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OBJECTIVE@#Medical image segmentation is a key step in medical image processing. An architecture of fully convolutional networks was proposed to realize automatic segmentation of anatomical areas in X-ray images.@*METHODS@#Enlightened by the advantages of convolutional neural networks on features extraction, fully convolutional networks consisting of 9 layers were designed to segment medical images. The networks used convolution kernels of various sizes to extract multi-dimensional image features in the images, meanwhile, eliminated pooling layers to avoid the loss of image details during downsampling procedures.@*RESULTS@#The experiment was conducted in accordance with the specific scene of X-ray images segmentation. Compared with traditional segmentation methods, this approach achieved more accurate segmentation of anatomical areas.@*CONCLUSIONS@#Fully convolutional networks can extract representative and multidimensional features of medical images, avoid the loss of image details during downsampling procedures, and complete automatic segmentation of anatomical areas accurately in X-ray images.
Subject(s)
Algorithms , Image Processing, Computer-Assisted , Neural Networks, Computer , X-RaysABSTRACT
Treatment position recognition in medical images is a key technique in medical image processing. Due to the excellent performance of convolutional neural networks on features extraction and classification, an architecture of parallel convolutional neural networks is proposed to recognize treatment positions in X-ray images, which uses convolution kernels of different sizes to extract local features of different sizes in these images. The experimental analysis shows that parallel convolution neural networks, which can extract representative image features with more dimensions, are competent to classify and recognize treatment positions in medical images.
Subject(s)
Algorithms , Image Processing, Computer-Assisted , Neural Networks, Computer , X-RaysABSTRACT
Objective To explore efficacy and safety of simulated artificial pancreas in modulating stress hyperglycemia in critically ill patients. Methods A prospective randomized controlled study was performed. Seventy-two critically ill patients with stress hyperglycemia, aged 18-85 years, acute physiology and chronic health evaluationⅡ(APACHEⅡ) score over 15, two consecutive random blood glucose 11.1 mmol/L or higher, glycated hemoglobin (HbA1C) below 0.065, unable to eat food for 3 days after inclusion, or only accepting parenteral nutrition, admitted to intensive care unit (ICU) in Shanghai Punan Hospital of Pudong New District from January 1st, 2015 to June 30th, 2017 were enrolled. The patients were divided into three groups according to the random number table method, high-intensity group and low-intensity group were injected Novolin R (high-intensity group 2/3 dosage, low-intensity group 1/3 dosage) to modulate stress hyperglycemia by simulated artificial pancreas. Simulated artificial pancreas consisted of Guardian real time glucose monitoring system (GRT system), close-circle control algorithm and micro-pump;subcutaneous injection of Humulin 70/30 was applied to modulate stress hyperglycemia in humulin group. Real-time glucose levels of interstitial fluid in abdominal wall, equivalent to blood glucose levels, 10 minutes each time, were monitored by using of GRT system for all patients in three groups. Fasting serum levels of stress hormones including epinephrine and cortisol and insulin resistance index (IRI) were recorded within 24 hours after inclusion. Mean blood glucose, blood glucose variation coefficient, blood glucose target-reaching rate, blood glucose target-reaching time, hypoglycemia rate and 6-month mortality were measured. Twenty healthy adults from health administration department of the hospital were recruited as healthy control group. Results A total of 60 eligible critically ill patients were included in this study, each group with 20 patients. There was no significant difference in gender, age, APACHE Ⅱ scores among three groups. The levels of serum epinephrine, cortisol and IRI within 24 hours after inclusion in the three groups were significantly higher than those in healthy control group. The mean blood glucose levels of humulin group, low-intensity group, high-intensity group were decreased (mmol/L: 10.2±3.2, 8.4±2.6, 8.1±2.2), the blood glucose target-reaching rate were increased [40.2% (3 295/8 196), 71.1% (5 393/7 585), 80.4% (6 286/7 818)], the blood glucose target-reaching time were shortened (hours: 49.1±5.8, 24.6±4.6, 17.5±4.2), the hypoglycemia rates were increased respectively [1.3% (108/8 196), 2.8% (211/7 585), 4.0% (313/7 818)], with statistically significant differences (all 1 = 0.000). There was no significant difference in blood glucose variation coefficient and 6-month mortality among three groups [blood glucose variation coefficient: (29.4±3.7)%, (28.5±5.3)%, (26.1±4.6)%, 6-month mortality: 55.0%, 45.0%, 40.0%, all 1 > 0.05]. Conclusions Simulated artificial pancreas could effectively and safely modulate stress hyperglycemia in critically ill patients, high-intensity modulation could bring about better efficacy in the regulation of hyperglycemia. High-frequency blood glucose monitoring by using GRT system could promptly identify hypoglycemia and help it to be corrected.
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OBJECTIVE To investigate and analysis of hearing status and characteristics of China civil aviation air traffic controllers(ATC). METHODS With cluster random sampling, air conduction threshold data of 1498 ATC, who had finished the class Ⅲa medical assessment this year in a certain area were studied. The subjects were tested by pure tone audiometry, the prevalence rate of speech and high frequency hearing loss between gender groups were compared; After age correction, the threshold of different frequencies were compared between age groups. RESULTS The prevalence rate of hearing loss at speech frequency was 6.68％ in male and 1.97％ in female. The result of high frequency was 7.87％ and 1.23％ respectively. Both the threshold and prevalence rate of hearing loss of every frequency were higher in male(P<0.05); The threshold of 3000 Hz<PTA<6000 Hz; After age correction, all the threshold had statistical difference between the former age groups(P<0.05) and the result of relatively young age group was worse than the elder. (Male: corrected P<0.0083, Female: corrected P<0.017). CONCLUSION The prevalence of hearing loss in the subjects was lower than that in general population. Males were prone to it and more prevalent at 6000 Hz; The hidden trouble of noise-induced hearing loss is especially serious in the young age group; Individualized hearing protection should be implemented early.
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Objective To explore the clinical effect of three doses of mifepristone on patients with dysfunc-tional uterine bleeding.Methods 150 patients with dysfunctional uterine bleeding were chosen,and they were randomly divided into 3 groups,including low dose group (50 patients),middle dose group (50 patients)and high dose group (50 patients).All patients adopted routine treatment.On the basis of this,the low dose group received 6.25mg/d mifepristone,the middle dose group received 12.5mg/d mifepristone,the high dose group received 18.25mg/d mifepristone,continued 6 months.The influence of follicle stimulating hormone (FSH),luteinizing hor-mone (LH),estradiol (E),progesterone (P),volume of uterine and endometrail thickness of patients were observed. Results After treatment,the FSH,LH,E and P levels in the three groups were significantly decreased compared with before treatment (FSH:t=4.406,5.329,3.610,LH:t=4.563,6.134,4.455,P=0.000,0.000,0.000;P=0.000, 0.000,0.000;E:t=7.173,6.815,7.018,P=0.000,0.000,0.000;E:t=2.367,6.315,4.351,P=0.020,0.000, 0.000),and the difference were statistically significant (all P0.05 ).Compared with the low dose group,E levels in the middle dose group and high dose group significantly decreased(t=3.850,2.085,P=0.000,0.004).Before and after treatment,the uterine volume among the three groups had no significant difference (P>0.05 ).After treatment,the functional uterine bleeding symptoms were significantly relieved in the three groups,the effective rate was 100%.The recurrence rate of the low dose group was 32%,which was significantly higher than 8%and 10%of the middle dose group and high dose group.The amenorrhea rate of the middle dose group and high dose group(6% and 2%)was significantly lower than that of the low dose group (46%).Conclusion The treatment of 12.5mg/d mifepristone is effectively adapted to patients with dysfunctional uterine bleeding.
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Objective To evaluate effect of intensive insulin treatment(IIT)on healthcare-associated infection (HAI)rate in patients with acute stroke and stress hyperglycemia.Methods Databases,including PubMed,Em-base,Cochrane Library,WanFang,and China National Knowledge Infrastructure(CNKI)Data,were electronically searched,relevant journals and references of the included literatures were also searched manually,literatures were selected according to the uniform inclusion and exclusion criteria,incidence of HAI and mean blood glucose in patients who received IIT for acute stroke were assessed systematically.Results A total of 13 randomized controlled trials (RCT)involving 1 032 patients were included in this systematic review.Meta-analysis results showed that 10 studies involving 832 patients were finally enrolled for comparing HAI rate, HAI rates in IIT group and conventional insulin treatment group were 28.3% and 56.1 %,respectively(Z =4.50 ),difference between two groups was statistically significant (RR=0.53 [95 %CI :0.40 to 0.70],P <0.001 );A total of 328 patients in 5 studies were finally included in the comparison of blood glucose,difference in mean blood glucose between two groups was statistically significant(MD =-2.52 [95% CI :-4.30 to -0.74],P =0.006).Funnel plot of HAI rate revealed that there was publication bias.Conclusion IIT is used for the regulation of stress hyperglycemia in acute stroke,it can reduce the incidence of HAI and blood glucose in patients.
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Objective To investigate the characteristics of blood pressure variability during 24 hours and pre-thrombotic state(PTS) in elderly patients with essential hypertension.Methods One hundred cases of old patients with essential hypertension in the department of Cardiology (hypertension group) and 65 controls with normal blood pressure from Punan Health Check Center (control group) were recruited.The systolic and diastolic blood pressure variability (SBPV,DBPV) during 24 h daytime and nighttime were monitored for all subjects by ambulatory blood pressure monitor.The plasma levels of P-selectin (PS),fibrinogen (Fg) and plasminogen activator inhibitor-1 (PAI-1) were measured.Results The systolic blood pressure variability (SBPV) in hypertension group was significantly larger than that of control group (P ＜ 0.05) in daytime,and no significant difference regarding of the diastolic blood pressure variability (DBPV) between two groups.While in nighttime,SBPV and DBPV in hypertension group were significantly higher than those of control group (P ＜ 0.05).The levels of plasma Fg and PAI-1 in hypertension group were significantly higher than those of control group ((2.8 ±0.9) g/L vs.(2.3 ±0.7) g/L and (29.8 ±2.7) μg/L vs.(25.6 ± 1.2) μg/L,respectively).While no significant difference was found between two groups for PS (P ＞ 0.05).Conclusion That indicated pre-thrombotic state including higher blood pressure variability during 24 hours,especially during nighttime in elderly patients with essential hypertension and plasma fibrinogen.
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Objective To investigate effective methods for preventing radiotherapy - induced oral mucositis among patients with cephalocervical malignant tumors. Methods 92 patients with cephalocer-vical malignant tumors treated with radiotherapy were randomly divided into group A (31 cases),group B (31 cases) and group C (30 cases). Mixture of 20 ml heartleaf houttuynia herb injection,20 ml salvia injection and 30 ml distilled water were given to patients in group A by means of nebulization inhalation one hour before and after every radiotherapy treatment, the inhalation lasted 20 minutes each time up to the end of radiotherapy. Mixture of 2 ml Kang-fu-xin injection,0.5 mg vitamin B|2 injection and SO ml normal saline were given to patients in group B by the same means as group A. Yangyin Qingfei decoction were given to patients in group C by means of selecting its 500 ml juice for oral use. Half of the 500 ml decoction were separately given 1 hour before and after each radiotherapy treatment up to the end of radiotherapy. Results The incidence rates of oral mucositis were obviously lower among patients in group A than in group B and C. Conclusions Nebulization inhalation of mixture of heartleaf houttuynia herb and salvia injections has significant clinical effects on oral mucositis after radiotherapy.