Watermarks can provide reliable and secure copyright protection for optical coherence tomography(OCT)fundus images.The effective image segmentation is helpful for promoting OCT image watermarking.However,OCT images ha...Watermarks can provide reliable and secure copyright protection for optical coherence tomography(OCT)fundus images.The effective image segmentation is helpful for promoting OCT image watermarking.However,OCT images have a large amount of low-quality data,which seriously affects the performance of segmentationmethods.Therefore,this paper proposes an effective segmentation method for OCT fundus image watermarking using a rough convolutional neural network(RCNN).First,the rough-set-based feature discretization module is designed to preprocess the input data.Second,a dual attention mechanism for feature channels and spatial regions in the CNN is added to enable the model to adaptively select important information for fusion.Finally,the refinement module for enhancing the extraction power of multi-scale information is added to improve the edge accuracy in segmentation.RCNN is compared with CE-Net and MultiResUNet on 83 gold standard 3D retinal OCT data samples.The average dice similarly coefficient(DSC)obtained by RCNN is 6%higher than that of CE-Net.The average 95 percent Hausdorff distance(95HD)and average symmetric surface distance(ASD)obtained by RCNN are 32.4%and 33.3%lower than those of MultiResUNet,respectively.We also evaluate the effect of feature discretization,as well as analyze the initial learning rate of RCNN and conduct ablation experiments with the four different models.The experimental results indicate that our method can improve the segmentation accuracy of OCT fundus images,providing strong support for its application in medical image watermarking.展开更多
BACKGROUND The Omicron variant of severe acute respiratory syndrome coronavirus 2(SARSCoV-2)mainly infects the upper respiratory tract.This study aimed to determine whether the probability of pulmonary infection and t...BACKGROUND The Omicron variant of severe acute respiratory syndrome coronavirus 2(SARSCoV-2)mainly infects the upper respiratory tract.This study aimed to determine whether the probability of pulmonary infection and the cycle threshold(Ct)measured using the fluorescent polymerase chain reaction(PCR)method were related to pulmonary infections diagnosed via computed tomography(CT).AIM To analyze the chest CT signs of SARS-CoV-2 Omicron variant infections with different Ct values,as determined via PCR.METHODS The chest CT images and PCR Ct values of 331 patients with SARS-CoV-2Omicron variant infections were retrospectively collected and categorized into low(<25),medium(25.00-34.99),and high(≥35)Ct groups.The characteristics of chest CT images in each group were statistically analyzed.RESULTS The PCR Ct values ranged from 13.36 to 39.81,with 99 patients in the low,155 in the medium,and 77 in the high Ct groups.Six abnormal chest CT signs were detected,namely,focal infection,patchy consolidation shadows,patchy groundglass shadows,mixed consolidation ground-glass shadows,subpleural interstitial changes,and pleural changes.Focal infections were less frequent in the low Ct group than in the medium and high Ct groups;these infections were the most common sign in the medium and high Ct groups.Patchy consolidation shadows and pleural changes were more frequent in the low Ct group than in the other two groups.The number of patients with two or more signs was greater in the low Ct group than in the medium and high Ct groups.CONCLUSION The chest CT signs of patients with pulmonary infection caused by the Omicron variants of SARSCoV-2 varied depending on the Ct values.Identification of the characteristics of Omicron variant infection can help subsequent planning of clinical treatment.展开更多
BACKGROUND Gastric cancer(GC)is one of the most common cancers and has a poor prognosis.Treatment of GC has remained unchanged over the past few years.AIM To investigate the potential therapeutic targets and related r...BACKGROUND Gastric cancer(GC)is one of the most common cancers and has a poor prognosis.Treatment of GC has remained unchanged over the past few years.AIM To investigate the potential therapeutic targets and related regulatory biomarkers of GC.METHODS We obtained the public GC transcriptome sequencing dataset from the Gene Expression Omnibus database.The datasets contained 348 GC tissues and 141 healthy tissues.In total,251 differentially expressed genes(DEGs)were identified,including 187 down-regulated genes and 64 up-regulated genes.The DEGs’enriched functions and pathways include Progesterone-mediated oocyte maturation,cell cycle,and oocyte meiosis,Hepatitis B,and the Hippo signaling pathway.Survival analysis showed that BUB1,MAD2L1,CCNA2,CCNB1,and BIRC5 may be associated with regulation of the cell cycle phase mitotic spindle checkpoint pathway.We selected 26 regulated genes with the aid of the protein-protein interaction network analyzed by Molecular Complex Detection.RESULTS We focused on three critical genes,which were highly expressed in GC,but negatively related to patient survival.Furthermore,we found that knockdown of Yu K et al.Biochemical analysis in GC WJCC https://www.wjgnet.com 5024 July 26,2023 Volume 11 Issue 21 BIRC5,TRIP13 or UBE2C significantly inhibited cell proliferation and induced cell apoptosis.In addition,knockdown of BIRC5,TRIP13 or UBE2C increased cellular sensitivity to cisplatin.CONCLUSION Our study identified significantly upregulated genes in GC with a poor prognosis using integrated bioinformatics methods.展开更多
Objective： To descript the incidence and mortality rates of oral cancer among Chinese population in 2011, and provide valuable data for oral cancer prevention and research. Methods： Data from 177 population-based ca...Objective： To descript the incidence and mortality rates of oral cancer among Chinese population in 2011, and provide valuable data for oral cancer prevention and research. Methods： Data from 177 population-based cancer registries distributed in 28 provinces were accepted for this study after evaluation based on quality control criteria, covering a total of 175,310,169 populations and accounting for 13.01% of the overall national population in 2011. Incidence and mortality rates were calculated by area, gender and age groups. The numbers of new cases and deaths were estimated using the 5-year age-specific cancer incidence/mortality rates and the corresponding populations. The Chinese population in 2000 and World Segi＇s population were used for age-standardized rates. Results： The estimate of new cases diagnosed with oral cancer was 39,450 including 26,160 males and 13,290 females. The overall crude incidence rate for oral cancer was 2.93/100,000. The age-standardized rates by China （ASRcN） population and by World population （ASRwld） were 2.22/100,000 and 2.17/100,000, respectively. Among subjects aged 0-74 years, the cumulative incidence rate was 0.25%. The estimated number of oral cancer deaths of China in 2011 was 16,933, including 11,794 males and 5,139 females. The overall crude mortality rate was 1.26/I00,000, accounting for 0.80% of all cancer deaths. The ASRcN and ASP^Id for mortality were 0.90/100,000 and 0.89/100,000, respectively. Among subjects aged 0-74 years, the cumulative mortality rate was 0.10%. The incidence and mortality rates of oral cancer were much higher in males and urban areas than in females and rural areas. In addition, the incidence and mortality rates were increased by the raising of ages. Conclusions： Results in the study may have important roles for oral cancer prevention and research. Although oral cancer burden of China is not high, we must pay attention to this malignancy as well. In addition, further researches need to be done for primary and secondary prevention research of oral cancer, especially for the high risk population.展开更多
Objective: To analyze the incidence and mortality rates of lung cancer in China from 2008 to 2012.Methods: Incident and death cases of lung cancer were retrieved from the National Central Cancer Registry(NCCR) databas...Objective: To analyze the incidence and mortality rates of lung cancer in China from 2008 to 2012.Methods: Incident and death cases of lung cancer were retrieved from the National Central Cancer Registry(NCCR) database collecting from 135 cancer registries in China during 2008-2012.The crude incidence and mortality rates of lung cancer were calculated by area(urban/rural),region(eastern,middle,western),gender and age group(0,1-4,5-9,…,85+).China census in 2000 and Segi’s world population were applied for agestandardized rates.JoinPoint(Version 4.5.0.1) model was used for time trend analysis.Results: The crude incidence rate of lung cancer was 54.66/100,000 which ranked the first in overall cancers.The age-standardized incidence rates by China population(ASIRC) and by World population(ASIRW) were35.13/100,000 and 34.86/100,000,respectively.The crude mortality of lung cancer in China was 45.60/100,000 and it was the first cause of cancer-related death in overall cancers.The age-standardized mortality rates by Chinese standard population(ASMRC) and by world standard population(ASMRW) were 28.57/100,000 and 28.22/100,000,respectively.Incidence and mortality rates of lung cancer were higher in males than in females and higher in urban areas than in rural areas.Eastern areas had the highest incidence and mortality rates followed by middle and western areas.Incidence and mortality rates of lung cancer retained low level in age groups before 40 years old but increased greatly after and peaked in age group of 80-84.During 2003-2012,the temporal trend of the incidence rate of lung cancer in both sexes in China was general stable(P<0.05).The lung cancer incidence rate increased by 0.71% per year in females(P<0.05) and 2.26% per year in rural areas(P<0.05).The mortality rate of lung cancer decreased slightly annually during 2003-2012 in China(P>0.05).In urban areas,it declined by 0.76%per year(P<0.05),but rose by 2.09% per year(P<0.05) in rural areas.Conclusions: Appropriate targeted prevention,early detection and treatment programs should be carried out to control the local burden of lung cancer.展开更多
Objective： Population-based cancer registration data in 2012 from all available cancer registries in Henan province were collected by Henan Office for Cancer Research and Control. The numbers of new cancer cases and ...Objective： Population-based cancer registration data in 2012 from all available cancer registries in Henan province were collected by Henan Office for Cancer Research and Control. The numbers of new cancer cases and cancer deaths in Henan province with compiled cancer incidence and mortality rates were estimated. Methods： In 2015, all registries＇ data in Henan province were qualified for the national cancer registry annual report in 2012. The pooled data were stratified by area （urban/rural）, gender, age group （0, 1-4, 5-9, 10-14, ..., 85＋） and cancer type. New cancer cases and deaths were estimated using age-specific rates and corresponding population of Henan province in 2012. The Chinese census data in 2000 and Segi＇s population were applied for age-standardized rates. All the rates were expressed per 100,000 person-years. Results： Qualified 19 cancer registries （4 urban and 15 rural registries） covered 16,082,688 populations of Henan province in 2012. The percentage of cases with morphologically verified （MV%） and death certificate- only cases （DCO%） were 69.84% and 2.30%, respectively, and the mortality to incidence rate ratio （M/ I） was 0.64. It was estimated that there were 248,510 new cancer cases and 158,630 cancer deaths in Henan province in 2012. The incidence rate was 266.17/100,000 （288.61/100,000 in males and 241.86/100,000 in females）, the age-standardized incidence rates by Chinese standard population （ASIRC） and by world standard population （ASIRW） were 208.95/100,000 and 206.41/100,000 with the cumulative incidence rate （0-74 years old） of 24.30%. The crude incidence rate in urban areas was higher than that in rural areas. However, after adjusted by age, the cancer incidence rate in rural was higher than that in urban areas. The crude mortality of all cancers in Henan province was 169.90/100,000 （201.23/100,000 in males and 135.95/100,000 in females）. The age-standardized mortality rates by Chinese standard population （ASMRC） and by world standard population （ASMRW） were 131.20/100,000 and 130.80/100,000, respectively. Among the patients aged 0-74 years, the cumulative mortality rate was 15.03%. The crude cancer mortality rate in urban areas was higher than that of rural areas. However, the age-standardized rate in rural areas was higher than that of urban areas. Cancers of lung, stomach, esophagus, liver, female breast, colorectum, cervix, brain, uterus and ovary were the most common cancers, accounting for about 82.80% of all cancer new cases. Lung cancer, stomach cancer, esophageal cancer, liver cancer, colorectal cancer, female breast cancer, brain cancer, leukemia, pancreatic cancer and cervix cancer were the leading causes of cancer deaths, accounting for about 88.50% of all cancer deaths. The burden between urban and rural, males and females were different. Conclusions： Registration data of Henan province was qualified to provide basic information on population-based cancer incidence, mortality for cancer prevention and control. The upper digestive tract cancer burden in Henan province, especially for males in rural areas, was higher. The incidence rate of female breast cancer was higher in urban areas. Targeted prevention, early detection and treatment programs should be carried out by health department to control the cancer burden.展开更多
S-phase kinase-associated protein 2 (Skp2), which plays a role in cell cycle regulation, is commonly overexpressed in a variety of human cancers and associated with poor prognosis. However, its role in nasopharyngeal ...S-phase kinase-associated protein 2 (Skp2), which plays a role in cell cycle regulation, is commonly overexpressed in a variety of human cancers and associated with poor prognosis. However, its role in nasopharyngeal carcinoma (NPC) is not well understood. In this study, we examined the clinical significance of Skp2, with a particular emphasis on overall survival (OS) and disease-free survival (DFS), in NPC cases in South China, where NPC is an epidemic. Additionally, we explored the function of Skp2 in maintaining a cancer stem cell -like phenotype in NPC cell lines. Skp2 expression was assessed for 127 NPC patients using tissue microarrays and immunohistochemistry and analyzed together with clinicopathologic features, OS, and DFS. Skp2 expression was detectable, or positive, in 75.6% of patients. Although there was no correlation between Skp2 and any clinicopathologic factor, Skp2 expression significantly portended inferior OS (P = 0.013) and DFS (P = 0.012). In the multivariate model, Skp2 expression remained significantly predictive of poor OS [P = 0.009, risk ratio (RR) = 4.06] and DFS (P = 0.008, RR = 3.56), and this was also true for clinical stage (P = 0.012 and RR=3.201 for OS; P = 0.002 and RR=1.94 for DFS) and sex (P = 0.016 and RR=0.31 for OS; P = 0.006 and RR = 0.27 for DFS). After Skp2 knockdown, a colony formation assay was used to evaluate the self-renewal property of stem-like cells in the NPC cell lines CNE-1 and CNE-2. The colony formation efficiency in CNE-1 and CNE-2 cells was decreased. In Skp2-transfected CNE-1 and CNE-2 cells, side population (SP) proportion was increased as detected by flow cytometry. Skp2 is an independent prognostic marker for OS and DFS in NPC. Skp2 may play a role in maintaining the cancer stem cell-like phenotype of NPC cell lines.展开更多
Background Increasing research suggests that mitochondrial defect plays a major role in pulmonary hypertension(PH) pathogenesis. Mitochondrial dynamics and quality control have a central role in the maintenance of the...Background Increasing research suggests that mitochondrial defect plays a major role in pulmonary hypertension(PH) pathogenesis. Mitochondrial dynamics and quality control have a central role in the maintenance of the cell proliferation and apoptosis balance. However, the molecular mechanism underlying of this balance is still unknown. Methods To clarify the biological effects of hypoxic air exposure and hypoxia-inducible factor-1α(HIF-1α) on pulmonary arterial smooth muscle cell(PASMC) and pulmonary arterial hypertension rats, the cells were cultured in a hypoxic chamber under oxygen concentrations. Cell viability, reactive oxygen species level, cell death, mitochondrial morphology, mitochondrial membrane potential, mitochondrial function and mitochondrial biosynthesis, as well as fission-and fusion-related proteins, were measured under hypoxic conditions. In addition, rats were maintained under hypoxic conditions, and the right ventricular systolic pressure, right ventricular hypertrophy index and right ventricular weight/body weight ratio were examined and recorded. Further, we assessed the role of HIF-1α in the development and progression of PH using HIF-1α gene knockdown using small interfering RNA transfection. Mdivi-1 treatment was performed before hypoxia to inhibit dynamin-related protein 1(Drp1). Results We found that HIF-1α expression was increased during hypoxia, which was crucial for hypoxia-induced mitochondrial dysfunction and hypoxia-stimulated PASMCs proliferation and apoptosis. We also found that targeting mitochondrial fission Drp1 by mitochondrial division inhibitor Mdivi-1 was effective in PH model rats. The results showed that mitochondrial dynamics were involved in the pulmonary vascular remodeling under hypoxia in vivo and in vitro. Furthermore, HIF-1α also modulated mitochondrial dynamics in pulmonary vascular remodeling under hypoxia through directly regulating the expression of Drp1. Conclusions In conclusion, our data suggests that abnormal mitochondrial dynamics could be a marker for the early diagnosis of PH and monitoring disease progression. Further research is needed to study the signaling pathways that govern mitochondrial fission/fusion in PH.展开更多
AIM:To report the refractive outcomes after vitrectomy combined with phacoemulsification and intraocular lens(IOL)implantation(phaco-vitrectomy)in idiopathic macular holes(IMH).METHODS:A total of 56 eyes with IMH(IMH ...AIM:To report the refractive outcomes after vitrectomy combined with phacoemulsification and intraocular lens(IOL)implantation(phaco-vitrectomy)in idiopathic macular holes(IMH).METHODS:A total of 56 eyes with IMH(IMH group)that underwent phaco-vitrectomy and 44 eyes with age-related cataract(ARC group)that underwent cataract surgery were retrospectively reviewed.The best corrective visual acuity(BCVA),predicted refractive error(PRE),actual refractive error(ARE),axial length(AL),were measured in both groups before and 6 mo after operation.The power calculation of IOL and the predicted refractive error(PRE)were calculated according to the SRK/T formula.The difference of PRE and ARE between the two groups were compared and analyzed.RESULTS:In the IMH group,the diameters of macular holes were 271.73±75.85μm,the closure rate was 100%.The pre-and post-operative BCVA were 0.80±0.35 and 0.40±0.35 log MAR.The PRE of A-ultrasound and IOL Master in the IMH group was-0.27±0.25 and 0.10±0.66 D.The postoperative mean absolute prediction error(MAE)was observed to be 0.58±0.65 and 0.53±0.37 D in the IOL Master and A-ultrasound(P=0.758).The PRE and ARE of the IMH group were 0.10±0.66 D and-0.19±0.64 D(P=0.102).The PRE and ARE of the ARC group was-0.43±0.95 and-0.31±0.93 D(P=0.383).The difference between PRE and ARE was-0.33±0.81 and 0.09±0.64 D in the IMH and ARC groups(P=0.021).The proportion of myopic shift was 67.9%in the IMH group and 27.3%in the ARC group(P=0.004).CONCLUSION:The myopic shift can be observed in patients with IMH after phaco-vitrectomy.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)is the most common type of primary liver malignancy.Contrast-enhanced ultrasound(CEUS)uses contrast microbubbles during ultrasound,allowing the detection and characterization of...BACKGROUND Hepatocellular carcinoma(HCC)is the most common type of primary liver malignancy.Contrast-enhanced ultrasound(CEUS)uses contrast microbubbles during ultrasound,allowing the detection and characterization of malignant focal liver lesions with much higher diagnostic accuracy than conventional ultrasound;however,there are few reports focusing on the pattern of enhancement of CEUS for the diagnosis of HCC smaller than 2 cm.AIM To investigate the clinical value of CEUS in the early detection of small HCC with high risk factors.METHODS A total of 395 patients with 632 nodules at high risk of HCC,who underwent regular follow-up at Xuhui Dahua Hospital from January 2007 to December 2021,were retrospectively examined.Conventional ultrasonography combined with CEUS was adopted to analyze the echo,size,location,and enhancement characteristics of benign and malignant nodules,as well as the enhancement methods for HCC with different diameters.RESULTS The follow-up rate and duration were 92.15%(364/395)and 51.28±45.09 mo,respectively.Conventional ultrasonography combined with CEUS revealed 65(11.80%)nodules with a follow-up diagnosis of HCC,19(3.45%)dysplastic nodules,and 467(84.75%)benign cirrhotic hyperplastic nodules.Among 65 cases of confirmed HCC,40(61.54%)were transformed from hypoechoic nodules,9(13.85%)from hyperechoic nodules,and the remaining 16(24.62%)from isoechoic nodules.Significant differences in CEUS characteristics were found among cirrhotic nodules,dysplastic nodules,and HCC nodules at each phase.Significant differences in the enhancement mode were observed between nodules≤1 cm and those 1–2 cm.The smaller the HCC nodule,the later the contrast agent began to flush and the longer the duration of contrast enhancement.CONCLUSION Conventional ultrasonography combined with CEUS could identify small HCC and help monitor patients with an early diagnosis of HCC.Significant differences in the enhancement mode are noted between nodules≤1 cm and those 1–2 cm.展开更多
Hepatocellular carcinoma(HCC)is one of the most common malignancies,and its treatment is limited.With the understanding of key genes and signaling pathways in the occurrence and development of HCC,targeted drugs with ...Hepatocellular carcinoma(HCC)is one of the most common malignancies,and its treatment is limited.With the understanding of key genes and signaling pathways in the occurrence and development of HCC,targeted drugs with high selectivity and low toxicity have been developed continuously,bringing a variety of options for the treatment of advanced HCC.In this article,the research progress on representative drugs of targeted therapy and potential therapeutic targets for HCC are reviewed.展开更多
AIM: To observe the effects of the different extents of internal limiting membrane(ILM) peeling on the surgical success and anatomical and functional outcomes of idiopathic macular hole(IMH).METHODS: In this retrospec...AIM: To observe the effects of the different extents of internal limiting membrane(ILM) peeling on the surgical success and anatomical and functional outcomes of idiopathic macular hole(IMH).METHODS: In this retrospective cohort study, 36 patients were reviewed and divided into two groups according to the extent of ILM peeling: group A(18 patients), with the peeling area within one-half of the optic disc macular distance as the radius;group B(18 patients), with the peeling area larger than that of group A but did not exceed the optic disc macular distance as the radius. The main outcomes included the best corrected visual acuity(BCVA), light-adaptive electroretinography, macular hole(MH) closure rate, central macular thickness(CMT), retinal nerve fiber layer(RNFL) and ganglion cell complex(GCC) thickness [nine regions based on the Early Treatment of Diabetic Retinopathy Study(ETDRS) ring] before and 1, 3, and 6mo after surgery.RESULTS: The closure rate was 94.4%(17/18) both in groups A and B. The BCVA in both groups improved significantly compared with the preoperative values, but there was no difference between the two groups. The b-wave amplitude of the electroretinogram analysis was significantly improved in both groups compared to that of the preoperative period, with a greater increase in group A than in group B at 6mo(P=0.017). The CMT in both groups gradually decreased after surgery, and there was no difference between the two groups. The RNFL thickness of the temporal outer ring region in group B was significantly lower than that in group A at 3 and 6mo after surgery(P=0.010, 0.032). The GCC thickness of the temporal outer ring region in group B was significantly lower than that in group A at 6mo after surgery(P=0.038).CONCLUSION: Enlarging the extent of ILM peeling doesn’t affect the IMH closure rate and visual acuity recovery, but the greater the extent of peeling, the greater the damage to the inner retinal structures.展开更多
BACKGROUND Reports on peripherally inserted central catheter(PICC)placement in neonates with persistent left superior vena cava(PLSVC)are rare.The majority of PLSVC patients have no clinical symptoms or hemodynamic ch...BACKGROUND Reports on peripherally inserted central catheter(PICC)placement in neonates with persistent left superior vena cava(PLSVC)are rare.The majority of PLSVC patients have no clinical symptoms or hemodynamic changes,which are usually detected during cardiac catheterization,cardiac pacemaker implantation,or PICC placement.However,in neonates with PLSVC,PICC placement can be challenging.Here,we report PICC placement in eight neonates with PLSVC.CASE SUMMARY This article introduces the concept of the“TIMB”bundle.After PICC implantation,we found PLSVC in all eight patients.The key points of care regarding PICC placement in neonates with PLSVC included“TIMB”,where“T”indicates a reasonable choice of the catheterization time,“I”refers to a retrospective analysis of imaging data before catheterization,“M”refers to correct measurement of the body surface length,and“B”indicates that the tip of the PICC is placed in the middle and lower 1/3 of the left superior vena cava under the guidance of B-ultrasound.CONCLUSION“TIMB”is a bundle for PICC placement in neonates,especially for those with PLSVC.Using this new approach can improve the first-attempt success rate of PICC placement,reveal cardiovascular abnormalities in advance,allow the selection of different measurement methods reasonably according to the puncture site,and finally,improve the accuracy of catheter positioning through the use of B-ultrasound guidance.展开更多
BACKGROUND There have been few reports on level 3 difficult removal of peripherally inserted central catheter(PICC)in neonates.Here,we reported a case of an extremely preterm infant who underwent level 3 difficult rem...BACKGROUND There have been few reports on level 3 difficult removal of peripherally inserted central catheter(PICC)in neonates.Here,we reported a case of an extremely preterm infant who underwent level 3 difficult removal of a PICC.CASE SUMMARY Female baby A,weighing 1070 g at 27^(+1) wk of gestational age,was diagnosed with extremely preterm infant and neonatal respiratory distress syndrome.She underwent PICC insertion twice.The first PICC insertion went well;the second PICC was inserted in the right lower extremity,however,phlebitis occurred on the second day after the placement.On the third day of catheterization,phlebitis was aggravated,while the right leg circumference increased by 2.5 cm.On the fourth day of catheterization,more red swelling was found in the popliteal part,covering an area of about 1.5 cm×4 cm,which was diagnosed as phlebitis level 3;thus,we decided to remove the PICC.During tube removal,the catheter rebounded and could not be pulled out(several conventional methods were performed).Finally,we successfully removed the PICC using a new approach termed“AFGP”.On the 36th day of admission,the baby fully recovered and was discharged.CONCLUSION The“AFGP”bundle approach was effective for an extremely preterm infant,who underwent level 3 difficult removal of a PICC.展开更多
AIM:To assist with retinal vein occlusion(RVO)screening,artificial intelligence(AI)methods based on deep learning(DL)have been developed to alleviate the pressure experienced by ophthalmologists and discover and treat...AIM:To assist with retinal vein occlusion(RVO)screening,artificial intelligence(AI)methods based on deep learning(DL)have been developed to alleviate the pressure experienced by ophthalmologists and discover and treat RVO as early as possible.METHODS:A total of 8600 color fundus photographs(CFPs)were included for training,validation,and testing of disease recognition models and lesion segmentation models.Four disease recognition and four lesion segmentation models were established and compared.Finally,one disease recognition model and one lesion segmentation model were selected as superior.Additionally,224 CFPs from 130 patients were included as an external test set to determine the abilities of the two selected models.RESULTS:Using the Inception-v3 model for disease identification,the mean sensitivity,specificity,and F1 for the three disease types and normal CFPs were 0.93,0.99,and 0.95,respectively,and the mean area under the curve(AUC)was 0.99.Using the DeepLab-v3 model for lesion segmentation,the mean sensitivity,specificity,and F1 for four lesion types(abnormally dilated and tortuous blood vessels,cotton-wool spots,flame-shaped hemorrhages,and hard exudates)were 0.74,0.97,and 0.83,respectively.CONCLUSION:DL models show good performance when recognizing RVO and identifying lesions using CFPs.Because of the increasing number of RVO patients and increasing demand for trained ophthalmologists,DL models will be helpful for diagnosing RVO early in life and reducing vision impairment.展开更多
基金the China Postdoctoral Science Foundation under Grant 2021M701838the Natural Science Foundation of Hainan Province of China under Grants 621MS042 and 622MS067the Hainan Medical University Teaching Achievement Award Cultivation under Grant HYjcpx202209.
文摘Watermarks can provide reliable and secure copyright protection for optical coherence tomography(OCT)fundus images.The effective image segmentation is helpful for promoting OCT image watermarking.However,OCT images have a large amount of low-quality data,which seriously affects the performance of segmentationmethods.Therefore,this paper proposes an effective segmentation method for OCT fundus image watermarking using a rough convolutional neural network(RCNN).First,the rough-set-based feature discretization module is designed to preprocess the input data.Second,a dual attention mechanism for feature channels and spatial regions in the CNN is added to enable the model to adaptively select important information for fusion.Finally,the refinement module for enhancing the extraction power of multi-scale information is added to improve the edge accuracy in segmentation.RCNN is compared with CE-Net and MultiResUNet on 83 gold standard 3D retinal OCT data samples.The average dice similarly coefficient(DSC)obtained by RCNN is 6%higher than that of CE-Net.The average 95 percent Hausdorff distance(95HD)and average symmetric surface distance(ASD)obtained by RCNN are 32.4%and 33.3%lower than those of MultiResUNet,respectively.We also evaluate the effect of feature discretization,as well as analyze the initial learning rate of RCNN and conduct ablation experiments with the four different models.The experimental results indicate that our method can improve the segmentation accuracy of OCT fundus images,providing strong support for its application in medical image watermarking.
文摘BACKGROUND The Omicron variant of severe acute respiratory syndrome coronavirus 2(SARSCoV-2)mainly infects the upper respiratory tract.This study aimed to determine whether the probability of pulmonary infection and the cycle threshold(Ct)measured using the fluorescent polymerase chain reaction(PCR)method were related to pulmonary infections diagnosed via computed tomography(CT).AIM To analyze the chest CT signs of SARS-CoV-2 Omicron variant infections with different Ct values,as determined via PCR.METHODS The chest CT images and PCR Ct values of 331 patients with SARS-CoV-2Omicron variant infections were retrospectively collected and categorized into low(<25),medium(25.00-34.99),and high(≥35)Ct groups.The characteristics of chest CT images in each group were statistically analyzed.RESULTS The PCR Ct values ranged from 13.36 to 39.81,with 99 patients in the low,155 in the medium,and 77 in the high Ct groups.Six abnormal chest CT signs were detected,namely,focal infection,patchy consolidation shadows,patchy groundglass shadows,mixed consolidation ground-glass shadows,subpleural interstitial changes,and pleural changes.Focal infections were less frequent in the low Ct group than in the medium and high Ct groups;these infections were the most common sign in the medium and high Ct groups.Patchy consolidation shadows and pleural changes were more frequent in the low Ct group than in the other two groups.The number of patients with two or more signs was greater in the low Ct group than in the medium and high Ct groups.CONCLUSION The chest CT signs of patients with pulmonary infection caused by the Omicron variants of SARSCoV-2 varied depending on the Ct values.Identification of the characteristics of Omicron variant infection can help subsequent planning of clinical treatment.
文摘BACKGROUND Gastric cancer(GC)is one of the most common cancers and has a poor prognosis.Treatment of GC has remained unchanged over the past few years.AIM To investigate the potential therapeutic targets and related regulatory biomarkers of GC.METHODS We obtained the public GC transcriptome sequencing dataset from the Gene Expression Omnibus database.The datasets contained 348 GC tissues and 141 healthy tissues.In total,251 differentially expressed genes(DEGs)were identified,including 187 down-regulated genes and 64 up-regulated genes.The DEGs’enriched functions and pathways include Progesterone-mediated oocyte maturation,cell cycle,and oocyte meiosis,Hepatitis B,and the Hippo signaling pathway.Survival analysis showed that BUB1,MAD2L1,CCNA2,CCNB1,and BIRC5 may be associated with regulation of the cell cycle phase mitotic spindle checkpoint pathway.We selected 26 regulated genes with the aid of the protein-protein interaction network analyzed by Molecular Complex Detection.RESULTS We focused on three critical genes,which were highly expressed in GC,but negatively related to patient survival.Furthermore,we found that knockdown of Yu K et al.Biochemical analysis in GC WJCC https://www.wjgnet.com 5024 July 26,2023 Volume 11 Issue 21 BIRC5,TRIP13 or UBE2C significantly inhibited cell proliferation and induced cell apoptosis.In addition,knockdown of BIRC5,TRIP13 or UBE2C increased cellular sensitivity to cisplatin.CONCLUSION Our study identified significantly upregulated genes in GC with a poor prognosis using integrated bioinformatics methods.
文摘Objective： To descript the incidence and mortality rates of oral cancer among Chinese population in 2011, and provide valuable data for oral cancer prevention and research. Methods： Data from 177 population-based cancer registries distributed in 28 provinces were accepted for this study after evaluation based on quality control criteria, covering a total of 175,310,169 populations and accounting for 13.01% of the overall national population in 2011. Incidence and mortality rates were calculated by area, gender and age groups. The numbers of new cases and deaths were estimated using the 5-year age-specific cancer incidence/mortality rates and the corresponding populations. The Chinese population in 2000 and World Segi＇s population were used for age-standardized rates. Results： The estimate of new cases diagnosed with oral cancer was 39,450 including 26,160 males and 13,290 females. The overall crude incidence rate for oral cancer was 2.93/100,000. The age-standardized rates by China （ASRcN） population and by World population （ASRwld） were 2.22/100,000 and 2.17/100,000, respectively. Among subjects aged 0-74 years, the cumulative incidence rate was 0.25%. The estimated number of oral cancer deaths of China in 2011 was 16,933, including 11,794 males and 5,139 females. The overall crude mortality rate was 1.26/I00,000, accounting for 0.80% of all cancer deaths. The ASRcN and ASP^Id for mortality were 0.90/100,000 and 0.89/100,000, respectively. Among subjects aged 0-74 years, the cumulative mortality rate was 0.10%. The incidence and mortality rates of oral cancer were much higher in males and urban areas than in females and rural areas. In addition, the incidence and mortality rates were increased by the raising of ages. Conclusions： Results in the study may have important roles for oral cancer prevention and research. Although oral cancer burden of China is not high, we must pay attention to this malignancy as well. In addition, further researches need to be done for primary and secondary prevention research of oral cancer, especially for the high risk population.
基金the Bureau of Disease Control,National HealthFamily Planning Commission of the People's Republic of China
文摘Objective: To analyze the incidence and mortality rates of lung cancer in China from 2008 to 2012.Methods: Incident and death cases of lung cancer were retrieved from the National Central Cancer Registry(NCCR) database collecting from 135 cancer registries in China during 2008-2012.The crude incidence and mortality rates of lung cancer were calculated by area(urban/rural),region(eastern,middle,western),gender and age group(0,1-4,5-9,…,85+).China census in 2000 and Segi’s world population were applied for agestandardized rates.JoinPoint(Version 4.5.0.1) model was used for time trend analysis.Results: The crude incidence rate of lung cancer was 54.66/100,000 which ranked the first in overall cancers.The age-standardized incidence rates by China population(ASIRC) and by World population(ASIRW) were35.13/100,000 and 34.86/100,000,respectively.The crude mortality of lung cancer in China was 45.60/100,000 and it was the first cause of cancer-related death in overall cancers.The age-standardized mortality rates by Chinese standard population(ASMRC) and by world standard population(ASMRW) were 28.57/100,000 and 28.22/100,000,respectively.Incidence and mortality rates of lung cancer were higher in males than in females and higher in urban areas than in rural areas.Eastern areas had the highest incidence and mortality rates followed by middle and western areas.Incidence and mortality rates of lung cancer retained low level in age groups before 40 years old but increased greatly after and peaked in age group of 80-84.During 2003-2012,the temporal trend of the incidence rate of lung cancer in both sexes in China was general stable(P<0.05).The lung cancer incidence rate increased by 0.71% per year in females(P<0.05) and 2.26% per year in rural areas(P<0.05).The mortality rate of lung cancer decreased slightly annually during 2003-2012 in China(P>0.05).In urban areas,it declined by 0.76%per year(P<0.05),but rose by 2.09% per year(P<0.05) in rural areas.Conclusions: Appropriate targeted prevention,early detection and treatment programs should be carried out to control the local burden of lung cancer.
文摘Objective： Population-based cancer registration data in 2012 from all available cancer registries in Henan province were collected by Henan Office for Cancer Research and Control. The numbers of new cancer cases and cancer deaths in Henan province with compiled cancer incidence and mortality rates were estimated. Methods： In 2015, all registries＇ data in Henan province were qualified for the national cancer registry annual report in 2012. The pooled data were stratified by area （urban/rural）, gender, age group （0, 1-4, 5-9, 10-14, ..., 85＋） and cancer type. New cancer cases and deaths were estimated using age-specific rates and corresponding population of Henan province in 2012. The Chinese census data in 2000 and Segi＇s population were applied for age-standardized rates. All the rates were expressed per 100,000 person-years. Results： Qualified 19 cancer registries （4 urban and 15 rural registries） covered 16,082,688 populations of Henan province in 2012. The percentage of cases with morphologically verified （MV%） and death certificate- only cases （DCO%） were 69.84% and 2.30%, respectively, and the mortality to incidence rate ratio （M/ I） was 0.64. It was estimated that there were 248,510 new cancer cases and 158,630 cancer deaths in Henan province in 2012. The incidence rate was 266.17/100,000 （288.61/100,000 in males and 241.86/100,000 in females）, the age-standardized incidence rates by Chinese standard population （ASIRC） and by world standard population （ASIRW） were 208.95/100,000 and 206.41/100,000 with the cumulative incidence rate （0-74 years old） of 24.30%. The crude incidence rate in urban areas was higher than that in rural areas. However, after adjusted by age, the cancer incidence rate in rural was higher than that in urban areas. The crude mortality of all cancers in Henan province was 169.90/100,000 （201.23/100,000 in males and 135.95/100,000 in females）. The age-standardized mortality rates by Chinese standard population （ASMRC） and by world standard population （ASMRW） were 131.20/100,000 and 130.80/100,000, respectively. Among the patients aged 0-74 years, the cumulative mortality rate was 15.03%. The crude cancer mortality rate in urban areas was higher than that of rural areas. However, the age-standardized rate in rural areas was higher than that of urban areas. Cancers of lung, stomach, esophagus, liver, female breast, colorectum, cervix, brain, uterus and ovary were the most common cancers, accounting for about 82.80% of all cancer new cases. Lung cancer, stomach cancer, esophageal cancer, liver cancer, colorectal cancer, female breast cancer, brain cancer, leukemia, pancreatic cancer and cervix cancer were the leading causes of cancer deaths, accounting for about 88.50% of all cancer deaths. The burden between urban and rural, males and females were different. Conclusions： Registration data of Henan province was qualified to provide basic information on population-based cancer incidence, mortality for cancer prevention and control. The upper digestive tract cancer burden in Henan province, especially for males in rural areas, was higher. The incidence rate of female breast cancer was higher in urban areas. Targeted prevention, early detection and treatment programs should be carried out by health department to control the cancer burden.
基金supported by National Natural Science Foundation of China (No. u0732005, No. 30930045)Major State Basic Research Development Program of China (No. 2010CB912201)+1 种基金National High Technology Research and Development Program of China (No. 2006AA02A404)Sun Yat-sen University 985 Program
文摘S-phase kinase-associated protein 2 (Skp2), which plays a role in cell cycle regulation, is commonly overexpressed in a variety of human cancers and associated with poor prognosis. However, its role in nasopharyngeal carcinoma (NPC) is not well understood. In this study, we examined the clinical significance of Skp2, with a particular emphasis on overall survival (OS) and disease-free survival (DFS), in NPC cases in South China, where NPC is an epidemic. Additionally, we explored the function of Skp2 in maintaining a cancer stem cell -like phenotype in NPC cell lines. Skp2 expression was assessed for 127 NPC patients using tissue microarrays and immunohistochemistry and analyzed together with clinicopathologic features, OS, and DFS. Skp2 expression was detectable, or positive, in 75.6% of patients. Although there was no correlation between Skp2 and any clinicopathologic factor, Skp2 expression significantly portended inferior OS (P = 0.013) and DFS (P = 0.012). In the multivariate model, Skp2 expression remained significantly predictive of poor OS [P = 0.009, risk ratio (RR) = 4.06] and DFS (P = 0.008, RR = 3.56), and this was also true for clinical stage (P = 0.012 and RR=3.201 for OS; P = 0.002 and RR=1.94 for DFS) and sex (P = 0.016 and RR=0.31 for OS; P = 0.006 and RR = 0.27 for DFS). After Skp2 knockdown, a colony formation assay was used to evaluate the self-renewal property of stem-like cells in the NPC cell lines CNE-1 and CNE-2. The colony formation efficiency in CNE-1 and CNE-2 cells was decreased. In Skp2-transfected CNE-1 and CNE-2 cells, side population (SP) proportion was increased as detected by flow cytometry. Skp2 is an independent prognostic marker for OS and DFS in NPC. Skp2 may play a role in maintaining the cancer stem cell-like phenotype of NPC cell lines.
基金supported by the National Natural Science Foundation of China (No. 81673858, No. 81704062, No. 30500644)the Science and Technology Project of Traditional Chinese Medicine in Hunan (No. 2009045, No. 2012027)the Program for National Center for Clinical Medicine for Geriatric Diseases (Ministry of Science and Technology)
文摘Background Increasing research suggests that mitochondrial defect plays a major role in pulmonary hypertension(PH) pathogenesis. Mitochondrial dynamics and quality control have a central role in the maintenance of the cell proliferation and apoptosis balance. However, the molecular mechanism underlying of this balance is still unknown. Methods To clarify the biological effects of hypoxic air exposure and hypoxia-inducible factor-1α(HIF-1α) on pulmonary arterial smooth muscle cell(PASMC) and pulmonary arterial hypertension rats, the cells were cultured in a hypoxic chamber under oxygen concentrations. Cell viability, reactive oxygen species level, cell death, mitochondrial morphology, mitochondrial membrane potential, mitochondrial function and mitochondrial biosynthesis, as well as fission-and fusion-related proteins, were measured under hypoxic conditions. In addition, rats were maintained under hypoxic conditions, and the right ventricular systolic pressure, right ventricular hypertrophy index and right ventricular weight/body weight ratio were examined and recorded. Further, we assessed the role of HIF-1α in the development and progression of PH using HIF-1α gene knockdown using small interfering RNA transfection. Mdivi-1 treatment was performed before hypoxia to inhibit dynamin-related protein 1(Drp1). Results We found that HIF-1α expression was increased during hypoxia, which was crucial for hypoxia-induced mitochondrial dysfunction and hypoxia-stimulated PASMCs proliferation and apoptosis. We also found that targeting mitochondrial fission Drp1 by mitochondrial division inhibitor Mdivi-1 was effective in PH model rats. The results showed that mitochondrial dynamics were involved in the pulmonary vascular remodeling under hypoxia in vivo and in vitro. Furthermore, HIF-1α also modulated mitochondrial dynamics in pulmonary vascular remodeling under hypoxia through directly regulating the expression of Drp1. Conclusions In conclusion, our data suggests that abnormal mitochondrial dynamics could be a marker for the early diagnosis of PH and monitoring disease progression. Further research is needed to study the signaling pathways that govern mitochondrial fission/fusion in PH.
文摘AIM:To report the refractive outcomes after vitrectomy combined with phacoemulsification and intraocular lens(IOL)implantation(phaco-vitrectomy)in idiopathic macular holes(IMH).METHODS:A total of 56 eyes with IMH(IMH group)that underwent phaco-vitrectomy and 44 eyes with age-related cataract(ARC group)that underwent cataract surgery were retrospectively reviewed.The best corrective visual acuity(BCVA),predicted refractive error(PRE),actual refractive error(ARE),axial length(AL),were measured in both groups before and 6 mo after operation.The power calculation of IOL and the predicted refractive error(PRE)were calculated according to the SRK/T formula.The difference of PRE and ARE between the two groups were compared and analyzed.RESULTS:In the IMH group,the diameters of macular holes were 271.73±75.85μm,the closure rate was 100%.The pre-and post-operative BCVA were 0.80±0.35 and 0.40±0.35 log MAR.The PRE of A-ultrasound and IOL Master in the IMH group was-0.27±0.25 and 0.10±0.66 D.The postoperative mean absolute prediction error(MAE)was observed to be 0.58±0.65 and 0.53±0.37 D in the IOL Master and A-ultrasound(P=0.758).The PRE and ARE of the IMH group were 0.10±0.66 D and-0.19±0.64 D(P=0.102).The PRE and ARE of the ARC group was-0.43±0.95 and-0.31±0.93 D(P=0.383).The difference between PRE and ARE was-0.33±0.81 and 0.09±0.64 D in the IMH and ARC groups(P=0.021).The proportion of myopic shift was 67.9%in the IMH group and 27.3%in the ARC group(P=0.004).CONCLUSION:The myopic shift can be observed in patients with IMH after phaco-vitrectomy.
基金Supported by National Natural Science Foundation of China,No.81571675Academic Experience and Research Workshop Construction Project of Shanghai Famous TCM Doctors,No.JCZYGZS-008Clinical Study on Control and Clearance of Hepatitis B Surface Antigen by Traditional Chinese Medicine,No.1340190290A。
文摘BACKGROUND Hepatocellular carcinoma(HCC)is the most common type of primary liver malignancy.Contrast-enhanced ultrasound(CEUS)uses contrast microbubbles during ultrasound,allowing the detection and characterization of malignant focal liver lesions with much higher diagnostic accuracy than conventional ultrasound;however,there are few reports focusing on the pattern of enhancement of CEUS for the diagnosis of HCC smaller than 2 cm.AIM To investigate the clinical value of CEUS in the early detection of small HCC with high risk factors.METHODS A total of 395 patients with 632 nodules at high risk of HCC,who underwent regular follow-up at Xuhui Dahua Hospital from January 2007 to December 2021,were retrospectively examined.Conventional ultrasonography combined with CEUS was adopted to analyze the echo,size,location,and enhancement characteristics of benign and malignant nodules,as well as the enhancement methods for HCC with different diameters.RESULTS The follow-up rate and duration were 92.15%(364/395)and 51.28±45.09 mo,respectively.Conventional ultrasonography combined with CEUS revealed 65(11.80%)nodules with a follow-up diagnosis of HCC,19(3.45%)dysplastic nodules,and 467(84.75%)benign cirrhotic hyperplastic nodules.Among 65 cases of confirmed HCC,40(61.54%)were transformed from hypoechoic nodules,9(13.85%)from hyperechoic nodules,and the remaining 16(24.62%)from isoechoic nodules.Significant differences in CEUS characteristics were found among cirrhotic nodules,dysplastic nodules,and HCC nodules at each phase.Significant differences in the enhancement mode were observed between nodules≤1 cm and those 1–2 cm.The smaller the HCC nodule,the later the contrast agent began to flush and the longer the duration of contrast enhancement.CONCLUSION Conventional ultrasonography combined with CEUS could identify small HCC and help monitor patients with an early diagnosis of HCC.Significant differences in the enhancement mode are noted between nodules≤1 cm and those 1–2 cm.
基金the Research Project 2017 of Health and Family Planning Commission of Hunan Province(A2017015).
文摘Hepatocellular carcinoma(HCC)is one of the most common malignancies,and its treatment is limited.With the understanding of key genes and signaling pathways in the occurrence and development of HCC,targeted drugs with high selectivity and low toxicity have been developed continuously,bringing a variety of options for the treatment of advanced HCC.In this article,the research progress on representative drugs of targeted therapy and potential therapeutic targets for HCC are reviewed.
基金Supported by a grant from the Natural Science Foundation of Tianjin City (No.20JCZXJC00040)Tianjin Key Medical Discipline (No.Specialty) Construction Project (No.TJYXZDXK-037A)。
文摘AIM: To observe the effects of the different extents of internal limiting membrane(ILM) peeling on the surgical success and anatomical and functional outcomes of idiopathic macular hole(IMH).METHODS: In this retrospective cohort study, 36 patients were reviewed and divided into two groups according to the extent of ILM peeling: group A(18 patients), with the peeling area within one-half of the optic disc macular distance as the radius;group B(18 patients), with the peeling area larger than that of group A but did not exceed the optic disc macular distance as the radius. The main outcomes included the best corrected visual acuity(BCVA), light-adaptive electroretinography, macular hole(MH) closure rate, central macular thickness(CMT), retinal nerve fiber layer(RNFL) and ganglion cell complex(GCC) thickness [nine regions based on the Early Treatment of Diabetic Retinopathy Study(ETDRS) ring] before and 1, 3, and 6mo after surgery.RESULTS: The closure rate was 94.4%(17/18) both in groups A and B. The BCVA in both groups improved significantly compared with the preoperative values, but there was no difference between the two groups. The b-wave amplitude of the electroretinogram analysis was significantly improved in both groups compared to that of the preoperative period, with a greater increase in group A than in group B at 6mo(P=0.017). The CMT in both groups gradually decreased after surgery, and there was no difference between the two groups. The RNFL thickness of the temporal outer ring region in group B was significantly lower than that in group A at 3 and 6mo after surgery(P=0.010, 0.032). The GCC thickness of the temporal outer ring region in group B was significantly lower than that in group A at 6mo after surgery(P=0.038).CONCLUSION: Enlarging the extent of ILM peeling doesn’t affect the IMH closure rate and visual acuity recovery, but the greater the extent of peeling, the greater the damage to the inner retinal structures.
基金Supported by the 2017 Scientific Research Project of Sichuan Health and Family Planning Commission,No.18PJ215.
文摘BACKGROUND Reports on peripherally inserted central catheter(PICC)placement in neonates with persistent left superior vena cava(PLSVC)are rare.The majority of PLSVC patients have no clinical symptoms or hemodynamic changes,which are usually detected during cardiac catheterization,cardiac pacemaker implantation,or PICC placement.However,in neonates with PLSVC,PICC placement can be challenging.Here,we report PICC placement in eight neonates with PLSVC.CASE SUMMARY This article introduces the concept of the“TIMB”bundle.After PICC implantation,we found PLSVC in all eight patients.The key points of care regarding PICC placement in neonates with PLSVC included“TIMB”,where“T”indicates a reasonable choice of the catheterization time,“I”refers to a retrospective analysis of imaging data before catheterization,“M”refers to correct measurement of the body surface length,and“B”indicates that the tip of the PICC is placed in the middle and lower 1/3 of the left superior vena cava under the guidance of B-ultrasound.CONCLUSION“TIMB”is a bundle for PICC placement in neonates,especially for those with PLSVC.Using this new approach can improve the first-attempt success rate of PICC placement,reveal cardiovascular abnormalities in advance,allow the selection of different measurement methods reasonably according to the puncture site,and finally,improve the accuracy of catheter positioning through the use of B-ultrasound guidance.
基金the 2017 Scientific Research Project of Sichuan Health and Family Planning Commission,No.18PJ215.
文摘BACKGROUND There have been few reports on level 3 difficult removal of peripherally inserted central catheter(PICC)in neonates.Here,we reported a case of an extremely preterm infant who underwent level 3 difficult removal of a PICC.CASE SUMMARY Female baby A,weighing 1070 g at 27^(+1) wk of gestational age,was diagnosed with extremely preterm infant and neonatal respiratory distress syndrome.She underwent PICC insertion twice.The first PICC insertion went well;the second PICC was inserted in the right lower extremity,however,phlebitis occurred on the second day after the placement.On the third day of catheterization,phlebitis was aggravated,while the right leg circumference increased by 2.5 cm.On the fourth day of catheterization,more red swelling was found in the popliteal part,covering an area of about 1.5 cm×4 cm,which was diagnosed as phlebitis level 3;thus,we decided to remove the PICC.During tube removal,the catheter rebounded and could not be pulled out(several conventional methods were performed).Finally,we successfully removed the PICC using a new approach termed“AFGP”.On the 36th day of admission,the baby fully recovered and was discharged.CONCLUSION The“AFGP”bundle approach was effective for an extremely preterm infant,who underwent level 3 difficult removal of a PICC.
基金Tianjin Science and Technology Project(No.BHXQKJXM-SF-2018-05)Tianjin Clinical Key Discipline(Specialty)Construction Project(No.TJLCZDXKM008).
文摘AIM:To assist with retinal vein occlusion(RVO)screening,artificial intelligence(AI)methods based on deep learning(DL)have been developed to alleviate the pressure experienced by ophthalmologists and discover and treat RVO as early as possible.METHODS:A total of 8600 color fundus photographs(CFPs)were included for training,validation,and testing of disease recognition models and lesion segmentation models.Four disease recognition and four lesion segmentation models were established and compared.Finally,one disease recognition model and one lesion segmentation model were selected as superior.Additionally,224 CFPs from 130 patients were included as an external test set to determine the abilities of the two selected models.RESULTS:Using the Inception-v3 model for disease identification,the mean sensitivity,specificity,and F1 for the three disease types and normal CFPs were 0.93,0.99,and 0.95,respectively,and the mean area under the curve(AUC)was 0.99.Using the DeepLab-v3 model for lesion segmentation,the mean sensitivity,specificity,and F1 for four lesion types(abnormally dilated and tortuous blood vessels,cotton-wool spots,flame-shaped hemorrhages,and hard exudates)were 0.74,0.97,and 0.83,respectively.CONCLUSION:DL models show good performance when recognizing RVO and identifying lesions using CFPs.Because of the increasing number of RVO patients and increasing demand for trained ophthalmologists,DL models will be helpful for diagnosing RVO early in life and reducing vision impairment.
