Non-rigid medical image registration is a popular subject in the research areas of the medical image and has an important clinical value. In this paper we put forward an improved algorithm of Demons, together with the conservation of gray model and local structure tensor conservation model, to construct a new energy function processing multi-modal registration problem. We then applied the L-BFGS algorithm to optimize the energy function and solve complex three-dimensional data optimization problem. And finally we used the multi-scale hierarchical refinement ideas to solve large deformation registration. The experimental results showed that the proposed algorithm for large de formation and multi-modal three-dimensional medical image registration had good effects.
Algorithms ; Diagnostic Imaging ; Humans ; Imaging, Three-Dimensional ; Models, Theoretical

Objective To investigate the effect of vitamin D supplementation on biochemical imdexes and compliations in patients with type 2 diabetes(T2DM).Methods Two hundred and ten patients with type 2 diabetes of the People's Hospital of Chongli County were selected from January 2001 to January 2002.According to the envelope sampling method they were divided into vitamin D supplementation group of 105 people and not supplemented group of 105 people,and 105 healthy people at the same period as control group.Compared the biochemical baseline indicators differences.After 10 years of follow-up,the biochemical indexes and the complications were detected and compared again.Results After ten years follow-up,82 cases of supplementation group were followed up,78 cases of not supplemented group were followed up.The level of FPG and HbA1c of supplementation group and not supplementation group were higher than that of control group,the differernce was significant(P＜0.05).In supplement group,TG levels,25(OH) D3 concentrations and BMD values were (2.11±0.41) mmol/L,(16.88±5.02) μg/L and-1.15±(-0.25) respectively,and equal to the control group ((2.12 ± 0.38) mmol/L,(44.83 ± 21.25) mmol/L,-0.94 ± (-0.21)),and TG levels were lower than not supplemented group,25 (OH) D3 concentrations and high bone density higher than not supplemented group((24.53±15.61) mmol/L,-3.15±(-0.33),P＜0.05).FPG,Cr,BUN,UA,FIB,and BNP in supplement group were(10.00±2.32) mmol/L,(64.77±9.31) μmol/L,(6.41± 1.24) mmol/L,(339.83±43.74) mmol/L,(2.41±0.46) g/L and (588.92±73.69) ng/L,in not supplemented group were (15.60±2.51) mmol/L,(92.69±11.68).μmol/L,(8.70±2.35) mmol/L,(398.94±49.13) mmol/L,(2.89±0.54) g/L and (761.09±91.52) ng/L,all higher than those in control group ((5.01 ±0.59) mmol/L,(57.81±6.61) μmol/L,(4.52±1.11) mmol/L,(311.83±49.51) mmol/L,(2.00±0.31) g/L,(434.31 ± ±71.03) ng/L),and those indexes in supplement group all higher than in not supplemented group(P＜0.05).The level of HbA1c of supplement group and not supplemented group both higher than control group((11.32 ± ±2.03) ％,(13.22±4.17) ％ and (5.34±1.99) ％,P＜0.05).There were 45 cases in supplement group occurred diabetic nephropathy and cardiovascular complications,and 65 cases of not supplemented group (x2 =15.07,P＜0.05).Conclusion The relationship of Vitamin D and various complications of diabetes mellitus are closely,and supplementing vitamin D can reduce the complications of diabetes.

Objective To explore the correlations of dyslipidemia and hypertension with diabetic retinopathy in diabetic patients aged 80 years and over. Methods The 487 diabetic patients admitted to endocrine department of our hospital from January 2013 to June 2017 were recruited and their medical records were retrospectively analyzed. According to the results of examination ,they were divided into three groups :non-diabetic retinopathy group (n = 306 ) ,non-proliferative diabetic retinopathy group (n = 143)and proliferative diabetic retinopathy group (n = 38).The course of diabetes ,levels of blood glucose and lipids ,and the course of hypertension were compared among the three groups. Results Prevalence of diabetic retinopathy was 37.2% (181/487) ,and was increased along with the prolongation of diabetes duration ,and occurrence of coexisted hypertension and dyslipidemia.Statistically significant differences were found among the 3 groups(all P＜0.05)in the levels of glycosylated hemoglobin A1c ,low-density lipoprotein cholesterol ,high-density lipoprotein cholesterol ,triglyceride ,apolipoprotein A ,apolipoprotein B and the ratio of apolipoprotein A over apolipoprotein B.Multivariate analysis showed that the levels of glycosylated hemoglobin A 1c ,low-density lipoprotein cholesterol and the ratio of apolipoprotein A and apolipoprotein B were correlated with the development and progression of diabetic retinopathy ( OR = 3.00 ,0.22 and 2.96 , respectively). Conclusions The incidence of diabetic retinopathy is higher in diabetic patients aged 80 years and over.Dyslipidemia is correlated with development and progression of diabetic retinopathy.

Objective To explore the correlation between diabetic retinopathy (DR)and glycosylated blood protein(HbA1c) among diabetic patients aged 80 years and over.Methods The medical records of 403 diabetic patients(≥80 years old)admitted to endocrine department of Heji Hospital Affilicated to Changzhi Medical College from January 2013 to March 2017 were retrospectively analyzed.They were divided to three groups of non-DR group (254 cases),non proliferative DR group (122 cases) and proliferative DR group (27 cases).The duration of diabetes,levels of fasting blood glucose and glycosylated hemoglobin were compared among groups.Results One-hundred and forty-nine(37.0％)elderly diabetic patients developed DR.DR was associated with longer history of diabetes and hypertension and with family history of diabetes.There were statistically significant differences in serum levels of fasting blood glucose and glycosylated hemoglobin(both P＜ 0.05)among three groups.Furthermore,multivariate analysis showed that glycosylated hemoglobin was associated with the incidence and development of DR(OR =4.137,P＜0.01).Conclusions More than one third(37.0 ％) elderly diabetic patients(≥80 years old) have diabetic retinopathy,which is associated with the level of glycosylated hemoglobin.

Objective:To observe the effects of FNS007 on collagen Ⅱ-induced arthritis(CIA) rat models and investigate the underlying mechanism.Methods: CIA model was induced by intradermal injection of Freunds adjuvant and bovine CⅡ.Rats were randomly divided into six groups:normal control group,model group,methotrexate group,high,middle and low doses of FNS007 groups,with 12 rats in each group.FNS007 was gived by intravenous injection,the normal control and model group were administrated with PBS.Observing the paw thickness,ankle joint width and the arthritis scores in the CIA rats during the experiment.On d 22 after injection of the drug, all rats were killed.Interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),interleukin-6 (IL-6) and level of anti-CⅡantibody in serum were examined by enzyme-linked immunosorbent assay (ELISA).The pathological score and radiography of ankle joint were evaluated.Results: Data revealed that FNS007 treated groups showed a significant reduction in paw thickness,ankle joint width and the arthritis scores compared to model group (P<0.05,P<0.01),especially FNS007 high dose goup.The levels of TNF-α,IFN-γ,IL-6 and anti-CⅡantibodies in serum in high dose goup were significantly lower than those of model group(P<0.05,P<0.01).X-ray examination showed that FNS007 could significantly alleviate the damage of joint and decrease the radiographic scores.Pathological examination exhibited that FNS007 could significantly reduce pathological scores,alleviate inflammatory cell infiltration and synovial hyperplasia,improve the histopathological changes.Conclusion: FNS007 has a treating effect on CIA rats,and the mechanisms may be through competitive inhibition of T cell,inhibiting inflammatory cytokines and anti-CⅡantibodies secretion,regulating the abnormal immune responses.

Aim To investigate the effect of non-T cell binding peptide(FNS007)on collagen type Ⅱ-induced arthritis(CIA)in mice and the possible mechanisms.Methods The CIA model was induced by intradermal injection of bovine CⅡ+Freunds adjuvant.At the clinical onset of CIA,mice were randomly divided into 6 groups: blank control group(Control),model group,ORENCIA(abatacept)group,FNS007 low dose(1.2 mg·kg-1)group,FNS007 middle dose(2.4 mg·kg-1)group and FNS007 high dose(4.8 mg·kg-1)group.FNS007 was given by intravenous injection on the first day of arthritis and every other day until the study was terminated on d 28 after injection of the drug.The paw thickness and the ankle joint width were measured,and the arthritis scores were recorded.At termination,interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and level of anti-CⅡ antibody in serum were examined by enzyme-linked immunosorbent assay(ELISA).Bone injury was analyzed by X-ray imaging,and HE staining was conducted to observe the histopathologic changes and pathological score of ankle tissues.Results CIA models were successfully induced.Compared with CIA group,FNS007 high dose significantly reduced the paw thickness and the ankle joint left-right diameter,lowered arthritis scores in CIA mice,reduced serum concentrations of IFN-γ,IL-6 and anti-CⅡ antibodies,and lowered the radiographic and histologic scores.Compared with CIA group,FNS007 middle dose group showed marked reduction in the arthritis scores,IL-6 content in serum,and inhibion in the radiographic and histologic scores.The arthritis scores,concentration of IFN-γ,the radiographic and histologic scores were significantly reduced in FNS007 low dose group compared with those in model group.Conclusion FNS007 can effectively inhibit the progression of CIA through inhibiting T-cell activation and reducing inflammatory cytokines,anti-CⅡ antibodies,and histoclasia and bone destruction.

Artificial intelligence (AI) is an emerging science and technology that studies and develops theories, methods, technologies, and application systems for simulating and expanding human intelligence. AI has made great breakthroughs in the field of intelligent medicine, and has shown great potential in the diagnosis and treatment of diabetic retinopathy (DR), retinopathy of prematurity, and other fundus diseases. A number of clinical trials on the application of AI technologies to DR screening have been carried out in the domestic and overseas, which not only have a high accuracy rate, but also save doctors' reading time and reduce the burden of society, medical work and patients. However, due to the lack of evaluation system for DR intelligent diagnosis technology, the accuracy of AI system still lacks of big data verification. Secondly, most of the color fundus photographs are taken in the posterior 45°, which only show the most vulnerable areas, making some lesions undetectable. In addition, the current DR screening system has not yet been applied to the clinic, most of which are in the stage of prospective research and trials. There are still many obstacles from the environment to the hospital or the clinic. Doctors cannot use real patient data to evaluate the AI system, so it is not popular in clinical practice. In the future, DR screening algorithms and diagnostic models can be further improved and established to make DR AI screening more accurate.

Alzheimer's disease(AD),the most common progressive neurodegenerative disease in dementia,is also a special lipid disease.From the perspective of modern medicine,cholesterol homeostasis is an important risk factor for AD.Amyloid-beta plaque deposition,neurofibrillary tangles,and large amount of lipid granule accumulation are typical pathological features of AD.From the perspective of TCM,turbidity is the key to the pathogenesis of AD.Phlegm turbid,stasis turbid and turbid toxin are the concrete derivation of turbidity,which are the standard of AD.Cholesterol is the greasy lipid which is produced from of the essence of water and food,the disturbance of cholesterol homeostasis is a typical embodiment of the pathogenesis mechanism of endogenous turbidity.Regulating cholesterol homeostasis by traditional Chinese medicine may be a new direction for the treatment of AD in the future.Focusing on the modern research of cholesterol homeostasis,taking the theory of turbidity as the starting point,this paper analyzed the correlation between the connotation of turbidity theory and the imbalance of cholesterol homeostasis as well as the pathogenesis mechanism,and further elucidated the clinical application results in the treatment of AD from the aspects of phlegm turbid,stasis turbid and turbid toxin,so as to better guide clinical practice and scientific research.

Objective:To investigate the value of pericoronary adipose tissue histogram parameters based on coronary CT angiography (CTA) images for the differentiation of acute coronary syndrome and stable coronary artery disease.Methods:The clinical data and CTA images of 93 patients with coronary CTA examination in Suzhou Kowloon Hospital from 2013 to 2018 were analyzed retrospectively. There were 39 patients with acute coronary syndrome (acute coronary syndrome group) and 54 patients with stable coronary artery disease (stable coronary artery disease group). A region of interest (ROI) was drawn around the stenosis of the coronary arteries, with CT attenuation ranging from-190 to -30 HU to exclude non-adipose tissue. The CT attenuation of ROI excluding non-adipose were measured and histogram analysis was performed. The obtained parameters included the mean value, median value and the 5th, 10th, 45th, 55th, 70th and 95th percentiles. The differences in histogram parameters between the two groups were compared, and then the value of each parameter in differentiating acute coronary syndrome and stable coronary artery disease was evaluated based on receiver operating characteristic (ROC) analysis. The stepwise regression of multivariate logistic regression analysis was used to identify the useful features and establish the final prediction model. The ROC curve of the final model was calculated and its value was analyzed.Results:The mean, median and the 5th, 10th, 45th, 55th,70th and 95th percentile differences between the acute coronary syndrome group and the stable coronary artery disease group were statistically significant (all P<0.05). The ROC curve for the median and the 95th percentile had the same area under curve (AUC) of 0.73. The sensitivity, specificity and AUC of the diagnostic model established by multiple logistic regression were 82.1%, 89.1% and 0.90 respectively. Conclusion:CT attenuation histogram of pericoronary adipose tissue is of high value in differentiating acute coronary syndrome from stable coronary artery disease.

Objective To observe the therapeutic effect of endovascular embolization for perimedullary arteriovenous fistula(PMAVF).Methods Data of 8 PMAVF patients who underwent endovascular embolization were retrospectively analyzed.Findings of digital subtraction angiography(DSA)immediately and 6 months after treatment were reviewed,and the modified Aminoff-Logue score(mALS)was compared before and 6 months after treatment.Results Among 8 cases of PMAVF,there were 2 cases of type Ⅰ,5 cases of type Ⅱand 1 case of type Ⅲ,among them 3 were treated with Onyx glue while 5 with Glubrane glue.The immediate DSA results after treatment showed complete embolization of the fistula in all 8 cases,while those 6 months after treatment showed no recurrence.One case recovered and the other 7 cases improved,and mALS(2.25±2.12)6 months after treatment was lower than that(5.50±2.39)before treatment(P＜0.05).Conclusion Endovascular embolization could safely and effectively treat PMAVF.