Objective:To explore the feasibility of artificial intelligence ultrasound to diagnose of biliary atresia (BA) based on deep learning.Methods:A total of 531 gallbladder ultrasound images in 177 cases of BA patients (BA group) and 585 gallbladder ultrasound images in 195 cases of Non-BA patients (Non-BA group) were collected in Hunan Children′s Hospital from September 2018 to October 2020. For the BA and Non-BA groups, all images were divided into training set and test set according to the ratio of 2∶1. The Mask R-CNN model was trained by training samples, and then the model was tested, according to patient and image as a unit respectively, to evaluate the gallbladder organ detection rate and the diagnostic accuracy of BA. In addition, the images of the test set were randomly numbered.Four sonographers were invited to interpret the images to calculate the diagnostic accuracy individually. Last, the diagnostic accuracy of the Mask R-CNN model was compared with that of sonographers.Results:In terms of the automatic detection of gallbladder organs, the detection rate in both BA and Non-BA group reached 100%, but there were 17 false alarms in 372 test images, with a false alarm rate of 4.57%. In terms of the diagnostic rate of gallbladders, when taking patient as a unit, the total diagnostic accuracy of the model in the test set was 95.97%, which was higher than that of the sonographers in other hospitals and the sonographer with intermediate professional title in our hospital, and the difference was statistically significant ( P<0.005). It was slightly higher than that of sonographer with senior professional title in our hospital (91.94%), but the difference was not statistically significant ( P=0.183). When taking picture as a unit, the total diagnostic accuracy of the model was 97.04%, which was higher than that of the sonographers in other hospitals and the sonographer with intermediate professional title in our hospital, and the difference was statistically significant ( P<0.001). It was slightly higher than that of sonographer with senior professional title in our hospital (94.09%), but the difference was not statistically significant ( P=0.05). Conclusions:The artificial intelligence technology based on Mask R-CNN can automatically and accurately detect gallbladder organs and diagnose BA, which is worthy of further study.

Objective To systematically evaluate the efficacy and compliance of domestic ketogenic diet(KD) for children with refractory epilepsy (RE),in order to provide the basis for further improving the curative effect and compliance by finding out the factors influencing efficacy and compliance. Methods The effect of KD on children with RE was investigated by systematically searching China National Knowledge Infrastructure(CNKI),China Science and Technology Journal Database(CSTJ),Wanfang Data Knowledge Service Platform and PubMed database from January 1, 1989 to January 17,2018. The relevant literature R3. 0. 2 software was used to combine the retention rate and therapeu-tic effect in different periods,based on the systematic analysis of the therapeutic efficacy and compliance literature. Results A total of 11 eligible documents were included. (1)The methodological index for non - randomized studies (MINORS)scores of included literature were rated from 10 to 18 points. (2)A secondary analysis of 9 literatures on the description of the subject′s composition showed that the proportion of male to female in children with RE ranged from 1. 441. 00 to 2. 731. 00,and that of 9 literatures included a total of 331 samples,there were 212 male and 119 female,the ratio of male to female was 1. 781. 00. (3)The sources of the included literatures were from Beijing, Shanghai,Changsha,Shenzhen,Nanchang,Zhengzhou,Suzhou,Chongqing,Shenyang and Xi′an. (4)The retention rates of 1 month(5 studies),3 months(10 studies),6 months(7 studies)and 12 months (6 studies)were respectively 93％ [95％ confidence interval (CI):88％ - 98％],80％ (95％ CI:71％ - 98％),70％ (95％ CI:61％ - 78％) and 54％ (95％ CI:37％ - 71％). (5)According to the Meta - analysis,the effective rate of 1 month(6 studies), 3 months(10 studies),6 months(7 studies)and 12 months (7 studies)were respectively 57％ (95％ CI:34％ -79％),68％ (95％ CI:57％ - 79％),76％ (95％ CI:62％ - 89％)and 80％ (95％ CI:68％ - 93％). (6)Through analyzing the adverse reactions and the causes of termination,the literature showed that common adverse reactions in-volved digestive system (72 cases),infection (23 cases),urinary calculus (4 cases),and the metabolic disorder. The reason of treatment termination was that the children were not cooperative (26 cases)and the parents had poor comp-liance (24 cases). Conclusion KD is one of the effective methods for treating RE in children. Reducing or relieving adverse reactions in KD to improve the treatment compliance of children with RE and their families is a subject worthy of further study and attention.

Background: Serum immunoglobulin A antibodies against Epstein–Barr virus (EBV), viral capsid antigen (VCA?IgA) and early antigen (EA?IgA), are used to screen for nasopharyngeal carcinoma (NPC) in endemic areas. However, their routine use has been questioned because of a lack of specificity. This study aimed to determine the distributions of different subtypes of antibody and to illustrate how the natural variation patterns affect the specificity of screening in non?NPC participants. Methods: The distribution of baseline VCA?IgA was analyzed between sexes and across 10?year age groups in 18,286 non?NPC participants using Chi square tests. Fluctuations in the VCA?IgA level were assessed in 1056 non?NPC participants with at least two retests in the first 5?year period (1987–1992) after the initial screening using the Kaplan–Meier method. Results: The titers of VCA?IgA increased with age (P < 0.001). Using a previous serological definition of high NPC risk, nasopharyngeal endoscopy and/or nasopharyngeal biopsy would be recommended in 55.5% of the non?NPC partici?pants with an initial VCA?IgA?positive status and in 20.6% with an initial negative status during the 5?year follow?up. However, seroconversions were common; 85.2% of the participants with a VCA?IgA?positive status at baseline con?verted to negative, and all VCA?IgA?negative participants changed to positive at least once during the 5?year follow?up. The EA?IgA status had a high seroconversion probability (100%) from positive to negative; however, it had a low probability (19.6%) from negative to positive. Conclusions: Age? and sex?specific cutoff titer values for serum anti?EBV antibodies as well as their specific titer fluc?tuation patterns should be considered when defining high NPC risk criteria for follow?up diagnostics and monitoring.

This study was aimed to develop an HPLC method for simultaneous determination of five active components in Baihu and Guizhi decoction.Simultaneous determination of mangiferin,neomangiferin,glycyrrhizic acid,liquiritin,and cinnamic acid in Baihu and Guizhi decoction were conducted by HPLC-PDA under multiple UV wavelengths.An Waters xBridge BEH C18 Column (4.6 mm × 250 μm,5 μm) was used.The mobile phase was acetonitrile-0.01％ formic acid solution.The flow rate was 1 mL·min-1.The column temperature was kept at 24℃.The detection wavelength was set at 255 nm and 280 nm.The results showed that the linear range of mangiferin,neomangiferin,glycyrrhizic acid,liquiritin,and cinnamic acid was 66-1 976 μg (r =0.999 3),70-3487 μg (r =0.999 7),30-913 μg (r =0.999 5),35-1 734 μg (r =0.999 5),0.6-187 μg (r =0.999 8) in 70 min,respectively.The average recovery was between 95.29％ and 100.17％.It was concluded that the method was convenient,stable,reliable and accurate for simultaneous determination of the five components in Baihu and Guizhi decoction.It provided an evaluation method for the quality control of Baihu and Guizhi decoction and the research o its granules.

Objective:To investigate the clinical manifestations and pathogenic gene mutation sites of familial cavernous hemangioma by a pedigree study of this disease.Methods:A family of cerebral cavernous hemangioma who was admitted to the Department of Neurology of the First Affiliated Hospital of Henan University of Science and Technology in April 2019 was diagnosed as cerebral cavernous hemangioma type 1 based on clinical manifestations and head magnetic resonance imaging (MRI), diffusion weighted imaging and susceptibility weighted imaging screening. According to Zabramski classification criteria, the family′s clinical data were collected and genes were sequenced.Results:A 58-year-old female proband had dizziness and headache as the main symptoms, her daughter and son had no clinical symptoms, and her granddaughter had clinical manifestations of cerebral hemorrhage and seizures. The proband and her family members showed multiple cavernous hemangioma on cranial MRI,and the p.L436fs mutation in the KRIT1 gene of familial cerebral cavernous malformation type 1 was confirmed through genetic examination, which was consistent with the Zabramski typing results based on head MRI. The mutation site of the familial spongiform malformation type 1 pathogenic gene was found to be p.L436fs in KRIT1 gene, which has not been reported in familial cerebral cavernous hemangioma type 1 until now.Conclusion:A new p.L436fs mutation of KRIT1 gene was found in familial cerebral cavernous malformation type 1, which expands understanding of the clinical manifestations and pathogenic gene mutation sites of familial cavernous hemangioma.

Objective:To investigate the impacts of ionizing radiation on protein expression profiles in esophageal tissues of rats using quantitative proteomics, in order to reveal the molecular mechanisms underlying the onset and development of radiation-induced esophagitis (RIE).Methods:A total of twenty-four male SD rats were divided by simple randomization into three groups: the control, 25 Gy irradiation, and 35 Gy irradiation groups, and their esophageal tissues were collected at 7 d post-irradiation to extract total protein. Then, changes in the protein expression profiles of the esophageal tissues in irradiated rats were investigated using tandem mass tag (TMT)-labeled quantitative proteomics and bioinformatics analysis. Additionally, the expressions of two key proteins, Hp and Ndufs4, were validated using immunohistochemistry and Western blot.Results:A comparison with the control group revealed a total of 847 differentially expressed proteins (DEPs; 483 up-regulated and 364 down-regulated) following 25 Gy irradiation and 699 DEPs (443 up-regulated and 256 down-regulated) following 35 Gy irradiation. Different radiation doses led to common 326 up-regulated proteins, which were mainly involved in biological processes and signaling pathways related to immune and inflammatory responses, and 210 down-regulated proteins, which were primarily involved in biological processes and signaling pathways related to energy production and metabolism. Furthermore, a total of 155 proteins were screened using a constructed protein protein interaction(PPI) network. Of these proteins, the up-regulated ones were most associated with three functional pathways, namely innate immune responses, complement and coagulation cascades, and innate immune system, while the down-regulated ones were most associated with energy acquisition via oxidizing organic compounds, oxidative phosphorylation, and the tricarboxylic acid (TCA) cycle and respiratory electron transfer. These functions were enriched with nine complement-related up-regulated and five mitochondria-related down-regulated proteins, respectively. Ionizing radiation significantly up-regulated Hp ( t = 27.94, 10.96, P<0.001) and down-regulated Ndufs4 ( t = 59.27, 54.07, P<0.001), consistent with the protein sequencing result. Conclusions:Ionizing radiation can change the protein expression profiles in the esophageal tissues of rats, and these DEPs are involved in multiple radiobiology-related functional pathways such as immune processes, inflammatory responses, and abnormal energy metabolism. Screening and validation of key proteins are helpful for identifying potential biomarkers of radiation-induced esophagitis.

Objective:To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the cognition of patients with mild cognitive impairment (MCI).Methods:The PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang, and VIP databases were searched for randomized controlled trials of rTMS treating MCI patients before March 2019. After screening the literature, extracting the data and two independent reviewers evaluating the quality of the included studies, the meta-analysis was conducted using version 5.3 of the RevMan software.Results:Nine studies covering 368 patients were included. The pooled results showed that compared with sham stimulation, rTMS treatment could effectively improve the cognitive ability (assessed using the Montreal instrument), episodic memory, verbal fluency and the amplitude of MCI patients′ P300 signals. P300 latency was also reduced. However, there was no significant difference, on average, in memory quotient or P300 latency between patients given rTMS plus donepezil hydrochloride and those given donepezil hydrochloride alone. Compared with the control groups, the rTMS treatment groups displayed slightly more frequent adverse reactions, mainly mild dizziness and scalp pain which disappeared within 1-2 hours without obvious residual effects.Conclusions:TMS treatment can effectively improve cognitive and memory function.

AIM:To observe the effect of fudostei-ne on induced sputum cell components and lung function in patients with stable neutrophil-dominat-ed COPD.METHODS:From October 2019 to Octo-ber 2022,53 patients with stable COPD were select-ed and divided into fudosteine group and placebo group.The placebo group was treated with routine treatment,and the fudosteine group was treated with fudosteine on the basis of routine treatment.The two groups were treated for 6 months.The clinical symptoms[Saint George's Respiratory Questionnaire(SGRQ),COPD Assessment Test(CAT)and Modified British Medical Research Council Dys-pnea scale(MMRC),Breathlessness,Cough,and Sputum Scale(BCSS)],lung function index,induced sputum cytology analysis and other related exami-nation results were recorded in detail before and after treatment.RESULTS:(1)Compared with the baseline,the forced expiratory volume in one sec-ond(FEV1),forced vital capacity(FVC),and the ra-tio of FEV1 to FVC(FEV1/FVC)of the two groups were improved after treatment,and the differenc-es were statistically significant(P＜0.05).However,after treatment,there was no significant difference in pulmonary function between the two groups ex-cept for the percentage of carbon monoxide diffu-sion in the predicted value(DLCO％pre)(DLCO％pre in the fudosteine group was higher than that in the placebo group).(2)After treatment,the total num-ber of induced sputum cells and neutrophil counts in the fudosteine group were lower than those in the placebo group.Compared with the number of cells in each component at baseline,the total num-ber of induced sputum cells and neutrophil count in the fudosteine group were significantly lower(P＜0.05).CONCLUSION:Fudosteine treatment in pa-tients with stable neutrophil-dominated COPD can improve lung function,reduce the total number of induced sputum cells and the total number of neu-trophils,thereby improving airway inflammation.

AIM:To observe the effect of fudostei-ne on induced sputum cell components and lung function in patients with stable neutrophil-dominat-ed COPD.METHODS:From October 2019 to Octo-ber 2022,53 patients with stable COPD were select-ed and divided into fudosteine group and placebo group.The placebo group was treated with routine treatment,and the fudosteine group was treated with fudosteine on the basis of routine treatment.The two groups were treated for 6 months.The clinical symptoms[Saint George's Respiratory Questionnaire(SGRQ),COPD Assessment Test(CAT)and Modified British Medical Research Council Dys-pnea scale(MMRC),Breathlessness,Cough,and Sputum Scale(BCSS)],lung function index,induced sputum cytology analysis and other related exami-nation results were recorded in detail before and after treatment.RESULTS:(1)Compared with the baseline,the forced expiratory volume in one sec-ond(FEV1),forced vital capacity(FVC),and the ra-tio of FEV1 to FVC(FEV1/FVC)of the two groups were improved after treatment,and the differenc-es were statistically significant(P＜0.05).However,after treatment,there was no significant difference in pulmonary function between the two groups ex-cept for the percentage of carbon monoxide diffu-sion in the predicted value(DLCO％pre)(DLCO％pre in the fudosteine group was higher than that in the placebo group).(2)After treatment,the total num-ber of induced sputum cells and neutrophil counts in the fudosteine group were lower than those in the placebo group.Compared with the number of cells in each component at baseline,the total num-ber of induced sputum cells and neutrophil count in the fudosteine group were significantly lower(P＜0.05).CONCLUSION:Fudosteine treatment in pa-tients with stable neutrophil-dominated COPD can improve lung function,reduce the total number of induced sputum cells and the total number of neu-trophils,thereby improving airway inflammation.

AIM:To observe the effect of fudostei-ne on induced sputum cell components and lung function in patients with stable neutrophil-dominat-ed COPD.METHODS:From October 2019 to Octo-ber 2022,53 patients with stable COPD were select-ed and divided into fudosteine group and placebo group.The placebo group was treated with routine treatment,and the fudosteine group was treated with fudosteine on the basis of routine treatment.The two groups were treated for 6 months.The clinical symptoms[Saint George's Respiratory Questionnaire(SGRQ),COPD Assessment Test(CAT)and Modified British Medical Research Council Dys-pnea scale(MMRC),Breathlessness,Cough,and Sputum Scale(BCSS)],lung function index,induced sputum cytology analysis and other related exami-nation results were recorded in detail before and after treatment.RESULTS:(1)Compared with the baseline,the forced expiratory volume in one sec-ond(FEV1),forced vital capacity(FVC),and the ra-tio of FEV1 to FVC(FEV1/FVC)of the two groups were improved after treatment,and the differenc-es were statistically significant(P＜0.05).However,after treatment,there was no significant difference in pulmonary function between the two groups ex-cept for the percentage of carbon monoxide diffu-sion in the predicted value(DLCO％pre)(DLCO％pre in the fudosteine group was higher than that in the placebo group).(2)After treatment,the total num-ber of induced sputum cells and neutrophil counts in the fudosteine group were lower than those in the placebo group.Compared with the number of cells in each component at baseline,the total num-ber of induced sputum cells and neutrophil count in the fudosteine group were significantly lower(P＜0.05).CONCLUSION:Fudosteine treatment in pa-tients with stable neutrophil-dominated COPD can improve lung function,reduce the total number of induced sputum cells and the total number of neu-trophils,thereby improving airway inflammation.