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Objective To propose a new evaluation system and evaluate the application value of diabetic retinopathy ( DR) intelligence assisted diagnostic technology based on fundus photography. Methods By using the diagnostic test method,an evaluation system of DR intelligent diagnostic technology based on fundus photography was established. The fundus photographs of 331 diabetic patients (662 eyes) with DR screening were collected in the First Affiliated Hospital of Huzhou University from January 2017 to October 2018. The results of experts ' diagnosis and intelligence assisted diagnosis were compared and evaluated. The evaluation system includes primary evaluation, intermediate evaluation and advanced evaluation. The primary evaluation is the consistency of non-DR ( NDR) in all diabetic patients receiving DR-assisted diagnostic techniques;the intermediate evaluation is the diagnosis consistency of DR lesion degree in patients diagnosed with DR (grade 1-4);the advanced evaluation is the diagnosis consistency of DR classification ( grade 0 -4 ) in all diabetic patients receiving DR-assisted diagnostic techniques. The intermediate evaluation includes two evaluation methods. The main evaluation indicators include sensitivity,specificity and Kappa value. Results Based on experts ' diagnosis, NDR accounted for 22. 7％;mild non-proliferative DR (NPDR),moderate NPDR,and severe NPDR accounted for 19. 9％,18. 7％ and 25. 7％,respectively;proliferative DR( PDR) accounted for 13. 0％. Based on intelligence diagnostic system,NDR accounted for 25. 8％;mild NPDR, moderate NPDR and severe NPDR accounted for 19. 7％,19. 3％ and 22. 8％,respectively;proliferative DR( PDR) accounted for 12. 4％. Based on evaluation system in the paper,the sensitivity,specificity and Kappa value in primary evaluation were 91. 4％, 84. 7％ and 0. 72;the sensitivity, specificity and Kappa value in intermediate evaluation method one were 88. 4％,91. 1％ and 0. 79;the sensitivity, specificity and Kappa value in intermediate evaluation method two were 80. 5％,93. 3％ and 0. 75;the Kappa value in advanced evaluation was 0. 62. Conclusions The evaluation system can be applied to the evaluation of DR intelligent diagnostic technology,and the evaluation result can be used as the basis for the selection of DR intelligent diagnosis application scene.
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·AIM: To evaluate a deep learning - assisted diagnostic system with an artificial intelligence for the detection of diabetic retinopathy (DR). ·METHODS:A total of 186 patients (372 eyes) with diabetes were recruited from January to July 2017. Discrepancies between manual grades and artificial intelligence results were sent to a reading center for arbitration. The sensitivity and specificity in the detection of DR were determined by comparison with artificial intelligence diagnostic system and experts human grading. ·RESULTS:Based on manual grades, the results as follows:non DR (NDR) in 42 eyes (11.3%), 330 eyes (88.7%) in different stages of DR. Among 330 DR eyes, there were mild non proliferative DR (NPDR) in 62 eyes (16.7%), moderate NPDR in 55 eyes (14.8%), severe NPDR in 155 eyes (41.7%), and proliferative DR (PDR) in 58 eyes (15. 6%). Based on artificial intelligence diagnostic system, the results were as follows: NDR in 38 eyes (10.2%),PDR in 44 eyes (11.8%), others were NPDR. The sensitivity and specificity of artificial intelligence diagnostic system, compared with human expert grading, for the detection of any DR were 0.82 and 0.91, and the kappa value was 0.77 (x2=20.39, P<0.05). ·CONCLUSION:This study shows that a deep learning-assisted diagnostic system with an artificial intelligence for grading diabetic retinopathy is a reliable alternative to diabetic retinopathy assessment, thus the use of this system may be a valuable tool in evaluating the DR.
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? AIM: To investigate the efficacy and safety of phacoemulsification combined with intraocular lens implantation in the treatment of shallow anterior chamber with cataract.?METHODS: Retrospective case series. From February 2014 to July 2015 in our hospital,65 eyes in 65 patients with cataract were enrolled and divided into mild and high risk of shallow anterior chamber group. Best-corrected visual acuity ( BCVA ) , intraocular pressure ( IOP ) , central anterior chamber dept ( CACD ) , angle opening distance ( AOD ) , complications pre- and post treatment, were observed and analyzed as outcome measures.?RESULTS: In this study, the mild shallow anterior chamber group included 34 eyes; postoperative BCVA were improved in 29 eyes, with 4 eyes remaining stable and decreased in 1 eye; BCVA was improved in 16 eyes, with 10 eyes remaining stable and decreased in 5 eyes in high risk of shallow anterior chamber group postoperatively. BCVA had a better prognosis in the mild shallow anterior chamber group than another group ( t=-2. 956, P<0. 05). Meanwhile, IOP decreased by 5. 71± 2. 07mmHg and CACD increased by 1. 37 ± 0. 38mm in the mild shallow anterior chamber group, by 9. 77±4. 04mmHg and 1. 67±0. 43mm respectively in high risk group, and the difference has statistical significance ( t=-5. 02,-3. 04; P<0. 05). The mean preoperative nasal AOD500 was 200. 57± 33. 74μm, and they were 346. 62 ± 101. 37μm and 410. 75 ± 137. 48μm and 398. 69 ± 122. 28μm respectively at postoperative 1d, 1 and 3mo, and all nAOD500 comparing with preoperative were increased obviously, and the difference has statistical significance (F=203. 75, P<0. 01). And AOD500 at temporal, superior and inferior presented similar trends. Complications were corneal edema ( 5 eyes ) , transient intraocular hypertension ( 2 eyes ) , posterior capsular opacification ( 4 eyes ) , and posterior capsular rupture (1 eye).?CONCLUSION:Micro incision cataract surgery is useful, effective and safe in patients with cataract and shallow anterior chamber which can stabilize or improve BCVA, reduce IOP, deepen CACD and open the anterior chamber angle.
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<p><b>OBJECTIVE</b>This study was purposed to detect the expressions of β-catenin and P-GSK-3 β in Wnt signaling pathway of patients with mantle cell lymphoma(MCL), and investigate its relationship with the pathogenesis of MCL.</p><p><b>METHODS</b>The expression levels of β -catenin protein and P-GSK-3 protein in mantle cell lymphoma and hyperplastic lymphadenitis were detected by using anti-β-catenin, P-GSK-3β polyclonal antibody and S-P staining technique.</p><p><b>RESULTS</b>The abnormal expression of β-catenin protein(73.33%) in mantle cell lymphoma group was significantly higher than that (6.7%) in reactive lymph node hyperplasia group (P<0.05); and the positive rate of P-GSK-3 β(66.67%) in mantle cell lymphoma group was significantly higher than that (16.67%) in reactive hyperplasia of lymph node group (P<0.05). Spearman correlation analysis showed that there was obvious positive correlation (R=0.852, P<0.01).</p><p><b>CONCLUSION</b>The abnormal high expressions of β-catenin and P-GSK-3 β protein have been confirmed to appeare in mantle cell lymphoma.</p>
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Humans , Glycogen Synthase Kinase 3 , Glycogen Synthase Kinase 3 beta , Lymphoma, Mantle-Cell , Signal Transduction , Wnt Signaling Pathway , beta CateninABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of short hairpin RNA (shRNA) and XAV939, a specific inhibitor for β-catenin, on growth and apoptosis of mantle cell lymphoma(MCL) Jeko-1 cell line.</p><p><b>METHODS</b>β-catenin shRNA eukaryotic expression vector was transfected into Jeko-1 cells, the antiproliferative effect of shRNA on Jeko-1 cells was detected by RT-PCR and Western blot. The proliferation inhibitory rate of Jeko-1 cells treated by different doses of XAV939 was assayed by MTT method; the level of apoptosis of Jeko-1 cells was detected by flow cytometry; the expression levels of apoptosis-related protein BCL-2, BAX, CyclinD1, C-MYC and Caspase-3 in Jeko-1 cells were determined by Western blot.</p><p><b>RESULTS</b>The expression of β-catenin mRNA and growth of Jeko-1 cell line were inhibited by shRNA; after Jeko-1 cells treated with 0,2 and 8 µmol/L XAV939 for 48 hours, the cell proliferation rate decreased, while the cell apoptosis rate increased, the expressions of apoptosis-related protein BCL-2, CyclinD1 and C-MYC were down-regulated, on the contrary, the expression of BAX and caspase-3 were up-regulated.</p><p><b>CONCLUSION</b>The specific inhibition of β-catenin can inhibit Jeko-1 cell proliferation and promote the cell apoptosis.</p>
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Humans , Apoptosis , Caspase 3 , Cell Line, Tumor , Cell Proliferation , Heterocyclic Compounds, 3-Ring , Lymphoma, Mantle-Cell , RNA, Messenger , RNA, Small Interfering , Transfection , beta CateninABSTRACT
Background Aheration of eyeball wall caused by ocular axial extension is associated with multiple complications of high myopia.However,the study on quantitative analysis of choroidal thickness and axial length in adult high myopic patients is less.Objective This study was to investigate the choroidal thickness in high myopic eyes of adult patients and estimate the correlation of choroidal thickness with axial length,age,and spherical equivalent(SE).Methods A prospective cohort study was designed.Seventy-five eyes of 75 adult patients with high myopia were entrolled from December 2012 to May 2013,and 70 eyes of 70 age-and gendermatched healthy volunteers were included in Renmin Hospital of Wuhan University.Enhanced depth imaging (EDI)on Cirrus spectral-domain optical coherence tomography (SD-OCT) was used to measure the choroidal thickness from the outer border of the retinal pigment epithelium through the inner scleral boarder among the 11 meridians in a 500 μm intervals and range of 2 500 μm for each from fovea toward temporal and nasal lateral.The differences of choroidal thickness and axial length were compared between the high myopia group and normal control group,and the correlation of choroidal thickness with axial length,age,SE were analyzed.Results The subfoveal and mean choroidal thickness values were (146±52) μm and (142±63) μm in the high myopia group,and those in the normal control group were (306±60) μm and (271 ±71) μm,with significant differences between the two groups (t =-17.130,P=0.000; t=-15.890,P=0.000).Choroid was thickest in the temporal and then was subfovea and nasal in the high myopia group,but in the normal control group,it was subfovea,temporal and nasal in turn,and the choroidal thicknesses in various areas were thinner in the high myopia group than those in the normal control group.A negative correlation was found between the choroidal thickness and axial length in high myopia group(r =-0.580,P =0.000),and the regression equation determined a decrease of 17.943 μm per millimeter of axial length.Conclusions SD-OCT determines that choroidal thickness is decreased in highly myopic eyes compared with normal eyes.Choroidal thickness varies with the change of axial length in adult high myopia patient.These findings indicate that abnormalities of the choroids may play a role in the pathogenesis of complication of high myopia.
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Objective To explore the prevention and treatment of acute kidney injury (AKI) after gastrointestinal surgical procedures.Method We retrospectively analyzed the data of patients underwent gastrointestinal surgery in recent 2 years in the First Affiliated Hospital of Kunming Medical University and the First People's Hospital of Yunnan Province. Result The incidence of AK1 was 2.1%. Elderly patients with basic diseases had poorer prognosis than non-elderly patients. Conclusion In the patients after gastrointestinal Surgery, early rehydration, diuresis, ant-infection and preventive hemodialysis can achieve the goal of prevention and treatment of acute kidney injury in early stage.
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Objective To investigate the prevalence of high risk human papillomavirus (HPV) genital infection and cervical cancer in adult women from Shenzhen.Methods Cluster sampling was used to investigate the prevalence of HPV infection and cervical cancer from women aged 20-59 years old living in Luohu,Futian,Nanshan,Longgang and Baoan districts in Shenzhen from April 2006 to April 2010.All women were detected for liquid-based cytology test (LCT) or Thinprep cytologic test (TCT)and high-risk HPV-DNA test with hybrid capture Ⅱ (HC-Ⅱ ).All women with ≥ASC-US by cytology and/or a positive HC- Ⅱ test were asked to return for colposcopy and four-quadrant biopsy.Endocervical curettage was performed.Pathological finding were used as the gold standard of the diagnosis of cervical intraepithelial neoplasia.Results 10 210 women were involved in the study and 10 017 of them having completed data.The overall positive rate of high-risk HPV-DNA was 16.29％.HPV positive rates in 20-,30-,35-,40-,45-,50-59 age groups were 17.37％,15.59％,16.33％,14.74％,17.16％ and 17.98％,respectively.The curve of HPV infection rates in different age groups appeared a ‘W' shape.HPV infection rates in the 25-years-olds and 50-59 year-olds groups were significantly higher than the other age groups (x2=4.50,P=0.03 ).The overall prevalence rate of cervical intraepithelial lesions (CIN) was 7.52％,of which the prevalence rates of low-grade cervical intraepithelial lesions (CIN Ⅰ) was 5.32％ high-grade cervical intraepithelial lesions (CIN Ⅱ/Ⅲ ) was 2.21％,cervical cancer was 0.12％.The prevalence of CIN Ⅰ was significantly higher than the CIN Ⅱ/Ⅲ (x2=134.15,P＜0.001 ).The prevalence of cervical cancer in 45- age group was 0.12％,the highest.HPV infection rates increased with the grades of cervical lesions including women without CIN as 44.31％,in CIN Ⅰ as 70.73％,in CIN Ⅱ as 86.73％,and in CIN Ⅲ as 96.75％ and in cancer as 100.00％.The HPV infection rates were different in districts (x2=17.81,P=0.03 ),with Futian and Luohu higher than those of Nanshan,Longgang and Baoan district.The prevalence rate of CIN in Baoan was lower than other districts.The CIN prevalence rates were not significantly different among the other districts of Shenzhen (x2=4.84,P=0.18).Conclusion The prevalence of cervical cancer was low in adult women living in Shenzhen,with cervical lesions still in the early stage.Prevention of HPV infection and treatment of CIN were the key points for the prevention of cervical cancer.
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<p><b>OBJECTIVE</b>To investigate the prevalence of high-risk human papillomavirus (HPV) and incidence of cervical intraepithelial neoplasia (CIN) in female populations in Shenzhen, Guangdong Province, China.</p><p><b>METHODS</b>Totally 1137 women aged 15-59 from Shahe Community, Nanshan District, Shenzhen were investigated for cervical cancer during an population-based epidemiological screening from November 2004 to December 2004. Visual inspection with acetic acid (VIA), colposcopy, liquid-based cytology test (LCT), and hybrid capture 2 (HC-) were performed to detect the high-risk HPV types in cervical secretions. Biopsy under colposcope was performed in women who were HPV-positive with LCT >or= atypical squamous cells of undetermined sign (ASCUS) or HPV-negative with LCT >or= low grade squamous intraepithelial lesion (LSIL), with the pathological results as the golden standards.</p><p><b>RESULTS</b>The detection rate of high-risk HPV-DNA was 14.0%. HPV detection rates in 15-24, 25-29, 30-34, 35-39, 40-44, 45-49, and 50-59 age groups were 15.5%, 17.7%, 12.6%, 8.8%, 10.2%, 15.3%, and 21.0%, respectively (P < 0.05). HPV detection rates in 25-29 years group and 50-59 years group were significantly higher than those in other groups (P < 0.05) and 35-39 group had the lowest detection rate. The curve of HPV infection rates in all groups was 'V' type. The overall incidence of CIN was 4.4%. The incidences of CIN , CIN , and CIN were 3.2%, 1.0%, and 0.3%, respectively, in which the incidence of CIN was significantly higher than those of CIN and . HPV detection rates increased with cervical lesion grades, which in >or=CIN groups and normal group were 100.0% and 8.3%, respectively. No cervical cancer was identified in this research. The sensitivities of VIA, colposcopy, LCT, and HC-II for high-risk HPV screening were 35.7%, 50.0%, 92.9%,and 100%, respectively, in detecting high-grade squamous intraepithelial lesion (HSIL), the specificities of these four methods were 96.0%, 87.2%, 88.4%, and 86.9%, respectively. Satisfactory negative predictive values were obtained for all methods.</p><p><b>CONCLUSIONS</b>HPV infection is the main risk factor for CIN. Cervical cancer among female populations in Shenzhen is still in early stages. Prevention of HPV infection and treatment of CIN are key for the prevention of cervical cancer.</p>
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Adolescent , Adult , Female , Humans , Middle Aged , Young Adult , Uterine Cervical Dysplasia , Epidemiology , Chi-Square Distribution , China , Epidemiology , DNA, Viral , Incidence , Mass Screening , Methods , Papillomaviridae , Genetics , Papillomavirus Infections , Epidemiology , Uterine Cervical Neoplasms , DiagnosisABSTRACT
Objective To evaluate the value of cervical cytology and hybrid capture Ⅱ (HC-Ⅱ) human papillomavarus (HPV) test for screening cervical lesion. Methods Conventional papanicolaou (Pap) smear by improved take-samples, liquid-based cytology test (LCT) and HC-Ⅱ human papillomavarus test were performed in 425 women in Shang Mei-lin community of Futian region in Shenzhen city, from December 2007 to March 2008 and the above methods were performed in 75 women in Shenzhen Hospital of Peking University at the same time. Age stratified sampling was used. Samples of Pap were taken a broom-type sampling device (take-samples used for LCT) with split-sampling method. Those women with HPV-positive, Pap≥atypical squamous cells of undetermined sign (ASCUS) or LCT≥ASCUS received multi-spot biopsy and endocervical curettage under colposcopy. Final diagnosis would depend on pathological findings as well, to evaluate the values of Pap, LCT, HC-Ⅱ HPV, Pap-HPV parallel test, LCT-HPV parallel test, Pap-HPV serial test and LCT-HPV serial test for the screening program on cervical cancer. Results (1) In this study, 7 women bad cervical intraepithelial neoplasia (CIN) Ⅱ, another 7 had CIN Ⅲ, 1 had cervical cancer in the community; 9 had CIN Ⅱ, 11 had CIN Ⅲ, 3 had cervical cancer in the hospital, respectively. (2) The sensitivity of HC-Ⅱ HPV and cytology-HPV parallel test for detecting≥CIN Ⅱ was >95.0% while negative pre-value were nearly 100.0%. (3) There were no significant differences of screening effectiveness and unsatisfactory rates between Pap of improved take-samples and LCT. (4) The cost-effectiveness ratio of Pap-HPV parallel test was higher than LCT-HPV parallel test. Conclusion It was suggested that the first choice for screening of cervical serious lesion were HC-Ⅱ HPV and cytology-HPV parallel test while Pap-HPV parallel test was the best method for screening purposes.
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<p><b>OBJECTIVE</b>To set up a new analysis method of the traditional Chinese medicine Scorpio.</p><p><b>METHODS</b>Ten Scorpio samples were obtained from Hubei, Shaanxi, and Shandong provinces and analyzed with X-ray diffraction Fourier pattern technique to obtain the geometric topology and characteristic marked peak of Scorpio.</p><p><b>RESULTS</b>The geometric topologies of 9 samples were similar, excepting Sample 7#. Totally 11 characteristic marked peaks were observed among these 9 samples.</p><p><b>CONCLUSION</b>X-ray diffraction Fourier pattern is a useful tool for the identification and quality control of the Scorpio.</p>