Multi?modality medical image processing has become a hot topic for research in the field of image processing and plays an important role in clinical diagnosis and treatment. Images with different modalities provide different information on patients. Anatomical images ( such as computed tomography and magnetic resonance imaging ) provide information on anatomical morphology and the structure of human body, and functional images ( such as single?photon emission computed tomography and positron emission tomography) provide the functional information on the distribution of radioactive concentration within human body. Such information needs to be fused to obtain comprehensive fusion images, and the images with different modalities need to be registered to obtain useful fusion images. This article reviews several image registration and fusion techniques used in the medical field, points out their advantages and shortcomings, and introduces the application of various processing techniques in clinical practice.

A new method based on the multiple locus variable number tandem repeat analysis (MLVA) was applied for the genotyping of combined HIV Mycobacterium tuberculosis in Dali to investigate the genotyping and distribution pattern of Myco‐bacterium tuberculosis clinical isolates with MLVA .Mycobacterium tuberculosis clinical isolates were selected from Dali area , and the polymorphism of VNTR locus was tested with PCR .The clustering of genotype was analyzed by BioNumerics (6 .6) . Result showed that 15 VNTR loci of 61 combined HIV Mycobacterium tuberculosis clinical isolates were analyzed respectively . There were obvious polymorphisms of VNTRs .The discrimination power of these loci appeared different from each other ,with the biggest Hunter‐Gaston index (0 .839) loci was MIRU26 ,and the smallest one (0 .341) loci was MIRU4 .The clustering of genotype showed that these strains could be categorized into 5 gene clusters and 61 genotype ,the proportions of cluster Ⅰ was the biggest one ,51 .6% were cluster Ⅰ which including 32 strains .The standard strain H37Rv was belongs to cluster Ⅱ .Its indicated that there are obvious polymorphisms of VNTRs of combined HIV Mycobacterium tuberculosis clinical isolates in Da‐li .The main genotype was Beijing family genotype .

Objective To comprehend the influences of vitamin C ,KCL and dicynone on blood cross matching of saline and mi-crocolumn gel and to compare them with polybrene crossing matching .Methods Under the conditions with and without the specific antibody ,KCI injection ,dicynone injection ,vitamin C injection and normal saline were added for conducting the immunological reac-tion with corresponding RBC .The influences of 3 kinds of drug on different medium cross matching methods of different mediums . Results The low concentration of vitamin C and KCL does not affect polybrene cross matching ,dicynone makes the experiment to generate pseudoagglutination ;the high concentration of these 3 kinds of drug can cause the test to fail .The sensitivity of the saline medium method is slightly lower ,the influence of vitamin C and KCL on the test is inapparent ,while in the KCL method ,with the dilution of antibody ,the agglutination intensity is weakened and even disappeared .Conclusion 3 kinds of drug all have influences on the mierocolumn gel cross matching method ,especially KCL .

Objective To investigate the effects of circumferential pulmonary vein isolation (CPVI) on atrial effective refractory period (ERP) in patients with paroxysmal atrial fibrillation.Methods 30 patients who underwent radiofrequency catheter ablation for paroxysmal AF were enrolled in this study.Using FAM mode,the RA and LA anatomical models were achieved in the CARTO 3 system.SVC,MRA,RAA,LA-A,LA-R,LA-P,LAA,LSPV,LIPV,RSPV,RIPV,CSp,CSd,were respectively located in the RA or LA anatomical model.Before and after CPVI,ERPs were measured in different locations of the atrium using programmed stimulation.The ERPs of the RA (SVC,MRA,RAA,CSp),LA (LA-A,LA-R,LA-P,LAA,CSd),PVs (LSPV,RSPV,LIPV,RIPV) were compared.Bilateral CPVIs were completed in all patients,and PV-LA bidirectional conduction block was achieved.The changes of electrophysiological characteristics of atrium before and after CPVI were observed.Results (1) ERP at different locations in the atrium before CPVI:Comparisons of ERPs at different locations of atrium:RAA had the minimal ERPs[(197.4 ± 28.6) ms (P ＜ 0.01);followed by PVs measuring,respectively,LSPV (213.0 ± 47.5) ms,LIPV (208.9 ± 45.9) ms,RSPV (209.3 ± 43.6) ms,RIPV (213.5 ± 48.1) ms and LAA (218.1 ± 27.7) ms.Comparisons of ERPs in RA,LA,and PVs showed:PVs had the lowest ERPs (211.2 ± 35.2) ms versus RA ERP (227.0 ± 23.7) ms versus LA ERP (241.0 ± 21.5) ms (P ＜ 0.05).(2) Comparisons of ERPs before and after CPVI:Comparisons of ERPs at different locations of atrium showed:RAA [(197.4 ± 28.6) ms vs.(208.6 ± 32.2) ms,P=0.003],CSp [(234.7 ± 29.1) ms vs.(246.9 ± 29.7) ms,P=0.007],LA-R [(242.9 ± 28.9) ms vs.(258.3 ± 26.9) ms,P=0.003],LA-P [(252.2 ± 28.5) ms vs.(261.1 ± 30.2) ms,P=0.039]and CSd [(238.6 ± 28.3) ms vs.(250.3 ± 23.6) ms,P =0.009].ERPs were found statistically prolonged at all different locations after CPVI.Comparisons of ERPs at RAand LA after CPVI showed:RA [(227.0 ± 23.7) ms vs.(235.9 ± 21.7)ms,P=0.002]and LA [(241.0 ± 21.5) ms vs.(249.7 ± 19.9) ms,P =0.001],which were statistically increased after CPVI.(3) A total of 90 episodes of atrial arrhythmias were induced before CPVI which were found at RAA (n =17),LAA (n =12),and PVs (n =36).After CPVI,8 episodes of atrial arrhythmias were induced which were found at,RAA (n =4),LAA (n =3),and SVC (n =1).Conclusions (1) Compared with other parts of atrium,ERPs at PVs,LAA and RAA are significantly shorter in patients with paroxysmal AF.At PVs,LAA and RAA,atrial arrhythmias are easily to be induce by programmed stimulation.(2) In patients with paroxysmal Af:PVs has the shortest ERPsfollowed by RAs whereas LA ERPs is the longest.There is a large ERP gradient change between PVs and LA.(3) The ERPs at RAs,LAs,As,and LA-PV are prolonged after CPVI.(4) Atrial arrhythmia is less likely to be induced after CPVI.

Objective: To understand the dilemma of different participants in school psychological crisis intervention, so as to provide guidance for the implementation of comprehensive psychological crisis intervention from multiple perspectives. Methods: From March 2022 to January 2023, a total of 10 psychological consultants, 10 counselors, 10 peer students, 10 parents and 10 clients were selected from a certain university using convenient sampling method was interviewed with semi structured interviews, and the transcribed data were analyzed according to grounded theory. Results: The predicaments of psychological crisis intervention mainly involved three core themes: early warning, ethical dilemma and negative emotion. Early warning approaches mainly included three core themes: school, social media and other institutions, and 50 participants reported mainly on peer students in schools(18 cases) and online media in social media(18 cases). Ethical dilemmas mainly focued on the conflict between confidentiality breaches and privacy protection. The negative emotions mainly include three core themes of anxiety, fear and powerlessness, which were characterized by dispersion. The optimization expectation of psychological crisis intervention mainly consisted of two core themes: professional expectation and collaborative expectation, both of which were the common expectation of the people involved. Conclusion School psychological crisis intervention should pay attention to the establishment of crisis early warning system and dialectic between confidentiality breaches and privacy protection. Schools should prevent the dispersion of negative emotions of participants, deepen professional construction and the coordination between home and school, and implement psychological crisis intervention from a comprehensive perspective.

OBJECTIVETo study the safety and efficacy of three-dimensional conformal radiotherapy in combination with temozolomide in treatment of patients with diffuse brainstem glioma.

METHODSTwelve patients with MRI-confirmed diffuse brainstem glioma received 54 Gy three-dimensional conformal radiotherapy for 6 weeks with 1.8 Gy per fraction, 5 times per week. All of the patients were given daily oral temozolomide 75 mg/m(2) during radiotherapy. Four weeks after radiotherapy, all of the patients received 6 cycles of temozolomide, each cycle lasted 5 days with 28 days interval between each two cycles. 150 mg/m(2) of temozolomide was given for the first cycle for five days, followed by 200 mg/m(2) of the drug for the rest of the cycles if no significant drug-related toxicities were observed. Magnetic resonance imaging and laboratory tests were performed to evaluate the efficacy and adverse reactions.

RESULTSIn the 12 patients, CR was 1 case (8.3%), PR 6 cases (50.0%), SD 2 cases (16.7%), and PD 3 cases (25.0%). The overall clinical benefit rate was 75.0%. Progression-free survival rate was 75.0% (9/12) at 6 months and 50.0% (6/12) at 1 year. The one-year overall survival rate was 75.0%. There were no severe temozolomide-related toxicities.

CONCLUSIONSConcurrent temozolomide with three-dimensional conformal radiotherapy and followed by 6 cycles of temozolomide chemotherapy for diffuse brainstem gliomas have a better clinical efficacy, good tolerance and with no severe toxicities.

Adolescent ; Adult ; Antineoplastic Agents, Alkylating ; adverse effects ; therapeutic use ; Brain Injuries ; etiology ; Brain Stem Neoplasms ; pathology ; therapy ; Chemoradiotherapy ; Child ; Dacarbazine ; adverse effects ; analogs & derivatives ; therapeutic use ; Disease-Free Survival ; Female ; Glioma ; pathology ; therapy ; Humans ; Leukopenia ; chemically induced ; Male ; Middle Aged ; Radiation Injuries ; etiology ; Radiotherapy, Conformal ; adverse effects ; methods ; Remission Induction ; Survival Rate ; Young Adult

Objective Review the current diagnosis and treatment of idiopathic pulmonary fibrosis acute exacerbations . Methods Herein present a male patients 69 years and with AE-IPF with considerable preoperative pulmonary function and make a literature review .Results The patient's preoperative lung function was better , but postoperative acute pulmonary fi-brosis exacerbated and died.Conclusion The conditions of patients having AE-IPF are usually unable to be discovered easily and it deteriorates rapidly, with a very poor prognosis.

Aim To explore the effects of miR-7 on astrocyte activation and the underlying mechanisms. Methods Following isolation and culturing, astro-cytes extracted from rat cortex were treated with culture solution (control group), ciliary neurotrophic factor (CNTF, an agonist of astrocyte activation), miR-7 mimic+CNTF, miR-7 mimic control+CNTF, miR-7 inhibitor+CNTF and miR-7 inhibitor control+CNTF, respectively. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the mRNA ex-pression of glial fibrillary acidic protein (GFAP) and epidermal growth factor receptor(EGFR). The protein expression of GFAP, EGFR, signal transducers and activators of transcription 3(STAT3) and phosphoryla-ted STAT3 (p-STAT3) was measured using Western blot. Wild type pGL3-EGFR and mutant pGL3-EGFR-m recombinant plasmids were constructed and then co-transfected with miR-7 mimic into HEK293T cells,re-spectively. The luciferase activity of reporter gene was measured. In addition,astrocytes were treated with ei-ther EGFR siRNA or S31-201 (an inhibitor of STAT3),followed by the incubation with miR-7 inhib-itor and CNTF. Both qRT-PCR and Western blot were subsequently used to detect the mRNA and protein lev-els of GFAP. Results The expression levels of GFAP and EGFR as well as p-STAT3/STAT3 ratio in CNTF group were higher than those in control group (P <0.01). When compared with CNTF group,GFAP and EGFR levels and p-STAT3/STAT3 ratio significantly decreased in miR-7 mimic+CNTF group but increased in miR-7 inhibitor+CNTF group(P<0.01). In com-parison with control group, transfection with miR-7 mimic markedly reduced the luciferase activity of wild type EGFR (P <0.01). Moreover, miR-7 inhibitor-induced up-regulation of GFAP expression was almost completely reversed by either EGFR siRNA or S31-201 pretreatment (P<0.01). Conclusion miR-7 antag-onizes the activation of astrocytes from rats by inhibi-ting the EGFR/STAT3 signaling pathway.

OBJECTIVETo investigate the mutations of mitochondrial genome in a pedigree with suspected maternally inherited diabetes and deafness and to explore the correlations between the mutations and clinical features.

METHODSGenomic DNA was isolated from blood leucocytes of each member of the pedigree. The mitochondrial genome was amplified with 24-pair primers that could cover the entire mitochondrial DNA. Direct sequencing of PCR products was used to identify any mitochondrial DNA mutations.

RESULTSFamily members on the maternal side all harbored the tRNALeu(UUR) A3243G mutation. The paternal side family members did not have the mutation. The age-of-onset of diabetes of the 4 maternal side family members was 15, 41, 44, and 65 years old, and their corresponding heteroplasmy level of the mutation was 34.5%, 14.9%, 14.6%, and 5.9%, respectively. The age-of-onset of diabetes and heteroplasmy level of A3243G mutation were negatively correlated with a correlation coefficient of -0.980 (P = 0.02). Meanwhile, patient with high heteroplasmy level of A3243G mutation had relatively low severity of disease. Moreover, 6 reported polymorphisms and 2 new variants were found.

CONCLUSIONSThe main cause of diabetes in this pedigree is the tRNALeu(UUR) A3243G mutation. However, other gene variants may contribute to its pathogenicity. The heteroplasmy level of the tRNALeu(UUR) A3243G mutation is positively associated with earlier age-of-onset and increasing severity of diabetes.

Adolescent ; Adult ; Age of Onset ; Aged ; Asian Continental Ancestry Group ; genetics ; China ; Diabetes Mellitus, Type 1 ; diagnosis ; genetics ; Female ; Hearing Loss ; genetics ; Humans ; Middle Aged ; Mitochondria ; genetics ; Pedigree ; Point Mutation ; genetics ; Polymorphism, Single Nucleotide ; genetics ; RNA, Transfer ; genetics ; RNA, Transfer, Leu ; genetics ; Young Adult

The oral administration of bioactive macromolecular drugs such as proteins, peptides and nucleic acids represents unprecedented challenges from the drug delivery point of view. One key consideration is how to overcome the gastrointestinal tract absorption barrier. Recent studies suggest that microfold cell (M cell), a kind of specialized antigen-sampling epithelial cell which is characterized by a high endocytic rate and low degradation ability, may play an important role in macromolecule oral absorption. The development of an in vitro M cell coculture system and its modified models greatly advanced the study of M cells and the development of oral delivery system for macromolecular drugs. The special structure, function and formation characteristics, and biomarkers of M cell are summarized in this review. The applications of in vitro M cell models in developing oral delivery system ofbioactive macromolecular drugs are discussed.
Administration, Oral ; Animals ; Drug Delivery Systems ; methods ; Humans ; Intestinal Mucosa ; cytology ; Macromolecular Substances ; administration & dosage ; pharmacokinetics ; Models, Biological ; Peptides ; administration & dosage ; pharmacokinetics ; Peyer's Patches ; cytology ; Proteins ; administration & dosage ; pharmacokinetics ; Vaccines ; pharmacokinetics