Objective:To explore the effect of fully automatic image segmentation of adenoid and nasopharyngeal airway by deep learning model based on U-Net network. Methods:From March 2021 to March 2022, 240 children underwent cone beam computed tomography（CBCT） in the Department of Otolaryngology, Head and Neck Surgery, General Hospital of Shenzhen University. 52 of them were selected for manual labeling of nasopharynx airway and adenoid, and then were trained and verified by the deep learning model. After applying the model to the remaining data, compare the differences between conventional two-dimensional indicators and deep learning three-dimensional indicators in 240 datasets. Results:For the 52 cases of modeling and training data sets, there was no significant difference between the prediction results of deep learning and the manual labeling results of doctors（P>0.05）. The model evaluation index of nasopharyngeal airway volume: Mean Intersection over Union（MIOU） s （86.32±0.54）%; Dice Similarity Coefficient（DSC）: （92.91±0.23）%; Accuracy: （95.92±0.25）%; Precision: （91.93±0.14）%; and the model evaluation index of Adenoid volume: MIOU: （86.28±0.61）%; DSC: （92.88±0.17）%; Accuracy: （95.90±0.29）%; Precision: （92.30±0.23）%. There was a positive correlation between the two-dimensional index A/N and the three-dimensional index AV/（AV+NAV） in 240 children of different age groups（P<0.05）, and the correlation coefficient of 9-13 years old was 0.74. Conclusion:The deep learning model based on U-Net network has a good effect on the automatic image segmentation of adenoid and nasopharynx airway, and has high application value. The model has a certain generalization ability.
Child ; Humans ; Adolescent ; Adenoids/diagnostic imaging* ; Image Processing, Computer-Assisted/methods* ; Pharynx ; Cone-Beam Computed Tomography ; Nose

Objective To study the relationship of microRNA (miR) in breast milk and neonatal breast milk associated jaundice.Method From Sep.to Dec.2016,neonates with severe hyperbilirubinemia caused by breast milk were selected as the observation group,and breast-fed neonates without jaundice were selected as the control group.Their breast milk were collected,and the expression profile of miR in the breast milk was examined using miR sequencing.The variation of miR profile was screened using bioinformatics method,and miR related to neonatal breast milk associated jaundice was studied and the target genes were predicted.Result The breast milk contained many miRs associated with immunity regulation and metabolism,including miR-148-3p,miR-30a-5p,miR-146-5p,let-7f-5p,miR-181-5p,miR-22-3p,and miR-182-5p.The expressions of miR-30a-5p,miR-146a-5p and miR-141-3p in the observation group were significantly higher than the control group,and the differences were 2.600,2.038 and 1.899-fold,respectively.Uridine diphosphate glucuronosyl transferase1A1 gene was one of the target genes of miR-141-3p.Conclusion Breast milk miR may influence the growth and development,immunity regulation and metabolism of newborns.Some miRs,such as miR-141-3p,may be correlated with neonatal breast milk associated jaundice.

OBJECTIVETo investigate the role played by γδ T cells in acute liver injury using the concanavalin A (ConA)-induced liver injury mouse model.

METHODSAcute liver injury was induced by intravenous injection of 10 mug/g of ConA into male C57BL/6J mice with wild-type or T cell receptor-γ knockout (TCR δ-/-) genetic backgrounds. Mice injected with PBS alone served as negative controls. The degree of liver damage was assessed by measuring serum levels of transaminase and cytokines at post-injection hours 3, 6, 12, 24, 48, and 72. The percentage of γδ T cells and proportions of different subsets in liver lymphocytes were measured by flow cytometry.

RESULTSThe TCR δ-/- mice showed significantly higher levels of the inflammatory cytokines IFN-γ, TNFα and IL-4 than the wild-type mice at post-injection hour 3. The percentage of liver γδ T cells increased with increased injury degree, and the extent of increase was significantly higher in the TCR δ-/- mice than the wild-type mice (post-injection hour 6: 6302.61+/-592.06 vs. 1319.26+/-355.48, 12: 6569.44+/-1060.98 vs. 3415.53+/-343.90, 24: 6514.29+/-757.26 vs. 2062.73+/-365.67, 48: 1262.61+/-558.07 vs. 113.66+/-113.26, and 72: 226.54+/-98.20 vs. 42.35+/-21.51 U/L; all P less than 0.05). In addition, compared to the negative control mice, the ConA-induced mice showed a higher proportions of Vγ4 γδ T cells to total γδ T cells (17.78+/-2.95 vs. 25.26+/-2.43) and to total liver lymphocytes (0.47+/-0.07 vs. 0.66+/-0.05). Similarly, compared to the negative control mice, the ConA-induced mice showed a higher proportion of Vγ1 γδ T cells to total γδ T cells (38.37+/-6.10 vs. 50.19+/-5.52) but the proportion to total liver lymphocytes was not significantly different among the groups (0.76+/-0.18 vs. 0.78+/-0.25). Reinfusion of Vγ4 γδ T lymphocytes into TCR δ-/- mice led to lower serum ALT levels than reinfusion of Vγ1 γδ T lymphocytes (5054.10+/-1748.51 vs. 12333.56+/-663.535 U/L).

CONCLUSIONγδ T cells play a protective role in ConA-induced liver injury and this effect maybe mediated by the Vγ4 γδ T cell subset.

Animals ; Chemical and Drug Induced Liver Injury ; immunology ; pathology ; Concanavalin A ; toxicity ; Interferon-gamma ; immunology ; Interleukin-4 ; immunology ; Liver ; drug effects ; immunology ; pathology ; Male ; Mice ; Mice, Inbred C57BL ; Receptors, Antigen, T-Cell, gamma-delta ; metabolism ; T-Lymphocyte Subsets ; immunology ; Tumor Necrosis Factor-alpha ; immunology

Objective To explore the effect of anti-TNF rcMAb in the treatment of patients with rheumatoid arthritis (RA) and its effect on peripheral blood Th1,Th17 and Treg cells.Methods Fifty rigorously screened RA patients were randomly divided to the therapy group (n=40) who received the combined treatment of anti-TNF rcMAb and MTX,and control group (n=10) who were given MTX along with placebo,both at week 0,2,6,and 14.The clinical data of the two groups were observed and accessed respectively at week 0 and 18.In addition,the percentage of Th1,Th17,Treg cells in the peripheral blood and the relative gene expressions of transcription factors T-bet,RORC,Foxp3 in these patients were also observed respectively before and after treatment.We used t inspection and x2 inspection as the statistical analysis methods in conducting this study.Results Comparing with the control group,more patients achieved ACR20,ACR50 and ACR70 response in the combined therapy group (Z=1.671,P=0.000 94).The percentage of peripheral blood Th1 cells decreased [week 0:(7.1±3.9)％; week 18:(4.2±2.8)％] and the percentage of Treg cells obviously increased [week 0:(1.5±0.8)％; week 18:(3.0±0.6)％,t=2.301,P=0.048] in the combined therapy recipients,while the percentage of Th1 cells fell [week 0:(9.1±3.1)％; week 18:(5.8±2.6)％] and that of Treg cells slightly increased [week 0:(1.2±0.6)％; week 18:(2.2±0.6)％] in the controls.The mRNA expressions of RORC and T-bet,the transcription factors of Th17 and Th1,were decreased respectively and that of Foxp3,the transcription factor of Treg,were elevated in both groups.Conclusion The combined therapy of anti-TNF rcMAb and MTX is very effective in RA patients.Good outcome is likely achieved by modifying the peripheral blood Th cell subsets in patients with RA.

Objective Infliximab is a kind of recombinant human mouse chimeric anti-tumor necrosis factor monoclonal antibody. Here we aimed to examine the impact of infliximab therapy on RANK/RANKL/OPG system in the peripheral blood of rheumatoid arthritis (RA) patients. Methods Fifty patients with RA were rigorously screened and randomly divided into 2 groups. One group was treated with infliximab (3 mg/kg)and methotrexate (MTX). As control, the other group was treated with MTX alone. Infliximab was administered at weeks 0, 2, 6 and 14. The expression of RANK, RANKL mRNA in the peripheral blood, serum OPG and clinical indicators changes at week 0 and 18 were compared.x2-test or t-test were used for statistical analysis.Results After treated with infliximab, bone damage of joints were slowed down when examined by radiography in RA patients compared with the control group. And the ratio of OPG/RANKL was also decreased in RA peripheral blood (w0: 80.25;w 18: 63.2); (control group w0: 83.37; w18: 30.87)(P＞0.05). Although after the treatment with either MTX alone [w0: (238±15) pg/ml; w18: (118±10) pg/ml] or infliximab combined with MTX [(w0: (223.1±6.2) pg/ml; w18:(162.4±5.5) pg/ml], the serum levels of OPG were all decreased (P＞0.05), the level of OPG in infliximab treatment group was declined slower than those in the control group. Conclusion RA bone destruction can be inhibited by the combination therapy of infliximab and MTX. The mechanism may be partly through the RANK/RANKL/OPG system.

Objective To compare the effects and safety of endoscopic balloon dilation with surgical therapy in treating esophageal achalasia. Methods The patients who were diagnosed as achalasia of cardia from Jan. 2002 to Dec. 2007 were consecutively collected. All patients were divided into endoscopic balloon dilation group (endoscopy group), thorascopic / laparoseopic surgery group (telescopy group) and standard thoracotomy group (operation group). The efficacy, relapse rate and safety were compared among three groups. Results Ninety eight patients were enrolled. There were 57 patients in endoscopy group, 24 patients in telescopy group, and 17 patients in opreation group. All of the patients completed the treatment. There was one case (1.6%) in endoscopy group complicated with esophageal rupture, two (8.3%) in telescopy group complicated with esophageal fistula, and one (5.9%) in operation group complicated with severe post-operation pneumonia infection, acute respiratory distress syndrome and infectious shock. The rest patients had symptomatic relief of dysphagia in different degrees after therapy, and that was further confirmed by symptoms assessment, x-ray, or endoscopic examination after one month. Five patients (8.9%) in endoscopy group relapsed, with a duration of 5 to 31 months (mean 8 months), and underwent re-dilation or stent placement successfully. One patient (4.2%) in telescopy group relapsed after 6 months and underwent re-dilation successfully. No one relapsed in operation group. Conclusions Compared with standard operation group and telescopy group, endoscopic balloon dilation is deserved to use widely in clinical application with its advantages of simple, convenient and low complication. In spite of its relapse, it still can be remedied well by endoscopic re-dilation or stent placement.

Objective To study the effect of comprehensive nursing of Traditional Chinese Medicine (TCM) on activity of daily living (ADL) and motor function of patients with hemiplegia after stroke. Methods 72 patients were divided into treatment group and control group randomly. The 36 patients in the treatment group were nursed with comprehensive nursing, such as TCM dietary, emotion regulation, acupoints massage, while the other 36 patients in the control received routinely TCM apoplexy nursed. They were assessed with ADL and motor assessment scale (MAS). Results The scores of both ADL and MAS improved significantly in the treatment group compared with that of the control (P<0.01). Conclusion Comprehensive nursing of TCM can facilitate the recovery of ADL and motor function in patients with stroke.

Objective To study the effect of type Ⅱ collagen (C Ⅱ) from Zaoeys dummies (Cantor)on the immune functions of rats with collagen-induced arthritis and to understand the mechanisms of RA treated with Zaoeys dhumnades (Cantor).Methods The rats with collagen-induced arthritis were randomly divided into three group:C Ⅱ from Zaocys dhumnades,bovine C Ⅱ and arthritis control group,a normal control group was set up,too.Every group had 7 rats.The C Ⅱ from Zaocys dhumnades and the bovine C Ⅱ group were fed with C Ⅱ from Zaocys dhumnades (15 mg/kg) and bovine C Ⅱ (15 mg/kg) per day respectivelyfor 15 days.The CD4/CD8 subset ratio,serum levels of anti-C Ⅱ antibody,TNF-a,IL-10,IL-1 and IL-4 in.rats were measured.Results In the arthritis group,CD4/CD8 subset ratio (P＜0.05) and serum levels of type Ⅱ collagen antibody (P＜0.01) and TNF-a (P＜0.01) were significant increased and IL-10 (P＜0.01) was significantly decreased.In the C Ⅱ from Zaocys dhumnades and bovine C Ⅱ group,CD4/CD8 subset ratio (P＜0.05) and the level of TNF-a (P＜0.01) were significantly decreased compared with the arthritis group,and had no difference compared with the normal group.The level of anti-C Ⅱ antibody was declined significantly compared with the arthritis group (P＜0.05) and had statistical difference with the normal group (P＜0.01).The level of IL-10 was significantly increased(P＜0.01),but lower than the normal group(P＜0.05).There was no statistical difference in the level of IL-1 and IL--4 in.all four groups.Conclusion C Ⅱ from Zaoeys dhum-nades (Cantor) is as effective as bovine C Ⅱ in modifying the immune functions of collagen-induced arth-ritis in rats.They can decrease the level of anti-C Ⅱ antibody,the level of TNF-a,CD4/CD8 subset ratio and increase the level of IL-10 in the peripheral blood of rats with collagen-induced arthritis.C Ⅱ from Zaocys dhumnades may be one of the important pharmacological active components that have the potential in treating rheumatoid arthritis.

OBJECTIVETo evaluate the efficacy and safety of leflunomide in comparison with methotrexate (MTX) on patients with rheumatoid arthritis (RA) in China.

METHODSFive hundred and sixty-six patients with active rheumatoid arthritis were randomly assigned to receive leflunomide at 20 mg once daily or MTX at 15 mg once weekly in a controlled trial. Five hundred and four patients completed the 12-week treatment and some patients continued the treatment for 24 weeks.

RESULTSBoth leflunomide and MTX could improve the symptoms, signs, and joint function, but there were no changes in X-ray observations of patients with rheumatoid arthritis. In the leflunomide group, the overall rates of effectiveness at 12 weeks and 24 weeks were 86.94% and 92.31% respectively; the rates of remarkable improvement were 64.95% and 79.81% respectively. In the MTX group, the overall rates of effectiveness at 12 weeks and 24 weeks were 84.04% and 83.15% respectively; the rates of remarkable improvement were 56.81% and 75.28% respectively. According to intent-to-treat analysis, the ACR 20% response rates at 12 weeks and 24 weeks in the leflunomide group were 62.54% and 67.18% respectively, compared with 60.08% and 61.32% respectively in MTX group. No statistical differences were shown in the efficacy between the two groups (P > 0.05). The adverse events in the leflunomide group were gastrointestinal symptoms, skin rash, alopecia, nervous system symptoms, decreased leukocyte count, and elevation of alanine aminotransferase (ALT). Most of these side effects were mild and transient. The incidence of adverse events in the leflunomide group was 16.84%, significantly lower than that in MTX group (28.17%, P = 0.002).

CONCLUSIONSLeflunomide is effective in the treatment of RA with less adverse events than MTX. Its efficacy is similar to MTX, but the incidence of adverse events and the rate of withdrawal due to adverse events were lower in the leflunomide group than in MTX group.

Antirheumatic Agents ; adverse effects ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; Female ; Growth Inhibitors ; adverse effects ; therapeutic use ; Humans ; Immunosuppressive Agents ; adverse effects ; therapeutic use ; Isoxazoles ; adverse effects ; therapeutic use ; Male ; Methotrexate ; adverse effects ; therapeutic use ; Middle Aged

Objective To explore the difference between T cells in the synovial fluid and peripheral blood in patients with rheumatoid arthritis(RA). Method Samples from 22 patients were studied. The differentiation and activation markers expressed on T cell surface were detected by immunofluorscence using flow cytometer. The specific proliferation of collagen Ⅱ and heat shock protein 70 was analyzed using standard 3H-TdR incorporation method. Restricted V beta usage of these T cell was analyzed by semi-quantitied RT-PCR. Results The majority of the T cell subsets in the synovial fluid were demonstrated to be CD4 and CD8 positive cells in which (40?10)% were CD4 positive and (36?16)% were CD8 T cells respectively. The ratio between CD4 and CD8 was much lower than that found in the PBL of RA patients. The percentage of CD3+/CD25+ T cells was (16?6)%. The specific proliferation of collagen Ⅱ and HSP70 to CD3+/CD25+ T cell was higher than that of CD3+/CD25+ negative T cells. The T cell receptor expressed on the T cells from both peripheral blood and synovial fluid were tested for ?? TCR (70?26)%. However, the T cells in the synovial fluid showed V?14,16 and 17 restriction. Conclusion The data here reported indicates that T cell subsets in the synovial fluid and peripheral blood circulation in patients with rheumatoid arthritis are different. The T cells in the synovial fluid demonstrates more activation and higher reactivation to collagen Ⅱ and HSP70. The TCR of T cells showes V?14,16 and 17 restriction.