Standardization for image characteristics in telemammography using genetic and nonlinear algorithms

As the soft copy reading and computer assisted diagnosis (CAD) in mammography become more and more important, the standardization of digital images becomes paramount. Telemammography and telemedicine requires the standardization for image characteristics, such as image resolution, bit-depth and intensity response. Soft copy reading and CAD in mammography are both dependent on the characteristics of the source of the digital data, either direct digital mammography or digitized screen-film mammography. An algorithm developed on images from one database may not perform well as on images from another database (with a different digitization). In this paper, we describe two methods based on a genetic algorithm and a nonlinear algorithm for standardization of digitized and digital mammography. The proposed standardization techniques are based on geometric and intensity transformations that are discovered using a set of calibration images. A set of transformation algorithm is used to search for the best standardization.     

Cephalometric image analysis and measurement for orthognathic surgery

Automatic identification of landmarks in cephalometry is very important and useful for orthognathic surgery. A computerised automatic cephalometric analysis system (CACAS), based on image processing, is presented. For an original X-ray image, median filtering and histogram equalisation are used to improve image quality. The edge of an X-ray image is detected by a wavelet transform and Canny filter. Seventeen landmarks in cephalometry are successfully identified by knowledge-based edge tracing and changeable templates. Seventy-three measurements based on distances, angles and ratios between landmarks are computed automatically. The reliability of the landmarks and the validity of the measurements are compared for automatic and manual operation. The values of measurements obtained by CACAS are more precise and reliable: the mean error for linear measurements is less than 0.9 mm; the mean error for angular measurements is less than 1.2°. The rate of validity is over 80%, even if the image quality is poor. For an image with a high signal-to-noise ratio, the rate of validity of landmarking and measurements using the CACAS system is over 90%.     

Estimation of bladder wall location in ultrasound images

A method of automatically estimating the location of the bladder wall in ultrasound images is proposed. Obtaining this estimate is intended to be the first stage in the development of an automatic bladder volume calculation system. The first step in the bladder wall estimation scheme involves globally processing the images using standard image processing techniques to highlight the bladder wall. Separate processing sequences are required to highlight the anterior bladder wall and the posterior bladder wall. The sequence to highlight the anterior bladder wall involves Gaussian smoothing and second differencing followed by zero-crossing detection. Median filtering followed by thresholding and gradient detection is used to highlight as much of the rest of the bladder wall as was visible in the original images. Then a ‘bladder wall follower’—a line follower with rules based on the characteristics of ultrasound imaging and the anatomy involved—is applied to the processed images to estimate the bladder wall location by following the portions of the bladder wall which are highlighted and filling in the missing segments. The results achieved using this scheme are presented.     

儿童再发川崎病临床特征分析并文献复习

目的探讨儿童再发川崎病的发生率、临床特征及冠状动脉病变(CAL)发生情况。 方法选择2010年5月至2019年10月,青岛市妇女儿童医院心脏中心收治的10例再发川崎病患儿为研究对象。回顾性分析这10例患儿的临床病例资料。采用配对t检验、Fisher确切概率法及Wilcoxon符号秩和检验,对10例患儿初发与再发时的临床表现、实验室检查结果等进行统计学比较。对国内外儿童再发川崎病相关文献进行文献复习。本研究经青岛市妇女儿童医院伦理委员会批准(审批文号：QFELL-KY-2019-64)。 结果①本中心2010年1月至2019年12月,川崎病再发率为1.16%(10/865),再发川崎病患儿中,男性患儿为7例、女性为3例。②10例患儿川崎病再发时年龄为(42.0±15.8)个月,初发至再发间隔时间为(12.1±6.2)个月,出院后随访至2020年4月预后良好。③本组川崎病患儿初发与再发时热程,皮疹、淋巴结肿大、球结膜充血、口唇充血及手足硬肿发生率,血清C反应蛋白(CRP)、红细胞沉降率(ESR)、血红蛋白(Hb)、白蛋白、丙氨酸转氨酶(ALT)及天冬氨酸氨基转移酶(AST)水平,以及白细胞及血小板计数比较,差异均无统计学意义(均为P>0.05)。初发与再发时,其CAL发生率比较,差异亦无统计学意义(P>0.05)。④文献复习结果：川崎病再发率为1.3%～3.4%,男性患儿多见,初发患儿年龄为0.4～2.2岁,初发距再发的间隔时间为1.0～3.3年,再发时患儿热程多短于初发时;川崎病患儿初发与再发时CAL发生率分别为6.3%～45.5%、6.3%～60.0%。 结论再发川崎病多见于5岁以下儿童,并且多发生于初次发病后1.5年内,再发患儿的CAL发生率较初发患儿无明显升高。尚未发现与川崎病再发明确相关的危险因素,婴幼儿期初发川崎病患儿其再发可能性更高。     

侵袭性牙周炎患者疱疹病毒感染和外周血病毒载量

目的分析不同严重程度侵袭性牙周炎(AGP)患者疱疹病毒(HV)感染情况和外周血病毒载量。方法选取2014年12月-2019年12月济南市市中区人民医院口腔科收治的2600例AGP患者,根据病变程度分为轻度AGP组(n=82)、中度AGP组(n=578)、重度AGP组(n=1940),以同期100名健康人群为对照组。入组后,检测龈沟液HV病毒感染情况和血浆单纯疱疹病毒1型(HSV-1)、EB病毒(EBV)、人类巨细胞病毒(HCMV)、人类疱疹病毒6型(HHV-6)载量、牙周特征和血炎症因子水平。结果AGP患者牙周菌斑指数(PLI)、探诊深度(PD)、附着丧失(AL)、出血指数(BI)高于对照组(P<0.05),HSV-1、EBV、HCMV、HHV-6感染率和病毒载量高于对照组(P<0.05),白细胞(WBC)、降钙素原(PCT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)高于对照组(P<0.05);随着AGP病情严重程度增加,HSV-1、EBV、HCMV、HHV-6感染率和病毒载量、PLI、PD、AL、BI、WBC、PCT、IL-6、TNF-α和CRP均增加(P<0.05)。结论HV感染率和病毒载量与AGP患者血清炎症因子水平和牙周特征随病情严重程度增加而升高。     

鹦鹉热衣原体肺炎患者临床特点分析

 目的 探讨分析鹦鹉热衣原体肺炎患者的临床表现及辅助检查结果特征,以提高对该病的认识。方法 回顾性分析某医院2019年6月- 2021年8月经宏基因组二代测序（mNGS）诊断鹦鹉热衣原体肺炎的9例患者临床资料。结果 9例患者中男性7例,女性2 例,包含1例妊娠36⁺²周孕妇;年龄25~70岁,中位年龄63岁;临床主要表现为高热（9例）、咳嗽（9例）、咳痰（7例）。白细胞计数正常8例,淋巴细胞计数降低9例,CRP升高9例,ESR升高9例,PCT正常4例,门冬氨酸氨基转移酶和丙氨酸氨基转移酶升高6例。9例患者胸部 CT均表现为斑片或斑片实变影。经血及肺泡灌洗液mNGS确诊后使用多西环素、莫西沙星、左氧氟沙星、阿奇霉素单药治疗方案,疗程14~21 d,均好转出院。结论 鹦鹉热衣原体肺炎临床表现多样、诊断困难,mNGS检测可以快速明确病原学诊断,有助于及时启动特异性抗感染治疗,可减少抗菌药物的使用,改善预后。     

胃肠道间质瘤的临床病理及免疫组化表达

目的：观察胃肠道间质肿瘤(gastrointestinal stromal tumor,GIST）临床病理特征及免疫组化表达,为临床诊断、治疗提供可靠依据。方法：采用常规病理切片HE染色,光镜观察,并行S－P法免疫组化Vimentin、CD34、SMA、Desmin、NF、S-100、EMA等标记物标记26例GIST。结果：26例GIST中,良性7例,恶性10例,低度恶性9例;发生于胃14例,小肠5例,回盲部2例,大肠和直肠5例;免疫组化Vimentin、CD34在瘤细胞中呈强阳性表达（阳性表达率分别为96．2％和84．6％）,肌源性和神经源性标记物SMA、S－100呈散在细胞阳性表达（阳性表达率分别为26．9％和15．4％）,而NF、EMA、Desmin均呈阴性表达。结论：GIST是一种源于原始间充质细胞的非定向分化的肿瘤,可伴有神经源性或／和肌源性分化,组织学上常以梭形细胞或上皮样细胞为主,具有类似肌源性或神经源性肿瘤的形态;临床手术切除前不易诊断,病理组织形态上易误诊为其它类型梭形细胞肿瘤;CD34和Vimentin对本瘤病理诊断具有较高的价值。     

发热伴血小板减少综合征流行病学研究进展

发热伴血小板减少综合征（SFTS）是21世纪初发现的一种新发蜱媒传染病。SFTS已在亚洲地区多个国家流行,包括中国、日本、韩国、越南、缅甸。截至2019年,我国已有25个省份报告SFTS病例,主要分布在山区和丘陵地带的农村,病例高度散发,但在地域分布上又相对集中,以河南、山东、安徽、湖北、辽宁、浙江和江苏7个省份为主。病例主要通过被携带病毒的蜱叮咬而感染,也可通过密切接触病例血液或体液感染。主要临床表现包括发热、胃肠道症状、血小板减少和白细胞减少,重症病例常因多器官功能衰竭而死亡。近年来,我国SFTS报告病例逐年上升,病死率始终维持较高水平,严重威胁人民身体健康。本文主要从SFTS的流行特征、传播流行的危险因素、临床特征等方面加以综述,旨在提升对SFTS疾病自然史的认知,加强传染病预防控制能力,降低疾病病死率。