Modelling on-demand preprocessing framework towards practical approach in clinical analysis of diabetic retinopathy

<p>Diabetic retinopathy (DR) refers to a complication of diabetes and a prime cause of vision loss in middle-aged people. A timely screening and diagnosis process can reduce the risk of blindness. Fundus imaging is mainly preferred in the clinical analysis of DR. However; the raw fundus images are usually subjected to artifacts, noise, low and varied contrast, which is very hard to process by human visual systems and automated systems. In the existing literature, many solutions are given to enhance the fundus image. However, such approaches are particular and limited to a specific objective that cannot address multiple fundus images. This paper has presented an on-demand preprocessing frame work that integrates different techniques to address geometrical issues, random noises, and comprehensive contrast enhancement solutions. The performance of each preprocessing process is evaluated against peak signal-to-noise ratio (PSNR), and brightness is quantified in the enhanced image. The motive of this paper is to offer a flexible approach of preprocessing mechanism that can meet image enhancement needs based on different preprocessing requirements to improve the quality of fundus imaging towards early-stage diabetic retinopathy identification.</p>

MicroRNA-517c Functions as a Tumor Suppressor in Hepatocellular Carcinoma via Downregulation of KPNA2 and Inhibition of PI3K/AKT Pathway

Objective. Hepatocellular carcinoma (HCC) is a kind of solid and highly aggressive malignant tumor with poor prognosis. MicroRNA (miRNA/miR) has been confirmed to be involved in HCC development. The current study focused on the functions and mechanisms of miR-517c in HCC. Methods. Expressions of miR-517c and Karyopherin α2 (KPNA2) mRNA in HCC cell lines and tissue samples were examined using quantitative real-time polymerase chain reaction (qRT-PCR). Western blot was conducted for detections of epithelial-to-mesenchymal transition (EMT) and PI3K/AKT markers. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) and Transwell assays were utilized to investigate the influence of miR-517c on HCC cell proliferation, invasion, and migration. TargetScan and luciferase reporter assay were performed to search for the potential target gene of miR-517c. Results. We demonstrated that miR-517c expressions were decreased in HCC tissues and cells. Moreover, the clinical analysis showed that decreased miR-517c expressions in HCC tissues correlated with shorter overall survival and malignant clinicopathologic features of HCC patients. MTT assay showed that miR-517c upregulation prominently repressed HCC cell proliferation. In addition, miR-517c restoration could significantly suppress HCC cell invasion and migration as demonstrated by Transwell assays. We also found that miR-517c directly targeted KPNA2 and regulated the PI3K/AKT pathway and EMT, exerting prohibitory functions in HCC. Conclusion. Taken together, this study stated that miR-517c inhibited HCC progression via regulating the PI3K/AKT pathway and EMT and targeting KPNA2 in HCC, providing a novel insight into HCC treatment.

Comparative Evaluation of the Prognosis of Septic Shock Patients from before to after the Onset of the COVID-19 Pandemic: A Retrospective Single-Center Clinical Analysis

In this study, we investigated the mortality of septic shock patients visiting emergency departments (ED) before and after the coronavirus disease (COVID-19) pandemic onset. We retrospectively reviewed medical records and National Emergency Department Information System data of septic shock patients who visited the ED of a tertiary medical center in South Korea from February 2019 to February 2021. Following the COVID-19 pandemic onset, revised institutional ED processes included a stringent isolation protocol for patients visiting the ED. The primary goal of this study was to determine the mortality rate of septic shock patients from before and after the onset of the COVID-19 pandemic. Durations of vasopressor use, mechanical ventilation, intensive care unit stay, and hospitalization were investigated. The mortality rates increased from 24.8% to 35.8%, before and after COVID-19-onset, but the difference was not statistically significant (p = 0.079). No significant differences in other outcomes were found. Multivariable analysis revealed that the Simplified Acute Physiology Score III (SAPS III) was the only risk factor for mortality (OR 1.07; 95% CI 1.04-1.10), whereas COVID-19 pandemic was not included in the final model. The non-significant influence of the COVID-19 pandemic on septic shock mortality rates in the present study belies the actual mortality-influencing potential of the COVID-19 pandemic.

Clinical Analysis of 44 Cases of Atypical Polypoid Adenomyoma of the Uterus

Background: Atypical polypoid adenomyoma (APA) is a rare intrauterine polypoid lesion that occurs predominantly in premenopausal women. Although, it is considered as a benign lesion and treated conservatively previously, more and more cases show that APA has a high rate of recurrence or residual, and is found to precede the development of carcinoma. The clinical management of APA remains to be established. The aim of this study was to analyse the clinicopathological features of APA and discuss its diagnosis and prognosis.Methods: Forty-four patients with APA were admitted to Beijing Obstetrics and Gynecology Hospital from 2005-2019, and their clinical and histopathologic features were evaluated. B-ultrasound was performed, and all patients (n=44) underwent hysteroscopy. Endometrium excision was performed by means of the “Four-step diagnosis and treatment” method. Hysteroscopic transcervical resection (TCR) was performed in 5 cases with APA-H and 11 with APA-L. Except for one patient who underwent transcervical endometrial resection, all patients underwent hysterectomy and salpingectomy or salpingo-oophorectomy. Data from a median follow-up of 42 months (ranging from 3 to 174 months) were available for these patients.Results: Pathological diagnoses were made according to the degree of abnormality of APA surface glands, resulting in APA-L in 36 cases and APA-H in 8 cases. Among these cases, 28 (25 APA-L and 3 APA-H) were treated conservatively. “Four-step diagnosis and treatment” method performed a excellent effect for APA therapy. During the follow-up no evidence of recurrence was found.Conclusions: For cases with intracavitary lesions > 1 cm, hysteroscopic “four-step diagnosis and treatment” and pathological diagnosis are the basis of clinical treatment. More than 30% of APA surface glands have complex structures, characterized by branching and budding, or other high-risk factors, such as endometrial hyperplasia, which are indications for hysterectomy. For patients with the desire to become pregnant or for uterine preservation, hysteroscopy with complete excision of the lesions should be the preferred treatment method. The patients should be treated individually, followed up closely, and followed up by regular hysteroscopy and endometrial biopsy.

Analytical report on post traumatic hydrocephalus

Post-traumatic hydrocephalus (PTH) is a field and disorder less explored in neurosurgery though we see many cases. The commonest causes in our set up includes head injury for which people have undergone decompressive craniectomies, severe head injuries with raised ICP. We did a clinical analysis on 23 cases in a period of 3 years duration from 2018 -2021. We did Evd in few cases for emergency purposes when there was decerebration and we went ahead with VP shunt in all the patients who had gross ventricular dilatation. We have projected our analytical report in these cases. METHODS A retrospective study was conducted in the Department of Neurosurgery in Sri Ramachandra medical college. The clinical outcome of patients diagnosed with PTH was studied. These cases were treated by surgery. The stastical analysis along with cause of the hydrocephalus with the outcome in pre and postoperative period were studied. RESULTS Among the 23 patients studied 82% were males. Road traffic accident was the main cause of injury. The other main cause was a fall from height. Assault was another reason for head injuries which we recorded. We found all road traffic accidents were only because of bike riders either pillion or the people driving the vehicle. . Craniotomy was done in 50 % of the patients, 90 % of the patients recovered who had a gcs of 13 to 7. People with gcs lss than 7 were intubated recovery rate was 7.5 %. . There was 100%mortality because of primary head injury in all the patients who had brain stem contusions with dilated pupil. CONCLUSIONS Trauma to head and who were operated had the highest incidence of post tramatic head injury. Smaller the decompressive craniectomies had symptomatic post traumatic head ache with post traumatic hydrocephalus.. CT scan of the brain is considered the choice of investigation toearly diagnose PTH.we even analysed the ct scan and found when there was periventricular lucency the patient outcome after VP shunting is good. KEY WORDS Hydrocephalus, Head Injury, Trauma

Features of the diagnosis and course of coronary heart disease in young people: a clinical case

This clinical analysis is devoted to the case of exacerbation of ischemic heart disease in a 36-year-old man. A feature of this case is the combination of young age and obstructive coronary artery disease, as well as diagnostic search and analysis of the data obtained in the group of young patients.

Identification and Determination of 1,3-Thiazinane-4-carboxylic Acid in Human Urine—Chromatographic Studies

It is well established that homocysteine (Hcy) and its thiolactone (HTL) are reactive towards aldehydes in an aqueous environment, forming substituted thiazinane carboxylic acids. This report provides evidence that Hcy/HTL and formaldehyde (FA) adduct, namely 1,3-thiazinane-4-carboxylic acid (TCA) is formed in vivo in humans. In order to provide definitive proof, a gas chromatography–mass spectrometry (GC–MS) based method was elaborated to identify and quantify TCA in human urine. The GC–MS assay involves chemical derivatization with isobutyl chloroformate (IBCF) in the presence of pyridine as a catalyst, followed by an ethyl acetate extraction of the obtained isobutyl derivative of TCA (TCA-IBCF). The validity of the method has been demonstrated based upon United States Food and Drug Administration recommendations. The assay linearity was observed within a 1–50 µmol L−1 range for TCA in urine, while the lowest concentration on the calibration curve was recognized as the limit of quantification (LOQ). Importantly, the method was successfully applied to urine samples delivered by apparently healthy volunteers (n = 15). The GC–MS assay may provide a new analytical tool for routine clinical analysis of the role of TCA in living systems in the near future.