ABSTRACT
Objective To propose a model for accurately segmenting blood vessels in medical fundus images. Methods The algorithm of deep learning was used for the task of automatic segmentation of blood vessels in retinal fundus images in this paper. An improved vascular segmentation algorithm was proposed. For the different types of blood vessels in the fundus image, a multi-scale network structure was designed to extract features of both main blood vessels and vessel branches at the same time. Results The segmentation model proposed could achieve good results on all kinds of blood vessels even if they have low contrast and few obvious characteristics. The automatic vessel segmentation of retinal fundus images was implemented, and the performance of the model was evaluated through multiple evaluation indexes which are widely used in the field of medical image segmentation in the test stage. A specificity of 0. 9829,an F1 score of 0. 7944,a G-mean of 0. 8748,an Matthews correlation coefficient(MCC) of 0. 7764 and a specificity of 0. 9782 were obtained on the DRIVE dataset. An F1 score of 0. 7735 and an MCC of 0. 7573 were obtained on the STARE data set. Conclusions The proposed method has a great improvement over the segmentation algorithm of the same task. Furthermore,the results generated by our model can achieve comparable effect with the segmentation of human doctor.
ABSTRACT
Objective To investigate clinical and pathologic features of hypertension patients with adre -noeorticotropic hormone ( ACTH)-independent adrenal hyperplasia , and to analyze the relationship between them . Methods The data of patients with ACTH-independent adrenal hyperplasia and hypertension was collected in Department of Urology , the First Affiliated Hospital of Zhengzhou University from Jan .2012 to Dec.2012.The clinical manifestations , endocrine examination results , imaging findings and the pathological changes of adrenal gland were retrospectively analyzed .Results 75 cases were followed-up.Among them, 39 cases were male and 36 were female.Their ages ranged from 20 to 74 years(with 47 as the average).Pathological results showed that diffusive hyperplasia was observed in 42 cases, tubercle hyperplasia in 26 cases, mixed corticomedullary patho-logical changes in 6 cases, and medullary hyperplasia in 1 case.No significant difference was found among diffu-sive, tubercle and mixed corticomedullary hyperplasia in clinical manifestations except for headache , endocrine examination results, or imaging findings(P>0.05).Conclusion There is no relation between clinical manifes-tations, endocrine examination results , imaging findings and pathological changes in adrenal gland for patients with ACTH-independent adrenal hyperplasia and hypertension .
ABSTRACT
Objective To investigate the clinical efficacy of pedicled adrenal transposition for the treatment of adrenocortical and medullary hyperplasia, Methods Twenty cases of adrenal hyperpla-sia (6 men and 14 women; mean age,36 years ) had history of hypertension from 0.5 to 5 years. Of all cases, 15 had centripetal obesity and purple striae, 2 had weakness and polyuria, 3 had durative hypertension. Serum potassium and aldosterone were increased in 4 and 3 cases, respectively. Urinary 17-OH and 17-KS were increased in 15 cases. Epinepgrine, norepinephrine and dopamine increased in 3 cases, VMA increased in 4 cases. CT scan and MRI revealed adrenal diffuse enlargement with in-creased thickness or nodules in 18 and 3 cases, respectively, 131I-MIBG scan showed positive in 3 ca-ses. Preoperative diagnoses were Cushing's syndrome in 11 cases, hyperaldosteronism in 2 cases, pheochromocytoma in 1 case, adrenomedullary hyperplasia in 2 cases, Cushing's syndrome-cate-cholamine syndrome in 4 cases. All cases were treated with transposition of pedicled adrenal gland into the subcutaneous tissues. Results All operations were successful. The average operation time was 120 min, the average blood loss was 40 ml and the average hospital stay was 10 d. No obvious surgical complications occurred. Pathological studies of all the cases revealed the coexistence of adrenocortical and medullary hyperplasia. Seventeen cases were followed up for 0.5-8 years. Thirteen cases had no symptom and normal biochemical results. Four cases still had hypertension and abnormal biochemical results. They were recovered after adrenal operation of the ther side. Conclusion Transposition of pedicled adrenal gland could be an available option to treat patients with adrenocortical and medullary hyperplasia.
ABSTRACT
Objective To explore the clinical efficacy of renal lymphatic stripping with laparo scope.Methods Twenty cases of chyluria (12 men and 8 women; mean age,52 years) were treatedwith laparoscopic renal lymphatic stripping.The diagnosis of chyluria was setup by chylous tests andcystoscopy.The ultrasonic harmonic scalpel was used during the dissociation and ligation.ResultsThe average operation time was 100 min.The average blood loss was 50 ml and the average hospitalstay after operation was 6 d.No surgical complications occurred.The urine was clear and the chyloustests were negative in 19 patients when the patents discharged Irom the hospital.No recurrence ofchyluria was found during the follow up of 6-24 months.One patient with bilateral chyluria occation ally showed chyluria during follow up.Conclusion Laparoscopic stripping of renal lymphatic vesselsfor the treatment of chyluria could be an efficient method with the advantages of simple operating,mini invasion and rapid recovery.
ABSTRACT
Purpose Progressive hypertensive intracerebral hemorrhage (PHICH) is often observed in clinical ward,but its prognosis is undetermined.This study is to investigate the duration and the risk factors of progressive hypertensive intracerebral hemorrhage.Methods The diagnosis of PHICH was determined by comparing the first and second CT scans.Potential risk factors including the sex,age,location of hematoma,blood pressure,coagulopathy and the duration of admission to the first CT scan were analyzed.Results In a cohort 143 patients,the PHICH were found in 41 cases(28.7%)after the second scan,and among them,32 patients(22.4%)were necessary to perform craniotomy for evacuation of hematoma,most of the PHICH occurred within 24 hours after onset.Older age,thalamus bleeding,high systolic blood pressure within 6 hours,coagulapathy and shorter duration from admission to the first CT scan were the predictors associated with PHICH.Conclusion PHICH occurs in almost 1/4 of hypertensive intracerebral hemorrhage,predominantly in elder,thalamus bleeding,coagulapathy,high systolic blood pressure within 6 hours and shorter duration between onset and the first CT scan.CT examination within 24 hours after admission is crucial to reveal the exact condition of the patient.
ABSTRACT
OBJECTIVE:To establish the quality control method for compound seabuckthorn oil granule.METHODS:Radix astragali,angelica root,rhizoma chuanxiong,seabuckthorn seed oil were identified by TLC and the content of astragalosideⅠin compound seabuckthorn oil granule was determined by TLC-scanning method.RESULTS:Radix astragali,angelica root,rhizoma chuanxiong,seabuckthorn seed oil could be detected by TLC.Good liner relationship achieved when the sample application size of astregalosideⅠwas with the range of 0.98?g～4.90?g,the average recovery was 99.62%(RSD=2.51%).CONCLUSION:This method is simple,accurate with good reproducibility and strong specificity,and it can be used for the quality control of compound seabuckthorn oil granule.
ABSTRACT
Objective To investigate the expression of ACTH in normal and hyperplastic adrenal cortical tissue, and to explore the relationship between plasma ACTH concentration and expression level of ACTH in adrenal cortical tissue of patients with adrenal cortical hyperplasia. Methods The expression of ACTH in adrenal cortical tissue was examined by immunohistochemical technique, and the result was analyzed by computer-assisted image analyzing system. Besides, plasma ACTH concentration was measured by RIA. The correlation between plasma ACTH concentration and expression level of ACTH in adrenal cortical tissue of patients with adrenal cortical hyperplasia was studied. Results The expression of ACTH was significantly higher in adrenal cortical tissue of patients with ACTH-independent adrenal cortical hyperplasia than those with ACTH-dependent adrenal cortical hyperplasia and normal adrenocortical tissue (both P0.05). Conclusion ACTH expression exists in normal adrenal cortical tissue. Local ACTH overproduction appears to participate in the pathogenesis of ACTH-independent adrenal cortical hyperplasia.The raised concentration of plasma ACTH influences the expression of ACTH in cortical tissue of patients with ACTH-dependent adrenal hyperplasia.
ABSTRACT
Objective To evaluate effectiveness of microvascular decompression in the treatment of trigeminal neuralgia. Methods 126 cases of trigeminal neuralgia were operated on by microvascular decompression via suboccipital retrosigmoid approach. It was found that nerves were compressed by vessels nerves in 122 cases. Cotton of Teflon was implanted between oppressive trigeminal nerve roots and vessels by minimally invasive surgery. Results 113 of 126 cases were followed up postoperatively for (1～9)years. Pain disappeared or died down in 110 cases. The total effective rate was 97.3%(110/113). Conclusions Microvascular decompression is effective treatment for trigeminal neuralgia.
ABSTRACT
Objective To summarize the clinical features and transsphenoidal microsurgical experiences of pituitary adenomas in the elderly patients over 70 years old Methods Twenty four elderly patients accepted transsphenoidal microsurgery were conductded a retrospective review,whose clinical data including clinical main presentation,histological types,surgical conditions,perioperative treatment and outcome were also analyzed Results There were 16 non functional adenomas (66 7%) and 18 giant macroadenomas(75%) respectively Visual deterioration was the commonest complain in 20 (83 3%) Despite the majority of patients having coexisting medical conditions,we had no mortality and no postoperative adjunctive morbidity with an average hospital stay of 17 8 days For an average follow up of 3 5 years,we did observe major patients(79 2%) vision had improved Conclusions Pituitary adenomas in the elderly are most frequently non functional macroadenomas that present with visual deterioration and hypopituitarism If special care is devoted to the perioperative treatment,in particular to fluid and electrolyte balances,transsphenoidal microsurgery is safe and effective in hands of an experienced team
ABSTRACT
AIM: To establish the method for determination of luteolin and isorhamnetin in Duyiwei Capsules (Lamiophl mis rotata(Benth.)Kudo). METHODS:Yilite-C_(18) column was used.The mobile phase was composed of methanol-water(50∶50),pH was adjusted to 3.0 with H_3PO_4.The flow rate was 0.8 mL?min~(-1) and detection wave-length was set at 360 nm. RESULTS:The linear range of Luteolin was 7.072-35.360 ?g?mL~(-1),(r=(0.999 7)) and the linear range of isorhamnetin was 1.658-8.290 ?g?mL~(-1)(r=0.999 2). The average recovery and RSD of luteolin were 96.3% and 2.7%,respectively. The average recovery and RSD of isorhamnetin were 97.3% and 2.1%,respectively. CONCLUSION:This method is sensitive,accurate and can be used for the quality study of Duyiwei Capsules.