Application of multi-modal neuroimaging three-dimensional reconstruction and virtual reality in neurosurgical specialists training / 中华医学教育探索杂志

Neurosurgery is considered as one of the most difficult areas in the field of medicine, and the complexity of nervous system is a leading cause. Therefore, it demands neurosurgeons possess basic knowledge, spatial thinking, and practical experiences. Here, we introduce a rapid developing technique applying multi-modal neuroimaging reconstruction and virtual reality, which constitutes a novel learning model for boosting the growth of neurosurgeons. The incorporation of multi-modal neuroimaging and virtual reality builds a bridge from two-dimensional image to actual surgical view. Neurosurgeons are able to perform surgical planning and simulation with naked eyes under the constructed three-dimensional hologram. The technique also provides evidence of accurate localization and guidance for operation. Therefore, multi-modal neuroimaging reconstruction and virtual reality are expected to tremendously promote the progress of young trainees, and can further enhance their all-round abilities. In short, this revolutionary learning model would impact the neurosurgical specialists training profoundly.

Research and development practice of traditional Chinese medicine based on network target theory and technology / 中国中药杂志

Network targets theory and technology have transcended the limitations of the "single gene, single target" model, aiming to decipher the mechanisms of traditional Chinese medicine(TCM) based on biological network from the perspective of informatics and system. As the core of TCM network pharmacology, with the development of computer science and high-throughput experimental techniques, the network target theory and technology are beginning to exhibit a trend of organic integration with artificial intelligence technology and high-throughput multi-modal multi-omics experimental techniques. Taking the network target analysis of TCM like Yinqiao Qingre Tablets as a typical case, network target theory and technology have achieved the systematic construction, in-depth analysis, and high-throughput multi-modal multi-omics validation of multi-level biological networks spanning from traditional Chinese and Western phenotypes to tissues, cells, molecules, and traditional Chinese and Western medicines. This development helps to address critical issues in the analysis of mechanisms of TCM, including the discovery of key targets, identification of functional components, discovery of synergistic effects among compound ingredients, and elucidation of the regulatory mechanisms of formulae. It provides powerful theoretical and technological support for advancing clinical precision diagnosis and treatment, precise positioning of TCM, and precise research and development of TCM. Thus, a new paradigm of TCM research gradually emerges, combining big data and artificial intelligence(AI) with the integration of human experience and scientific evidence.

Deep learning method for magnetic resonance imaging fluid-attenuated inversion recovery image synthesis / 生物医学工程学杂志

Magnetic resonance imaging(MRI) can obtain multi-modal images with different contrast, which provides rich information for clinical diagnosis. However, some contrast images are not scanned or the quality of the acquired images cannot meet the diagnostic requirements due to the difficulty of patient's cooperation or the limitation of scanning conditions. Image synthesis techniques have become a method to compensate for such image deficiencies. In recent years, deep learning has been widely used in the field of MRI synthesis. In this paper, a synthesis network based on multi-modal fusion is proposed, which firstly uses a feature encoder to encode the features of multiple unimodal images separately, and then fuses the features of different modal images through a feature fusion module, and finally generates the target modal image. The similarity measure between the target image and the predicted image in the network is improved by introducing a dynamic weighted combined loss function based on the spatial domain and K-space domain. After experimental validation and quantitative comparison, the multi-modal fusion deep learning network proposed in this paper can effectively synthesize high-quality MRI fluid-attenuated inversion recovery (FLAIR) images. In summary, the method proposed in this paper can reduce MRI scanning time of the patient, as well as solve the clinical problem of missing FLAIR images or image quality that is difficult to meet diagnostic requirements.

Current research progress of diagnosis of iliac vein stenosis based on multi-modal imaging / 国际外科学杂志

Iliac vein stenosis (IVS), known as iliac vein compression syndrome, refers to a series of diseases caused by iliac vein compression or intraluminal adhesions leading to lower extremity vein or pelvic vein drainage disturbance and other clinical manifestations which is quite common in vascular surgery. The vast majority of patients with symptoms of chronic venous insufficiency (CVI) have IVS. In clinical work, IVS does not typically appear as a single symptom, while often combining with other lesions, such as varicose veins of the lower extremities, skin pigmentation, ulcer formation. Studies on its aetiology and epidemiology have found a mean age of onset of 40 years, the age of onset in females is lower than that in males, and the average of stress in females is significantly higher than that in males. Typical IVS occurs mainly in the left lower extremity in young women of reproductive age, but exceptions remain. In summary, the importance of the diagnosis of IVS in clinical practical work can be seen. CVI is a general term for all diseases that affect the morphology and function of the venous system. Compared with chronic venous disease (CVD), CVI include venous system abnormalities without symptoms or signs. Thus, it more accurately describes the diagnosis and treatment of IVS that requires clinical guidance, so its concept is quoted. With the development and advancement of medical imaging, more and more techniques provide help in the diagnosis and treatment of IVS. Therefore, professionals in various specialties have made relevant studies about the benefits and drawbacks of imaging techniques for diagnosis, treatment modalities, and prognostic management of this disease, in order to improve the diagnostic efficacy. Consequently, this review is focused on the current situation of the diagnosis and treatment of IVS under multi-modal imaging, hoping to provide choices of medical imaging technologies for the different states, and to find a better and personalized plan for patients.

Joint Multi-modal Parcellation of the Human Striatum: Functions and Clinical Relevance / 神经科学通报·英文版

The human striatum is essential for both low- and high-level functions and has been implicated in the pathophysiology of various prevalent disorders, including Parkinson's disease (PD) and schizophrenia (SCZ). It is known to consist of structurally and functionally divergent subdivisions. However, previous parcellations are based on a single neuroimaging modality, leaving the extent of the multi-modal organization of the striatum unknown. Here, we investigated the organization of the striatum across three modalities-resting-state functional connectivity, probabilistic diffusion tractography, and structural covariance-to provide a holistic convergent view of its structure and function. We found convergent clusters in the dorsal, dorsolateral, rostral, ventral, and caudal striatum. Functional characterization revealed the anterior striatum to be mainly associated with cognitive and emotional functions, while the caudal striatum was related to action execution. Interestingly, significant structural atrophy in the rostral and ventral striatum was common to both PD and SCZ, but atrophy in the dorsolateral striatum was specifically attributable to PD. Our study revealed a cross-modal convergent organization of the striatum, representing a fundamental topographical model that can be useful for investigating structural and functional variability in aging and in clinical conditions.

Joint Multi-modal Parcellation of the Human Striatum: Functions and Clinical Relevance / 神经科学通报·英文版

The human striatum is essential for both low- and high-level functions and has been implicated in the pathophysiology of various prevalent disorders, including Parkinson's disease (PD) and schizophrenia (SCZ). It is known to consist of structurally and functionally divergent subdivisions. However, previous parcellations are based on a single neuroimaging modality, leaving the extent of the multi-modal organization of the striatum unknown. Here, we investigated the organization of the striatum across three modalities-resting-state functional connectivity, probabilistic diffusion tractography, and structural covariance-to provide a holistic convergent view of its structure and function. We found convergent clusters in the dorsal, dorsolateral, rostral, ventral, and caudal striatum. Functional characterization revealed the anterior striatum to be mainly associated with cognitive and emotional functions, while the caudal striatum was related to action execution. Interestingly, significant structural atrophy in the rostral and ventral striatum was common to both PD and SCZ, but atrophy in the dorsolateral striatum was specifically attributable to PD. Our study revealed a cross-modal convergent organization of the striatum, representing a fundamental topographical model that can be useful for investigating structural and functional variability in aging and in clinical conditions.

In vitro multi-modal imaging of magnetic targeted nanoparticles and their targeting effect on hepatic stellate cells / 中国组织工程研究

BACKGROUND: In recent years, molecular imaging combined with medical imaging technology and targeted molecular probes have gradually become a research focus. The targeted tissues at the molecular level can be observed using molecular imaging, medical imaging technology, and targeted molecular probes in combination to realize non-invasive imaging of the occurrence and development of the diseases. OBJECTIVE: To develop the magnetic targeted nanoparticle probes, observe the ultrasound/CT/MRI imaging properties in vitro, and investigate their targeting ability to rat hepatic stellate cells in vitro. METHODS: Taking poly(lactic-co-glycolic acid) (PLGA) polymer as the shell, cyclic arginine-glycine-aspartic acid (cRGD) octapeptide as the ligand, targeted magnetic nanoparticles with superparamagnetic Fe3O4 embedded in the shell and perfluorooctyl bromide(PFOB) loaded in the core were prepared by double emulsion evaporation method. The physical and chemical properties of the nanoparticles were detected. The ultrasound/CT/MRI multi-modal imaging properties of the nanoparticles at different concentrations diluted with double-distilled water were tested in vitro. Cyclic RGD peptide immobilization on PLGA-Fe3O4-PFOB NPs was completed through the amide condensation reaction. The conjugation efficiency of the cRGD on PLGA-Fe3O4-PFOB NPs and targeting ability of targeted magnetic nanoparticles in vitro were verified. Cytotoxicity experiments were used to measure the toxic effects of nanoparticles at different concentrations on BRL-3A cells in each group. RESULTS AND CONCLUSION: The targeted magnetic nanoparticles with the average size of (221. 5±60. 3) nm were uniform in dispersion and size. The prepared individual nanoparticle was spherical with the superparamagnetic Fe3O4 scattered on the shell. The encapsulation rate of Fe3O4 was 38%. In vitro ultrasound imaging and CT imaging signal decreased gradually as the concentrations of the nanoparticle suspension decreased. The T2-weighted signal of MRI decreased gradually with the increase of the concentrations of magnetic particle Fe3O4. Flow cytometry results showed that 94. 13% of the cRGD was bound to the nanoparticles. In vitro cell targeting experiments showed that compared to PLGA-Fe3O4-PFOB NPs, cRGD-PLGA-Fe3O4-PFOB NPs exhibited greater cell targeting and affinity efficiency to hepatic stellate cells. Cytotoxicity experiments results showed the nanoparticles had no significant influence on cell viability of the BRL-3A cells. These results suggest that targeted magnetic nanoprobe cannot only be used as a multi-modal imaging contrast agent for ultrasound/CT/MRI, but also exhibits a strong specific affinity to rat hepatic stellate cells in vitro. It has great potential for the early diagnosis of liver fibrosis.

A comparative dose-response study on the efficacy and safety of intrathecal morphine effectiveness in post-cesarean patients under spinal anesthesia at a tertiary hospital / The Health Sciences Journal

INTRODUCTION@#Intrathecal morphine, commonly administered at doses of 100 to 200 mcg, is a popular choice for post-cesarean analgesia; however, a trade-off between opioid analgesia and side effects exists. This study was conducted to determine the lowest dose of intrathecal morphine that will provide adequate analgesia with the least side effects among post-cesarean patients.@*METHODS@#Sixty term parturients for cesarean delivery under spinal anesthesia were randomized into three treatment groups to receive 50, 100 or 150 mcg of intrathecal morphine with a standard multimodal pain regimen and intravenous tramadol as needed. Pain scores, demand for rescue analgesic, and incidence of adverse effects (nausea, vomiting, and pruritus) during the first 24 hours’ post-spinal anesthesia were recorded and compared between groups.@*RESULTS@#Pain scores and demand for rescue doses of tramadol were higher for the 50-mcg group as compared to the other groups. There was no significant difference in pain scores between the 100 and 150-mcg groups. No rescue dose of tramadol was necessary in the 100 and 150-mcg groups. No significant difference was seen in the incidence and severity of nausea and vomiting across treatment groups. The incidence and severity of pruritus were significantly higher in the 150-mcg group. No significant difference was noted in the incidence and severity of pruritus between the 50 and 100-mcg groups.@*CONCLUSION@#A dose of 100 mcg of intrathecal morphine, in combination with a multimodal regimen, provides adequate analgesia with the least side effects.

Clinical efficacy of selective dorsal rhizotomy combined with multi-modal techniques in spastic cerebral palsy / 中华神经医学杂志

Objective:To observe the clinical efficacy and safety of selective dorsal rhizotomy (SDR) combined with multi-modal techniques in spastic cerebral palsy (SCP).Methods:Thirty-one SCP patients, admitted to our hospital from June 2016 to June 2019, were chosen in our study; these patients received SDR combined with multi-modal techniques(single-level laminectomy, and intraoperative electromyography monitoring combined with micro-neurosurgery); and all patients received regular physical therapy postoperatively. Grading of manual muscle test (MMT) and grading modified Ashworth scale (MAS), and scores of Gross Motor Function Measure-88 (GMFM-88), Berg balance scale (BBS) and Functional Independence Measure (FIM) before surgery, and one, three, and 6 months after surgery were evaluated and compared.Results:As compared with those before surgery, significantly increased MMT grading, statistically decreased MAS grading, and significantly increased GMFM-88 scores, BBS scores, and FIM scale scores one, 3, and 6 months after surgery were recorded in these patients ( P<0.05). As compared with those one month after surgery, significantly increased MMT grading, statistically decreased MAS grading, and significantly increased GMFM-88 scores and FIM scores 6 months after surgery were recorded in these patients ( P<0.05). As compared with those 3 months after surgery, statistically decreased MAS grading 6 months after surgery were recorded in these patients ( P<0.05). There were no severe complications as CNS infection, cerebrospinal fluid leakage, incontinence, spondylolisthesis or spinal deformity, but only transient muscle weakness and numbness of lower limbs. Conclusion:SDR combined with multi-modal techniques is a safe and effective method for patients with SCP, which is minimally invasive, accurate and safe.

Progress in imaging evaluation of ischemic penumbra in acute ischemic stroke / 第二军医大学学报

Acute ischemic stroke (AIS) is the most common cerebrovascular disease with high morbidity, mortality and disability. The imaging evaluation of ischemic penumbra has great clinical implication for early diagnosis and reperfusion therapy of AIS. Here, we reviewed the evaluation methods, advangtages and disadvangtages of computed tomography (CT) and magnetic resonance imaging for ischemic penumbra, and discussed the advantages of one-stop multi-modal CT.

Application of combination of intraoperative neuroelectrophysiological monitoring and neuronavigation multi-modal fusion technology in the glioma resection / 中国神经精神疾病杂志

Objective To analyze the application of intraoperative neurophysiological monitoring combined with neuronavigation multi-modal fusion technology in the brainstem glioma resection. Methods One hundred twenty patients with brainstem glioma were divided into observation group and control group. The control group was treated by traditional operation, while the observation group was treated by intraoperative nerve electrophysiological monitoring combined with neuronavigation multimodal fusion technology. The general condition, clinical efficacy, KPS score, complications and survival rate of the two groups were compared. Results The effect was significantly better in the observation group(76.66%)than in control group(53.33%)( x2=11.962,P=0.001).KPS scores were significantly higher in the observation group (27.91 ±1.98) than in the control group (12.11 ±2.13)(t=32.669, P<0.001). Conclusions Intraoperative nerve electrophysiological monitoring plus neuronavigation multimodality fusion technology can improve clinical efficacy and quality of life in patients with brainstem glioma.

Application of multi-modal and multi-functional molecular imaging based on near-infrared fluorescence dye in tumor models / 中国实验动物学报

Multi-modal fusion molecular imaging technology integrates the advantages of a variety of molecular imaging techniques,and has become a hotspot and trend in the field of molecular imaging. Heptamethine cyanine dye is a class of novel near-infrared fluorescence(NIRF)dye with tumor targeting properties. With its unique optical properties, the dye has broad application prospects in tumor molecular imaging, targeted therapy and drug delivery system. Nano-materials containing heptamethine cyanine dye can be used for NIRF/MRI dual-modal imaging. NIRF/PET dual-modal imaging can be achieved after labeling with nuclides. Conjugated with chemotherapy drugs,targeted delivery of anti-tumor drugs can also be achieved. Complexes of multiple heptamethine cyanine dyes have been used for multi-modal imaging as a new strategy for photothermal therapy,photodynamic therapy and combined treatment of tumors.

Design and experiment of a multi-modal electroencephalogram-near infrared spectroscopy helmet for simultaneously acquiring at the same brain area / 生物医学工程学杂志

Multi-modal brain-computer interface and multi-modal brain function imaging are developing trends for the present and future. Aiming at multi-modal brain-computer interface based on electroencephalogram-near infrared spectroscopy (EEG-NIRS) and in order to simultaneously acquire the brain activity of motor area, an acquisition helmet by NIRS combined with EEG was designed and verified by the experiment. According to the 10-20 system or 10-20 extended system, the diameter and spacing of NIRS probe and EEG electrode, NIRS probes were aligned with C3 and C4 as the reference electrodes, and NIRS probes were placed in the middle position between EEG electrodes to simultaneously measure variations of NIRS and the corresponding variation of EEG in the same functional brain area. The clamp holder and near infrared probe were coupled by tightening a screw. To verify the feasibility and effectiveness of the multi-modal EEG-NIRS helmet, NIRS and EEG signals were collected from six healthy subjects during six mental tasks involving the right hand clenching force and speed motor imagery. These signals may reflect brain activity related to hand clenching force and speed motor imagery in a certain extent. The experiment showed that the EEG-NIRS helmet designed in the paper was feasible and effective. It not only could provide support for the multi-modal motor imagery brain-computer interface based on EEG-NIRS, but also was expected to provide support for multi-modal brain functional imaging based on EEG-NIRS.

The diagnosis and treatment of localized high-risk prostate cancer: a case report and regimen prescription strategy / 中华泌尿外科杂志

Objective To exploie the choices and timing of different treatment regimens of prostate cancer.Methods The complete clinical data of one case of localized high-risk prostate cancer was reported.The patient,aged 69 years old,was admitted to hospital with urinary frequency and dysuria for 2 years.Serum total PSA was 36.8ng/ml and prostate biopsy dignosed as prostate cancer.The Gleason score was 4 + 3,and the clinical stage was T2b N0M0.Results The patient underwent radical prostatectomy,salvage radiotherapy + androgen deprivation therapy,abiraterone,enzalutamide,Radium-223,docetaxel + prednisone chemotherapy and mitoxantrone + prednisone chemotherapy,which included almost all of the current domestic treatment regimens.The patient lived for 57 months from the initiation of treatment.Conclusions For the patients with high-risk prostate cancer,especially for elderly patients,they should firstly be recommended the treatment of radical radiotherapy + 2-3 years of androgen deprivation therapy.For young patients,radical prostatectomy + extended pelvic lymph node dissection as part of multi-modal therapies is considered to be a positive choice.However,for the patients with risk factors or recurrence after radical prostatectomy,the postoperative radiotherapy should be performed in order to reduce biochemical recurrence and improve local control.Currently,the order of choice of abiraterone,enzalutamide or docetaxel + prednisone chemotherapy,is based on the patient's situation,past history of treatment,symptoms,side effects as well as other related clinical features.

Metodología multi-modal en relaciones cuantitativas estructura-actividad / Multi-Modal approach in quantitative structure-activity relationships studies

Los estudios QSAR definidos en la literatura están basados en enfoques uni-modales, dejando de analizar conjuntos de datos que contienen distintas informaciones químicas. En esta investigación se propone aplicar por primera vez y analizar el comportamiento del enfoque multi-modal en el desarrollo de estudios QSAR. Para este fin se utilizó una base de compuestos con actividad hepatotóxica, a partir de la cual se construyeron cuatro modalidades considerando distintos descriptores moleculares basados en diversas teorías y enfoques. Se desarrollaron varios modelos usando los enfoques uni-modales y multi-modales utilizando algoritmos de clasificación reportados en la literatura e implementados en el lenguaje R. Los parámetros de cada uno de los algoritmos se optimizaron con el procedimiento peatedgrid-searchcross-validation, mientras la validación de dichos modelos se realizó mediante validación cruzada de 10 pliegues con 10 repeticiones. Estadísticamente se comprobó que el enfoque multimodal mejora el desempeño de los modelos predictivos comparado con algunos de los modelos derivados de los conjuntos de datos con modalidades individuales(AU)

The QSAR studies defined in the literature are based on uni-modal approaches and do not consider datasets with different chemical information. Thus, this research has as objective to apply and analyze the behavior of multi-modal approaches when QSAR studies are carried out. To this end, a compound dataset with hepatotoxicity activity was employed and four modalities were built considering molecular descriptors based on different mathematical theories. Also, several predictive models were developed taking into account both uni-modal and multi-modal approaches by using classification algorithms reported in the literature and implemented in R language. The parameters of these algorithms with the procedure parameter tuning with repeated grid-search cross-validation were optimized, while the strategy 10-fold cross-validation with 10 repetitions was used to corroborate the predictive accuracy of the models. As result of this study it can be stated that the behavior of the models based on multi-modal approach present significant differences with to those models developed from uni-modal approaches(AU)

ARTIFICIAL IMMUNE ALGORITHM OF MULTICELLULAR GROUP AND ITS CONVERGENCE / 药物分析学报

Objective To find out more extrema simultaneously including global optimum and multiple local optima existed in multi-modal functions. Methods Germinal center is the generator and selector of high-affinity B cells, a multicellular group's artificial immune algorithm was proposed based on the germinal center reaction mechanism of natural immune systems. Main steps of the algorithm were given, including hyper-mutation, selection, memory, similarity suppression and recruitment of B cells and the convergence of it was proved. Results The algorithm has been tested to optimize various multi-modal functions, and the simulation results show that the artificial immune algorithm proposed here can find multiple extremum of these functions with lower computational cost. Conclusion The algorithm is valid and can converge on the satisfactory solution set D with probability 1 and approach to global solution and many local optimal solutions existed.

Intravenous thrombolysis for acute ischemic stroke / 中国实用内科杂志

Reperfusion therapies(thrombolysis,mechanical thrombectomy,or stenting,etc.) for acute ischemic stroke are the most effective therapy.Reperfusion therapy may limit ischemic tissue enlargement,leading to a reduced infarct size and favorable clinical outcome by restoring the blood flow before the salvageable penumbra became the progress of ischemic brain infarction.intravenous (IV) recombinant tissue plasminogen activator (rt-PA) therapy is the only proven effective treatment of acute ischemic stroke.Although thrombolytic therapy has matured,but the standard intravenous thrombolytic therapy (non-enhanced computed tomography (CT)-guided,3 h time window,the intravenous injection of tPA) have many restrictions,including a short therapeutic time window,recanalization rate was only 50 %,and the major dangers of symptomatic hemorrhagic transformation.As a result,currently in clinical practice,only a minority of patients (usually 1% to 3%) received thrombolytic therapy.So there are some issues still need to be further explored,such as the expansion of thrombolytic time window,a new thrombolytic drugs are used for more than 3h incidence of acute ischemic stroke patients,the evaluation of new reperfusion methods (in particular,multi-modal imaging technology),intravenous,and intra-arterial thrombolysis combined application of thrombolytic therapy,and new anti-platelet drug combination,and the application of mechanical devices or by transcranial Doppler ultrasound to promote the role of thrombolytic drugs.