Objective:To explore the feasibility of automatic assessment of abdominal and pelvic CT radiation dose index (CTDI vol) based on deep learning models. Methods:A retrospective analysis was conducted on clinical abdominal and pelvic CT data collected continuously from February 2021 to February 2022. A total of 1 084 sets of patient images were obtained using equipment of Siemens SOMATOM Definition Flash CT, Philips iCT, and GE lightspeed VCT. The volume CT dose index (CTDI vol) prediction model consisted of two functional modules: organ segmentation and dose prediction. Based on the result of actual scanning area segmentation in the abdominal and pelvic area, CTDI vol was evaluated automatically by dose regression prediction module. The images of 1 084 patients included in the study were randomly divided into a training set of 784, a validation set of 196 and a test set of 104. Dice coefficient was used to evaluate the abdominal and pelvic segmentation performance of the hybrid model, and accurate number proportion and root-mean-square logarithm error (RMSLE) were used as the evaluation index of the CTDI vol estimation model performance. Results:In the test set, the Dice coefficient of the deep learning model in the task of CT abdominal image segmentation was as high as 0.998, and the RMSLE of the CTDI vol regression model in estimation of radiation dose was 9.41%, with an accuracy rate of 92%. Scatter plot analysis showed that some CTDI vol estimates had significant errors, indicating that the model might need to be further optimized in these situations. Conclusions:The deep learning models can accurately and automatically segment CT abdominal images and estimate radiation dose, which can be used for clinical radiation dose monitoring and management.

[摘 要] 目的：探讨中药地黄提取物梓醇（Cat）对乳腺癌MCF-7细胞增殖与凋亡，以及裸鼠移植瘤生长的影响及其机制。方法：以不同质量浓度（0、5、25、50、100、200 μg/mL）Cat处理人乳腺癌MCF-7细胞，用MTT法筛选Cat给药浓度。将MCF-7细胞分为空白对照组、Cat低剂量组、Cat中剂量组、Cat高剂量组、Cat+sh-NC组和Cat+sh-FOXO3组，采用Edu细胞增殖实验、平板克隆实验、流式细胞术分别检测各组细胞的增殖与克隆形成能力、凋亡率和细胞周期，WB法检测各组细胞中FOXO3、FOXM1、caspase-3和caspase-8蛋白表达。构建乳腺癌MCF-7细胞裸鼠移植瘤模型，观察Cat对移植瘤生长的影响，WB法检测移植瘤组织中FOXO3和FOXM1蛋白表达。结果：Cat低（50 μg/mL）、中（100 μg/mL）、高（200 μg/mL）剂量处理的MCF-7细胞的增殖能力均显著下降（均P<0.05）。与空白对照组比较，Cat低、中、高剂量组Edu阳性细胞率、克隆形成数、S期与G2/M期细胞比例及FOXO3蛋白表达均显著降低（均P<0.05），细胞凋亡率、G0/G1期细胞比例及FOXM1、caspase-3、caspase-8蛋白表达均显著升高（均P<0.05）；与Cat+sh-NC组比较，Cat+sh-FOXO3组Edu阳性细胞率、克隆形成数、S期与G2/M期细胞比例及FOXO3蛋白表达均显著升高（均P<0.05），细胞凋亡率、G0/G1期细胞比例及FOXM1、caspase-3和caspase-8蛋白表达均显著下降（均P<0.05）。Cat组MCF-7细胞裸鼠移植瘤体积、质量和FOXO3蛋白表达均显著降低（均P<0.05），FOXM1的蛋白表达显著升高（P<0.05）。结论：Cat抑制乳腺癌MCF-7细胞增殖并促进凋亡，在体内抑制裸鼠移植瘤的生长，其机制可能与上调FOXO3、下调FOXM1的表达有关。

Objective To explore the correlation between the total imaging burden of cerebral small vessel disease(CSVD)and heart rate variability(HRV)in elderly patients with hypertension.Methods A total of 256 elderly patients with hypertension admitted to Department of Neurolo-gy,Changzhou Second People's Hospital form September 2021 to December 2022 were consecu-tively recruited in this study.According to the total brain MRI burden,they were divided into scored 0-2 group(180 cases)and 3-4 group(76 cases).Their general clinical data and HRV parameters were compared between the two groups.Multivariate logistic regression analysis was used to analyze the relationship between HRV and total CSVD burden in these patients,and Spearman correlation analysis was employed used to analyze the correlation between HRV and to-tal CSVD burden,and between blood pressure variability and HRV.Results Older age,longer course of hypertension,and higher homocysteine level were observed in the group of scored 3-4 than the group of 0-2(P＜0.01).The former group had significantly lower SDNN,SDANN,ASDNN,rMSSD,PNN50,LF and HF when compared with the latter group(all P＜0.01).But there was no statistical difference in LF/HF ratio between the two groups(P＞0.01).Multivariate logistic regression analysis indicated that SDNN(OR=0.989,95％CI:0.979-0.999,P=0.034),SDANN(OR=0.988,95％CI:0.977-0.999,P=0.039)and rMSSD(OR=0.965,95％CI:0.938-0.994,P=0.016)were independent risk factors for total burden of severe CSVD in elderly hypertensive patients.Spearman correlation analysis showed that SDNN,SDANN,ASDNN,rMSSD,PNN50,LF and HF were negatively correlated with the total CSVD burden(P＜0.01);the standard deviation of 24-h SBP was negatively correlated with SDNN,SDANN and rMSSD(P＜0.01);the coefficient of variation of 24-h SBP was negatively correlated with SDNN,SDANN and rMSSD(P＜0.01).Conclusion HRV is an independent risk factor for total burden of severe CSVD in elderly hypertensive patients,and HRV parameters are negatively correlated with the to-tal CSVD burden.

The adhesive protein secreted by marine sessile animals can resist the resistance of water and exert stickiness under the humid environment. It has become a candidate for the development of high-performance materials in the field of biomedicine and bionics. Barnacles are as one of the marine macrofoulers that can be firmly attached to the underwater substrate materials with different surface characteristics through its cement proteins. To date, the adhesion process of barnacle has been understood in-depth, but the specific underwater adhesion mechanism has not been elucidated and needs further exploration. This review first presented an overview of barnacle and its adhesion process, followed by summarizing the advances of barnacle adhesive protein, its production methods, and applications. Moreover, challenges and future perspectives were prospected.
Animals ; Thoracica/metabolism* ; Proteins/metabolism* ; Adhesives/metabolism*

Objective To explore the correlation between the pathogenesis of coronary heart disease and the polymorphism of methylenetetrahydrofolate reductase ( MTHFR ) .Methods 130 cases of coronary heart disease diagnosed and treated in Heze Municiple Hospital from July 2015 to July 2017 were selected as observation group .At the same time,130 healthy people were selected as control group .The serum folate and homocysteine ( HCY) levels were compared between the two groups .At the same time, polymerase chain reaction -restriction fragment length polymorphism was used to analyze the MTHFR gene polymorphisms .The distribution of MTHFR gene polymorphism was compared between the two groups .Results The level of serum folic acid in the observation group was (5.76 ± 2.14)g/L,which was significantly lower than (7.34 ±2.43)g/L in the control group (t=5.64,P<0.05).The level of serum HCY in the observation group was (15.46 ±5.74)μmol/L,which was significantly higher than (10.28 ± 4.38)μmol/L in the control group (t=6.43,P<0.05).The frequencies of TT type,TC type and CC type of MTHFR gene in the observation group were 36.92％,46.92％and 16.15％,respectively.The frequencies of TT type,TC type and CC type of MTHFR gene in the control group were 21.54％,55.38％ and 23.08％,respectively.The frequency of TT type in the observation group was significantly higher than that of the control group (χ2 =8.25,P<0.05). There were no statistically significant differences in folic acid levels among different gene types in the observationgroup(t=1.31,0.55,0.73,all P>0.05),but the serum HCY level of TT type was significantly higher than that of CT type and CC type in the observation group (t=5.33,4.62,all P<0.05).Conclusion Serum folic acid level, HCY level and homozygous mutations of MTHFR gene type have certain relationship with the occurrence of coronary heart disease ,the body serum folic acid level and the distribution of MTHFR genotypes can affect the concentration of HCY,thus affecting the occurrence of coronary heart disease .

Objective To explore the relationship between the levels of plasma coagulation factors (F) and acute myocardial infarction (AMI) in low age period (<60 years old) and their diagnostic value in diagnosing AMI in low age period.Methods One hundred and sixty inpatients with low age AMI in the cardiology department of the Heze Municipal Hospital were selected as the case group,and contemporaneous 160 cases of low age non-AMI served as the control group.F Ⅱ,FⅦ,FⅧ,fibrinogen (Fg) and von willebrand (vWF) were measured with enzyme-linked immunoabsorbent anti-sandwich assay.The relationship between coagulation factors and low age AMI was analyzed with univariate and multivariate analysis,and their value for diagnosing low age AMI was evaluated with diagnostic test and receiver operating characteristics (ROC) curve.Results The univariate analysis showed that FⅡ,FⅦ,FⅧ and Fg levels had significantly statistical difference between the case group and control group(P<0.05),and the vWF level had no statistically difference(P>0.05).The multivariate analysis indicated that the FⅡ level≥ 14.27 μg/L and FⅦ level ≥22.99 μg/L were the independent risk factors for low age AMI.The value of FⅡ for diagnosing low age AMI was lower,and the optimal cut off value of Fg for diagnosing low age AMI was 22.99 μg/L,its area under ROC curve was 0.709 with a moderate diagnostic value,and the sensitivity (91.88%) and negative predictive value (86.02%) were higher,the false negative rate (13.98%) was lower,and the accuracy (70.94%) was moderate.Conclusion The FⅡ level ≥14.27 μg/L and Fg level ≥22.99 μg/L are the independent risk factors for low age AMI,and detecting the Fg level could have hint significance in diagnosing low age AMI.

Objective To study the risk factors of lymph node metastasis in the central neck compartment of thyroid carcinoma,and to explore the reasonable range of lymph node dissection in central neck dissection for clinically node-negative papillary thyroid microcarcinoma patients.Methods From Dec.2015 to Dec.2016,a total of 200 patients with CN0 papillary thyroid carcinoma were randomly divided into two groups according to the registration number:unilateral central neck dissection group and bilateral central neck dissection group in Department of Thyroid Surgery,Fujian Medical University Union Hospital.The risk factors of lymph node metastasis and value of bilateral central neck dissection were analyzed.Results The risk factors of lymph node metastasis in the central papillary thyroid carcinoma were ≥0.7 cm in diameter and older than 45 years in age and gender in male.Further analysis found that contralateral central lymph node metastasis occurred in patients with tumor diameter ≥0.5 cm.The positive rate was 22％.The number of lymph nodes detected in the unilateral and bilateral central areas was 9.53±6.04 and 12.19±7.18,P=0.035,respectively.The positive numbers of lymph nodes were 1.17±1.47 and 2.11±2.75,P=0,022 respectively.Conclusion In patients with tumor diameter ≥0.5 cm,bilateral central neck dissection is conducive to improving the thoroughness of tumor dissection and does not increase the risk of complications.

Objective:To discuss the accuracy of stereolithography (SLA)-3D printing model in orthopedics and maxillofacial surgery,and to clarify the reliability of its clinical application.Methods:A total of 33 cases of SLA-3D printing models were randomly included (10 long bones,13 irregular bones and 10 prostheses),and the CT scanning and three-dimensional reconstruction were performed.According to the clinical application characteristics of the models,the max height (MH),max length (ML),max width (MW),width of the trochlear (WT),length of the trochlear (LT),length of the glenoid cavity (LGC),width of the glenoid cavity (WGC),distance of pubic tubercle-anterior superior iliac spine (DPI),diameter of the acetabulum (DA),diameter of the marrow cavity (DMC),anterior height of right ramus (AHRR) and posterior height of right ramus (PHRR) were selected to measure the original data and model data,respectively.The absolute / relative errors were calculated.Intraclass correlation coefficient (ICC) was used to evaluate the consistency of the data.The three-dimensional error analysis of the prosthesis model was carried out.Results:There were no significant differences in the anatomical parameters except MW of irregular bone (P＞0.05) in 33 cases of SLA-3D printing model.The values of ICC were all greater than 0.950;the maximum values of absolute / relative errors were-0.58 mm and-1.37％,respectively;the maximum 3D error of prosthesis model was 0.237 mm,and the average value was 0.132 mm.Conclusion:The CT data of SLA-3D model is highly consistent with the original data,and it is accurate and reliable in the diagnosis and treatment of the diseases in orthopedics and maxillofacial surgery.

Objective To explore the significance of parathyroid hormone (PTH) measurement in drainage liquid after thyroid surgery,and to evaluate its relationship with parathyroid glands in situ.Methods Form Dec.2013 to Aug.2014,166 patients who underwent unilateral thyroidectomy were chosen as the research object.According to the number of parathyroid reserved in situ,patients were divided into group A0,group A1 and group A2.The levels of blood PTH and serum calcium were measured before and after operation,and postoperative PTH in drainage liquid was measured.Results The levels of postoperative blood PTH and serum calcium were lower than those before operation(P＜0.05).The difference of PTH level in drainage liquid in each group had statistical significance(P＜0.05).The level of drainage liquid PTH was highest in group A2,following group A1,and finally group A0.We found a positive correlation between the number of parathyroid glands protected in situ and the level of drainage liquid PTH.Conclusion Drainage liquid PTH measurement can be used to determine whether parathyroid gland is reserved in situ and its secretion function.

OBJECTIVETo study application of needlescopic assisted hemithyroidectomy and central neck dissection using bilateral breast approach.

METHODSTotally 145 cases of papillary thyroid cancer patients received endoscopic hemithyroidectomy in Fujian Medical University Union Hospital were randomized to needle assisted endoscopic group (NE group, n=81) and conventional endoscopic group (CE group, n=64). The average age of the patients was 35.9 years and 11 patients were male.All patients underwent hemithyroidectomy and central neck dissection through bilateral breast approach, the NE group additional used the MiniLap-assisted intraoperation.The operative time, postoperative complications and cosmetic results were analyzed by t-test and χ(2) test.

RESULTSThe operation time of thyroid gland in NE and CE Group was (42±7) min and (31±7) min(t=9.082, P=0.000), respectively. The operation time of central neck dissection was (33±6) min and (26±3) min (t=9.050, P=0.000), respectively.There were 4 cases occurs transient recurrent laryngeal nerve paralysis in CE group and no case occur in NE group(χ(2)=5.206, P=0.036). There was no significant different in other postoperative complications and cosmetic results.

CONCLUSIONSHemithyroidectomy and central neck dissection using bilateral breast approach and needlescopic assisted technique isa safe and reliable approach, with high cosmetic effect. Application needle assistive devices can shorten the operation time while no significant increase trauma in patients, it will makes endoscopic thyroid surgery easier to promote.

Adult ; Breast ; Carcinoma ; surgery ; Carcinoma, Papillary ; Endoscopy ; instrumentation ; Female ; Humans ; Male ; Neck Dissection ; Needles ; Operative Time ; Postoperative Complications ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; methods