Artificial intelligence-assisted blood cell morphology examination of blood cells is very promising in clinical applications. Because it can significantly improve work efficiency, reduce the burden of manpower, avoid subjectivism, and facilitate standardization. The main difficulties lie in several key technical links, such as image acquisition, image segmentation, cell identification, and classification, etc. In recent years, both hardware devices and software algorithms have made rapid progress, which has led to the important development of artificial intelligence auxiliary systems from digital image acquisition, white blood cell segmentation, cell feature extraction, and classification. Compared with the traditional machine learning, the application of deep learning technology in the morphological identification of blood cells is particularly worthy of attention. In addition, the continuous emergence of microscopic blood cell image databases also provides important support for the further development and improvement of various algorithms. Understanding the key technical progress of artificial intelligence-assisted blood cell morphology examination will help to promote its continuous development and better clinical application. In recent years, artificial intelligence technology has changed from "traditional machine learning" to "deep learning", which no longer relies on manual extraction of features, but on its ability to automatically extract data to achieve. Compared with the blood cell image database from foreign countries, the construction of domestic databases should be strengthened to minimize the gap between foreign databases.

Objective To compare the effectiveness of loop-mediated isothermal amplification (LAMP) assay and microscopic examinations for detection of Schistosoma japonicum infections in Oncomelania hupensis in transmission-interrupted regions, so as to provide insights into the optimization of snail surveillance tools in these regions. Methods Four hilly schistosomiasis-endemic villages where transmission interruption was achieved were selected in Heqing County of Yunnan Province as the study villages, including Xinzhuang and Gule villages in hilly regions and Lianyi and Yitou villages in dam regions. Snail survey was performed by means of systematic sampling combined with environmental sampling in July 2018. All captured snails were identified for S. japonicum infections using microscopy. In addition, 10 to 20 snails were randomly sampled from each snail habitat following microscopy, numbered according to environments and subjected to LAMP assay. The positive rate of settings with S. japonicum-infected snails was compared among villages. Results A total of 7 949 living snails were captured from 83 snail habitats in 4 villages, and no S. japonicum infection was detected in snails. There were 226 mixed samples containing 1 786 snails subjected to LAMP assay, and positive LAMP assay was found in 3 mixed samples from 3 snail habitats in 2 dam villages. The positive rates of settings with S. japonicum-infected snails were comparable between Lianyi Village (one setting) and Yitou Village (2 set tings) (5.89% vs. 14.29%, P = 0.344). However, the overall positive rate of settings with S. japonicum-infected snails was significantly higher in dam villages (9.67%, 3/31) than in hilly villages (0) (P = 0.048). Conclusions LAMP assay is more sensitive to detect S. japonicum infections in O. hupensis than conventional microcopy method, which may serve as a supplementary method for detection of S. japonicum infections in O. hupensis in high-risk snail habitats in hilly transmission-interrupted regions.

The obstruction of post-insulin receptor signaling is the main mechanism of insulin-resistant diabetes. Progestin and adipoQ receptor 3 (PAQR3), a key regulator of inflammation and metabolism, can negatively regulate the PI3K/AKT signaling pathway. Here, we report that gentiopicroside (GPS), the main bioactive secoiridoid glycoside of Gentiana manshurica Kitagawa, decreased lipid synthesis and increased glucose utilization in palmitic acid (PA) treated HepG2 cells. Additionally, GPS improved glycolipid metabolism in streptozotocin (STZ) treated high-fat diet (HFD)-induced diabetic mice. Our findings revealed that GPS promoted the activation of the PI3K/AKT axis by facilitating DNA-binding protein 2 (DDB2)-mediated PAQR3 ubiquitinated degradation. Moreover, results of surface plasmon resonance (SPR), microscale thermophoresis (MST) and thermal shift assay (TSA) indicated that GPS directly binds to PAQR3. Results of molecular docking and cellular thermal shift assay (CETSA) revealed that GPS directly bound to the amino acids of the PAQR3 NH₂-terminus including Leu40, Asp42, Glu69, Tyr125 and Ser129, and spatially inhibited the interaction between PAQR3 and the PI3K catalytic subunit (P110α) to restore the PI3K/AKT signaling pathway. In summary, our study identified GPS, which inhibits PAQR3 expression and directly targets PAQR3 to restore insulin signaling pathway, as a potential drug candidate for the treatment of diabetes.

Based on ASP.NET framework, The Intelligent Estimated System for Rational Deployment of Medical Equipment (MERDIS) is designed and developed with SQL Server 2012 database and C# language. The system is used to realize the rational deployment suggestions and evaluation of medical equipment in hospitals. The system input the data of hospital medical equipment and clinical pathway into the database, and then feedback the deployment information to users which are calculated by big data information, so as to achieve the purpose of giving rational deployment of hospital medical equipment.
Databases, Factual ; Equipment Design ; Hospitals

Objective:To investigate the clinical effect of remote injection device assisted percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures.Methods:Using retrospective research and analysis methods, 168 patients with osteoporotic vertebral compression fractures admitted to Heze Municipal Hospital from September 2019 to August 2020 were selected. A total of 139 cases were followed up, with a follow-up rate of 82.7%, including 22 males and 117 females, with an average age of 74.17 years. According to the different equipment used, they were divided into two groups. Seventy-two cases used remote injection device to assist percutaneous vertebroplasty (observation group), 67 cases used traditional puncture needle puncture percutaneous vertebroplasty (control group). All patients were completed follow-up at 3 months after surgery. The operation time, intraoperative blood loss, bone cement injection volume, bone cement leakage rate, VAS score and ODI score of 1 day, 1 month and 3 months after operation were observed. Measurement data were expressed as ( Mean± SD), using t test, counting data were expressed as percentage [ n(%)], using χ2 test. Results:Both groups of patients successfully completed the operation without complications such as paraplegia, pulmonary embolism, or infection. There was no statistically significant difference between the two groups in operation time of two groups[(47.71±6.05) min vs (47.61±5.66) min, t=0.100, P=0.920]. The intraoperative blood loss of the two groups was no statistically significant difference [(7.08±3.00) mL vs (8.06±3.48) mL, t=1.782, P=0.079]. The difference between two groups of the amount of bone cement injected was statistically significant, [(6.44±1.03) mL vs (5.73±1.41) mL, t=3.369, P=0.001]. The bone cement leakage rate of the observation group was 27.78% (19/72), and the control group was 43.28% (29/67), and there was statistically significant( χ2=4.382, P=0.036). The preoperative VAS score of the observation group was (6.75±1.14) , and the control group was (6.64±1.08), and there was no significant difference between two groups( t=0.583, P=0.561) The VAS scores of the observation group and the control group were (1.28±0.75) and (1.21±0.77) respectively at 1 day after surgery. There was no statistically significant difference between two groups( t=0.583, P=0.588). The VAS scores of the observation group and the control group were (0.89±0.76) and (1.09±0.67) respectively at 1 month after operation. There was no statistically significant difference between two groups( t=1.641, P=0.103). The VAS scores of the observation group and the control group were (0.74±0.63) and (0.87±0.74) respectively at 3 months after operation. There was no statistically significant difference between two groups( t=1.118, P=0.266). The preoperative ODI scores of the observation group and the control group were (60.32±7.46) and (61.96±9.76) respectively, and there was no statistically significant difference between two groups( t=1.121, P=0.264). The ODI scores of the observation group and the control group were (14.93±6.01) and (15.10±6.43) respectively at 1 day after operation, there was no statistically significant difference between two groups( t=0.161, P=0.872). The ODI scores of the observation group and the control group were (10.54±4.24) and (11.31±3.71) respectively at 1 month after operation, and there was no statistically significant difference between two groups( t=1.136, P=0.258). The ODI scores of the observation group and the control group were (10.64±3.70) and (10.39±3.74) respectively at 3 months after operation, and there was no statistically significant difference between two groups( t=0.396, P=0.693). Conclusion:Compared with traditional puncture needle puncture percutaneous vertebroplasty, the remote injection device assisted percutaneous vertebroplasty has a definite clinical effect in the treatment of osteoporotic vertebral compression fractures, and the bone cement leakage rate is low.

Objective To identify the preoperative MRI findings for predicting microvascular invasion (MVI) using texture analysis (TA) on multiple MRI sequences. Methods Two hundred and fifty patients with HCC pathologically confirmed by surgery in Zhongshan Hospital from October 2015 to October 2016 were analyzed retrospectively. All patients underwent conventional MRI plain scan and dynamic contrast?enhanced examination within 2 weeks before operation. According to the ratio of 1∶1, the patients were divided into a training set (125 cases) and a test set (125 cases).The training set was used to establish a classifier to predict MVI of HCCs via the TA, and the test set was used to evaluate the performance of the classifier. An image analysis was performed using an in?house software contained a set of 2 415 features which were generated from all conventional axial sequences, including the T2WI, DWI, ADC map, and dynamic enhancement images.. A four?fold cross validation (FFCV) and sequential forward floating feature selection strategy (SFFS) were employed to select an optimal subset of features and a linear discriminant analysis (LDA) was employed to establish a classifier. The clinical laboratory examination, morphologic characteristics and quantitative analysis of conventional MR were used to compare the performance of predicting MVI with the classifier. A Chi?squared test or Fisher exact probablities test were used for categorical variables, and independent t test or Mann?Whitney U test were used for used for continuous variables. Factors with a P value less than 0.05 at univariate analyses were entered into the multivariate model to identify independent predictors. The Hosmer?Lemeshow test was performed to explain the goodness of fit of the multivariate logistic model. A receiver operating characteristic curve analysis was performed to evaluate the diagnostic performance. Results The classifier set up by the training set consists of 13 texture features. When conventional MRI texture features of test set were used to judge whether there was MVI or not, the AUC of all texture features of arterial phase (AP) was the highest (0.506 3). Univariate regression analysis showed that there were significant differences in pathological grade (P=0.026), AFP level (P=0.033), lesion edge shape (P=0.038), AP enhancement (P=0.038), and AP peritumoral enhancement (P=0.008). Multivariate binary logistic regression analysis showed that peritumoral enhancement and texture classifier assessed MVI with P values of 0.005 and 0.001,which were independent risk factors for MVI. The significance level of Hosmer Lemeshow test was 0.796, indicating the goodness of fit of acceptable models. The AUCs of single variable, combined variable (including of AFP level, irregular tumor margin, enhancement intensity in AP and peritumoral enhancement in AP) and texture classifier for MVI were 0.588 to 0.627, 0.798 and 0.733, respectively. When compared the AUC of the combination features (including of AFP level, irregular tumor margin, enhancement intensity in AP and peritumoral enhancement in AP) with the classifier to identify MVI of HCC in the test set, no significant difference was found(P=0.108 6). However, although the sensitivity of them were same as 70.73%, the specificity of the combination features was mildly higher than that of classifier (82.14% vs. 78.57%). Conclusions Combination features of AFP level, tumor margin, enhancement intensity in AP and peritumoral enhancement in AP can be used to predict MVI of HCCs. It is a new method of noninvasive evaluation of MVI before operation. The performance of the classifier made by TA was not superior to that of combination features based on clinic and conventional MR sequences.

Objective To compare the MRI features of focal nodular hyperplasia (FNH) and inflammatory hepatocellular adenoma (Ⅰ-HCA),with an aim to improve the diagnostic accuracy in the two lesions.Methods Patients who underwent dynamic-enhanced MRI with histopathologically confirmed FNHs (21 patients with 21 tumors) and Ⅰ-HCAs (10 patients with 12 tumors) were included in this retrospective study.The clinical and the imaging features,including the T2-and T1-weighted,diffusion weighted images,and the dynamic enhanced imagings were analyzed.Results No significant difference was observed in the clinical data between the 2 groups of patients,except in the serum levels of C-reactive protein.The serum C-reactive protein levels were significantly elevated in Ⅰ-HCA than in FNH.Significant differences between patients with FNHs and Ⅰ-HCAs were also found in the morphologic findings and the signal intensities (including shape,centre scar,necrosis,signal intensity of T2WI and DWI,and lesion signal intensity compared to those of the liver in the portal venous phase and delayed phase).The differences in lesion to liver signal in FNH were significantly lower than those in Ⅰ-HCA in the T2WI and the delayed phases.The area under the curve (AUC) for the 2 groups of patients were 0.843 and 0.743,respectively,with no significant difference between them.Conclusions The MRI appearances of atypical FNHs overlapped with Ⅰ-HCA.MRI features of isointensity on T2 Wl and DWI,and isointensity to the liver in the delayed phase were valuable to differentiate FNHs from Ⅰ-HCAs.Most Ⅰ-HCAs showed moderate and marked high signal intensity on T2WI and DWI.These features,when combined with an elevated serum C-reaction protein,necrosis in the lesion and hyperintensity in the delayed phase,were valuable in differentiating Ⅰ-HCAs from FNH.

Objective To investigate the MRI findings of combined hepatocellular cholangio-carcinoma(cHCC-CC)and their correlation with pathologic types. Methods Twenty-nine patients with surgical pathology-confirmed cHCC-CC(20 patients with 24 cHCC-CCs were categorized as classical, and 9 patients with 10 cHCC-CCs as subtypes with stem cell features)were retrospectively analyzed. The clinical features, morphological and MRI signal characteristics on T1WI, T2WI, dynamic enhancement patterns and diffusion-weighted imaging were evaluated in detail and compared these imaging findings with pathologic types. The ADC values of 17 patients with 24 cHCC-CCs were measured. The imaging features were compared by using t test and Fisher test. Results The average maximum diameter of classical type and stem cell feature type were (3.8 ± 2.5) cm and (4.5 ± 1.8) cm, respectively, there was no significant difference(t=0.749,P=0.462). Seven cHCC-CCs showed heterogeneously high signal and twenty-seven cHCC-CCs showed low signal on T1WI. Seventeen cHCC-CCs showed hypointense in the central with mixed high and low signal on T2WI. Twenty-one cHCC-CCs showed peripheral enhancement and 13 lesions showed heterogeneously enhancement during arterial phase. The enhancement pattern of quickly wash-in and quickly wash-out were seen in 17 lesions, the other 17 lesions showed reversal enhancement. Twenty-five lesions presented with pseucapsule. There was no significant difference in clinical features and MRI findings between the two pathologic tumor types(classical type versus stem cell feature type)except for the enhancement pattern in arterial phase and peri-tumoral bile duct dilatation(P<0.05).The mean ADC value of the tumors with stem cell feature type(1.41 ± 0.52) × 10-3mm2/s was mildly lower than that of classical type (1.60 ± 0.39) × 10-3mm2/s, and no statistical differences were found(t=-1.005,P=0.326). Conclusions The MRI findings of cHCC-CCs has specificity. However, it is not easy to distinguish the classical type and stem cell feature type of cHCC-CC only by MRI findings.

Taking the Wechat public service platform of Administration of Traditional Chinese Medicine of Yunnan- Yunnan Zhongyi as an example,the paper uses the Importance-performance Analysis (IPA) and corresponding analysis method,from the users' satisfaction perspective,evaluates 28 satisfaction indicators,discusses the relationship between the importance recognition of health Wechat of Traditional Chinese Medicine (TCM) and user characteristic,so as to propose the development of individual TCM health information recommendation and strengthen the effective interaction of platform users.

Objective To investigate the MRI findings of combined hepatocellular cholangio-carcinoma(cHCC-CC)and their correlation with pathologic types. Methods Twenty-nine patients with surgical pathology-confirmed cHCC-CC(20 patients with 24 cHCC-CCs were categorized as classical, and 9 patients with 10 cHCC-CCs as subtypes with stem cell features)were retrospectively analyzed. The clinical features, morphological and MRI signal characteristics on T1WI, T2WI, dynamic enhancement patterns and diffusion-weighted imaging were evaluated in detail and compared these imaging findings with pathologic types. The ADC values of 17 patients with 24 cHCC-CCs were measured. The imaging features were compared by using t test and Fisher test. Results The average maximum diameter of classical type and stem cell feature type were (3.8 ± 2.5) cm and (4.5 ± 1.8) cm, respectively, there was no significant difference(t=0.749,P=0.462). Seven cHCC-CCs showed heterogeneously high signal and twenty-seven cHCC-CCs showed low signal on T1WI. Seventeen cHCC-CCs showed hypointense in the central with mixed high and low signal on T2WI. Twenty-one cHCC-CCs showed peripheral enhancement and 13 lesions showed heterogeneously enhancement during arterial phase. The enhancement pattern of quickly wash-in and quickly wash-out were seen in 17 lesions, the other 17 lesions showed reversal enhancement. Twenty-five lesions presented with pseucapsule. There was no significant difference in clinical features and MRI findings between the two pathologic tumor types(classical type versus stem cell feature type)except for the enhancement pattern in arterial phase and peri-tumoral bile duct dilatation(P<0.05).The mean ADC value of the tumors with stem cell feature type(1.41 ± 0.52) × 10-3mm2/s was mildly lower than that of classical type (1.60 ± 0.39) × 10-3mm2/s, and no statistical differences were found(t=-1.005,P=0.326). Conclusions The MRI findings of cHCC-CCs has specificity. However, it is not easy to distinguish the classical type and stem cell feature type of cHCC-CC only by MRI findings.