In recent years, the artificial intelligence machine learning and deep learning technology have made leap progress. Using clinical decision support system for auxiliary diagnosis and treatment is the inevitable developing trend of wisdom medical. Clinicians tend to ignore the interpretability of models while pursuing its high accuracy, which leads to the lack of trust of users and hamper the application of clinical decision support system. From the perspective of explainable artificial intelligence, the authors make some preliminary exploration on the construction of clinical decision support system in the field of liver disease. While pursuing high accuracy of the model, the data governance techniques, intrinsic interpretability models, post-hoc visualization of complex models, design of human-computer interactions, providing knowledge map based on clinical guidelines and data sources are used to endow the system with interpretability.

A multi-label based level set model for multiple sclerosis lesion segmentation is proposed based on the shape, position and other information of lesions from magnetic resonance image. First, fuzzy c-means model is applied to extract the initial lesion region. Second, an intensity prior information term and a label fusion term are constructed using intensity information of the initial lesion region, the above two terms are integrated into a region-based level set model. The final lesion segmentation is achieved by evolving the level set contour. The experimental results show that the proposed method can accurately and robustly extract brain lesions from magnetic resonance images. The proposed method helps to reduce the work of radiologists significantly, which is useful in clinical application.
Algorithms ; Humans ; Magnetic Resonance Imaging ; Multiple Sclerosis ; diagnostic imaging

Sustained release and non-parental formulations of peptides and protein drugs are highly desirable because of enhanced therapeutic effects as well as improved patient compliance. This is especially true for small peptides such as thymopentin (TP5). To this end, implantable sandwich poly (hydroxybutyrate--hydroxyhexanoate) (PHBHHx) films were designed to prolong release time and to inhibit burst release phenomenon of TP5 by a simple volatilization method. release studies revealed that sandwich films had nearly no burst release. release time of sandwich films was prolonged to 42 days. Pharmacodynamic evaluation demonstrated that TP5 sandwich films significantly increased survival rates in a rat immunosuppressive model and normalized CD4/CD8 values. These results suggest that TP5 released from sandwich films can attenuate cyclophosphamide's immunosuppressive activity, and possibly achieve results comparable to daily TP5 injection therapy. Thus, sandwich PHBHHx films show excellent potential as a sustained, burst-free release system for small molecular weight, hydrophilic peptide drugs.

OBJECTIVE:To investigate and analyze the situation of measurement method for antimicrobial resistance(AMR) burden research,in order to provide methodology literature support for conducting AMR burden research in China. METHODS:Retrieved from PubMed,ProQuest Health & Medical Complete,Springer datebase,related researches were summarized,and foreign calculation method of resistance burden of commonly used antimicrobial and matters of attention were analyzed. RESULTS& CONCLUSIONS:AMR burden is usually evaluated using indicators like the number of resistant incidents,deaths due to AMR, excess length of stay and economic burden of AMR. The issues needed to be considered during calculating the burden included the perspective,definition of the outcome indicator,controlling the length of stay before infection,selection of control group, adjustment for severity of illness,time point calculation,calculation of onset time of infection,definition of the cost and scale of the economic burden. Future studies needs to be focused on a social perspective to estimate the burden of AMR,so as to provide baseline data evidence for decision makers to further control the resistance.

Objective:To establish the fingerprint analysis method for the root of Rosa laevigata Michx from different regions by UPLC. Methods:The column was ACQUITY UPLC? Phenyl(2.1 mm × 100 mm,1.7 μm). The mobile phase consisted of methanol-water with gradient elution. The flow rate was 0. 2 ml·min-1 , the detection wavelength was 210 nm, the column temperature was 30℃, and the injection volume was 3 μl. Results:The fingerprint consisted of 15 common peaks. The range of similarity for twelve bat-ches of the root of R. laevigata Michx was 0. 489-0. 942. And the reference fingerprint of the root of R. laevigata Michx was estab-lished by UPLC. Conclusion:The fingerprint method is simple and reproducible, which can provide basis for the quality control and the medicinal resources exploration.

OBJECTIVETo study the chemical constituents of Dolomiaea souliei.

METHODVarious chromatographic techniques were adopted to separate the constituents, and the spectrum analysis was made to identify their structures.

RESULTSeventeen compounds were isolated and identified as: dehydrocostus lactone (1), costunolide (2), mokko lactone (3), santamarine(4), reynosin (5), 4alpha-hydroxy-4beta-methyldihydrocostol (6), sulfocostunolide A (7), beta-costic acid (8), beta-cyclocostunolide (9), vladinol A (10), ursolic acid (11), betulinic acid (12), betulin (13), dibutyl terephthalate (14), dibutyl phthalate (15), uridine (16), and emodin (17).

CONCLUSIONCompounds 6-9 and 12-17 were obtained from this genus for the first time, and compound 11 was obtained from this plant for the first time.

4-Butyrolactone ; analogs & derivatives ; chemistry ; Asteraceae ; chemistry ; Emodin ; chemistry ; Lactones ; chemistry ; Sesquiterpenes ; chemistry ; Triterpenes ; chemistry

BACKGROUND:Treatment methods of pterygium mainly include pterygium excision,pterygium excision combined with local application of mitomycin,pterygium excision combined with conjunctival flap transfusion and pterygium excision combined with autologous corneal limbus stem cell transplantation.Dry eye commonly occurred in many patients following pterygium excision.OBJECTIVE:To evaluate the effects of stem cell transplantation of limbus cornea and simple excision of pterygium on tear film stability.METHODS:Eighty patients(eighty eyes)with pterygium were involved in this clinical experiment.All patients were randomly divided into 2 groups:Group A accepted simple excision of pterygium in 40 patients with 40 eyes under a 10-fold microscope,and Group B accepted excision of pterygium with stem cell transplantation of limbus cornea in 40 patients with 40 eyes under a 10-fold microscope,in which a free transplantation of the superotemporal limbus stem with an adjacent piece of conjunctiva was transplanted in the excision area.Slit-lamp examination,tear film break-up time and questionnaire on dry eye were performed before operation,at one week post-operation,and at three months post-operation.RESULTS AND CONCLUSION:In both groups,following surgery,some patients affected dryness,foreign body sensation,burning sensation.These symptoms were more in the group A compared with group B(P ＜ 0.05).Implant was red 1 week following surgery in the group B,and confluence was found,without infection or rejection.The tear film break-up time was prolonged in the group B compared with the group A at 1 week following surgery,and no significant difference was determined at 3 months.Results indicated that compared with simple excision of pterygium,combined excision of pterygium with stem cell transplantation of limbus cornea obtained better outcomes,and could decrease the manifestations of dry eye and maintain better tear film stability in patients with pterygium.