Retrieving keyframes most relevant to text from small intestine videos with given labels can efficiently and accurately locate pathological regions. However, training directly on raw video data is extremely slow, while learning visual representations from image-text datasets leads to computational inconsistency. To tackle this challenge, a small bowel video keyframe retrieval based on multi-modal contrastive learning (KRCL) is proposed. This framework fully utilizes textual information from video category labels to learn video features closely related to text, while modeling temporal information within a pretrained image-text model. It transfers knowledge learned from image-text multimodal models to the video domain, enabling interaction among medical videos, images, and text data. Experimental results on the hyper-spectral and Kvasir dataset for gastrointestinal disease detection (Hyper-Kvasir) and the Microsoft Research video-to-text (MSR-VTT) retrieval dataset demonstrate the effectiveness and robustness of KRCL, with the proposed method achieving state-of-the-art performance across nearly all evaluation metrics.
Humans ; Video Recording ; Intestine, Small/diagnostic imaging* ; Machine Learning ; Image Processing, Computer-Assisted/methods* ; Algorithms

Diffuse pediatric-type high-grade glioma (pHGG), H3- and isocitrate dehydrogenase (IDH)-wild-type, is a World Health Organization (WHO) grade 4 diffuse glioma with malignant histological features, which typically affects in children and adolescents. This multidisciplinary treatment case involves a 24-year-old young female patient initially diagnosed via biopsy. After concurrent chemoradiotherapy reduced the tumor size, complete resection was achieved, followed by adjuvant therapy with temozolomide and regorafenib. After recurrence, the tumor was resected again, and a second course of radiotherapy was administered, but the disease ultimately progressed rapidly, with an overall survival exceeding 32 months. pHGGs are highly malignant, aggressive, and associated with poor prognosis. Accurate diagnosis and targeted intervention require close collaboration among a multidisciplinary team, which highlights the critical value of multidisciplinary manage-ment in clinical practice.

Objective::Microchannels are associated with the progression of atherosclerotic vulnerable plaques. However, in patients with culprit optical coherence tomography (OCT)-defined plaque erosion, the knowledge of microchannels and culprit lesion vulnerability is limited. The aim of this study was to investigate culprit lesion characteristics in patients with ST-segment elevated myocardial infarction (STEMI) caused by plaque erosion with and without microchannels using OCT.Methods::In all, 348 STEMI patients with plaque erosion who underwent OCT of the culprit lesion at the 2 nd Affiliated Hospital of Harbin Medical University (Harbin, China) from August 2014 to December 2017 were included and divided into the microchannel group ( n= 116, 33.3%) and no-microchannel group ( n = 232, 66.7%). The clinical characteristics and OCT-derived plaque features were compared between both groups. Results::Among the 348 STEMI patients with plaque erosion, culprit lesions with microchannels had higher incidence of lipid plaque (59.5% vs. 45.3%, P= 0.012); calcification (41.4% vs. 24.6%, P= 0.002); spotty calcification (30.2% vs. 18.1%, P= 0.014); macrophages accumulation (72.4% vs. 45.7%, P < 0.001); and cholesterol crystals (32.8% vs. 14.2%, P < 0.001) than those without microchannels. In addition, minimal lumen area was smaller ((1.9 ± 0.9) mm 2vs. (2.8 ± 2.3) mm 2, P < 0.001) and lumen area stenosis was greater ((71.3% ± 13.4%) vs. (65.3% ± 19.3%), P= 0.001) in the microchannel group than in the no-microchannel group. Conclusion::In patients with STEMI caused by plaque erosion, one-third manifested typical microchannel characteristics, and those with microchannels were associated with more severe luminal stenosis and more vulnerable plaque features than those without microchannels.

Objective::Microchannels are associated with the progression of atherosclerotic vulnerable plaques. However, in patients with culprit optical coherence tomography (OCT)-defined plaque erosion, the knowledge of microchannels and culprit lesion vulnerability is limited. The aim of this study was to investigate culprit lesion characteristics in patients with ST-segment elevated myocardial infarction (STEMI) caused by plaque erosion with and without microchannels using OCT.Methods::In all, 348 STEMI patients with plaque erosion who underwent OCT of the culprit lesion at the 2 nd Affiliated Hospital of Harbin Medical University (Harbin, China) from August 2014 to December 2017 were included and divided into the microchannel group ( n= 116, 33.3%) and no-microchannel group ( n = 232, 66.7%). The clinical characteristics and OCT-derived plaque features were compared between both groups. Results::Among the 348 STEMI patients with plaque erosion, culprit lesions with microchannels had higher incidence of lipid plaque (59.5% vs. 45.3%, P= 0.012); calcification (41.4% vs. 24.6%, P= 0.002); spotty calcification (30.2% vs. 18.1%, P= 0.014); macrophages accumulation (72.4% vs. 45.7%, P < 0.001); and cholesterol crystals (32.8% vs. 14.2%, P < 0.001) than those without microchannels. In addition, minimal lumen area was smaller ((1.9 ± 0.9) mm 2vs. (2.8 ± 2.3) mm 2, P < 0.001) and lumen area stenosis was greater ((71.3% ± 13.4%) vs. (65.3% ± 19.3%), P= 0.001) in the microchannel group than in the no-microchannel group. Conclusion::In patients with STEMI caused by plaque erosion, one-third manifested typical microchannel characteristics, and those with microchannels were associated with more severe luminal stenosis and more vulnerable plaque features than those without microchannels.

Objective:To investigate the electrocardiographic characteristics of left and right ventricles origin of premature ventricular contractions(PVCs) during V3 transition of precordial leads, right ventricular outflow tract (RVOT) anterior septum and right coronary sinus (RCC), and RVOT middle-posterior septum and left coronary sinus (LCC).Methods:From January 2017 to September 2019, 91 patients with ventricular extrasystole of outflow tract who had V3 transition in precordial lead and had successful radiofrequency ablation in RVOT anterior septum, middle posterior septum, LCC and RCC were selected for retrospective case control study.The electrocardiography measurements of PVCs were compared between the anteroseptal RVOT group and RCC group, as well as the middle-posterior septal RVOT group and the LCC group, respectively.The measurements included the R-wave amplitude in lead Ⅰ, Ⅱ, Ⅲ and aVF, R amplitude ratio in leads Ⅲ to Ⅱ, Q-wave amplitude in lead aVL and aVR, Q amplitude ratio in leads aVL to aVR, R-wave and S-wave amplitude from leads V1 to V3, the V2S/V3R index, the transition zone index, and the V2 transition ratio.Results:Thirty-six cases originated from the anteroseptal RVOT, and 11 from the LCC.Lead I R-wave amplitude in anterior septal RVOT was higher than LCC group((0.22±0.25) mV vs.(-0.17±0.33) mV; P=0.003). R-wave amplitude in lead Ⅱ was lower than that in the LCC group((1.59±0.35) mV vs.(1.76±0.27) mV; P=0.035). R-wave amplitude in lead aVF was lower compared with the LCC group((1.53±0.35) mV vs.(1.78±0.39) mV; P=0.050). The V2S/V3R index showed a significant difference between these two groups(1.99±0.66 vs.0.76±0.38; P<0.001). The V2 transition ratio also appeared a significant difference between the two groups(0.69±0.43 vs.1.05±0.35; P=0.005). PVCs arose from the middle-posterior septal RVOT in 32 cases, and from the RCC in 12 cases.Compared with RCC group, lead Ⅰ R-wave amplitude showed lower ((0.25±0.31) mV vs.(0.57±0.12) mV; P<0.001); R amplitude ratio in leads Ⅲ to Ⅱ higher (0.89±0.14 vs.0.72±0.18; P=0.002); Q amplitude in lead aVL((0.72±0.24) mV vs.(0.51±0.16) mV; P=0.002)higher, and Q amplitude ratio in leads aVL to aVR higher in the middle-posterior septal RVOT(0.76±0.23 vs.0.50±0.21; P=0.002). Conclusion:Among the cases with lead V3 transition, PVCs originated from the anteroseptal RVOT show significantly different R wave in lead Ⅰ, Ⅱ, aVF, V2S/V3R index, and the V2 transition ratio compared with those from the LCC.The PVCs from the middle-posterior septal RVOT and the RCC have different R wave in lead Ⅰ, R amplitude ratio in leads Ⅱ and Ⅲ, Q amplitude ratio in leads aVL and aVR.Combined with its different characteristics, it can help to identify the origin of left and right ventricles.

Objective:To observe the therapeutic effect of blood purification with oXiris on cytokine storm in severe COVID-19 patients.Methods:In February to April, 2020 in the intensive care unit (ICU) of a hospital in Wuhan, 7 cases with severe COVID-19 as the study participant, treated with oXiris for blood purification. The general information of patients, the basic information of the blood purification treatment, blood purification treatment before and after treatment for 24 hours, 48 hours, 72 hours of routine blood, liver and kidney function and inflammatory markers were collected to understand the trend of change.Results:The number of blood purification treatment of 7 patients were 2.13±1.64 times, and the duration of blood purification was 66.31±48.73 hours. Treatment was interrupted twice due to hypothermia. After treatment, the level of interleukin 6 (IL-6) of the patients decreased from (1342.20±1822.01) pg/ml before treatment to (202.69±276.24) pg/ml in 4 cases decreased by more than 90% and in 2 cases decreased by 63% and 77%. The level of TNF decreased from 51.94±59.64 pg/ml before treatment to 18.93±9.84 pg/ml, and TNF decreased by 28%~78% in 4 patients. The hypersensitive C-reactive protein (HS-CRP) of the patients decreased from 147.81±100.54 mg/L before treatment to 89.43±108.31 mg/L after treatment, in 4 cases decreased by 63% to 91%.Conclusions:oXiris blood purification treatment can effectively reduce inflammatory markers in patients with severe COVID-19. Correct use of oXiris filter during treatment can prolong the life of the filter. During the treatment, the pressure monitoring value and whether there is thrombosis in the pipeline should be closely observed and recorded. Meanwhile, it is necessary to keep patients warm to prevent hypothermia in. The application of ultrasound to monitor blood coagulation and venous thrombosis plays a positive role in preventing the occurrence of pulmonary embolism.

Object: To systematically evaluate the effect of Danhong injection combined with conventional medication on inflammatory factors after percutaneous coronary intervention in coronary heart disease, and providing evidence for further research and design. Methods: PubMed, The Cochrane Library, EMbase, MEDLINE, CBM, VIP, CMCI, CNKI, Wanfang Medical Database and other Chinese and foreign medical databases collected the clinical study of Danhong injection in the treatment of inflammatory factors after coronary intervention, using Revman 5.3 software for analysis.Results: A total of 7 studies were included, including 831 patients. 1) Inflammatory response index: hs-CRP of danhong injection treatment group was significantly different from that of control group [RR=-0.86, 95％CI (-1.03, -0.69), P ＜0.0001]. There were significant differences in IL-6 test values between the danhong injection group and the control group[RR =-1.19, 95％CI (-1.41, -0.96), P ＜ 0.00001]. The MMP-9 test values of danhong injection group were significantly different from those of the control group [RR =-0.39, 95％CI (-0.78, -0.00), P = 0.05]. 2) Myocardial injury index:There were significant differences in the CK MB test values of danhong injection treatment group and control group[RR =-0.89, 95％ CI (-1.12, -0.67, P ＜ 0.00001) ]. The cTnT test values of the danhong injection group were significantly different from those of the control group [RR =-1.25, 95％CI (-1.51, -0.98), P ＜ 0.00001]. Conclusion:Current research indicates that Danhong injection can reduce inflammatory factors hs-CRP, IL-6 and MMP-9 and myocardial injury indicators creatine kinase-MB (CK-MB) and cardiac troponin T (cTnT) after coronary intervention. In other words, Danhong injection can reduce the levels of inflammatory factors such as hs-CRP, IL-6 and MMP-9 and improve the myocardial injury index such as CK-MB and cTnT after coronary intervention, and then have a certain protective effect on the myocardium. However, the above conclusions still need further research and verification.

Stem cells have self-renewal and differentiation potential.Cyclin-dependent kinase (CDK) plays an important role in promoting pluripotency and self-renewal.The crucial activity of S-phase,DNA replication,presents a unique opportunity during the cell cycle for the genetic and epigenetic regulation that may be involved in stabilizing the pluripotent state.It is also clear that Myc acts to coordinate both the cell cycle and the pluripotency transcription network in stem cells.Here we review the regulating mechanisms of stem cell cycles and pluripotency by CDK and Myc to help researchers obtain a better understanding of mutual regulation of the cell cycle and the pluripotent state by CDK and Myc which may be exploited in regenerative medicine.

Objective To study the morphological character of blood-spleen barrier in patients with hypersplenism,and to discuss the relevance and pathogenesis of hypersplenism.Methods The spleens of 33 patients with cirrhosis with portal hypertension were collected as the experimental group,and 20 patients with traumatic spleen as the matched group.Five pieces of tissues in each spleen were sampled.The samples were made into pathological sections,stained with H.E.and examined microscopically for the total number of germinal centers (GC).The data of patients before operation were collected which included:blood routine (count of RBC,WBC,PLT and HB) and splenic weight.The correlation of blood routine values and sum of GC was studied using relative linear analysis.Results In the experimental group:The blood routine values were remarkably lower,splenic weight (average 764.2 g) and the quantity of the germinal center (average 8817/case) were higher.There was a reverse relationship between the total quantity of germinal centers and the PLT.There was a close relationship between the quantity of germinal center and the extent of the hypersplenism,i.e.the lower the preoperative platelet number,the greater the total number of germinal center; the heavier the splenic weight,the greater the number of germinal center.Conclusions The total number of germinal center increased dramatically in patients with cirrhosis with portal hypertension.The change is accompanied by changes in morphology of the germinal centers and dysfunction in blood-spleen barrier.It is likely that hypersplenism develops on the basis of dysfunction of blood-spleen barrier.

According to the clinical needs of precise radiotherapy, an integrative thermoplastic immobilization board for radiotherapy was developed for the purpose of immobilizing head position, head, neck and shoulder positions and body position respectively. The new style board has several characteristics: a board with multi-purposes, ease of handling and good accuracy of patients' positions, etc.
Equipment Design ; Humans ; Immobilization ; Posture ; Radiotherapy ; instrumentation