Meningeal lymphatic vessels form a relationship between the nervous system and periphery, which is relevant in both health and disease. Meningeal lymphatic vessels not only play a key role in the drainage of brain met...Meningeal lymphatic vessels form a relationship between the nervous system and periphery, which is relevant in both health and disease. Meningeal lymphatic vessels not only play a key role in the drainage of brain metabolites but also contribute to antigen delivery and immune cell activation. The advent of novel genomic technologies has enabled rapid progress in the characterization of myeloid and lymphoid cells and their interactions with meningeal lymphatic vessels within the central nervous system. In this review, we provide an overview of the multifaceted roles of meningeal lymphatic vessels within the context of the central nervous system immune network, highlighting recent discoveries on the immunological niche provided by meningeal lymphatic vessels. Furthermore, we delve into the mechanisms of crosstalk between meningeal lymphatic vessels and immune cells in the central nervous system under both homeostatic conditions and neurodegenerative diseases, discussing how these interactions shape the pathological outcomes. Regulation of meningeal lymphatic vessel function and structure can influence lymphatic drainage, cerebrospinal fluid-borne immune modulators, and immune cell populations in aging and neurodegenerative disorders, thereby playing a key role in shaping meningeal and brain parenchyma immunity.展开更多
Retinal blood vessel segmentation is crucial for diagnosing ocular and cardiovascular diseases.Although the introduction of U-Net in 2015 by Olaf Ronneberger significantly advanced this field,yet issues like limited t...Retinal blood vessel segmentation is crucial for diagnosing ocular and cardiovascular diseases.Although the introduction of U-Net in 2015 by Olaf Ronneberger significantly advanced this field,yet issues like limited training data,imbalance data distribution,and inadequate feature extraction persist,hindering both the segmentation performance and optimal model generalization.Addressing these critical issues,the DEFFA-Unet is proposed featuring an additional encoder to process domain-invariant pre-processed inputs,thereby improving both richer feature encoding and enhanced model generalization.A feature filtering fusion module is developed to ensure the precise feature filtering and robust hybrid feature fusion.In response to the task-specific need for higher precision where false positives are very costly,traditional skip connections are replaced with the attention-guided feature reconstructing fusion module.Additionally,innovative data augmentation and balancing methods are proposed to counter data scarcity and distribution imbalance,further boosting the robustness and generalization of the model.With a comprehensive suite of evaluation metrics,extensive validations on four benchmark datasets(DRIVE,CHASEDB1,STARE,and HRF)and an SLO dataset(IOSTAR),demonstrate the proposed method’s superiority over both baseline and state-of-the-art models.Particularly the proposed method significantly outperforms the compared methods in cross-validation model generalization.展开更多
AIM:To compare the effects of different types of negative pressure suction on the macular and optic disc retinal vessel density(VD)in myopic patients with different axial lengths(ALs)undergoing femtosecond laser-assis...AIM:To compare the effects of different types of negative pressure suction on the macular and optic disc retinal vessel density(VD)in myopic patients with different axial lengths(ALs)undergoing femtosecond laser-assisted excimer laser in situ keratomileusis(FS-LASIK)by optical coherence tomography angiography(OCTA).METHODS:A prospective,nonrandomized,controlled study.Participants underwent FS-LASIK surgery were divided into the short AL group(SAL,22≤AL<26 mm)and the long AL group(LAL,26≤AL<28 mm)according to the different ALs.Further,the two groups were divided into subgroups according to the corneal flap using VisuMax or WaveLight FS200 femtosecond laser(FS)platform.All patients underwent OCTA before the surgery and 1-day/1-week/1-month after the surgery.ANOVA statistically analyzed data with two-factor repeated measurement in SPSS.RESULTS:Totally 108 participants(108 eyes,18–35y)were divided into SAL group[22 patients(4 males and 18 females)were treated with VisuMax,and 24(3 males and 21 females)were treated with WaveLight FS200]and LAL group[34 patients(4 males and 30 females)were treated with VisuMax,and 28 patients(6 males and 22 females)were treated with WaveLight FS200].In the LAL group,there was no significant difference in macular superficial capillary plexuses vessel density(SCP-VD)in the fovea and perifovea region,but compared with the VisuMax subgroup,SCP-VD in the parafoveal region(t=2.647,P=0.010)and the whole area(t=2.030,P=0.047)in WaveLight FS200 subgroup decreased at one day after the operation and increased to a preoperative level at 1-week and 1-month after operation.There was no significant difference between SCP-VD in the two SAL subgroups,neither of deep capillary plexuses vessel density(DCP-VD)and optic nerve head vessel density(ONH-VD)in the SAL and LAL groups.CONCLUSION:With the increase of AL and suction intensity,a transient decrease of SCP-VD in the macular region is observed at 1d postoperatively during FS-LASIK,and it increases to preoperative level at 1-week and 1-month postoperatively.However,the AL and suction intensity do not affect the macular DCP-VD and ONH-VD.展开更多
Since the problems of branch loss and fracture in retinal blood vessel segmentation algorithms,an image segmentation method is proposed based on improved pulse coupled neural network(PCNN)and gray wolf optimization al...Since the problems of branch loss and fracture in retinal blood vessel segmentation algorithms,an image segmentation method is proposed based on improved pulse coupled neural network(PCNN)and gray wolf optimization algorithm(GWO).Simplifying the neuron input domain and neuron connection domain of the PCNN network,increasing the gradient information factor in the internal activity items,reducing the model parameters,enhancing the pulse issuing ability,and the optimal parameters of the network are automatically obtained based on multiple feature evaluation criteria and the GWO algorithm.The test in the public data set drive shows that the sensitivity,accuracy,precision,and specificity of the algorithm are 0.799549,0.962789,0.889163,and 0.986552,respectively.The accuracy and specificity are better than the classical segmentation algorithm.It solved the influence of low illumination,optic disc highlight,and foveal shadow on vascular segmentation,and showed excellent performance of vessel connectivity and terminal sensitivity.展开更多
The mechanical properties,microstructure and second phase precipitation behavior of flange forgings for high-pressure hydrogen storage vessels at different tempering temperatures(620–700℃)were studied.The results sh...The mechanical properties,microstructure and second phase precipitation behavior of flange forgings for high-pressure hydrogen storage vessels at different tempering temperatures(620–700℃)were studied.The results showed that when tempered at 620–680°C,the main microstructure of the test steel was tempered sorbite,and the main microstructure of tempered steel changed to martensite at 700℃.At 700℃,the dislocation density increased and some retained austenite existed.With the tempering temperature increasing,the yield strength showed a decreasing trend,the formation of fresh martensite made the tensile strength first decrease and then increase slightly,the impact energy at−40℃increased first and then decreased,and the impact energy at 660℃had the maximum value.The precipitates of MC type were mainly(Mo,V,Ti)C.The test steel had excellent strength and toughness matching at 660℃tempering,the tensile strength at different cross section locations was above 750 MPa,the impact energy was above 200 J at−40℃,and the relative percentage reduction of area(ZH2/ZN2)was above 75%at hydrogen environment of 6.3 MPa.展开更多
Objective:To study the application effect of bundle nursing strategy in the maintenance of difficult blood vessels for long-term hemodialysis patients.Methods:A prospective study was conducted on 40 long-term hemodial...Objective:To study the application effect of bundle nursing strategy in the maintenance of difficult blood vessels for long-term hemodialysis patients.Methods:A prospective study was conducted on 40 long-term hemodialysis patients admitted from January 2024 to January 2025.The patients were randomly divided into a control group(20 cases)and an observation group(20 cases)using computer random sampling.The control group received routine nursing for difficult blood vessels,while the observation group received a bundle nursing strategy for difficult blood vessels.The self-care ability,complication rate,and nursing satisfaction were compared between the two groups.Results:After nursing,the self-care ability score of the observation group was higher than that of the control group(P<0.05).The complication rate in the observation group was lower than that in the control group(P<0.05).The nursing satisfaction in the observation group was higher than that in the control group(P<0.05).Conclusion:The application of the bundle nursing strategy in the maintenance of difficult blood vessels for long-term hemodialysis patients is beneficial for improving self-care ability,reducing complications,and increasing patient satisfaction with nursing services.展开更多
The segmentation of retinal vessels and coronary angiographs is essential for diagnosing conditions such as glaucoma,diabetes,hypertension,and coronary artery disease.However,retinal vessels and coronary angiographs a...The segmentation of retinal vessels and coronary angiographs is essential for diagnosing conditions such as glaucoma,diabetes,hypertension,and coronary artery disease.However,retinal vessels and coronary angiographs are characterized by low contrast and complex structures,posing challenges for vessel segmentation.Moreover,CNN-based approaches are limited in capturing long-range pixel relationships due to their focus on local feature extraction,while ViT-based approaches struggle to capture fine local details,impacting tasks like vessel segmentation that require precise boundary detection.To address these issues,in this paper,we propose a Global–Local Hybrid Modulation Network(GLHM-Net),a dual-encoder architecture that combines the strengths of CNNs and ViTs for vessel segmentation.First,the Hybrid Non-Local Transformer Block(HNLTB)is proposed to efficiently consolidate long-range spatial dependencies into a compact feature representation,providing a global perspective while significantly reducing computational overhead.Second,the Collaborative Attention Fusion Block(CAFB)is proposed to more effectively integrate local and global vessel features at the same hierarchical level during the encoding phase.Finally,the proposed Feature Cross-Modulation Block(FCMB)better complements the local and global features in the decoding stage,effectively enhancing feature learning and minimizing information loss.The experiments conducted on the DRIVE,CHASEDB1,DCA1,and XCAD datasets,achieving AUC values of 0.9811,0.9864,0.9915,and 0.9919,F1 scores of 0.8288,0.8202,0.8040,and 0.8150,and IOU values of 0.7076,0.6952,0.6723,and 0.6878,respectively,demonstrate the strong performance of our proposed network for vessel segmentation.展开更多
Tensile deformation and microvoid formation of quenched and tempered SA508 Gr.3 steel were studied using an in-situ digital image correlation technique and in-situ electron backscatter diffraction(EBSD)measurements.Th...Tensile deformation and microvoid formation of quenched and tempered SA508 Gr.3 steel were studied using an in-situ digital image correlation technique and in-situ electron backscatter diffraction(EBSD)measurements.The quenched steel with a mixture of up-per bainite and granular bainite exhibited a high ultimate tensile strength(UTS)of~795 MPa and an elongation of~25%.After temper-ing,long-rod carbides and accumulated carbide particles were formed at the interface of bainite–ferrite subunits and prior austenite grain boundaries(PAGBs),respectively.The UTS of the tempered steel decreased to~607 MPa,whereas the total elongation increased to 33.0%with a local strain of 191.0%at the necked area.In-situ EBSD results showed that strain localization in the bainite–ferrite pro-duced lattice rotation and dislocation pileup,thus leading to stress concentration at the discontinuities(e.g.,martensite–austenite islands and carbides).Consequently,the decohesion of PAGBs dotted with martensite–austenite islands was the dominant microvoid initiation mechanism in the quenched steel,whereas microvoids primarily initiated through the fracturing of long-rod carbides and the decohesion of PAGBs with carbides aggregation in the tempered steel.The fracture surfaces for both the quenched and tempered specimens featured dimples,indicating the ductile failure mechanism caused by microvoid coalescence.展开更多
Background:Diabetic retinopathy(DR)is one of the primary causes of visual impairment globally,resulting from microvascular abnormalities in the retina.Accurate segmentation of retinal blood vessels from fundus images ...Background:Diabetic retinopathy(DR)is one of the primary causes of visual impairment globally,resulting from microvascular abnormalities in the retina.Accurate segmentation of retinal blood vessels from fundus images plays a pivotal role in the early diagnosis,progression monitoring,and treatment planning of DR and related ocular conditions.Traditional convolutional neural networks often struggle with capturing the intricate structures of thin vessels under varied illumination and contrast conditions.Methods:In this study,we propose an improved U-Net-based framework named MSAC U-Net,which enhances feature extraction and reconstruction through multiscale and attention-based modules.Specifically,the encoder replaces standard convolutions with a Multiscale Asymmetric Convolution(MSAC)block,incorporating parallel 1×n,n×1,and n×n kernels at different scales(3×3,5×5,7×7)to effectively capture fine-grained vascular structures.To further refine spatial representation,skip connections are utilized,and the decoder is augmented with dual activation strategies,Squeeze-and-Excitation blocks,and Convolutional Block Attention Modules for improved contextual understanding.Results:The model was evaluated on the publicly available DRIVE dataset.It achieved an accuracy of 96.48%,sensitivity of 88.31%,specificity of 97.90%,and an AUC of 98.59%,demonstrating superior performance compared to several state-of-the-art segmentation methods.Conclusion:The proposed MSAC U-Net provides a robust and accurate approach for retinal vessel segmentation,offering substantial clinical value in the early detection and management of diabetic retinopathy.Its design contributes to enhanced segmentation reliability and may serve as a foundation for broader applications in medical image analysis.展开更多
The effect of rare-earth cerium on impurity P-induced embrittlement for an advanced SA508Gr.4N reactor pressure vessels steel is investigated by virtue of microstructural characterization,Auger electron spectroscopy(A...The effect of rare-earth cerium on impurity P-induced embrittlement for an advanced SA508Gr.4N reactor pressure vessels steel is investigated by virtue of microstructural characterization,Auger electron spectroscopy(AES),and spin-polarized density functional theory(DFT)calculations.The ductile-to-brittle transition temperatures(DBTTs)are evaluated by Charpy impact testing,and grain boundary segregation(GBS)of P is quantified by AES.Trace addition of Ce can effectively reduce GBS level of P,thereby substantially decreasing the embrittlement induced by P.A linear correlation between DBTT(℃)and GBS level of P(Cp,at.%)is observed for both undoped and Ce-doped samples,being expressed as DBTT=13.13C_(p)-335.70(undoped)and DBTT=12.67C_(p)-350.78(Ce-doped).In the absence of GBS of P,the incorporation of Ce appears to play a pivotal role in augmenting the intrinsic toughness.These results imply that the impact of Ce on impurity P-induced embrittlement may be attributed to a combination of increasing the intrinsic toughness and lowering GBS of P.DFT calculations indicate that there is a negligible interaction between Ce and P in the ternary alloy,and thus GBS of P and Ce is mainly site-competitive.展开更多
Segmentation of the retinal vessels in the fundus is crucial for diagnosing ocular diseases.Retinal vessel images often suffer from category imbalance and large scale variations.This ultimately results in incomplete v...Segmentation of the retinal vessels in the fundus is crucial for diagnosing ocular diseases.Retinal vessel images often suffer from category imbalance and large scale variations.This ultimately results in incomplete vessel segmentation and poor continuity.In this study,we propose CT-MFENet to address the aforementioned issues.First,the use of context transformer(CT)allows for the integration of contextual feature information,which helps establish the connection between pixels and solve the problem of incomplete vessel continuity.Second,multi-scale dense residual networks are used instead of traditional CNN to address the issue of inadequate local feature extraction when the model encounters vessels at multiple scales.In the decoding stage,we introduce a local-global fusion module.It enhances the localization of vascular information and reduces the semantic gap between high-and low-level features.To address the class imbalance in retinal images,we propose a hybrid loss function that enhances the segmentation ability of the model for topological structures.We conducted experiments on the publicly available DRIVE,CHASEDB1,STARE,and IOSTAR datasets.The experimental results show that our CT-MFENet performs better than most existing methods,including the baseline U-Net.展开更多
This study,based on the theory of shifting essence and changing Qi in Inner Canon of Huangdi,deeply explores the theoretical basis,operation method of Conception Vessel Dredging Therapy and its influence on human heal...This study,based on the theory of shifting essence and changing Qi in Inner Canon of Huangdi,deeply explores the theoretical basis,operation method of Conception Vessel Dredging Therapy and its influence on human health.Through case analysis and the statistical analysis of medical records during the pandemic,it reveals the remarkable effects of this method in regulating the endocrine system,improving metabolism,and relieving physical and mental diseases.It provides a theoretical and practical basis for the application of traditional Chinese medicine anti-aging therapy in the modern health field,and helps to explore new ways to delay aging and improve physical and mental health.展开更多
Cerebral small vessel disease encompasses a group of neurological disorders characterized by injury to small blood vessels,often leading to stroke and dementia.Due to its diverse etiologies and complex pathological me...Cerebral small vessel disease encompasses a group of neurological disorders characterized by injury to small blood vessels,often leading to stroke and dementia.Due to its diverse etiologies and complex pathological mechanisms,preventing and treating cerebral small vessel vasculopathy is challenging.Recent studies have shown that the glymphatic system plays a crucial role in interstitial solute clearance and the maintenance of brain homeostasis.Increasing evidence also suggests that dysfunction in glymphatic clearance is a key factor in the progression of cerebral small vessel disease.This review begins with a comprehensive introduction to the structure,function,and driving factors of the glymphatic system,highlighting its essential role in brain waste clearance.Afterwards,cerebral small vessel disease was reviewed from the perspective of the glymphatic system,after which the mechanisms underlying their correlation were summarized.Glymphatic dysfunction may lead to the accumulation of metabolic waste in the brain,thereby exacerbating the pathological processes associated with cerebral small vessel disease.The review also discussed the direct evidence of glymphatic dysfunction in patients and animal models exhibiting two subtypes of cerebral small vessel disease:arteriolosclerosis-related cerebral small vessel disease and amyloid-related cerebral small vessel disease.Diffusion tensor image analysis along the perivascular space is an important non-invasive tool for assessing the clearance function of the glymphatic system.However,the effectiveness of its parameters needs to be enhanced.Among various nervous system diseases,including cerebral small vessel disease,glymphatic failure may be a common final pathway toward dementia.Overall,this review summarizes prevention and treatment strategies that target glymphatic drainage and will offer valuable insight for developing novel treatments for cerebral small vessel disease.展开更多
Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension a...Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension and cerebral small vessel disease remains unclear.Hypertension has substantial negative impacts on brain health and is recognized as a risk factor for cerebrovascular disease.Chronic hypertension and lifestyle factors are associated with risks for stro ke and dementia,and cerebral small vessel disease can cause dementia and stroke.Hypertension is the main driver of cerebral small vessel disease,which changes the structure and function of cerebral vessels via various mechanisms and leads to lacunar infarction,leukoaraiosis,white matter lesions,and intracerebral hemorrhage,ultimately res ulting in cognitive decline and demonstrating that the brain is the to rget organ of hypertension.This review updates our understanding of the pathogenesis of hypertensioninduced cerebral small vessel disease and the res ulting changes in brain structure and function and declines in cognitive ability.We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.展开更多
Cerebral small vessel disease is a neurological disease that affects the brain microvasculature and which is commonly observed among the elderly.Although at first it was considered innocuous,small vessel disease is no...Cerebral small vessel disease is a neurological disease that affects the brain microvasculature and which is commonly observed among the elderly.Although at first it was considered innocuous,small vessel disease is nowadays regarded as one of the major vascular causes of dementia.Radiological signs of small vessel disease include small subcortical infarcts,white matter magnetic resonance imaging hyperintensities,lacunes,enlarged perivascular spaces,cerebral microbleeds,and brain atrophy;however,great heterogeneity in clinical symptoms is observed in small vessel disease patients.The pathophysiology of these lesions has been linked to multiple processes,such as hypoperfusion,defective cerebrovascular reactivity,and blood-brain barrier dysfunction.Notably,studies on small vessel disease suggest that blood-brain barrier dysfunction is among the earliest mechanisms in small vessel disease and might contribute to the development of the hallmarks of small vessel disease.Therefore,the purpose of this review is to provide a new foundation in the study of small vessel disease pathology.First,we discuss the main structural domains and functions of the blood-brain barrier.Secondly,we review the most recent evidence on blood-brain barrier dysfunction linked to small vessel disease.Finally,we conclude with a discussion on future perspectives and propose potential treatment targets and interventions.展开更多
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a monogenic small vessel disease caused by mutations in the NOTCH3 gene. However, the pathogenesis of CADASIL rem...Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a monogenic small vessel disease caused by mutations in the NOTCH3 gene. However, the pathogenesis of CADASIL remains unclear, and patients have limited treatment options. Here, we use human induced pluripotent stem cells (hiPSCs) generated from the peripheral blood mononuclear cells of a patient with CADASIL carrying a heterozygous NOTCH3 mutation (c.1261C>T, p.R421C) to develop a disease model. The correction efficiency of different adenine base editors (ABEs) is tested using the HEK293T-NOTCH3 reporter cell line. ABEmax is selected based on its higher efficiency and minimization of predicted off-target effects. Vascular smooth muscle cells (VSMCs) differentiated from CADASIL hiPSCs show NOTCH3 deposition and abnormal actin cytoskeleton structure, and the abnormalities are recovered in corrected hiPSC-derived VSMCs. Furthermore, CADASIL blood vessel organoids generated for in vivo modeling show altered expression of genes related to disease phenotypes, including the downregulation of cell adhesion, extracellular matrix organization, and vessel development. The dual adeno-associated virus (AAV) split-ABEmax system is applied to the genome editing of vascular organoids with an average editing efficiency of 8.82%. Collectively, we present potential genetic therapeutic strategies for patients with CADASIL using blood vessel organoids and the dual AAV split-ABEmax system.展开更多
BACKGROUND Vessels encapsulating tumor clusters(VETC)represent a recently discovered vascular pattern associated with novel metastasis mechanisms in hepatocellular carcinoma(HCC).However,it seems that no one have focu...BACKGROUND Vessels encapsulating tumor clusters(VETC)represent a recently discovered vascular pattern associated with novel metastasis mechanisms in hepatocellular carcinoma(HCC).However,it seems that no one have focused on predicting VETC status in small HCC(sHCC).This study aimed to develop a new nomogram for predicting VETC positivity using preoperative clinical data and image features in sHCC(≤3 cm)patients.AIM To construct a nomogram that combines preoperative clinical parameters and image features to predict patterns of VETC and evaluate the prognosis of sHCC patients.METHODS A total of 309 patients with sHCC,who underwent segmental resection and had their VETC status confirmed,were included in the study.These patients were recruited from three different hospitals:Hospital 1 contributed 177 patients for the training set,Hospital 2 provided 78 patients for the test set,and Hospital 3 provided 54 patients for the validation set.Independent predictors of VETC were identified through univariate and multivariate logistic analyses.These independent predictors were then used to construct a VETC prediction model for sHCC.The model’s performance was evaluated using the area under the curve(AUC),calibration curve,and clinical decision curve.Additionally,Kaplan-Meier survival analysis was performed to confirm whether the predicted VETC status by the model is associated with early recurrence,just as it is with the actual VETC status and early recurrence.RESULTS Alpha-fetoprotein_lg10,carbohydrate antigen 199,irregular shape,non-smooth margin,and arterial peritumoral enhancement were identified as independent predictors of VETC.The model incorporating these predictors demonstrated strong predictive performance.The AUC was 0.811 for the training set,0.800 for the test set,and 0.791 for the validation set.The calibration curve indicated that the predicted probability was consistent with the actual VETC status in all three sets.Furthermore,the decision curve analysis demonstrated the clinical benefits of our model for patients with sHCC.Finally,early recurrence was more likely to occur in the VETC-positive group compared to the VETC-negative group,regardless of whether considering the actual or predicted VETC status.CONCLUSION Our novel prediction model demonstrates strong performance in predicting VETC positivity in sHCC(≤3 cm)patients,and it holds potential for predicting early recurrence.This model equips clinicians with valuable information to make informed clinical treatment decisions.展开更多
AIM:To assess the repeatability,interocular correlation,and agreement of quantitative swept-source optical coherence tomography angiography(OCTA)optic nerve head(ONH)parameters in healthy subjects.METHODS:Thir ty-thre...AIM:To assess the repeatability,interocular correlation,and agreement of quantitative swept-source optical coherence tomography angiography(OCTA)optic nerve head(ONH)parameters in healthy subjects.METHODS:Thir ty-three healthy subjects were enrolled.The ONH of both eyes were imaged four times by a swept-source-OCTA using a 3 mm×3 mm scanning protocol.Images of the radial peripapillary capillary were analyzed by a customized Matlab program,and the vessel density,fractal dimension,and vessel diameter index were measured.The repeatability of the four scans was determined by the intraclass correlation coefficient(ICC).The most well-centered optic disc from the four repeated scans was then selected for the interocular correlation and agreement analysis using the Pearson correlation coefficient,ICC and Bland-Altman plots.RESULTS:All swept-source-OCTA ONH parameters exhibited certain repeatability,with ICC>0.760 and coefficient of variation(CoV)≤7.301%.The obvious interocular correlation was observed for papillary vessel density(ICC=0.857),vessel diameter index(ICC=0.857)and fractal dimension(ICC=0.906),while circumpapillary vessel density exhibited moderate interocular correlation(ICC=0.687).Bland-Altman plots revealed an agreement range of-5.26%to 6.21%for circumpapillary vessel density.CONCLUSION:OCTA ONH parameters demonstrate good repeatability in healthy subjects.The interocular correlations of papillary vessel density,fractal dimension and vessel diameter index are high,but the correlation for circumpapillary vessel density is moderate.展开更多
BACKGROUND Intracranial atherosclerosis,a leading cause of stroke,involves arterial plaque formation.This study explores the link between plaque remodelling patterns and diabetes using high-resolution vessel wall imag...BACKGROUND Intracranial atherosclerosis,a leading cause of stroke,involves arterial plaque formation.This study explores the link between plaque remodelling patterns and diabetes using high-resolution vessel wall imaging(HR-VWI).AIM To investigate the factors of intracranial atherosclerotic remodelling patterns and the relationship between intracranial atherosclerotic remodelling and diabetes mellitus using HR-VWI.METHODS Ninety-four patients diagnosed with middle cerebral artery or basilar artery INTRODUCTION Intracranial atherosclerotic disease is one of the main causes of ischaemic stroke in the world,accounting for approx-imately 10%of transient ischaemic attacks and 30%-50%of ischaemic strokes[1].It is the most common factor among Asian people[2].The adaptive changes in the structure and function of blood vessels that can adapt to changes in the internal and external environment are called vascular remodelling,which is a common and important pathological mechanism in atherosclerotic diseases,and the remodelling mode of atherosclerotic plaques is closely related to the occurrence of stroke.Positive remodelling(PR)is an outwards compensatory remodelling where the arterial wall grows outwards in an attempt to maintain a constant lumen diameter.For a long time,it was believed that the degree of stenosis can accurately reflect the risk of ischaemic stroke[3-5].Previous studies have revealed that lesions without significant luminal stenosis can also lead to acute events[6,7],as summarized in a recent meta-analysis study in which approximately 50%of acute/subacute ischaemic events were due to this type of lesion[6].Research[8,9]has pointed out that the PR of plaques is more dangerous and more likely to cause acute ischaemic stroke.Previous studies[10-13]have found that there are specific vascular remodelling phenomena in the coronary and carotid arteries of diabetic patients.However,due to the deep location and small lumen of intracranial arteries and limitations of imaging techniques,the relationship between intracranial arterial remodelling and diabetes is still unclear.In recent years,with the development of magnetic resonance technology and the emergence of high-resolution(HR)vascular wall imaging,a clear and multidimensional display of the intracranial vascular wall has been achieved.Therefore,in this study,HR wall imaging(HR-VWI)was used to display the remodelling characteristics of bilateral middle cerebral arteries and basilar arteries and to explore the factors of intracranial vascular remodelling and its relationship with diabetes.展开更多
基金supported by the National Natural Science Foundation of China, No.82274616the Key Laboratory Project for General Universities in Guangdong Province, No.2019KSYS005Guangdong Province Science and Technology Plan International Cooperation Project, No.2020A0505100052 (all to QW)。
文摘Meningeal lymphatic vessels form a relationship between the nervous system and periphery, which is relevant in both health and disease. Meningeal lymphatic vessels not only play a key role in the drainage of brain metabolites but also contribute to antigen delivery and immune cell activation. The advent of novel genomic technologies has enabled rapid progress in the characterization of myeloid and lymphoid cells and their interactions with meningeal lymphatic vessels within the central nervous system. In this review, we provide an overview of the multifaceted roles of meningeal lymphatic vessels within the context of the central nervous system immune network, highlighting recent discoveries on the immunological niche provided by meningeal lymphatic vessels. Furthermore, we delve into the mechanisms of crosstalk between meningeal lymphatic vessels and immune cells in the central nervous system under both homeostatic conditions and neurodegenerative diseases, discussing how these interactions shape the pathological outcomes. Regulation of meningeal lymphatic vessel function and structure can influence lymphatic drainage, cerebrospinal fluid-borne immune modulators, and immune cell populations in aging and neurodegenerative disorders, thereby playing a key role in shaping meningeal and brain parenchyma immunity.
文摘Retinal blood vessel segmentation is crucial for diagnosing ocular and cardiovascular diseases.Although the introduction of U-Net in 2015 by Olaf Ronneberger significantly advanced this field,yet issues like limited training data,imbalance data distribution,and inadequate feature extraction persist,hindering both the segmentation performance and optimal model generalization.Addressing these critical issues,the DEFFA-Unet is proposed featuring an additional encoder to process domain-invariant pre-processed inputs,thereby improving both richer feature encoding and enhanced model generalization.A feature filtering fusion module is developed to ensure the precise feature filtering and robust hybrid feature fusion.In response to the task-specific need for higher precision where false positives are very costly,traditional skip connections are replaced with the attention-guided feature reconstructing fusion module.Additionally,innovative data augmentation and balancing methods are proposed to counter data scarcity and distribution imbalance,further boosting the robustness and generalization of the model.With a comprehensive suite of evaluation metrics,extensive validations on four benchmark datasets(DRIVE,CHASEDB1,STARE,and HRF)and an SLO dataset(IOSTAR),demonstrate the proposed method’s superiority over both baseline and state-of-the-art models.Particularly the proposed method significantly outperforms the compared methods in cross-validation model generalization.
基金Supported by Wu Jieping Medical Foundation(No.320.6750.2021-4-15).
文摘AIM:To compare the effects of different types of negative pressure suction on the macular and optic disc retinal vessel density(VD)in myopic patients with different axial lengths(ALs)undergoing femtosecond laser-assisted excimer laser in situ keratomileusis(FS-LASIK)by optical coherence tomography angiography(OCTA).METHODS:A prospective,nonrandomized,controlled study.Participants underwent FS-LASIK surgery were divided into the short AL group(SAL,22≤AL<26 mm)and the long AL group(LAL,26≤AL<28 mm)according to the different ALs.Further,the two groups were divided into subgroups according to the corneal flap using VisuMax or WaveLight FS200 femtosecond laser(FS)platform.All patients underwent OCTA before the surgery and 1-day/1-week/1-month after the surgery.ANOVA statistically analyzed data with two-factor repeated measurement in SPSS.RESULTS:Totally 108 participants(108 eyes,18–35y)were divided into SAL group[22 patients(4 males and 18 females)were treated with VisuMax,and 24(3 males and 21 females)were treated with WaveLight FS200]and LAL group[34 patients(4 males and 30 females)were treated with VisuMax,and 28 patients(6 males and 22 females)were treated with WaveLight FS200].In the LAL group,there was no significant difference in macular superficial capillary plexuses vessel density(SCP-VD)in the fovea and perifovea region,but compared with the VisuMax subgroup,SCP-VD in the parafoveal region(t=2.647,P=0.010)and the whole area(t=2.030,P=0.047)in WaveLight FS200 subgroup decreased at one day after the operation and increased to a preoperative level at 1-week and 1-month after operation.There was no significant difference between SCP-VD in the two SAL subgroups,neither of deep capillary plexuses vessel density(DCP-VD)and optic nerve head vessel density(ONH-VD)in the SAL and LAL groups.CONCLUSION:With the increase of AL and suction intensity,a transient decrease of SCP-VD in the macular region is observed at 1d postoperatively during FS-LASIK,and it increases to preoperative level at 1-week and 1-month postoperatively.However,the AL and suction intensity do not affect the macular DCP-VD and ONH-VD.
基金The 2019 Guangdong Province General College Youth Innovation Talent Project(2019GKQNCX009)。
文摘Since the problems of branch loss and fracture in retinal blood vessel segmentation algorithms,an image segmentation method is proposed based on improved pulse coupled neural network(PCNN)and gray wolf optimization algorithm(GWO).Simplifying the neuron input domain and neuron connection domain of the PCNN network,increasing the gradient information factor in the internal activity items,reducing the model parameters,enhancing the pulse issuing ability,and the optimal parameters of the network are automatically obtained based on multiple feature evaluation criteria and the GWO algorithm.The test in the public data set drive shows that the sensitivity,accuracy,precision,and specificity of the algorithm are 0.799549,0.962789,0.889163,and 0.986552,respectively.The accuracy and specificity are better than the classical segmentation algorithm.It solved the influence of low illumination,optic disc highlight,and foveal shadow on vascular segmentation,and showed excellent performance of vessel connectivity and terminal sensitivity.
基金supported by the National Key research and Development Program of China(No.2022YFB4003001).
文摘The mechanical properties,microstructure and second phase precipitation behavior of flange forgings for high-pressure hydrogen storage vessels at different tempering temperatures(620–700℃)were studied.The results showed that when tempered at 620–680°C,the main microstructure of the test steel was tempered sorbite,and the main microstructure of tempered steel changed to martensite at 700℃.At 700℃,the dislocation density increased and some retained austenite existed.With the tempering temperature increasing,the yield strength showed a decreasing trend,the formation of fresh martensite made the tensile strength first decrease and then increase slightly,the impact energy at−40℃increased first and then decreased,and the impact energy at 660℃had the maximum value.The precipitates of MC type were mainly(Mo,V,Ti)C.The test steel had excellent strength and toughness matching at 660℃tempering,the tensile strength at different cross section locations was above 750 MPa,the impact energy was above 200 J at−40℃,and the relative percentage reduction of area(ZH2/ZN2)was above 75%at hydrogen environment of 6.3 MPa.
文摘Objective:To study the application effect of bundle nursing strategy in the maintenance of difficult blood vessels for long-term hemodialysis patients.Methods:A prospective study was conducted on 40 long-term hemodialysis patients admitted from January 2024 to January 2025.The patients were randomly divided into a control group(20 cases)and an observation group(20 cases)using computer random sampling.The control group received routine nursing for difficult blood vessels,while the observation group received a bundle nursing strategy for difficult blood vessels.The self-care ability,complication rate,and nursing satisfaction were compared between the two groups.Results:After nursing,the self-care ability score of the observation group was higher than that of the control group(P<0.05).The complication rate in the observation group was lower than that in the control group(P<0.05).The nursing satisfaction in the observation group was higher than that in the control group(P<0.05).Conclusion:The application of the bundle nursing strategy in the maintenance of difficult blood vessels for long-term hemodialysis patients is beneficial for improving self-care ability,reducing complications,and increasing patient satisfaction with nursing services.
基金supported by Natural Science Research Project of Tianjin Education Commission(Grant 2020KJ124)National Natural Science Foundation of China(Grant 11601372)National Key Research and Development Program of China(Grant 2022YFF0706003).
文摘The segmentation of retinal vessels and coronary angiographs is essential for diagnosing conditions such as glaucoma,diabetes,hypertension,and coronary artery disease.However,retinal vessels and coronary angiographs are characterized by low contrast and complex structures,posing challenges for vessel segmentation.Moreover,CNN-based approaches are limited in capturing long-range pixel relationships due to their focus on local feature extraction,while ViT-based approaches struggle to capture fine local details,impacting tasks like vessel segmentation that require precise boundary detection.To address these issues,in this paper,we propose a Global–Local Hybrid Modulation Network(GLHM-Net),a dual-encoder architecture that combines the strengths of CNNs and ViTs for vessel segmentation.First,the Hybrid Non-Local Transformer Block(HNLTB)is proposed to efficiently consolidate long-range spatial dependencies into a compact feature representation,providing a global perspective while significantly reducing computational overhead.Second,the Collaborative Attention Fusion Block(CAFB)is proposed to more effectively integrate local and global vessel features at the same hierarchical level during the encoding phase.Finally,the proposed Feature Cross-Modulation Block(FCMB)better complements the local and global features in the decoding stage,effectively enhancing feature learning and minimizing information loss.The experiments conducted on the DRIVE,CHASEDB1,DCA1,and XCAD datasets,achieving AUC values of 0.9811,0.9864,0.9915,and 0.9919,F1 scores of 0.8288,0.8202,0.8040,and 0.8150,and IOU values of 0.7076,0.6952,0.6723,and 0.6878,respectively,demonstrate the strong performance of our proposed network for vessel segmentation.
基金financially supported by the National Natural Science Foundation of China(No.52171042),the National Key Research and Development Program of China(No.2023YFB3406804)the“Jianbing”R&D Program of Zhejiang Province,China(No.2023C01081)the Na-tional Engineering Research Center for Advanced Manufac-turing Technology and Equipment of Heavy Castings and Forgings(Erzhong(Deyang)Heavy Equipment Co.,Ltd.).
文摘Tensile deformation and microvoid formation of quenched and tempered SA508 Gr.3 steel were studied using an in-situ digital image correlation technique and in-situ electron backscatter diffraction(EBSD)measurements.The quenched steel with a mixture of up-per bainite and granular bainite exhibited a high ultimate tensile strength(UTS)of~795 MPa and an elongation of~25%.After temper-ing,long-rod carbides and accumulated carbide particles were formed at the interface of bainite–ferrite subunits and prior austenite grain boundaries(PAGBs),respectively.The UTS of the tempered steel decreased to~607 MPa,whereas the total elongation increased to 33.0%with a local strain of 191.0%at the necked area.In-situ EBSD results showed that strain localization in the bainite–ferrite pro-duced lattice rotation and dislocation pileup,thus leading to stress concentration at the discontinuities(e.g.,martensite–austenite islands and carbides).Consequently,the decohesion of PAGBs dotted with martensite–austenite islands was the dominant microvoid initiation mechanism in the quenched steel,whereas microvoids primarily initiated through the fracturing of long-rod carbides and the decohesion of PAGBs with carbides aggregation in the tempered steel.The fracture surfaces for both the quenched and tempered specimens featured dimples,indicating the ductile failure mechanism caused by microvoid coalescence.
基金supported by the Guangdong Basic and Applied Basic Research Foundation(2024A1515010987)the Medical Scientific Research Foundation of Guangdong Province(B2024035).
文摘Background:Diabetic retinopathy(DR)is one of the primary causes of visual impairment globally,resulting from microvascular abnormalities in the retina.Accurate segmentation of retinal blood vessels from fundus images plays a pivotal role in the early diagnosis,progression monitoring,and treatment planning of DR and related ocular conditions.Traditional convolutional neural networks often struggle with capturing the intricate structures of thin vessels under varied illumination and contrast conditions.Methods:In this study,we propose an improved U-Net-based framework named MSAC U-Net,which enhances feature extraction and reconstruction through multiscale and attention-based modules.Specifically,the encoder replaces standard convolutions with a Multiscale Asymmetric Convolution(MSAC)block,incorporating parallel 1×n,n×1,and n×n kernels at different scales(3×3,5×5,7×7)to effectively capture fine-grained vascular structures.To further refine spatial representation,skip connections are utilized,and the decoder is augmented with dual activation strategies,Squeeze-and-Excitation blocks,and Convolutional Block Attention Modules for improved contextual understanding.Results:The model was evaluated on the publicly available DRIVE dataset.It achieved an accuracy of 96.48%,sensitivity of 88.31%,specificity of 97.90%,and an AUC of 98.59%,demonstrating superior performance compared to several state-of-the-art segmentation methods.Conclusion:The proposed MSAC U-Net provides a robust and accurate approach for retinal vessel segmentation,offering substantial clinical value in the early detection and management of diabetic retinopathy.Its design contributes to enhanced segmentation reliability and may serve as a foundation for broader applications in medical image analysis.
基金supported by the China Postdoctoral Science Foundation(No.2023M740973)the Shenzhen Polytechnic University Research Fund,China(No.6023310017K)the National Natural Science Foundation of China(Nos.52071088 and 51871064).
文摘The effect of rare-earth cerium on impurity P-induced embrittlement for an advanced SA508Gr.4N reactor pressure vessels steel is investigated by virtue of microstructural characterization,Auger electron spectroscopy(AES),and spin-polarized density functional theory(DFT)calculations.The ductile-to-brittle transition temperatures(DBTTs)are evaluated by Charpy impact testing,and grain boundary segregation(GBS)of P is quantified by AES.Trace addition of Ce can effectively reduce GBS level of P,thereby substantially decreasing the embrittlement induced by P.A linear correlation between DBTT(℃)and GBS level of P(Cp,at.%)is observed for both undoped and Ce-doped samples,being expressed as DBTT=13.13C_(p)-335.70(undoped)and DBTT=12.67C_(p)-350.78(Ce-doped).In the absence of GBS of P,the incorporation of Ce appears to play a pivotal role in augmenting the intrinsic toughness.These results imply that the impact of Ce on impurity P-induced embrittlement may be attributed to a combination of increasing the intrinsic toughness and lowering GBS of P.DFT calculations indicate that there is a negligible interaction between Ce and P in the ternary alloy,and thus GBS of P and Ce is mainly site-competitive.
基金the National Natural Science Foundation of China(No.62266025)。
文摘Segmentation of the retinal vessels in the fundus is crucial for diagnosing ocular diseases.Retinal vessel images often suffer from category imbalance and large scale variations.This ultimately results in incomplete vessel segmentation and poor continuity.In this study,we propose CT-MFENet to address the aforementioned issues.First,the use of context transformer(CT)allows for the integration of contextual feature information,which helps establish the connection between pixels and solve the problem of incomplete vessel continuity.Second,multi-scale dense residual networks are used instead of traditional CNN to address the issue of inadequate local feature extraction when the model encounters vessels at multiple scales.In the decoding stage,we introduce a local-global fusion module.It enhances the localization of vascular information and reduces the semantic gap between high-and low-level features.To address the class imbalance in retinal images,we propose a hybrid loss function that enhances the segmentation ability of the model for topological structures.We conducted experiments on the publicly available DRIVE,CHASEDB1,STARE,and IOSTAR datasets.The experimental results show that our CT-MFENet performs better than most existing methods,including the baseline U-Net.
基金Supported by Natural Science Foundation of China,Taoist Qi Healing the World Project(Project No.:71971359).
文摘This study,based on the theory of shifting essence and changing Qi in Inner Canon of Huangdi,deeply explores the theoretical basis,operation method of Conception Vessel Dredging Therapy and its influence on human health.Through case analysis and the statistical analysis of medical records during the pandemic,it reveals the remarkable effects of this method in regulating the endocrine system,improving metabolism,and relieving physical and mental diseases.It provides a theoretical and practical basis for the application of traditional Chinese medicine anti-aging therapy in the modern health field,and helps to explore new ways to delay aging and improve physical and mental health.
基金supported by the National Natural Science Foundation of China,No.82274304(to YH)the Major Clinical Study Projects of Shanghai Shenkang Hospital Development Center,No.SHDC2020CR2046B(to YH)Shanghai Municipal Health Commission Talent Plan,No.2022LJ010(to YH).
文摘Cerebral small vessel disease encompasses a group of neurological disorders characterized by injury to small blood vessels,often leading to stroke and dementia.Due to its diverse etiologies and complex pathological mechanisms,preventing and treating cerebral small vessel vasculopathy is challenging.Recent studies have shown that the glymphatic system plays a crucial role in interstitial solute clearance and the maintenance of brain homeostasis.Increasing evidence also suggests that dysfunction in glymphatic clearance is a key factor in the progression of cerebral small vessel disease.This review begins with a comprehensive introduction to the structure,function,and driving factors of the glymphatic system,highlighting its essential role in brain waste clearance.Afterwards,cerebral small vessel disease was reviewed from the perspective of the glymphatic system,after which the mechanisms underlying their correlation were summarized.Glymphatic dysfunction may lead to the accumulation of metabolic waste in the brain,thereby exacerbating the pathological processes associated with cerebral small vessel disease.The review also discussed the direct evidence of glymphatic dysfunction in patients and animal models exhibiting two subtypes of cerebral small vessel disease:arteriolosclerosis-related cerebral small vessel disease and amyloid-related cerebral small vessel disease.Diffusion tensor image analysis along the perivascular space is an important non-invasive tool for assessing the clearance function of the glymphatic system.However,the effectiveness of its parameters needs to be enhanced.Among various nervous system diseases,including cerebral small vessel disease,glymphatic failure may be a common final pathway toward dementia.Overall,this review summarizes prevention and treatment strategies that target glymphatic drainage and will offer valuable insight for developing novel treatments for cerebral small vessel disease.
基金supported by the National Natural Science Foundation of China,Nos.82274611(to LZ),82104419(to DM)Capital Science and Technology Leading Talent Training Project,No.Z191100006119017(to LZ)+3 种基金Beijing Hospitals Authority Ascent Plan,No.DFL20190803(to LZ)Cultivation Fund of Hospital Management Center in Beijing,No.PZ2022006(to DM)R&D Program of Beijing Municipal Education Commission,No.KM202210025017(to DM)Beijing Gold-Bridge Project,No.ZZ20145(to DM)。
文摘Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension and cerebral small vessel disease remains unclear.Hypertension has substantial negative impacts on brain health and is recognized as a risk factor for cerebrovascular disease.Chronic hypertension and lifestyle factors are associated with risks for stro ke and dementia,and cerebral small vessel disease can cause dementia and stroke.Hypertension is the main driver of cerebral small vessel disease,which changes the structure and function of cerebral vessels via various mechanisms and leads to lacunar infarction,leukoaraiosis,white matter lesions,and intracerebral hemorrhage,ultimately res ulting in cognitive decline and demonstrating that the brain is the to rget organ of hypertension.This review updates our understanding of the pathogenesis of hypertensioninduced cerebral small vessel disease and the res ulting changes in brain structure and function and declines in cognitive ability.We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.
基金supported by China Scholarship Council(202208210093,to RJ)。
文摘Cerebral small vessel disease is a neurological disease that affects the brain microvasculature and which is commonly observed among the elderly.Although at first it was considered innocuous,small vessel disease is nowadays regarded as one of the major vascular causes of dementia.Radiological signs of small vessel disease include small subcortical infarcts,white matter magnetic resonance imaging hyperintensities,lacunes,enlarged perivascular spaces,cerebral microbleeds,and brain atrophy;however,great heterogeneity in clinical symptoms is observed in small vessel disease patients.The pathophysiology of these lesions has been linked to multiple processes,such as hypoperfusion,defective cerebrovascular reactivity,and blood-brain barrier dysfunction.Notably,studies on small vessel disease suggest that blood-brain barrier dysfunction is among the earliest mechanisms in small vessel disease and might contribute to the development of the hallmarks of small vessel disease.Therefore,the purpose of this review is to provide a new foundation in the study of small vessel disease pathology.First,we discuss the main structural domains and functions of the blood-brain barrier.Secondly,we review the most recent evidence on blood-brain barrier dysfunction linked to small vessel disease.Finally,we conclude with a discussion on future perspectives and propose potential treatment targets and interventions.
基金funded by the National Natural Science Foundation of China(31971365)the Guangdong Basic and Applied Basic Research Foundation(2020B1515120090)the Local Innovative and Research Teams Project of Guangdong Pearl River Talents Program(2019BT02Y276).
文摘Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a monogenic small vessel disease caused by mutations in the NOTCH3 gene. However, the pathogenesis of CADASIL remains unclear, and patients have limited treatment options. Here, we use human induced pluripotent stem cells (hiPSCs) generated from the peripheral blood mononuclear cells of a patient with CADASIL carrying a heterozygous NOTCH3 mutation (c.1261C>T, p.R421C) to develop a disease model. The correction efficiency of different adenine base editors (ABEs) is tested using the HEK293T-NOTCH3 reporter cell line. ABEmax is selected based on its higher efficiency and minimization of predicted off-target effects. Vascular smooth muscle cells (VSMCs) differentiated from CADASIL hiPSCs show NOTCH3 deposition and abnormal actin cytoskeleton structure, and the abnormalities are recovered in corrected hiPSC-derived VSMCs. Furthermore, CADASIL blood vessel organoids generated for in vivo modeling show altered expression of genes related to disease phenotypes, including the downregulation of cell adhesion, extracellular matrix organization, and vessel development. The dual adeno-associated virus (AAV) split-ABEmax system is applied to the genome editing of vascular organoids with an average editing efficiency of 8.82%. Collectively, we present potential genetic therapeutic strategies for patients with CADASIL using blood vessel organoids and the dual AAV split-ABEmax system.
基金Supported by the Project of Shanghai Municipal Commission of Health,No.2022LJ024.
文摘BACKGROUND Vessels encapsulating tumor clusters(VETC)represent a recently discovered vascular pattern associated with novel metastasis mechanisms in hepatocellular carcinoma(HCC).However,it seems that no one have focused on predicting VETC status in small HCC(sHCC).This study aimed to develop a new nomogram for predicting VETC positivity using preoperative clinical data and image features in sHCC(≤3 cm)patients.AIM To construct a nomogram that combines preoperative clinical parameters and image features to predict patterns of VETC and evaluate the prognosis of sHCC patients.METHODS A total of 309 patients with sHCC,who underwent segmental resection and had their VETC status confirmed,were included in the study.These patients were recruited from three different hospitals:Hospital 1 contributed 177 patients for the training set,Hospital 2 provided 78 patients for the test set,and Hospital 3 provided 54 patients for the validation set.Independent predictors of VETC were identified through univariate and multivariate logistic analyses.These independent predictors were then used to construct a VETC prediction model for sHCC.The model’s performance was evaluated using the area under the curve(AUC),calibration curve,and clinical decision curve.Additionally,Kaplan-Meier survival analysis was performed to confirm whether the predicted VETC status by the model is associated with early recurrence,just as it is with the actual VETC status and early recurrence.RESULTS Alpha-fetoprotein_lg10,carbohydrate antigen 199,irregular shape,non-smooth margin,and arterial peritumoral enhancement were identified as independent predictors of VETC.The model incorporating these predictors demonstrated strong predictive performance.The AUC was 0.811 for the training set,0.800 for the test set,and 0.791 for the validation set.The calibration curve indicated that the predicted probability was consistent with the actual VETC status in all three sets.Furthermore,the decision curve analysis demonstrated the clinical benefits of our model for patients with sHCC.Finally,early recurrence was more likely to occur in the VETC-positive group compared to the VETC-negative group,regardless of whether considering the actual or predicted VETC status.CONCLUSION Our novel prediction model demonstrates strong performance in predicting VETC positivity in sHCC(≤3 cm)patients,and it holds potential for predicting early recurrence.This model equips clinicians with valuable information to make informed clinical treatment decisions.
基金Natural Science Foundation of Guangdong Province(No.2018A0303130306)Shantou Science and Technology Program(No.190917085269835,No.200629165261641).
文摘AIM:To assess the repeatability,interocular correlation,and agreement of quantitative swept-source optical coherence tomography angiography(OCTA)optic nerve head(ONH)parameters in healthy subjects.METHODS:Thir ty-three healthy subjects were enrolled.The ONH of both eyes were imaged four times by a swept-source-OCTA using a 3 mm×3 mm scanning protocol.Images of the radial peripapillary capillary were analyzed by a customized Matlab program,and the vessel density,fractal dimension,and vessel diameter index were measured.The repeatability of the four scans was determined by the intraclass correlation coefficient(ICC).The most well-centered optic disc from the four repeated scans was then selected for the interocular correlation and agreement analysis using the Pearson correlation coefficient,ICC and Bland-Altman plots.RESULTS:All swept-source-OCTA ONH parameters exhibited certain repeatability,with ICC>0.760 and coefficient of variation(CoV)≤7.301%.The obvious interocular correlation was observed for papillary vessel density(ICC=0.857),vessel diameter index(ICC=0.857)and fractal dimension(ICC=0.906),while circumpapillary vessel density exhibited moderate interocular correlation(ICC=0.687).Bland-Altman plots revealed an agreement range of-5.26%to 6.21%for circumpapillary vessel density.CONCLUSION:OCTA ONH parameters demonstrate good repeatability in healthy subjects.The interocular correlations of papillary vessel density,fractal dimension and vessel diameter index are high,but the correlation for circumpapillary vessel density is moderate.
基金Supported by National Natural Science Foundation of China,No.82071871Guangdong Basic and Applied Basic Research Foundation,No.2021A1515220131+1 种基金Guangdong Medical Science and Technology Research Fund Project,No.2022111520491834Clinical Research Project of Shenzhen Second People's Hospital,No.20223357022。
文摘BACKGROUND Intracranial atherosclerosis,a leading cause of stroke,involves arterial plaque formation.This study explores the link between plaque remodelling patterns and diabetes using high-resolution vessel wall imaging(HR-VWI).AIM To investigate the factors of intracranial atherosclerotic remodelling patterns and the relationship between intracranial atherosclerotic remodelling and diabetes mellitus using HR-VWI.METHODS Ninety-four patients diagnosed with middle cerebral artery or basilar artery INTRODUCTION Intracranial atherosclerotic disease is one of the main causes of ischaemic stroke in the world,accounting for approx-imately 10%of transient ischaemic attacks and 30%-50%of ischaemic strokes[1].It is the most common factor among Asian people[2].The adaptive changes in the structure and function of blood vessels that can adapt to changes in the internal and external environment are called vascular remodelling,which is a common and important pathological mechanism in atherosclerotic diseases,and the remodelling mode of atherosclerotic plaques is closely related to the occurrence of stroke.Positive remodelling(PR)is an outwards compensatory remodelling where the arterial wall grows outwards in an attempt to maintain a constant lumen diameter.For a long time,it was believed that the degree of stenosis can accurately reflect the risk of ischaemic stroke[3-5].Previous studies have revealed that lesions without significant luminal stenosis can also lead to acute events[6,7],as summarized in a recent meta-analysis study in which approximately 50%of acute/subacute ischaemic events were due to this type of lesion[6].Research[8,9]has pointed out that the PR of plaques is more dangerous and more likely to cause acute ischaemic stroke.Previous studies[10-13]have found that there are specific vascular remodelling phenomena in the coronary and carotid arteries of diabetic patients.However,due to the deep location and small lumen of intracranial arteries and limitations of imaging techniques,the relationship between intracranial arterial remodelling and diabetes is still unclear.In recent years,with the development of magnetic resonance technology and the emergence of high-resolution(HR)vascular wall imaging,a clear and multidimensional display of the intracranial vascular wall has been achieved.Therefore,in this study,HR wall imaging(HR-VWI)was used to display the remodelling characteristics of bilateral middle cerebral arteries and basilar arteries and to explore the factors of intracranial vascular remodelling and its relationship with diabetes.
