Medical image segmentation is a classical puzzle for researchers.Image segmentation is the method to delineate anatomic structures or other interested regions automatically or semi-automatically,which is helpful to diagnosis and plays a crucial role in many medical imaging applications.In this article,a rather complete survey to medical image segmentation methods and their characteristics are given,especially to the new methods or improvement of the classical methods which was put forward recently.The prospects and the challenge of medical image segmentation is discussed.

Objective To investigate the clinical characteristics of neonatal tuberous sclerosis complex (TSC).Methods A total of 134 patients were admitted and diagnosed as TSC in Beijing Children′s Hospital,Capital Medical University from September 2006 to September 2015.The clinical characteristics of TSC in 8 patients who had clinical symptoms initiating from the neonatal period (skin lesion,neurologic abnormality,etc.) were analyzed,so as to conduct the auxiliary examinations (skin biopsy,ultrasonic cardiogram,cranial imaging) and the follow-up results.Results Among 8 patients,4 were diagnosed as TSC in the neonatal period while other 4 were diagnosed at later period from 4 months to 14 years old.Six patients had skin lesions in neonatal period,accounting for 75% of 8 patients,with predominant symptoms:hypomelanotic macules (5 cases),angiofibroma (2 cases),and shagreen patch (1 case).Cardiac abnormalities in neonatal period mainly included cardiac rhabdomyoma,which were characterized by high incidence,multi-regional occurrence,and wide distribution,noticed in 4 patients (50%).Ultrasonic cardiogram showed a mass in 4 patients with moderate-strong echo,uniform texture and clear boundary,and slight effect on tricuspid valve blood flows (in 1 case).Electrocardiogram abnormalities were found in 1 case,like atrial premature beats with intraventricular aberrant conduction,and accelerated atrial escape.Neurologic abnormality of neonatal TSC could present convulsive seizures.Cranial imaging lesions showed subependymal nodules (3 cases),leukodystrophy (2 cases),and giant-cell astrocytoma (1 case).Evidence for TSC2 gene positive and heterozygous mutation was identified in 1 case.The nucleic acid mutation site was at c.268C>T (E4),and the amino acid mutation was p.90Q>X.The mutant effect was nonsense mutation,which could lead to premature termination of protein translation.Conclusion The clinical characteristics of neonatal TSC may involve multi-system lesions,most commonly seen in the skin,cardiac,and ner-vous system.Neonatal physical examinations,cranial CT/magnetic resonance imaging and cardiac ultrasound screening should be done for the suspected TSC patients,and genetic diagnosis may contribute to the early diagnosis of the disease.

Objective To investigate the therapeutic effects of botulinum toxin type A injection and acupuncture on periorbital wrinkles.Methods From May to September in 2015,24 patents were randomly divided into experimental and control group according to random number table:the patients in experimental group were treated with disposable acupuncture needles,20 min for each treatment,once a day,five times each course for courses,2 days interval between the two courses;the patients in control group were treated with 20 units of hotulinum toxin type A injection.The therapeutic results were observed 2 weeks after the treatment by the third-party doctor according to skin wrinkles grading.Results The periorbital wrinkles in both groups improved remarkably,and the wrinkle grading in control group was significantly lower than that in the experimental group (0.67±0.67 vs 1.33±0.61,P＜0.05).The skin quality and facial expression sensation in the experimental group improved significantly when compared with those in the control group.Conclusions Acupuncture can be used as a complementary treatment of periorbital wrinkles,and it improves the skin quality in terms of elasticity and color and keeps the natural facial expression sensation.

Objective To explore the clinical significance of platelet count, C-reaction protein and D-dimer in Kawasaki disease children with coronary artery lesion. Methods 54 cases of children with KD treated in our hospital from January 2013 to December 2015 were divided into coronary artery injury (CAL) group (n=15) and without coronary artery injury (NCAL) group (n=39), according to the cardiac ultrasound examination. The relationship between the changes of platelet count, C reactive protein and D- two and coronary artery lesion in the 2 groups of acute and convalescent stages were detected. Platelet count, C-reaction protein and D-dimer of 54 healthy children were measured as a control. Results The levels of the platelet count, C-reaction protein and D-dimer of the KD children during acute stage are significantly higher than the control group (P<0.05), while the levels of C-reaction protein and D-dimer of the KD children during recovery stage was significantly decreased after treatment (P<0.05), the platelet count is remarkably increased (P<0.01). The platelet count, C-reaction protein and D-dimer for the KD children with coronary artery malformation, either at acute stage or recovery stage, compared with the control group were significantly different (P<0.05), with statistical significance. Conclusion The changes of the platelet count, C-reaction protein and D-dimer levels have close relations with the cardiovascular damage to the KD children.

Abstract: This retrospective analysis examines the diagnosis and treatment of a case of chronic liver disease infected with Vibrio vulnificus, admitted to the First Affiliated Hospital of Hainan Medical University on August 8, 2023. The patient, a 34-year-old male fisherman, had chronic viral hepatitis B. He sustained a leg abrasion while fishing on August 3, and developed fever and continuous swelling pain in both lower limbs, more severe in the left limb, on the night of the injury. On the fourth day of the disease, he went to the local hospital where he received antibiotic treatment and was transferred to the First Affiliated Hospital of Hainan Medical College on August 8. Upon admission, the patient exhibited low blood pressure, high lower limb skin temperature, poor peripheral blood transport, visible scab, and signs of infectious shock. Within 12 hours of admission, an abscess incision and drainage procedure was performed on his left calf, along with negative pressure wound therapy, and tissue samples from the infected left lower limb were sent for microbial culture.The pathogen culture indicated a Vibrio vulnificus infection, and the histopathology results confirmed necrotizing fasciitis. Treatment included meropenem combined with vancomycin for infection control, maintenance of blood pressure and electrolyte balance, tenofovir disoproxil fumarate for antiviral therapy, and polyene phosphatidylcholine capsules for liver protection based on the drug sensitivity results. Additionally, levofloxacin and cefotaxime were administered for infection control and debridement was performed based on wound conditions. After 17 days of hospitalization, the infection was substantially controlled, but the liver function enzyme was still higher than the normal level, and the wound still had blood and exudation. The patient and his family members requested discharge; however, due to poor wound healing, he was readmitted on September 11, 2023, receiving antiviral and liver preservation treatment. On the fifth day,the secretion culture identified a co-infection with Corynebacterium striatum and Providencia stuartii infection. Corynebacterium striatum was subsequently reported as multidrug-resistant, prompting an immediate switch to sensitive antibiotics and supportive care. Sixteen days after readmission, the patient's general condition improved, but the liver function enzyme levels were still higher than normal, so he was discharged. Four months after discharge, a follow-up phone call revealed that the patient had actively pursued antiviral treatment and abstained from alcohol, showing reasonable wound recovery. The patient's case, with a typical exposure history and clinical manifestations, matches the characteristics of septic shock and necrotizing fasciitis caused by V. vulnificus. Clinically, it is crucial todiagnose and treat V. vulnificus infection early according to its pathological characteristics and clinical characteristics to improve the prognosis of patients.

Agmatine was first identified and characterized as a candidate for CDS (clonidine displacing substance) in the bovine brain in 1994. The following researches demonstrated that agmatine was a widely distributed endogenous substance and performed a lot of biological functions in the central nervous system. The evidences revealed its targets were diverse and its mechanisms were complicated. Now it is well accepted that agmatine is a new neurotransmitter and/or neuromodulator and it might be an endogenous ligand of imidazoline receptor.

tralateral parietal lobe. Conclusions CIMT can improve the patients' upper-limb function effectively. The constraint-induced movement of the affected arm during CIMT appears to induce cortical reorganization and compensation as measured by fMRL

Aim To investigate the effect of piperazinyl estrone(PE) on estrogen receptor expression and the transcriptional regulation of target genes.Methods Ovariectomized mice were given with PE in different doses (0.5 mg·kg~(-1),1 mg·kg~(-1),2 mg·kg~(-1))and estrone(0.71 mg·kg~(-1)) for 42 days,the protein expressions of Ers(Erαand Erβ)were shown by immunohistochemical method; To study transcriptional regulation of PE, PACT2-hERα and ERE2-TATA-LUC were co-transfected into MCF-7 cells by using Tfx 50 cationic liposome.Results Compared with ovx group, the groups with PE could up-regulate Ers of uteri in a dose-dependent manner,but its effect on Erα subtype was obvious.The classical ER signaling pathways could be activated by PE in co-transfected MCF-7 cells,but activation of PE was feebler than estrone with the same dose.Conclusion PE can up-regulate estrogen receptors in uteri. PE can transactivate ERE reportor gene through Erα and Erβ in MCF-7 cells, but its effect is feeble.

ASICs are H+-gated novel cation ion channels, which belong to the epithelial sodium channels (NaC/DEG) superfamily. As recent studies focus, ASICs are expected to be pharmacological targets on protecting the neuron from ischemia and damage, improving the ability of memory and study, curing epilepsy and analgesia. It is not until the most recentness that the subunits of ASICs have been cloned. Now, researchers have paid more attention to the distribution, expression, function and modulation of ASICs in the organism.

Objective To prepare gadolinium-loaded stearic acid grafted chitooligosaccharide (COSSA-DTPA-Gd) and evaluate its micelle properties,cytotoxicity,relaxation rate in vitro,and pancreatic tumor in vivo imaging.Methods Stear ic acid grafted chitooligosaccharide (COSSA) was synthesized by acetylation reaction between stearic acid and chitooligosaccharide.Diethylenetriaminepentaacetic dianhydride (DTPA) was conjugated to the residual amino groups of COSSA,then Gd3+ was chelated to obtain the final product.The micelle properties were measured using an electron microscopy and a laser particle sizer.The MTT assay was adopted to determine cytotoxicity.The in vitro relaxation rate and in vivo imaging of pancreatic tumor were evaluated using an MR scanner.Results COSSA-DTPA-Gd could self-assemble into stable micelles in aqueous solutions with a critical micelle concentration of (5.12±0.43)μg/ml.The micelles had positive charge and exhibited roughly spherical shape with a mean diameter of (58.3± 5.7)nm.The content of Gd3+ in COSSA-DTPA-Gd was 330.31 μmol/g.The nanoprobe and Magnevist,the commercial formulation,showed similar cytotoxicity (P＞0.05).The cell survival rate within 24 h were higher than 85％.The in vitro relaxation rate of COSSA-DTPA-Gd was 8.23 mM-1 ·s-1.After intravenous injection,COSSA-DTPA-Gd showed a better positive contrast-enhancing effect for pancreatic tumor than Magnevist.The MR images at the tumor periphery was rapidly enhanced,while a slow increase in image quality was observed in tumor core.Conclusion The prepared COSSA-DTPA-Gd can be used for efficient MR imaging of pancreatic tumor.