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In recent years, the task of object detection and segmentation in medical image is the research hotspot and difficulty in the field of image processing. Instance segmentation provides instance-level labels for different objects belonging to the same class, so it is widely used in the field of medical image processing. In this paper, medical image instance segmentation was summarized from the following aspects: First, the basic principle of instance segmentation was described, the instance segmentation models were classified into three categories, the development context of the instance segmentation algorithm was displayed in two-dimensional space, and six classic model diagrams of instance segmentation were given. Second, from the perspective of the three models of two-stage instance segmentation, single-stage instance segmentation and three-dimensional (3D) instance segmentation, we summarized the ideas of the three types of models, discussed the advantages and disadvantages, and sorted out the latest developments. Third, the application status of instance segmentation in six medical images such as colon tissue image, cervical image, bone imaging image, pathological section image of gastric cancer, computed tomography (CT) image of lung nodule and X-ray image of breast was summarized. Fourth, the main challenges in the field of medical image instance segmentation were discussed and the future development direction was prospected. In this paper, the principle, models and characteristics of instance segmentation are systematically summarized, as well as the application of instance segmentation in the field of medical image processing, which is of positive guiding significance to the study of instance segmentation.
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Imaging, Three-Dimensional/methods , Image Processing, Computer-Assisted , Tomography, X-Ray Computed/methods , AlgorithmsABSTRACT
Objective:To investigate the value of quantitative CT (QCT) body component parameters before and after transcatheter arterial chemoembolization (TACE) as prognostic indicator for patients with hepatic cell carcinoma (HCC).Methods:Retrospective analysis was performed on 40 patients with advanced HCC who received TACE treatment in Anhui Provincial Hospital Affiliated to Anhui Medical University from November 2013 to May 2017, all of them received QCT scanning before and after treatment. The information were recorded, including gender, age, alpha-fetoprotein (AFP), TNM stage, liver function Child-Pugh grade, portal venous thromboembolism, cirrhosis, maximum tumor diameter, tumor type, and frequency of interventional therapy. QCT parameters were measured before and after treatment, including L1, L2 bone mineral density (BMD), L3-level paravertebral muscle area (MA), subcutaneous fat area (SFA) and visceral fat area (VFA), and the change rate of QCT parameters (ΔBMD, ΔMA, ΔSFA, ΔVFA) before and after TACE were calculated after the QCT scan interval was standardized. The cut-off values of ΔBMD, ΔMA, ΔSFA and ΔVFA to diagnose the prognosis of HCC patients after TACE were obtained by drawing the ROC curves. The Kaplan-Meier method was used to calculate the survival rate, the Log-rank method was used for univariate analysis, and the Cox regression analysis model was used for multivariate analysis to screen out independent factors affecting the prognosis of HCC patients after TACE.Results:ROC curve analysis showed that the cut-off values of ΔBMD, ΔMA, ΔSFA and ΔVFA to diagnose the prognosis of HCC patients after TACE were -8.64%, -6.84%, -9.84% and 5.70%, respectively. Univariate analysis showed that AFP, TNM stage, liver function Child-Pugh grade, portal venous thrombosis, tumor type and ΔMA, ΔSFA, ΔVFA had statistically significant effects on prognosis ( P<0.1). Multivariate analysis showed that ΔMA, ΔVFA and portal venous thromboembolism were independent influencing factors for the prognosis of HCC patients after TACE treatment ( P<0.05). Conclusions:ΔMA, ΔVFA and portal venous thromboembolism have reference value for prognosis assessment of TACE treatment for HCC patients, and QCT body composition analysis is helpful to evaluate the prognosis of HCC patients.
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Objective:To evaluate the application value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) and dynamic contrast enhancement MRI (DCE-MRI) in the prediction of the early efficacy of concurrent chemoradiotherapy (CCRT) for cervical squamous cell carcinoma.Methods:Fifty patients with cervical squamous cell carcinoma confirmed by pathology were included. Before CCRT, IVIM-DWI and DCE-MRI were scanned, and the values of quantitative parameters including ADC, D, D * and f of IVIM-DWI and K trans, K ep, V e and V p of DCE-MRI before treatment were measured for all patients. MRI reexamination was performed 1 month after the end of CCRT, and all patients were divided into the cure group and the residual group according to the tumor remission. The parameters of IVIM-DWI and DCE-MRI before treatment were statistically compared between two groups. The optimal predictive parameters and predictive thresholds were determined by drawing the receiver operating characteristic (ROC) curve. Results:Twenty-four patients were assigned into the cure group and twenty-six patients in the residual group. The ADC, D and V e values before treatment in the cure group were significantly lower than those in the residual group (all P<0.05), whereas the f and K trans values were significantly higher than those in the residual group (both P<0.05). The other parameters did not significantly differ between two groups (all P>0.05). The area under ROC curve (AUC=0.823) of D value was the largest, followed by K transvalue (AUC=0.754). The combined prediction efficacy of D and K trans (AUC=0.867) was higher than that of either D or K trans alone. The sensitivity was 88.5%, 85.8% and 88.8%, and the specificity was 70.8%, 66.7% and 79.2%, respectively. Conclusions:Quantitative parameters of IVIM-DWI and DCE-MRI before treatment have certain predictive value for the early efficacy of CCRT in cervical squamous cell carcinoma, among which the predictive efficacy of D value is the highest, and the combined application of D and K trans can improve the predictive efficacy.
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Abstract@#Through a review of the current state and risks of adolescent health in the world and in China, the main health issues faced by adolescents are summarized. The importance of promoting adolescent health and the importance of effective adolescent health services are highlighted. The past 30 years important documents of international adolescent health and development have been sorted out. The history of the development of adolescent health care in China has been reviewed. It was pointed out that the health and development of adolescents has become a hot spot and focus of international attention, and it has received more and more attention in China. The adolescent health care has ushered in a new opportunity for development, which will help the health and development of adolescents in China.
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Objective:To analysis clinical curative effect of laparoscopic radical prostatectomy bladder cancer and influence on serum levels of ferritin (SF),soluble interleukin-2 receptor (SIL-2 R) and rumor specific growth factor (TSGF).Methods:98 cases of bladder cancer who were treated in our hospital from August 2012 to February 2016 were selected and randomly divided into the control group 0=49) and the research group (n=49).The patients in the control group were treated with open radical radical cystectomy,while the patients in the research group were treated with laparoscopic radical cystectomy.Then the operation time,intraoperative blood loss,anal exhaust time,hospitalization,the lymph node cleaning,the serum levels of SF,SIL-2R,TSGF,white blood cells and cortisol,the complications and recurrence rate in the two groups were observed and compared.Results:The operation time of research group was longer than that of the control group,while the intraoperative blood loss,the hospitalization and the anal exhaust time were less than those of the control group,and the differences were statistically significant (P＜0.05).There was no statistically significant difference about the numbers of the lymph node and the recurrence rate between two groups (P＜0.05).After treatment,the serum levels of SF,SIL-2R and TSGF in the two groups decreased,while there was no statistically significant difference between the two groups (P＞0.05);After treatment,the white blood cell count and cortisol rise in the two groups increased,while the research group was lower than that of the control group (P＜0.05).Conclusion:LRC and ORC clinical efficacy similar,both of which can reduce the serum levels of SF,SIL-2R and TSGF of patients with laparoscopic radical prostatectomy bladder cancer.
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Objective To analyze and assess the major functions of medical APP by investigating its application in self management of chronic diseases. Methods The 3 major functions of APP were analyzed, including data record and condition assessment, medical consultation, and life therapy. Results The medical APP possesses its basic functions for chronic diseases management. However, it lacks of practicality and convenience and its homogenization is severe. Conclusion The APP +hardware +cloud medical management model should be promoted by making use of the Internet + medical technology, the supervision of mobile medical APP should be strengthened, the mobile information management mechanisms of chronic diseases should be perfected, and the self management efficiency of patients with chronic diseases should be improved.
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Objective To study the relevance between the level of thyroid hormone and anti‐thyroid peroxidase antibody (TPOAb) during gestation period .Methods From November 2011 to May 2014 ,150 gravidas were chosen as objectives ,and were divided into 2 groups according TPOAb .The clinical feature ,level of thyroid hormone ,pregnancy outcome ,and complication of neo‐phyte between 2 groups were compared .Results In 150 gravidas ,44 were positive in TPOAb and 106 were negative .The age ,ges‐tational weeks and BMI between two groups had no statistical difference(P>0 .05) .At the early and middle pregnancy as well as at the late pregnancy ,the level of thyroid hormone between two groups had statistical difference(P<0 .05);In study group ,the level of thyroid hormone of early and middle pregnancy and that of late pregnancy had statistical difference(P<0 .05) .The rate of unde‐sirable gestational outcome and that of neophyte complication between two groups had statistical difference(P<0 .05) .Conclusion During gestation period ,the TPOAb was significant for the diagnosis of the sub‐clinical hypothyroidism ,as well for prognosis of gravidas .
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Objective To investigate the characteristics of esophageal motility in patients with type Ⅱ achalasia and evaluate the clinical value of high resolution manometry (HRM).Methods A total of 20 patients with type Ⅱ achalasia(observation group) and 15 healthy controls(control group) were enrolled for high resolution manometry.The characteristics of esophageal motility of two groups were compared.Results The motor pattern of esophageal body of observation group was mostly non-conductive synchronous contraction(88.2％,176/200),but in control group it was normal esophageal peristalsis.Lower esophageal sphincter pressure,4 s integrated relaxation pressure(4s IRP) and upper esophageal sphincter residual pressure in observation group were (37.6 ± 12.8)mmHg,(31.5 ± 13.4)mmHg and (14.0 ± 3.8)mmHg,respectively,which were higher than those ot the control group,(23.7 ± 5.6) mmHg(t =3.925,P =0.000),(10.5 ±4.3) mmHg(t =5.835,P =0.000) and (7.9 ± 4.5) mmHg (t =4.325,P =0.000).The lower esophageal sphincter relaxation rate in observation group was(23.6 ± 19.6)％,which was lower than that of the control group(58.1 ±16.7)％ (t =-5.491,P =0.000).There was no significant difference in lower esophageal sphincter length and upper esophageal sphincter pressure between type Ⅱ achalasia group and control group (P ＞0.05).Conclusion The characteristics of esophageal manometry in type Ⅱ achalasia is non-conductive synchronous contraction and elevated 4s IRP,and HRM contributes to early diagnosis,reclassification and evaluation of expected outcome in achalasia.
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Objective To explore the correlation between the length of peristaltic break (LPB) and the severity of the symptoms in patients with non-erosive reflux disease (NERD) and negative pH monitoring.Methods A total of 35 patients with NERD and negative pH monitoring were enrolled,and at same time 10 healthy individuals were selected as controls.The LPB of esophageal body of both groups was measured by high resolution manometry (HRM).Meanwhile,the symptom of NERD patients with negative pH monitoring was scored.The LPB of esophageal body between the two groups was compared by t test.The correlation between the LPB and the severity of the symptoms in NERD patients with negative pH monitoring was analyzed by Pearson correlation analysis.Results The average LPB of esophageal body of NERD patients with negative pH monitoring was (3.3±0.9)cm,which was longer than that of healthy controls ((1.2 ± 0.4) cm),and the difference was statistically significant (t=9.17,P＜0.01).The symptom score of NERD patients with negative pH monitoring was 21.6± 7.8.There was a positive correlation between the LPB and NERD symptom score (r=0.894,P＜ 0.01).Conclusion The LPB of esophageal body is a kind of expression of esophageal motility dysfunction,which is correlated with the symptom of NERD.
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Objective To investigate esophageal high-resolution manometry (HRM) combined with 24-hour pH monitor in detecting endoscopy-negative chest pain of esophageal origin.Methods Test results of esophageal HRM combined with 24-hour pH monitor from 40 patients with recurring chest pain of esophageal origin were retrospectively analyzed.Results In 40 patients,27 (67.5％) were diagnosed as gastroesophageal reflux disease with an average DeMeester scores at 18.3 ± 3.4,including 19 patients with esophageal body dismotility and 11 with reduced lower esophageal sphincter pressure (LESP) at a mean reduction of 5.7 mm Hg.There were 6 cases (15.0％) of achalasia,in which 1 (2.5％) was type Ⅰ and 5 (12.5％)was type Ⅱ,with an average relaxation ratio of lower esophageal sphincter (RRLES) at (30.1 ± 2.3) ％.There were 4 cases of diffuse esophageal spasm (DES),with an average contraction frontal velocity (CFV) of 12.3 ± 2.4 cm ·s-1 and abnormal contraction waves in esophageal body,spontaneous synchronous contraction waves were observed in 3 of 4 patients LESP increased in 1 patient with DES and remained normal in other 3.RRLES decreased in 2 cases with DES and remained normal in other 2.There were 2 cases (5.0％)of nutcracker esophagus,with an average distal contractile integral at 6745.5 ± 175.2 mm Hg·cm-1 ·s-1 and an average CFV at 4.3 ±0.4 cm·s-1.There was 1 case (2.5％) with absence of esophageal peristalsis,with a low LESP at 2 mmHg and DeMeester scores at 38.3.The patient was finally diagnosed as systemic sclerosis according to esophageal biopsy and other auxiliary examination.Conclusion HRM combined with 24-hour pH monitor is valuable in detecting endoscopy-negative chest pain of esophageal origin.
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To compare the performance of ArcCheck and film verification for volumetric intensity modulated arc therapy (VMAT) in the treatment of nasopharyngeal carcinoma, and to study the feasibility of ArcCheck in VMAT dosimetric verification. Five patients of nasopharyngeal carcinoma treated with VMAT were enrolled in this study. Dose verification was carried out by ArcCheck and film respectively. The result showed that there were no significant differences between ArcCheck and film verification. ArcCheck software can obtain three dimensional dose distribution directly with simple operation. It is convenient for ArcCheck to be used for VMAT dosimetric verification.
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Humans , Carcinoma , Nasopharyngeal Neoplasms , Radiotherapy , Radiotherapy Dosage , Radiotherapy Planning, Computer-Assisted , Methods , SoftwareABSTRACT
BACKGROUND: Transplantation of fragments of ovarian cortex is performed without vascular reanastomosis, therefore, to increase the tolerance of ovarian tissue to the freezing-thawing and ischemic injuries is critical for follicular survival and functional longevity of the graft.OBJECTIVE: To investigate the effect of follicle stimulating hormone (FSH) on the morphological and function of sheep ovary tissue in the process of cryopreservation, so that to provide new freezing method for human ovary tissues. METHODS: Healthy BALB/c strain female nude mice were equally and randomly divided into 3 groups and subjected to heterotopic transplantation of fragments of sheep ovarian cortex. (1) Control group: transplantation following sampling; (2) experimental group: transplantation following freezing-thawing, and the solution was free of FSH; (3) FSH group: the freezing and thawing and culture fluid contained FSH. The estrous cycle recovering rate, estrous cycle recovering time, the number of follicle were observed following transplantation. The histological changes, and the level of E2 in blood serum were observed at 4 weeks after transplantation.RESULTS AND CONCLUSION: There were no significant differences in estrous cycle recovering rate and number of follicle/PHF between FSH and control groups (P> 0.05), but the number of follicle was greater than the experimental group (P< 0.05). Moreover, the time of estrous cycle recovering in FSH group was similar to control group, but shorter than experimental group (P < 0.05). There were more developing follicular in FSH group, but few in experimental group at 4 weeks. No significant difference was detected in E2 level in blood serum between FSH and control group (P > 0.05), but significantly greater than the experimental group (P< 0.05). Results show that FSH addition in vitrification fluid can improve ovarian follicle survival following cryopreserved sheep ovary tissue transplantation.
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ted in a loss of cell fusion,which suggests the 928 site on G2 is crucial for cell fusion and the fusion peptide is likely on G2.
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Type 2 diabetic patients with the decline of urinary Tamm-Horsfall protein excretory rate showed the increment of fasting plasma homocysteine levels, suggesting that the damage of synthetic function of renal tubule may participate in the increment of homocysteine levels.