Multi-scale GCN-assisted two-stage network for joint segmentation of retinal layers and discs in peripapillary OCT images

An accurate and automated tissue segmentation algorithm for retinal optical coherence tomography (OCT) images is crucial for the diagnosis of glaucoma. However, due to the presence of the optic disc, the anatomical structure of the peripapillary region of the retina is complicated and is challenging for segmentation. To address this issue, we develop a novel graph convolutional network (GCN)-assisted two-stage framework to simultaneously label the nine retinal layers and the optic disc. Specifically, a multi-scale global reasoning module is inserted between the encoder and decoder of a U-shape neural network to exploit anatomical prior knowledge and perform spatial reasoning. We conduct experiments on human peripapillary retinal OCT images. We also provide public access to the collected dataset, which might contribute to the research in the field of biomedical image processing. The Dice score of the proposed segmentation network is 0.820 ± 0.001 and the pixel accuracy is 0.830 ± 0.002, both of which outperform those from other state-of-the-art techniques.     

胍丁胺鞘内注射对骨癌痛大鼠痛行为及脊髓CXCL13表达的影响

目的 探讨胍丁胺鞘内注射对骨癌痛大鼠痛行为及脊髓趋化因子CXC配体13（CXCL13）表达的影响。方法 成年雌性SD大鼠60只,体质量200~220 g,采用随机数字表法分为3组：假手术组（A组）、骨癌痛组（B组）、骨癌痛+胍丁胺组（C组）,各20只。B、C组采用大鼠胫骨上端骨髓腔内注入Walker 256癌细胞的方法建立骨癌痛模型,A组胫骨髓腔内注射等量生理盐水,B、C两组鞘内置管。造模成功后,C组鞘内注射胍丁胺160 mg/kg,连续6天;B组鞘内给予等量生理盐水,连续6天;A组不作处理。于造模后第12天用von Frey丝测定3组大鼠机械缩足反射阈值（MWT）;痛阈测定结束后,麻醉处死大鼠,取脊髓组织,采用免疫荧光法检测CXCL13在神经元中的表达;采用Western blot法分析CXCL13蛋白表达及逆转录-聚合酶链反应（RT-PCR）法检测CXCLl3 mRNA的表达。结果 建模后12天,与A组比较,B、C组大鼠MWT明显低于A组,与B组比较,C组MWT高于B组,差异均有统计学意义（P<0.05）。建模后12天,与A组比较,B、C组大鼠CXCL13在脊髓背角神经元中表达增加,CXCL13蛋白及其mRNA表达明显增加（P<0.05）;与B组比较,C组大鼠CXCL13在脊髓背角神经元中表达降低,CXCL13蛋白及其mRNA表达明显减少（P<0.05）。结论 鞘内注射胍丁胺可有效改善大鼠骨癌痛痛觉过敏行为,其机制可能与抑制大鼠脊髓CXCL13表达有关。     

血尿酸水平与急性脑梗死脑白质病变的相关性研究

目的探讨急性脑梗死病人血尿酸水平与脑白质病变( WMLs)程度及部位的关系。方法连续入选 2016年 6月至 2018年 6月蚌埠市第三人民医院神经内科收治的急性脑梗死病人进行横断面回顾性研究,按照 Fazekas量表评分将病人分成四组:重度 WMLs组,中度 WMLs组,轻度 WMLs组和无 WMLs组。比较各组病人性别、年龄、既往史及血尿酸及其他血生化相关指标,并进行 logistic回归分析 WMLs及不同程度 WMLs危险因素。分析不同部位脑白质病变与血尿酸水平的相关性。结果共入选急性脑梗死病人 659例,其中重度 WMLs 60例,中度 145例,轻度 425例,无 WMLs 29例,对四组进行基线分析,年龄( χ2＝ 16.84,P＝0.000)、既往脑梗死病史( χ2＝28.06,P＝0.000)、冠心病( χ2＝20.119,P＝0.000)、 TC水平( F＝3.00,P＝0.030)、 HDL?C水平( F＝3.01,P＝0.032)及尿酸水平( F＝4.672,P＝0.03)差异有统计学意义。多因素回归分析后,年龄及既往梗死是 WMLs发生的显著影响因素。其中年龄［比值比( OR)1.042,95%置信区间( CI)1.005~1.080,P＝0.027］是轻度 WMLs的独立危险因素;年龄［比值比( OR)1.055,95%置信区间( CI)1.013~1.099,P＝0.010］、既往脑梗死病史［比值比( OR)3.533,95%置信区间(CI)1.108~11.268,P＝0.033］是中度 WMLs的独立危险因素;年龄［比值比( OR)1.104,95%置信区间( CI)1.042~1.169,P＝0.001］、既往脑梗死病史［比值比( OR)4.371,95%置信区间( CI)1.342~18.345,P＝0.001］及高血尿酸水平［比值比( OR)1.004, 95%置信区间( CI)1.001~1.007,P＝0.009］是重度 WMLs的独立危险因素。与无 WMLs病人比较发现单纯脑室旁白质病变及深部脑白质病变病人的血尿酸水平差异无统计学意义,仅重度混合病变组血尿酸水平较无病变组明显升高,差异有统计学意义(P＜0.05)。结论高龄及既往梗死病史与急性脑梗死病人并发脑白质病变呈正相关,高血尿酸水平是重度脑白质病变发生的独立危险因素。     

Tea polyphenols alleviate tri‐ortho‐cresyl phosphate‐induced autophagy of mouse ovarian granulosa cells

Tri‐ortho‐cresyl phosphate (TOCP), a widely used plasticizer in industry, can cause female reproductive damage. Tea polyphenols (TPs) have multiple health effects via inhibiting oxidative stress. However, the reproductive protection of TPs in TOCP‐induced female reproductive system damage is yet to be elucidated. In the study, TOCP inhibited cell viability and induced autophagy of mouse ovarian granulosa cells; while TPs could rescue the inhibition of viability and induction of autophagy. 3‐MA, an autophagy inhibitor, could also rescue the inhibition of cell viability. These results indicated that TPs played a protective role in TOCP‐induced autophagy. Furthermore, TPs could inhibit the induction of oxidative stress of the cells by TOCP, which implying that TPs might alleviate TOCP‐induced autophagy via inhibiting oxidative stress. Furthermore, TPs could rescue TOCP‐induced autophagy and oxidative stress in the mouse ovarian tissues. Taken together, these results indicated that TPs could protect TOCP‐induced ovarian damage via inhibiting oxidative stress.     

综合医院住院患者心理障碍研究进展

21世纪以来,人类疾病谱和死亡顺位发生了明显改变,从心、身两方面来看,这些疾病多属于心身疾病范畴,单纯的生物医学已经不能完全认识现代疾病与有效解决临床的诊断和治疗问题。因此,必须应用心身医学的基础和理论,从心与身两个方面来研究疾病的发生和发展、转归和预后,为从根本上防治疾病开辟新思路。     

腹腔镜下远端胃癌根治与D2淋巴结清扫安全性及可行性分析

目的：探讨腹腔镜下远端胃癌根治与D2淋巴结清扫的效果及安全性。方法收集80例远端胃癌患者,40例行腹腔镜下远端胃癌根治术的患者为研究组,40例采用开腹手术治疗的患者为对照组,对比分析两组手术指标(切口长度、手术时间、术中出血)、术后恢复情况(排气时间、下床活动时间、镇痛次数、并发症)及肿瘤根治范围等,评价腹腔镜胃癌根治的效果和安全性。结果研究组手术时间显著长于对照组,但切口长度、术中出血量均明显少于对照组,差异有统计学意义( P<0．05)。两组肿瘤近端及远端切缘、淋巴结清扫数量比较,差异无统计学意义(P>0．05)。研究组术后镇痛次数、肛门排气时间、下床活动时间明显少于对照组,差异有统计学意(P<0．05);除肺部感染外,两组其他并发症发生率差异无统计学意义(P>0．05)。结论腹腔镜下远端胃癌根治与D2淋巴结清扫虽然手术时间较长,操作复杂,但能够达到开腹手术相同的胃癌切除标准和淋巴清扫范围,且术后恢复方面有明显优势,值得应用。     

锌指蛋白ZBTB20生物学功能的研究进展

锌指蛋白ZBTB20是ZBTB锌指蛋白亚家族的新成员,与已知的BCL6和PLZF同源.通过基因打靶小鼠和疾病人群研究,学者们发现ZBTB20在肝脏、胰岛、神经系统和免疫系统等多个器官与系统中具有重要生理学功能,是个体发育、学习记忆、痛觉感受、糖脂代谢等正常生理过程所必需的调节分子.ZBTB20表达或功能异常可导致个体发育障碍,与智障、肿瘤和代谢性疾病等多种重大疾病的病理生理过程密切相关.作为甲胎蛋白基因的主要转录抑制因子,ZBTB20在出生后肝脏甲胎蛋白基因的表达失活中发挥了关键性作用,且与肝癌预后密切相关.人群中ZBTB20基因的缺失与多种肿瘤有关,其点突变可导致Primrose综合征.本文就ZBTB20的生物学功能研究进展作一综述.