A New GAN-Based Approach to Data Augmentation and Image Segmentation for Crack Detection in Thermal Imaging Tests

As a popular nondestructive testing (NDT) technique, thermal imaging test demonstrates competitive performance in crack detection, especially for detecting subsurface cracks. In thermal imaging test, the temperature of the crack area is higher than that of the non-crack area during the NDT process. By extracting the features of the thermal image sequences, the temperature curve of each spatial point is employed for crack detection. Nevertheless, the quality of thermal images is influenced by the noises due to the complex thermal environment in NDT. In this paper, a modified generative adversarial network (GAN) is employed to improve the image segmentation performance. To improve the feature extraction ability and alleviate the influence of noises, a penalty term is put forward in the loss function of the conventional GAN. A data preprocessing method is developed where the principle component analysis algorithm is adopted for feature extraction. The data argumentation technique is utilized to guarantee the quantity of the training samples. To validate its effectiveness in thermal imaging NDT, the modified GAN is applied to detect the cracks on the eddy current pulsed thermography NDT dataset.

     

芦荟对小鼠便秘的作用及其机制初探

目的观察芦荟对便秘小鼠的通便作用和对小鼠肠蠕动和肠壁重吸收水分功能的影响。方法通过给小鼠灌服复方地芬诺酯混悬液建立小鼠便秘模型。采用观察首次排红便的时间、粪便的性状、干重量以及小鼠肠推动的推进百分率,来判断芦荟治疗便秘的作用,并探讨其对小鼠肠蠕动和肠壁重吸收水分功能的影响。结果高或中浓度用药组小鼠首便时间为(200.8±19.4)min和(229.3±17.5)min,与阴性对照组(253.8±23.2)min比较,均能缩短便秘小鼠的首便时间(P<0.05),且高浓度用药组的效果更为明显(P<0.05);高或中浓度用药组小鼠排便的总干重量为(45.0±8.5)mg和(33.0±9.5)mg,与阴性对照组(16.5±9.3)mg比较,均能增加便秘小鼠排便的总干重量(P<0.05),且高浓度用药组的效果更为明显(P<0.05),而且湿便较多,与阳性对照组(64.5±18.8)mg比较(P<0.05);高、中或低浓度芦荟治疗组小鼠肠蠕动的推进百分率分别为(93.7±4.0)%,(86.5±9.5)%和(80.4±13.4)%,与空白对照组(69.0±8.4)%比较,均能提高便秘小鼠肠蠕动的推进百分率(P<0.05), 其中高浓度组最为明显。结论芦荟能有效加强小鼠肠蠕动和减少肠壁重吸收水分功能,且作用温和,起到治疗便秘的作用。     

Associations of obesity with antidiabetic medication use after living kidney donation: An analysis of linked national registry and pharmacy fill records

We examined a novel linkage of national US donor registry data with records from a pharmacy claims warehouse (2007‐2016) to examine associations (adjusted hazard ratio, _LCLaHR_UCL) of post‐donation fills of antidiabetic medications (ADM, insulin or non‐insulin agents) with body mass index (BMI) at donation and other demographic and clinical factors. In 28 515 living kidney donors (LKDs), incidence of ADM use at 9 years rose in a graded manner with higher baseline BMI: underweight, 0.9%; normal weight, 2.1%; overweight, 3.5%; obese, 8.5%. Obesity was associated with higher risk of ADM use compared with normal BMI (aHR, _3.364.59_6.27). Metformin was the most commonly used ADM and was filled more often by obese than by normal weight donors (9‐year incidence, 6.87% vs 1.85%, aHR, _3.555.00_7.04). Insulin use was uncommon and did not differ significantly by BMI. Among a subgroup with BMI data at the 1‐year post‐donation anniversary (n = 19 528), compared with stable BMI, BMI increase >0.5 kg/m² by year 1 was associated with increased risk of subsequent ADM use (aHR, _1.031.48_2.14, P = .04). While this study did not assess the impact of donation on the development of obesity, these data support that among LKD, obesity is a strong correlate of ADM use.     

体外膜肺氧合联合主动脉内球囊反搏治疗难治性心源性休克的疗效观察

目的观察体外膜肺氧合(ECMO)联合主动脉内球囊反搏(IABP)治疗难治性心源性休克(RCS)的疗效及安全性。方法 96例RCS患者被分为3组:IABP组(n=34)、ECMO组(n=32)及联合(IABP+ECMO)组(n=30)。在常规抗休克用药基础上分别应用IABP、ECMO及IABP+ECMO支持治疗。比较3组患者治疗前、治疗后6h、1天、2天、3天的心率、平均动脉压(MAP)、中心静脉压(CVP)、血氧饱和度(SO_2)、动脉血乳酸、心肌钙蛋白I(cTnⅠ)、脑利钠肽(BNP)、左心室舒张末内径(LVED)、左心室射血分数(LVEF)及血管活性药物(多巴酚丁胺、去甲肾上腺素)用量的变化、并发症及临床转归(撤机成功率及住院期间死亡率)。结果治疗3天后,3组患者上述指标均有逐步改善,而联合组上述指标的改善较IABP组及ECMO组更显著(P0.05或P0.01);ECMO组的心率、MAP、CVP、SO_2、动脉血乳酸、cTnⅠ、LVEF及多巴酚丁胺、去甲肾上腺素用量等指标的改善优于IABP组(均P0.01);IABP组BNP、LVED的改善优于ECMO组(P0.05,P0.01);联合组并发症发生率高于IABP组和ECMO组(χ~2=15.875,P0.001;χ~2=4.504,P=0.034);ECMO组并发症发生率高于IABP组(χ~2=3.957,P=0.047);联合组撤机成功率高于IABP组和ECMO组(χ~2=16.063,P0.001;χ~2=5.792,P=0.016);3组患者住院期间死亡率比较,差异无统计学意义(P0.05)。结论 IABP+ECMO联合治疗在改善RCS患者血液动力学方面优于IABP和ECMO,但联合治疗增加了并发症发生率,影响了临床预后的改善;降低并发症成为提高联合治疗疗效的关键。     

个体化透析液温度处方在透析中的应用

目的研究个体化透析液温度处方对维持血液透析患者透析中并发症的影响。方法选择山东省济南市中心医院友谊肾脏病/血液净化中心维持血液透析患者60例,根据透析前血压、既往透析中血压变化特点、透析中是否进餐等情况选用不同的透析液温度处方。记录每次透析中每位患者最高、最低平均动脉压,严重高血压、低血压、畏寒、发热、透析器凝血等不良反应发生次数,连续记录25次,并与同组透析患者未应用个体化透析液温度处方前25次的透析结果进行比较。结果透析液温度个体化调节后,患者透析中严重高血压、低血压发生次数明显下降(P<0.001),透析中血压波动幅度明显低于调整前(P<0.001),心脑血管事件发生率明显下降(P<0.001)。仅1例患者透析中出现畏寒症状,未见其他不良反应。结论个体化温度处方能够减少透析中严重高血压和低血压的发生率,保护重要器官供血,且患者耐受性好,方法简单,值得在透析中心推广应用。目的研究个体化透析液温度处方对维持血液透析患者透析中并发症的影响。方法选择山东省济南市中心医院友谊肾脏病/血液净化中心维持血液透析患者60例,根据透析前血压、既往透析中血压变化特点、透析中是否进餐等情况选用不同的透析液温度处方。记录每次透析中每位患者最高、最低平均动脉压,严重高血压、低血压、畏寒、发热、透析器凝血等不良反应发生次数,连续记录25次,并与同组透析患者未应用个体化透析液温度处方前25次的透析结果进行比较。结果透析液温度个体化调节后,患者透析中严重高血压、低血压发生次数明显下降(P<0.001),透析中血压波动幅度明显低于调整前(P<0.001),心脑血管事件发生率明显下降(P<0.001)。仅1例患者透析中出现畏寒症状,未见其他不良反应。结论个体化温度处方能够减少透析中严重高血压和低血压的发生率,保护重要器官供血,且患者耐受性好,方法简单,值得在透析中心推广应用。     

Center practice drives variation in choice of US kidney transplant induction therapy: a retrospective analysis of contemporary practice

To assess factors that influence the choice of induction regimen in contemporary kidney transplantation, we examined center‐identified, national transplant registry data for 166 776 US recipients (2005–2014). Bilevel hierarchical models were constructed, wherein use of each regimen was compared pairwise with use of interleukin‐2 receptor blocking antibodies (IL2rAb). Overall, 82% of patients received induction, including thymoglobulin (TMG, 46%), IL2rAb (22%), alemtuzumab (ALEM, 13%), and other agents (1%). However, proportions of patients receiving induction varied widely across centers (0–100%). Recipients of living donor transplants and self‐pay patients were less likely to receive induction treatment. Clinical factors associated with use of TMG or ALEM (vs. IL2rAb) included age, black race, sensitization, retransplant status, nonstandard deceased donor, and delayed graft function. However, these characteristics explained only 10–33% of observed variation. Based on intraclass correlation analysis, “center effect” explained most of the variation in TMG (58%), ALEM (66%), other (51%), and no induction (58%) use. Median odds ratios generated from case‐factor adjusted models (7.66–11.19) also supported large differences in the likelihood of induction choices between centers. The wide variation in induction therapy choice across US transplant centers is not dominantly explained by differences in patient or donor characteristics; rather, it reflects center choice and practice.     

提升基础医学研究生培养质量的有效方法

提升基础医学研究生培养质量是基础医学发展的需要,培养质量将直接影响着医学科学研究能否立足于国际平台。为寻找或建立一种有效提升研究生培养质量的方法．很多管理者进行着不同的尝试。本文结合研究生管理工作实际经验,初步建立了一种提升基础医学研究生培养质量方法,仅与同行商榷。     

基于整合药理学策略及药效验证探讨交泰丸抗心律失常分子机制＊

目的 从分子水平探究交泰丸治疗心律失常的作用机制。方法 ①采用中医药整合药理学研究平台（Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine， TCMIP）V2.0，检索并获取黄连和肉桂活性成分、靶标，以及心律失常疾病和证候靶标信息，借助平台构建“中药-证素-疾病-靶标-通路”多维网络，获得药物干预疾病的关键靶标，通过基因本体数据库（Gene Ontology，GO）和京都基因与基因组百科全书库（Kyoto Encyclopaedia of Genes and Genomes，KEGG）进行富集分析，预测交泰丸治疗心律失常的分子机制。②选取雄性SD大鼠32只，随机分为对照组（N）、模型组（M）、交泰丸组（J）、阳性药组（Meto）4组，以尾静脉推注肾上腺素（Epi）制造心律失常模型，利用酶联免疫吸附法（ELISA）观察各组大鼠血浆血管紧张素Ⅱ（AngⅡ）、儿茶酚抑素（CST）、神经肽Y（NPY）的含量。结果 ①交泰丸共筛选出23个活性成分（黄连14个，肉桂9个），心律失常相关靶标850个。这些活性成分通过调控基因表达的正调控、丝裂原活化蛋白激酶（mitogen-activated protein kinase，MAPK）级联激活、信号识别颗粒（signal recognition particle，SRP）依赖的共翻译蛋白靶向膜、细胞因子介导的信号通路、调节心室心肌细胞动作电位、通过心脏传导调节心率等生物过程，直接或间接参与促红细胞生成素激活肾素-血管紧张素系统（RAS）、加速纤维肉瘤蛋白（rapidly accelerated fibrosarcoma，RAF）激活等信号通路，从而发挥抗心律失常的作用。②模型组大鼠血浆AngⅡ、CST、NPY含量明显高于对照组（P<0.01），交泰丸组AngⅡ、CST、NPY水平与模型组比较明显下降（P<0.05或P<0.01），且交泰丸组疗效优于阳性药组。结论 通过整合药理学策略结合药效验证，揭示了交泰丸多途径抗心律失常作用的分子机制，验证了RAS系统与交感神经活性在心律失常中的重要作用，并明确交泰丸对心律失常有一定的调节作用，疗效确切。     

乌头汤加味配合云克治疗类风湿性关节炎的疗效分析

目的探讨乌头汤加味配合云克治疗类风湿性关节炎的临床疗效。方法 56例RA患者按初诊顺序进行编号,再按"随机数字表法"分为治疗组(乌头汤加味配合云克治疗)与对照组(口服雷公藤片)各28例。治疗后8周比较两组的疗效及血沉(ESR)、类风湿因子(RF)的变化。结果治疗8周后,治疗组显效率达42.86%,总有效率达85.71%,对照组分别为25.00%和67.86%,明显低于治疗组,两组上述指标分别比较差异有显著性(P<0.05)。两组患者治疗后ESR及RF均较治疗前明显降低,且治疗组较对照组降低更明显(P<0.05)。结论乌头汤加味配合云克静脉用药治疗类风湿性关节炎有较好的疗效,值得推广。     

糖尿病合并年龄相关性白内障与年龄相关性白内障术后并发症的对比分析

背景　老龄化社会的到来使得国内年龄相关性白内障（ARC）的发病率升高。白内障是糖尿病常见的并发症，其中糖尿病合并ARC临床较多见，其临床表现与ARC相似，但发病较早、进展快。不同病因所致的老年白内障，如无手术禁忌证，多可行白内障手术治疗，但其术后的临床结局不尽相同。目的　探讨糖尿病合并ARC与ARC患者术后并发症的发生状况，分析临床可采取的防治措施。方法　对海南医学院第二附属医院2017年1-12月收治的182例（189眼）行白内障手术老年患者的临床资料进行回顾性分析，其中糖尿病合并ARC患者51例（53眼）作为观察组，ARC患者131例（136眼）作为对照组。比较两组术后1周并发症（角膜水肿、纤维性渗出、瞳孔后粘连、前房出血、黄斑水肿），术后1周、1个月、3个月矫正视力及预后情况。结果　观察组术后1周并发症发生率〔56.9%（29/51）〕高于对照组〔18.3%（24/131）〕（P<0.05）。两组术后1周、1个月、3个月矫正视力情况比较，差异无统计学意义（P>0.05）。术后1个月观察组3例（4眼，7.55%，4/53）切口愈合不良，对照组0例；两组术后1个月预后情况比较，差异有统计学意义（P<0.05）。结论　糖尿病合并ARC患者术后并发症发生率更高，应引起临床的高度重视，需采取积极措施合理控制术前血糖，选择合理的手术时机，尽可能减少术后并发症，以使患者获得更佳的预后。