Application of robotic surgery and traditional laparoscopic surgery in lymph node dissection for gynecological cancer: A meta­analysis.

Since the advantages of robotic surgery and laparoscopic surgery in the number of lymph node resections are not well understood, this meta-analysis used evidence-based medicine to assess the difference in the number of lymph nodes retrieved in gynecological cancer between the two surgical methods to guide clinical treatment. In the present meta-analysis, the Pubmed, Embase, Cochrane, China National Knowledge Infrastructure and Wanfang libraries were searched for articles that were published from the time of the database's inception to January 2021, including cohort studies and randomized controlled trials, where the observation group underwent robotic surgery to treat gynecological cancers and the control group underwent laparoscopic surgery to treat gynecological cancers, including cervical and ovarian cancers and endometrial cancers. Duplicate publications, studies with no full text, incomplete information or where the authors were unable to perform data extraction, animal experiments, reviews and systematic reviews were excluded. STATA 15.1 was used to analyze the data. Robotic surgery resulted in a significant increase in the number of lymph nodes retrieved from the pelvis [standard mean difference (SMD)=0.24; 95% CI, 0.04-0.45; P=0.007] and para-aortic (SMD=0.41; 95% CI, 0.13-0.69; P=0.004) regions compared with the number retrieved by laparoscopic surgery. Furthermore, there was no significant difference in operating time between robotic and laparoscopic surgery, despite the use of different instruments (SMD=0.12; 95% CI, -0.35-0.58; P=0.616). The amount of blood lost during robotic surgery was significantly less compared with that lost during laparoscopic surgery [SMD=-0.40; 95% CI, -0.58-(-0.22); P<0.001]. The present study evaluated cancer recurrence and death in further detail, and no statistically significant difference was demonstrated between robotic surgery and laparoscopic surgery in terms of recurrence rate [odds ratio (OR)=0.59; 95% CI, 0.21-1.65; P=0.318] and mortality rate (OR=0.31; 95% CI, 0.08-1.30; P=0.109). The present study demonstrated that robotic surgery was able to retrieve more pelvic and para-aortic lymph nodes than traditional laparoscopic surgery, which was consistent with previous reports. With regards to blood loss, The difference in operation time between the two surgical methods was not statistically significant, whereas the estimated blood loss of robotic surgery was significantly lower than that of traditional laparoscopic surgery. There was no statistically significant difference in the recurrence rate and mortality rate of the two surgical modality.

Anomaly Detection in Videos Using Two-Stream Autoencoder with Post Hoc Interpretability.

The growing interest in deep learning approaches to video surveillance raises concerns about the accuracy and efficiency of neural networks. However, fast and reliable detection of abnormal events is still a challenging work. Here, we introduce a two-stream approach that offers an autoencoder-based structure for fast and efficient detection to facilitate anomaly detection from surveillance video without labeled abnormal events. Furthermore, we present post hoc interpretability of feature map visualization to show the process of feature learning, revealing uncertain and ambiguous decision boundaries in the video sequence. Experimental results on Avenue, UCSD Ped2, and Subway datasets show that our method can detect abnormal events well and explain the internal logic of the model at the object level.

Imaging pediatric acute head trauma using 100-kVp low dose CT with adaptive statistical iterative reconstruction (ASIR-V) in single rotation on a 16 cm wide-detector CT.

OBJECTIVE: To demonstrate the ability of achieving low dose and high-quality head CT images for children with acute head trauma using 100 kVp and adaptive statistical iterative reconstruction (ASIR-V) algorithm in single rotation on a 16 cm wide-detector system. MATERIALS AND METHODS: We retrospectively analyzed the CT dose index (CTDI) and image quality of 104 children aged 0-6 years with acute head trauma (1 hour -3 days) in two groups: Group 1(n = 50) on a 256-row CT with single rotation at a reduced-dose of 100 kVp/240 mA and reconstructed using ASIR-V at 70%level; Group 2(n = 54) on a 64-row CT with multiple rotations at a standard dose of 120 kVp/ 180mA and reconstructed using a conventional filtered back-projection (FBP). Both groups used the 0.5 s/r axial scan mode. CT dose index (CTDI) and quantitative image quality measurements were compared using the Student t test; qualitative image quality comparison was carried out using Mann-Whitney rank test and the inter-reviewer agreement was evaluated using Kappa test. RESULTS: The exposure time was 0.5 s for Group 1 and 3.27±0.29 s for Group 2. The CTDI in Group 1 was 9.74±0.86mGy, 36.38%lower than the 15.31mGy in Group 2 (p < 0.001). Group 1 and Group 2 had similar artifact index (2.06±1.06 vs. 2.37±1.18) in the cerebellar hemispheres, and similar contrast-to-noise ratio (2.32±0.83 vs. 1.69±0.68), (1.47±0.72 vs. 1.10±0.43) respectively for cerebellum and thalamus (p > 0.05). Image quality was acceptable for diagnosis, and motion artifacts were reduced in Group 1 (p < 0.001). CONCLUSION: Single rotation CT with 100 kVp and 70%ASIR-V on 16 cm wide-detector CT reduces radiation dose and motion artifacts for children with acute head trauma without compromising diagnostic quality as compared with standard dose protocol. Thus, it provides a novel imaging method in management of pediatric acute head trauma.

Organizing pneumonia of COVID-19: Time-dependent evolution and outcome in CT findings.

BACKGROUND: As a pandemic, a most-common pattern resembled organizing pneumonia (OP) has been identified by CT findings in novel coronavirus disease (COVID-19). We aimed to delineate the evolution of CT findings and outcome in OP of COVID-19. MATERIALS AND METHODS: 106 COVID-19 patients with OP based on CT findings were retrospectively included and categorized into non-severe (mild/common) and severe (severe/critical) groups. CT features including lobar distribution, presence of ground glass opacities (GGO), consolidation, linear opacities and total severity CT score were evaluated at three time intervals from symptom-onset to CT scan (day 0-7, day 8-14, day > 14). Discharge or adverse outcome (admission to ICU or death), and pulmonary sequelae (complete absorption or lesion residuals) on CT after discharge were analyzed based on the CT features at different time interval. RESULTS: 79 (74.5%) patients were non-severe and 103 (97.2%) were discharged at median day 25 (range, day 8-50) after symptom-onset. Of 67 patients with revisit CT at 2-4 weeks after discharge, 20 (29.9%) had complete absorption of lesions at median day 38 (range, day 30-53) after symptom-onset. Significant differences between complete absorption and residuals groups were found in percentages of consolidation (1.5% vs. 13.8%, P = 0.010), number of involved lobe > 3 (40.0% vs. 72.5%, P = 0.030), CT score > 4 (20.0% vs. 65.0%, P = 0.010) at day 8-14. CONCLUSION: Most OP cases had good prognosis. Approximately one-third of cases had complete absorption of lesions during 1-2 months after symptom-onset while those with increased frequency of consolidation, number of involved lobe > 3, and CT score > 4 at week 2 after symptom-onset may indicate lesion residuals on CT.

A Pattern Categorization of CT Findings to Predict Outcome of COVID-19 Pneumonia.

Background: As global healthcare system is overwhelmed by novel coronavirus disease (COVID-19), early identification of risks of adverse outcomes becomes the key to optimize management and improve survival. This study aimed to provide a CT-based pattern categorization to predict outcome of COVID-19 pneumonia. Methods: One hundred and sixty-five patients with COVID-19 (91 men, 4-89 years) underwent chest CT were retrospectively enrolled. CT findings were categorized as Pattern 0 (negative), Pattern 1 (bronchopneumonia pattern), Pattern 2 (organizing pneumonia pattern), Pattern 3 (progressive organizing pneumonia pattern), and Pattern 4 (diffuse alveolar damage pattern). Clinical findings were compared across different categories. Time-dependent progression of CT patterns and correlations with clinical outcomes, i.e." discharge or adverse outcome (admission to ICU, requiring mechanical ventilation, or death), with pulmonary sequelae (complete absorption or residuals) on CT after discharge were analyzed. Results: Of 94 patients with outcome, 81 (86.2%) were discharged, 3 (3.2%) were admitted to ICU, 4 (4.3%) required mechanical ventilation, 6 (6.4%) died. 31 (38.3%) had complete absorption at median day 37 after symptom onset. Significant differences between pattern-categories were found in age, disease severity, comorbidity and laboratory results (all P < 0.05). Remarkable evolution was observed in Pattern 0-2 and Pattern 3-4 within 3 and 2 weeks after symptom-onset, respectively; most of patterns remained thereafter. After controlling for age, CT pattern significantly correlated with adverse outcomes [Pattern 4 vs. Pattern 0-3 [reference]; hazard-ratio [95% CI], 18.90 [1.91-186.60], P = 0.012]. CT pattern [Pattern 3-4 vs. Pattern 0-2 [reference]; 0.26 [0.08-0.88], P = 0.030] and C-reactive protein [>10 vs. ≤ 10 mg/L [reference]; 0.31 [0.13-0.72], P = 0.006] were risk factors associated with pulmonary residuals. Conclusion: CT pattern categorization allied with clinical characteristics within 2 weeks after symptom onset would facilitate early prognostic stratification in COVID-19 pneumonia.

Evolution of CT findings in patients with mild COVID-19 pneumonia.

OBJECTIVES: To delineate the evolution of CT findings in patients with mild COVID-19 pneumonia. METHODS: CT images and medical records of 88 patients with confirmed mild COVID-19 pneumonia, a baseline CT, and at least one follow-up CT were retrospectively reviewed. CT features including lobar distribution and presence of ground glass opacities (GGO), consolidation, and linear opacities were analyzed on per-patient basis during each of five time intervals spanning the 3 weeks after disease onset. Total severity scores were calculated. RESULTS: Of patients, 85.2% had travel history to Wuhan or known contact with infected individuals. The most common symptoms were fever (84.1%) and cough (56.8%). The baseline CT was obtained on average 5 days from symptom onset. Four patients (4.5%) had negative initial CT. Significant differences were found among the time intervals in the proportion of pulmonary lesions that are (1) pure GGO, (2) mixed attenuation, (3) mixed attenuation with linear opacities, (4) consolidation with linear opacities, and (5) pure consolidation. The majority of patients had involvement of ≥ 3 lobes. Bilateral involvement was more prevalent than unilateral involvement. The proportions of patients observed to have pure GGO or GGO and consolidation decreased over time while the proportion of patients with GGO and linear opacities increased. Total severity score showed an increasing trend in the first 2 weeks. CONCLUSIONS: While bilateral GGO are predominant features, CT findings changed during different time intervals in the 3 weeks after symptom onset in patients with COVID-19. KEY POINTS: • Four of 88 (4.5%) patients with COVID-19 had negative initial CT. • Majority of COVID-19 patients had abnormal CT findings in ≥ 3 lobes. • A proportion of patients with pure ground glass opacities decreased over the 3 weeks after symptom onset.

Natural product-based design, synthesis and biological evaluation of anthra[2,1-d]thiazole-6,11-dione derivatives from rhein as novel antitumour agents.

Two series of novel 2-substituted 5,7-dihydroxyanthra[2,1-d]thiazole-6,11-dione derivatives from natural rhein were designed, synthesized and evaluated for their antitumour activities against human cancer cell lines A549 and HeLa in vitro.