Research advances in the bile acid membrane receptor TGR5 in biliary tract diseases / 临床肝胆病杂志

TGR5 is a bile acid-activated G protein-coupled receptor and plays an important role in the physiological and pathological processes of the biliary system. This article describes the normal expression of TGR5 in the liver and bile duct under normal physiological conditions and its functions including the regulation of bile acid secretion and metabolism and cytoprotection. This article also summarizes the changes in the expression and function of TGR5 under pathophysiological conditions and the mechanism of TGR5 in affecting the development and progression of biliary tract diseases through inflammatory response and cell proliferation and apoptosis. TGR5 may be a potential target for the treatment of biliary tract diseases in the future.

Design of magneto-acoustic-electrical detection system and verification of its linear sweep theory / 生物医学工程学杂志

Clinical studies had demonstrated that early diagnosis of lesion could significantly reduce the risk of cancer. Magneto-acoustic-electrical tomography (MAET) is expected to become a new detection method due to its advantages of high resolution and high contrast. Based on thinking of modular design, a low-cost, digital magneto-acoustic conductivity detection system was designed and implemented in this study. The theory of MAET using chirp continuous wave excitation was introduced. The results of homogeneous phantom experiment with 0.5% NaCl clearly showed that the conductivity curve of homogeneous phantom was highly consistent with the actual physical size, which indicated that the chirp excitation theory in our proposed system was correct and feasible. Besides, the resolution obtained by 1 000 μs sweep time was better than that obtained by 500 μs and 1 500 μs, which means that sweep time is an important factor affecting the detection resolution of the conductivity. The same result was obtained in the experiments carried out on homogeneous phantoms with different concentrations of NaCl, which demonstrated the repeatability of our proposed MAET system.

The influence of hepatic steatosis on the evaluation of fibrosis with non-alcoholic fatty liver disease by acoustic radiation force impulse.

Acoustic radiation force impulse (ARFI) elastography is a non-invasive method for the assessment of liver by measuring liver stiffness. The aim of this study is to evaluate the accuracy of ARFI for the diagnosis of liver fibrosis and to assess impact of steatosis on liver fibrosis stiffness measurement, in rats model of non-alcoholic fatty liver disease (NAFLD). The rat models were conducted in 59 rats. The right liver lobe was processed and embedded in a fabricated gelatin solution. Liver mechanics were measured using shear wave velocity (SWV) induced by acoustic radiation force. In rats with NAFLD, the diagnostic performance of ARFI elastography in predicting severe fibrosis (F ≥ 3) and cirrhosis (F ≥ 4) had the areas under the receiver operating characteristic curves (AUROC) of 0.993 and 0.985. Among rats mean SWV values were significantly higher in rats with severe steatosis by histology compared to those mild or without steatosis for F0-F2 fibrosis stages (3.07 versus 2.51 m/s, P = 0.01). ARFI elastography is a promising method for staging hepatic fibrosis with NAFLD in rat models. The presence of severe steatosis is a significant factor for assessing the lower stage of fibrosis.

Effect of lithagogue decoction combined with tamsulosin on calculus removal rate and renal colic in patients with lower ureter calculus / 中国生化药物杂志

Objective Analyzed from row stone soup combined tan solo symplectic auxiliary row stone calculi in patients with ureteral Duan Jieshi under net rate and the influence of renal colic, so as to provide the basis for clinical treatment.Methods 90 patients with ureteral Duan Jieshi under in our hospital from January 2014 to February 2016 were selected, urology clinic of according to random, the principle of equal distribution is divided into group A (from row stone soup combined tan solo symplectic group) and group B (pure tan solo symplectic group), group C (pure traditional Chinese medicine medicinal broth group), 30 cases in each group.Observe and record the bladder irritation, frequent urination urgency), ureteral colic, discharge time, stones row net rate and incidence of adverse reactions after the comparison.Results In group A discharge time and stones row net both significantly better than B and C groups, the difference was statistically significant (P<0.05); the discharge time and stones row net between group B and C was no statistically significant difference.Group C on frequent urination urgency and ureteral colic happens to have more of A and B groups, the difference was statistically significant ( P <0.05 ); there was no statistically significant difference between group A and B.Adverse reaction of three groups of appeared in the process of treatment: group A in one case of mild diarrhea and one case of mild dizziness , group B in one case of mild headache and one case of mild dizziness, group C not present any adverse reaction, there were no significant differences in the incidence of adverse reactions among the three groups.Conclusion From row stone soup with tan solo symplectic auxiliary platoon stone therapy has good effect for patients with ureteral Duan Jieshi under, can give full play to the acetanilide spasmolysis effect of western medicine, also can better exert TCM row Shi Tong drench, analgesic anti-inflammatory, clear the role of the hot and humid, can improve the stone free rate, relieve patients with renal colic.

Effects of estrogen on the fibrosis process of intrauterine adhesions and the expression of forkhead box F2 / 解放军医学杂志

Objective To investigate the effect of estrogen on the fibrosis process of intrauterine adhesions and the expression of forkhead box F2 (FoxF2).Methods Primary human endometrial stromal cells (HESCs) were obtained by separation with 0.2％ collagenase Ⅰ digestion-mesh filtration-differential adherence,and identified by immunocytochemistry.HESCs affected with 10ng/ml transforming growth factor β1 (TGF-β1) for 48 hours.HESCs in model group were affected with 0,10-6,10-8,10-10 and 10-12mol/L estrogen,the expressions of smooth muscle actin alpha (α-SMA),Collagen I (COL Ⅰ) and FoxF2 were detected by quantitative PCR (qPCR) and Western blotting.Results HESCs with high purity and good activity were obtained by using 0.2％ collagenase Ⅰ digestion-mesh filtration-differential adherence separation method.Immunocytochemistry showed positive vimentin and negative cytokeratin 18 in HESCs.The results of qPCR and Western blotting showed that the mRNA and protein expression levels of α-SMA,COL Ⅰ and FoxF2 were higher in model group than in control group (P＜0.05),the model was built successfully.qPCR revealed that the mRNA expression levels ofα-SMA,COL Ⅰ and FoxF2 were significantly lower in 10-6,10-8 and 10-10mol/L estrogen groups than in model group (P＞0.05 in 10-10mol/L estrogen group,P＜0.05 in other groups),while in 10-12mol/L estradiol group,the expression levels of FoxF2 mRNA significantly decreased (P＜0.05),and of α-SMA and COL Ⅰ mRNA increased,but no significant difference were found (P＞0.05).Compared with the model group,the protein expression levels of α-SMA,COL Ⅰ and FoxF2 in 10-6,10-8 and 10 10mol/L estrogen groups decreased,but no significant difference was found (P＜0.05),while in 10-12mol/L estradiol group,the expression levels ofα-SMA protein increased (P＞0.05),and of COL Ⅰ and FoxF2 proteins decreased (P＜0.05).Conclusions The expression of FoxF2 in intrauterine adhesions is increased.Estrogen can reverse the fibrosis process of intrauterine adhesions in a certain range and inhibit the expression of FoxF2.

Value of acoustic radiation force impulse elastography in evaluation of nonalcoholic fatty liver disease and hepatic fibrosis in rats / 中国医学影像技术

Objective To evaluate the value of acoustic radiation force impulse (ARFI) elastography in assessment of nonalcoholic fatty liver disease (NAFLD) and hepatic fibrosis in rats.Methods Models with various degrees of NAFLD severity were conducted in 110 rats by feeding high fat emulsion.The right liver lobe of rat models were processed and embedded in a fabricated gelatin solution to measure the shear wave velocity (SWV) by ARFI.And the other liver lobes were used for histologic assessment.Based on NAFLD activity score (NAS),the final pathologic NAFLD diagnosis were considered as normal group (NAS=0),simple steatosis (SS) group (1≤NAS≤2),borderline (3≤NAS≤4) group and nonalcoholic steatohepatitis (NASH) group (NAS≥5).The diagnostic accuracy of the SWV parameters in evaluating NAFLD severity and fibrosis stages was studied using ROC curves.Results The difference of SWV values among normal group,SS group,borderline group and NASH group was statistically significant (F=31.53,P＜0.001).Taking SWV≥ 2.54 m/s as the diagnostic standard to differentiate normal rats from rats with SS,and SWV≥2.90 m/s to differentiate SS from NASH in rats,the area under ROC curve (AUC) was 0.922 (95％CI [0.871,0.973],P＜0.001) and 0.882 (95％ CI [0.807,0.956],P＜0.001) respectively.The sensitivity and specificity were 93.5 ％ and 100 ％ for differentiating normal and SS groups,83.3 ％ and 84.2 ％ for differentiating SS and NASH groups.Taking SWV≥3.48 m/s as cutoff to predict fibrosis (≥F2 stage),the AUC was 0.963 (95％CI [0.909,1.000],P＜0.001),the sensitivity was 92.9％ and the specificity was 97.6％.Taking SWV≥3.61 m/s as cutoff to predict severe fibrosis (≥F3 stage),the AUC was 0.997 (95％CI [0.990,1.000],P＜0.001),sensitivity was 100％ and specificity was 98.9％.The same high validity was maintained as in the prediction of cirrhosis (F4 stage) with the cutoff as SWV≥4.50 m/s,and the AUC was 0.993 (95％CI [0.982,1.000],P＜0.001),the sensitivity was 100 ％ and the specificity was 96.8％.Conclusion ARFI elastography is a promising method for differentiating the different severity of NAFLD and staging the degree of hepatic fibrosis with NAFLD in rat models.

Fetal facial standard plane recognition via very deep convolutional networks.

The accurate recognition of fetal facial standard plane (FFSP) (i.e., axial, coronal and sagittal plane) from ultrasound (US) images is quite essential for routine US examination. Since the labor-intensive and subjective measurement is too time-consuming and unreliable, the development of the automatic FFSP recognition method is highly desirable. Different from the previous methods, we leverage a general framework to recognize the FFSP from US images automatically. Specifically, instead of using the previous hand-crafted visual features, we utilize the recent developed deep learning approach via very deep convolutional networks (DCNN) architecture to represent fine-grained details of US image. Also, very small (3×3) convolution filters are adopted to improve the performance. The evaluation of our FFSP dataset shows the superiority of our method over the previous studies and achieves the state-of-the-art FFSP recognition results.

Research of Electronic Sphygmomanometer Intelligent Aeration Based on Pulse Wave Identification / 中国医疗器械杂志

Through various common domestic and foreign electronic sphygmomanometers to test blood pressure, we find that when measuring high blood pressure or low blood pressure, there is a mismatch between the maximum inflation pressure and the blood pressure measurement, which often results in repeatedly inflating and deflating as well as the problem of high inflation pressure. In order to solve these problems and find a suitable maximum inflation pressure, two intelligent pneumatic solutions based on identifying of pulse wave are suggested and 700 groups of blood pressure experiments are done, then the two solutions are verified by experiments. The experiment proved that these solutions proposed have good stability and accuracy, they can solve the problems appeared in measuring blood pressure effectively, at the same time, the second solution that estimate the maximum inflation pressure during inflation is considered as the best one.

Design and Application of Portable Micro Sleep Monitoring System / 中国医疗器械杂志

Through the study of the pathology of sleep apnea-hypopnea syndrome, evaluation indexes, diagnosis requirements and so on, a portable sleep monitoring system was designed, which had the characteristics of convenience, wireless transmission and no disturbance. The system can be assessed by respiration monitoring and pulse oximetry, which is based on the pressure variation in miniature air-bag and spectral absorption method. It provides the value of the apnea-hypopnea index (AHI), which is used to evaluate OSAHS severity. The experiment of the system's stability and accuracy is done, which exhibits good performance, it can diagnose OSAHS effectively and provide convenience for home monitoring.

Design of acoustic radiation force module for ultrasound elastography / 中国医疗器械杂志

Developing an acoustic radiation force excitation module including 64 channels based in FPGA for ultrasound elastography. The circuit of the module was derived in bipolar, and the parameters such as excitation frequency, pulse repetition frequency, pulse number, element number and focus depth were adjustable. The acoustic field for special parameter was experimented with OptiSon laser acoustic field system with a result which reflects the width of focal spot is about 3 mm. The acoustic power was experimented with RFB2000 radiation force balance with a result which reflects acoustic power is increasing linearly with the number of pulses and the number of elements, and is increasing squarely with the peak-to-peak value of excitation voltage. The module is promising in factual application which can be triggered externally in synchronously, and can be combined with B-mode ultrasound system for ultrasound elastography.

The development and transplantation of LCD module-based interface for medical diagnosis instrument / 中国医疗器械杂志

Based on LCD Module and Visual C++ development environment, this paper proposes a new method which can quickly develop the human-machine interface .We define a LCD module programming interface by designing Serial Communication Class(SCS). On this basis,we achieve the transplantation on an Embedded ARM Platform to fulfil the requirements of Medical Diagnostic Instruments (MDI). Experimental results show that this method has advantages of short development cycle and high level transplantation which has broad application prospects in the field of Medical Diagnosis Instrument.

Finite element analysis of the dynamic behaviour of a microbubble within a rigid micro-tube / 生物医学工程学杂志

The dynamic behaviour of a microbubble confined within a rigid micro-tube was studied using finite element method. The results indicated that the microbubble oscillation was limited when constrained within the micro-tube. Both the expansion ratio of its effective radius and natural frequency decreased with the decrease of the tube radius. Meanwhile, the deformation of the microbubble was non-spherical and became more significant when the ultrasound pressure amplitude increased. The dynamic behaviour in micro-tube was different from that in infinite liquid.

Instruction of clinical testing method for medical devices / 中国医疗器械杂志

The article introduces the clinical testing method for the product of patient monitor, the definition of direct measurement and indirect measurement method, and the different testing methods. The clinical testing methods for none invasive blood pressure, pulse oxygen saturation and ECG analysis have significant value, which are important solutions to test the safety and effectiveness of medical devices by using the equivalent analysis method. These methods above are also provided as reference for other medical devices' clinical testing.

A water-fat separation imaging method for the brain on low field magnetic resonance imaging / 药物分析学报

Water-fat separation is a particularly important problem for magnetic resonance imaging. Although many methods have been proposed, the reliability is still challenging. In this work, we have presented a method based on the combination of the branch-cut method and multigrid algorithm to get a more robust performance of water-fat separation. First, the branch-cut method is applied to identify residues, which violates the requirement that the interacting phase gradient around a closed path be zero. Residues and branches are marked to be zeros and filled to the weighting factor array. Then, the unwrapped phase array can be given by the multigrid algorithm. Finally, the Dixon method for water-fat separation is applied to the unwrapped phase array. Experiments for brain scanning on the 0.3T low field MRI system demonstrate the successful application of the proposed method.

Narrow-band level set and visualization technology for cochlea segmentation / 生物医学工程学杂志

Segmentation is a precondition step for modeling and analysis of the cochlea. In this paper, an interactive segmentation approach with a combination of 3D (three-dimensional) narrow-band level set algorithm and visualization technology was adopted to separate the cochlea. The 3D narrow-band level set algorithm was used to separate the objective of interest from volume data, and the visualization technology was used to display the segmented result. Users could modify intermediate parameters based on the direct 3D visual feedback until getting satisfying result. The basic principle and characteristics of level set and narrow-band level set algorithms were described in detail. The 3D narrow-band level set algorithm was successfully used to separate the cochlea from spiral CT images of the temporal bone. The experimental results show that the interactive method combining the narrow-band level set algorithm with visualization technique is capable of segmenting the cochlea from the medical volume data. Compared with the method of segmenting object from image volume slice by slice, our method can save much time.

3D navigation of CTVE and correction of MinIP methods in non-invasive diagnostic detection.

Navigation is important in Computed Tomography Virtual Endoscopy (CTVE) functions. Existing navigation methods involve planning and pre-calculating of a fixed path before the viewpoint flight inside the targeted organs. This includes path construction, centering, smoothing and multi-branch processing. This paper proposes a 3D navigation method which was achieved by utilizing the compatibility of the 3D navigation and the ray casting 3D rendering method, without the necessity of planning and pre-calculating a fixed path, eliminating the multi-branch problems. In our 3D navigation method, the viewpoint direction and location are tracked in real time when the viewpoint is inside the organs. At the same time it presents and controls the direction changes and location changes of the viewpoint in x, y, z dimensions. With interactive control of the viewpoint, it can fly in any direction in 3D, not only along a fixed path, thus eliminating multi-branch problems. The viewpoint locations and directions will change smoothly and will be used to calculate the current scene of CTVE. Accelerated ray casting is used to render 3D scenes, which is compatible with the 3D navigation method. In Minimum Intensity Projection (MinIP) applications, if the conventional MinIP reconstruction method is used, realistic results cannot be achieved when they are rotated in multi-directions because the Computed Tomography (CT) images always contain empty regions surrounding the tissue regions. The conventional MinIP reconstruction algorithm always chalks up a minimum intensity voxel which relates to the empty regions instead of the tissue regions. To solve such valid voxel searching problems, seed-filling algorithms are used to fill the empty regions of each slice automatically. The empty voxels are labeled automatically and are avoided in MinIP calculation to gain correct results in all directions.

3D semi-automatic segmentation of the cochlea and inner ear.

Though interactive direct volume rendering produces meaningful images with high quality, it cannot display separate inner ear labyrinth or cochlea only by adjusting imaging parameters to suppress the surrounding structures. Novel semi-automatic segmentation methods were presented to extract the cochlea and inner ear from spiral CT images. The cochlea was separated from the medical image volume by applying the 3D narrow band level set segmentation algorithm with user interaction introduced to locate the initial contour and adjust the parameters. The inner ear was extracted with a similar semi-automatic segmentation method: manual segmentation was first applied to remove several closely interconnected regions in boundary by viewing image volume slice by slice, then the 3D narrow band level set segmentation algorithm was used to complete fine segmentation on image volume. Generating 3D models of cochlea and inner ear structures with such methods not only takes advantage of the combination of 2D images with 3D volume but also saves much time of post-processing. The segmented results were rendered with the Marching Cubes surface rendering method. The correlation of the point on the resultant surface to the three orthogonal sections that intersect at that point on the surface was built to evaluate the segmented object and display the spatial relations of the anatomical structures. The performance of the presented semi-automatic segmentation methods is tested using spiral CT images of the temporal bone.

Medical image automatic adjusting window and segmentation / 生物医学工程学杂志

Image guided surgical navigation system is the most advanced surgical apparatus, which develops most rapidly and has great application prospects in neurosurgery, orthopaedics, E.N.T. department etc. In current surgical navigation systems, windowing, segmenting and registration of medical images all depend on manual operation, and automation of image processing is urgently needed. This paper proposes the algorithm which realizes very well automatic windowing and segmentation of medical images: first, we analyze a lot of MRI and CT images and propose corresponding windowing algorithm according to their common features of intensity distribution. Experiments show that the effects of windowing of most MRI and CT images are optimized. Second, we propose the seed growing algorithm based on intensity connectivity,which can segment tumor and its boundary exactly by simply clicking the mouse, and control dynamically the results in real time. If computer memory permits, the algorithm can segment 3D images directly. Tests show that this function is able to shorten the time of surgical planning, lower the complexity, and improve the efficiency in navigation surgery.

An open strategy for implementing PACS and its primary application.

The strategy for implementing PACS in China is currently hospital-oriented, that causes difficulties of transferring patients among hospitals and sharing patients' images and other case information among doctors. To overcome such shortcomings, an open strategy, which is patient-oriented, was presented. In the open strategy, connections among all the hospitals could be established through Internet by image center, and patient-oriented mechanism also covers the courses of image archiving and other case information management, that would make the limited resources of experienced doctors sharable among all the patients effectively. Moreover, the security, authenticity and validity of patients' images and other case information could be guaranteed better than before. A primary application on probation of PACS implemented with such an open strategy, which was put into practice in China, was also presented. According to the results, the open strategy could extend the application area of PACS from large hospitals to small ones and expedite building of electrical hospitals in China.

Simulation data mapping in virtual cardiac model.

Although 3D heart and torso model with realistic geometry are basis of simulation computation in LFX virtual cardiac model, the simulation results are mostly output in 2D format. To solve such a problem and enhance the virtual reality of LFX virtual cardiac model, the methods of voxel mapping and vertex project mapping were presented. With these methods, excitation isochrone map (EIM) was mapped from heart model with realistic geometry to real visible man heart model, and body surface potential map (BSPM) was mapped from torso model with realistic geometry to real visible man body surface. By visualizing in the 4Dview, which is a real-time 3D medical image visualization platform, the visualization results of EIM and BSPM simulation data before and after mapping were also provided. According to the visualization results, the output format of EIM and BSPM simulation data of LFX virtual cardiac model were extended from 2D to 4D (spatio-temporal) and from cardiac model with realistic geometry to real cardiac model, and more realistic and effective simulation was achieved.