Objective:To establish a three-dimensional U-shaped residual coordinated attention network (URCA-Net) based on enhanced CT images for small bowel polyp detection and analyze its application effectiveness in intelligent detection of small bowel polyps.Methods:Abdominal CT data of patients with small bowel polyps were collected from the Air Force Medical Center between June 2019 and July 2023. All patients underwent bowel preparation followed by thin-slice spiral CT scanning to obtain enhanced CT arterial phase images. The data were randomly divided into training, validation and test sets in an 8∶1∶1 ratio. The URCA-Net deep learning model was used for small bowel polyp segmentation. The training set was used for model parameter training, the validation set for hyperparameter adjustment and monitoring of model generalization performance and the test set for final unbiased evaluation of the model. An early intelligent detection model for small bowel polyps was constructed, and its performance was evaluated. Evaluation metrics included pixel-level metrics for the segmentation task [Dice Similarity Coefficient (DSC)], as well as sensitivity and precision for polyp detection. A two-stage segmentation strategy was adopted: the first stage segmented the small bowel region to remove external interference, and the second stage performed polyp segmentation within the small bowel region.Results:A total of 78 subjects were included in the study, with an average age of (54±7) years. A total of 23 400 scan images were extracted, including 136 hyperplastic polyps, 298 hamartomatous polyps, 14 adenomatous polyps, and 4 cancerous polyps. On the test set, the average DSC for the first stage (small bowel segmentation) and the second stage (polyp segmentation) was 0.790 and 0.314, respectively. In the second stage task (polyp segmentation based on small bowel region), the polyp segmentation DSC increased to 0.701, with a precision of 0.836 (95% CI: 0.700-0.972) and a sensitivity of 0.759 (95% CI: 0.631-0.888) for polyp detection. Conclusion:The URCA-Net deep learning technique demonstrates good auxiliary diagnostic effectiveness in small bowel polyp detection and can provide a reference for screening and detection of small bowel polyps. The model is capable of generating high-quality segmentation results, which could facilitate evaluating polyp lesion morphology and provide support for downstream tasks such as preoperative navigation and risk prediction.

Objective:To establish a three-dimensional U-shaped residual coordinated attention network (URCA-Net) based on enhanced CT images for small bowel polyp detection and analyze its application effectiveness in intelligent detection of small bowel polyps.Methods:Abdominal CT data of patients with small bowel polyps were collected from the Air Force Medical Center between June 2019 and July 2023. All patients underwent bowel preparation followed by thin-slice spiral CT scanning to obtain enhanced CT arterial phase images. The data were randomly divided into training, validation and test sets in an 8∶1∶1 ratio. The URCA-Net deep learning model was used for small bowel polyp segmentation. The training set was used for model parameter training, the validation set for hyperparameter adjustment and monitoring of model generalization performance and the test set for final unbiased evaluation of the model. An early intelligent detection model for small bowel polyps was constructed, and its performance was evaluated. Evaluation metrics included pixel-level metrics for the segmentation task [Dice Similarity Coefficient (DSC)], as well as sensitivity and precision for polyp detection. A two-stage segmentation strategy was adopted: the first stage segmented the small bowel region to remove external interference, and the second stage performed polyp segmentation within the small bowel region.Results:A total of 78 subjects were included in the study, with an average age of (54±7) years. A total of 23 400 scan images were extracted, including 136 hyperplastic polyps, 298 hamartomatous polyps, 14 adenomatous polyps, and 4 cancerous polyps. On the test set, the average DSC for the first stage (small bowel segmentation) and the second stage (polyp segmentation) was 0.790 and 0.314, respectively. In the second stage task (polyp segmentation based on small bowel region), the polyp segmentation DSC increased to 0.701, with a precision of 0.836 (95% CI: 0.700-0.972) and a sensitivity of 0.759 (95% CI: 0.631-0.888) for polyp detection. Conclusion:The URCA-Net deep learning technique demonstrates good auxiliary diagnostic effectiveness in small bowel polyp detection and can provide a reference for screening and detection of small bowel polyps. The model is capable of generating high-quality segmentation results, which could facilitate evaluating polyp lesion morphology and provide support for downstream tasks such as preoperative navigation and risk prediction.

"Quality evaluation through identification"(QECI)is a theory that summarizes the essence of quality identification experience about traditional Chinese medicine(TCM).As an important component of the current quality evaluation system of TCM,the theory provides theoretical guidance for controlling and evaluating TCM's quality.Identifying based on human senses,traditional appearance identification relies on experience,which is subjective,difficult to quantify,and poorly repeatable.Modern measurement tools and biomimetic technology can quantify appearance characters(shape,color,smell,taste)of TCM.Then associate the results with content of active ingredients or biological effects.Make use of the visualization,quantifiability,portability,and repeatability of modern scientific means and screen feasible and controllable quality control indicators,which can be applied to quality evaluation and control of TCM's production and processing in each stage.The origin,connotation,modern research progress,and application value of QECI are reviewed,aiming to provide reference for addressing the shortcomings of traditional appearance evaluation,expanding the application scope of QECI,and promoting the construction of TCM's quality evaluation system.

Objective To evaluate the clinical effect of 3D printing-assisted percutaneous screw fixation in treating unstable pelvic fracture.Methods A total of 80 patients with unstable pelvic fractures,who received treatment at the Lianyungang Municipal First People's Hospital of China from January 2022 to January 2023,were enrolled in this study.According to the surgical methods,the patients were divided into percutaneous screw fixation group(n=47,receiving 3D printing-assisted percutaneous screw fixation)and open reduction group(n=33,receiving open reduction with steel plate internal fixation).The intraoperative blood loss,time spent for surgery,total hospitalization time,fracture healing time,levels of serum creatine kinase(CK),myoglobin(Myo),lactate dehydrogenase(LDH)levels,and incidence of surgical complications were compared between the two groups.Results In the percutaneous screw fixation group,the time spent for surgery[(62.96±19.31)min vs(100.07±26.71)min],intraoperative blood loss[(112.71±25.43)mL vs(230.65±30.29)mL],total hospitalization time[(11.04±2.35)days vs(15.16±2.58)days]and fracture healing time[(102.18±9.74)days vs(113.42±11.52)days]were remarkably higher than those in the open reduction group(all P＜0.01);the postoperative 3-month total effective rate was 95.74％,which was significantly higher than 80.00％in the open reduction group(P＜0.05);and the excellent rate of fracture reduction quality was higher than that in the open reduction group(P＜0.05).The postoperative one-,3-and 6-month Majeed scores in the percutaneous screw fixation group were strikingly higher than those in the open reduction group(all P＜0.05).No statistically significant differences in the preoperative levels of CK,Myo and LHD existed between the two groups(all P＞0.05),while the postoperative levels of CK,Myo and LHD in the percutaneous screw fixation group were prominently lower than those in the open reduction group(all P＜0.05).The difference in the incidence of postoperative complications between the two groups was not statistically significant(P＞0.05).Conclusion For the treatment of unstable pelvic fracture,3D printing-assisted percutaneous screw fixation is superior to open reduction with plate internal fixation in achieving better clinical results,reducing surgical injury,and shortening postoperative recovery time.

Objective:To compare the efficacy of internal fixation and external fixation in the treatment of pelvic fractures.Methods:A retrospective case control study was conducted to analyze the data of 66 patients with anterior pelvic ring fracture treated from December 2015 to December 2017 at First People's Hospital of Lianyungang, including 36 males and 30 females, with an average age of 42.7 years (range, 19 to 63 years). There were 36 patients with Tile type B fractures and 30 with Tile type C fractures. Minimally invasive percutaneous internal fixation through the anterior inferior iliac spine was performed in 33 patients (internal fixation group) and external fixator was employed in another 33 patients (external fixation group). The two groups were compared in terms of the operation time, intraoperative blood loss, fracture healing time, fracture reduction assessment with Matta criteria, Majeed score and surgical complications.Results:All patients were followed up for 9-24 months (mean, 14.5 months). The operation time was (33.7±3.6)minutes in internal fixation group , and (24.5±3.5)minutes in external fixation group ( P<0.05). Intraoperative blood loss was (25.8±3.3)ml in internal fixation group and (21.8±4.3)ml in external fixation group ( P<0.05). The fractures were healed acceptably, with the healing time of (13.8±1.6)weeks in internal fixation group and (21.7±1.9)weeks in external fixation group ( P< 0.05). According to the Matta criteria, internal fixation group showed excellent results in 17 patients, good in 14, fair in 2 and poor in 0, with the excellent and good rate of 94%; external fixation group showed excellent results in 14 patients, good in 12, fair in 6 and poor in 1 , with the excellent and good rate of 79% ( P>0.05). For Majeed function score, the results in internal fixation group were excellent in 18 patients, good in 13, fair in 2 and poor in 0, with the excellent and good of 94%; the results in external fixation group were excellent in 14 patients, good in 12, fair in 7 and poor in 0, with the excellent and good of 79% ( P>0.05). After operation, frequent urinary occurred in one patient, unilateral femoral nerve partial paralysis in one, nail cap stimulation in two and incisional redness, swelling and exudation in one in internal fixation group. In external fixation group, there were 5 patients with nail rod exudation. Conclusion:Compared with the external fixator, the internal fixation for pelvic fractures is less invasive and more reliable, can accelerate fracture healing without interfering with the patient's daily life, and can be used as the final fixation.

Objective To investigate the expression and clinical significance of lactate dehydrogenase A (LDHA) in breast cancer.Methods Tissue samples of 76 breast cancers and corresponding paired adjacent normal tissues were collected and made into tissue micrcarrays (TMAs).Immunohistochemistry (IHC) analysis was performed to detect the expression of LDHA and further analyzed the correlation of LDHA expression and clinicopathological variables and prognosis of breast cancers.Results LDHA was frequently upregulated in breast cancer tissues compared to the normal breast tissues (P ＜ 0.05).High LDHA expression was associated with distant metastasis (P ＜ 0.05) and worse patient prognosis (P ＜ 0.05).Conclusions LDHA is closely related to the occurrence and clinical progress of breast cancers.LDHA might be a potential novel molecular marker for diagnosis,prognosis and therapy in breast cancers.

Objective:To investigate the prognostic value of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and prognostic nutritional index (PNI) before radiation in pancreatic cancer patients underwent radiation therapy. Methods:Clinical data of 61 patients with pathologically confirmed pancreatic cancer were retrospectirely analyzed. Query index values for each patient were clinically tested through electronic medical records. Overall survival (OS) data were collected through electronic medical records or telephone follow-up. Survival curves were compared using Kaplan-Meier methodology and log-rank test. Cox regression methodolo-gy was used for univariate analysis. Results:Using log-rank test and univariate regression analysis, we found that patients with lower NLR, PLR, CA19-9, increased PNI, and lower TNM-staging lived longer than those with increased NLR, PLR, CA19-9, lower PNI, and high-er TNM-staging, and that the difference was statistically significant. Through multivariate analysis, we found that NLR (P=0.029, OR 2.344, 95%CI:1.090-5.041) and PNI (P=0.026, OR 0.477, 95%CI:0.248-0.917) were independent predictors of OS in patients with pan-creatic cancer. Conclusion:NLR, PLR, and PNI are simple, effective, and reliable indicators for evaluating the prognosis of pancreatic cancer.

Objective To analyze the morphological features of smokers' lung on MDCT scan,measure the CT volumetric parameters,and explore the correlation with pulmonary functional test(PFT) indexes.Methods 59 smokers were enrolled,in which 14 were chronic obstructive pulmonary disease(COPD) patients,and 39 non-smokers were chosen as control group.All subjects underwent inspiratory and expiratory phase MDCT scan and PFT.Eleven pulmonary CT features caused by smoking among three groups were analyzed and compared.The emphysema index (EI 95) and mean lung density (MLD) were measured.The correlation between above mentioned parameters and PFT indexes were analyzed.Results ①Among three groups,significant differences were found for the score and incidence of entrilobular emphysema,paraseptal emphysema and brochiectasis or bronchial wall thickness(P＜0.01).②In COPD patients,paraseptal emphysema and DLCO/VA,brochiectasis or bronchial wall thickness and DLCO SB(％P),DLCO/VA(％P),as well as EI and MEF25％ (％P),DLCO SB(％P),DLCO/VA (％P)were negatively related.In smokers without COPD,there were negative correlation between centrilobular emphysema and FEV1/FVC,MEF25％ (％ P),MEF5％ (％ P),DLCO SB (％ P),DLCO/VA (％ P),paraseptal emphysema and DLCO SB(％P),DLCO/VA(％P),brochiectasis or bronchial wall thickness and DLCO/VA(％P),as well as EI and FEV1/FVC,MEF5％ (％P),and MLD and FEV1 (％ P),MEF25％ (％ P)were positively related.Conclusion MDCT can be used to analyze smokers' pulmonary morphology,and the morphological features and volumetric parameters are good predictions for pulmonary function.

Objective To investigate the impact of quantitative measurement for lung volume using iterative model reconstruction (IMR),hybrid iterative reconstruction (iDose4 )and filtered back projection (FBP),and to compare the image noise between different reconstruction methods.Methods 70 subjects were performed with low-dose chest CT scan (Philips Brilliance 256 iCT),and the original data were reconstructed with IMR (algorithm:Routine,SharpPlus,Soft Tissue,level:1 - 3 ),iDose4 and FBP respectively.We set less than -950 HU as emphysema threshold,calculated the total lung volume (TLV),total emphysema volume (TEV),emphysema index (EI)and objective image noise (OIN),and then compared the quantitative parameters and OIN between different groups.Results All parameters showed a significantly statistical difference (P =0.000)except TLV (P =1.000).The TEV and EI are significant higher in IMR-S group than in other groups.The OIN in IMR-S-L1 group was the highest,and the FBP group was the second-highest.OIN in iDose4 group was lower than that in IMR-S groups but higher than that in IMR-R and IMR-ST group.Conclusion SharpPlus algorithm of IMR will affect the quantitative measurement of lung volume under low-radiation-dose condition,and the OIN in IMR-S groups is obvious.Therefore SharpPlus algorithm is not recommended for quantitative analysis of lung volume.The Routine and Soft Tissue algorithm will not affect the quantitative measurement,and can distinctly reduce the OIN compared with idose4 and FBP.

Objective To explore the application value of quantitative assessment of emphysema using CT in CT subjective evaluation of normal population,and compare the quantitative parameters of emphysema among groups.Methods A total of 1 231 volunteers with negative results of subjective assessment in low dose CT screening were included in this study.The threshold of emphysema was set at -950 HU,and the total lung volume(TLV),total emphysema volume(TEV),emphysema index(EI)and 15th percentile lung density(PD15)were quantified.The presence of emphysema was defined by an EI higher than or equal to 5%.The volunteers were divided into different groups by gender and age,and the quantitative parameters were compared among different groups.Results A total of 102 cases of emphysema were detected in 1 231 volunteers,with a detection rate of 8.29%,with 76 male volunteers,accounting for 9.93%,and 26 female volunteers,accounting for 5.58%,respectively.There were statistically significant differences in TLV,TEV, EI and PD15 between genders and age groups,with TLV,TEV,EI higher and PD15 lower in male(P<0.001)and with TEV and EI higher in older than 60 years old group(P<0.001).Conclusion Quantitative assessment of emphysema using CT exhibites relatively high clinical value in CT subjective evaluation of normal population.There are statistically significant differences in the quantitative parameters of emphysema among different groups.