Objective To propose a lung artery segmentation method that integrates shape and position prior knowledge, aiming to solve the issues of inaccurate segmentation caused by the high similarity and small size differences between the lung arteries and surrounding tissues in CT images. Methods Based on the three-dimensional U-Net network architecture and relying on the PARSE 2022 database image data, shape and position prior knowledge was introduced to design feature extraction and fusion strategies to enhance the ability of lung artery segmentation. The data of the patients were divided into three groups: a training set, a validation set, and a test set. The performance metrics for evaluating the model included Dice Similarity Coefficient (DSC), sensitivity, accuracy, and Hausdorff distance (HD95). Results The study included lung artery imaging data from 203 patients, including 100 patients in the training set, 30 patients in the validation set, and 73 patients in the test set. Through the backbone network, a rough segmentation of the lung arteries was performed to obtain a complete vascular structure; the branch network integrating shape and position information was used to extract features of small pulmonary arteries, reducing interference from the pulmonary artery trunk and left and right pulmonary arteries. Experimental results showed that the segmentation model based on shape and position prior knowledge had a higher DSC (82.81%±3.20% vs. 80.47%±3.17% vs. 80.36%±3.43%), sensitivity (85.30%±8.04% vs. 80.95%±6.89% vs. 82.82%±7.29%), and accuracy (81.63%±7.53% vs. 81.19%±8.35% vs. 79.36%±8.98%) compared to traditional three-dimensional U-Net and V-Net methods. HD95 could reach (9.52±4.29) mm, which was 6.05 mm shorter than traditional methods, showing excellent performance in segmentation boundaries. Conclusion The lung artery segmentation method based on shape and position prior knowledge can achieve precise segmentation of lung artery vessels and has potential application value in tasks such as bronchoscopy or percutaneous puncture surgery navigation.

AIM: To explore the effect of lncRNA SNHG6 on injury of human retinal microvascular endothelial cells(hRMECs)induced by high glucose and its possible mechanism.METHODS: The D-glucose-induced hRMECs were used to establish normal glucose(NG)and high glucose(HG)cell injured model. In the HG group, the hRMECs were cultured in DMEM medium at a concentration of 25 mmol/L D-glucose for 24 h, while in the NC group, they were cultured in DMEM medium at a concentration of 5.5 mmol/L D-glucose; according to experimental design, si-NC, si-SNHG6, si-SNHG6 and anti-miR-NC and si-SNHG6 and anti-miR-186-5p were transfected into hRMECs, and then incubated at a concentration of 25 mmol/L D-glucose for 24 h, with HG+si-NC group, HG+si-SNHG6 group, HG+si-SNHG6+anti-miR-NC group and HG+si-SNHG6+anti-miR-186-5p group marked, respectively. The quantitative real-time polymerase chain reaction(qRT-PCR)was used to detect the expression of lncRNA SNHG6 and miR-186-5p; dual-luciferase reporter assay was used to detect the targeting relationship; MTT assay and flow cytometry were used to detect the cell proliferation and apoptosis, respectively; enzyme linked immunosorbent assay(ELISA)was used to detect the levels of IL-1β, TNF-α, IL-8, IL-10; testing kits were used to detect activity of SOD and level of MDA; the Western blot was used to detect the protein expression of cleaved-caspase3, Bax and Bcl-2.RESULTS: The lncRNA SNHG6 expression increased in the HG group, while miR-186-5p expression decreased(both P<0.05). There was target binding of lncRNA SNHG6 with miR-186-5p. After the transfection of si-SNHG6, cell inhibition rate, apoptosis rate, cleaved-caspase3, Bax protein levels, IL-1β, TNF-α, IL-8 contents, and MDA activity were decreased(P<0.05), while Bcl-2 protein, IL-10 contents, and SOD activity were increased(P<0.05). Co-transfection of si-SNHG6 and anti-miR-186-5p increased cell proliferation inhibition rate, apoptosis rate, cleaved-caspase3, Bax, IL-1β, TNF-α, IL-8, and MDA(P<0.05), but decreased Bcl-2, IL-10 and SOD(P<0.05).CONCLUSION: Interfering with lncRNA SNHG6 could inhibit cell apoptosis, inflammation and oxidative stress of high-glucose- induced hRMECs by elevating the expression of miR-186-5p.

A semi-supervised learning method based on multi-scale consistency and regional reliability perception is proposed to combine unlabeled data with a small amount of labeled data to achieve high-performance lung tumor segmentation tasks.A multi-scale consistency mean teacher framework is used to construct a multi-scale consistency loss and constrain the outputs in the mean teacher network to be consistent across multiple scales,so that the model learns richer consistency knowledge.In addition,a regional reliability perception scheme is adopted to make the knowledge exchange between consistency learning more efficient,enabling the model to learn more valid and reliable knowledge from unlabeled data.The evaluation on the lung tumor dataset in the Medical Segmentation Decathlon shows superior performance of the proposed method over current state-of-the-art semi-supervised learning methods,validating its effectiveness.

Objective:To investigate the impact of relative locations of multiple foci and microsatellite status of sporadic, synchronous, multiple, primary, colorectal carcinomas on clinicopathological features and prognosis.Methods:The clinicopathologic and prognostic data of 278 patients with sporadic, synchronous, multiple, primary, colorectal carcinomas who had been admitted to the Department of Colorectal Surgery at Zhejiang Cancer Hospital from January 2008 to July 2022 were retrospectively collected. The patients were categorized into three groups based on the relative locations of their multiple cancer foci: (1) a right-sided group that comprised patients with multiple cancer foci in the cecum, ascending colon, hepatic flexure of the colon, and transverse colon; (2) a left-sided group that comprised patients with multiple cancer foci in the splenic flexure of the colon, descending colon, sigmoid colon, and rectum; and (3) a left- and right-sided group that comprised patients with multiple cancer foci in the right half of the colon and left half of the colon/rectum. Additionally, the patients were further divided into two groups based on microsatellite status: a high microsatellite instability (MSI-H) and a low MSI/stable MSI (MSI/L&MSS) group. We compared differences in clinical characteristics and prognostic indicators between these groups. The χ 2 test was utilized to compare selected clinical characteristics, whereas Kaplan-Meier survival analyses and log-rank tests were performed to compare their effects on prognosis. Result:Among 278 patients with SSCRC, 256 (92.1%) presented with two cancer foci and 22 (7.9%) with more than two foci. Additionally, 255 patients (91.7%) had adenocarcinomas, whereas the remaining 23 (8.3%) had mucinous adenocarcinomas. Lymph node metastases were identified in 136 patients (48.9%); the cancer foci had infiltrated beyond the muscular layer in 238 (85.6%); and 147 patients (52.9%) were diagnosed with TNM Stage III–IV disease. There were 155 patients (55.8%) in the left-sided group, 55 (19.8%) in the right-sided group, and 68 (24.5%) in the left- and right-sided group. Immunohistochemical examination of all four mismatch repair proteins were performed in 199 cases, revealing that 166 of these patients had MSI/L&MSS and 33 MSI-H disease. In the left-sided, left- and right-sided, and right-sided groups, the proportion of women was 16.8% (26/155), 26.5% (18/68), and 49.1% (27/55), respectively; these differences are statistically significant (χ 2=22.335, P<0.001). The proportions of patients with more than three cancer foci were 5.2% (8/155), 16.2% (11/68), and 5.5% (3/55), respectively; these differences are statistically significant (χ 2=8.438, P=0.015). The proportions of mucinous adenocarcinomas were 4.5% (7/155), 8.8% (6/68), and 18.2% (10/55), respectively; these differences are statistically significant (χ 2=10.026, P=0.007). The proportions of patients with lymph node metastases were 55.5% (86/155), 48.5% (33/68), and 30.9% (17/55); these differences are statistically significant (χ 2=9.817, P=0.007). The proportions of patients with Stage T3 & T4 disease in each group according to location were 81.3% (126/155), 88.2% (60/68), and 94.5% (52/55), respectively; these differences are statistically significant (χ 2=6.293, P=0.043). The proportions of TNM Stage III–IV tumors were 59.4% (92/155), 54.4% (37/68), and 32.7% (18/55), respectively; these differences are statistically significant (χ 2=11.637, P=0.003). Age, size of cancer foci, presence of distant metastasis, adenoma, nerve invasion, and vascular invasion did not differ significantly between the three groups (all P>0.05). Compared with those with MSI-H, patients with MSI/L&MSS disease were more likely to be aged >65 years and male (50.6% [84/166] vs. 15.2% [5/33], χ 2=13.994, P<0.001; 80.7% [134/166] vs. 54.5% [18/33], χ 2=10.457, P=0.001), more likely to be in the left-sided group (63.3% [105/166] vs. 24.2% [8/33], χ 2=18.232, P<0.001), had a higher proportion of cancer foci of diameter <4 cm (54.8% [91/166] vs. 33.3% [11/33], χ 2=5.086, P=0.024), and a lower proportion of mucinous adenocarcinomas (4.2% [7/166] vs. 27.3% [9/33], χ 2=19.791, P<0.001), more likely to develop distant metastases (22.3% [37/166] vs. 6.1% [2/33], χ 2=4.601, P=0.032), more likely to have lymph node metastases (57.2% [95/166) vs. 24.2% [8/33], χ 2=11.996, P<0.001) and nerve invasion (28.9% [48/166] vs. 6.1% [2/33], χ 2=7.643, P=0.006), had a higher proportion of TNM Stage III–IV disease (60.2% [100/166] vs. 24.2% [8/33], χ 2=14.374, P<0.001), and a smaller proportion of family history of tumors (28.9% [48/166] vs. 60.6% [20/33], χ 2=12.228, P<0.001). All the above-listed differences are statistically significant (all P<0.05). The differences in number of cancer foci, depth of infiltration, presence or absence of adenomas, and vascular invasion were not statistically significant (all P>0.05). In the 33 patients with MSI-H status and mismatch repair protein loss, the highest frequency of deletion was found in PMS-2 (66.7%, 22/33), followed by MLH-1 (57.6%, 19/33), whereas the proportions of MSH-2 (33.3%, 11/33) and MSH-6 (24.2%, 8/33) deletions were relatively low. There were statistically significant differences in the 3-year overall survival rates among the groups according to relative locations of cancer foci. The 3-year overall survival rates were 96.8%, 79.6%, and 88.5% in the right-sided, left- and right-sided, and left-sided groups, respectively ( P=0.021). As to microsatellite status, the 3-year overall survival rate of patients with MSI-H disease was 93.8%, which is significantly better than the 78.4% for those with MSI/L & MSS ( P=0.026). Conclusions:Among sporadic, synchronous, multiple, primary, colorectal carcinomas, those with right-sided disease had the deepest local infiltration, whereas those with left-sided disease had the greatest number of lymph node metastases, most advanced clinical TNM stage, lowest percentage of MSI-H disease, and the poorest prognosis.

Objective:To investigate the impact of relative locations of multiple foci and microsatellite status of sporadic, synchronous, multiple, primary, colorectal carcinomas on clinicopathological features and prognosis.Methods:The clinicopathologic and prognostic data of 278 patients with sporadic, synchronous, multiple, primary, colorectal carcinomas who had been admitted to the Department of Colorectal Surgery at Zhejiang Cancer Hospital from January 2008 to July 2022 were retrospectively collected. The patients were categorized into three groups based on the relative locations of their multiple cancer foci: (1) a right-sided group that comprised patients with multiple cancer foci in the cecum, ascending colon, hepatic flexure of the colon, and transverse colon; (2) a left-sided group that comprised patients with multiple cancer foci in the splenic flexure of the colon, descending colon, sigmoid colon, and rectum; and (3) a left- and right-sided group that comprised patients with multiple cancer foci in the right half of the colon and left half of the colon/rectum. Additionally, the patients were further divided into two groups based on microsatellite status: a high microsatellite instability (MSI-H) and a low MSI/stable MSI (MSI/L&MSS) group. We compared differences in clinical characteristics and prognostic indicators between these groups. The χ 2 test was utilized to compare selected clinical characteristics, whereas Kaplan-Meier survival analyses and log-rank tests were performed to compare their effects on prognosis. Result:Among 278 patients with SSCRC, 256 (92.1%) presented with two cancer foci and 22 (7.9%) with more than two foci. Additionally, 255 patients (91.7%) had adenocarcinomas, whereas the remaining 23 (8.3%) had mucinous adenocarcinomas. Lymph node metastases were identified in 136 patients (48.9%); the cancer foci had infiltrated beyond the muscular layer in 238 (85.6%); and 147 patients (52.9%) were diagnosed with TNM Stage III–IV disease. There were 155 patients (55.8%) in the left-sided group, 55 (19.8%) in the right-sided group, and 68 (24.5%) in the left- and right-sided group. Immunohistochemical examination of all four mismatch repair proteins were performed in 199 cases, revealing that 166 of these patients had MSI/L&MSS and 33 MSI-H disease. In the left-sided, left- and right-sided, and right-sided groups, the proportion of women was 16.8% (26/155), 26.5% (18/68), and 49.1% (27/55), respectively; these differences are statistically significant (χ 2=22.335, P<0.001). The proportions of patients with more than three cancer foci were 5.2% (8/155), 16.2% (11/68), and 5.5% (3/55), respectively; these differences are statistically significant (χ 2=8.438, P=0.015). The proportions of mucinous adenocarcinomas were 4.5% (7/155), 8.8% (6/68), and 18.2% (10/55), respectively; these differences are statistically significant (χ 2=10.026, P=0.007). The proportions of patients with lymph node metastases were 55.5% (86/155), 48.5% (33/68), and 30.9% (17/55); these differences are statistically significant (χ 2=9.817, P=0.007). The proportions of patients with Stage T3 & T4 disease in each group according to location were 81.3% (126/155), 88.2% (60/68), and 94.5% (52/55), respectively; these differences are statistically significant (χ 2=6.293, P=0.043). The proportions of TNM Stage III–IV tumors were 59.4% (92/155), 54.4% (37/68), and 32.7% (18/55), respectively; these differences are statistically significant (χ 2=11.637, P=0.003). Age, size of cancer foci, presence of distant metastasis, adenoma, nerve invasion, and vascular invasion did not differ significantly between the three groups (all P>0.05). Compared with those with MSI-H, patients with MSI/L&MSS disease were more likely to be aged >65 years and male (50.6% [84/166] vs. 15.2% [5/33], χ 2=13.994, P<0.001; 80.7% [134/166] vs. 54.5% [18/33], χ 2=10.457, P=0.001), more likely to be in the left-sided group (63.3% [105/166] vs. 24.2% [8/33], χ 2=18.232, P<0.001), had a higher proportion of cancer foci of diameter <4 cm (54.8% [91/166] vs. 33.3% [11/33], χ 2=5.086, P=0.024), and a lower proportion of mucinous adenocarcinomas (4.2% [7/166] vs. 27.3% [9/33], χ 2=19.791, P<0.001), more likely to develop distant metastases (22.3% [37/166] vs. 6.1% [2/33], χ 2=4.601, P=0.032), more likely to have lymph node metastases (57.2% [95/166) vs. 24.2% [8/33], χ 2=11.996, P<0.001) and nerve invasion (28.9% [48/166] vs. 6.1% [2/33], χ 2=7.643, P=0.006), had a higher proportion of TNM Stage III–IV disease (60.2% [100/166] vs. 24.2% [8/33], χ 2=14.374, P<0.001), and a smaller proportion of family history of tumors (28.9% [48/166] vs. 60.6% [20/33], χ 2=12.228, P<0.001). All the above-listed differences are statistically significant (all P<0.05). The differences in number of cancer foci, depth of infiltration, presence or absence of adenomas, and vascular invasion were not statistically significant (all P>0.05). In the 33 patients with MSI-H status and mismatch repair protein loss, the highest frequency of deletion was found in PMS-2 (66.7%, 22/33), followed by MLH-1 (57.6%, 19/33), whereas the proportions of MSH-2 (33.3%, 11/33) and MSH-6 (24.2%, 8/33) deletions were relatively low. There were statistically significant differences in the 3-year overall survival rates among the groups according to relative locations of cancer foci. The 3-year overall survival rates were 96.8%, 79.6%, and 88.5% in the right-sided, left- and right-sided, and left-sided groups, respectively ( P=0.021). As to microsatellite status, the 3-year overall survival rate of patients with MSI-H disease was 93.8%, which is significantly better than the 78.4% for those with MSI/L & MSS ( P=0.026). Conclusions:Among sporadic, synchronous, multiple, primary, colorectal carcinomas, those with right-sided disease had the deepest local infiltration, whereas those with left-sided disease had the greatest number of lymph node metastases, most advanced clinical TNM stage, lowest percentage of MSI-H disease, and the poorest prognosis.

Recent advancement in natural language processing (NLP) and medical imaging empowers the wide applicability of deep learning models. These developments have increased not only data understanding, but also knowledge of state-of-the-art architectures and their real-world potentials. Medical imaging researchers have recognized the limitations of only targeting images, as well as the importance of integrating multimodal inputs into medical image analysis. The lack of comprehensive surveys of the current literature, however, impedes the progress of this domain. Existing research perspectives, as well as the architectures, tasks, datasets, and performance measures examined in the present literature, are reviewed in this work, and we also provide a brief description of possible future directions in the field, aiming to provide researchers and healthcare professionals with a detailed summary of existing academic research and to provide rational insights to facilitate future research.
Humans ; Natural Language Processing ; Surveys and Questionnaires

The lateral hypothalamic area (LHA) plays a pivotal role in regulating consciousness transition, in which orexinergic neurons, GABAergic neurons, and melanin-concentrating hormone neurons are involved. Glutamatergic neurons have a large population in the LHA, but their anesthesia-related effect has not been explored. Here, we found that genetic ablation of LHA glutamatergic neurons shortened the induction time and prolonged the recovery time of isoflurane anesthesia in mice. In contrast, chemogenetic activation of LHA glutamatergic neurons increased the time to anesthesia and decreased the time to recovery. Optogenetic activation of LHA glutamatergic neurons during the maintenance of anesthesia reduced the burst suppression pattern of the electroencephalogram (EEG) and shifted EEG features to an arousal pattern. Photostimulation of LHA glutamatergic projections to the lateral habenula (LHb) also facilitated the emergence from anesthesia and the transition of anesthesia depth to a lighter level. Collectively, LHA glutamatergic neurons and their projections to the LHb regulate anesthetic potency and EEG features.

Objective:To investigate the efficacy and safety of neuroendoscopy in the treatment of non-acute traumatic intracranial hematoma.Methods:Thirty-six patients with non-acute traumatic intracranial hematoma, admitted to our hospital from June 2018 to December 2019, were chosen in our study. These patients accepted small-bone window craniotomy and straight incision, or removal of intracranial hematoma by neuroendoscopy. The clinical data of these patients were retrospectively analyzed. Pain numerical rating scale (NRS) was used to assess degrees of pain in 22 patients with headache one d before surgery and three d after surgery. The neurological functions after treatment were evaluated by activity of daily living (ADL) evaluation criteria one d before surgery and 7 d after surgery.Results:All 36 patients were cured and discharged from hospital, and no death was noted; length of hospital stays was (6.7±1.1) d. No secondary hemorrhage re-craniotomy was needed, no postoperative complications such as cerebrospinal fluid leakage were noted, and no re-injection of urokinase was needed to melt the hematoma. As compared with the preoperative NSR scores (7.82±1.097), the postoperative NSR scores of 22 headache patients were significantly decreased (1.05±0.653, P<0.05). In these 36 patients, preoperative ADL level I was noted in 8 patients, level II in 14 patients, level III in 12 patients, and level IV in 2 patients. Postoperative nerve function in 30 patients were fully recovered, with ADL level I; and 6 patients had mild symptom of dizziness, with ADL level II. Conclusion:Non-acute traumatic intracranial hematoma treated by neuroendoscopy enjoys good curative effect, less surgical trauma, short hospital stays and high safety.

Objective To study the detection of Na+/H+exchanger regulatory factor 3(NHERF3) protein expression in renal carcinoma and its correlation with malignant biological behavior. Methods Renal clear cell carcinoma and their adjacent tissues of forty- eight patients were collected. Immunohistochemical method was used to detect the positive expression of NHERF3 protein,and specific expression was detected by Western-blot.Patients were further divided into high NHERF3 group and low NHERF3 group according to median expression of NHERF3 protein,and each group had 24 cases.The expressions of proliferation,invasion and autophagy genes in tumor tissues were detected by fluorescent quantitative PCR.Results The positive rate of NHERF3 protein and the expression of NHERF3 protein in renal carcinoma tissue was significantly lower than that in paracancerous tissue(P<0.05).Expressions of proliferation genes such as k-Ras,c-Myc,TRPC1 mRNA in low NHERF3 group were higher than those in high NHERF3 group:141.74 ± 18.95 vs. 100.00 ± 0.00, 135.88 ± 16.32 vs. 100.00 ± 0.00, 137.21 ± 16.98 vs.100.00 ± 0.00;MIIP,FOXO1 mRNA levels were lower than those in high NHERF3 group: 43.19 ± 5.88 vs. 100.00 ± 0.00, 38.76 ± 4.51 vs. 100.00 ± 0.00; expressions of invasion genes such as CD74, Fascin, MACC1, TRPM8 mRNA were significantly higher than those in high NHERF3 group:152.18 ± 17.64 vs. 100.00 ± 0.00, 146.29 ± 17.63 vs. 100.00 ± 0.00, 139.76 ± 15.82 vs. 100.00 ± 0.00,150.47 ± 17.95 vs.100.00 ± 0.00;expressions of autophagy genes such as Beclin-1,LC3 mRNA were significantly lower than those in high NHERF3 group: 63.21 ± 7.09 vs. 100.00 ± 0.00, 56.28 ± 7.15 vs. 100.00 ± 0.00; EZH2 mRNA level was higher than that in high NHERF3 group:159.47 ± 17.82 vs.100.00 ± 0.00,and there were significant differences(P<0.05).Conclusions The positive rate of NHERF3 protein expression and the amount of protein expression in renal carcinoma tissue is increased, and the specific expression is closely related to tumor proliferation, invasion and activity of autophagy.

Aim To investigate the effect of Ginsen-oside Rh2 on apoptosis in human colorectal cancer cell SW480,and to explore the possible mechanism of it. Methods The proliferation activity of SW480 treated with Ginsenoside Rh2 was measured CCK-8 assay.Ap-optosis rates were evaluated by FCM.Hoechst 33258 staining was used to observe cell nucleus morphologi-cal;change SW480 cells were treated with Ginsenoside Rh2,and the protein expressions of Bcl-2,Bax,p53, cleaved caspase-3 ,PI3 K,AKT,P-AKT,GSK-3β,P-GSK-3βwere detected by Western blot;SW480 cells were treated with LY294002,Rh2,LY294002+Rh2, the expressions of PI3 K,AKT,P-AKT,GSK-3β,P-GSK-3βwere detected by Western blot.Results The proliferation of SW480 cells was significantly inhibited by Ginsenoside Rh2 in dose-dependent and time-de-pendent manner.FCM showed the inducing apoptosis effect of Ginsenoside Rh2 was significantly different from that of control group.Hoechst 33258 staining in-dicated clearly cell apoptosis in Ginsenoside Rh2 treat-ment groups.Western blot showed Ginsenoside Rh2 decreased expression of Bcl-2,increased expression of Bax,p53 and cleaved caspase-3,PI3K/AKT/GSK-3βpathway proteins PI3 K,P-AKT,P-GSK-3βdecreased obviously,AKT and GSK-3βwere not changed signifi-cantly in SW480.SW480 cells were separately treated with LY294002,Rh2,LY294002 +Rh2,there were no significant difference in AKT and GSK-3βprotein a-mong all groups,and the expression of PI3 K,P-AKT, P-GSK-3βdecreased more obviously in LY294002 +Rh2 group compared with LY294002 and Rh2 alone. Conclusion Rh2 induces colorectal cancer cell apop-tosis through PI3 K/AKT/GSK-3βpathway,which ac-tivates p53 and cleaved caspase-3,and destroys the balance of Bcl-2/Bax.