scholarly journals Cascaded Segmentation Network based on Double Branch Boundary Enhancement

2021 ◽  
Author(s):  
Li Zeng ◽  
Hongqiu Wang ◽  
Xin Wang ◽  
Miao Tian ◽  
Shaozhi Wu
Keyword(s):  
Cervical Cancer ◽  
Region Of Interest ◽  
Target Volume ◽  
Single Image ◽  
Cancer Dataset ◽  
West China Hospital ◽  
West China ◽  
Common Causes ◽  
Model Computer ◽  
Deep Learning Model

Cervical cancer is one of the most common causes of cancer death in women. During the treatment of cervical cancer, it is necessary to make a radiation plan based on the clinical target volume (CTV) on the CT image. At present, CTV is manually sketched by physicists, which is time-consuming and laborious. With the help of deep learning model, computer can accurately draw the outline of CTV in Colleges and universities. The CDBNet proposed in this paper is a cascaded segmentation network based on double-branch boundary enhancement. First, classification network determines whether a single image contains a region of interest (ROI), and then the segmentation network uses DBNet to segment more accurately at the ROI contour. In this paper, we propose CDBNet, a cascaded segmentation network based on doublebranch boundary enhancement. First, classification network determines whether a single image contains a region of interest (ROI), and then the segmentation network uses DBNet to segment more accurately at the ROI contour. The CDBNet proposed in this paper was verified on the cervical cancer dataset provided by the Department of Radiation Oncology, West China Hospital, Sichuan Province. The average dice and 95HD of the delineation results are 86.12% and 2.51mm. At the same time, the classification accuracy rate of whether the image contains ROI can reach 93.19%, and the average Dice of the image containing ROI can reach 70%.

West China Hospital Back Pain Treatment Measures

2010 ◽  
Author(s):  
Ernest Volinn ◽  
Bangxiang Yang ◽  
Jing He ◽  
Xiaoming Sheng ◽  
Jian Ying ◽  
...  
Keyword(s):  
Back Pain ◽  
Pain Treatment ◽  
West China Hospital ◽  
West China ◽  
Treatment Measures

Equity in Telemedicine for Older Adults During the Covid-19 Pandemic (Preprint)

2020 ◽  
Author(s):  
Weihong Kuang ◽  
Guojun Zeng ◽  
Yunbo Nie ◽  
Yan Cai ◽  
Jin Li ◽  
...  
Keyword(s):  
Older Adults ◽  
Paradigm Shift ◽  
Drug Prescription ◽  
Rapid Change ◽  
Policy Makers ◽  
West China Hospital ◽  
West China ◽  
Effective Strategies ◽  
Online Treatment ◽  
Treatment Disparities

UNSTRUCTURED The COVID-19 pandemic spurred unprecedented progress on a paradigm shift to telemedicine to limit exposure to the virus. Telemedicine has many benefits. In the West China Hospital of Sichuan University, we use it to do COVID-19 related tele-educations to health professionals and general population, tele-diagnosis, online treatment and internet-based drug prescription and delivery. However, at our practices, we are noticing that many older adults could not make appointment with doctors due to their difficulty using the internet-based platform. We worried that older adults who need healthcare the most are not well prepared for this rapid change. We need to pay attention to avoid causing treatment disparities for vulnerable older adults 60 years of age and over. Researchers and policy makers should work together to study effective strategies and make proper policies to mitigate barriers older adults face when using telemedicine.

scholarly journals Severe hypernatremia in children after surgical resection of hepatic echinococcosis: a rare and potentially fatal complication

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kewei Li ◽  
Yijun Liu ◽  
Xiaolong Xie ◽  
Rongxing Zhou ◽  
Bo Xiang
Keyword(s):  
Alveolar Echinococcosis ◽  
Disease Free Survival ◽  
West China Hospital ◽  
Free Survival ◽  
West China ◽  
Neurologic Sequelae ◽  
Scolicidal Agent ◽  
Hepatic Echinococcosis ◽  
Disease Free

Abstract Background Using effective scolicidal agents intraoperatively is essential to lessen the recurrence rate of hepatic echinococcosis. However, severe hypernatremia may occur after hypertonic saline (HS) has been applied as the scolicidal agent. The aim of this study is to report on pediatric patients with severe hypernatremia after hepatic echinococcus surgery. Methods Patients who presented to West China Hospital between January 2010 and February 2017 were retrospectively analyzed. Children under 16 years with echinococcosis treated by resection were included in the study. Results A total of 26 children were enrolled in this study, including 16 boys and 10 girls with a median age of 8 (2–16). 24 (92.3 %) cases were cystic echinococcosis (CE) and two (7.7 %) were alveolar echinococcosis (AE). According to Clavien-Dindo classification of surgical complications, the complication rate of all 26 patients was 19.2 %, among which three cases belonged to Grade I, one to Grade III b and 1 to Grade IV. Two children encountered severe hypernatremia (sodium: 155.3 mmol/L and 190.0mmol/L). Data showed classic clinical features of severe hypernatremia: profound and persistent bradycardia, hypotension and coma. After treatment, they recovered well without any neurologic sequelae. All patients were followed up regularly for a median time of 38 months (range 4–89 months); the overall disease-free survival was 100.0 %. Conclusions HS irrigation of intra-abdominal echinococcosis may cause acute hypernatremia and severe consequences. Diagnostic suspicion and early intervention are vital tools for avoiding morbidity and mortality.

scholarly journals CT based automatic clinical target volume delineation using a dense-fully connected convolution network for cervical Cancer radiation therapy

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhongjian Ju ◽  
Wen Guo ◽  
Shanshan Gu ◽  
Jin Zhou ◽  
Wei Yang ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Patients ◽  
Clinical Target Volume ◽  
Target Volume ◽  
Ct Images ◽  
Clinical Samples ◽  
Model Parameters ◽  
Convolutional Network ◽  
Volume Delineation ◽  
Fully Connected

Abstract Background It is very important to accurately delineate the CTV on the patient’s three-dimensional CT image in the radiotherapy process. Limited to the scarcity of clinical samples and the difficulty of automatic delineation, the research of automatic delineation of cervical cancer CTV based on CT images for new patients is slow. This study aimed to assess the value of Dense-Fully Connected Convolution Network (Dense V-Net) in predicting Clinical Target Volume (CTV) pre-delineation in cervical cancer patients for radiotherapy. Methods In this study, we used Dense V-Net, a dense and fully connected convolutional network with suitable feature learning in small samples to automatically pre-delineate the CTV of cervical cancer patients based on computed tomography (CT) images and then we assessed the outcome. The CT data of 133 patients with stage IB and IIA postoperative cervical cancer with a comparable delineation scope was enrolled in this study. One hundred and thirteen patients were randomly designated as the training set to adjust the model parameters. Twenty cases were used as the test set to assess the network performance. The 8 most representative parameters were also used to assess the pre-sketching accuracy from 3 aspects: sketching similarity, sketching offset, and sketching volume difference. Results The results presented that the DSC, DC/mm, HD/cm, MAD/mm, ∆V, SI, IncI and JD of CTV were 0.82 ± 0.03, 4.28 ± 2.35, 1.86 ± 0.48, 2.52 ± 0.40, 0.09 ± 0.05, 0.84 ± 0.04, 0.80 ± 0.05, and 0.30 ± 0.04, respectively, and the results were greater than those with a single network. Conclusions Dense V-Net can correctly predict CTV pre-delineation of cervical cancer patients and can be applied in clinical practice after completing simple modifications.

scholarly journals PENYULUHAN PENTINGNYA PEMERIKSAAN IVA PADA WUS (Wanita Usia Subur) DI DESA SUKAMAJU KABUPATEN MUARO JAMBI TAHUN 2018

2020 ◽  
Vol 1 (1) ◽  
pp. 1-4
Author(s):  
Lia Artika Sari ◽  
Enny Susilawati
Keyword(s):  
Cervical Cancer ◽  
Community Service ◽  
Causes Of Death ◽  
Hpv Infection ◽  
Reproductive Age ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Women Of Reproductive Age ◽  
Common Causes ◽  
Post Test

ABSTRAK Latar Belakang: Kanker merupakan salah satu penyebab kematian yang paling utama di dunia, sekitar 40 wanita tiap harinya terdiagnosa kanker leher rahim. Kanker leher rahim disebabkan oleh virus HPV, infeksi HPV sendiri sering kali tidak menimbulkan gejala. Desa Suka Maju merupakan salah satu desa yang terdapat di Kabupaten Muaro Jambi dan mempunyai jumlah wanita usia subur berjumlah 820 orang, namun hanya 17,11% wanita usia subur yang baru memanfaatkan pelayanan IVA.Metode: Dengan memberikan penyuluhan kepada wanita usia subur dengan (WUS) sebanyak 40 orang, dan diberikan pre dan post test untuk mengevaluasi pengetahuan wanita usia subur mengenai pemeriksaan IVA Hasil: terjadi kenaikan pengetahuan wanita usia subur di Desa Sukamaju sebesar 87,5%.Kesimpulan: Penyuluhan dapat meningkatkan pengetahuan wanita usia subur terhadap pentingnya pemeriksaan IVA. ABSTRACT Background: Cancer is one of the most common causes of death in the world. About 40 women are diagnosed with cervical cancer every day. Cervical cancer is caused by the HPV virus, HPV infection itself often causes no symptoms. Suka Maju Village is one of the villages in Muaro Jambi Regency that has 820 women of childbearing age, but only 17.11% of women of childbearing age have just used IVA services.Methods: employed in community service was to provide counseling to women of reproductive age with (WUS) as 40 women, and then given pre and posttests to evaluate the knowledge of women of childbearing age After being given counseling on IVA examinations. In brief,Result: There was an increase in the knowledge of women of childbearing age in Sukamaju Village by 87.5 %. Conclusion: Health education can increasedthe knowledge of women of childbearing age on the importance of IVA Chencking

scholarly journals Safety and Efficacy of Neostigmine Against Residual Neuromuscular Blockade in Pediatric Patients During Recovery From General Anesthesia: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Hongyang Chen ◽  
Lei Yang ◽  
Zining Wang ◽  
Di Yang ◽  
Weiyi Zhang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Oxygen Saturation ◽  
Pediatric Patients ◽  
Neuromuscular Block ◽  
Length Of Hospital Stay ◽  
West China Hospital ◽  
West China ◽  
Medical Expenses ◽  
Residual Neuromuscular Block ◽  
Endotracheal Extubation

Abstract Introduction: with the wide application of muscle relaxants in clinic, the anesthesiologists pay more and more attention to the residual neuromuscular block. While the pediatric patients have poor tolerance to hypoxia, compared to adult patients, the residual neuromuscular block do more harm to them in recovery period of anesthesia, such as respiratory failure, hypoxia, asphyxia and even death. In order to reduce the risk of the residual neuromuscular block complications, we design the following regression cohort study to conform the safety and effectiveness of routine use of neostigmine after operation.Methods: This study was a retrospective cohort study (ChiCTR1900028048), approved by the ethics committee of West China Hospital, Sichuan University. We reviewed pediatric patients who received surgical treatment in West China Hospital, Sichuan University from January 1, 2018 to September 30, 2019.The exposure factor was the use of neostigmine during the period of anesthesia recovery. Inclusion criteria: the pediatric surgery department patients who underwent general anesthesia in West China Hospital, Sichuan University. Exclusion criteria: cases without medical electronic records; Cases with missing outcome data; No muscle relaxants were used during general anesthesia. The outcomes included: lowest pulse oxygen saturation after endotracheal extubation; incidence of hypoxemia after endotracheal extubation; in-hospital mortality; length of hospital stay; medical expenses. IBM SPSS Statistics 23.0 software was used for statistical analysis.1:1 propensity score matching was used to eliminate the influence of confounding factors. For continuous variables, student t test was used . For categorical variables, the chi-square test was used. The results were considered statistically significant, if p value < 0.05. Subgroup analysis was performed according to the age (<2 years / 3-5 years or >6 years) and the dose of neostigmine (low dose group <=0.02mg/kg or high dose group >0.02mg/kg).Results: A total of 4358 pediatric patients were included. After 1:1 propensity score matching, 1820 pediatric patients were included for statistical analysis. In-hospital mortality (1/910 vs 0/910, p = 0.32), lowest pulse oxygen saturation after endotracheal extubation (98.90±3.05 vs 98.78±3.48, p = 0.43), incidence of hypoxemia after endotracheal extubation (23/910 vs 21/910, p=0.76), length of hospital stay (5.66±6.11 vs 5.88±6.59, p= 0.46), and medical expenses (17967.04±21325.86 vs 17406.96±18358.17, p=0.55) showed no significantly statistical differences between the pediatric patients with or without neostigmine application to reverse the neuromuscular blockade during anesthesia recovery. Subgroup analysis found no significant associations between the outcomes and age of the patients or the dose of neostigmine.Conclusion: For pediatric patients, neostigmine application to reverse the neuromuscular blockade was not significantly associated with in hospital mortality, lowest pulse oxygen saturation after endotracheal extubation, incidence of hypoxemia after endotracheal extubation, medical expenses, or length of hospital stay. However, as some confounding factors cannot be eliminated in this retrospective study, the results of this study are needed to be confirmed by future prospective studies.Trial registration: Medical records based study for the recovery effect of antagonitst of muscle relaxant in pediatric patients, ChiCTR1900028048, Registered 8 September 2019, https://www.chictr.org.cn/showproj.aspx?proj=46686

scholarly journals Recommended psychological crisis intervention response to the 2019 novel coronavirus pneumonia outbreak in China: a model of West China Hospital

2020 ◽  
Vol 3 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Jun Zhang ◽  
Weili Wu ◽  
Xin Zhao ◽  
Wei Zhang
Keyword(s):  
Crisis Intervention ◽  
Psychological Intervention ◽  
Psychological Impact ◽  
Psychological Problems ◽  
Internet Technology ◽  
Social Psychological ◽  
West China Hospital ◽  
West China ◽  
Face To Face ◽  
Novel Coronavirus

Abstract The novel coronavirus pneumonia (COVID-19) epidemic has brought serious social psychological impact to the Chinese people, especially those quarantined and thus with limited access to face-to-face communication and traditional social psychological interventions. To better deal with the urgent psychological problems of people involved in the COVID-19 epidemic, we developed a new psychological crisis intervention model by utilizing internet technology. This new model, one of West China Hospital, integrates physicians, psychiatrists, psychologists and social workers into Internet platforms to carry out psychological intervention to patients, their families and medical staff. We hope this model will make a sound basis for developing a more comprehensive psychological crisis intervention response system that is applicable for urgent social and psychological problems.

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