Twist-Net: A multi-modality transfer learning network with the hybrid bilateral encoder for hypopharyngeal cancer segmentation.

Hypopharyngeal cancer (HPC) is a rare disease. Therefore, it is a challenge to automatically segment HPC tumors and metastatic lymph nodes (HPC risk areas) from medical images with the small-scale dataset. Combining low-level details and high-level semantics from feature maps in different scales can improve the accuracy of segmentation. Herein, we propose a Multi-Modality Transfer Learning Network with Hybrid Bilateral Encoder (Twist-Net) for Hypopharyngeal Cancer Segmentation. Specifically, we propose a Bilateral Transition (BT) block and a Bilateral Gather (BG) block to twist (fuse) high-level semantic feature maps and low-level detailed feature maps. We design a block with multi-receptive field extraction capabilities, M Block, to capture multi-scale information. To avoid overfitting caused by the small scale of the dataset, we propose a transfer learning method that can transfer priors experience from large computer vision datasets to multi-modality medical imaging datasets. Compared with other methods, our method outperforms other methods on HPC dataset, achieving the highest Dice of 82.98%. Our method is also superior to other methods on two public medical segmentation datasets, i.e., the CHASE_DB1 dataset and BraTS2018 dataset. On these two datasets, the Dice of our method is 79.83% and 84.87%, respectively. The code is available at: https://github.com/zhongqiu1245/TwistNet.

Retropharyngeal Abscess in an Adult With Pneumonia During COVID-19 Outbreak.

BACKGROUND: Retropharyngeal abscesses are rarely reported in adults and occur mostly in patients with immunocompromised or as a foreign body complication. Admittedly, the treatment of retropharyngeal abscesses frequently involves surgical drainage to achieve the best results. However, when retropharyngeal abscesses occurred in a highly suspected patient with COVID-19, the managements and treatments should be caution to prevent the spread of the virus. CLINICAL PRESENTATION: On February 13, a 40-year-old male with retropharyngeal abscesses turned to our department complaining dyspnea and dysphagia. In addition, his chest CT scan shows a suspected COVID-19 infection, thus making out Multiple Disciplinary Team determine to perform percutaneous drainage and catheterization through left anterior cervical approach under the guidance of B-ultrasound. Finally, the patient recovered and was discharged from the hospital on February 27 after 14 days of isolation. There was no recurrence after half a year follow-up. CONCLUSIONS: By presenting this case, we aim at raising awareness of different surgical drainage methods and summarizing our experience in the management of retropharyngeal abscesses during the outbreak of COVID-19.

Manganese nanodepot augments host immune response against coronavirus.

Interferon (IFN) responses are central to host defense against coronavirus and other virus infections. Manganese (Mn) is capable of inducing IFN production, but its applications are limited by nonspecific distributions and neurotoxicity. Here, we exploit chemical engineering strategy to fabricate a nanodepot of manganese (nanoMn) based on Mn2+. Compared with free Mn2+, nanoMn enhances cellular uptake and persistent release of Mn2+ in a pH-sensitive manner, thus strengthening IFN response and eliciting broad-spectrum antiviral effects in vitro and in vivo. Preferentially phagocytosed by macrophages, nanoMn promotes M1 macrophage polarization and recruits monocytes into inflammatory foci, eventually augmenting antiviral immunity and ameliorating coronavirus-induced tissue damage. Besides, nanoMn can also potentiate the development of virus-specific memory T cells and host adaptive immunity through facilitating antigen presentation, suggesting its potential as a vaccine adjuvant. Pharmacokinetic and safety evaluations uncover that nanoMn treatment hardly induces neuroinflammation through limiting neuronal accumulation of manganese. Therefore, nanoMn offers a simple, safe, and robust nanoparticle-based strategy against coronavirus. Electronic Supplementary Material: Supplementary material (RNA-seq data analysis, IFN and ISGs examination, in vitro viral infection, flow cytometry, ICP-MS, DHE staining, and detection of inflammatory factors) is available in the online version of this article at 10.1007/s12274-020-3243-5.