLUSIONS: AOS prevents against D-gal-mediated cataract in C57BL/6 J mice via inhibiting oxidative stress and up-regulating antioxidant system. Consequently, our results suggest that AOS may be an effective therapeutic strategy against cataract.