Electrical impedance tomography as a bedside assessment tool for COPD treatment during hospitalization.

For patients with chronic obstructive pulmonary disease (COPD), the assessment of the treatment efficacy during hospitalization is of importance to the optimization of clinical treatments. Conventional spirometry might not be sensitive enough to capture the regional lung function development. The study aimed to evaluate the feasibility of using electrical impedance tomography (EIT) as an objective bedside evaluation tool for the treatment of acute exacerbation of COPD (AECOPD). Consecutive patients who required hospitalization due to AECOPD were included prospectively. EIT measurements were conducted at the time of admission and before the discharge simultaneously when a forced vital capacity maneuver was conducted. EIT-based heterogeneity measures of regional lung function were calculated based on the impedance changes over time. Surveys for attending doctors and patients were designed to evaluate the ease of use, feasibility, and overall satisfaction level to understand the acceptability of EIT measurements. Patient-reported outcome assessments were conducted. User's acceptance of EIT technology was investigated with a five-dimension survey. A total of 32 patients were included, and 8 patients were excluded due to the FVC maneuver not meeting the ATS criteria. Spirometry-based lung function was improved during hospitalization but not significantly different (FEV1 %pred.: 35.8% ± 6.7% vs. 45.3% ± 8.8% at admission vs. discharge; p = 0.11. FVC %pred.: 67.8% ± 0.4% vs. 82.6% ± 5.0%; p = 0.15. FEV1/FVC: 0.41 ± 0.09 vs. 0.42 ± 0.07, p = 0.71). The symptoms of COPD were significantly improved, but the correlations between the improvement of symptoms and spirometry FEV1 and FEV1/FVC were low (R = 0.1 and -0.01, respectively). The differences in blood gasses and blood tests were insignificant. All but one EIT-based regional lung function parameter were significantly improved after hospitalization. The results highly correlated with the patient-reported outcome assessment (R > 0.6, p < 0.001). The overall acceptability score of EIT measurement for both attending physicians and patients was high (4.1 ± 0.8 for physicians, 4.5 ± 0.5 for patients out of 5). These results demonstrated that it was feasible and acceptable to use EIT as an objective bedside evaluation tool for COPD treatment efficacy.

Visualizing pursed lips breathing of patients with chronic obstructive pulmonary disease through evaluation of global and regional ventilation using electrical impedance tomography.

Objective. This study aims to explore the possibility of using electrical impedance tomography (EIT) to assess pursed lips breathing (PLB) performance of patients with chronic obstructive pulmonary disease (COPD).Methods. 32 patients with COPD were assigned equally to either the conventional group or the EIT guided group. All patients were taught to perform PLB by a physiotherapist without EIT in the conventional group or with EIT in the EIT guided group for 10 min. The ventilation of all patients in the final test were continuously monitored using EIT and the PLB performances were rated by another physiotherapist before and after reviewing EIT. The global and regional ventilation between two groups as well as between quite breathing (QB) and PLB were compared and rating scores with and without EIT were also compared.Results.For global ventilation, the inspiratory depth and the ratio of expiratory-to-inspiratory time during PLB was significantly larger than those during QB for both group (P< 0.001). The inspiratory depth and the ratio of expiratory-to-inspiratory time during PLB in the EIT guided group were higher compared to those in the conventional group (P< 0.001), as well as expiratory flow expiratory uniformity and respiratory stability were better (P< 0.001). For regional ventilation, center of ventilation significantly decreased during PLB (P< 0.05). The expiratory time constant during PLB in the EIT guided group was greater than that in the conventional group (P< 0.001). Additionally, Bland-Altman plots analysis suggested a high concordance between subjective rating and rating with the help of EIT, but the score rated after EIT observation significantly lower than that rated subjectively in both groups (score drop of -2.68 ± 1.1 in the conventional group and -1.19 ± 0.72 in the EIT guided group,P< 0.01).Conclusion.EIT could capture the details of PLB maneuver, which might be a potential tool to quantitatively evaluate PLB performance and thus assist physiotherapists to teach PLB maneuver to patients.

A triggered DNA nanomachine with enzyme-free for the rapid detection of telomerase activity in a one-step method.

BACKGROUND: Telomerase is considered a biomarker for the early diagnosis and clinical treatment of cancer. The rapid and sensitive detection of telomerase activity is crucial to biological research, clinical diagnosis, and drug development. However, the main obstacles facing the current telomerase activity assay are the cumbersome and time-consuming procedure, the easy degradation of the telomerase RNA template and the need for additional proteases. Therefore, it is necessary to construct a new method for the detection of telomerase activity with easy steps, efficient reaction and strong anti-interference ability. RESULTS: Herein, an efficient, enzyme-free, economical, sensitive, fluorometric detection method for telomerase activity in one-step, named triggered-DNA (T-DNA) nanomachine, was created based on target-triggered DNAzyme-cleavage activity and catalytic molecular beacon (CMB). Telomerase served as a switch and extended few numbers of (TTAGGG)n repeat sequences to initiate the signal amplification in the T-DNA nanomachine, resulting in a strong fluorescent signal. The reaction was a one-step method with a shortened time of 1 h and a constant temperature of 37 °C, without the addition of any protease. It also sensitively distinguished telomerase activity in various cell lines. The T-DNA nanomachine offered a detection limit of 12 HeLa cells µL-1, 9 SK-Hep-1 cells µL-1 and 3 HuH-7 cells µL-1 with a linear correlation detection range of 0.39 × 102-6.25 × 102 HeLa cells µL-1 for telomerase activity. SIGNIFICANCE: In conclusion, our study demonstrated that the triggered-DNA nanomachine fulfills the requirements for rapid detection of telomerase activity in one-step under isothermal and enzyme-free conditions with excellent specificity, and its simple and stable structure makes it ideal for complex systems. These findings indicated the application prospect of DNA nanomachines in clinical diagnostics and provided new insights into the field of DNA nanomachine-based bioanalysis.

Monitoring of spontaneous pneumothorax using electrical impedance tomography: A case report.

Pneumothorax is an emergency in thoracic surgeries and respiratory medicine. A technique is warranted for real-time monitoring of pneumothorax at the bedside so that rapid diagnosis and timely intervention can be achieved. We report herein a case in which electrical impedance tomography (EIT) was employed at the bedside to monitor lung ventilation of a patient with spontaneous pneumothorax during treatment. It was found that the affected side/healthy side ventilation ratio and global inhomogeneity were strongly correlated with the severity of pneumothorax. The use of EIT allowed intuitive observation of the effect of pneumothorax on ventilation, which helped the doctors make immediate diagnosis and intervention. After timely and successful treatment, the patient was discharged. This is the first case reporting a complete therapeutic course of spontaneous pneumothorax assessed with EIT. Our case demonstrated that EIT could monitor regional ventilation loss of the affected side of pneumothorax patients at the bedside, and dynamically assess the treatment effect of pneumothorax, which provides an important imaging basis for clinical pneumothorax treatment.

Evaluation of adjacent and opposite current injection patterns for a wearable chest electrical impedance tomography system.

Objective.Wearable electrical impedance tomography (EIT) can be used to monitor regional lung ventilation and perfusion at the bedside. Due to its special system architecture, the amplitude of the injected current is usually limited compared to stationary EIT system. This study aims to evaluate the performance of current injection patterns with various low-amplitude currents in healthy volunteers.Approach.A total of 96 test sets of EIT measurement was recorded in 12 healthy subjects by employing adjacent and opposite current injection patterns with four amplitudes of small current (i.e. 1 mA, 500 uA, 250 uA and 125 uA). The performance of the two injection patterns with various currents was evaluated in terms of signal-to-noise ratio (SNR) of thorax impedance, EIT image metrics and EIT-based clinical parameters.Main results.Compared with adjacent injection, opposite injection had higher SNR (p< 0.01), less inverse artifacts (p< 0.01), and less boundary artifacts (p< 0.01) with the same current amplitude. In addition, opposite injection exhibited more stable EIT-based clinical parameters (p< 0.01) across the current range. For adjacent injection, significant differences were found for three EIT image metrics (p< 0.05) and four EIT-based clinical parameters (p< 0.01) between the group of 125 uA and the other groups.Significance.For better performance of wearable pulmonary EIT, currents greater than 250 uA should be used in opposite injection, 500 uA in adjacent one, to ensure a high level of SNR, a high quality of reconstructed image as well as a high reliability of clinical parameters.

A lightweight multi-modality medical image semantic segmentation network base on the novel UNeXt and Wave-MLP.

Medical images sometimes contain diseased regions that are different sizes and. shapes, which makes it difficult to accurately segment these areas or their edges. However, directly coupling CNN and MLP to construct global and local dependency. models may also cause significant computational complexity issues. In this paper, a. unique, lightweight UNeXt network segmentation model for medical images based on. dynamic aggregation tokens was proposed. Firstly, the Wave Block module in Wave-MLP was introduced to replace the Tok-MLP module in UNeXt. The phase term in Wave Block can dynamically aggregate tokens, improving the segmentation accuracy of the model. Secondly, an AG attention gate module is added at the skip connection to suppress irrelevant feature representations in the sampling path of the encoding. network, thereby reducing computational costs and paying attention to noise and artifacts. Finally, the Focal Tversky Loss was added to handle both binary and multiple classification jobs. Quantitative and qualitative experiments were conducted on two public datasets: COVID-19 CT and BraTS 2018 MRI. The Dice score, Precision score, recall score, and Iou score of the proposed model on the COVID-19 dataset were 0.928, 0.867, 0.916, and 0.940, respectively. On BraTS 2018, the Dice scores of the ET, WT, and TC categories were 0.933, 0.925, and 0.918, respectively, and the HD scores were 1.595, 2.348, and 1.549, respectively. At the same time, the model is lightweight and has a considerably decreased training time with GFLOPs and Params of 0.52 and 0.76, respectively. The proposed lightweight model is superior to other existing methods in terms of segmentation accuracy and computing complexity according to experimental data.

Protonation-mediated DNA tile self-assembly with nuclease resistance characteristic for signal-amplified detection of microRNAs.

DNA nanotechnology, developing rapidly in recent years, has unprecedented superiorities in biological application-oriented research including high programmability, convenient functionalization, reconfigurable structure, and intrinsic biocompatibility. However, the susceptibility to nucleases in the physiological environment has been an obstacle to applying DNA nanostructures in biological science research. In this study, a new DNA self-assembly strategy, mediated by double-protonated small molecules instead of classical metal ions, is developed to enhance the nuclease resistance of DNA nanostructures while retaining their integrality and functionality, and the relative application has been launched in the detection of microRNAs (miRNAs). Faced with low-abundance miRNAs, we integrate hybrid chain reaction (HCR) with DNA self-assembly in the presence of double-protonated small molecules to construct a chemiluminescence detection platform with nuclease resistance, which utilizes the significant difference of molecular weight between DNA arrays and false-positive products to effectively separate of reaction products and remove the detection background. This strategy attaches importance to the nucleic acid stability during the assay process via improving nuclease resistance while rendering the detection results for miRNAs more authentic and reliable, opening our eyes to more possibilities for the multiple applications of customized DNA nanostructures in biology, including bioassay, bioimaging, drug delivery, and cell modulation.

A specific and low background nucleic acids sensing strategy based on rolling circle amplification coupled with a magnetic DNA machine.

We propose a universal fluorescence method for detection of nucleic acids based on rolling circle amplification (RCA) combined with a magnetic DNA machine and using dengue virus nucleic acids as an example target. RCA specifically amplifies the target and yields a large number of initiators employing heat-labile double-stranded DNase. The magnetic DNA machine produces a fluorescence signal and eliminates background noise. This method achieved a wide linear range, promising recovery and ultrahigh recognition specificity for one-base mismatches, and indicates the potential application of this sensing strategy in the clinical diagnosis of nucleic acids of pathogens.

The Influence of Breathing Exercises on Regional Ventilation in Healthy and Patients with Chronic Obstructive Pulmonary Disease.

We hypothesized that the respiratory exercises have uniform effects on ventilation in healthy subjects but the effects varied in patients with chronic obstructive pulmonary disease (COPD). In this study, a total of 30 healthy volunteers and 9 patients with COPD were included. Data were recorded continuously during (1) diaphragmatic breathing; (2) pursed lip breathing with full inhalation; (3) pursed lip combining diaphragmatic breathing. The sequence of the three breathing exercises was randomized using machine generated random permutation. Spatial and temporal ventilation distributions were evaluated with electrical impedance tomography. Results showed that, tidal volume was significantly larger during various breathing exercises compared to quiet tidal breathing, in both healthy and COPD (p < 0.01). However, for other EIT-based parameters, statistical significances were only observed in healthy volunteers, not in patients. Diaphragmatic breathing alone might not be able to decrease functional residual capacity in COPD and the effect varied largely from patient to patient (6:3, decrease vs. increase). Ventilation distribution moved toward ventral regions in healthy during breathing exercises (p < 0.0001). Although this trend was observed in the COPD, the differences were not significant. Ventilation became more homogeneous when diaphragmatic breathing technique was implemented (p < 0.0001). Again, the improvements were not significant in COPD. Regional ventilation delay was relatively high in COPD and comparable in various breathing periods. In conclusions, the impact of pursed lip and diaphragmatic breathing varied in different patients with COPD. Breathing exercise may need to be individualized to maximize the training efficacy with help of EIT.

Size-Controlled DNA Tile Self-Assembly Nanostructures Through Caveolae-Mediated Endocytosis for Signal-Amplified Imaging of MicroRNAs in Living Cells.

Signal-amplified imaging of microRNAs (miRNAs) is a promising strategy at the single-cell level because liquid biopsy fails to reflect real-time dynamic miRNA levels. However, the internalization pathways for available conventional vectors predominantly involve endo-lysosomes, showing nonideal cytoplasmic delivery efficiency. In this study, size-controlled 9-tile nanoarrays are designed and constructed by integrating catalytic hairpin assembly (CHA) with DNA tile self-assembly technology to achieve caveolae-mediated endocytosis for the amplified imaging of miRNAs in a complex intracellular environment. Compared with classical CHA, the 9-tile nanoarrays possess high sensitivity and specificity for miRNAs, achieve excellent internalization efficiency by caveolar endocytosis, bypassing lysosomal traps, and exhibit more powerful signal-amplified imaging of intracellular miRNAs. Because of their excellent safety, physiological stability, and highly efficient cytoplasmic delivery, the 9-tile nanoarrays can realize real-time amplified monitoring of miRNAs in various tumor and identical cells of different periods, and imaging effects are consistent with the actual expression levels of miRNAs, ultimately demonstrating their feasibility and capacity. This strategy provides a high-potential delivery pathway for cell imaging and targeted delivery, simultaneously offering a meaningful reference for the application of DNA tile self-assembly technology in relevant fundamental research and medical diagnostics.

The influence of gravity on electrical impedance tomography measurements during upper body position change.

Objective: The aim of the study was to examine the influence of gravity on regional ventilation measured by electrical impedance tomography (EIT) with the standard electrode belt position at the 5th intercostal space during tilting from supine to sitting positions. Methods: A total of 30 healthy volunteers were examined prospectively in supine position during quiet tidal breathing. Subsequently, the bed was tilted so that the upper body of the subjects achieved 30, 60 and 90° every 3 min. Regional ventilation distribution and end-expiratory lung impedance (EELI) were monitored with EIT throughout the whole experiment. Absolute tidal volumes were measured with spirometry and the volume-impedance ratio was calculated for each position. Results: The volume-impedance ratio did not differ statistically between the studied body positions but 11 subjects exhibited a large change in ratio at one of the positions (outside 99.3% coverage). In general, ventilation distribution became more heterogeneous and moved towards dorsal regions as the upper body was tilted to 90-degree position. EELI increased and tidal volume decreased. The lung regions identified at various positions differed significantly. Conclusion: Gravity has non-negligible influence on EIT data, as the upper body tilted from supine to sitting positions. The standard electrode belt position might be reconsidered if ventilation distribution is to be compared between supine and sitting positions.

Shape dependency of gold nanorods through TMB2+-mediated etching for the visual detection of NT-proBNP.

Heart failure (HF) is a major public health problem triggered by heart circulation disorders. Early detection and diagnosis are conducive to the prevention and treatment of HF. Hence, it is necessary to establish a simple and sensitive method to monitor the diagnostic biomarkers of HF. The N-terminal B-type natriuretic peptide precursor (NT-proBNP) is acknowledged as a sensitive biomarker. In this study, a visual detection method for NT-proBNP was developed based on the oxidized 3,3',5,5'-tetramethylbenzidine (TMB2+)-mediated etching of gold nanorods (AuNRs) and double-antibody-sandwich ELISA. The etching color for different amounts of NT-proBNP was obvious and significant differences could be ascertained based on the blue-shift of the longitudinal localized surface plasmon resonance (LLSPR) of the AuNRs. The results could be observed by the naked eye. The constructed system showed a concentration range from 6 to 100 ng mL-1 and a low detection limit of 6 ng mL-1. This method exhibited negligible cross-reactivity toward other proteins, and the recoveries of the samples ranged from 79.99% to 88.99%. These results demonstrated that the established method is suitable for the simple and convenient detection of NT-proBNP.

Synergistic effects of transcutaneous vagus nerve stimulation and inhibitory control training on electrophysiological performance in healthy adults.

Transcutaneous vagal nerve stimulation (tVNS) is a non-invasive nerve stimulation technique that exerts a positive "exogenous" online neuromodulatory effect on inhibitory control (IC). Additionally, IC training (ICT) is an effective approach for enhancing IC via the "endogenous" activation of brain regions implicated in this process. The aim of the present study was to examine the synergistic effects of tVNS and ICT on IC enhancement. For this, we measured the changes in neural activity in frontal, fronto-central, and central regions in the time domain of the N2 component and the frequency domain of alpha power during the stop signal task. A total of 58 participants were randomly divided into four groups that received five sessions of either ICT or sham ICT with either online tVNS or sham tVNS. No differences in N2 amplitude were detected after any of the interventions. However, N2 latency shortened after tVNS + ICT in frontal, fronto-central, and central regions. N2 latency shortened after the intervention of sham tVNS + ICT in frontal region. Moreover, alpha power after tVNS + ICT intervention was larger than those of the other interventions in frontal, fronto-central, and central regions. The obtained electrophysiological data suggested that combining tVNS with ICT has synergistic ameliorative effects on IC, and provide evidence supporting the IC-enhancing potential of tVNS combined with ICT.

Kinetics-accelerated one-step detection of MicroRNA through spatially localized reactions based on DNA tile self-assembly.

The localization of isothermal amplification systems has elicited extensive attention due to the enhanced reaction kinetics when detecting ultra-trace small-molecule nucleic acids. Therefore, the seek for an appropriate localization cargo of spatially confined reactions is urgent. Herein, we have developed a novel approach to localize the catalytic hairpin assembly (CHA) system into the DNA tile self-assembly nanostructure. Thanks to the precise programming and robust probe loading capacity, this strategy achieved a 2.3 × 105-fold higher local reaction concentration than a classical CHA system with enhanced reaction kinetics in theory. From the experimental results, this strategy could reach the reaction plateau faster and get access to a magnified effect of 1.57-6.99 times higher in the linear range of microRNA (miRNA) than the simple CHA system. Meanwhile, this strategy satisfied the demand for the one-step detection of miRNA in cell lysates at room temperature with good sensitivity and specificity. These features indicated its excellent potential for ultra-trace molecule detection in clinical diagnosis and provided new insights into the field of bioassays based on DNA tile self-assembly nanotechnology.

Assessment of Low Back Pain in Helicopter Pilots Using Electrical Bio-Impedance Technique: A Feasibility Study.

Low back pain (LBP) is known to pose a serious threat to helicopter pilots. This study aimed to explore the potential of electrical bio-impedance (EBI) technique with the advantages of no radiation, non-invasiveness and low cost, which is intended to be used as a daily detection tool to assess LBP in primary aviation medical units. The LBP scales (severity) in 72 helicopter pilots were assessed using a pain questionnaire, while the bilateral impedance measurements of the lumbar muscle were carried out with a high precision EBI measurement system. Results showed that the modulus of lumbar muscle impedance increased with LBP scale whereas the phase angle decreased. For different LBP scales, significant differences were found in the modulus of lumbar muscle impedance sum on both sides (Z sum ), as well as in the modulus and phase angle of lumbar muscle impedance difference between both sides (Z diff and ϕ diff ), respectively (P < 0.05). Moreover, Spearman's correlation analysis manifested a strong correlation between Z sum and LBP scale (R = 0.692, P < 0.01), an excellent correlation between Z diff and LBP scale (R = 0.86, P < 0.01), and a desirable correlation between ϕ diff and LBP scale (R = -0.858, P < 0.01). In addition, receiver operator characteristic analysis showed that for LBP prediction, the area under receiver operator characteristic curve of Z sum , Z diff , and ϕ diff were 0.931, 0.992, and 0.965, respectively. These findings demonstrated that EBI could sensitively and accurately detect the state of lumbar muscle associated with LBP, which might be the potential tool for daily detection of LBP in primary aviation medical units.

Training and Transfer Effects of Combining Inhibitory Control Training With Transcutaneous Vagus Nerve Stimulation in Healthy Adults.

Inhibitory control training (ICT) is a promising method to improve individual performance of inhibitory control (IC). Recent studies have suggested transcutaneous vagus nerve stimulation (tVNS) as a novel approach to affect cognitive function owing to its ability to modulate the locus coeruleus-noradrenaline system. To examine the synergistic effects of combining ICT with tVNS, 58 young males in college were randomly assigned to four groups: ICT + tVNS, ICT + sham tVNS, sham ICT + tVNS, and sham ICT + sham tVNS. Participants were instructed to complete three sessions that comprised pre-training tests, a training session, and post-training tests sequentially. Results showed that the ICT + tVNS group significantly improved training and near-transfer effects on the stop-signal and Go/No-go tasks, and these effects were larger than those of the other groups. However, none of the groups exhibited the far-transfer effect on the color-word Stroop task. These results suggest that tVNS augments the intervention effects of training and similar inhibition tasks to achieve the synergistic effect; however, it does not modulate the effects of non-training tasks and obtain the far-transfer effect. ICT combined with tVNS may be a valuable intervention for improving IC in healthy individuals in certain industries and offers novel research ideas for using tVNS for cognitive improvement.

The effects of emotional trait factors on simulated flight performance under an acute psychological stress situation.

Objective. Pilots are commonly exposed to some sources of emotional and cognitive stressors, especially for flight cadets, which have an important influence on flight safety. The present study aimed to study the relationship between emotional trait factors, emotional state, mental workload and simulated flight performance (SFP) under an acute psychological stress situation. Methods. Fifty-five undergraduates were included in the study. The Wong and Law emotional intelligence scale (WLEIS), state-trait anxiety inventory (STAI), stress rating questionnaire (SRQ) and National Aeronautics and Space Administration task load index (NASA-TLX) were used as data collection tools. Nine hours of simulated flight training were conducted in a simulator of the Type-6 Primary Trainer (Aviation University Air Force, China). The simulated flight assessment was taken as the acute psychological stressor. Results. SFP was negatively correlated with tensity and state anxiety. Emotional intelligence (EI) indirectly affected the SFP mediated by emotional state and workload, and emotional state had a mediating effect on the relationship between trait anxiety and SFP. Conclusions. The findings indicated that emotional trait factors (EI and trait anxiety) may indirectly affect SFP under an acute psychological stress situation, and emotional state (tensity and state anxiety) and mental workload played an important mediating role.

The influence of reference electrode in electrical impedance tomography.

Background: Some electrical impedance tomography (EIT) devices equip reference electrodes. In practice, it is not uncommon to observe high contact impedance for the reference electrode. The influence of bad contact reference electrode on data quality is unknown. The study aimed to investigate the influence of reference electrode on EIT image reconstruction. Methods: Thirty lung healthy volunteers were prospectively examined with EIT. The subjects were spontaneously breathing in supine position. Three scenarios were constructed: 1. Normal measurement; 2. Reference electrode disconnected without recalibration; 3. Reference electrode disconnected, and the measurement restarted after recalibration of the system. EIT-based parameters measuring spatial and temporal ventilation distributions were calculated and compared. A so-call deviation score was calculated to assess the differences in EIT parameters between scenarios 2 and 1, between 3 and 1. Results: The absolute differences for all parameters were significantly higher than zero (p < 0.01 for all parameters and scenarios). Deviation score for scenario 2 was 4.5 ± 3.5. Four subjects had a deviation score of 0 in scenario 2 and five subjects had a score of 1. The deviation in scenario 3 was higher (6.1 ± 3.1). No subjects had a score of 0 and only two subjects had a score of 1. Conclusions: For EIT systems that equips with reference electrode, it is important to ensure the proper contact and functionality of the reference electrode. The EIT data quality would remain unchanged in only a small portion of subjects.

Automated layer segmentation of macular OCT images via graph-based SLIC superpixels and manifold ranking approach.

Using the graph-based a simple linear iterative clustering (SLIC) superpixels and manifold ranking technology, a novel automated intra-retinal layer segmentation method is proposed in this paper. Eleven boundaries of ten retinal layers in optical coherence tomography (OCT) images are exactly, fast and reliably quantified. Instead of considering the intensity or gradient features of the single-pixel in most existing segmentation methods, the proposed method focuses on the superpixels and the connected components-based image cues. The image is represented as some weighted graphs with superpixels or connected components as nodes. Each node is ranked with the gradient and spatial distance cues via graph-based Dijkstra's method or manifold ranking. So that it can effectively overcome speckle noise, organic texture and blood vessel artifacts issues. Segmentation is carried out in a three-stage scheme to extract eleven boundaries efficiently. The segmentation algorithm is validated on 2D and 3D OCT images in three databases, and is compared with the manual tracings of two independent observers. It demonstrates promising results in term of the mean unsigned boundaries errors, the mean signed boundaries errors, and layers thickness errors.