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Retinopathy of prematurity (ROP) is a major cause of vision loss and blindness among premature infants. Timely screening, diagnosis, and intervention can effectively prevent the deterioration of ROP. However, there are several challenges in ROP diagnosis globally, including high subjectivity, low screening efficiency, regional disparities in screening coverage, and severe shortage of pediatric ophthalmologists. The application of artificial intelligence (AI) as an assistive tool for diagnosis or an automated method for ROP diagnosis can improve the efficiency and objectivity of ROP diagnosis, expand screening coverage, and enable automated screening and quantified diagnostic results. In the global environment that emphasizes the development and application of medical imaging AI, developing more accurate diagnostic networks, exploring more effective AI-assisted diagnosis methods, and enhancing the interpretability of AI-assisted diagnosis, can accelerate the improvement of AI policies of ROP and the implementation of AI products, promoting the development of ROP diagnosis and treatment.
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Objective: To explore the impact of different atorvastatin doses on platelet function and highreactivity in patients with acute ST-elevation myocardial infarction (STEMI) after emergent percutaneouscoronary intervention (PCI) therapy. Methods:A total of 120 STEMI patients with emergent PCI therapy were randomly divided into 2 groups:Standard group, the patients received atorvastatin 20 mg/day and Intensive group, the patientsreceived atorvastatin 40 mg/day, all patients were treated for 7 days. n=60 in each group. Blood lipids and biochemistry were examined before PCI and 7 days after atorvastatin treatment respectively;platelet fibrin clot strength induced by ADP (MAADP), AA and ADP induced platelet inhibition rate were measured by thrombelastography (TEG) test. Results: With 7 days treatment, compared with Standard group, Intensive group showed decreased MAADP (38.40±17.40) mm vs (45.70±14.50) mm, P0.05. The patients were followed-up for 3 months and the end point events including unstable angina, non-fatal MI, in-stent restenosis, in-stent thrombosis, and cardiovascular death or target vessel revascularization were similar between 2 groups, P>0.05. Conclusion: Early stage and short term administration of high dose atorvastatin could obviously inhibit platelet activity in STEMI patients after emergent PCI;such intensive atorvastatin treatment had no reduction on end point events in 3 months follow-up period.
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Objective To investigate the effects of different doses of atorvastatin on plasma endothelin and platelet function in acute ST-segment elevation myocardial infarction (STEMI) patients after emergency percutaneous coronary intervention (PCI).Methods A total of 120 patients with acute STEMI treated with emergency PCI were enrolled and randomly divided into 20 mg of atorvastatin treatment group (standard group,n =60),and 40 mg of atorvastatin treatment group (intensive group,n =60).The blood C reactive protein (CRP),blood lipid profiles,plasma endothelin (ET) were measured before atorvastatin treatment and after 7 days of treatment,respectively.The platelet fibrin clot strength induced by ADP (MAADP) was determined by thrombelastography (TEG).Results Seven days after of atorvastatin treatment,the level of plasma ET in intensive group was significantly lower than that in standard group [(0.49 ± 0.21) pmol/L vs (0.63 ± 0.58) pmol/L,P ＜ 0.05].Moreover,the MAADP in intensive group was significantly decreased compared with the standard group [(38.4 ± 17.4) mm vs (45.7 ± 14.5) mm,P ＜ 0.05].There was a positive correlation between the ET level and MAADP in intensive group after treatment (r =0.378,P ＜ 0.05).However,no significantly differences could be viewed in the CRP and LDL-C levels between the two groups (P ＞ 0.05).Conclusion In patients with acute STEMI,early administration of 40 mg atorvastatin after emergency PCI could significantly reduce the vascular endothelial injury,improve endothelial function,and reduce the residual platelet activity.
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Objective To evaluate the effects of the range and the frequency of the compression load on the accuracy for discerning target stiffness differences in ultrasound elastography.Methods Quantitative ultrasound elastography was achieved by integrating two compression force sensors,a laptop computer and a clinical ultrasound elastographic system.The force sensors and the ultrasound probe were assembled in a 3D printed mounting bracket for continuous monitoring of compression loads during ultrasound elastography. Both the force measurements and the elastographic maps were acquired and displayed on the laptop computer in real time.Four targets of the same diameter(10.4 mm),the same depth (3 cm) and different stiffness levels (8,14,45 and 80 kPa) were examined by a HITACHI preirus,L74M linear-array transducer.Each target was evaluated 45 times with two different method(i.e.,freehand elastography and quantitative elastography),yielding 1 80 evaluations.The data were divided into the following three groups:group Ⅰ(80 kPa vs 45,14 and 8 kPa),group Ⅱ(80,45kPa vs 14,8 kPa)and group Ⅲ(80,45 and 14 kPa vs 8 kPa).Area under ROC curves(AUC)were calculated for different stiffness levels.Results In group Ⅲ, quantitative elastography yielded an greater AUC level than that of freehand elastography(P =0.0379).In group Ⅰ and group Ⅱ,two methods yielded the similar AUC levels (P = 1 .000).However,quantitative elastography was able to discern 8 kPa and 14 kPa targets (P <0.001),while freehand elastography was hard to differentiate them(P =0.258).Conclusions In comparison with freehand elastography,quantitative ultrasound elastography is able to improve the accuracy for discerning different target stiffnesses.
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Objective To investigate the relationship between molecular biological markers and recombinant human endostatin targeted therapy in non-small-cell lung cancer(NSCLC).Methods 68 cases patients with non-small-cell lung cancer to meet the requirements were randomly divided into group A (n=34)and group B (n=34).Group A received docetaxel and cisplatin(DP)and gefitinib;group B received recombinant human endostatin on the base of group A.The biological markers species,such as,EGFR,KRAS,VEGF,BRCA1,EML4-ALK,ERCC1,β-tubulin and CD3 were detected by immunohistochemical.The types of population for different programs were summarized according to the expression of biological markers and progression free survival (PFS)of the two groups. Results Group B median PFS was significantly longer than that in group A;no matter low or high expression of VEGF and BRCA1,group B median PFS was significantly longer than that in group A(P<0.05);high expression of ERCC1,KRAS,EML4-ALK andβ-tubulin,group B median PFS was significantly longer than that in group A(P<0.05);low expression of EGFR and CD3,group B median PFS was significantly longer than that in group A (P<0.05 ).Conclusion No matter low or high expression of VEGF and BRCA1 ,low expression of KRAS, ERCC1,EML4-ALK and β-tubulin and high expression of EGFR and CD3 in patients with non-small cell lung cancer may be more sensitive to the treatment of DP and gefitinib combined with recombinant human endostatin.
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<p><b>OBJECTIVE</b>To evaluate the relationship between levels of soluble Fas (sFas) and soluble Fas ligand (sFasL) in serum and peritoneal fluid of endometriosis-associated infertility.</p><p><b>METHODS</b>The soluble Fas ligand and soluble Fas levels in serum and peritoneal fluid of 20 infertile patients with endometriosis were assessed with enzyme-linked immunosorbent assay, and were compared with 14 infertile patients due to chronic pelvic infectious disease and 16 fertile controls.</p><p><b>RESULTS</b>The sFasL levels were significantly higher in infertile patients with endometriosis (175.09 +/- 80.55 pg/mL in serum and 284.50 +/- 152.38 pg/mL in peritoneal fluid) than those of infertile controls (88.47 +/- 43.55 pg/mL in serum and 17.30 +/- 9.62 pg/mL in peritoneal fluid) and fertile controls (16.13 +/- 11.75 pg/mL in serum and 8.84 +/- 2.31 pg/mL in peritoneal fluid). In contrast, as for the sFas levels, infertile patients with endometriosis (828.60 +/- 429.65 pg/mL in serum and 349.61 +/- 288.89 pg/mL in peritoneal fluid) did not show any significant difference compared with those in infertile patients resulting from pelvic infectious disease (868.75 +/- 570.48 pg/mL in serum and 181.76 +/- 157.78 pg/mL in peritoneal fluid) and fertile control (822.26 +/- 129.12 pg/mL in serum and 318.42 +/- 145.16 pg/mL in peritoneal fluid).</p><p><b>CONCLUSIONS</b>Based upon these results, high level of sFasL in serum and peritoneal fluid and thus apoptosis mediated by it may be implicated in the mechanism involved in endometriosis-related infertility.</p>
Subject(s)
Female , Humans , Ascitic Fluid , Chemistry , Endometriosis , Metabolism , Fas Ligand Protein , Infertility, Female , Metabolism , Ligands , Membrane Glycoproteins , Blood , Metabolism , Pelvic Infection , Metabolism , Solubility , fas Receptor , Blood , MetabolismABSTRACT
Objective To investigate the effect of esophageal mucosal acid exposure on visceral sensation of patients with non-erosive gastroesophageal reflux disease (NERD) and to evaluate the role of visceral hypersensitivity in NERD pathogenesis. Methods We recruited 21 NERD patients and 10 normal healthy volunteers. Mechanical distentions stimulation and acid perfusion through esophagus were performed using the balloon-affixed and polyvinyl multilumen catheter. Esophageal visceral perception thresholds were examined before and after acid perfusion with esophageal balloon distention by means of a computer-controlled barostat. Results As compared with healthy subjects, NERD patients demonstrated significantly lower initial perception threshold and maximally tolerated pain threshold (P
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Objective To assess short term results of papilla functional status after endoscopic sphincterotomy (EST) with thin-barium meal examination.Methods From August, 2001 to December, 2003, eighty-nine patients were included for endoscopic sphincterotomy. Size of EST was (0.5～1.5) cm. Patients were prospectively followed on the short term-period (7 days, 6 months and 1 year) by clinical and thin-barium(100/100 V/W) meal examination which would be observed biliary gas and barium reflux from duodenal papilla.Results The patient number of gas reflux shows: 19 of 89 cases(21.3%) in one week, 5 of 36 cases(13.9%) in six months, 13 of 23 cases (13.0%)in one year; barium reflux with thin-barium meal examination shows: 11 of 89 cases(12.4%) in one week, 3 of 36 cases(8.3%) in six months, 2 of 23 cases(8.7%) in one year. In the size of EST more than 1.1 cm, these were nine patients (47.4%) with gas reflux, and seven patients (36.8%) with barium reflux, and five patients with gas-barium mix reflux. 6 month and 1 year after sphincterotomy, includes EST size 1.2 cm,2 cases and 1.5 cm,3 cases.Conclusion Thin-barium meal examination of papilla function after endoscopic sphincterotomy is an efficient procedure. Incidence rate of gas reflux and thin barium reflux were closely related to the size of EST.
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Objective The aim of this study was to evaluate and to characterize the visceral hypersensitivity in non-erosive reflux disease(NERD)through the detection of esophageal distension-cerebral evoked potentials(ED-CEP)and calcitonin gene related peptide(CGRP)and substance P(SP)levels in esophageal mucosa.Methods NERD patients(N 26)and 12 controls were enrolled in this study from Oct.2004 to Mar.2005.Mechanical distention stimulation was performed using the balloon-affixed and polyvinyl multilumen catheter.The ED- CEP was recorded with a muti-channel international 10~20 system of electroencephalograph.The esophageal specimens were immune-histologically evaluated for CGRP/SP-stain positive contents.Results Esophageal distention may evoke recognizable and reproducible muti-peak CEP.CEP morphology of NERD patients was characterized by randomly distributed patterns,and the peak latencies for N1,P1,and N2 were significantly shorter compared with control group(P
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Objective Clinical features of primary biliary cirrhrosis(PBC) were reviewed in order to improve its diagnosis and treatment. Method The general conditions, clinical manifestations, biochemical and immunological changes, and pathological findings were assessed in 31 patients. Result Twenty five cases were females, the mean age at definite diagnosis was (49.2?10.7)years. Jaundice(74.2%) was the most frequent symptoms, pruritus (51.6%) and fatigues (32.3%)were the second and thrid, respectively. Three patients (9.7%)were complicated by ascites. Serum alkline phosphatase (ALP) , glutamyl transpeptidase (? GT) and bilirubin levels were markedly elevated ((388.9?277.5)U/L, (381.6?213.2)U/L and( 176.4 ?176.1)?mol/ L, respectively).ALT and AST levels were mildly or moderately elevated ((79.7?46.3) U/L and(119.8?61.2)U/L, respectively),mean level of IgM was also elevated to (3.0?1.9)g/L. 92% (23/25) of patients had positive anti mitochondrial antibody(AMA). Ursodeoxycholic acid (UDSA) was efficitive in 61.3% of patients. Conclusions PBC most frequently affects middle aged women. The elevated level of ALP, ? GT and IgM and AMA positive may be crucial to diagnosis of PBC. Liver biopsy can help to identify the diagnosis and carry on pathological staging.
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Objective To investigate characteristics and alternation of cerebral evoked potentials (CEP) response to esophageal mucosal acid exposure and distention in patients with non-erosive gastro-oesoph- ageal reflux disease (NERD) and in healthy subjects,and to study the mechanism of visceral hypersensitivity in NERD.Methods Twenty-one NERD patients and 10 volunteers were recruited.Mechanical distention stimulation and acid perfusion of the esophagus were performed using the balloon-affixed and polyvinyl multi- lumen catheter.First,maximally tolerated pain thresholds of all subjects were recorded,then esophageal mechanical stimulation with a 75% of maximal tolerated intensity and a frequency of 0.2 Hz was performed altogether 64 times by means of a computer-controlled barostat.The alternation of esophageal CEP was recorded before and after acid perfusion with a multichannel international 10-20 system of electroencephalography. Experimental data was analyzed by student's t-test and one way analysis of variance.Results Esophageal mu- cosal distention may evoke recognizable and reproducible and multi-peak CEP.The latencies for N1,P1 and N2 in volunteers were (246?77),(388?84)and (502?78) ms,CEP morphology of NERD patients was charac- terized by randomly distributed patterns,and the latencies for N1 ,P1 and N2 were (192?46),(293?76) and (440?79)ms,significantly shorter for mechanical stimulation compared with those of control group respectively (all P value
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Objective To investigate the clinical features, management, surveillance and possible pathophysiology of short segment Barrett's esophagus (SSBE).Methods Fifty two cases of SSBE identified by endoscopy and pathology were enrolled in this retrospective study. The endoscopic manifestations, pathological changes, esophageal motor function, management and follow up results were assessed.Results The island pattern was most prominent type accounting for 86.5%, and specialized intestinal metaplasia (SIM) was found in 15.4% of patients with routing H E stain. Abnormal motor function were showed in 8 of 11 cases(72.7%) who received 24 hs esophageal pH and bilirubin monitoring and esophageal manomery. Argon plasma coagulation therapy was carried out in 21 cases and SSBE ablation was achieved in 15 cases based on shor term follow up result. No esophageal adenocarcinoma was found in 49 patients revisited.Conclusions SSBE is associated with abnormal gastroesophageal acid and bile reflux. Island pattern is the most common endoscopic appearance. Specialized intestinal metaplasia and dysplasia may be less frequent in patients with SSBE.
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Objective To investigate clinical characteristics of reflux esophagitis ( RE) in Chinese population according to the retrospective analysis of RE in the past 14 years. Methods 3851 cases of RE were diagnosised in our department according to the Los Angeles grading system, and the general status, clinical symptoms, endoscopic findings and values of esophageal manometry,24-hour esophageal pH and biliru-bin monitoring were assessed. Results RE accounted for 2. 95% of the total endoscopy numbers, but the present of RE during 2000 - 2004 y was significantly elevated to 4. 25%. The gender ratio (male: female) was 3.4-1. In the recent 4 years mean age of the patients with original RE was (53. 9 ?14. 5) years. Grade A and B RE comprised of 85. 8% and grade C and D only 14. 2%. The index values such as percent of time with pH 0. 14 and total reflux times were abnormal in RE group, and significant difference existed between the mild and severe RE (P
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Objective To study the effect of bone marrow mononuclear cells transplantation on restenosis rate and its mechanism. Methods The left anterior descending coronary arteries of swines were obstructed by balloon to create myocardial infarction models. After 3 weeks coronary stents were implanted at the middle part of the left anterior descending coronary arteries followed by the injection of bone marrow mononuclear cells into the coronary arteries. The degree of restenosis were measure by quantitative coronary angiography (QCA) after four weeks. Vascular tissue at both ends of stents were tested by HE and Sirius staining to analyse the mechanism of restenosis. Results At end of the experiment there were 8 swines in the bone marrow mononuclear cells transplantation group and 9 in the control group. After injection of bone marrow mononuclear cells the restenosis rate was similar to the control group (50% vs 44%, P=0.762). The lumen late loss was also similar between the two groups (1.50?1.45 mm vs 1.31?1.07 mm,P=0.736). Conclusion Bone marrow mononuclear cells transplantation does not increase the restenosis rate after percutaneous coronary artery intervention.
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Objective To study the effects of bone marrow mononuclear cells (MNCs) transplantation on left ventricular (LV) remodeling and its potential mechanism in swine myocardial infarction models. Methods The left anterior descending coronary arteries of swines were obstructed by balloon to create myocardial infarction models. Three weeks later, MNCs(n= 7)or PBS(n=5) were injected into the infarction related coronary arteries through balloon catheter. The cardiac function were measured by echocardiography and ventriculargraphy. Collagen amount was also assessed at 4 weeks after transplantation. Results At 4 weeks after transplantation, LV end-diastolic dimension decreased in the BM-MNC group than before (40.40?4.51 mm vs. 45.88?4.15 mm, P=0.026), but increased in the control group (48.50?9.31 mm vs. 42.40?7.29 mm, P=0.328). Left ventricular function was improved from 41.16%?9.83% to 47.50%?9.07% in the BM-MNC group (P=0.020) but there was no significant change in the control group. Significant differences existed between the 2 groups in their absolute change before and after the procedure in both LV dimension and LV function (P=0.046 and P=0.030 respectively). The results showed reduction of collagen content in the border and the remote infarct regions in the BM-MNC group compared with the control (P=0.047 and P=0.034 respectively). Conclusion BM-MNCs transplantation regulates collagen content in heart and attenuates the degree of post-MI LV dilation and the development of infarction area. This effect of BM-MNCs transplantation may be one of the mechanisms which intervene ventricular remodeling following myocardial infarction.