BACKGROUND:Rapid and accurate segmentation of brain tissue in medical images is of great significance for three-dimensional biomechanical modeling and diagnosis of craniocerebral injuries.Currently,artificial intelligence(AI)-based baseline models exhibit excellent generalization capabilities on large-scale datasets.However,due to the specificity and complexity of craniocerebral tissues,these models have certain limitations in their application to craniocerebral tissue segmentation.Additionally,the scarcity of craniocerebral tissue samples makes it difficult for baseline models to achieve precise segmentation results through fine-tuning.OBJECTIVE:To construct a craniocerebral tissue segmentation model based on texture feature retrieval enhancement to improve segmentation accuracy under a small number of samples.METHODS:Segment Anything in Medical Images(MedSAM)model was selected as the basic framework,and texture features were combined with deep learning to build a brain tissue segmentation model based on texture feature retrieval enhancement(DP-MedSAM).Dice Coefficient and mean intersection over union(MIoU)were selected to evaluate the efficiency of image segmentation results.In comparison with the original MedSAM model,the ablation experiment systematically evaluated the influence of key components on the model performance.The sensitivities of MedSAM,the Segment Anything Model(SAM)for medical image segmentation(SAM-Med2D)and DP-MedSAM in the mandible,left optic nerve,and left parotid gland were compared.RESULTS AND CONCLUSION:(1)By verifying the impact of the number of point prompts on segmentation results on the HaN-Seg dataset,the experimental results indicated that the optimal Dice score was achieved with the addition of three points.(2)DP-MedSAM demonstrated performance improvements compared with MedSAM and SAM-Med2D on two datasets(HaN and Public Domain Database for Computational Anatomy).Especially on the Public Domain Database for Computational Anatomy dataset,in terms of the MIoU metric,DP-MedSAM outperformed MedSAM by 6.59％and SAM-Med2D by 37.35％;in terms of the Dice metric,DP-MedSAM outperformed MedSAM and SAM-Med2D by 4.34％and 25.32％,respectively.(3)The ablation experiment results showed that removing the texture feature extraction module in the DP-MedSAM model,relying solely on original image features,led to a significant decrease in results on the test set.Furthermore,removing the vector cache database and its retrieval enhancement function from the model,which deprived the ability of the model to perform similarity retrieval using an external knowledge base,further reduced model performance.(4)Under conditions of limited data resources,the DP-MedSAM model outperformed the other two models in all evaluation metrics.The DP-MedSAM model performed excellently when processing simple and moderately difficult samples,demonstrating a clear advantage over the other two models and indicating good generalization ability.Processing the fine structures of difficult samples placed higher demands on the model's segmentation capabilities.Although the performance of the DP-MedSAM model declined slightly,it still outperformed the other two models.(5)This study proposes an innovative craniocerebral tissue segmentation model,DP-MedSAM,which improves the baseline model's performance in capturing local details and global structural information in medical images by introducing target region texture feature extraction.Through vector similarity retrieval technology,DP-MedSAM can retrieve the feature vector most similar to the current target region from a pre-constructed vector database,providing more precise guiding information for the segmentation process.

BACKGROUND:Rapid and accurate segmentation of brain tissue in medical images is of great significance for three-dimensional biomechanical modeling and diagnosis of craniocerebral injuries.Currently,artificial intelligence(AI)-based baseline models exhibit excellent generalization capabilities on large-scale datasets.However,due to the specificity and complexity of craniocerebral tissues,these models have certain limitations in their application to craniocerebral tissue segmentation.Additionally,the scarcity of craniocerebral tissue samples makes it difficult for baseline models to achieve precise segmentation results through fine-tuning.OBJECTIVE:To construct a craniocerebral tissue segmentation model based on texture feature retrieval enhancement to improve segmentation accuracy under a small number of samples.METHODS:Segment Anything in Medical Images(MedSAM)model was selected as the basic framework,and texture features were combined with deep learning to build a brain tissue segmentation model based on texture feature retrieval enhancement(DP-MedSAM).Dice Coefficient and mean intersection over union(MIoU)were selected to evaluate the efficiency of image segmentation results.In comparison with the original MedSAM model,the ablation experiment systematically evaluated the influence of key components on the model performance.The sensitivities of MedSAM,the Segment Anything Model(SAM)for medical image segmentation(SAM-Med2D)and DP-MedSAM in the mandible,left optic nerve,and left parotid gland were compared.RESULTS AND CONCLUSION:(1)By verifying the impact of the number of point prompts on segmentation results on the HaN-Seg dataset,the experimental results indicated that the optimal Dice score was achieved with the addition of three points.(2)DP-MedSAM demonstrated performance improvements compared with MedSAM and SAM-Med2D on two datasets(HaN and Public Domain Database for Computational Anatomy).Especially on the Public Domain Database for Computational Anatomy dataset,in terms of the MIoU metric,DP-MedSAM outperformed MedSAM by 6.59％and SAM-Med2D by 37.35％;in terms of the Dice metric,DP-MedSAM outperformed MedSAM and SAM-Med2D by 4.34％and 25.32％,respectively.(3)The ablation experiment results showed that removing the texture feature extraction module in the DP-MedSAM model,relying solely on original image features,led to a significant decrease in results on the test set.Furthermore,removing the vector cache database and its retrieval enhancement function from the model,which deprived the ability of the model to perform similarity retrieval using an external knowledge base,further reduced model performance.(4)Under conditions of limited data resources,the DP-MedSAM model outperformed the other two models in all evaluation metrics.The DP-MedSAM model performed excellently when processing simple and moderately difficult samples,demonstrating a clear advantage over the other two models and indicating good generalization ability.Processing the fine structures of difficult samples placed higher demands on the model's segmentation capabilities.Although the performance of the DP-MedSAM model declined slightly,it still outperformed the other two models.(5)This study proposes an innovative craniocerebral tissue segmentation model,DP-MedSAM,which improves the baseline model's performance in capturing local details and global structural information in medical images by introducing target region texture feature extraction.Through vector similarity retrieval technology,DP-MedSAM can retrieve the feature vector most similar to the current target region from a pre-constructed vector database,providing more precise guiding information for the segmentation process.

Many triterpenoid compounds have been successfully heterologously synthesized in Saccharomyces cerevisiae. To increase the yield of triterpenoids, various metabolic engineering strategies have been developed. One commonly applied strategy is to enhance the supply of precursors, which has been widely used by researchers. Squalene, as a precursor to triterpenoid biosynthesis, plays a crucial role in the synthesis of these compounds. This study primarily investigates the effect of different squalene levels in chassis strains on the synthesis of triterpenoids(oleanolic acid and ursolic acid), and the underlying mechanisms are further explored using real-time quantitative PCR(qPCR) analysis. The results demonstrate that the chassis strain CB-9-5, which produces high levels of squalene, inhibits the synthesis of oleanolic acid and ursolic acid. In contrast, chassis strains with moderate to low squalene production, such as Y8-1 and CNPK, are more conducive to the synthesis of oleanolic acid and ursolic acid. The qPCR analysis reveals that the expression levels of ERG1, βAS, and CrCYP716A154 in the oleanolic acid-producing strain CB-OA are significantly lower than those in the control strains C-OA and Y-OA, suggesting that high squalene production in the chassis strains suppresses the transcription of certain genes, leading to a reduced yield of triterpenoids. Our findings indicate that when constructing S. cerevisiae strains for triterpenoid production, chassis strains with high squalene content may suppress the expression of certain genes, ultimately lowering their production, whereas chassis strains with moderate squalene levels are more favorable for triterpenoid biosynthesis.
Squalene/analysis* ; Saccharomyces cerevisiae/genetics* ; Triterpenes/metabolism* ; Metabolic Engineering ; Oleanolic Acid/biosynthesis* ; Ursolic Acid

Panax species are mostly valuable medicinal plants. While some species' seeds are sensitive to dehydration, the dehydration tolerance of seeds from other Panax species remains unclear. The phospholipase D(PLD) gene plays an important role in plant responses to dehydration stress. However, the characteristics of the PLD gene family and their mechanisms of response to dehydration stress in seeds of Panax species with different dehydration tolerances are not well understood. This study used seeds from eight Panax species to measure the germination rates and PLD activity after dehydration and to analyze the correlation between dehydration tolerance and seed traits. Bioinformatics analysis was also conducted to characterize the PnPLD and PvPLD gene families and to evaluate their expression patterns under dehydration stress. The dehydration tolerance of Panax seeds was ranked from high to low as follows: P. ginseng, P. zingiberensis, P. quinquefolius, P. vietnamensis var. fuscidiscus, P. japonicus var. angustifolius, P. japonicus, P. notoginseng, and P. stipuleanatus. A significant negative correlation was found between dehydration tolerance and seed shape(three-dimensional variance), with flatter seeds exhibiting stronger dehydration tolerance(r=-0.792). Eighteen and nineteen PLD members were identified in P. notoginseng and P. vietnamensis var. fuscidiscus, respectively. These members were classified into five isoforms: α, β, γ, δ, and ζ. The gene structures, subcellular localization, physicochemical properties, and other characteristics of PnPLD and PvPLD were similar. Both promoters contained regulatory elements associated with plant growth and development, hormone responses, and both abiotic and biotic stress. During dehydration, the PLD enzyme activity in P. notoginseng seeds gradually increased as the water content decreased, whereas in P. vietnamensis var. fuscidiscus, PLD activity first decreased and then increased. The expression of PLDα and PLDδ in P. notoginseng seeds initially increased and then decreased, whereas in P. vietnamensis var. fuscidiscus, the expression of PLDα and PLDδ consistently decreased. In conclusion, the dehydration tolerance of Panax seeds showed a significant negative correlation with seed shape. The dehydration tolerance in P. vietnamensis var. fuscidiscus and dehydration sensitivity of P. notoginseng seeds may be related to differences in PLD enzyme activity and the expression of PLDα and PLDδ genes. This study provided the first systematic comparison of dehydration tolerance in Panax seeds and analyzed the causes of tolerance differences and the optimal water content for long-term storage at ultra-low temperatures, thus providing a theoretical basis for the short-term and ultra-low temperature long-term storage of medicinal plant seeds with varying dehydration tolerances.
Seeds/metabolism* ; Panax/physiology* ; Plant Proteins/metabolism* ; Gene Expression Regulation, Plant ; Phospholipase D/metabolism* ; Plants, Medicinal/enzymology* ; Germination ; Multigene Family ; Water/metabolism* ; Dehydration ; Phylogeny

The medicinal materials of Bawei Chenxiang Pills(BCPs) were extracted via three methods: reflux extraction by water, reflux extraction by 70% ethanol, and extraction by pure water following reflux extraction by 70% ethanol, yielding three extracts of ST, CT, and CST. The efficacy of ST(760 mg·kg~(-1)), CT(620 mg·kg~(-1)), and CST(1 040 mg·kg~(-1)) were evaluated by acute myocardial ischemia(AMI) and p-chlorophenylalanine(PCPA)-induced insomnia in mice, respectively. Western blot was further utilized to investigate their hypnosis mechanisms. The main chemical components of different extracts were identified by the UPLC-Q-Exactive-MS technique. The results showed that CT and CST significantly increased the ejection fraction(EF) and fractional shortening(FS) of myocardial infarction mice, reduced left ventricular internal dimension at end-diastole(LVIDd) and left ventricular internal dimension at end-systole(LVIDs). In contrast, ST did not exhibit significant effects on these parameters. In the insomnia model, CT significantly reduced sleep latency and prolonged sleep duration, whereas ST only prolonged sleep duration without shortening sleep latency. CST showed no significant effects on either sleep latency or sleep duration. Additionally, both CT and ST upregulated glutamic acid decarboxylase 67(GAD67) protein expression in brain tissue. A total of 15 main chemical components were identified from CT, including 2-(2-phenylethyl) chromone and 6-methoxy-2-(2-phenylethyl) chromone. Six chemical components including chebulidic acid were identified from ST. The results suggested that chromones and terpenes were potential anti-myocardial ischemia drugs of BCPs, and tannin and phenolic acids were potential hypnosis drugs. This study enriches the pharmacological and chemical research of BCPs, providing a basis and reference for their secondary development, quality standard improvement, and clinical application.
Animals ; Drugs, Chinese Herbal/isolation & purification* ; Mice ; Male ; Sleep Initiation and Maintenance Disorders/physiopathology* ; Humans ; Myocardial Infarction/drug therapy* ; Myocardial Ischemia/drug therapy*

OBJECTIVE: To investigate the clinical utility of novel of new hematological markers in the preoperative diagnosis of periprosthetic joint infection (PJI). METHODS: A retrospective analysis was conducted on a total of 149 patients who underwent revision of total hip arthroplasty (THA) or total knee arthroplasty (TKA) at a single center between January 2016 and June 2022, including 63 males and 86 females, aged from 47 to 93 years old with an average of (69.5±11.8) years old. Of them, 46 were diagnosed as PJI(PJI group), including 22 males and 24 females. The mean age was (71.3±12.5) years old. The body mass index (BMI) was (26.4±3.1) kg·m^-2. And 103 patients were diagnosed as aseptic prosthesis loosening (aseptic group), including 41 males and 62 females. The mean age was (68.7±11.4) years old. The BMI was (25.8±3.5) kg·m^-2. Preoperatively analyzed clinical parameters included C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), albumin, globulin, albumin-to-globulin ratio (AGR), plasma D-dimer, and plasma fibrinogen. The receiver operating characteristic curve (ROC), sensitivity, and specificity analysis were employed to compare the diagnostic value of each blood marker in preoperative PJI diagnosis. RESULTS: In the PJI group, the levels of CRP were 16.6 (7.6, 4.5) mg·L^-1, ESR was 17.0 (12.8, 35.5) mm·h^-1, plasma D-dimer was 1.0 (0.5, 3.1) μg·L^-1, and plasma fibrinogen was 4.2 (3.2, 3.1) mg·L^-1;all of which were higher compared to the aseptic group with CRP at 4.2 (2.6, 7.8) mg·L^-1, ESR at 12.0(8.0, 20.0 )mm·h^-l, D-dimer at 0.4(0.2, 0.7)μg·L^-1, and fibrinogen at 2.8(2.4, 3.3 ) g·L^-1(P<0.05). However, the albumin level of 35.3 (32.3, 37.5) g·L^-1 and the WBC ratio of 1.0(0.9, 1.1) in the PJI group were significantly lower compared to the aseptic group with levels of 39.8 (36.1, 41.8) g·L^-1 and 1.4 (1.3, 1.5), respectively (P<0.05). Only the area under the curve (AUC) of AGR and plasma fibrinogen were greater than 0.8. The optimal predictive cut-1off, AUC, sensitivity and specificity were 3.4 g·L-1, 0.820, 69.57% and 84.47% for plasma fibrinogen; 1.18, 0.813, 82.61% and 78.64% for AGR, respectively. CONCLUSION AGR and plasma fibrinogen are promising blood markers for improving the diagnosis of PJI.
Humans ; Female ; Fibrinogen/metabolism* ; Male ; Middle Aged ; Aged ; Prosthesis-Related Infections/blood* ; Retrospective Studies ; Biomarkers/blood* ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/adverse effects* ; Arthroplasty, Replacement, Hip/adverse effects* ; Leukocyte Count

OBJECTIVE: To investigate the clinical effect of minimally invasive technique in the treatment of moderate and severe gluteal muscle contracture. METHODS: A retrospective study was conducted on 85 patients (170 sides) with bilateral gluteal muscle contracture admitted from January 2016 to December 2019. All patients were treated with minimally invasive release of tendon knife. There were 32 males and 53 females, ranging in age from 15 to 37 years old, with an average age of (22.3±6.3) years old. Operation time, intraoperative blood loss, incision length, first postoperative ambulation time, complication rate, recurrence rate, and Harris hip score (HHS) were analyzed and evaluated. RESULTS: The average follow-up time was (16.2±4.6) months, ranging from 12 to 30 months. The operation time ranged from 7 to 15 min, with an average of (10.2±3.1) min. Intraoperative blood loss ranged from 2 to 20 ml, with an average of (8.4±2.2) ml. The incision length ranged from 0.6 to 2.0 cm, with an average of (0.8±0.3) cm. The time to postoperative ambulation ranged from 12 to 28 h, with an average of (20.0±3.2) h. All patients achieved primary wound healing without sciatic nerve injury or recurrence. HHS hip function scores ranged from 90 to 98, with an average score of (96.2±1.4). Complications included intraoperative tendon blade tip fracture in two cases (removed under fluoroscopic guidance) and subcutaneous hematoma in three cases-two resolved with compression and one with open evacuation.. Twenty-nine patients exhibited transient swaying gait postoperatively, of which 24 patients returned to normal after 4 weeks and 5 patients returned to normal after 6 weeks. CONCLUSION Minimally invasive tendon blade release is a safe and effective technique for treating gluteal muscle contracture, offering minimal trauma, rapid recovery, and excellent cosmetic and functional outcomes. However, it exhibits a low risk of blade tip fracture and sciatic nerve injury, warranting experienced surgical handling.
Humans ; Male ; Female ; Adult ; Minimally Invasive Surgical Procedures/methods* ; Adolescent ; Retrospective Studies ; Buttocks/surgery* ; Young Adult ; Contracture/surgery* ; Tendons/surgery* ; Muscle, Skeletal/surgery*

OBJECTIVES: To investigate the relationship between the polygenic risks for various psychiatric disorders and clinical and neuropsychological characteristics in children with attention-deficit/hyperactivity disorder (ADHD). METHODS: Using a cross-sectional design, 285 children with ADHD and 107 healthy controls were assessed using the Child Behavior Checklist, the Behavior Rating Inventory of Executive Function for parents, the Wechsler Intelligence Scale for Children, Fourth Edition, and the Cambridge Neuropsychological Test Automated Battery. Blood samples were collected for genetic data. Polygenic risk scores (PRSs) for various psychiatric disorders were calculated using the PRSice-2 software. RESULTS: Compared with the healthy controls, the children with ADHD displayed significantly higher PRSs for ADHD, major depressive disorder, anxiety disorder, and obsessive-compulsive disorder (P<0.05). In terms of daily-life executive function, ADHD-related PRS was significantly correlated with the working memory factor; panic disorder-related PRS was significantly correlated with the initiation factor; bipolar disorder-related PRS was significantly correlated with the shift factor; schizophrenia-related PRS was significantly correlated with the inhibition, emotional control, initiation, working memory, planning, organization, and monitoring factors (P<0.05). The PRS related to anxiety disorders was negatively correlated with total IQ and processing speed index (P<0.05). The PRS related to obsessive-compulsive disorder was negatively correlated with the processing speed index and positively correlated with the stop-signal reaction time index of the stop-signal task (P<0.05). CONCLUSIONS PRSs for various psychiatric disorders are closely correlated with the behavioral and cognitive characteristics in children with ADHD, which provides more insights into the heterogeneity of ADHD.
Humans ; Attention Deficit Disorder with Hyperactivity/genetics* ; Child ; Male ; Female ; Cross-Sectional Studies ; Neuropsychological Tests ; Multifactorial Inheritance ; Adolescent ; Mental Disorders/etiology* ; Executive Function ; Genetic Risk Score

BACKGROUND: Atrial fibrillation (AF) is a common cardiac arrhythmia in the elderly. This study aimed to evaluate urban-rural disparities in its prevalence and management in elderly Chinese. METHODS: Consecutive participants aged ≥ 65 years attending outpatient clinics were enrolled for AF screening using handheld single-lead electrocardiogram (ECG) from April 2017 to December 2022. Each ECG rhythm strip was reviewed from the research team. AF or uninterpretable single-lead ECGs were referred for 12-lead ECG. Primary study outcome comparison was between rural and urban areas for the prevalence of AF. The Student's t-test was used to compare mean values of clinical characteristics between rural and urban participants, while the Pearson's chi-square test was used to compare between-group proportions. Multivariate stepwise logistic regression analysis was performed to estimate the association between AF and various patient characteristics. RESULTS: The 29,166 study participants included 13,253 men (45.4%) and had a mean age of 72.2 years. The 7073 rural participants differed significantly (P ≤ 0.02) from the 22,093 urban participants in several major characteristics, such as older age, greater body mass index, and so on. The overall prevalence of AF was 4.6% (n = 1347). AF was more prevalent in 7073 rural participants than 22,093 urban participants (5.6% vs. 4.3%, P < 0.01), before and after adjustment for age, body mass index, blood pressure, pulse rate, cigarette smoking, alcohol consumption and prior medical history. Multivariate logistic regression analysis identified overweight/obesity (OR = 1.35, 95% CI: 1.17-1.54) in urban areas and cigarette smoking (OR = 1.62, 95% CI: 1.20-2.17) and alcohol consumption (OR = 1.42, 95% CI: 1.04-1.93) in rural areas as specific risk factors for prevalent AF. In patients with known AF in urban areas (n = 781) and rural areas (n = 338), 60.6% and 45.9%, respectively, received AF treatment (P < 0.01), and only 22.4% and 17.2%, respectively, received anticoagulation therapy (P = 0.05). CONCLUSIONS In China, there are urban-rural disparities in AF in the elderly, with a higher prevalence and worse management in rural areas than urban areas. Our study findings provide insight for health policymakers to consider urban-rural disparity in the prevention and treatment of AF.