Lung cancer has brought tough challenges to human health due to its high incidence and mortality rate in the current practice. Nowadays, computed tomography (CT) imaging is still the most preferred diagnostic tool for early screening of lung cancer. However, a great challenge brought from accumulative CT imaging data can not meet the demand of the current clinical practice. As a novel kind of artificial intelligence technique aimed to deal with medical images, a computer-aided diagnosis has been found to provide useful auxiliary information, attenuate the workload of doctors, and significantly improve the efficiency and accuracy for clinical diagnosis of lung cancer. Therefore, an effective combination of computer-aided techniques and CT imaging has increasingly become an active area of investigation in early diagnosis of lung cancer. This review aims to summarize the latest progress on the diagnostic value of computer-aided technology with regard to early stage lung cancer from the perspectives of machine learning and deep learning.
ObjectiveTo observe and analyze the changes of macular choroidal thickness in children with occult high myopia and its influencing factors.MethodsA prospective, non-randomized, contemporaneous controlled trial. From September 2019 to October 2020, 56 children (110 eyes) who first visited the ophthalmic clinic of the Affiliated Hospital of Chengde Medical College without any myopia correction training were enrolled in this study. There were 33 males (64 eyes) and 23 females (46 eyes), with the average age of 8.62±1.87 years old; the age ranged from 6 to 12 years old. According to the clinical manifestations of myopia in children, they were divided into occult high myopia group (27 cases, 52 eyes) and control group (29 cases, 58 eyes). In the 52 eyes of the occult high myopia group, the spherical equivalent refraction (SER) of －0.00 to －1.00 D, ＞－1.00 to －2.00 D, ＞－2.00 to －3.00 D were 15, 16 and 21 eyes. Among 58 eyes in the control group, the SER of －0.00 to －1.00 D, ＞－1.00 to －2.00 D, ＞－2.00 to －3.00 D were 21, 18 and 19 eyes, respectively. The macular fovea within 6 mm was divided into three concentric circles centered on the macular fovea, which included the central area with a diameter of 1 mm, the inner ring area with a diameter of 1-3 mm, and the outer ring area with a diameter of 3-6 mm, totally 9 areas. The inner ring and outer ring were divided into upper, lower, nasal and temporal areas. The changes of choroidal thickness in each macular area of children in occult high myopia group and control group were observed. The choroidal thickness in each macular area was compared between the two groups using independent sample t-test. Pearson correlation analysis was used to analyze the correlation between mean foveal choroidal thickness and gender, age, intraocular pressure, ocular axis, diopter and corneal curvature in occult high myopia group.ResultsChoroidal thickness in macular area of children in occult high myopia group was thinnest in nasal side and thickest in temporal side. Compared with the control group, the mean choroidal thickness in the 9 macular zones of children in the occult high myopia group was significantly thinner than that in the control group, and the difference was statistically significant (P＜0.05). The mean choroidal thickness in each macular region decreased with the increase of diopter in children with occult high myopia. Compared with the control group with the same spherical equivalent, there was no significant difference in the area above the inner ring and the outer ring of the macular fovea in the occult high myopia group of －0.00 to －1.00 D and the temporal side of the inner ring and the outer ring of the macular fovea in the occult high myopia group of ＞－2.00 to －3.00 D (P＞0.05), but there were significant differences among the other regions (P＜0.05). Pearson correlation analysis results showed that the average choroidal thickness of the fovea in children with occult high myopia was negatively correlated with age (r=－3.410, R2=11.630, P=0.010), eye axis (r=1.420, R2=2.016, P=0.030) and diopter (r=－2.680, R2=7.182, P=0.040), but not significantly correlated with gender (r=0.166, R2=0.028, P=0.240), intraocular pressure (r=0.330, R2=0.109, P=0.800) and corneal curvature (r=－0.260, R2=0.068, P=0.850).ConclusionsThe thickness of macular choroidal in children with occult high myopia is the thinnest on the nasal side of the macular fovea and the thickest on the temporal side of the macular fovea. The mean choroidal thickness in each region of the macular is thinner than that in the common myopia children with the same diopter. The mean choroidal thickness of fovea is negatively correlated with age, ocular axis and diopter.
Objective To investigate the effect ofstaphylococcal lipoteichoic acid (LTA-sa) on RAW264.7 cells differentiation into osteoclasts. Methods RAW264.7 cells were cultured with LTA-sa of 100 ng/mL (group A), LTA-sa of 200 ng/mL (group B), LTA-sa of 400 ng/mL (group C), receptor activator of nuclear factor κB (NF-κB) ligand (RANKL) of 100 ng/mL as positive control (group D), and equal volume of PBS as blank control (group E) respectively for 5 days. And then, tartrate resistant acid phosphatase staining (TRAP) was used to detect the formation of osteoclast-like cells, Image-Pro Plus 6.0 software to measure the areas of bone resorption pits in Corning Osteo Assay Surface (COAS) wells, and MTT assay to observe the proliferation activity of RAW264.7 cells in group A, B, C, and E. Results After cultured for 5 days, the formation of osteoclast-like cells and bone resorption pits were observed in all groups. The number of osteoclast-like cells and the area of bone resorption pits in groups A, B, C, and D were more than those in group E. And with the increased concentration of LTA-sa, the indexes in groups A, B, and C increased gradually, but were lower than those in group D, and differences were significant between groups (P<0.05). At 5 days after culture, there was no significant difference in absorbance value among the experimental groups (groups A, B, C, and E) (P>0.05). Conclusion LTA-sa has promoting effect on RAW264.7 cells differentiation into osteoclasts.
Integrins is a family of multi-functional cell-adhesion molecules, heterodimeric receptors that connect extracellular matrix to actin cytoskeleton in the cell cortex, thus regulating various physiological and pathological processes. Risuteganib (Luminate?) is a novel broad-spectrum integrin inhibitor. Based on multiple biological functions of anti-angiogenesis, vitreolysis, and neuroprotection, risuteganib is hopeful in treating several fundus diseases such as diabetic macular edema, vitreomacular traction, and non-exudative age-related macular degeneration. By far, risuteganib has successfully met the endpoints for three phase 2 studies and is preparing to enter the phase 3 of diabetic macular edema clinical trials. Overall the risuteganib is safe with no serious ocular or systemic adverse events. Given the unique mechanism of action and longer duration of efficacy, intravitreal injection of risuteganib has the potential to serve as a primary therapy, or adjunctive therapy to anti-VEGF agents.
Ultra-wide-field fluorescein angiography (UWFA) is a novel breakthrough in ocular fundus imaging technology, which can capture a single, high-resolution, 200° wide image of the ocular fundus that traditional fluorescein angiography cannot reach. This technology has important impacts on the screening, diagnosis, staging, treatment and follow-up of vascular diseases involving peripheral retina (such as diabetic retinopathy, age-related macular degeneration, retinal vein occlusion, uveitis and so on).
ObjectiveTo determine the expressions of Lgr5 protein and Ki-67 protein in gastric cancer tissues, and to analyze the possible function in the carcinogenesis and development of gastric cancer.MethodsThe SABC immunohistochemical method was adopted to examine the expressions of Lgr5 protein and Ki-67 protein in the 69 paraffin slices of gastric cancer from the patients, with the adjacent normal gastric tissue as the control group. The statistical relationship between the expressions of these two kinds of proteins and clinicopathologic features of gastric cancer was examined respectively.ResultsIn the gastric cancer tissue group, the expressions of Lgr5 protein and Ki-67 protein upregulated in comparison to the adjacent normal gastric tissue group [Lgr5 protein: 87.0% (60/69) versus 16.7% (5/30), χ2=45.81, P<0.001; Ki-67 protein: 79.7% (55/69) versus 36.7% (11/30), χ2=17.43, P<0.001]. The expressions of Lgr5 protein and Ki-67 protein all upregulated in the N1–N3 stage groups, lowly differentiated+undifferentiated groups and positive Helicobacter pylori (HP) groups. The expression of Lgr5 protein upregulated in the T3+T4 stage groups in comparison to T1+T2 stage groups, while, no significant relationship was found in the expression of Ki-67 protein and tumor T staging. No significant relationship was found between the gender or metastasis and the expression of these two proteins. There was a positive correlation between the Lgr5 protein expression and the Ki-67 protein expression in the gastric cancer (rs=0.340, P=0.004).ConclusionsIn the development progress of gastric cancer, the Lgr5 protein might get involved in the mechanism of tumor invasion, lymph nodal metastasis, and low differentiation. Ki-67 protein might get involved in the mechanism of lymph nodal metastasis and low differentiation. The two proteins, together with the HP infection, might play a synergistic role in tumorigenesis and development.
ObjectiveTo evaluate the curative effect of robot-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS) for early stage lung cancer patients.MethodsWe retrospectively analyzed the clinical data of 80 patients with radical resection of lung cancer in Gansu Provincial Hospital between January 2016 and December 2017. The patients were divided into two groups: 43 patients in a VATS group and 37 in a RATS group. There were 51 males and 29 females. Data were processed with STATA v14.0 statistical software.ResultsThere were significant differences in the operative time, duration of hospital stay and operative costs between the two groups. In the RATS group, operative duration was longer (172.21 minutes versus 162.20 minutes, P=0.018), cost was higher (74 076.69 yuan versus 54 814.73 yuan, P<0.001), and required significantly shorter hospital stay (8.27 days versus 10.76 days, P=0.001) compared with those of the VATS group. There was no statistical difference between the two groups in terms of conversion (3 versus 0, P=0.144), blood loss during operation (61.29 ml versus 90.63 ml, P=0.213), dissected lymph node number (17.38 versus 12.63, P=0.095), drainage volume (1 406.76 ml versus 1 514.60 ml, P=0.617) and the drainage time (7.92 days versus 7.20 days, P=0.440).ConclusionIn the early lung cancer patients who underwent thoracic surgery, the postoperative hospitalization time of the RATS group is shorter than that of the VATS group, and the operation time is longer than that of the VATS group. The other short-term surgical indexes are similar to those of thoracoscopic surgery. However, the robot has great advantages in the treatment of patients with difficult lymph node dissection, serious pleural adhesion and complicated anatomical relationship.
ObjectiveTo compare clinical effects of extended thymectomy for the treatment of thymic abnormalities with myasthenia gravis (MG) between subxiphoid and subcostal arch thoracoscopic resection (SR) and the unilateral thoracoscopic resection (UR) by a propensity-score matching analysis.MethodsWe retrospectively analyzed the clinical data of 612 patients who presented with MG and were admitted to Tangdu Hospital of Air Force Military Medical University between December 2011 and December 2018. Of these patients, 520 patients underwent subxiphoid and subcostal arch thoracoscopic extended thymectomy (a SR group) and 92 unilateral thoracoscopic extended thymectomy (a UR group). Ninety-two patients in the SR group were matched with the UR group by propensity-score matching analysis. There were 52 males and 40 females with an average age of 26-70 (50.2±10.3) years in the SR group, and 47 males and 45 females with an average age of 20-73 (51.5±12.1) years in the UR group. The operation time, intraoperative blood loss, thoracic drainage time, postoperative hospital stay, thorough adipose tissue removal, postoperative remission of MG, patients’ satisfaction score, pain and complications were compared and analyzed between the two groups.ResultsAll operations were accomplished successfully, without conversion to thoracotomy of the two groups. There were statistical differences between the two groups in operation time (46.2±19.5 min vs. 53.4±23.5 min), chest drainage duration (0 d vs. 3.4±1.2 d), hospital stay (2.9±1.9 d vs. 3.6±1.7 d), patients’ satisfaction score (7.9±2.1 points vs. 6.7±1.2 points) and pain scores (all P<0.05). There were no statistical differences between the two groups in intraoperative blood loss (52.2±12.7 mL vs. 51.2±10.3 mL), peripheral adipose tissue removal (8.1±0.6 vs. 7.9±0.9), remission rate of MG (89.1% vs. 85.9%) and rate of postoperative complications (10.9% vs. 6.5%) (all P>0.05). ConclusionSubxiphoid and subcostal arch thoracoscopic extended thymectomy is a safe and feasible minimally invasive procedure for the management of MG with thymic abnormalities.
Uveitis is the most common extra-articular manifestation of juvenile idiopathic arthritis, typically as chronic anterior uveitis with insidious onset. Delayed and inadequate treatment may result in loss of patients' vision and even blindness. For refractory or severe uveitis related to juvenile idiopathic arthritis, systemic immunosuppressive agents should be used as early as possible. With the advantage of controlling ocular inflammation, avoiding ocular complications and reducing the use of traditional immunosuppressant drugs and glucocorticoid, tumor necrosis factor-α inhibitors have been new therapeutic options for uveitis associated with juvenile idiopathic arthritis, although methotrexate is known as the first-line approach. However, there are no internationally unified guidelines for clinical issues regarding the timing of application, reduction and withdrawal of tumor necrosis factor-α inhibitors, and no agreement on the application of tumor necrosis factor-α inhibitors in the management of ocular complications either. An in-depth understanding of the application status and progress of tumor necrosis factor alpha inhibitors in the treatment of juvenile idiopathic arthritis-associated uveitis has important clinical significance.
Objective To explore the components of passive movement resistance in the wrist flexor in subjects after stroke, and investigate the correlations between these components and clinical scales such as Modified Ashworth Scale (MAS) and Fugl-Meyer Assessment (FMA). Methods From March to August 2017, a cross-sectional study was performed in 15 stroke survivors in the Department of Rehabilitation Medicine, the First Affiliated Hospital, Sun Yat-sen University. MAS and FMA were assessed by an experienced physical therapist. Components of passive movement resistance in the flexors of wrist and finger were recorded by NeuroFlexor (Aggro MedTech AB, Solna, Sweden), then the average resisting force in one second ensued the passive stretch at 5°/s was took as peak resisting force (PRF). The PRF between paretic side and non-paretic side was compared. Spearman’s rank correlation was used to test the relation between the components and clinical scales. Results The PRF of the paretic side during the slow passive stretch (5°/s) was significantly higher than that of the non-paretic side [(10.49±1.65) vs. (8.98±1.11) N, P<0.05]. Correlations between MAS and the components/PRF were insignificant (P>0.05). FMA had a significant correlation with neural component of the paretic side (rs=–0.645, P=0.009). Conclusions The higher PRF of slow passive stretch in the paretic side may be attributed to the higher muscle stiffness. Neural component of the paretic wrist is correlated with FMA. These findings could be applied in clinical evaluation of functional performance of the wrist muscle of stroke survivors.