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IntroductionRetinal diseases significantly impact patients’ quality of life and increase social medical costs. Optical coherence tomography (OCT) offers high-resolution imaging for precise detection and monitoring of these conditions. While deep learning techniques have been employed to extract features from OCT images for classification, convolutional neural networks (CNNs) often fail to capture global context due to their focus on local receptive fields. Transformer-based methods, on the other hand, suffer from quadratic complexity when handling long-range dependencies.MethodsTo overcome these limitations, we introduce the Multi-Resolution Visual Mamba (MRVM) model, which addresses long-range dependencies with linear computational complexity for OCT image classification. The MRVM model initially employs convolution to extract local features and subsequently utilizes the retinal Mamba to capture global dependencies. By integrating multi-scale global features, the MRVM enhances classification accuracy and overall performance. Additionally, the multi-directional selection mechanism (MSM) within the retinal Mamba improves feature extraction by concentrating on various directions, thereby better capturing complex, orientation-specific retinal patterns.ResultsExperimental results demonstrate that the MRVM model excels in differentiating retinal images with various lesions, achieving superior detection accuracy compared to traditional methods, with overall accuracies of 98.98\% and 96.21\% on two public datasets, respectively.DiscussionThis approach offers a novel perspective for accurately identifying retinal diseases and could contribute to the development of more robust artificial intelligence algorithms and recognition systems for medical image-assisted diagnosis.

It is critical to develop the methods and technologies of studying the species and concentration in the processing of adsorption, and diffusion of some important radionuclides in spent fuel waste processing such as Beishan granites in domestic institutions and universities for the geological disposal of high-level radioactive wastes. Enrich the models used or constructed and the calculation procedures developed in the past two decades in this field. In order to evaluate the safety of the repository, chemical speciation analysis of nuclides is the premise of research to accurately predict the migration behavior of nuclides. In view of the rapid development of China's nuclear energy industry and the need to establish the identification of nuclides in the environment, it is of great significance to carry out the study of the chemical forms of nuclides around the repository in China. Aiming at the research requirements of element speciation distribution in the environment, a set of B/S architecture element speciation distribution simulation software is developed with JAVA as the development tool, MySQL as the database, and Tomcat as the container. In order to solve the convergence problem of chemical reaction equilibrium nonlinear equations encountered in simulation calculation, the method based on chemical reaction potential energy is introduced to solve the chemical reaction nonlinear equations quickly, and the multi-phase equilibrium calculation can be expanded. SSCS was used to study the species of U in groundwater and the effects of Eh, pH, different ions and concentrations. The calculation results indicate that neptunium mainly exists as NpO2CO-3(aq) in groundwater. Under strong acidic conditions, neptunium maily exists as NpO+2(aq), while in weak acidic, neutral or weak alkaline conditions, the main species are NpO+2(aq) and NpO2OH.When the solution is in strong alkaline conditions, the species are complicated most of neptunium exists as NpO2(CO3)-3(aq), with the possible generation of NpO2(CO3)3-2 or NpO2(CO3)5-3. Np(Ⅴ) is stable in the reduction condition, while Np(Ⅳ) and Np(Ⅵ) are the possible generation. Comparing the neptunium calculation results of the software in the environment with the PHREEQC calculation results, the relative error is within 10 %. For the distribution of trace elements in the environment, a theoretical calculation solution is provided.

Abstract Objectives Spinocerebellar ataxia type 3 is a disorder within the brain network. However, the relationship between the brain network and disease severity is still unclear. This study aims to investigate changes in the white matter (WM) structural motor network, both in preclinical and ataxic stages, and its relationship with disease severity. Methods For this study, 20 ataxic, 20 preclinical SCA3 patients, and 20 healthy controls were recruited and received MRI scans. Disease severity was quantified using the SARA and ICARS scores. The WM motor structural network was created using probabilistic fiber tracking and was analyzed using graph theory and network‐based statistics at global, nodal, and edge levels. In addition, the correlations between network topological measures and disease duration or clinical scores were analyzed. Results Preclinical patients showed increasing assortativity of the motor network, altered subnetwork including 12 edges of 11 nodes, and 5 brain regions presenting reduced nodal strength. In ataxic patients assortativity of the motor network also increased, but global efficiency, global strength, and transitivity decreased. Ataxic patients showed a wider altered subnetwork and a higher number of reduced nodal strengths. A negative correlation between the transitivity of the motor network and SARA and ICARS scores was observed in ataxic patients. Interpretation Changes to the WM motor network in SCA3 start before ataxia onset, and WM motor network involvement increases with disease progression. Global network topological measures of the WM motor network appear to be a promising image biomarker for disease severity. This study provides new insights into the pathophysiology of disease in SCA3/MJD.

Abstract To investigate if deep-sedated colonoscopy affects adenoma detection in certain colorectal segment. Review of colonoscopy reports, electronic images and medical records of individuals underwent screening colonoscopy with or without propofol sedation between October 2020 and March 2021 from seven hospitals in China. A total of 4500 individuals were analyzed. There was no significant difference in ADR between deep-sedated colonoscopy and unsedated colonoscopy [45.4% vs. 46.3%, P > 0.05]. The APP of deep-sedated colonoscopy was lower than unsedated colonoscopy (1.76 ± 0.81 vs. 2.00 ± 1.30, P

BackgroundBabao Dan (BBD) is a traditional Chinese medicine that has been widely used as a complementary and alternative medicine to treat chronic liver diseases. In this study, we aimed to observe the effect of BBD on the incidence of diethylnitrosamine (DEN)-initiated hepatocellular carcinoma formation in rats and explored its possible mechanism.MethodsTo verify this hypothesis, BBD was administrated to rats at a dose of 0.5g/kg body weight per two days from the 9th to 12th week in HCC-induced by DEN. Liver injury biomarkers and hepatic inflammatory parameters were evaluated by histopathology as well as serum and hepatic content analysis. We applied immunohistochemical analysis to investigate the expression of CK-19 and SOX-9 in liver tissues. The expression of TLR4 was determined by immunohistochemical, RT-PCR, and western blot analysis. Furthermore, we also detected the efficacy of BBD against primary HPCs neoplastic transformation induced by LPS.ResultsWe observed that DEN could induce hepatocarcinogenesis, and BBD could obviously decrease the incidence. The biochemical and histopathological examination results confirmed that BBD could protect against liver injury and decrease inflammatory infiltration. Immunohistochemistry staining results showed that BBD could effectively inhibit the ductal reaction and the expression of TLR4. The results showed that BBD-serumcould obviously inhibit primary HPCs neoplastic transformation induced by regulating the TLR4/Ras/ERK signaling pathway.ConclusionIn summary, our results indicate that BBD has potential applications in the prevention and treatment of HCC, which may be related to its effect on hepatic progenitor cells malignant transformation via inhibiting the TLR4/Ras/ERK signaling pathway.

Background: Obstructive sleep apnea (OSA) is common in surgical patients and associated with worse perioperative outcomes. Objectives: To investigate the effect of mini-dose dexmedetomidine supplemented analgesia on postoperative sleep quality pattern in patients at high risk of OSA. Design: A pilot randomized, double-blind, placebo-controlled trial. Setting: A tertiary university hospital in Beijing, China. Patients: One hundred and fifty-two adult patients who had a STOP-Bang score ≥3 and a serum bicarbonate level ≥28  mmol/L and were scheduled for major noncardiac surgery between 29 January 2021 and 20 September 2022. Intervention: After surgery, patients were provided with high-flow nasal cannula and randomized in a 1:1 ratio to receive self-controlled opioid analgesia supplemented with either mini-dose dexmedetomidine (median 0.02  μg/kg/h) or placebo. We monitored polysomnogram from 9:00  pm to 6:00  am during the first night. Main outcome measures: Our primary outcome was the percentage of stage 2 non-rapid eye movement (N2) sleep. Secondary and exploratory outcomes included other postoperative sleep structure parameters, sleep-respiratory parameters, and subjective sleep quality (Richards-Campbell Sleep Questionnaire; 0–100 score range, higher score better). Results: All 152 patients were included in intention-to-treat analysis; 123 patients were included in sleep structure analysis. Mini-dose dexmedetomidine supplemented analgesia increased the percentage of stage N2 sleep (median difference, 10%; 95% CI, 1 to 21%; p  =  0.029); it also decreased the percentage of stage N1 sleep (median difference, −10%; 95% CI, −20% to −1%; p  =  0.042). Other sleep structure and sleep-respiratory parameters did not differ significantly between the two groups. Subjective sleep quality was slightly improved with dexmedetomidine on the night of surgery, but not statistically significant (median difference, 6; 95% CI, 0 to 13; p  =  0.060). Adverse events were similar between groups. Conclusion: Among patients at high risk of OSA who underwent noncardiac surgery, mini-dose dexmedetomidine supplemented analgesia may improve sleep quality without increasing adverse events. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease (COPD) can be prevented and treated, although presenting with persistent airflow restriction; the airflow restriction caused by COPD is mostly progressive. In recent years, more attention has been paid to the home-based pulmonary rehabilitation (PR) and its influence on COPD. Exercise training is the basic constituent of PR. However, it is not clear which exercise trainings are the ideal ways to deliver home-based PR.