PurposeTo explore the segmentation accuracy of different filtering and segmentation methods in brain tumor MRI, and to identify the best algorithm for brain glioma.Materials and Methods Using the nonlocal average ifltering, median ifltering, the anisotropic ifltering and improved mean shift algorithm segmentation, the watershed segmentation algorithm, fuzzy c-means segmentation algorithm to realize image segmentation in MATLAB program, 39 glioma images from different patients were analyzed. Pathology manual segmentation was used as gold standard to evaluate different segmentation precision.Results The signal-to-noise ratio was 7.9243, 6.2160 and 6.5426 for different iflter methods, respectively. The segmentation methods accuracy was 92.31%, 88.03% and 84.93%, respectively.Conclusion The nonlocal average ifltering effect is more accurate than median ifltering and the anisotropic ifltering. The improved mean shift algorithm segmentation is more accurate than watershed segmentation algorithm and fuzzy c-means segmentation algorithm with precision of 92.31%.

Objective To explore the expression of TLR4/NF-κB pathway in cerebral injury resulting from DHCA ( deep hypothermia circulatory arrest ) as well as the effect of SACP ( selective antegrade cerebral perfusion). Methods Twelve pigs were randomly assigned to DHCA group (n = 6) or SACP group (n = 6) at 18 ℃ for 80 min. IL-6 was assayed by ELISA. Apoptosis and NF-κB proteins were detected by fluorescence TUNEL and Western blot, respectively. The level of TLR4 was determined through qRT-PCR and Western blot. Results Serum IL-6 level of SACP group was significantly lower at the end of circulation arrest and experiment and apoptotic index and NF-κB protein were apparently lower in SACP group (P < 0.05). The level of TLR4 protein and mRNA from SACP group decreased significantly (P < 0.05). Conclusions TLR4/NF-κB pathway plays a critical role in pathogenesis of DHCA cerebral injury and attenuating TLR4/NF-κB cytokines probably contributes to neuroprotection of SACP. TLR4/NF-κB pathway may be a novel target for DHCA.

Objective: To explore the relationship between protease-chymase secreted by mast cells, and activated transforming growth factor-β1(TGF-β1), in skin with secondary lymphedema(SLE)in lower extremity, so as toidentify the key factors in fibrosis of lymphedema. Methods: In this study, the affected limb skin of 7 SLE patients was includedas the experimental group, and normal skin tissue of the lower limb of 7 volunteers was used as controls. The skin samples were assayed by Masson staining, and the expressions of chymase and TGF-β1 were assayed by immunohistochemistry, immunofluorescent staining and enzyme-linked immunosorbent assay. Results: There was obvious fibrosis in the skin of lower extremity in patients with lymphedema. The number of MCs andthe expressions of chymase, latency-associated peptide TGF-β1 (LAP TGF-β1) and TGF-β1 were all significantly increased in fibrotic skin in lymphedema, compared with those in normal skin. At the same time, the chymase-containing mast cells accumulated in the lymphatic vessels, with higher expression of TGF-β1. Conclusions The expression of chymase and TGF-β1 was significantly increased in the fibrotic skin insecondary lower extremity lymphedema. The increased expression of chymase in the skin may activate more TGF-β1 expression, and the increased TGF-β1 may promote skin fibrosis in SLE.

Objective: To explore the appropriate treatment cycle of complex decongestive Therapy (CDT) for extremity lymphedema, which is the summary of the relationship between treatment time and curative effect. Methods: From January to December 2015, 203 patients with limb lymphedema were divided into four stages according to the degree of edema and the degree of fibrosis, that is, four groups. All patients were given CDT treatment for a course of treatment (4 weeks). During the treatment period, the multi frequency bioelectrical resistance body composition analyzer was used to monitor the change of tissue moisture and the tape diameter was used to measure the circumference of the affected limb. SPSS software is used to analyze the data. Results: 203 cases were treated with CDT therapy. Water in limb tissue and limb circumference of affected side was decreased significantly (P<0.01). To the tissues water dynamic changes, in the first group there was a significant difference (P<0.01) in the first week and second week. There was no obvious difference in 2-4 weeks; In the 2, 3 and 4 groups, there was significant difference in the first week and the second week, as well as the second week and the third week (P<0.05). And there was no difference in the third and fourth week. To the circumference dynamic change, in the first group there was no significant difference in patients in the first and the second week; In the third group, there was significant difference in the first week and the second week, as well as the second week and the third week (P<0.05). There was no significant difference in the last two weeks; In the fourth group, there was significant difference in the first week and the second week, as well as the third week and the fourth week(P<0.01). There was no difference in the second week and the third week. There is a correlation between the tissue water and the circumferential diameter (r=0.643). The patient has a good subjective feeling. Conclusions CDT therapy is effective in the treatment of lymphedema. For the first stage of edema, the therapy lasted two-week at least; For the second and the third stage edema, a 3 week therapy was suitable; For the fourth stage therapy, a four-week therapy is appropriate. It is suggested that CDT therapy should be maintained for at least half a year or so.

Objective: To identify confounding factors associated with dental caries prevention, as the basis for the development of subsequent health management plan for dental caries prevention in young children. Methods: From June to September 2019, a questionnaire survey was conducted among parents of young children enrolled in five kindergartens in the district of Shanggang Steel Community, Pudong New District, Shanghai, using the convenience sampling method. The survey included basic demographic characteristics on parents and children, as well as information factor, motivation factor, behavioral skills, and caries prevention behavior. Results: Among 718 parents surveyed, the median information factor score was 8 (7, 9), the median personal motivation factor score was 20 (19, 20), the median social motivation factor score was 9 (8, 10), the median behavioral skills score was 25 (24, 25), and the median caries prevention behavior score was 7 (5, 8). Motivation factor was positively associated with behavioral skills, both information factor and behavioral skills were positively associated with dental caries prevention (P<0.05). Personal motivation factor had a direct influence factor of 0.80 on behavioral skills and an indirect influence factor of 0.15 on dental caries prevention behavior; behavioral skills and information factor had a direct influence factor of 0.19 and 0.26 respectively on dental caries prevention. Conclusion The finding suggest that in addition to oral hygiene information and education for parents of young children, mental support should be a key component of any community-based dental caries prevention program.

Objective To investigate the role of TLR4/NF-κB signal pathway in pathogenesis of brain inju-ry during deep hypothermia circulatory arrest(DHCA). Methods BV2 microglia cells were subjected to oxygen-glucose deprivation/reoxygenation(OGD/R),in vitro model for DHCA. The BV2 were randomly divided into the control group(C group)and the experimental group(O group). BV2 viability was determined by CCK-8 assay. TLR4 and its downstream signaling molecules ,MyD88 and phosphorylated NF-κB (p-p65) expressions were detected by Western blotting. TLR4 mRNA expression in BV2 microglial cells were determined by RT-PCR. Level of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) in culture medium was detected by ELASA. Results Compared with the group C,BV2 microglia cell viability in experiment group was obviously weaker(P<0.05). Expressions of TLR4,MyD88 and phosphorylated NF-κB(p-p65)from the experiment group increased remarkedly than those from the group C (P < 0.05). TLR4 mRNA level was higher significantly in the group O than in the group C (P < 0.01). Production of IL-6 and TNF-α in the group O were up-regulated apparently compared to the group C(P<0.01). Conclusion TLR4/NF-κB signaling pathway contributed to activation of BV2 microglia cells treated by OGD/Reoxygenation ,which was probably the exactly way that involved in pathogenesis of brain injury during deep hypothermia circulatory arrest.

Objective: To evaluate the diagnostic value of indocyanine green(ICG)lymphography in primary lymphedema of extremities. Methods: 61 patients with limb lymphedema were enrolled in the study. The contralateral healthy limbs were used as controls. After intradermal injection of Indocyanine Green, dynamic observation of lymphatic vessels and lymph flow was performed using PDE near-infrared fluorescent instrument. The frequency of lymphatic contraction was calculated. Results: Lymphatic vessel images were clearly visualized in healthy limbs. Inguinal or axillary lymph nodes can be visualized when examined 30 minutes after injection. Lymphatic contraction frequency was 1(0.33-5.00)time per minute. 94.8% lymphedematous limb demonstrated delayed lymphatic vessel or lymph nodes. "Dermal backflow" and diffused shadow pattern can be observed in all affected limbs. Abnormal lymphatic vasculature and contraction can be visualized. The frequency of lymphatic contraction in the affected limb was higher compared to controls: 2.5(0.5-7.0) times per minute. Conclusions ICG lymphography possess high sensitivity for lymphedema diagnosis. ICG lymphography furthers our understanding of pathophysiological alterations of lymphatic disorders.

Objective To explore the effect of the orthokeratology lenses on the control of different types of aniso-metropia in myopic children.Methods A total of 99 myopic children aged 8 to 16 years who got the orthokeratology len-ses at the Department of Ophthalmology,Heping Hospital Affiliated to Changzhi Medical College from September 2020 to November 2022 with complete data were included.These children were divided into the simple myopic anisometropia group(monocular myopia,binocular diopter difference ≥ 1.00 D,n=39)and the compound myopic anisometropia group(binoc-ular myopia,binocular diopter difference ≥ 1.00 D,n=60).The children with higher anisometropia(binocular diopter difference ≥ 2.50 D)in the two groups were set as the high anisometropia subgroup(n=18 and 29,respectively),and chil-dren with lower anisometropia(1.00 D≤ binocular diopter difference＜2.50 D)were set as the low anisometropia subgroup(n=21 and 31,respectively).In each group,eyes with a higher diopter were set as the high diopter eyes,and the contra-lateral eyes with a lower diopter were set as the low diopter eyes.Diopter,corneal topography,intraocular pressure,cor-neal endothelium and axial length of children in the two groups were examined and recorded.The changes in axial length before and after wearing orthokeratology lenses for 1 year were compared between the two groups,analyzing the correla-tion between the degree of anisometropia and changes in the binocular axial length.Results After wearing orthokeratolo-gy lenses for 1 year,children in both groups had an increase in the axial length with a lower increase in the axial length of the high diopter eyes compared to the low diopter eyes;before and 1 year after wearing orthokeratology lenses,the axial length of high diopter eyes was greater than that of the low diopter eyes in both groups,and the differences were statistical-ly significant(all P＜0.05).Both groups of children showed a decrease in the binocular axial length difference after wear-ing the orthokeratology lenses for 1 year;before and 1 year after wearing orthokeratology lenses,the binocular axial length difference of children in the simple myopic anisometropia group was greater than that in the compound myopic anisometro-pia group,and the differences were statistically significant(t=4.903 and 2.670;both P＜0.05).The changes in binocular axial length difference before and after wearing the orthokeratology lenses of children in the high anisometropia subgroup and low anisometropia subgroup of the simple myopic anisometropia group were greater than those in the high anisometro-pia subgroup and low anisometropia subgroup of the compound myopic anisometropia group,respectively,and the differ-ences were statistically significant(both P＜0.05).In the simple myopic anisometropia and compound myopic anisometro-pia groups,the degree of anisometropia was positively correlated with the binocular axial length changes before and 1 year after wearing the orthokeratology lenses(r=0.423 and 0.510,both P＜0.05).Conclusion Orthokeratology lenses can effectively reduce the difference in binocular axial length of children with myopic anisometropia,and their control effect on simple myopic anisometropia is better than that of compound myopic anisometropia.

Objective:To investigate the effect of complex decongestive therapy(CDT) on elephantiasis and skin texture improvement.Methods:The clinical data of patients with elephantiasis of lower limbs who were admitted to the Department of Plastic Surgery, Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2016 to December 2018 were retrospectively analyzed. The patients with elephantiasis of different causes were treated with CDT for 1 course (4 weeks). The skin texture parameters (skin water content, transepidermal water loss, skin fibrosis), limb circumference and segmental edema were measured before and after treatment and analyzed by paired t test. Pearson correlation analysis was used to detect the correlation between segmental edema and skin texture parameters before and after treatment. The subjective feelings of patients were recorded during follow-up. A self-designed online questionnaire was used to follow up the patient’s disease control status, including the limb circumferences, changes in quality of life (life, work, social and emotion), the adaptability to bandages and elastic socks. Data were classified and analysed as excellent, good, medium and poor.Results:A total of 20 patients were included, including 16 females and 4 males. The average age was 50.45 years (ranged 9-70 years). 5 cases were primary lymphedema and 15 cases were secondary lymphedema. The duration of the disease ranged from 2 years to 27 years, with an average of 8.4 years. After 1 course of treatment, the skin texture was significantly improved. The skin water content decreased from 55.6%±7.4% before treatment to 42.1%±7.4% after treatment ( P< 0.001). The transepidermal water loss decreased from (14.981±5.699) g·m -2·h -1 before treatment to (9.312±2.590) g·m -2·h -1 after treatment. The skin fibrosis decreased from (0.087±0.042) N before treatment to (0.065±0.033) N after treatment ( P<0.001). The circumference of the affected limb decreased from (11.09±3.14) cm before treatment to (4.82±2.83)cm after treatment ( P<0.001). The segmental edema decreased from (4.00±2.14)L before treatment to (1.21±0.78) L after treatment. Segmental edema was positively correlated with skin water content, transepidermal water loss, and skin fibrosis ( r=0.447, r=0.429, r=0.751, P<0.05). The patients were followed up for 6 months after treatment. The circumference control was excellent in 13 cases, good in 5 cases and moderate in 2 cases. The quality-of-life changes were excellent in 16 cases, good in 3 cases, medium in 1 case. The adaptability of elastic material was excellent in 9 cases, good in 8 cases, medium in 2 cases and poor in 1 case. Conclusions:CDT can reduce subcutaneous edema, effectively reduce limb volume, decrease skin fibrosis, improve skin barrier function, improve skin texture, restore the appearance of the limb and improve patients’ quality of life.

Objective:To investigate the effect of complex decongestive therapy(CDT) on elephantiasis and skin texture improvement.Methods:The clinical data of patients with elephantiasis of lower limbs who were admitted to the Department of Plastic Surgery, Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2016 to December 2018 were retrospectively analyzed. The patients with elephantiasis of different causes were treated with CDT for 1 course (4 weeks). The skin texture parameters (skin water content, transepidermal water loss, skin fibrosis), limb circumference and segmental edema were measured before and after treatment and analyzed by paired t test. Pearson correlation analysis was used to detect the correlation between segmental edema and skin texture parameters before and after treatment. The subjective feelings of patients were recorded during follow-up. A self-designed online questionnaire was used to follow up the patient’s disease control status, including the limb circumferences, changes in quality of life (life, work, social and emotion), the adaptability to bandages and elastic socks. Data were classified and analysed as excellent, good, medium and poor.Results:A total of 20 patients were included, including 16 females and 4 males. The average age was 50.45 years (ranged 9-70 years). 5 cases were primary lymphedema and 15 cases were secondary lymphedema. The duration of the disease ranged from 2 years to 27 years, with an average of 8.4 years. After 1 course of treatment, the skin texture was significantly improved. The skin water content decreased from 55.6%±7.4% before treatment to 42.1%±7.4% after treatment ( P< 0.001). The transepidermal water loss decreased from (14.981±5.699) g·m -2·h -1 before treatment to (9.312±2.590) g·m -2·h -1 after treatment. The skin fibrosis decreased from (0.087±0.042) N before treatment to (0.065±0.033) N after treatment ( P<0.001). The circumference of the affected limb decreased from (11.09±3.14) cm before treatment to (4.82±2.83)cm after treatment ( P<0.001). The segmental edema decreased from (4.00±2.14)L before treatment to (1.21±0.78) L after treatment. Segmental edema was positively correlated with skin water content, transepidermal water loss, and skin fibrosis ( r=0.447, r=0.429, r=0.751, P<0.05). The patients were followed up for 6 months after treatment. The circumference control was excellent in 13 cases, good in 5 cases and moderate in 2 cases. The quality-of-life changes were excellent in 16 cases, good in 3 cases, medium in 1 case. The adaptability of elastic material was excellent in 9 cases, good in 8 cases, medium in 2 cases and poor in 1 case. Conclusions:CDT can reduce subcutaneous edema, effectively reduce limb volume, decrease skin fibrosis, improve skin barrier function, improve skin texture, restore the appearance of the limb and improve patients’ quality of life.