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Objective:To investigate the feasibility and clinical value of 4D flow magnetic resonance imaging (MRI) in evaluating hemodynamics of ischemic stroke patients with intracranial artery stenosis.Methods:Ischemic stroke patients with unilateral middle cerebral artery stenosis admitted from March 2017 to June 2018 in Beijing Tsinghua Changgung Hospital Stroke Center were prospectively enrolled. Time of flight magnetic resonance angiography was used to evaluate vascular stenosis, 4D flow MRI was used to measure net forward flow at the proximal of stenosis, and brain tissue perfusion was acquired simultaneously to validate flow.Results:A total of 33 patients with symptomatic middle cerebral artery stenosis were included [mean age: 56 years; male: 63.6% ( n=21)]. The flow rates among patients with stenosis of <30%, 30%-49%, 50%-69% and ≥70% were (3.56±1.08), (2.96±0.94), (3.72±0.60) and (2.50±1.03) ml/s individually, demonstrating a decreased flow in subjects with severe (≥70%) stenosis ( F=4.34, P=0.008). Further analysis about forward flow and brain tissue perfusion showed that the significant negative correlation between absolute flow rate or relative flow rate and relative time to peak could only be established in subjects with poor collateral (collateral score: 0-2), with r=-0.76 and -0.61 individually, both P<0.05. Conclusion:4D flow MRI could be used as a quantitative flow assessment in subjects with intracranial artery stenosis, and its association with distal brain tissue perfusion depends on collateral status.
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Objective To investigate and analyze the epidemiological characteristics of an epidemic situation of human brucellosis epidemic in Xinchang County Zhejiang Province,and provide experience for prevention and treatment of brucellosis.Methods Retrospective analysis was performed to collect the data of epidemic situation,field case investigation,serum test and hospital diagnosis and treatment,and the situation of epidemic situation in 2018 of Xinchang County and field investigation were summarized and analyzed.Results A total of 3 confirmed cases were reported in this outbreak,one of them was a laboratory diagnosed case of brucellosis,2 cases were closely contacted with sick animals,and those 2 cases were confirmed by serological tests (n =30).The source of infection was the purchase and slaughter of unquarantined goats.A total of 10 goats blood samples were collected in the inter-animal investigation,4 of them were positive.Conclusion Unprotected contact with infected goats is a major exposure factor,raising awareness and promoting publicity about the path of infection with brucellosis is the key to preventing brucellosis.
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Objective To investigate whether routine laboratory findings should be awaited before intravenous thrombolytic therapy for ischemic stroke.Methods Emergency patients (including ischemic and non-ischemic stroke cases) treated at the Department of Neurology,Beijing Tsinghua Changgung Hospital between January 1st 2016 and October 1st 2017 were analyzed retrospectively.The platelet count,prothrombin time (PT),activated partial thromboplastin time (APTT),and international normalized ratio (INR) in the first test were used as the main indicators.The proportion of patients with abnormalities between the overall population and the ischemic stroke subgroup was analyzed,and the above indicators between all patients with ischemic stroke and those receiving intravenous thrombolytic therapy were compared.The specific causes of failure to receive intravenous thrombolytic therapy in patients with ischemic stroke were analyzed descriptively.Results A total of 3 348 patients were enrolled.The emergency blood routine data were available in all patients.The emergency blood biochemical data were available in 3 278 patients (97.9％),and the emergency coagulation function data were available 1 742 patients (52.0％).There were no significant differences in the proportion of platelet count ＜ 100 × 109/L (1.3％ vs.1.5％;x2=0.29,P=0.586),APTT＞36.5s (3.8％ vs.3.6％;x2=0.06,P=0.809),PT ＞15s (2.6％ vs.2.8％;x2 =0.03,P=0.866),and INR ＞ 1.5 (2.0％ vs.2.0％;x2 =0.01,P=0.970) between the general population and the ischemic stroke subgroup.In a total of 687 patients with ischemic stroke,57 (8.3％) received intravenous thrombolysis.There were no significant difference in mean platelet count,APTT,PT,and INR between the thrombolytic group and the entire ischemic stroke group.Forty-nine patients (5.1％) with ischemic stroke had abnormal main indicators,of which 57.1％ (28/49) had a history of related diseases at the same time,while only 6.1％ (3/49) had abnormal laboratory indicators as the main factor of contraindication for intravenous thrombolysis.Conclusions Patients with acute ischemic stroke (especially in the absence of a history of related disease) have a low proportion of abnormal blood test findings and are less likely to be the main contributor of contraindication for intravenous thrombolysis.Therefore,when there is no reason to suspect that the test findings are abnormal,intravenous thrombolytic therapy should not be delayed because of waiting for the test findings.
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Exoskeleton nursing robot is a typical human-machine co-drive system. To full play the subjective control and action orientation of human, it is necessary to comprehensively analyze exoskeleton wearer's surface electromyography (EMG) in the process of moving patients, especially identifying the spatial distribution and internal relationship of the EMG information. Aiming at the location of electrodes and internal relation between EMG channels, the complex muscle system at the upper limb was abstracted as a muscle functional network. Firstly, the correlation characteristics were analyzed among EMG channels of the upper limb using the mutual information method, so that the muscle function network was established. Secondly, by calculating the characteristic index of network node, the features of muscle function network were analyzed for different movements. Finally, the node contraction method was applied to determine the key muscle group that reflected the intention of wearer's movement, and the characteristics of muscle function network were analyzed in each stage of moving patients. Experimental results showed that the location of the myoelectric collection could be determined quickly and efficiently, and also various stages of the moving process could effectively be distinguished using the muscle functional network with the key muscle groups. This study provides new ideas and methods to decode the relationship between neural controls of upper limb and physical motion.
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Humans , Electromyography , Exoskeleton Device , Muscle, Skeletal , Physiology , Robotics , Upper ExtremityABSTRACT
Alzheimer's disease (AD) is a typical neurodegenerative disease, which is clinically manifested as amnesia, loss of language ability and self-care ability, and so on. So far, the cause of the disease has still been unclear and the course of the disease is irreversible, and there has been no cure for the disease yet. Hence, early prognosis of AD is important for the development of new drugs and measures to slow the progression of the disease. Mild cognitive impairment (MCI) is a state between AD and healthy controls (HC). Studies have shown that patients with MCI are more likely to develop AD than those without MCI. Therefore, accurate screening of MCI patients has become one of the research hotspots of early prognosis of AD. With the rapid development of neuroimaging techniques and deep learning, more and more researchers employ deep learning methods to analyze brain neuroimaging images, such as magnetic resonance imaging (MRI), for early prognosis of AD. Hence, in this paper, a three-dimensional multi-slice classifiers ensemble based on convolutional neural network (CNN) and ensemble learning for early prognosis of AD has been proposed. Compared with the CNN classification model based on a single slice, the proposed classifiers ensemble based on multiple two-dimensional slices from three dimensions could use more effective information contained in MRI to improve classification accuracy and stability in a parallel computing mode.
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Humans , Alzheimer Disease , Diagnosis , Brain , Diagnostic Imaging , Cognitive Dysfunction , Deep Learning , Neural Networks, Computer , Neuroimaging , PrognosisABSTRACT
In recent years, researchers have introduced various methods in many domains into medical image processing so that its effectiveness and efficiency can be improved to some extent. The applications of generative adversarial networks (GAN) in medical image processing are evolving very fast. In this paper, the state of the art in this area has been reviewed. Firstly, the basic concepts of the GAN were introduced. And then, from the perspectives of the medical image denoising, detection, segmentation, synthesis, reconstruction and classification, the applications of the GAN were summarized. Finally, prospects for further research in this area were presented.
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Objective To assess the value of brain atrophy and lesion index(BALI),based on magnetic resonance imaging(M RI),in the evaluation of brain aging. Methods 169 healthy older adults were divided into five age groups(40-49,50-59,60-69,70-79,and 80-89 years).MRI scans were evaluated by the 3.0T GE signa and the BALI rating schemes,based on the T1 weighted(T1WI),T2 weighted(T2WI),and T2 weighted fluid attenuated inversion recovery(T2-FLAIR),and T2*weighted gradient-recalled echo(T2 * GRE)images were recorded. Results Based on T1WI,T2WI,T2-FLAIR and T2 * GRE,total scores of BALI increased with age,and showed significant differences between the five age groups(F= 35.35,42.87,46.57,and 54.15,respectively;all P= 0.000).In addition,BALI scores from each sequence were correlated with age(T1WI:r=0.71;T2WI:r=0.73;T2-FLAIR:r=0.73;T2*GRE:r=0.77;all P<0.01).Furthermore,T2*GRE was most sensitive to microbleeds and T2-FLAIR revealed a greater level of deep white matter(χ2 =53.47,P= 0.000)and periventricular lesions(χ2 =29.93,P=0.000)than other sequences. Conclusions The T1WI,T2WI, T2-FLAIR and T2 * GRE,BALI scores can be used to assess whole brain structural changes with aging and provide semi-quantitative indicators for the assessment of brain health.
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The demand for diagnosis and therapy of diseases should be higher in the era of precision medicine.The superparamagnetic iron oxide nanoparticles (SPION) is used in diagnosis,therapy,and monitor of diseases due to its good superparamagnetism,which has always been paid more attention in molecular imaging.The research progresses of SPION in precision medicine were reviewed in this article.
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The pharmacokinetic profile of gallocatechin-7-gallate (J10688) was studied in rats after intravenous administration. Male and female Sprague-Dawley (SD) rats received 1, 3, and 10 mg/kg (i.v.) of J10688 and plasma drug concentrations were determined by a high performance liquid chromatography-mass spectrometry (LC-MS) method. The pharmacokinetic software Data Analysis System (Version 3.0) was used to calculate the pharmacokinetic parameters. For different i.v. doses of J10688, the mean peak plasma concentration (C 0) values ranged from 11.26 to 50.82 mg/L, and mean area under the concentration-time curve (AUC0-t ) values ranged from 1.75 to 11.80 (mg·h/L). J10688 lacked dose-dependent pharmacokinetic properties within doses between 1 and 10 mg/kg, based on the power model. The method developed in this study was sensitive, precise, and stable. The pharmacokinetic properties of J10688 in SD rats were shown to have rapid distribution and clearance values. These pharmacokinetic results may contribute to an improved understanding of the pharmacological actions of J10688.
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objective To investigate the recurrence of stroke,clinical prognosis and vascular changes in patients with ischemic stroke due to middle cerebral artery stenosis. Methods The ischemic stroke patients with symptomatic middle cerebral artery stenosis were enrolled continuously and followed up prospectively for six months. The recurrence of ipsilateral stroke,clinical prognosis and dynamic changes of vessels were analyzed. Results Eighty patients were included,and 20.0% of the patients(16 cases)presented with recurrence of ipsilateral ischemic stroke and 56 cases (70.0%)with a good outcome(modified Rankin scale[mRS]≤1)during the 6 months follow-up;38.6% patients (27 cases) presented with significant vascular changes with progression in 12 cases (17.1%)and regression in 15 cases (21.4%). Conclusion The patients with simple symptomatic middle cerebral artery stenosis have an high rate recurrence of ipsilateral stroke but have good prognosis;Lesioned artery of the majority of patients in the short period after stroke was stable,but vascular stenosis in some patients could appear progression or remission.
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Objective To explore the feasibility of radical cholecystectomy for early gallbladder car cinoma found during or after laparoscopic cholecystectomy.Methods A retrospective study was conducted on patients who received laparoscopic cholecystectomy between January 2007 to August 2013 and were diagnosed to have gallbladder cancer during or after the operation.There were 34 patients.In 29 patients intraoperative frozen section diagnosed gallbladder carcinoma.In 5 patients postoperative histopathological study diagnosed stage Ⅰ or Ⅱ gallbladder carcinoma.Results Surgery was conducted successfully on these 34 patients.In 20 patients with stage Ⅰ,Ⅱ and Ⅲ,the tumor had invaded the serosa,or into the liver with a depth of less than 2 cm,laparoscopic cholecystectomy alone or radical/extended radical cholecystectomy were carried out.In 9 patients,the laparoscopic surgery was converted to open surgery and these patients underwent cholecystectomy with resection of the adjacent liver segments/sections.In 5 patients who were diagnosed to have gallbladder carcinoma after laparoscopic cholecystectomy,they were re-operated with laparoscopic radical cholecystectomy.Conclusions Stage Ⅰ,Ⅱ and Ⅲ gallbladder carcinoma with tumor invasion into serosa,or patients with tumor invasion into the liver with a depth of less than 2 cm should undergo radical or extended radical cholecystectomy.Laparoscopic assisted radical or extended radical cholecystectomy could achieve the same operation as with open surgery but with better short-term results.There were less pain,smaller incisions,better scars and shorter hospitalization stay.