Follow-up study of gallbladder stones in 44 children.

BACKGROUND: Cholesterol stones affect a certain subpopulation of children. Concerns have been raised on the impact of gallbladder surgery on the growth of children and adolescents. AIM: To study the population characteristics, clinical features, treatment, and prognosis of gallstones in children. METHODS: The clinical data of 44 children with gallstones admitted to The First Affiliated Hospital of Naval Medical University from August 2009 to August 2021 were collected, the children were followed up by telephone to monitor their prognoses. The follow-up ended in August 2023. The shortest follow-up time was 2 years and 6 months, whereas the longest was 13 years and 11 months. The population characteristics, general clinical characteristics, and treatments were retrospectively analyzed. The children were divided according to whether they underwent surgical gallbladder removal into an operation group (n = 28) and a non-operation group (n = 16), The effects of surgical gallbladder resection on the growth and development of children were analyzed. RESULTS: The male-female ratio in the population was 6:5 and 84.09% of the children had onset in adolescence. Furthermore, 29.55% of the children were overweight or obese. The study identified 26 cases with metabolic abnormalities, 9 with hemolytic anemia, and 4 with choledochal cyst. Of the population, 68.18% had recurrent symptomatic cholecystolithiasis. Surgical treatment accounted for 63.64%, with laparoscopic cholecystectomy accounting for 71.43% of surgical treatment. No significant differences were observed in symptoms and complications between the surgery and non-surgery groups. Furthermore, no significant differences were found between the two groups in the attainment of genetic height target and the rightward shift of height curve during follow-up. CONCLUSION: The sex characteristics of gallstones in children were not observed. Most gallstones occurred in adolescents and rarely in young children. A considerable proportion of children have inborn causes, which are often concurrent with metabolic abnormalities and hemolytic anemia. Most children had recurrent symptomatic gallstones. Surgical treatment, especially laparoscopic cholecystectomy, is still the main treatment for gallstones in children. Surgical treatment did not affect the growth and development of children who underwent gallstone removal.

dMIL-Transformer: Multiple Instance Learning Via Integrating Morphological and Spatial Information for Lymph Node Metastasis Classification.

Automated classification of lymph node metastasis (LNM) plays an important role in the diagnosis and prognosis. However, it is very challenging to achieve satisfactory performance in LNM classification, because both the morphology and spatial distribution of tumor regions should be taken into account. To address this problem, this article proposes a two-stage dMIL-Transformer framework, which integrates both the morphological and spatial information of the tumor regions based on the theory of multiple instance learning (MIL). In the first stage, a double Max-Min MIL (dMIL) strategy is devised to select the suspected top-K positive instances from each input histopathology image, which contains tens of thousands of patches (primarily negative). The dMIL strategy enables a better decision boundary for selecting the critical instances compared with other methods. In the second stage, a Transformer-based MIL aggregator is designed to integrate all the morphological and spatial information of the selected instances from the first stage. The self-attention mechanism is further employed to characterize the correlation between different instances and learn the bag-level representation for predicting the LNM category. The proposed dMIL-Transformer can effectively deal with the thorny classification in LNM with great visualization and interpretability. We conduct various experiments over three LNM datasets, and achieve 1.79%-7.50% performance improvement compared with other state-of-the-art methods.

Repair effect of photobiomodulation combined with human umbilical cord mesenchymal stem cells on rats with acute lung injury.

Acute lung injury (ALI) impaired the function of blood oxygen exchange function, resulting in tissue hypoxia and patient death. Recently, human umbilical cord mesenchymal stem cells (hUCMSCs) are thought to mitigate the effects of ALI, which boosts researchers' interest in employing stem cell-based therapies to manage ALI. However, as a novel therapy, hUCMSCs still face various limitations such as migrating weakly and insufficient proliferation in vivo. Photobiomodulation (PBM) effciently promotes cell proliferation, migration and homing, which presents a promising strategy for overcoming above limitations. In this study, PBM was emerged to intervene hUCMSCs through detecting cell proliferation, oxidative stress-related factors and inflammatory factors. These results assuredly confirmed that PBM enhanced the antioxidant capacity of cells and improved cell survival in vitro experiments. In vivo, PBM-intervened hUCMSCs intuitively reduce thickness of alveolar septum, excessive secretion of inflammatory factors, relieves bleeding, edema and fibrosis. As a physical intervention, PBM further strengthens the therapeutic effect of hUCMSCs and depicted a hopeful therapy in ALI treatment.

RFormer: Transformer-Based Generative Adversarial Network for Real Fundus Image Restoration on a New Clinical Benchmark.

Ophthalmologists have used fundus images to screen and diagnose eye diseases. However, different equipments and ophthalmologists pose large variations to the quality of fundus images. Low-quality (LQ) degraded fundus images easily lead to uncertainty in clinical screening and generally increase the risk of misdiagnosis. Thus, real fundus image restoration is worth studying. Unfortunately, real clinical benchmark has not been explored for this task so far. In this paper, we investigate the real clinical fundus image restoration problem. Firstly, We establish a clinical dataset, Real Fundus (RF), including 120 low- and high-quality (HQ) image pairs. Then we propose a novel Transformer-based Generative Adversarial Network (RFormer) to restore the real degradation of clinical fundus images. The key component in our network is the Window-based Self-Attention Block (WSAB) which captures non-local self-similarity and long-range dependencies. To produce more visually pleasant results, a Transformer-based discriminator is introduced. Extensive experiments on our clinical benchmark show that the proposed RFormer significantly outperforms the state-of-the-art (SOTA) methods. In addition, experiments of downstream tasks such as vessel segmentation and optic disc/cup detection demonstrate that our proposed RFormer benefits clinical fundus image analysis and applications.

Effective Capture of Carbon Dioxide Using Hydrated Sodium Carbonate Powders.

The emission of CO2 has been considered a major cause of greenhouse effects and global warming. The current CO2 capture approaches have their own advantages and weaknesses. We found that free-flowing hydrated sodium carbonate (Na2CO3) powders with 30 wt % water can achieve a very high CO2 sorption capacity of 282 mg/g within 60 min and fast CO2 uptake (90% saturation uptake within 16 min). The results suggest that the alkaline solution resulting from the dissolution of partial Na2CO3 can freely attach onto the hydrated Na2CO3 particles, which provides an excellent gas-liquid interface for CO2 capture, leading to significantly enhanced CO2 sorption capacity and kinetics.