Accurate segmentation of pediatric echocardiograms is a challenging task, because significant heart-size changes with age and faster heart rate lead to more blurred boundaries on cardiac ultrasound images compared with adults. To address these problems, a dual decoder network model combining channel attention and scale attention is proposed in this paper. Firstly, an attention-guided decoder with deep supervision strategy is used to obtain attention maps for the ventricular regions. Then, the generated ventricular attention is fed back to multiple layers of the network through skip connections to adjust the feature weights generated by the encoder and highlight the left and right ventricular areas. Finally, a scale attention module and a channel attention module are utilized to enhance the edge features of the left and right ventricles. The experimental results demonstrate that the proposed method in this paper achieves an average Dice coefficient of 90.63% in acquired bilateral ventricular segmentation dataset, which is better than some conventional and state-of-the-art methods in the field of medical image segmentation. More importantly, the method has a more accurate effect in segmenting the edge of the ventricle. The results of this paper can provide a new solution for pediatric echocardiographic bilateral ventricular segmentation and subsequent auxiliary diagnosis of congenital heart disease.
Adult ; Humans ; Child ; Heart Ventricles/diagnostic imaging* ; Echocardiography ; Image Processing, Computer-Assisted

Sleep deficiency is a common public health problem associated with many diseases, such as obesity and cardiovascular disease. In this study, we established a sleep deprivation (SD) mouse model using a ‘stick over water’ method and observed the effect of sleep deficiency on ocular surface health. We found that SD decreased aqueous tear secretion; increased corneal epithelial cell defects, corneal sensitivity, and apoptosis; and induced squamous metaplasia of the corneal epithelium. These pathological changes mimic the typical features of dry eye. However, there was no obvious corneal inflammation and conjunctival goblet cell change after SD for 10 days. Meanwhile, lacrimal gland hypertrophy along with abnormal lipid metabolites, secretory proteins and free amino-acid profiles became apparent as the SD duration increased. Furthermore, the ocular surface changes induced by SD for 10 days were largely reversed after 14 days of rest. We conclude that SD compromises lacrimal system function and induces dry eye. These findings will benefit the clinical diagnosis and treatment of sleep-disorder-related ocular surface diseases.

Objective To explore the protective effect of Zhenbao pill on acute spinal cord injury of rat and its possible mechanisms.Methods 64 Wistar rats were randomly divided into a injury group and a drug group, with 32 rats in each group, A T10 acute incomplete spinal cord injury model was produced by using modified Allen technique in the two groups,Zhenbao pill mixed suspension of 0.6 g/kg was given by gavage method daily in the drug group 30 min after moding, the same amount of saline was given in the injury group. Behavior detection were conducted in the first day, third day, and the seventh day after modeling to each 8 rats of the two groups. Spinal cord specimens was got centered about the damage points after rats were executed. histopathological changes were observed under HE staining, the MDA content were determined by thiobarbituric acid spectrophotometer and the apoptotic cells were marked by TUNEL method.Results After 1, 3, 7 d, compared with the injury group, the MDA level in the rat spinal cord tissue in the drug group (15.12 ± 1.27 nmol/mgvs.19.71 ± 1.29 nmol/mg, 20.42 ± 1.33 nmol/mgvs.24.65 ±1.36 nmol/mg, 10.46±1.49 nmol/mg vs.15.46 ± 1.44 nmol/mg) decreased(P<0.05); the apoptosis rate of drug groups (19.61% ± 1.49%vs.26.61% ±1.52%, 21.49% ± 1.37% vs.32.37% ± 1.24%, 13.04% ±  1.30%vs.18.35% ± 1.27%)decreased (P<0.05); the BBB score of drug groups (6.52 ± 1.27vs. 2.63 ± 1.27), (12.68 ± 1.32 vs.6.17 ± 1.34), (15.47 ± 1.27 vs.11.57 ± 1.29) was higher than the injury group (P<0.05). Conclusion Zhenbao pill can significantly improve the histopathological examination,reduce the MDA content in the injured spinal cord specimen of the rat and the rate of neuronal apoptosis, which may promote recovery of neurologic function in the rat suffered from ASCI.

For clinical surgeons,physical diagnosis is the stepping stone or open sesame in clinical practice such as inquiry of medical history,physical examination,medical investigation,and disease comprehension.It is the starting point and complementation of clinical diagnosis in surgical practice.It helps and leads young practitioners to acquire basic,true,and useful scientific information and evidence of clinical diagnosis in each patient.It is the essential technique and procedure,which is applicable for lifelong time in young or elder surgeons.

Surgical pathology is an important ele ment of surgery,as well as the foundation and prop of surgi cal practice.The technical surgeons,who are void of basis knowledge of pathology,may improve their own techniques,but could not enhance the ability of clinical judgement.To eliminate these surgeons' ignorance is better than to improve their surgical techniques.

Perioperative Management is not a new issue in clinical practice,but a nonnegligible core issue related to the safety of surgical patients.In recent years,it has been neglected by surgeons.We must pay great attention and vigilance to perioperative management for the quality and safety of surgical practice.A master surgeon is from the patients' bedside-Mutual Encouragement !

During the past half century,the great development and progress has been achieved in basic research and clinical management of biliary surgery in our country.The clinical treatment and relative complications of bile duct obstructive disease based on the central of hilar cholangiocarcinoma caused by hepatolithiasis has been explored and recognized.The systemic and supporting clinical strategy and joint treatment principle has been made,which resulted in qualified clinical outcome and formed hepatobiliary surgerythe bile duct surgery with Chinese characteristics.This series of studies had been honored as The National Science and Technology Progress Award in 2000. Bile duct tree is a closed tract full of alkaline liquid secreted by liver and pancreas to ensure the effective digestions.Previous studies had been mainly focus on the biochemical changes of structure and disease.The basic and clinical research for biomechanics of bile duct (Fluid mechanics) is obviously delayed,which caused one-sidedness,blindness and randomness in clinical thinking and treatment strategy.This also indicates the urgency to carry out the exploration and research in this field.This paper introduced the biomechanics of bile duct functions,relative physiological and pathological factors and proposed numbers of important points in the angle of clinical understanding and treatment.

Objective To explore the brain electrophysiological mechanism of object rotation in first-episode schizophrenia.Methods 30 patients with schizophrenia and 28 normal healthy people,who were from the Center for Mental Disease Control and Prevention,Third Hospital of PLA,took part in the mental rotation tasks,then the incubation period and amplitude of P500,and the wrong number and reaction time were measured.Results Compared with control group ( normal:(494.16 ± 34.68 ) ms,( 9.56 ± 2.54) μV; mirror:(496.51 ± 33.10 ) ms,(6.38 ± 2.41 ) μV),schizophrenia' incubation periods were significantly delayed ( normal:( 571.30 ± 51.21 ) ms;mirror:(573.41 ±39.27) ms) and volatility were significantly lower ( normal:(4.26 ± 1.01 ) μV; mirror:(3.61± 1.21 )μV) in normal and mirror rotation (P＜0.05 ).The mirror-normal differences were not significant on the incubation periods of two groups (P ＞ 0.05 ) ; the mirror-normal image differences were not significant on the patient group' volatility (P ＞ 0.05 ) ; the normal volatility was significantly higher than mirror in the control group (P ＜ 0.05).Conclusion Schizophrenia'mental rotation ability is impaired,and mirror-normal differences on mental rotation are disappeared.It can be used as an early-stage clinical auxiliary diagnosis index.

Currently,as various liver cancer-related treatments in China become developed,doctors also become super-subspecialized.This results in the doctors having more specialized skills and knowledge but a narrower vision.There is a tendency for these super-subspecialists to think and to make decisions based on a narrow perspective.As a consequence,interdisciplinary collaboration is becoming difficult.This hinders further improvement of treatment of liver cancer which has reached a plateau for many years.The present paper proposes a systematic perspective in decisionmaking for treatment of liver cancer.There are seven aspects which include the basic nature of medical care,the history of development of treatment,liver anatomical and functional characteristics,multicentric tumour occurrence,pathology,tumor immunology and biology.We aim to broaden the doctors’ vision and optimize their clinical thinking process.

Instead of the breakthrough progress and change of basic theory and principles of surgery, developments of minimally invasive and transplant techniques in recent two decades are all due to the technology reform. In clinical trail, effectiveness, safety and long-term outcome must be concerned; fine selection must also be applied according to operative surgery. In the mean time, we must emphasize technical training, access to technology and compliance with the rules. We should serve the majority of the patient based on traditional technology, avoid over-treatment and technical misapplying. We should be a doctor with good personality and high skill and keep in mind the patient-centered rule, instead of a doctor machine.