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@#Objective In tongue diagnosis, the location, color, and distribution of spots can be used to speculate on the viscera and severity of the heat evil. This work focuses on the image analysis method of artificial intelligence (AI) to study the spotted tongue recognition of traditional Chinese medicine (TCM). Methods A model of spotted tongue recognition and extraction is designed, which is based on the principle of image deep learning and instance segmentation. This model includes multiscale feature map generation, region proposal searching, and target region recognition. Firstly, deep convolution network is used to build multiscale low- and high-abstraction feature maps after which, target candidate box generation algorithm and selection strategy are used to select high-quality target candidate regions. Finally, classification network is used for classifying target regions and calculating target region pixels. As a result, the region segmentation of spotted tongue is obtained. Under non-standard illumination conditions, various tongue images were taken by mobile phones, and experiments were conducted. Results The spotted tongue recognition achieved an area under curve (AUC) of 92.40%, an accuracy of 84.30% with a sensitivity of 88.20%, a specificity of 94.19%, a recall of 88.20%, a regional pixel accuracy index pixel accuracy (PA) of 73.00%, a mean pixel accuracy (mPA) of 73.00%, an intersection over union (IoU) of 60.00%, and a mean intersection over union (mIoU) of 56.00%. Conclusion The results of the study verify that the model is suitable for the application of the TCM tongue diagnosis system. Spotted tongue recognition via multiscale convolutional neural network (CNN) would help to improve spot classification and the accurate extraction of pixels of spot area as well as provide a practical method for intelligent tongue diagnosis of TCM.
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OBJECTIVE@#To compare clinical effects of different postoperative rehabilitation modes on lumbar degenerative diseases, and explore influence of rehabilitation mode and other factors on postoperative effect.@*METHODS@#From June 2013 to July 2016, totally 900 patients were admitted from nine tertiary hospitals in Beijing to perform single segment bone grafting and internal fixation due to lumbar degenerative diseases were prospectively analyzed. There were 428 males and 472 females, the age of patient over 18 years old, with an average of (51.42±12.41) years old;according to patients' subjective wishes and actual residence conditions, all patients were divided into three groups, named as observation group 1 (performed integrated rehabilitation approach and orthopedic treatment model intervention), observation group 2 (performed integrated rehabilitation approach and orthopedic treatment, classified rehabilitation model intervention), and control group(performed routine rehabilitation model intervention). Visual analogue scale(VAS), Oswestry Disability Index(ODI) and Japanese Orthopaedic Association (JOA) were used to evaluate postoperative efficacy among three groups at 24 weeks. Possible factors affecting the postoperative efficacy including age, age grouping, gender, body mass index (BMI), BMI grouping, education level, visiting hospital, payment method of medical expenses, preoperative complications, preoperative JOA score, clinical diagnosis, surgery section, operative method, intraoperative bleeding volume, postoperative complications and rehabilitation mode were listed as independent variables, and postoperative ODI score at 24 weeks as dependent variables. Univariate analysis was used to analyze relationship between influencing factors and postoperative efficacy. Multiple linear regression was used to analyze relationship between influencing factors, rehabilitation mode and postoperative ODI score at 24 weeks, in further to find out the main reasons which affect postoperative efficacy, and to analyze impact of rehabilitation mode on postoperative efficacy.@*RESULTS@#All patients were followed up for 24 weeks after operation. All incisions healed at stage I with stable internal fixation. (1)Evaluation of postoperative efficacy:① There were no statistical differences in preoperative VAS and ODI among three groups(@*CONCLUSION@#Preoperative JOA score, gender, age could predict postoperative clinical effects of lumbar degenerative diseases in varying degrees treated with single level bone graft fusion and internal fixation. Different rehabilitation modes could improve clinical effects. Intergrated rehabilitation orthopedic treatment model and integrated rehabilitation approach and orthopedic treatment with classifiedrehabilitation model are superior to conventional rehabilitation model in improving patients' postoperative function and relieving pain, which is worthy of promoting in clinical.
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Adolescent , Adult , Aged , Female , Humans , Infant , Male , Middle Aged , Lumbar Vertebrae/surgery , Lumbosacral Region , Retrospective Studies , Spinal Fusion , Treatment OutcomeABSTRACT
Abstract@#Although the number of injury deaths among child and adolescent has been decreasing during recent years, it is still one of the main threats to the health of children and adolescents, and is a major global public health issue. This editorial aims to explore main risk factors related to injury occurrence in various stages of early life, to identify key preventive interventions following the physical and mental development characteristics of children and adolescents, and to connect within different life stages. To reduce the occurrence of injuries effectively and promote the health of children and adolescents.
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<p><b>OBJECTIVE</b>To investigate the involvement of PI3K/Akt signaling pathway in the changes of urine protein in adriamycin-induced nephropathic rats treated with dexamethasone and LY294002 (a PI3K inhibitor).</p><p><b>METHODS</b>SD rats were randomized into normal control group, ariamycin-induced nephropathy group (ADR group), ariamycin+dexamethasone group (DEX group), and ADR+DEX+LY294002 group (LY294002 group). On days 7, 14 and 28 after the treatments, 24-h urine was collected from the rats to analyze the total urine proteins. The renal tissues were obtained on day 28 to examine the expressions of p-AKT, AKT and Bad proteins in the cortical tissues using Western blotting; the expression of Bad mRNA in the cortical tissues was measured by QPCR.</p><p><b>RESULTS</b>Urine protein increased progressively in ADR group accompanied by significantly reduced p-AKT/AKT ratio and increased Bad mRNA expression in comparison with those in the normal control group (P<0.05). Urine protein was obviously reduced in DEX group with comparable p-AKT/AKT ratio and Bad mRNA expression level with those in the control group (P>0.05). Urine protein showed no significant reduction in LY294002 group, but the p-AKT/AKT ratio was significantly reduced and Bad mRNA expression was increased compared with those in DEX group (P<0.05).</p><p><b>CONCLUSION</b>Dexamethasone increases the expression of Bad mRNA and reduces urine protein in adriamycin-induced nephropathic rats by activating PI3K/Akt signaling pathway. LY294002 can inhibit PI3K/Akt signaling pathway to block the effect of dexamethasone, suggesting that PI3K/Akt signaling pathway is one of the signaling pathways that mediate the effect of dexamethasone on proteinuria.</p>
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BACKGROUND:There were no uniform standards or conclusion in the diagnosis of lumbar spinal stenosis, choice of therapeutic manner, location of affected segment, range of decompression, choice of fixation and fusion, indication of surgical treatment and the judgment of posttreatment effects. OBJECTIVE:To search abundant literatures on the advantage and disadvantages of surgical therapies and the range of decompression therapy is of great value on reducing the injury to spine structure and keeping spine stability. METHODS: The first author retrieved PubMed, China National Knowledge Infrastructure and Wanfang Database by computer for related articles published from January 1990 to January 2014. Literatures were about treatment progress of lumbar spinal stenosis, non-surgery therapy and various surgical manners (Laminectomy, fusion, fusion and fixation, non-fusion fixation and minimaly invasive decompression) in treatment of lumbar spinal stenosis. A total of 42 literatures were included. RESULTS AND CONCLUSION:Patients’ age, type and degree of stenosis and morphology of intervertebral disc and vertebral canal were comprehensively evaluated. The indication of surgical treatment was strictly analyzed. The correlation of decompression and stability was handled during surgical therapy. On the basis of thorough decompression, spinal column was kept maximaly. In accordance with patients’ clinical symptoms, signs and imaging characteristics, the range of decompression, fusion and (or) fixation were considered to avoid blindness decompression and non-symptomatic area decompression. Only careful choice could elevate the clinical therapeutic efficacy of lumbar spinal stenosis, make surgical therapy target, save time, and reduce trauma.