Deep cross-view co-regularized representation learning for glioma subtype identification

The new subtypes of diffuse gliomas are recognized by the World Health Organization (WHO) on the basis of genotypes, e.g., isocitrate dehydrogenase and chromosome arms 1p/19q, in addition to the histologic phenotype. Glioma subtype identification can provide valid guidances for both risk-benefit assessment and clinical decision. The feature representations of gliomas in magnetic resonance imaging (MRI) have been prevalent for revealing underlying subtype status. However, since gliomas are highly heterogeneous tumors with quite variable imaging phenotypes, learning discriminative feature representations in MRI for gliomas remains challenging. In this paper, we propose a deep cross-view co-regularized representation learning framework for glioma subtype identification, in which view representation learning and multiple constraints are integrated into a unified paradigm. Specifically, we first learn latent view-specific representations based on cross-view images generated from MRI via a bi-directional mapping connecting original imaging space and latent space, and view-correlated regularizer and output-consistent regularizer in the latent space are employed to explore view correlation and derive view consistency, respectively. We further learn view-sharable representations which can explore complementary information of multiple views by projecting the view-specific representations into a holistically shared space and enhancing via adversary learning strategy. Finally, the view-specific and view-sharable representations are incorporated for identifying glioma subtype. Experimental results on multi-site datasets demonstrate the proposed method outperforms several state-of-the-art methods in detection of glioma subtype status.     

某妇幼保健院药品不良反应监测改进工作分析

目的通过某院改进前后对比,总结成效、发现问题,保障该院药品不良反应监测工作高质高效运行。方法应用PDCA循环模式,分析原因,实施对策,通过改进前后对比进行效果检查,运用雷达图分析法查找改进后的不足并持续优化。结果该院药品不良反应上报率明显提高,各科室医护能够主动监测更多系统和各类药品的不良反应。运用雷达图分析法可以发现不足之处,利于对下一步的改进标准进行修订。结论该院药品不良反应监测质量改进工作行之有效,持续开展不断优化,充分保障患者用药安全。     

Unifying neural learning and symbolic reasoning for spinal medical report generation

Automated medical report generation in spine radiology, i.e., given spinal medical images and directly create radiologist-level diagnosis reports to support clinical decision making, is a novel yet fundamental study in the domain of artificial intelligence in healthcare. However, it is incredibly challenging because it is an extremely complicated task that involves visual perception and high-level reasoning processes. In this paper, we propose the neural-symbolic learning (NSL) framework that performs human-like learning by unifying deep neural learning and symbolic logical reasoning for the spinal medical report generation. Generally speaking, the NSL framework firstly employs deep neural learning to imitate human visual perception for detecting abnormalities of target spinal structures. Concretely, we design an adversarial graph network that interpolates a symbolic graph reasoning module into a generative adversarial network through embedding prior domain knowledge, achieving semantic segmentation of spinal structures with high complexity and variability. NSL secondly conducts human-like symbolic logical reasoning that realizes unsupervised causal effect analysis of detected entities of abnormalities through meta-interpretive learning. NSL finally fills these discoveries of target diseases into a unified template, successfully achieving a comprehensive medical report generation. When employed in a real-world clinical dataset, a series of empirical studies demonstrate its capacity on spinal medical report generation and show that our algorithm remarkably exceeds existing methods in the detection of spinal structures. These indicate its potential as a clinical tool that contributes to computer-aided diagnosis.     

血小板输注疗效的影响因素分析

目的分析血小板输注疗效的影响因素。方法观察84例血小板输注治疗患者共363次血小板输注的治疗效果,运用校正血小板增加值和血小板回收率作为量化判断标准,并结合患者的临床出血表现,综合分析患者各项临床基本情况对血小板输注疗效的影响。结果二分类Logistic回归分析结果显示,细菌培养阳性(OR=1. 752,95%CI:1. 055～2. 910)、脾大(OR=2. 133,95%CI:1. 035～4. 395)及活动性出血(OR=1. 784,95%CI:1. 113～2. 861)为血小板输注无效的危险因素(P 0. 05)。结论影响血小板输注疗效的因素包括细菌培养阳性、脾大及活动性出血。     

The RND protein is involved in the vulnibactin export system in Vibrio vulnificus M2799

Vibrio vulnificus, an opportunistic marine bacterium that causes a serious, often fatal, infection in humans, requires iron for its pathogenesis. This bacterium exports vulnibactin for iron acquisition from the environment. The mechanisms of vulnibactin biosynthesis and ferric-vulnibactin uptake systems have recently been reported, while the vulnibactin export system has not been reported. Mutant growth under low-iron concentration conditions and a bioassay of the culture supernatant indicate that the VV1_0612 protein plays a crucial role in the vulnibactin secretion as a component of the resistance-nodulation-division (RND)-type efflux system in V. vulnificus M2799. To identify which RND protein(s) together with VV1_0612 TolC constituted the RND efflux system for vulnibactin secretion, deletion mutants of 11 RND protein-encoding genes were constructed. The growth inhibition of a multiple mutant (Δ11) of the RND protein-encoding genes was observed 6 h after the beginning of the culture. Furthermore, ΔVV1_1681 exhibited a growth curve that was similar to that of Δ11, while the multiple mutant except ΔVV1_1681 showed the same growth as the wild-type strain. These results indicate that the VV1_1681 protein is involved in the vulnibactin export system of V. vulnificus M2799. This is the first genetic evidence that vulnibactin is secreted through the RND-type efflux systems in V. vulnificus.     

改良美容缝合法对急诊面部皮肤软组织损伤切口愈合、瘢痕产生及美学效果影响

目的:评价改良美容缝合术在急诊面部皮肤软组织损伤患者中的应用效果,观察对术后切口愈合、瘢痕产生及美学满意度的影响.方法:选择我院2018年2月-2019年1月急诊科治疗的65例面部皮肤软组织损伤患者为本次研究对象,患者随机分为对照组32例,观察组33例.对照组开展传统缝合术,观察组开展改良美容缝合术,对比2组患者术后切口愈合、瘢痕产生及美学满意度情况.结果:观察组甲级愈合率63.64%,明显多于对照组31.25%,组间数据比较差异存在统计学意义(P<0.05);观察组患者Ⅰ级瘢痕率57.58%,明显多于对照组31.25%,组间数据比较差异存在统计学意义(P<0.05);观察组术后美学满意度93.94%,明显高于对照组的75.00%,组间数据比较差异存在统计学意义(P<0.05).结论:改良美容缝合法在急诊面部皮肤软组织损伤患者中应用可提升切口愈合效果,减少瘢痕产生,提高患者术后美学满意度,值得临床应用.     

对慢性心力衰竭患者进行院外干预的依从性及其效果

目的观察对慢性心力衰竭（CHF）患者进行院外干预的效果。方法：通过前瞻性随机对照方法,将215名出院的心力衰竭（HF）患者随机分为普通随访组和强化干预组,通过1年的随访观察,最终完成随访的患者共计205例。普通随访组仅进行常规的门诊随访,强化干预组患者接受电话咨询、专门的心力衰竭门诊随诊及定期健康宣教。结果：强化干预组和普通组相比较,限水限钠达标率和坚持每天监测体质量的比例大幅度增加（P〈0-01）,强化干预组利尿剂的使用率明显高于普通组（P〈0-01）,血管紧张素转换酶抑制剂（ACEI）／血管紧张素II受体拮抗剂（ARB）类药物、B受体阻滞剂的靶剂量达标率方面明显高于普通组（P〈0-01）,强化干预组左室射血分数高于普通随访组;与普通随访组相比,强化干预组氨基端脑钠肽前体（NT-pro-BNP）降低更明显（P〈0-05）,且6分钟步行试验优于普通组（P〈0-05）。两组再次入院和总心血管事件发生率有显著差异（3％伪．11％,P〈0-05）,强化于预措施显著降低了死亡和再住院联合终点事件的发生率。结论：对CHF患者进行院外强化干预,可以提高患者的自我管理能力,提高抗HF治疗药物的使用比例及二级预防药物的靶剂量达标率,降低再住院率和心血管事件发生率。     

HIV/AIDS相关性腮腺淋巴上皮囊肿合并非霍奇金淋巴瘤1例报告

HIV相关性腮腺淋巴上皮囊肿合并非霍奇金淋巴瘤是一种罕见的疾病,组织病理学和免疫组化检查可以明确诊断,手术结合化疗可获得满意疗效。本文报告1例双侧腮腺与腋窝3个不同部位同时发生与HIV相关的2种性质不同肿瘤的病例,并结合相关文献,分析其临床病理特点。