Alzheimer's disease(AD)is a neurodegenerative disease characterized by clinical manifestations of cognitive decline,abnormal mental behavior and decreased ability to engage in daily activities.The etiology of this disease is diverse and the onset is insidious.Traditional neuropsychological assessments are time-consuming,imaging detection sensitivity is low,and drug development progress is slow.With the rapid development of cognitive neuroscience and digital technology,digital technologies such as artificial intelligence and virtual reality are receiving increasing attention.This article aims to review the clinical research on digital technology in the prediction,screening,auxiliary diagnosis and treatment of AD in recent years,as well as the progress and breakthroughs in multiple fields such as AD gait,fine motor and speech,providing a directions for clinical diagnosis and further exploration.

Objective To compare the efficacy and safety of suction ureteral stent and conventional ureteral stent in the treatment of patients with urinary calculi,so as to evaluate the clinical application value.Methods A total of 196 patients with urinary calculi admitted to in our hospital during Dec.2022 and May 2023 were selected to undergo ureteral holmium laser lithotripsy with hard ureteroscopy or soft ureteroscopy,including 100 with suction ureteral stent(suction group)and 96 with conventional ureteral stent(conventional group).Basic data,visual analog scale(VAS),extubation time,extubation success rate,gross hematuria,lumbar and abdominal pain,and urinary tract infection were compared between the two groups.Results Compared with the conventional group,the suction group had lower VAS[(2.94±1.24)vs.(5.78±1.50)],shorter extubation time[(4.28±0.51)min vs.(13.51±1.81)min],and the differences were statistically significant(P＜0.01).After extubation,the suction group had a lower incidence of complications(P＜0.05).Conclusion Compared with conventional ureteral stent,extraction of suction ureteral stent has the advantages of simpler operation,better patient comfort,fewer complications,shorter extubation time and lower medical costs.

Corona virus disease 2019 (COVID-19) is an acute respiratory infectious disease with strong contagiousness, strong variability, and long incubation period. The probability of misdiagnosis and missed diagnosis can be significantly decreased with the use of automatic segmentation of COVID-19 lesions based on computed tomography images, which helps doctors in rapid diagnosis and precise treatment. This paper introduced the level set generalized Dice loss function (LGDL) in conjunction with the level set segmentation method based on COVID-19 lesion segmentation network and proposed a dual-path COVID-19 lesion segmentation network (Dual-SAUNet++) to address the pain points such as the complex symptoms of COVID-19 and the blurred boundaries that are challenging to segment. LGDL is an adaptive weight joint loss obtained by combining the generalized Dice loss of the mask path and the mean square error of the level set path. On the test set, the model achieved Dice similarity coefficient of (87.81 ± 10.86)%, intersection over union of (79.20 ± 14.58)%, sensitivity of (94.18 ± 13.56)%, specificity of (99.83 ± 0.43)% and Hausdorff distance of 18.29 ± 31.48 mm. Studies indicated that Dual-SAUNet++ has a great anti-noise capability and it can segment multi-scale lesions while simultaneously focusing on their area and border information. The method proposed in this paper assists doctors in judging the severity of COVID-19 infection by accurately segmenting the lesion, and provides a reliable basis for subsequent clinical treatment.
Humans ; COVID-19/diagnostic imaging* ; Respiratory Rate ; Tomography, X-Ray Computed

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

Cardiovascular disease is one of the important factors that threaten the health of residents, ranking the first among various causes of death, so the monitoring and diagnosis of human cardiovascular health is particularly important. Compared with traditional brachial artery pressure, central arterial pressure (CAP) has a higher correlation with the occurrence of many cardiovascular events. The measurement of CAP can more accurately reflect the real situation of human blood pressure, and provide an important basis for diagnosis and disease prevention. Therefore, the realization of high-precision, high-generalization ability and low-cost non-invasive measurement of CAP has always been the research focus in this field. This article combines the relevant literature in China and abroad to summarize the current status of CPA measurement, introduces related research progress from two aspects, namely parameter measurement and waveform measurement, and discusses the characteristics of the existing methods and the future development.

Lung diseases such as lung cancer and COVID-19 seriously endanger human health and life safety, so early screening and diagnosis are particularly important. computed tomography (CT) technology is one of the important ways to screen lung diseases, among which lung parenchyma segmentation based on CT images is the key step in screening lung diseases, and high-quality lung parenchyma segmentation can effectively improve the level of early diagnosis and treatment of lung diseases. Automatic, fast and accurate segmentation of lung parenchyma based on CT images can effectively compensate for the shortcomings of low efficiency and strong subjectivity of manual segmentation, and has become one of the research hotspots in this field. In this paper, the research progress in lung parenchyma segmentation is reviewed based on the related literatures published at domestic and abroad in recent years. The traditional machine learning methods and deep learning methods are compared and analyzed, and the research progress of improving the network structure of deep learning model is emphatically introduced. Some unsolved problems in lung parenchyma segmentation were discussed, and the development prospect was prospected, providing reference for researchers in related fields.
COVID-19 ; Humans ; Lung/diagnostic imaging* ; Machine Learning ; SARS-CoV-2 ; Tomography, X-Ray Computed

Objective:To compare the results of thinned latissimus dorsi muscle flap combined with skin grafting and dorsal free flaps in repairing traumatic dorsal foot defects.Methods:From January 2005 to December 2019, 41 patients with large soft tissue defects in the dorsum of the foot were admitted to our department. Inclusion criteria: unilateral dorsal foot and ankle soft tissue defects, accompanied by tendon and/or bone exposure, cannot be repaired by simple methods such as skin grafting and local flaps, and the affected area has blood vessels that can be used for anastomosis. Exclusion criteria: primary or secondary vascular diseases, systemic conditions intolerant to prolonged surgery. According to the patient’s choices, the latissimus dorsi flap or the scapular flap were used for repair, namely the traditional flap group. Or latissimus dorsi muscle flap was used to fill and cover the defect, and then the surface of the muscle flap was sealed with split-thickness or full-thickness skin grafting, which is the combined transplantation group. Postoperative follow-up was mainly focused on the recovery of foot function, whether the shoes were worn normally, the appearance of the flap, and the rate of second operation.Results:A total of 41 patients were included in this study. All the flaps survived without infection and tissue necrosis. Twenty three cases, 16 males and 7 females, age from 6 to 52 years with an average of 27.6 years, were repaired with latissimus dorsi flap or scapula flap. The area of soft tissue defects was from 5.5 cm×8.0 cm to 19.5 cm×23.0 cm, with an average areaof 10.1 cm×16.2 cm. The follow-up time was from 6 to 24 months with an average of 9.7 months. All walking function of the foot was basically restored, and the texture of the flap was good. Eighteen patients had bloated flap appearance, 15 of which affected shoe-wearing, and 14 had debulking surgery, 2 had developed hypertrophic scar. Eighteen cases, 14 males and 4 females, age from 19 to 49 years with an average of 30.7 years, were repaired with latissimus dorsimuscle flap combined with split-thickness or full-thickness skin grafts. The area of soft tissue defects was from 4.0 cm×6.5 cm to 20.5 cm×23.0 cm, and the average area was 11.7 cm × 17.3 cm. All donor-site incisions are sutured in one stage without skin grafting. The follow-up time was from 4 to 20 months with an average of 8.3 months. The walking function of all operative feet, with good shape and without bloating, was basically restored. The contour and curve was similar to the healthy side and no skin injury and ulcer was observed. All patients were satisfied with wearing shoes and walking function, and no secondary surgery was required. However, 9 patients had developed hypertrophic scar.Conclusions:Compared with the traditional flap, the free latissimus dorsi muscle flap combined with skin grafting can effectively cover large area of soft tissue defect on the dorsal foot, without bloated flap appearance and secondary surgery. However, the risk of scar hyperplasia after combined transplantation increased.

Objective:To compare the efficacy and safety of subcutaneous endoscope assisted suction-curettage shaver and small-incision scissor in the treatment of axillary osmidrosis.Methods:A total of 71 cases (142 sides) of patients with osmidrosis were treated. Among them, 38 cases (76 sides) were treated with subcutaneous endoscope assisted suction-curettage shaver for the resection of apocrine sweat glands, and 33 cases (66 sides) were treated with small-incision scissor. The postoperative recovery was evaluated by Tung grading. The postoperative complications, efficacy, operative time and satisfaction rate were also included in the comparison evaluation.Results:The effective rate of the subcutaneous endoscope assisted suction-curettage shaver group was 100% (75/75), which was significantly higher than that of the small-incision scissor group (89.39%, 59/66), with a statistically significant difference ( χ2=8.479, P=0.004). Complications in subcutaneous endoscope assisted suction-curettage shaver group(3.95%, 3/76) were significantly lower than that in small-incision scissor(25.76%, 17/66), χ2=39.699, P<0.001. The operative time of the endoscope group [(58.212±4.897) min] was slightly longer than that of small-incision scissor group [(54.079±6.096) min]. But the dressing time, stitches removal time and rehabilitation exercise time were significantly shorter than those of the small-incision scissor group, with statistically significant differences ( P<0.05). The satisfaction rate of subcutaneous endoscope assisted suction-curettage shaver group(97.37%, 74/76) was significantly higher than that of the small-incision scissor group(74.24%, 49/66), χ2=33.102, P<0.001. Conclusions:Subcutaneous endoscope assisted suction-curettage shaver has more significant efficacy, less postoperative complications, faster recovery and higher satisfaction than small-incision scissor in the treatment of axillary osmidrosis.

Objective:To compare the results of thinned latissimus dorsi muscle flap combined with skin grafting and dorsal free flaps in repairing traumatic dorsal foot defects.Methods:From January 2005 to December 2019, 41 patients with large soft tissue defects in the dorsum of the foot were admitted to our department. Inclusion criteria: unilateral dorsal foot and ankle soft tissue defects, accompanied by tendon and/or bone exposure, cannot be repaired by simple methods such as skin grafting and local flaps, and the affected area has blood vessels that can be used for anastomosis. Exclusion criteria: primary or secondary vascular diseases, systemic conditions intolerant to prolonged surgery. According to the patient’s choices, the latissimus dorsi flap or the scapular flap were used for repair, namely the traditional flap group. Or latissimus dorsi muscle flap was used to fill and cover the defect, and then the surface of the muscle flap was sealed with split-thickness or full-thickness skin grafting, which is the combined transplantation group. Postoperative follow-up was mainly focused on the recovery of foot function, whether the shoes were worn normally, the appearance of the flap, and the rate of second operation.Results:A total of 41 patients were included in this study. All the flaps survived without infection and tissue necrosis. Twenty three cases, 16 males and 7 females, age from 6 to 52 years with an average of 27.6 years, were repaired with latissimus dorsi flap or scapula flap. The area of soft tissue defects was from 5.5 cm×8.0 cm to 19.5 cm×23.0 cm, with an average areaof 10.1 cm×16.2 cm. The follow-up time was from 6 to 24 months with an average of 9.7 months. All walking function of the foot was basically restored, and the texture of the flap was good. Eighteen patients had bloated flap appearance, 15 of which affected shoe-wearing, and 14 had debulking surgery, 2 had developed hypertrophic scar. Eighteen cases, 14 males and 4 females, age from 19 to 49 years with an average of 30.7 years, were repaired with latissimus dorsimuscle flap combined with split-thickness or full-thickness skin grafts. The area of soft tissue defects was from 4.0 cm×6.5 cm to 20.5 cm×23.0 cm, and the average area was 11.7 cm × 17.3 cm. All donor-site incisions are sutured in one stage without skin grafting. The follow-up time was from 4 to 20 months with an average of 8.3 months. The walking function of all operative feet, with good shape and without bloating, was basically restored. The contour and curve was similar to the healthy side and no skin injury and ulcer was observed. All patients were satisfied with wearing shoes and walking function, and no secondary surgery was required. However, 9 patients had developed hypertrophic scar.Conclusions:Compared with the traditional flap, the free latissimus dorsi muscle flap combined with skin grafting can effectively cover large area of soft tissue defect on the dorsal foot, without bloated flap appearance and secondary surgery. However, the risk of scar hyperplasia after combined transplantation increased.

Objective:To compare the efficacy and safety of subcutaneous endoscope assisted suction-curettage shaver and small-incision scissor in the treatment of axillary osmidrosis.Methods:A total of 71 cases (142 sides) of patients with osmidrosis were treated. Among them, 38 cases (76 sides) were treated with subcutaneous endoscope assisted suction-curettage shaver for the resection of apocrine sweat glands, and 33 cases (66 sides) were treated with small-incision scissor. The postoperative recovery was evaluated by Tung grading. The postoperative complications, efficacy, operative time and satisfaction rate were also included in the comparison evaluation.Results:The effective rate of the subcutaneous endoscope assisted suction-curettage shaver group was 100% (75/75), which was significantly higher than that of the small-incision scissor group (89.39%, 59/66), with a statistically significant difference ( χ2=8.479, P=0.004). Complications in subcutaneous endoscope assisted suction-curettage shaver group(3.95%, 3/76) were significantly lower than that in small-incision scissor(25.76%, 17/66), χ2=39.699, P<0.001. The operative time of the endoscope group [(58.212±4.897) min] was slightly longer than that of small-incision scissor group [(54.079±6.096) min]. But the dressing time, stitches removal time and rehabilitation exercise time were significantly shorter than those of the small-incision scissor group, with statistically significant differences ( P<0.05). The satisfaction rate of subcutaneous endoscope assisted suction-curettage shaver group(97.37%, 74/76) was significantly higher than that of the small-incision scissor group(74.24%, 49/66), χ2=33.102, P<0.001. Conclusions:Subcutaneous endoscope assisted suction-curettage shaver has more significant efficacy, less postoperative complications, faster recovery and higher satisfaction than small-incision scissor in the treatment of axillary osmidrosis.