With the wide application of deep learning technology in disease diagnosis, especially the outstanding performance of convolutional neural network (CNN) in computer vision and image processing, more and more studies have proposed to use this algorithm to achieve the classification of Alzheimer's disease (AD), mild cognitive impairment (MCI) and normal cognition (CN). This article systematically reviews the application progress of several classic convolutional neural network models in brain image analysis and diagnosis at different stages of Alzheimer's disease, and discusses the existing problems and gives the possible development directions in order to provide some references.
Alzheimer Disease/diagnostic imaging* ; Cognitive Dysfunction/diagnosis* ; Humans ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging ; Neural Networks, Computer

Objective:To improve the understanding of adult primary hemophagocytic syndrome (HPS) with aggressive natural killer cell leukemia (ANKL).Methods:The clinicopathological data of one adult patient with suspected primary HPS complicated with ANKL in Huiqiao Medical Center, Nanfang Hospital of Southern Medical University in October 2017 were retrospectively analyzed, and literatures were reviewed.Results:A 21-year-old male patient presented with persistent fever, hemocytopenia, splenomegaly, low fibrinogen, a significant increase in ferritin, hemophagocytes in bone marrow, decreased natural killer (NK) cell activity, and increased soluble CD25. Flow cytometry detection showed that the expression of NK cells was abnormal, and there were familial lysosomal trafficking regulator (LYST) and UNC13D gene defects. He was suspected of primary HPS complicated with ANKL. The patient was given 4 courses of EPOCH+PEG-Asp (etoposide, dexamethasone, vindesine, cyclophosphamide, doxorubicin hydrochloride liposome, pegaspargase) regimen chemotherapy, 20 mg of citalopidine twice a week maintenance therapy and matched unrelated hematopoietic stem cell transplantation. After 35 months of follow-up, he got sustained remission.Conclusions:Even if there are secondary causes of adult HPS, it is necessary to screen out related genes to avoid misdiagnosis. HPS patients with ANKL progress rapidly, and the early mortality is high. EPOCH+ PEG-Asp regimen induction therapy and allogeneic hematopoietic stem cell transplantation should be used as early as possible after diagnosis.

Objective To explore the efficacy and safety of apatinib combined with S-1 in patients with advanced NSCLC without sensitive gene mutation or unknown mutation status.Methods One hundred and four patients with advanced NSCLC without sensitive gene mutation or unknown mutation status were selected from the oncology department of the First Hospital of Qinhuangdao City,Hebei Province from April 2015 to April 2017.All patients refused intravenous chemotherapy.One hundred and four patients were randomly divided into treatment group (apatinib combined with S-1 group) and control group (S-1 alone group) by 1:1 digital method.However,two patients in the treatment group transferred to the control group for personal reasons.There is 50 cases in apatinib combined with S-1 group and 54 cases in S-1 group.The efficacy and adverse reactions of the two groups were evaluated.Results The objective remission rate was 48.0％ (24/50) and 27.8％ (15/54) (x2=4.530,P =0.033),the disease control rate was 82.0％ (41/50) and 74.1％ (40/54) (x2=0.947,P=0.331),the median PFS was 6.6 months and 3.4 months (t=25.555,P =0.000),the median OS was 16.0 months and 10.5 months (t =59.439,P =0.000),respectively.The overall incidence of adverse reactions was 82.0％ (41/50) and 70.4％ (38/54) respectively (x2 =1.923,P=0.166),of which 18.0％ (9/50) and 13.0％ (7/54) were more than grade 3 respectively (x2 =0.506,P =0.477).There was no death caused by treatment-related adverse reactions in both groups.Conclusion Appatinib combined with S-1 capsule has good short-term and long-term efficacy in the treatment of advanced non-small cell lung cancer without gene mutation or unknown mutation.The adverse reactions are tolerable and can be used as first-line treatment for patients unwilling to receive intravenous chemotherapy.

Both immunosuppressants and antibiotics (ABX) are indispensable for transplant patients. However, the former increases the risk of new-onset diabetes, whereas the latter impacts intestinal microbiota (IM). It is still unclear whether and how the interaction between immunosuppressants and ABX alters the IM and thus leads to glucose metabolism disorders. This study examined the alterations of glucose and lipid metabolism and IM in mice exposed to tacrolimus (TAC) with or without ABX. We found that ABX further aggravated TAC-induced glucose tolerance and increased insulin secretion. Combined treatment resulted in exacerbated lipid accumulation in the liver. TAC-altered microbial community was further amplified by ABX administration, as characterized by reductions in phylum Firmicutes, family Lachnospiraceae, and genus Coprococcus. Analyses based on the metagenomic profiles revealed that ABX augmented the effect of TAC on microbial metabolic function mostly related to lipid metabolism. The altered components of gut microbiome and predicted microbial functional profiles showed significant correlation with hepatic lipid accumulation and glucose disorders. In conclusion, ABX aggravated the effect of TAC on the microbiome and its metabolic capacities, which might contribute to hepatic lipid accumulation and glucose disorders. These findings suggest that the ABX-altered microbiome can amplify the diabetogenic effect of TAC and could be a novel therapeutic target for patients.

Objective To investigate the risk factors of early rebleeding after endoscopic treatment of esophageal varices. Methods A retrospective analysis was performed on the clinical data of 384 cirrhotic patients with esophageal varices. The factors of early rebleeding group[n=36(9.4%)]and non?bleeding group(n=348)were compared by single factor analysis and multivariate analysis of Logistic regression. Results Single factor analysis showed that there were differences between the two groups in cirrhosis with hepatocellular carcinoma, Child?Pugh classification, Child?Pugh score, ascites volume, portal vein thrombosis, portal vein width, portal hypertensive gastropathy, shapes and numbers of varicose veins, numbers of varicose vein ligation, varicose vein red syndrome, albumin, total bilirubin, prothrombin time, prothrombin activity and platelet number. Further multivariate analysis showed that mass ascites(P=0.000, OR=7.614,95%CI: 3.590?16.147), portal vein thrombosis(P=0.003, OR=2.867, 95%CI: 1.429?5.750),portal hypertensive gastropathy(P=0.000, OR=6.212, 95%CI: 3.036?12.711), and Child?Pugh C(P=0.008,OR=3.078,95%CI:1.338?7.083)were independent risk factors of early rebleeding after endoscopic treatment. Conclusion The early rebleeding rate was high after endoscopic treatment of esophageal varices. Patients with massive ascites,portal vein thrombosis,portal hypertensive gastropathy and Child?Pugh C should be highly vigilant for early rebleeding.

Objective To study the safety of transfusion of itraconazole through PICC and to evaluate the effect of different amount of blood transfusion before and after the infusion. Methods Patients were recruited from January 1, 2014, until December 31, 2015, in the Hematology hematopoietic stem cell transplantation ward. Thiry-two patients were recruited in the control group. Ninety patients wererecruited in the experience group. They were randomly assigned to three groups with 30 cases each, extracting different amounts of itraconazole before infusion, back phlebotomize in group A, B, C respectively was 10.0, 0.5, 1.0 ml. Comparing the phlebitis and obstruction after ten days from the transfusion day on. Results Catheter obstruction was not observed in any case. There was a significant difference between control group (21.9%,7/32) and observation group (0) regarding the incidence of phlebitis (χ2=21.157,P < 0.05). No statistical difference was noted among the observation groups regarding the incidence of phlebitis (P>0.05). Conclusions Drawing a small amount of blood volume before itraconazole injection through PICC can effectively avoid the drug-induced catheterobstruction. What′s more, transfusion through PICC can significantly reduce the incidence of phlebitis compared with peripheral infusion.

We investigated the carrying status of the virulence genes of Salmonella from different sources in Shijiazhuang City,China,to provide the basic data for the further risk assessment of Salmonella.A total of 186 isolates of Salmonella from different sources were collected and identified serotypes in the area of Shijiazhuang from 2011 to 2016.PCR was performed for eight virulence genes (invA,sopE,agfA,spvR,hilA,stn,pefA,shdA).These Salmonella bacteria were detected in 13 kinds of serotypes.Enteritidis is a significant advantage of the group.The above 8 virulence genes were analyzed,and the virulence genes hilA,stn and invA were the most frequently carried,their respective carrying rate were 90.3％ (168/186),86.6％ (161/186) and 82.8％ (154/186) respectively.We found the virulence genes of Salmonella from different sources were different.It is necessary to take measures to strengthen the food hygiene supervision and prevention and control of the storage and sale of raw poultry stalls in the morning market in Shijiazhuang area.

Objective To investigate the differences and characteristics of virulence genes carried by Salmonella enteritidis from different sources in Shijiazhuang City.Methods One hundred and twenty-four strains of Salmonella enteritidis isolated from morning markets of raw and poultry stalls,slaughterhouses and food poisoning specimens in Shijiazhuang area were collected.Eight virulence genes (invA,sopE,agfA,spvR,hilA,stn,pefA,shdA) were detected by polymerase chain reaction (PCR).Results Salmonella enteritidis might have different virulence gene profiles.The above eight virulence genes were detected in different strains.The carrying rate of virulence genes invA,sopE,stn,hilA,spvR and pefA in the food poisoning strains was higher than 94％.There was no difference in the carrying rate of 8 virulence gene between the morning raw poultry stalls isolates and the patient strains,but was different with the slaughterhouse strains.Conclusion There were more risks of food poisoning caused by Salmonella enteritidis from morning markets,and the hygiene supervision should be strengthened to prevent and control foodborne disease.

Objective To investigate the effect of miR-27a mimic and inhibitor on proliferation and apoptosis in melanoma cell line WM239. Methods The miR-27a mimic,inhibitor and its negative control were transfected into WM239 cells. The transfection efficiency was evaluated by fluorescence microscope. The expres-sion of miR-27a was detected by real-time fluorescent quantitative PCR. The proliferation of cells was detected by MTT. The cell apoptosis and cell cycle were analyzed by flow cytometry. Results The transfection efficiency in WM239 cells was 80% to 90%. The expression of miR-27a was markedly up-regulated in miR-27a mimic group (2-△△CT value is 26. 98 ± 0. 01),with statistically significant difference(t= -1 123. 67,P=0. 00);and the miR-27a inhibitor group showed lower expression of miR-27a(2-△△CT value is 0. 96 ± 0. 02),there was no statisti-cally significant difference compared with normal control group(t=0. 04,P=0. 06). The proliferation of cells was obviously inhibited in miR-27a mimic group,and there was statistically significant difference compared with normal control group[absorbance of 72 h(0. 45 ± 0. 02)∶(0. 72 ± 0. 01),F=129. 56,P﹤0. 05]. The percent-age of WM239 cells in G0-G1 phase was increased[(74. 83 ± 1. 46)∶(63. 73 ± 1. 25),F=30. 33,P﹤0. 05], and the percentage of WM239 cells in S phase and G2-M phase were decreased[(21. 33 ± 1. 75)∶(27. 50 ± 1. 25),F=14. 98,P﹤0. 05;(3. 90 ± 1. 31)∶(8. 80 ± 2. 10),F=3. 66,P﹤0. 05]. The apoptosis rate of cells was significantly increased in miR-27a mimic group compared with normal group[(29. 67 ± 0. 91)%∶(1. 44 ± 0. 85)%,F=530. 90,P﹤0. 01],but the inhibitor group had no obvious effect on cell cycle and cell apoptosis. Conclusion MiR-27a can suppress melanoma cell proliferation and act as a tumor suppressor gene,which is rel-evant to induce cell apoptosis and block cell cycle in G0-G1 phase.

Objective To evaluate the value of diffusion weighted imaging (DWI)in distinguishing the solid solitary pulmonary nodule (SPN).Methods 42 patients with SPN (malignant in 25 and benign in 1 7)who were confirmed by operation,biopsy or follow up after treatment underwent routine chest T1 WI,T2 WI and DWI.The b values were chosen as 300,500,800 and 1 000 s/mm2 ,and the corresponding apparent diffusion coefficient (ADC)values and the signal intensity (SI)were respectively measured.Results The ADC values and SI of benign and malignant SPNs were gradually reduced with increasing b value.The ADC value between benign and malignant SPNs was statistically significant with b value of 500 s/mm2 (P 500 =0.03 <0.05 ),meanwhile the SI was statistically significant with b values from 300 to 1000 s/mm2 (P 300 <0.001,P 500 =0.03 <0.05,P 800 =0.01 <0.05, P 1 000 =0.02<0.05).Conclusion Both SI and ADC value of DWI play important role in distinguishing benign and malignant SPNs, and the diagnostic efficiency of SI is superior to ADC value.