Background: Liver cancer poses a significant health challenge due to its high incidence rates and complexities in detection and treatment. Accurate segmentation of liver tumors using medical imaging plays a crucial role in early diagnosis and treatment planning.
Objective: This study proposes a novel approach combining U-Net and ResNet architectures with the Adam optimizer and sigmoid activation function. The method leverages ResNet's deep residual learning to address training issues in deep neural networks. At the same time, U-Net's structure facilitates capturing local and global contextual information essential for precise tumor characterization. The model aims to enhance segmentation accuracy by effectively capturing intricate tumor features and contextual details by integrating these architectures. The Adam optimizer expedites model convergence by dynamically adjusting the learning rate based on gradient statistics during training.
Methods: To validate the effectiveness of the proposed approach, segmentation experiments are conducted on a diverse dataset comprising 130 CT scans of liver cancers. Furthermore, a state-of-the-art fusion strategy is introduced, combining the robust feature learning capabilities of the UNet-ResNet classifier with Snake-based Level Set Segmentation.
Results: Experimental results demonstrate impressive performance metrics, including an accuracy of 0.98 and a minimal loss of 0.10, underscoring the efficacy of the proposed methodology in liver cancer segmentation.
Conclusion: This fusion approach effectively delineates complex and diffuse tumor shapes, significantly reducing errors.
Background: Advancements in laparoscopic technology have popularized laparoscopic total gastrectomy over traditional open surgery, yet postoperative complications like anastomotic leakage and stenosis persist, particularly in esophagojejunostomy. To address this, since 2017, the authors have introduced the "Pant-Shaped" esophagojejunostomy as an improvement over the classic Roux-en-Y method, especially beneficial for patients with small intestinal diameters or those with gastric body cancer or Siewert III.
Objective: To assess the viability and safety of employing 'Pant-Shaped' anastomosis following laparoscopic-assisted total gastrectomy.
Methods: A method of descriptive case study was used. In our department of the First Affiliated Hospital of Wannan Medical College, records of 210 patients who underwent laparoscopic-assisted total gastrectomy for gastric body cancer or adenocarcinoma at the junction of esophagus and jejunum with "Pant-Shaped" anastomosis between January 2017 and December 2022 were examined. Clinicopathological features and postoperative conditions were also examined and assessed.
Results: The mean age of the 164 male and 46 female research participants was 69.2 ± 8.3 years. There was a mean estimated blood loss of 63.4 ± 29.7 ml, an anastomosis time of 25.9 ± 3.0 minutes, an operation time of 208.2 ± 40.4 minutes, and a postoperative hospital stay of 12.2 ± 8.0 days. Nine patients (4.3%) experienced postoperative problems (Clavien-Dindo > grade II), including two episodes of anastomotic leakage that were resolved with irrigation and drainage, anti-infection therapy, and nutritional assistance. After an unforeseen reoperation, two cases of duodenal stump leaking were resolved. Anastamotic hemorrhage was treated with hemostasis and blood transfusion, and the patient made a full recovery. Due to a Peterson's hernia, one patient required emergent open surgery. three months subsequent to LATG.
Conclusions: The "Pant-Shaped" anastomosis method after laparoscopic-assisted total gastrectomy is simple, easy to promote, and has fewer complications. It is a safe and feasible modified method for esophagojejunostomy, especially suitable for patients with poor intestinal dilation and contraction ability and small jejunal diameter.
Background: This study aimed to investigate the effects of the Kidney-Tonifying and Blood-Activating Formula on combating the downregulation of integrin β3 and integrin β5 in mouse placental tissue induced by phospholipid antibodies.
Objective: This study aimed to investigate the effects of kidney-tonifying and blood-activating formulations on combating the downregulation of integrin β3 and integrin β5 in mouse placental tissue induced by phospholipid antibodies.
Methods: Mice in the phospholipid antibody group and phospholipid antibody + kidney-tonifying and blood-activating formula group underwent repeated implantation experiments, and the expression of integrin β3 and integrin β5 in placental tissue was observed. The effects of the kidney-tonifying and blood-activating formula on mouse placental tissue were evaluated through biochemical index tests, histopathological observations, and immunohistochemical staining.
Results: After intervention with the kidney-tonifying and blood-activating formula, the expression of integrin β3 and integrin β5 in placental tissue was notably upregulated, and placental structure was restored. Kidney-Tonifying and Blood-Activating Formula significantly improved abnormal biochemical indices and exerted a remarkable protective effect on placental tissue pathology.
Conclusion: The kidney-tonifying and blood-activating formula effectively counteracted the downregulation of integrin β3 and integrin β5 in mouse placental tissue induced by phospholipid antibodies and alleviated placental tissue pathology through structural improvement and protection. Therefore, kidney-tonifying and blood-activating formulas may serve as potential therapeutic agents for recurrent implantation failure, offering new insights and approaches for clinical treatment.
Background: In radiography procedures, radiographers' suboptimal positioning and exposure parameter settings may necessitate image retakes, subjecting patients to unnecessary ionizing radiation exposure. Reducing retakes is crucial to minimize patient X-ray exposure and conserve medical resources.
Objective: We propose a Digital Radiography (DR) Pre-imaging All-round Assistant (PIAA) that leverages Artificial Intelligence (AI) technology to enhance traditional DR.
Methods: PIAA consists of an RGB-Depth (RGB-D) multi-camera array, an embedded computing platform, and multiple software components. It features an Adaptive RGB-D Image Acquisition (ARDIA) module that automatically selects the appropriate RGB camera based on the distance between the cameras and patients. It includes a 2.5D Selective Skeletal Keypoints Estimation (2.5D-SSKE) module that fuses depth information with 2D keypoints to estimate the pose of target body parts. Thirdly, it also uses a Domain expertise (DE) embedded Full-body Exposure Parameter Estimation (DFEPE) module that combines 2.5D-SSKE and DE to accurately estimate parameters for full-body DR views.
Results: Optimizes DR workflow, significantly enhancing operational efficiency. The average time required for positioning patients and preparing exposure parameters was reduced from 73 seconds to 8 seconds.
Conclusions: PIAA shows significant promise for extension to full-body examinations.
Background: Although literature suggests that exercise can improve symptoms in Parkinson's Disease (PD) patients, research on the effects of aerobic exercise and resistance training (AE&RT) in early-stage PD remains limited. Understanding the synergistic effects of these exercise modalities can provide valuable insights for optimizing exercise interventions for PD patients, particularly in the early stages of the disease, where interventions may have the greatest impact on long-term functional outcomes.
Objective: This study aimed to investigate the effects of a combined AE&RT program on motor function, postural stability, and cognitive processing speed in early stage PD patients.
Methods: A total of 236 participants with early-stage PD were assigned to either the Aerobic Exercise Group (AE group) (n= 112) or the AE&RT Group (n= 124) inthis controlled randomized trial. The study employed a one-year supervised exercise program, with the AE Group participating in aerobic activities and the AE&RT Group engaging in combined AE&RT. Outcome measures included symptom improvement, motor function, postural stability, cognitive processing speed, peak oxygen consumption, quality of life evaluation, and the incidence of adverse events.
Results: The AE&RT Group demonstrated greater improvements in tremor, muscle rigidity, gait instability, sleep problems, and hyposmia compared to the AE Group. Additionally, the combined exercise group exhibited better cognitive processing speed, as well as enhanced motor function and postural stability. Peak oxygen consumption was significantly higher in the AE&RT Group. However, the quality of life evaluation indicated a statistically higher quality of life in the AE Group. There was no significant difference in the incidence of adverse events between the two groups.
Conclusion: The findings suggest that the integration of AE&RT in early-stage PD patients leads to more comprehensive improvements in motor symptoms, cognitive function, postural stability, and cardiovascular fitness compared to aerobic exercise alone. These results have important implications for developing tailored exercise interventions to enhance the physical and cognitive well-being of individuals with early-stage PD.
Background: Fiber post (FP) reinforced restoration was widespread in endodontically treated teeth, of which the retention was closely related to fit and operation process. However, the question whether the fit and self-etching adhesive (SED) affect the success of FP restoration still remained unclear.
Objective: This research aimed to assess how the fit and self-etching adhesive (SED) impact the pull-out bond strength (BS) of glass fiber-reinforced composite posts from the root canal dentin.
Methods: Eighty lower first premolars underwent simulated endodontic treatment, after which their canals were shaped to accommodate a size three RelyX fiber post (FP) (diameter 1.9 mm). They were then divided into 4 equal groups [Unfit post and no SEA (Group UN), Fit post and no SEA (Group FN), Unfit post with SEA (Group UA) and Fit post with SEA (Group FA)] using two different sized FPs and SEA. Cement thickness was acquired by histological analysis and stereomicroscopy. Each sample was tested for pull-out strength through a universal testing machine. Based on the pull-out test, the failure types were observed and scored by visualizing through a stereomicroscope.
Results: Group FA demonstrated significantly greater BS compared to Group UN and Group UA, with Group UN showing a statistically significant difference at p< 0.01 and Group UA at p< 0.05. Main failure types in Group FA were Type II, which illustrated that the cement detachment mainly occurred from the post-cement interface. Therefore, Group FA possessed the STRONGEST BS and was most suitable for FP-reinforced crown restorations.
Conclusions: Both the fit and SEA enhanced the pull-out BS. The SEA was critical for BS promotion when the mechanical retention was inadequate.
Background: sTREM-1H and miR-126 play crucial roles in inflammation and immune responses, yet their involvement in patients with pulmonary infection following cranial injury remains understudied.
Objective: The distribution of pathogens causing infection in patients with pulmonary infection after craniocerebral injury was explored, and the changes in the levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and miR-126 in peripheral blood were analyzed.
Methods: In this study, 60 patients (study group) with postoperative lung infection in craniocerebral injury treated from January 2019 to December 2, 2021, and 60 patients without lung infection were selected as the control group. The study group received anti-infection treatment. The infection pathogen of the study group was tested, and the changes of sTREM-1 and miR-126 levels in the peripheral blood of the study and control groups were recorded to explore the diagnosis and predictive Value of prognostic death.
Results: 66 pathogens were detected, including 18 gram-positive bacteria, 42 gram-negative bacteria, and 6 fungi. The sTREM-1 level was higher than the control group, and the miR-126 level was lower than the control group. By ROC curve analysis, the diagnostic AUC values of both patients were 0.907 and 0.848, respectively (P< 0.05). Compared to those in the study group, patients had decreased sTREM-1 levels and increased miR-126 levels after treatment (P< 0.05). Compared with the survival group, patients in the death group had increased sTREM-1 levels and decreased miR-126 levels, and ROC curve analysis, the predicted AUC death values were 0.854 and 0.862, respectively.
Conclusion: Gram-negative bacteria, with increased peripheral sTREM-1 levels and decreased miR-126 levels. The levels of sTREM-1 and miR-126 have specific diagnostic and prognostic Values for pulmonary infection after craniocerebral injury. However, the study's conclusions are drawn from a limited sample and short-term data, which might limit their broader applicability. Future studies with larger populations and longitudinal designs are required to confirm these findings and determine these biomarkers' robustness across different settings. Further research should also explore how these biomarkers influence patient outcomes in craniocerebral injuries.
Background: Accurately identifying the branches of pulmonary segmental vessels and bronchi, as well as adjacent structures, and determining the spatial location of lesions within pulmonary segments, are major challenges for thoracic surgeons. The application of three-dimensional reconstruction technology holds promise in addressing this issue.
Objective: To evaluate the clinical value of three-dimensional reconstruction in thoracoscopic segmental surgery.
Methods: Seventy-seven patients who underwent thoracoscopic segmental surgery combined with three-dimensional reconstruction at our hospital from January 1, 2020, to August 31, 2023, were retrospectively analyzed. Preoperative chest enhanced CT scans were conducted, and MIMICS software aided in reconstructing DICOM format original data for patients with pulmonary nodules to facilitate intraoperative nodule localization. Accurate segmental pneumonectomy was performed by comparing preoperative anatomical identification of target segmental arteries, veins, and bronchi, with surgical details and postoperative outcomes recorded, including intraoperative pulmonary resection distribution, operation time, blood loss, chest tube drainage, extubation time, hospital stay, and complications.
Results: Following preoperative three-dimensional reconstruction, successful segmental lung surgeries were performed, predominantly with single segmental resection (92.2%), and a minority with combined segmentectomy (7.8%). Median operation time was 130225 minutes, with intraoperative blood loss at 70100 mL and postoperative chest tube drainage at 347 mL (159690 mL). Median extubation time and hospital stay were 4 days and 7 days, respectively. Complications within the 3-month follow-up affected 11.7% of cases, including persistent pulmonary leakage (7.1%), pulmonary infection (4.3%), atelectasis (4.3%), and pleural effusion (1.4%), with no fatalities.
Conclusion: Preoperative 3D reconstruction can help the operator to perform safe, efficient and accurate thoracoscopic segmental pneumonectomy, which is worth popularizing in clinic.
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