BACKGROUND: Over 20 million colonoscopies are performed in China annually. An automatic clinical decision support system (CDSS) with accurate semantic recognition of colonoscopy reports and guideline-based is helpful to relieve the increasing medical burden and standardize the healthcare. In this study, the CDSS was built under a hierarchical-label interpretable classification framework, trained by a state-of-the-art transformer-based model, and validated in a multi-center style. METHODS: We conducted stratified sampling on a previously established dataset containing 302,965 electronic colonoscopy reports with pathology, identified 2041 patients' records representative of overall features, and randomly divided into the training and testing sets (7:3). A total of five main labels and 22 sublabels were applied to annotate each record on a network platform, and the data were trained respectively by three pre-training models on Chinese corpus website, including bidirectional encoder representations from transformers (BERT)-base-Chinese (BC), the BERT-wwm-ext-Chinese (BWEC), and ernie-3.0-base-zh (E3BZ). The performance of trained models was subsequently compared with a randomly initialized model, and the preferred model was selected. Model fine-tuning was applied to further enhance the capacity. The system was validated in five other hospitals with 3177 consecutive colonoscopy cases. RESULTS: The E3BZ pre-trained model exhibited the best performance, with a 90.18% accuracy and a 69.14% Macro-F1 score overall. The model achieved 100% accuracy in identifying cancer cases and 99.16% for normal cases. In external validation, the model exhibited favorable consistency and good performance among five hospitals. CONCLUSIONS The novel CDSS possesses high-level semantic recognition of colonoscopy reports, provides appropriate recommendations, and holds the potential to be a powerful tool for physicians and patients. The hierarchical multi-label strategy and pre-training method should be amendable to manage more medical text in the future.
Humans ; Colonoscopy/methods* ; Deep Learning ; Decision Support Systems, Clinical ; Female ; Male

Corticotomy is a clinical procedure to accelerate orthodontic tooth movement characterized by the regional acceleratory phenomenon (RAP). Despite its therapeutic effects, the surgical risk and unclear mechanism hamper the clinical application. Numerous evidences support macrophages as the key immune cells during bone remodeling. Our study discovered that the monocyte-derived macrophages primarily exhibited a pro-inflammatory phenotype that dominated bone remodeling in corticotomy by CX3CR1^CreERT2; R26^GFP lineage tracing system. Fluorescence staining, flow cytometry analysis, and western blot determined the significantly enhanced expression of binding immunoglobulin protein (BiP) and emphasized the activation of sensor activating transcription factor 6 (ATF6) in macrophages. Then, we verified that macrophage specific ATF6 deletion (ATF6^f/f; CX3CR1^CreERT2 mice) decreased the proportion of pro-inflammatory macrophages and therefore blocked the acceleration effect of corticotomy. In contrast, macrophage ATF6 overexpression exaggerated the acceleration of orthodontic tooth movement. In vitro experiments also proved that higher proportion of pro-inflammatory macrophages was positively correlated with higher expression of ATF6. At the mechanism level, RNA-seq and CUT&Tag analysis demonstrated that ATF6 modulated the macrophage-orchestrated inflammation through interacting with Tnfα promotor and augmenting its transcription. Additionally, molecular docking simulation and dual-luciferase reporter system indicated the possible binding sites outside of the traditional endoplasmic reticulum-stress response element (ERSE). Taken together, ATF6 may aggravate orthodontic bone remodeling by promoting Tnfα transcription in macrophages, suggesting that ATF6 may represent a promising therapeutic target for non-invasive accelerated orthodontics.
Animals ; Mice ; Macrophages/metabolism* ; Tumor Necrosis Factor-alpha/genetics* ; Tooth Movement Techniques/methods* ; Activating Transcription Factor 6/metabolism* ; Bone Remodeling ; Flow Cytometry ; Blotting, Western

Five new flavan-4-ol glycosides jixueqiosides A-E (1-5) and two new flavan glycosides jixueqiosides F and G (6 and 7), along with twelve known flavan-4-ol glycosides (8-19), were isolated from the roots of Pronephrium penangianum. Comprehensive spectral analyses, X-ray single-crystal diffraction, and theoretical electronic circular dichroism (ECD) calculations established structures and absolute configurations. A single crystal structure of flavan-4-ol glycoside (14) was reported for the first time, while the characteristic ECD and NMR data for all isolated flavan-4-ol glycosides (1-5 , 8-19) were analyzed, establishing a set of empirical rules. Activity screening of these isolates showed that 8 and 9 could inhibit the proliferation of MDA-MB-231 and MCF-7 cells with IC₅₀ values of 7.93 ? 2.85 ?mol?L^-1 and 5.87 ? 1.58 ?mol?L^-1 (MDA-MB-231), and 2.21 ? 1.38 ?mol?L^-1 and 3.52 ? 1.55 ?mol?L^-1 (MCF-7), respectively. Western blotting and flow cytometry analyses demonstrated that 8 and 9 dose-dependently induced apoptosis in MDA-MB-231 cells by up-regulating BAX, activating caspase-3 and down-regulating BCL-2. Additionally, compound 8 affected autophagy-related proteins, increasing the ratio of LC3-II/LC3-I and Beclin-1 levels to inhibit MDA-MB-231 cell proliferation. Moreover, anti-inflammatory studies indicated that 2, 3, 7, 13, 14, and 18 moderately inhibited tumor necrosis factor-a (TNF-a), interleukin-6 (IL-6), and nitric oxide (NO) release.
Humans ; Plant Roots/chemistry* ; Glycosides/isolation & purification* ; Anti-Inflammatory Agents/isolation & purification* ; Flavonoids/isolation & purification* ; Cell Proliferation/drug effects* ; Antineoplastic Agents, Phytogenic/isolation & purification* ; Molecular Structure ; Apoptosis/drug effects* ; Cell Line, Tumor ; Tumor Necrosis Factor-alpha/immunology* ; Drugs, Chinese Herbal/pharmacology* ; Interleukin-6/immunology* ; Animals ; Mice

Accurately obtaining the crop quantity and density is not only crucial for the demand-based input of water and fertilizer in the field but also vital for ensuring the yield and quality of crops. Aerial photography by unmanned aerial vehicles (UAVs) can quickly acquire the distribution image information of crops over a large area. However, the accurate recognition of a single type of dense targets is a huge challenge for most recognition algorithms. Taking banana seedlings as an example in this study, we captured the images of banana plantations by UAVs from high altitudes to explore an efficient recognition method for dense targets. We proposed a strategy of "cut-recognition-stitch" and constructed a counting method based on the improved Faster R-CNN algorithm. First, the images containing highly dense targets were cropped into a large number of image tiles according to different sizes (simulating different flight altitudes), and the Contrast Limited Adaptive Histogram Equalization (CLAHE) algorithm was adopted to improve the image quality. A banana seedling dataset containing 36 000 image tiles was constructed. Then, the Faster R-CNN network with optimized parameters was used to train the banana seedling recognition model. Finally, the recognition results were reversely stitched together, and a boundary deduplication algorithm was designed to correct the final counting results to reduce the repeated recognition caused by image cropping. The results show that the recognition accuracy of the Faster R-CNN with optimized parameters for banana image datasets of different sizes can reach up to 0.99 at most. The deduplication algorithm can reduce the average counting error for the original aerial images from 1.60% to 0.60%, and the average counting accuracy of banana seedlings reaches 99.4%. The proposed method effectively addresses the challenge of recognizing dense small objects in high-resolution aerial images, providing an efficient and reliable technical solution for intelligent crop density monitoring in precision agriculture.
Musa/growth & development* ; Crops, Agricultural/growth & development* ; Algorithms ; Neural Networks, Computer ; Unmanned Aerial Devices ; Seedlings/growth & development* ; Image Processing, Computer-Assisted/methods* ; Photography ; Agriculture/methods*

Diabetes has long been considered a risk factor in implant therapy and impaired wound healing in soft and hard oral tissues. Magnesium has been proved to promote bone healing under normal conditions. Here, we elucidate the mechanism by which Mg²⁺ promotes angiogenesis and osseointegration in diabetic status. We generated a diabetic mice model and demonstrated the alveolar bone healing was compromised, with significantly decreased angiogenesis. We then developed Mg-coating implants with hydrothermal synthesis. These implants successfully improved the vascularization and osseointegration in diabetic status. Mechanically, Mg²⁺ promoted the degradation of Kelch-like ECH-associated protein 1 (Keap1) and the nucleation of nuclear factor erythroid 2-related factor 2 (Nrf2) by up-regulating the expression of sestrin 2 (SESN2) in endothelial cells, thus reducing the elevated levels of oxidative stress in mitochondria and relieving endothelial cell dysfunction under hyperglycemia. Altogether, our data suggested that Mg²⁺ promoted angiogenesis and osseointegration in diabetic mice by regulating endothelial mitochondrial metabolism.
Mice ; Animals ; Kelch-Like ECH-Associated Protein 1/metabolism* ; Magnesium/metabolism* ; Osseointegration ; Diabetes Mellitus, Experimental/metabolism* ; Endothelial Cells/metabolism* ; NF-E2-Related Factor 2/metabolism*

Objective To investigate the effect of berberine(BBR)on chronic renal failure(CRF)rats and its mechanism.Methods CRF rat model was established by removing 5/6 kidneys and all rats were randomly divided into sham group,chronic renal failure model group,berberine treatment group and uremic clearance granules(UCG)treatment group with 10 in each.Renal function indexes in each group were examined by an automated bio-chemistry instrument.The level of MMP-2 and MMP-9 were detected by ELISA.The degree of renal fibrosis was observed by PAS and Masson staining microscopy.The expression of NF-κB p65 and IL-6 were detected by immu-nohistochemistry method.Expression of fibrosis-related proteins and TGF-β1/ERK signaling pathway proteins in re-nal tissues was detected by Western blot.Results Compared with sham group,renal function and renal histopatho-logical damage was significantly increased in the model group,and BBR improved renal function and histopathological damage in CRF rats.Compared with the sham group,the serum level of MMP-2 and MMP-9 was significantly de-creased(P＜0.05),the expression of IL-6 and NF-κB p65 was up-regulated(P＜0.05).The expression of FN,α-SMA,Col-Ⅰ,Col-Ⅲ,TGF-β1,and p-ERK1/2 proteins was up-regulated in the model group of rats(P＜0.05),while the BBR treatment significantly reversed the expression of these molecules(P＜0.05).Conclusions BBR may improve inflammation and fibrosis by inhibiting TGF-β1/ERK1/2 pathway,and play a protective role in the kidney of CRF rat.

Objective:To sort out medical device related policies in Anhui Province,to analyze the distribution of content in each policy text to provide reference for policy optimization in the later stage.Methods:The official websites of the People's Government of Anhui Province and the Anhui Provincial Drug Administration were searched by using the keywords of"medical devices","medical device enterprises",and"medical consumables"to search for medical device related policy documents released from January 2011 to December 2022.The 21 medical device-related policy documents retrieved shall be coded using the content analysis method in the sequence of"policy code-chapter number-unit number-sentence number".A two-dimensional analytical framework of"Basic Policy Instruments-Involved Subjects"was constructed to quantitatively analyze the medical device policy text from the two dimensions of policy instruments-involved subjects.Results:A total of 338 items were codes,including 107 supply-based policy tools(accounting for 31.66%),40 demand-based policy tools(accounting for 11.83%),and 191 environmental policy tools(accounting for 56.51%).The 338 codes involved entities including 202 government departments(accounting for 59.76%),62 operating enterprises(accounting for 18.34%),59 production enterprises(accounting for 17.46%),9 medical institutions(accounting for 2.66%),and 6 industry associations(accounting for 1.78%).Conclusion:The medical device policy in Anhui Province is mainly based on environmental policy tools,and demand-based policy tools are rarely used.The rationality of the distribution of internal items and participating entities in policy tools needs to be improved.There are certain differences in the interaction between each entity and policy tools.Therefore,it is necessary to strengthen the balance of policy tool use,increase the participation of multiple entities,and optimize the synergy between entities and policy tools.

Diabetes has long been considered a risk factor in implant therapy and impaired wound healing in soft and hard oral tissues.Magnesium has been proved to promote bone healing under normal conditions.Here,we elucidate the mechanism by which Mg2+ promotes angiogenesis and osseointegration in diabetic status.We generated a diabetic mice model and demonstrated the alveolar bone healing was compromised,with significantly decreased angiogenesis.We then developed Mg-coating implants with hydrothermal synthesis.These implants successfully improved the vascularization and osseointegration in diabetic status.Mechanically,Mg2+ promoted the degradation of Kelch-like ECH-associated protein 1(Keap1)and the nucleation of nuclear factor erythroid 2-related factor 2(Nrf2)by up-regulating the expression of sestrin 2(SESN2)in endothelial cells,thus reducing the elevated levels of oxidative stress in mitochondria and relieving endothelial cell dysfunction under hyperglycemia.Altogether,our data suggested that Mg2+ promoted angiogenesis and osseointegration in diabetic mice by regulating endothelial mitochondrial metabolism.

Diabetes has long been considered a risk factor in implant therapy and impaired wound healing in soft and hard oral tissues.Magnesium has been proved to promote bone healing under normal conditions.Here,we elucidate the mechanism by which Mg2+ promotes angiogenesis and osseointegration in diabetic status.We generated a diabetic mice model and demonstrated the alveolar bone healing was compromised,with significantly decreased angiogenesis.We then developed Mg-coating implants with hydrothermal synthesis.These implants successfully improved the vascularization and osseointegration in diabetic status.Mechanically,Mg2+ promoted the degradation of Kelch-like ECH-associated protein 1(Keap1)and the nucleation of nuclear factor erythroid 2-related factor 2(Nrf2)by up-regulating the expression of sestrin 2(SESN2)in endothelial cells,thus reducing the elevated levels of oxidative stress in mitochondria and relieving endothelial cell dysfunction under hyperglycemia.Altogether,our data suggested that Mg2+ promoted angiogenesis and osseointegration in diabetic mice by regulating endothelial mitochondrial metabolism.

Diabetes has long been considered a risk factor in implant therapy and impaired wound healing in soft and hard oral tissues.Magnesium has been proved to promote bone healing under normal conditions.Here,we elucidate the mechanism by which Mg2+ promotes angiogenesis and osseointegration in diabetic status.We generated a diabetic mice model and demonstrated the alveolar bone healing was compromised,with significantly decreased angiogenesis.We then developed Mg-coating implants with hydrothermal synthesis.These implants successfully improved the vascularization and osseointegration in diabetic status.Mechanically,Mg2+ promoted the degradation of Kelch-like ECH-associated protein 1(Keap1)and the nucleation of nuclear factor erythroid 2-related factor 2(Nrf2)by up-regulating the expression of sestrin 2(SESN2)in endothelial cells,thus reducing the elevated levels of oxidative stress in mitochondria and relieving endothelial cell dysfunction under hyperglycemia.Altogether,our data suggested that Mg2+ promoted angiogenesis and osseointegration in diabetic mice by regulating endothelial mitochondrial metabolism.