To address the challenges faced by current brain midline segmentation techniques, such as insufficient accuracy and poor segmentation continuity, this paper proposes a deep learning network model based on a two-stage framework. On the first stage of the model, prior knowledge of the feature consistency of adjacent brain midline slices under normal and pathological conditions is utilized. Associated midline slices are selected through slice similarity analysis, and a novel feature weighting strategy is adopted to collaboratively fuse the overall change characteristics and spatial information of these associated slices, thereby enhancing the feature representation of the brain midline in the intracranial region. On the second stage, the optimal path search strategy for the brain midline is employed based on the network output probability map, which effectively addresses the problem of discontinuous midline segmentation. The method proposed in this paper achieved satisfactory results on the CQ500 dataset provided by the Center for Advanced Research in Imaging, Neurosciences and Genomics, New Delhi, India. The Dice similarity coefficient (DSC), Hausdorff distance (HD), average symmetric surface distance (ASSD), and normalized surface Dice (NSD) were 67.38 ± 10.49, 24.22 ± 24.84, 1.33 ± 1.83, and 0.82 ± 0.09, respectively. The experimental results demonstrate that the proposed method can fully utilize the prior knowledge of medical images to effectively achieve accurate segmentation of the brain midline, providing valuable assistance for subsequent identification of the brain midline by clinicians.
Humans ; Brain/diagnostic imaging* ; Deep Learning ; Image Processing, Computer-Assisted/methods* ; Algorithms ; Magnetic Resonance Imaging/methods* ; Neural Networks, Computer

ObjectiveTo explore the syndrome elements and evolving patterns of patients with hepatitis B virus-related acute on chronic liver failure （HBV-ACLF） at different stages. MethodsClinical information of 1,058 hospitalized HBV-ACLF patients， including 618 in the early stage， 355 in the middle stage， and 85 in the late stage， were collected from 18 clinical centers across 12 regions nationwide from January 1， 2012 to February 28， 2015. The “Hepatitis B-related Chronic and Acute Liver Failure Chinese Medicine Clinical Questionnaire” were designed to investigate the basic information of the patients， like the four diagnostic information （including symptoms， tongue， pulse） of traditional Chinese medicine （TCM）， and to count the frequency of the appearance of the four diagnostic information. Factor analysis and cluster analysis were employed to determine and statistically analyze the syndrome elements and patterns of HBV-ACLF patients at different stages. ResultsThere were 76 four diagnostic information from 1058 HBV-ACLF patients， and 53 four diagnostic information with a frequency of occurrence ≥ 5% were used as factor analysis entries， including 36 symptom information， 12 tongue information， and 5 pulse information. Four types of TCM patterns were identified in HBV-ACLF， which were liver-gallbladder damp-heat pattern， qi deficiency and blood stasis pattern， liver-kidney yin deficiency pattern， and spleen-kidney yang-deficiency pattern. In the early stage， heat （39.4%， 359/912） and dampness （27.5%， 251/912） were most common， and the pattern of the disease was dominated by liver-gallbladder damp-heat pattern （74.6%， 461/618）； in the middle stage， dampness （30.2%， 187/619） and blood stasis （20.7%， 128/619） were most common， and the patterns of the disease were dominated by liver-gallbladder damp-heat pattern （53.2%， 189/355）， and qi deficiency and blood stasis pattern （27.6%， 98/355）； and in the late stage， the pattern of the disease was dominated by qi deficiency （26.3%， 40/152） and yin deficiency （20.4%， 31/152）， and the patterns were dominated by qi deficiency and blood stasis pattern （36.5%， 31/85）， and liver-gallbladder damp-heat pattern （25.9%， 22/85）. ConclusionThere are significant differences in the distribution of syndrome elements and patterns at different stages of HBV-ACLF， presenting an overall trend of evolving patterns as "from excess to deficiency， transforming from excess to deficiency"， which is damp-heat → blood stasis → qi-blood yin-yang deficiency.

OBJECTIVE: To observe the clinical effect and safety of fire needle therapy combined with bladder function training on neurogenic bladder (NB) caused by spinal cord injury. METHODS: A total of 60 patients with NB caused by spinal cord injury were randomly divided into an observation group and a control group , with 30 cases in each group. On the basis of conventional treatment with western medicine, the bladder function training was adopted in the control group, once a day and for 4 weeks. In the observation group, on the basis of the interventions as the control group, fire needling was operated at bilateral Sanyinjiao (SP 6) and Guanyuan (CV 4) and Zhongji (CV 3), once every two days and for 4 weeks (14 interventions in total). Separately, at the baseline and in 2 and 4 weeks of interventions, the urination conditions (average daily urination frequency, average daily leakage frequency, average daily single urination volume) were recorded in the two groups; the urodynamic parameters (maximum flow rate [Qmax], maximum detrusor pressure at maximum flow rate [PdetQmax], residual urine volume [RUA], maximum cystometric capacity [MCC], and bladder pressure) were detected; the neurogenic bladder symptom score (NBSS), urinary symptom distress score (USDS) were observed. Before and after treatment, the score of World Health Organization quality of life assessment scale-brief (WHOQOL-BREF) was observed in the two groups. The therapeutic effect, the incidence of urinary infection, and the safety were evaluated. RESULTS: In 2 and 4 weeks of interventions, the average daily urination frequency, the average daily leakage frequency, RUA, and the scores of NBSS and USDS decreased in the two groups when compared with the baseline (P<0.05). In 4 weeks of interventions, the above-mention outcomes were lower than those in 2 weeks of interventions (P<0.05); and the results in the observation group were lower in 2 and 4 weeks of interventions when compared with the control group (P<0.05). In 2 and 4 weeks of interventions, the average daily single urination volume, Qmax, PdetQmax, MCC, and bladder pressure increased in the two groups compared with the baseline (P<0.05). In 4 weeks of interventions, the above-mention outcomes were elevated in comparison with those in 2 weeks of interventions (P<0.05); and except for bladder pressure, the results in the observation group in 2 and 4 weeks of interventions were higher when compared with the control group (P<0.05). In 4 weeks of interventions, the scores of each dimension and the total scores of WHOQOL-BREF increased in comparison with the baseline in the two groups (P<0.05), and the scores of the observation group were higher than those of the control group (P<0.05). The incidence of urinary infection was 0% (0/30) in the observation group and 10.0% (3/30) in the control group, without significant difference (P>0.05). The total effective rate of the observation group was 93.3% (28/30), which was higher than that (73.3%, 22/30) of the control group (P<0.05). No serious adverse reactions occurred in the patients of the observation group. CONCLUSION Fire needle therapy combined with bladder function training can effectively relieve the clinical symptoms, ameliorate urination, restore bladder function and improve the quality of life in the patients with NB caused by spinal cord injury. This therapeutic regimen presents a high safety in practice.
Humans ; Spinal Cord Injuries/therapy* ; Female ; Male ; Acupuncture Therapy ; Middle Aged ; Adult ; Urinary Bladder, Neurogenic/etiology* ; Urinary Bladder/physiopathology* ; Urination ; Young Adult ; Treatment Outcome ; Aged ; Adolescent ; Combined Modality Therapy

Multiple plant lineages have independently evolved sex chromosomes and variable kary-otypes to maintain their sessile lifestyles through constant biological innovation.Morus notabilis,a dioecious mulberry species,has the fewest chromosomes among Morus spp.,but the genetic basis of sex determination and karyotype evolution in this species has not been identified.In this study,three high-quality genome assemblies were generated for Morus spp.[including dioecious M.notabilis(male and female)and Morus yunnanensis(female)]with genome sizes of 301-329 Mb and were grouped into six pseudochromosomes.Using a combination of genomic approaches,we found that the putative ancestral karyotype of Morus species was close to 14 protochromosomes,and that sev-eral chromosome fusion events resulted in descending dysploidy(2n=2x=12).We also charac-terized a～6.2-Mb sex-determining region on chromosome 3.Four potential male-specific genes,a partially duplicated DNA helicase gene(named MSDH)and three Ty3_Gypsy long terminal repeat retrotransposons(named MSTG1/2/3),were identified in the Y-linked area and considered to be strong candidate genes for sex determination or differentiation.Population genomic analysis showed that Guangdong accessions in China were genetically similar to Japanese accessions of mul-berry.In addition,genomic areas containing selective sweeps that distinguish domesticated mul-berry from wild populations in terms of flowering and disease resistance were identified.Our study provides an important genetic resource for sex identification research and molecular breeding in mulberry.

Objective : To study the guidance effects of fibroblast growth factor 3 ( FGF3) on the prethalamic γ⁃aminobutyric acid (GABA) inhibitory axons, and to explore the effect of FGF3 on the formation of thalamic axonal network. Methods : Expression and localization of FGF3 and prethalamic GABA marker gene in chicken embryonic diencephalon were detected by immunofluorescence. Early orientation of GABA axons was tracked by DiI. Three⁃dimensional gel co⁃culture experiment was carried out to investigate guidance effects of FGF3 on early prethalamic GABA inhibitory axons. Results : Prethalamic GABA cells were adjacent to the FGF3 + hypothalamas, located above the hypothalamus. DiI tracing experiments revealed that prethalamic GABA inhibitory axons had already extended into the thalamus at E6. Compared with the blank control group, FGF3 not only significantly promoted the growth of prethalamic GABA inhibitory nerve fibers in the prethalamus, but also repelled the newborn prethalamic axons to the dorsal thalamus. The number of prethalamic axons was significantly less in proximal section (towards FGF3 beads) than that in distal section (away from FGF3 beads) (P < 0. 01) . Moreover, the guidance effects of FGF3 on prethalamic axons could be blocked by the FGF pathway inhibitor SU5402. Conclusion FGF3, an axon guidance molecule expressed in hypothalamus, exerts guidance effects on the pathway selection of adjacent prethalamic GABA inhibitory nerve fibers.

Objective To investigate the early clinical efficacy of Masquelet membrane induction technique in the treatment of traumatic long bone defects.Methods A retrospective case series study was conducted to analyze the clinical data of 41 patients with traumatic long bone defects admitted to the General Hospital of the Northern Theater Command from January 2012 to April 2017.There were 36 males and five females,aged 15-70 years,with an average of 38.2 years.There were 20 patients with bone defect at the femur,19 at the tibia,one at the fibula,and one at the ulna.All patients received staged treatment using the Masquelet membrane induction technique.In stage Ⅰ surgery,thorough debridement was first performed,and the secretions were taken for bacterial culture.The average bone defect length after debridement was 6.9 cm (2.0-18.5 cm).The bone defect was filled with antibiotic bone cement to induce the biofilm formation.If the postoperative bacterial culture showed positive results,debridement surgery was performed again.Stage Ⅱ surgery was performed after 6-12 weeks.The white blood cell count,C-reactive protein (CRP),procalcitonin (PCT),erythrocyte sedimentation rate (ESR) were measured before the operation.During the operation,bone biopsy was performed,and the bone cement placeholder was completely removed.The autologous cancellous bone and artificial bone were implanted in the bone defect areas,and the induced membrane was sutured.The healing time of bone defects was recorded,and the Paley fracture healing scoring criteria were used to evaluate the limb function.The complications were observed.The inflammatory markers were reviewed at the last follow-up.Results All patients were followed up for 7-36 months with an average of 13.6 months.A total of 37 patients obtained bone healing.The fracture healing rate of stage Ⅰ was 90％,and the healing time was 6-13 months,with an average of 9 months.According to the Paley fracture healing scoring criteria,the results were excellent in 25 patients,good in 10,and fair in two patients,with the excellent and good rate of 85％.In terms of complications,one patient with superficial infection recovered after dressing change,three patients had deep infection,of which one patient was treated with amputation and two received other treatments,and three patients were treated with membrane induction again because of bone resorption.At the last follow-up,there were significant differences between preoperative and postoperative White blood cell count,CRP,PCT and ESR(P ＜ 0.05).Conclusion For traumatic long bone defects,Masquelet membrane induction technique can promote fracture healing,restore limb function and reduce complications.

Objective To investigate the activities of different soft and hard materials during right chewing masticatory muscles, describing the masticatory muscles of time domain and frequency domain features. Methods 11 experimental subjects who conform to the standards of measurement chew two materials of different soft and hard texture. Then record surface EMG of each bilateral temporalis anterior bundle, masseter, two bilateral anterior abdominal muscles, analysis to 5 kinds of characteristics of the study of EMG.Results When subjects chewing different soft and hard materials, al the EMG features in the bilateral anterior temporalis and masseter values had signifi cant difference (P < 0.05). The results in bilateral digastric anterior abdominal except zero crossing rate have signifi cant difference; median frequency on the right side of the masticatory muscle has decreased trend. ConclusionThe anterior temporalis and masseter EMG active more intense when chewing hard objects; the right side of the masticatory muscles have obvious fatigue trend after chewing hard masticatory 30 cycles.

Currently, various kinds of electrical stimulation equipment are used in the rehabilitation of muscle function for patients with hemiplegia, but many defects can be found in those designs, for example, insufficient feedback parameter, unsynchronized information, unintuitive display and so on. Therefore, this study introduces an electrical stimulation system with surface electromyography (sEMG) feedback based on LabVIEW, which combines with multi-channel sEMG acquisition, electrical stimulator and other hardware system. This system can not only provide a wide electrical stimulation parameters range for frequency, pulse width and intensity, but also acquire sEMG during the treatment. Meanwhile, this system can compute iEMG, CCR, RMS and MPF in real-time. The verification results shows that the whole system is effective and stable. This system can help physicians observe the muscle condition of different patients, who can explore suitable electrical stimulation parameters to design individualized treatment projects.

Laparoscopic technique is now widely used in gastrointestinal surgery, but the limitation of its “tubular vision” pose disadvantages. Benefits from the realization of dynamic navigation which can match the preoperative dimensional reconstruction model and the surgical scene in real time, the computer-aided surgery(CAS) can supplement the insufficiency of laparoscopic view. Focusing on pancreas, the key organ in the laparoscopic gastrectomy for cancer cancer,the initial experience of dynamic navigation in such surgery using a virtual surgical model is shared. The method is as follows: First, the virtual model of pancreas and peripheral blood vessels was reconstructed with the Mimics17.0 based on the abdominal computed tomography data of the patients with gastric cancer; and the location information of the virtual marker was captured with the tracking software. Second, the three dimensional (3D) construction image displayed in SLT file, was read in ZEditTM3.21 and was printed by Spectrum ZTM510 printer. Then, the 3D model was fixed in a laparoscopic simulation training device to achieve the simulation operation. The location information of the laparoscopic training device , lens and laparoscopic instrument was recorded with tracking software. Besides, the coordinate information of simulation operation was also achieved. Third, we conducted a match between the virtual and simulation operation. Our study show that scenes splitting is conducive to the tracking and matching of the surgical navigation in laparoscopic surgery for gastric cancer.

Laparoscopic technique is now widely used in gastrointestinal surgery, but the limitation of its “tubular vision” pose disadvantages. Benefits from the realization of dynamic navigation which can match the preoperative dimensional reconstruction model and the surgical scene in real time, the computer-aided surgery(CAS) can supplement the insufficiency of laparoscopic view. Focusing on pancreas, the key organ in the laparoscopic gastrectomy for cancer cancer,the initial experience of dynamic navigation in such surgery using a virtual surgical model is shared. The method is as follows: First, the virtual model of pancreas and peripheral blood vessels was reconstructed with the Mimics17.0 based on the abdominal computed tomography data of the patients with gastric cancer; and the location information of the virtual marker was captured with the tracking software. Second, the three dimensional (3D) construction image displayed in SLT file, was read in ZEditTM3.21 and was printed by Spectrum ZTM510 printer. Then, the 3D model was fixed in a laparoscopic simulation training device to achieve the simulation operation. The location information of the laparoscopic training device , lens and laparoscopic instrument was recorded with tracking software. Besides, the coordinate information of simulation operation was also achieved. Third, we conducted a match between the virtual and simulation operation. Our study show that scenes splitting is conducive to the tracking and matching of the surgical navigation in laparoscopic surgery for gastric cancer.