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Background: To introduce and determine the value of optimized strategies for the management of urological tube-related emergencies with increased incidence, complexity and operational risk during the global spread of coronavirus disease 2019 (COVID-19) Methods: All emergent urological patients at Tongji Hospital, Wuhan, during the period of January 23 (the beginning of lockdown in Wuhan) to March 23, 2020, and the corresponding period in 2019 were recruited to form this study’s COVID-19 group and control group, respectively Tongji Hospital has the most concentrated and strongest Chinese medical teams to treat the largest number of severe COVID-19 patients Patients in the control group were routinely treated, while patients in the COVID-19 group were managed following the optimized principles and strategies The case incidence for each type of tube-related emergency was recorded Baseline characteristics and management outcomes (surgery time, secondary complex operation rate, readmission rate, COVID-19 infection rate) were analyzed and compared across the control and COVID-19 periods Results: The total emergent urological patients during the COVID-19 period was 42, whereas during the control period, it was 124 The incidence of tube-related emergencies increased from 53% to 88% (P

Background The coronavirus disease 2019 (COVID-19) has been spreading all over the world since December 2019. However, medical information regarding the urogenital involvement in recovered COVID-19 patients is limited or unknown. Objectives To comprehensively evaluate urogenital involvement in recovered COVID-19 patients. Materials and methods Men aged between 20 years and 50 years who were diagnosed with SARS-CoV-2 infection and recovered when the study was conducted were enrolled in our study. Demographic and clinical characteristics, and history of hospitalization were collected and analyzed. Urine, expressed prostatic secretions (EPSs), and semen samples were collected for SARS-CoV-2 RNA detection. Semen quality and hormonal profiles were analyzed. Results Among 74 male recovered COVID-19 patients, 11 (14.9%) were asymptomatic, classified into mild type, and 31 (41.9%) were classified into moderate type. The remaining patients (32/74, 43.2%) had severe pneumonia. No critically ill recovered COVID-19 patient was recruited in our cohort. The median interval between last positive pharyngeal swab RT-PCR test and semen samples collection was 80 days (IQR, 64-93). The median age was 31 years (IQR, 27-36; range, 21-49), and the median body mass index (BMI) was 24.40 (IQR, 22.55-27.30). Forty-five (61.6%) men were married, and 28 (38.4%) were unmarried. Fifty-three (72.6%) patients denied cigarette smoking, 18 (24.7%) were active smokers, and 2 of them were past smokers. The majority of our participants (53/74, 72.6%) did not consume alcohol. Fever occurred in most of the patients (75.3%), and 63 of them had abnormal chest CT images. Only one patient complained of scrotal discomfort during the course of COVID-19, which was ruled out orchitis by MRI (data not shown). A total of 205 samples were collected for SARS-CoV-2 detection (74 urine samples, 70 semen samples, and 61 EPS samples). However, viral nucleic acid was not detected in body fluids from the urogenital system. In terms of hormonal profiles, the levels of FSH, LH, testosterone, and estradiol were 5.20 [4.23] mIU/mL, 3.95 [1.63] mIU/mL, 3.65 [1.19] ng/mL, and 39.48 [12.51] pg/mL, respectively. And these values were within the normal limits. The overall semen quality of recovered COVID-19 patients was above the lower reference limit released by the WHO. While compared with healthy control, sperm concentration, total sperm count, and total motility were significantly declined. In addition, different clinical types of COVID-19 have no significant difference in semen parameters, but total sperm count showed a descending trend. Interestingly, subjects with a longer recovery time showed worse data for sperm quality. Small sample size and lacking semen parameters before the infection are the major limitations of our study. Discussion and conclusions To the best of our knowledge, it is the largest cohort study with longest follow-up for urogenital evaluation comprehensively so far. Direct urogenital involvement was not found in the recovered COVID-19 male patients. SARS-CoV-2 RNA was undetectable in the urogenital secretions, and semen quality declined slightly, while hormonal profiles remained normal. Moreover, patients with a long time (≥90 days) since recovery had lower total sperm count. Great attention and further study should be conducted and follow-up on the reproductive function in the following months.

High-efficiency lung nodule detection dramatically contributes to the risk assessment of lung cancer. It is a significant and challenging task to quickly locate the exact positions of lung nodules. Extensive work has been done by researchers around this domain for approximately two decades. However, previous computer-aided detection (CADe) schemes are mostly intricate and time-consuming since they may require more image processing modules, such as the computed tomography image transformation, the lung nodule segmentation, and the feature extraction, to construct a whole CADe system. It is difficult for these schemes to process and analyze enormous data when the medical images continue to increase. Besides, some state of the art deep learning schemes may be strict in the standard of database. This study proposes an effective lung nodule detection scheme based on multigroup patches cut out from the lung images, which are enhanced by the Frangi filter. Through combining two groups of images, a four-channel convolution neural networks model is designed to learn the knowledge of radiologists for detecting nodules of four levels. This CADe scheme can acquire the sensitivity of 80.06% with 4.7 false positives per scan and the sensitivity of 94% with 15.1 false positives per scan. The results demonstrate that the multigroup patch-based learning system is efficient to improve the performance of lung nodule detection and greatly reduce the false positives under a huge amount of image data.

Background Oxidative stress is a significant contributor to the poor treatment efficacy on erectile dysfunction induced by diabetes mellitus (DMED). Thus, understanding the mechanism underlying oxidative stress will aid in the identification of novel therapeutic targets. Aim To define the role of Janus kinase 2 (JAK2) in mediating oxidative stress in the corpus cavernosum smooth muscle cells (CCSMCs) and to investigate the therapeutic effect of monomeric berberine (BB), which inhibits JAK2, in the pathogenesis of DMED. Methods Streptozotocin was used to establish type I diabetic rat models and apomorphine tests were conducted to determine DMED rats. Eighteen DMED rats were divided into the DMED group and the DMED+BB group, whereas another 10 age-matched rats formed the control group. CCSMCs were isolated from the corpus cavernosum of rats and were treated with the JAK2 inhibitor alpha cyanano-(3,4-hydroxyl)N-benzophenylamine (AG490) and/or BB. Outcomes Metabolic parameters; erectile function; histologic and molecular alterations. Results Erectile function was impaired and excessive oxidative stress was found in the DMED group. Excessive oxidative stress led to decreased expression level of phosphorylated endothelial nitric oxide synthase at serine 1177/endothelial nitric oxide synthase and increased expression level of Ras homolog gene family and Rho kinase 1/2. Meanwhile, the relative expression ratio of phosphorylated JAK2/JAK2 was significantly greater in the DMED group than that in the other groups. In vitro, oxidative stress was significantly reduced along with reduced intracellular calcium upon treatment with the JAK2 inhibitor, AG490. Moreover, the CCSMCs treated with BB showed changes similar to those upon treatment with AG490. In vivo experiments also confirmed that the erectile function of the DMED+BB group was improved, accompanied by decreased phosphorylated JAK2/JAK2 and decreased oxidative stress. Clinical Translation JAK2 can be used as a therapeutic target and BB can be used as a potential drug for the clinical treatment of DMED. Strengths and Limitations This study examines the promoting effect of JAK2 on oxidative stress occurrence in the corpus cavernosum and on the development of DMED in both animal experiments and cell experiments, as well evaluates the inhibitory effect of BB on JAK2 and its therapeutic effect on DMED. The main limitation of our current study is the lack of an appropriate means for activating JAK2. Conclusions JAK2 can induce DMED by enhancing oxidative stress and BB can play a role in treating DMED by inhibiting JAK2 and reducing oxidative stress. Our study provides an option and an idea for further studies on the pathogenesis and treatment of DMED.

Obesity and overweight are independent risk factors of erectile dysfunction (ED). It is controversial whether weight loss can improve erectile function. We thereby performed this meta-analysis to clarify the therapeutic effect of weight loss on erectile function in overweight or obese men. Literature search was conducted on databases including Cochrane Library, Embase, Web of Science and PubMed to obtain all relevant English articles published before March 1, 2021. The primary outcome was final International Index of Erectile Function (IIEF) score or change in IIEF score. The secondary outcome was final body weight and body mass index (BMI) or change in body weight and BMI. After screening, 5 studies with 619 participants were enrolled in our meta-analysis. Our result showed that the mean difference in body weight between weight loss group and control group was -18.07 kg with p

Background Janus kinase 2 (JAK2) is activated in diabetic mellitus (DM) conditions and may enhance oxidative stress, apoptosis and fibrosis in many tissues. Whether JAK2 activation is involved in the occurrence of diabetic erectile dysfunction (ED) is unknown. Objectives We performed this study to investigate the effect of JAK2 deficiency on diabetic ED. Materials and methods Conditional JAK2 gene knockout mice (Cre+/+ -JAK2fl/fl ) were used, in which JAK2 gene knockout could be induced by tamoxifen. Mice fell into four groups: control, JAK2 knockout (JAK2-/- ), DM, and DM with JAK2-/- . DM was induced by intraperitoneal injection of streptozotocin. Two months later, JAK2 gene knockout was induced with tamoxifen in Cre+/+ -JAK2fl/fl mice. After another 2 months, erectile function was measured by electrical stimulation of the cavernous nerve, and penile tissues were harvested. Ratio of maximal intracavernosal pressure (MIP) to mean arterial blood pressure (MAP), expression and phosphorylation of JAK2, oxidative stress level, NO/Cyclic Guanosine Monophosphate (cGMP) pathway, apoptosis, fibrosis, and transforming growth factor beta 1 (TGF-β1)/Smad/Collagen IV pathway in corpus cavernosum, were measured. Results JAK2 expression was remarkably decreased after induction with tamoxifen. JAK2 was activated in penile tissues of diabetic mice, and JAK2 deficiency could improve the impaired erectile function caused by DM. However, in mice without DM, JAK2 deficiency had no apparent influence on erectile function. Levels of oxidative stress, apoptosis, fibrosis, and TGF-β1/Smad/Collagen IV pathway were all elevated by DM, whereas JAK2 deficiency lessened these alterations in diabetic mice. Moreover, JAK2 deficiency improved the expression of the down-regulated NO/cGMP pathway in diabetic mice. In non-diabetic mice, no apparent changes were found in aforementioned parameters after JAK2 gene knockout. Discussion and conclusion Our study showed that JAK2 deficiency could improve erectile function in diabetic mice, which might be mediated by reduction in oxidative stress, apoptosis, and fibrosis in corpus cavernosum.

ObjectivesTo systematically evaluate and compare the predictive capability for microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients based on radiomics from multi-parametric MRI (mp-MRI) including six sequences when used individually or combined, and to establish and validate the optimal combined model.MethodsA total of 195 patients confirmed HCC were divided into training (n = 136) and validation (n = 59) datasets. All volumes of interest of tumors were respectively segmented on T2-weighted imaging, diffusion-weighted imaging, apparent diffusion coefficient, artery phase, portal venous phase, and delay phase sequences, from which quantitative radiomics features were extracted and analyzed individually or combined. Multivariate logistic regression analyses were undertaken to construct clinical model, respective single-sequence radiomics models, fusion radiomics models based on different sequences and combined model. The accuracy, sensitivity, specificity and area under the receiver operating characteristic curve (AUC) were calculated to evaluate the performance of different models.ResultsAmong nine radiomics models, the model from all sequences performed best with AUCs 0.889 and 0.822 in the training and validation datasets, respectively. The combined model incorporating radiomics from all sequences and effective clinical features achieved satisfactory preoperative prediction of MVI with AUCs 0.901 and 0.840, respectively, and could identify the higher risk population of MVI (P < 0.001). The Delong test manifested significant differences with P < 0.001 in the training dataset and P = 0.005 in the validation dataset between the combined model and clinical model.ConclusionsThe combined model can preoperatively and noninvasively predict MVI in HCC patients and may act as a usefully clinical tool to guide subsequent individualized treatment.

Objective Traditional approaches that involve measuring the height and volume of the pituitary by magnetic resonance imaging (MRI) are unreliable. We investigated the use of a more accurate method using texture analysis to evaluate idiopathic central precocious puberty (ICPP) by MRI. Methods In total, 352 texture features of the pituitary were extracted from 12 healthy girls and 18 girls with ICPP. A LASSO regression model and linear regression model were used to create the prediction model. Pearson’s correlation analysis and receiver operating characteristic curves were used to evaluate the predictive performance. Results The radiomics score had a significant linear relationship with the luteinizing hormone concentration and the luteinizing hormone/follicle-stimulating hormone ratio. The radiomics score showed better predictive performance than traditional pituitary measurements. The area under the curve of the radiomics score, pituitary height, and variable combinations was 0.759 (95% confidence interval [CI], 0.583–0.936), 0.681 (95% CI, 0.483–0.878), and 0.829 (95% CI, 0.681–0.976), respectively. Conclusion Combination of the radiomics score with pituitary height measurements allows for better evaluation of the pituitary during diagnostic imaging, indicating satisfactory potential for efficacy assessments.

The characteristics of diabetic retinopathy (DR) fundus images generally consist of multiple types of lesions which provided strong evidence for the ophthalmologists to make diagnosis. It is particularly significant to figure out an efficient method to not only accurately classify DR fundus images but also recognize all kinds of lesions on them. In this paper, a deep learning-based multi-label classification model with Gradient-weighted Class Activation Mapping (Grad-CAM) was proposed, which can both make DR classification and automatically locate the regions of different lesions. To reducing laborious annotation work and improve the efficiency of labeling, this paper innovatively considered different types of lesions as different labels for a fundus image so that this paper changed the task of lesion detection into that of image classification. A total of five labels were pre-defined and 3228 fundus images were collected for developing our model. The architecture of deep learning model was designed by ourselves based on ResNet. Through experiments on the test images, this method acquired a sensitive of 93.9% and a specificity of 94.4% on DR classification. Moreover, the corresponding regions of lesions were reasonably outlined on the DR fundus images.

The amygdala is an important part of the medial temporal lobe and plays a pivotal role in the emotional and cognitive function. The aim of this study was to build and validate comprehensive classification models based on amygdala radiomic features for Alzheimer’s disease (AD) and amnestic mild cognitive impairment (aMCI). For the amygdala, 3360 radiomic features were extracted from 97 AD patients, 53 aMCI patients and 45 normal controls (NCs) on the three-dimensional T1-weighted magnetization-prepared rapid gradient echo (MPRAGE) images. We used maximum relevance and minimum redundancy (mRMR) and least absolute shrinkage and selection operator (LASSO) to select the features. Multivariable logistic regression analysis was performed to build three classification models (AD-NC group, AD-aMCI group, and aMCI-NC group). Finally, internal validation was assessed. After two steps of feature selection, there were 5 radiomic features remained in the AD-NC group, 16 features remained in the AD-aMCI group and the aMCI-NC group, respectively. The proposed logistic classification analysis based on amygdala radiomic features achieves an accuracy of 0.90 and an area under the ROC curve (AUC) of 0.93 for AD vs. NC classification, an accuracy of 0.81 and an AUC of 0.84 for AD vs. aMCI classification, and an accuracy of 0.75 and an AUC of 0.80 for aMCI vs. NC classification. Amygdala radiomic features might be early biomarkers for detecting microstructural brain tissue changes during the AD and aMCI course. Logistic classification analysis demonstrated the promising classification performances for clinical applications among AD, aMCI and NC groups.

Malignant middle cerebral artery infarction (mMCAi) is a serious complication of cerebral infarction usually associated with poor patient prognosis. In this retrospective study, we analyzed clinical information as well as non-contrast computed tomography (NCCT) and computed tomography angiography (CTA) data from patients with cerebral infarction in the middle cerebral artery (MCA) territory acquired within 24 h from symptoms onset. Then, we aimed to develop a model based on the radiomics signature to predict the development of mMCAi in cerebral infarction patients. Patients were divided randomly into training (n = 87) and validation (n = 39) sets. A total of 396 texture features were extracted from each NCCT image from the 126 patients. The least absolute shrinkage and selection operator regression analysis was used to reduce the feature dimension and construct an accurate radiomics signature based on the remaining texture features. Subsequently, we developed a model based on the radiomics signature and Alberta Stroke Program Early CT Score (ASPECTS) based on NCCT to predict mMCAi. Our prediction model showed a good predictive performance with an AUC of 0.917 [95% confidence interval (CI), 0.863-0.972] and 0.913 [95% CI, 0.795-1] in the training and validation sets, respectively. Additionally, the decision curve analysis (DCA) validated the clinical efficacy of the combined risk factors of radiomics signature and ASPECTS based on NCCT in the prediction of mMCAi development in patients with acute stroke across a wide range of threshold probabilities. Our research indicates that radiomics signature can be an instrumental tool to predict the risk of mMCAi.

Gonadotropin therapy is commonly used to induce virilization and spermatogenesis in male isolated hypogonadotropic hypogonadism (IHH) patients. In clinical practice, 5.6%-15.0% of male IHH patients show poor responses to gonadotropin treatment; therefore, testosterone (T) supplementation can serve as an alternative therapy to normalize serum T levels and promote virilization. However, treatment with exogenous T impairs spermatogenesis and suppresses intratesticular T levels. This retrospective study aimed to determine whether oral testosterone undecanoate (TU) supplementation together with human chorionic gonadotropin (hCG) would negatively affect spermatogenesis in IHH patients compared with hCG alone. One hundred and seven IHH patients were included in our study. Fifty-four patients received intramuscular hCG and oral TU, and 53 patients received intramuscular hCG alone. The median follow-up time was 29 (range: 12-72) months in both groups. Compared with the hCG group, the hCG/TU group required a shorter median time to normalize serum T levels (P < 0.001) and achieve Tanner stage (III and V) of pubic hair and genital development (P < 0.05). However, there were no significant differences in the rate of seminal spermatozoa appearance, sperm concentration, or median time to achieve different sperm concentration thresholds between the groups. In addition, there were no significant differences in side effects, such as acne and gynecomastia, observed in both groups. This study indicates that oral TU supplementation together with hCG does not impair spermatogenesis in treated IHH patients compared with hCG alone, and it shortens the time to normalize serum T levels and promote virilization.

PURPOSE: The purpose of the study is to explore testicular sperm cryopreservation in patients with nonobstructive azoospermia (NOA) whether affect the outcome of subsequent intracytoplasmic sperm injection (ICSI). METHODS: A systematic review and meta-analysis was conducted by searching the MEDLINE and EMBASE databases for relevant published studies in English language (1997–2017). Studies were eligible if they included the comparison of using fresh and frozen-thawed testicular sperm followed by ICSI. Two reviewers independently performed data extraction, quality assessment and assessed the risk of bias. The overall summary risk estimated the number of events. A meta-analysis was conducted using a random effects or fixed effects model analysis according to the test of heterogeneity. RESULTS: A total of 17 studies with 1,261 ICSI cycles were identified. Analysis of the present data showed no difference in the fertilization outcome when comparing fresh versus frozen-thawed spermatozoa (RR = 1.02, 95% CI 0.86–1.09). Similarly, no difference in CR (RR = 1.01, 95% CI 0.96–1.05), good embryo rate (RR = 1.01, 95% CI 0.95–1.09), and IR (RR = 0.93, 95% CI 0.66–1.30) was observed if the spermatozoa was fresh or frozen-thawed. Finally, no difference in CPR or LBR was noted when using fresh or frozen-thawed cycles were analyzed separately (RR = 1.03, 95% CI 0.86–1.24; RR 1.11, 95% CI 0.88–1.41, respectively). CONCLUSIONS: In men with NOA, the ICSI outcome is not affected by whether the retrieved testicular sperm is fresh or frozen. Sperm cryopreservation ought to be considered in every surgical sperm retrieval case, which remain feasible even in patients with few testicular sperm retrieved.

Traditional Chinese medicine (TCM), including acupuncture and Chinese herbs, is used as an alternative therapy to increase the curative effect for erectile dysfunction (ED). A large number of studies have been conducted to investigate the effect and mechanism of TCM for treating ED. The therapeutic effect of acupuncture on ED is still controversial at present. However, some Chinese herbs exhibited satisfying outcomes and they might improve erectile function by activating nitric oxide synthase (NOS)-cyclic guanosine monophosphate (cGMP) pathway, increasing cyclic adenosine monophosphate (cAMP) expression, elevating testosterone level, reducing intracellular Ca 2+ concentration, down-regulating transforming growth factor β1 (TGFβ1)/Smad2 signaling pathway, or ameliorating the oxidative stress.

The main purpose of this paper is to quantificationally predict the pathologic characteristics of pulmonary nodules using a novel and effective computer assisted diagnosis (CADx) scheme based on latent Dirichlet allocation (LDA) model. To make use of LDA model, we propose a novel 3D rotation invariant LBP feature to construct image words through the K-means algorithm from 3D pulmonary nodule slices. A topic distribution for each pulmonary nodule can be acquired by well-trained LDA model, which was used for pathologic analysis based on rank-based statistical analysis. Using the LIDC/IDRI database, this study made experiments based on different parameters, including topic number and size of vocabulary. Experiments demonstrate that the performance of all the characteristics reached to accuracies of more than 80%. Especially, this study obtained an accuracy of 84.2% with the root mean square error (RMSE) of 1.068 on quantitative assessment of malignancy likelihood. Compared with the latest study of multi-task convolutional neutral network regression, the proposed method can obtain more accurate results of characteristic prediction of a pulmonary nodule.

Diabetic retinopathy (DR) is one kind of eye disease that is caused by overtime diabetes. Lots of patients around the world suffered from DR which may bring about blindness. Early detection of DR is a rigid quest which can remind the DR patients to seek corresponding treatments in time. This paper presents an automatic image-level DR detection system using multiple well-trained deep learning models. Besides, several deep learning models are integrated using the Adaboost algorithm in order to reduce the bias of each single model. To explain the results of DR detection, this paper provides weighted class activation maps (CAMs) that can illustrate the suspected position of lesions. In the pre-processing stage, eight image transformation ways are also introduced to help augment the diversity of fundus images. Experiments demonstrate that the method proposed by this paper has stronger robustness and acquires more excellent performance than that of individual deep learning model.

Background: Recent evidence suggests the presence of hippocampal neuroanatomical abnormalities in subjects of amnestic mild cognitive impairment (aMCI). Our study aimed to identify the radiomic biomarkers of the hippocampus for building the classification models in aMCI diagnosis. Methods: For this target, we recruited 42 subjects with aMCI and 44 normal controls (NC). The right and left hippocampi were segmented for each subject using an efficient learning-based method. Then, the radiomic analysis was applied to calculate and select the radiomic features. Finally, two logistic regression models were built based on the selected features obtained from the right and left hippocampi. Results: There were 385 features derived after calculation, and four features remained after feature selection from each group of data. The area under the receiver operating characteristic (ROC) curve, specificity, sensitivity, positive predictive value, negative predictive value, precision, recall, and F-score of the classification evaluation index of the right hippocampus logistic regression model were 0.76, 0.71, 0.69, 0.69, 0.71, 0.69, 0.69, and 0.69, and those of the left hippocampus model were 0.79, 0.71, 0.54, 0.64, 0.63, 0.64, 0.54, and 0.58, respectively. Conclusion: Results demonstrate the potential hippocampal radiomic biomarkers are valid for the aMCI diagnosis. The MRI-based radiomic analysis, with further improvement and validation, can be used to identify patients with aMCI and guide the individual treatment.

Alzheimer’s disease (AD) is a neurodegenerative disease with main symptoms of chronic primary memory loss and cognitive impairment. The study aim was to investigate the correlation between intrahippocampal functional connectivity (FC) and MRI radiomic features in AD. A total of 67 AD patients and 44 normal controls (NCs) were enrolled in this study. Using the seed-based method of resting-state functional MRI (rs-fMRI), the whole-brain FC with bilateral hippocampus as seed was performed, and the FC values were extracted from the bilateral hippocampus. We observed that AD patients demonstrated disruptive FC in some brain regions in the left hippocampal functional network, including right gyrus rectus, right anterior cingulate and paracingulate gyri, bilateral precuneus, bilateral angular gyrus, and bilateral middle occipital gyrus. In addition, decreased FC was detected in some brain regions in the right hippocampal functional network, including bilateral anterior cingulate and paracingulate gyri, right dorsolateral superior frontal gyrus, and right precentral gyrus. Bilateral hippocampal radiomics features were calculated and selected using the A.K. software. Finally, Pearson’s correlation analyses were conducted between these selected features and the bilateral hippocampal FC values. The results suggested that two gray level run-length matrix (RLM) radiomic features and one gray level co-occurrence matrix (GLCM) radiomic feature weakly associated with FC values in the left hippocampus. However, there were no significant correlations between radiomic features and FC values in the right hippocampus. These findings present that the AD group showed abnormalities in the bilateral hippocampal functional network. This is a prospective study that revealed the weak correlation between the MRI radiomic features and the intrahippocampal FC in AD patients.

Macrophages play an important role in renal injury and repair after acute kidney injury (AKI) and the subsequent chronic kidney disease (CKD) that often results. However, as macrophages have a high degree of plasticity and heterogeneity, the function(s) of macrophage subtypes in AKI-to-CKD progression are not fully understood. Here, we focused on Ly6C− macrophages, which are derived from the embryonic yolk sac and post-development become resident in the kidneys. We found that C–C chemokine receptor type 2 (CCR2) deficiency, which blocks the migration of Ly6C+ macrophages from the bone marrow to the sites of injury, alleviated ischemia-induced AKI in mice. Unexpectedly, though, CCR2 deficiency worsened the subsequent renal fibrosis, which was marked by notable intra-renal infiltration of Ly6C− macrophages. These Ly6C− macrophages were greater in number in both the acute and chronic phases after ischemia reperfusion (I/R) in kidneys of wild type (WT) mice, and we showed them to be derived from the bone marrow by bone marrow chimerism. Clodronate Liposomes (CLs)-mediated depletion of renal Ly6C− macrophages in CCR2−/− mice or in WT mice after I/R alleviated the renal injury and fibrosis. On the contrary, adoptive transfer of Ly6C− macrophages from injured kidneys of WT mice into immune-deficient mice was sufficient to induce renal injury and fibrosis. Transcriptome sequencing of Ly6C− macrophages from injured kidneys revealed that they secreted various cytokines and growth factors, which were associated with the transdifferentiation of fibroblasts into myofibroblasts. This transdifferentiation effect was further supported by in vitro studies showing that Ly6C− macrophages induced the secretion of extracellular matrix proteins from co-cultured fibroblasts. In conclusion, the presence of bone marrow-derived Ly6C− macrophages after ischemia induces AKI and worsens subsequent CKD.

Accurate assessment of pulmonary nodules can help to diagnose the serious degree of lung cancer. In most computed aided diagnosis (CADx) systems, the feature extraction module plays quite an important role in classifying pulmonary nodules based on different attributes of them. To precisely evaluate the malignancy of an unknown pulmonary nodule, this paper first proposes a novel pixel value space statistics map (PVSSM) for pulmonary nodules classification. By means of PVSSM this study can transform an original two-dimensional (2D) or three-dimensional (3D) pulmonary nodule into a 2D feature matrix, which contributes to better classifying a pulmonary nodule. To validate the proposed method, this study assembled 5385 valid 3D nodules from 1006 cases in LIDC-IDRI database. This study extracts sets of features from the created feature matrixes by singular value decomposition (SVD) method. Using several popular classifiers including KNN, random forest and SVM, we acquire the classification accuracies of 77.29%, 80.07% and 84.21%, respectively. Moreover, this study also utilizes the convolutional neural network (CNN) to assess the malignancy of nodules and the sensitivity, specificity and area under the curve (AUC) reach up to 86.0%, 88.5% and 0.913, respectively. Experiments demonstrate that the PVSSM has a benefit for nodules classification.

Minimally invasive percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) are both alternatives for PCNL to treat renal calculi. This study is aimed at comparing the stone-free rate (SFR) and other surgery parameters of two approaches for treating upper urinary calculi. We performed this meta-analysis in September 2016 by searching studies about mini-PCNL and RIRS for treating upper urinary calculi in various databases, and RevMan v.5.3 was applied. Three randomized controlled trials and ten nonrandomized trials were included, involving a total of 1317 patients. Meta-analysis showed that mini-PCNL group led to a higher SFR [odds ratio: 1.96; 95% confidence interval: 1.46–2.64; P<0.00001] but brought a larger postoperative decrease in hemoglobin levels compared with RIRS. RIRS provided a shorter hospital time. There was no significant difference in operation time. Higher postoperative complications were detected in the mini-PCNL, but the difference was not significant. Grade I and III complications did not vary between two procedures, but grade II complications were of lower incidence in RIRS group. In the light of these results, compared with RIRS, mini-PCNL provided significantly higher SFR and efficiency quotient for managing calculi; however, it resulted in higher incidence of postoperative complications, larger hemoglobin drops, and longer hospital stay.

Millions of people around the world suffer from varying degrees of vision loss (including complete blindness) because of retinal degenerative diseases. Artificial retinal prosthesis, which is usually based on electrical neurostimulation, is the most advanced technology for different types of retinal degeneration. However, this technology involves placing a device into the eyeball, and such a highly invasive procedure is inevitably highly risk and expensive. Ultrasound has been demonstrated to be a promising technology for noninvasive neurostimulation, making it possible to stimulate the retina and induce action potentials similar to those elicited by light stimulation. However, the technology of ultrasound retinal stimulation still requires considerable developments before it could be applied clinically. This paper proposes a novel contact-lens array transducer for use in an ultrasound retinal prosthesis (USRP). The transducer was designed in the shape of a contact lens so as to facilitate acoustic coupling with the eye liquid. The key parameters of the ultrasound transducer were simulated, and results are presented that indicate the achievement of 2-D pattern generation and that the proposed contact-lens array is suitable for multiple-focus neurostimulation, and can be used in a USRP.

Lung cancer is still the most concerned disease around the world. Lung nodule generates in the pulmonary parenchyma which indicates the latent risk of lung cancer. Computer-aided pulmonary nodules detection system is necessary, which can reduce diagnosis time and decrease mortality of patients. In this study, we have proposed a new computer aided diagnosis (CAD) system for detection of early pulmonary nodule, which can help radiologists quickly locate suspected nodules and make judgments. This system consists of four main sections: pulmonary parenchyma segmentation, nodule candidate detection, features extraction (total 22 features) and nodule classification. The publicly available data set created by the Lung Image Database Consortium (LIDC) is used for training and testing. This study selects 6400 slices from 80 CT scans containing totally 978 nodules, which is labeled by four radiologists. Through a fast segmentation method proposed in this paper, pulmonary nodules including 888 true nodules and 11,379 false positive nodules are segmented. By means of an ensemble classifier, Random Forest (RF), this study acquires 93.2, 92.4, 94.8, 97.6% of accuracy, sensitivity, specificity, area under the curve (AUC), respectively. Compared with support vector machine (SVM) classifier, RF can reduce more false positive nodules and acquire larger AUC. With the help of this CAD system, radiologist can be provided with a great reference for pulmonary nodule diagnosis timely.

Cuff-less blood pressure (BP) measurement provides an efficient way to estimate blood pressure and thus prevent cardiovascular disease caused by hypertension. Pulse transit time (PTT) based BP estimation model has attracted much interests but with limited application. The measurement of PTT needs two photoplethysmographic (PPG) sensors or one electrocardiogram (ECG) sensor and one PPG sensor and thus restricted its widespread acceptance. In this study, a novel indicator, Photoplethysmography Acceleration Ratio (PAR), is extracted from the second-order derivative of PPG signal, which is validated as a significant parameter for estimating BP. 120 subjects, aged from 18 to 84, participated in this experiment. The results show that the correlation coefficient between PAR and systolic, diastolic and mean BP are 0.701, 0.331 and 0.629 respectively. Furthermore, the performance of accuracy and precision is good through correlation analysis. Therefore, the proposed PAR is demonstrated to be useful for SB measurement with only one sensor.

Objective The introduction of nerve-sparing radical prostatectomy represents a milestone in the treatment of prostate cancer. However, a certain percentage of cancer survivors still suffer from erectile dysfunction. Recent research has stated that using PDE 5-inhibitors after radical prostatectomy may lead to biochemical recurrence. This study was performed to identify the expression profile of small RNA in rats with neurogenic erectile dysfunction, and to investigate possible genes and signaling pathways involving in the disease. Methods Neurogenic erectile dysfunction (ED) was induced in male rats by bilateral cavernous nerve crushing injury (BCNI). After 28 days, erectile function was evaluated by cavernous nerve electrostimulation. Masson’s trichrome staining was performed to assess histologic changes. RNA was isolated from the corpus cavernosum (CC) of both control rats and neurogenic ED rats. Small RNA sequencing was conducted using an Illumina Hiseq 2,500/2,000 platform. Candidate small RNAs were validated by real-time polymerase chain reaction. Results Intracavernous pressure (ICP) was significantly decreased in BCNI group compared with SHAM group. Corporal tissue in the neurogenic ED rats showed a significantly lower smooth muscle/collagen ratio compared with tissue in the SHAM controls. Real time PCR validated that miR-9a-5p, miR-203a-5p, miR-378a-3p and miR-3557-5p were upregulated, and meanwhile miR-3084a-3p was downregulated. Conclusions Small RNA, including microRNA, may play an important role in the regulation of genes in CC and some certain miRs may participate in post-prostatectomy ED. Further studies will be designed to investigate the specific mechanisms of these changes.