Objective:To build a small-sample ultra-widefield fundus images (UWFI) multi-disease classification artificial intelligence model, and initially explore the ability of artificial intelligence to classify UWFI multi-disease tasks.Methods:A retrospective study. From 2016 to 2021, 1 608 images from 1 123 patients who attended the Eye Center of the Renmin Hospital of Wuhan University and underwent UWFI examination were used for UWFI multi-disease classification artificial intelligence model construction. Among them, 320, 330, 319, 268, and 371 images were used for diabetic retinopathy (DR), retinal vein occlusion (RVO), pathological myopia (PM), retinal detachment (RD), and normal fundus images, respectively. 135 images from 106 patients at the Tianjin Medical University Eye Hospital were used as the external test set. EfficientNet-B7 was selected as the backbone network for classification analysis of the included UWFI images. The performance of the UWFI multi-task classification model was assessed using the receiver operating characteristic curve, area under the curve (AUC), sensitivity, specificity, and accuracy. All data were expressed using numerical values and 95% confidence intervals ( CI). The datasets were trained on the network models ResNet50 and ResNet101 and tested on an external test set to compare and observe the performance of EfficientNet with the 2 models mentioned above. Results:The overall classification accuracy of the UWFI multi-disease classification artificial intelligence model on the internal and external test sets was 92.57% (95% CI 91.13%-92.92%) and 88.89% (95% CI 88.11%-90.02%), respectively. These were 96.62% and 92.59% for normal fundus, 95.95% and 95.56% for DR, 96.62% and 98.52% for RVO, 98.65% and 97.04% for PM, and 97.30% and 94.07% for RD, respectively. The mean AUC on the internal and external test sets was 0.993 and 0.983, respectively, with 0.994 and 0.939 for normal fundus, 0.999 and 0.995 for DR, 0.985 and 1.000 for RVO, 0.991 and 0.993 for PM and 0.995 and 0.990 for RD, respectively. EfficientNet performed better than the ResNet50 and ResNet101 models on both the internal and external test sets. Conclusion:The preliminary UWFI multi-disease classification artificial intelligence model using small samples constructed in this study is able to achieve a high accuracy rate, and the model may have some value in assisting clinical screening and diagnosis.

To evaluate whether the in vitro fertilization-embryo transfer (IVF-ET) procedures could increases the risks of adverse pregnancy outcomes (APOs) in offspring.
 Methods: A hospital-based prospective cohort design was conducted, which contained a control group of singleton pregnancies with indicators of subfertility who were still conceived naturally after using simple medical treatment (e.g. minimal medical intervention or ovulation induction), and an exposure group consisted of singleton pregnancies who had a history of infertility and IVF-ET treatment. All factors different between two groups in the univariate analysis were included in the multivariable logistic regression to evaluate the independent effect of IVF-ET procedures themselves on APOs.
 Results: After controlling for confounding factors by using multivariate logistic regression analysis, our results showed that pregnancies after IVF-ET experienced a higher risk of preterm birth (OR=1.28, 95% CI 1.05 to 1.56), low birth weight (OR=1.69, 95% CI 1.27 to 2.31), perinatal mortality (OR=5.33, 95% CI 2.44 to 11.81), and congenital malformations (OR=1.83, 95% CI 1.12 to 2.94).
 Conclusion: The IVF-ET operational factors may increase the risk of APOs.
Cohort Studies ; Embryo Transfer ; statistics & numerical data ; Female ; Fertilization in Vitro ; statistics & numerical data ; Humans ; Infant, Newborn ; Logistic Models ; Pregnancy ; Pregnancy Outcome ; Prospective Studies

BACKGROUND:It is wel-known that vitamin E holds antioxidant capacity, but whether other growth factors have the same effect on endplate chondrocytes has not yet been reported. OBJECTIVE:To observe the effect of different growth factors on the antioxidant ability of endplate chondrocytes in the intervertebral disc. METHODS:Endplate chondrocytes were primary cultured, and then divided into four groups, including blank control, serum deprivation, hydrogen peroxide stimulation and hydrogen peroxide stimulation combined with different growth factors groups. The 4th group was subdivided into insulin-like growth factor-1, basic fibroblast growth factor, transforming growth factorβ, forskolin and vitamin E groups. The expression levels of caspase-3, matrix metal oproteinase 13 and 3, inhibitor of metal oproteinase 1 as wel as thrombin 4 and 5 were detected by real-time PCR. Cel apoptosis was analyzed through apoptosis kit and flow cytometry. Cel synthesis and secretion were detected by western blot assay. The total antioxidant capacity and the hydrogen peroxide content were determined by kit, and then statistical y analyzed. RESULTS AND CONCLUSION:Different growth factors had significant differences in the endplate chondrocyte apoptosis, secretion and antioxidant capacity. To conclude, transforming growth factorβand forskolin do further damage to the cel s stimulated by hydrogen peroxide, while insulin-like growth factor-1 and vitamin E expose protective effect on the injured cel s.

Objective:To understand the spatial distribution of mushroom poisoning in Hunan Province and its influential factors,and to provide the evidence for control of the mushroom poisoning.Methods:The surveillance data for mushroom poisoning cases from 122 counties in Hunan Province in 2015 were collected.Based on geographical information system database,spatial autocorrelation analysis and spatial regression analysis (via OpenGeoDa) was conducted.Results:The incidence of mushroom poisoning in Hunan Province in 2015 was 2.94/100 000.Global Moran's I values was 0.315 (P＜0.05).Local spatial autocorrelation analysis indicated that Ningxiang,Xiangtan,Shaoyang,Lingling,Jiahe,and Linwu districts et al were "positive hotspot" regions.Guzhang,Hecheng,Dingcheng,Yueyang districts et al were "negative hotspot" regions.Spatial regression analysis revealed that the reported incidence of mushroom poisoning was positively correlated with the annual average temperate (Z=2.145,P=0.032),the number of health care institutions per capita (Z=2.352,P=0.019),and the number of students enrollment in secondary schools (Z=4.309,P＜0.001).It was negatively associated with the number of school staff and workers of secondary schools (Z=-2.626,P=0.009).Conclusion:The spatial distribution of mushroom poisoning cases in Hunan Province in 2015 is highly clustered.Mushroom poisoning cases are more prevalent in the middle and southern regions and less prevalent in the northern areas of the province.The annual average temperate and the number of students enrollment in secondary schools demonstrate a certain positive influence on the distribution of mushroom poisoning in Hunan.

Objective:To estimate the status of pregnancy complications among women with polycystic ovary syndrome (PCOS) through a systematic review of published literatures.Methods:Systematic literature searches were conducted in PubMed,Web of Science,Medline,Embase,Cochrane Library,China National Knowledge Infrastructure (CNKI),Wanfang,Weipu and China Biology Medicine disc (CBMdisc),as well as the relevant articles published from inception to April 1st 2017,which reported the prevalence of pregnancy complications among women with PCOS.Random effective models were used to calculate pooled prevalence and 95％ confidence intervals.The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of those included studies.Subgroup analyses were used to evaluate the influence of overweight/obesity and insulin resistance before pregnancy on the estimates of pregnancy complications among women with PCOS.Results:Fifty-nine studies involving 13 378 PCOS women and 49 395 non-PCOS women were included.Among women with PCOS,pooled estimates were 20.26％ for gestational diabetes mellitus,13.94％ for hypertensive disorder ofpregnancy,64.16％ for caesarean section,13.35％ for preterm birth,9.84％ for macrosomia,5.88％ for low birth weight,5.25％ for early gestational age,8.45％ for late gestational age,1.93％ for neonatal malformations,0.88％ for perinatal mortality and 3.71％ for neonatal asphyxia.And the estimates of gestational diabetes mellitus,hypertensive disorder of pregnancy,caesarean section,preterm birth,macrosomia and neonatal asphyxia among women with PCOS were significantly higher than those in women without PCOS (all P＜0.05).Subgroup analysis showed the estimates of gestational diabetes mellitus,macrosomia and late gestational age among PCOS women who were overweight/obesity before pregnancy were significant higher than those among PCOS women with normal BMI (all P＜0.05);and compared to PCOS women without insulin resistance prior to pregnancy,PCOS women with pre-pregnancy insulin resistance were at an increased risk for gestational diabetes mellitus,preterm birth and macrosomia (all P＜0.05).Conclusion:PCOS in pregnancy is associated with high rates of pregnancy complications.It is an important risk factor for pregnancy complications.

Objective To investigate the prevalence of human immunodeficiency virus (HIV) infection and its characteristics among pregnant women in Hunan.Methods Data from information system of prevention of mother-to-child transmission of HIV management in Hunan 2011-2015 was analyzed in the study (3 + 1 mode by year statistics).Results The total HIV-positive infection rate was 0.19‰ among pregnant women from 2011 to 2015 in Hunan.The rate of HIV infection showed upward trend by years (P ＜ 0.05).The proportion of diagnosis of HIV positive cases intrapartum was 44.66％,showed declining trend by years (P ＜ 0.05).The 786 cases of HIV positive pregnant women were mainly the Han's,the age distribution of 20 to 35 years old,90.21％ of them were farmers or unemployed.A percentage (76.84％) of them had junior high school education level or lower 37.91％ of them were found in delivery or postpartum.A percentage (36.51％) of them accepted service in delivery or postpartum.A percentage (45.67％) of them was infected through sexual contact,46.82％ of them were infected by unknown ways.Conclusions The rate of HIV infection among pregnant women was increased by years in Hunan.It is suggested to strengthen health education among high-risk groups and high incidence areas,improve detection rate of early pregnant women,implement the Prevention of Mother to Child Transmission (PMTCT) measures to reduce the rate of mother to child transmission of Acquired Immune Deficiency Syndrome (AIDS).

To estimate the national prevalence of paternal postpartum depression in China and evaluate its association with maternal postpartum depression.
 Methods: Systematic literature searches were conducted in databases including PubMed, Web of Science, Embase, Medline, China National Knowledge Infrastructure (CNKI), Wangfang Database, Chinese science & technology journal database (VIP) and SinoMed database. The articles reported the prevalence of paternal postpartum depression in China were collected from inception to October 1, 2015. Random effect models were used to calculate pooled estimates and 95% confidence intervals. Subgroup analysis were undertaken by period of measurement, case identification, study location and study quality.
 Results: Fourteen studies with a total sample size of 3 819 partners were included in this study. The pooled estimate of paternal postpartum depression was 13.6% (95% CI 8.7%-21.3%). The Pearson correlation coefficien between maternal PPD and paternal PPD was 0.295 (95% CI 0.218-0.367). The subgroup analysis showed that the estimates of paternal PPD in 0-5+6 weeks postpartum, 6-8 weeks postpartum and 8+1-24 weeks postpartum were 28.7%, 11.4% and 5.5%, respectively; when the rating scale was used as case identification method, the estimate of paternal PPD was 16.8%, and it was 4.1% when interview was used. The estimate of paternal PPD in inner areas was 22.2%, in coastal areas was 13.3% and in Hongkong/Taiwan was 7.8%. In studies with lower quality, the estimate of paternal PPD was 23.0%, and it was 9.1% in studies with higher quality.
 Conclusion: The national prevalence of paternal postpartum depression in China was at a high level, particularly during the postpartum 0-5+6 weeks. Paternal postpartum depression also showed a moderate positive correlation with maternal postpartum depression.
Asian Continental Ancestry Group ; China ; epidemiology ; Depression, Postpartum ; epidemiology ; Fathers ; psychology ; Female ; Humans ; Male ; Mothers ; psychology ; Postpartum Period ; Prevalence

Objective To estimate HIV seroprevalence among pregnant women with syphilis and evaluate the influence of syphilis infection on mother-to-child-transmission (MTCT) of HIV by meta-analysis.Methods We conducted a systematic literature search for 1 678 articles related to maternal syphilis and HIV infection published until October 1st 2015 using the PubMed,Web of Science,Chinese Web of Knowledge,Wanfang,Weipu,and SinoMed databases and evaluated the quality of each papers using the STROBE checklist,and the keywords were "pregnant women/maternal/pregnancy","syphilis/AIDS","HIV/human immunodeficiency virus","mother-to-child transimission/vertical transmission".Excluding studies with the special subgroups of HIV-positive pregnant women as the research objects,review or meeting abstract,impossibility of full-text acquisition,sample size ＜50,duplication or impossibility of data extraction,finally,16 studies were included.Random-effects meta-analysis was used to estimate HIV seroprevalence among pregnant women with syphilis and the RR of MTCT for women infected with both syphilis and HIV.Subgroup analyses were undertaken by study location,sample size,use of anti-retroviral therapy and study quality.Results Sixteen studies with a combined sample of 110 573 pregnant women were included in the analysis.Of these,ten reported HIV seroprevalences among pregnant women with syphilis and six studies evaluated the influence of syphilis infection on MTCT of HIV.Pooled estimates yielded a HIV seroprevalence of 11.6％ (95％CI:6.7％-19.5％) among pregnant women with syphilis.We estimated that the risk of MTCT of HIV was 1.86 times (RR=l.86,95％CI:0.89％-3.89％) higher among pregnant women with syphilis compared with those only infected with HIV-although this effect was not statistically significant.Cochran's Q test showed a high degree of heterogeneity in estimates of HIV seroprevalence and the effect of syphilis infection on MTCT of HIV across studies (I2=89.4％ and 86.2％,respectively,P＜0.10).Subgroup analysis estimated HIV seroprevalences of 24.9％ (95％CI:17.4％-34.3％)in Africa,2.8％ (95％CI:1.4％-5.6％) in Asia and 2.2％ (95％CI:0.7％-6.7％) in South America.While studies with a large sample size (≥100) or of higher quality estimated overall seroprevalence at 15.2％ (95％CI:9.0％-24.7％),this was 2.2％ (95％CI:0.7％-6.7％) for lower-quality or smaller studies.Meanwhile,subgroup analyses of the RR of MTCT of HIV in pregnant women infected both with HIV and syphilis gave estimates of 1.19 (0.62-2.29) for the higher quality studies,4.76 (2.65-8.53) for the lower-quality studies,1.47 (0.77-2.81) for studies with a large sample size,5.82 (3.16-10.74) for studies with a small sample size,4.76 (2.65-8.53) for studies in which participants received antiretroviral treatment and 1.19 (0.62-2.29) for studies in which they did not.While Begg's test showed evidence of publication bias in studies of HIV seroprevalence estimates in pregnant women with syphilis (t=-2.48,P=-0.038),no evidence of publication bias was found in studies on the influence of syphilis infection on MTCT of HIV (t=-0.22,P=0.835).Conclusion HIV seroprevalence is higher among pregnant women with syphilis than uninfected women.Further research is warranted to verify whether syphilis infection can increase the risk of MTCT of HIV.

Objective To estimate HIV seroprevalence among pregnant women with syphilis and evaluate the influence of syphilis infection on mother-to-child-transmission (MTCT) of HIV by meta-analysis.Methods We conducted a systematic literature search for 1 678 articles related to maternal syphilis and HIV infection published until October 1st 2015 using the PubMed,Web of Science,Chinese Web of Knowledge,Wanfang,Weipu,and SinoMed databases and evaluated the quality of each papers using the STROBE checklist,and the keywords were "pregnant women/maternal/pregnancy","syphilis/AIDS","HIV/human immunodeficiency virus","mother-to-child transimission/vertical transmission".Excluding studies with the special subgroups of HIV-positive pregnant women as the research objects,review or meeting abstract,impossibility of full-text acquisition,sample size ＜50,duplication or impossibility of data extraction,finally,16 studies were included.Random-effects meta-analysis was used to estimate HIV seroprevalence among pregnant women with syphilis and the RR of MTCT for women infected with both syphilis and HIV.Subgroup analyses were undertaken by study location,sample size,use of anti-retroviral therapy and study quality.Results Sixteen studies with a combined sample of 110 573 pregnant women were included in the analysis.Of these,ten reported HIV seroprevalences among pregnant women with syphilis and six studies evaluated the influence of syphilis infection on MTCT of HIV.Pooled estimates yielded a HIV seroprevalence of 11.6％ (95％CI:6.7％-19.5％) among pregnant women with syphilis.We estimated that the risk of MTCT of HIV was 1.86 times (RR=l.86,95％CI:0.89％-3.89％) higher among pregnant women with syphilis compared with those only infected with HIV-although this effect was not statistically significant.Cochran's Q test showed a high degree of heterogeneity in estimates of HIV seroprevalence and the effect of syphilis infection on MTCT of HIV across studies (I2=89.4％ and 86.2％,respectively,P＜0.10).Subgroup analysis estimated HIV seroprevalences of 24.9％ (95％CI:17.4％-34.3％)in Africa,2.8％ (95％CI:1.4％-5.6％) in Asia and 2.2％ (95％CI:0.7％-6.7％) in South America.While studies with a large sample size (≥100) or of higher quality estimated overall seroprevalence at 15.2％ (95％CI:9.0％-24.7％),this was 2.2％ (95％CI:0.7％-6.7％) for lower-quality or smaller studies.Meanwhile,subgroup analyses of the RR of MTCT of HIV in pregnant women infected both with HIV and syphilis gave estimates of 1.19 (0.62-2.29) for the higher quality studies,4.76 (2.65-8.53) for the lower-quality studies,1.47 (0.77-2.81) for studies with a large sample size,5.82 (3.16-10.74) for studies with a small sample size,4.76 (2.65-8.53) for studies in which participants received antiretroviral treatment and 1.19 (0.62-2.29) for studies in which they did not.While Begg's test showed evidence of publication bias in studies of HIV seroprevalence estimates in pregnant women with syphilis (t=-2.48,P=-0.038),no evidence of publication bias was found in studies on the influence of syphilis infection on MTCT of HIV (t=-0.22,P=0.835).Conclusion HIV seroprevalence is higher among pregnant women with syphilis than uninfected women.Further research is warranted to verify whether syphilis infection can increase the risk of MTCT of HIV.

PurposeAdrenal schwannoma is rare and quite difficult to diagnose before operation. This paper aims to analyze the CT findings of adrenal schwannoma to improve the recognition and diagnosis of this disease.Materials and Methods The CT findings of 6 patients with adrenal schwannomas proved by operation and pathology were retrospectively analyzed.Results Four schwannomas were located in the right adrenal and 2 in the left adrenal. The tumors, with diameters ranging from 3.0 cm to 6.4 cm, mean (4.5±1.3) cm, had well-defined margin. The densities of all the masses were close to or slightly lower than those of kidneys on plain scan images, with mean CT attenuation value of (32±7) HU. Three masses showed homogeneous density and the other 3 were mildly heterogeneous with patches of lower density. All the 6 schwannomas were enhanced mildly or moderately after intravenous administration of contrast material and showed gradual enhancement mode. They showed mild homogeneous or flocculent enhancement on arterial phase and had gradual progress on venous and delayed phases. The mean increase of CT attenuation value was (13±2) HU on arterial phase, (18±4) HU on venous phase and (23±4) HU on delayed phase. Only 1 mass showed some patches of cystic degeneration without enhancement inside.Conclusion Adrenal schwannoma should be included in the differential diagnosis of solid nonfunctioning adrenal tumors. Features such as relatively homogeneous mass, mild to moderate enhancement and gradual enhancement mode after contrast enhancement are possibly the unique CT manifestations of adrenal schwannoma.