基于改进Double-Head RCNN的无人机航拍图像小目标检测算法

为解决无人机航拍图像中小目标特征信息少且容易被噪声干扰导致现有算法漏检率和误检率高的问题,提出一种改进Double-Head Region-卷积神经网络(RCNN)的无人机航拍图像小目标检测算法。在骨干网络ResNet-50上引入Transformer和可变形卷积(DCN)模块,更有效提取小目标特征信息和语义信息;提出一种基于内容感知特征重组(CARAFE)的特征金字塔网络(FPN)结构模块,解决特征融合过程中小目标被背景噪声干扰而丢失特征信息的问题;在区域建议网络中针对小目标尺度分布特点重新设置Anchor生成尺度,进一步提升小目标检测性能。在VisDrone-DET2021数据集上的实验结果表明:所提算法能提取更具有表征能力的小目标特征信息和语义信息,对比Double-Head RCNN算法,所提算法的参数量增加了9.73×10^(6),FPS损失了0.6,但是AP、AP50和AP75分别提升了2.6%、6.2%和2.1%,APs提升了3.1%。

融合MacBERT和Talking⁃Heads Attention实体关系联合抽取模型

针对现有的医学文本关系抽取任务模型在训练过程中存在语义理解能力不足,可能导致关系抽取的效果不尽人意的问题,文中提出一种融合MacBERT和Talking⁃Heads Attention的实体关系联合抽取模型。该模型首先利用MacBERT语言模型来获取动态字向量表达,MacBERT作为改进的BERT模型,能够减少预训练和微调阶段之间的差异,从而提高模型的泛化能力;然后,将这些动态字向量表达输入到双向门控循环单元(BiGRU)中,以便提取文本的上下文特征。BiGRU是一种改进的循环神经网络(RNN),具有更好的长期依赖捕获能力。在获取文本上下文特征之后,使用Talking⁃Heads Attention来获取全局特征。Talking⁃Heads Attention是一种自注意力机制,可以捕获文本中不同位置之间的关系,从而提高关系抽取的准确性。实验结果表明,与实体关系联合抽取模型GRTE相比,该模型F1值提升1%,precision值提升0.4%,recall值提升1.5%。

Knowledge, Attitude, and Practice of Using Helmets in Children amongst Parents to Prevent Head Injuries: A Cross-Sectional Study in Riyadh, Saudi Arabia

Objectives: The primary objective was to characterize the range of Knowledge, Attitude, and Practice (KAP) of Helmet use in children amongst parents to prevent head injuries and death. Methods: This is a cross-sectional study, done by online survey using a snowball sampling technique, the number of included responses were 386 parents (Male and female) living in Riyadh Aged 21 - 60 years old or above. Results: The study showed that there is a difference in Parents’ belief in the importance of helmet use while riding a Bicycle vs Motorcycle/Quad bike and that was affected by parents’ education level, almost all the people who answered the survey (76.7%) agree that it is important for their children to wear a helmet when riding both a Bicycle and a Motorcycle or Quadbike with a cumulative percentage of (93.8%). And almost all agreed on multiple approaches to help increase helmet use be it by forcing rental shops to give out helmets, forcing sellers to recommend the use of helmets, increasing awareness campaigns, and imposing fines for not wearing helmets. Conclusions: This study is the first to explore Family helmet use while riding Bicycles and Motorcycles/Quad bikes. Although Parent’s belief in the importance of helmet use for their children was high, it is clear that the level of practice is low. With that the risk of head injuries might be high, our findings suggest that safety interventions for increasing pediatric helmet use are needed to increase helmet use and reduce the risk of head injury and hospitalization.

Bilateral Avascular Necrosis of the Femoral Head in Renal Transplant Recipient: A Case Report

Osteoarticular complications are common after renal transplantation. The complications may result from the bone condition prior to transplantation or the iatrogenic effects of the treatments administered. These complications lead to significant morbidity and mortality, in addition to chronic pain and functional impairment. We report the clinical case of bilateral avascular necrosis (AVN) of the femoral head in a kidney transplant recipient. Clinical Case: 53-year-old male with a history of chronic hypertension. He underwent chronic hemodialysis for 12 months and was treated with Entecavir for chronic hepatitis B. The patient received a kidney transplant from a non-related living donor. Induction therapy included Thymoglobulin along with tapered corticosteroids, reaching a dose of 5 mg/day after 3 months, Mycophenolate mofetil (2 g/day), and Tacrolimus adjusted based on residual levels. There was good recovery of renal graft function. After six months, the patient reported bilateral hip pain and functional impairment of both lower limbs. Pelvic X-rays showed signs suggestive of bilateral AVN of the femoral heads. The diagnosis was confirmed by MRI. The patient underwent right hip drilling and total left hip replacement (THR). A right THR was performed a year later. Conclusion: AVN constitutes a frequent cause of morbidity and mortality after RT. The pathophysiology of osteonecrosis remains complex and multifactorial. We emphasize the importance of conducting a thorough assessment of bone health in patients both before and after RT.

Surgical Treatment of Osteonecrosis of the Femoral Head Using Minimally Invasive Surgical Drilling and Cancellous Grafting at Brazzaville University Hospital

Introduction: Osteonecrosis of the femoral head (ONTF) is a debilitating condition. Several treatments have been proposed with controversial results. The aim of our study was to evaluate treatment by surgical drilling coupled with in situ cancellous grafting. Materials and methods: Our study was a case-control study conducted at Brazzaville University Hospital from 1st January 2018 to 31 December 2023. It compared two groups of patients with ONTF: non-operated (13 patients, 20 hips) and operated (22 patients, 35 hips). We used the visual digital scale (VDS) for pain assessment, the Merle D’Aubigne-Postel (MDP) scoring system for clinical and functional assessment, and the evolution of necrosis. Results: The group of non-operated patients had a mean age of 35.69 ± 3.4 years, no improvement in pain with an EVN above seven at the last recoil and a mean global MDP score falling from 12.7 before offloading to 10.13 at one year. The group of patients operated on had a mean age of 37.86 ± 7.02 years, a significant reduction in pain (p = 0.00004) and a significantly increased MDP score (p = 0.0034). A comparison of the two groups of patients showed significant stabilization of the necrotic lesions in the operated patients (p = 0.00067), with better satisfaction in the same group. Conclusion: Surgical drilling combined with grafting in the treatment of early-stage ONTF has improved progress in our series. The technique is reproducible and less invasive. It has made it possible to delay unfavorable progression and, consequently, hip replacement surgery.

Loggerhead Sea Turtles Hand-Reared in Captivity: Isotopic Insights into Their Inherent Dietary Variation

Stable isotope analysis is a widely used method for gathering ecological insights into the diet and feeding habitats of various species. While captive studies often limit lethal sampling and differ from wild conditions, they offer valuable insights into inherent isotopic variations among individuals, which are often assumed to reflect differences between natural populations. In the Sea Turtle Conservation Program, loggerhead turtle hatchlings from different nests were fed. Necropsies were conducted on turtles that died during this period, obtaining bone fragments for analysis. We evaluated the isotopic variation of carbon (δ13C) and nitrogen (δ15N) in bone tissue across six turtle nests (n = 66 samples) and assessed differences in Straight Carapace Length (SCL, n = 71 samples). Using SIBER and nicheROVER in R, we calculated niche width and overlap, while the simmr package determined primary prey assimilation. Despite feeding the hatchlings the same prey, we observed variations in nitrogen isotope assimilation between nests. Nests 4 and 6 had a niche width >1.8‰, indicating consistent consumption frequencies across all prey and >70% niche overlap with other nests. In contrast, nests 1 and 2 showed a narrower niche width (Mugil sp. constituted the primary diet component (>40%) across all groups. This study demonstrates how factors like competition or prey preference can influence the assimilation of diet, even when the source remains constant (inherent variation).

Fetal Head Compression: Its Possible Role in Neurologic Injury

It is widely assumed that fetal ischemic brain injury during labor derives almost exclusively from severe, systemic hypoxemia with marked neonatal depression and acidemia. Severe asphyxia, however, is one of several causes of perinatal neurological injury and may not be the most common;most neonates diagnosed with hypoxic-ischemic encephalopathy do not have evidence of severe asphyxia. Sepsis, direct brain trauma, and drug or toxin exposure account for some cases, while mechanical forces of labor and delivery that increase fetal intracranial pressure sufficiently to impair brain perfusion may also contribute. Because of bony compliance and mobile suture lines, the fetal skull changes shape and redistributes cerebrospinal fluid during labor according to constraints imposed by contractions, and bony and soft tissue elements of the birth canal as the head descends. These accommodations, including the increase in intracranial pressure, are adaptive and necessary for efficient descent of the head while safeguarding cerebral blood flow. Autonomic reflexes mediated through central receptors normally provide ample protection of the brain from the considerable pressure exerted on the skull. On occasion, those forces, which are transmitted intracranially, may overcome the various adaptive anatomical, cardiovascular, metabolic, and neurological mechanisms that maintain cerebral perfusion and oxygen availability, resulting in ischemic brain injury. Accepting the notion of a potentially adverse impact of fetal head compression suggests that avoidance of excessive uterine activity and of relentless pushing without steady progress in descent may offer protection for the fetal brain during parturition. Excessive head compression should be considered in the differential diagnosis of ischemic encephalopathy.

Effect of Mouth Opening Training Stick Combined with Oral Massage on Mouth Opening Difficulty in Head and Neck Cancer Patients after Treatment

Objective: To study the application effect of mouth-opening training sticks combined with oral massage on patients with mouth-opening difficulty after treatment for head and neck cancer. Methods: Using convenient sampling, 60 patients with mouth-opening difficulty after treatment for head and neck cancer admitted to the Oncology Department from February 2022 to October 2023 were selected for a 2-week exercise and nursing program. The patients were divided into a control group (February 1, 2022 to November 30, 2022) and an observation group (December 1, 2022 to October 31, 2023), with 30 patients in each group. The control group underwent routine mouth-opening functional exercises combined with cork for oral support training, while the observation group underwent routine mouth-opening functional exercises combined with oral massage and mouth-opening training sticks for oral support training. The mouth-opening degree, mouth-opening difficulty level, comfort level, compliance, and quality of life were observed in both groups. Results: Before the intervention, there were no statistically significant differences in mouth-opening degree and mouth-opening difficulty level between the two groups (P > 0.05). After the intervention, the mouth-opening degree, mouth-opening difficulty level, oral comfort level, compliance, and QLICP-HN scores in the observation group were all better than those in the control group, with statistically significant differences (P < 0.05). Conclusion: The combination of mouth-opening training sticks and oral massage with mouth-opening functional exercises can effectively improve the degree of mouth-opening difficulty, enhance oral comfort, increase compliance with mouth-opening exercises, and improve quality of life.

Epidemiology and Histopathology of Cancers of the Upper Aerodigestive Tract in the ENT and Head and Neck Surgery Department of the Ignace Deen National Hospital

Introduction: Head and neck cancers represent a significant burden of cancer, collectively ranking fourth for cancer incidence and second for cancer mortality worldwide. Objective: To study the epidemiological and histopathological aspects of head and neck cancers in the ENT-CCF department of Ignace Deen National Hospital. Materials and Methods: This was a descriptive retrospective study covering a period of 5 years from September 1, 2016, to September 30, 2021. Results: We collected 43 cases of head and neck cancers, representing a hospital frequency of 1.85%. The mean age was 45.21 ± 13.23 years. Males predominated, accounting for 65.12%, compared to 34.88% for females, with a male-to-female ratio of 1.87. Housewives accounted for 27.90%, followed by farmers at 23.26% and traders/merchants at 18.60%, with 41.86% being uneducated. The main risk factors were tobacco (37.21%) and alcohol (34.88%). Pain (53.49%), dysphonia (51.16%), and dyspnea (39.53%) were the main presenting symptoms. Squamous cell carcinoma (74.42%) and large cell lymphoma (18.60%) were the most commonly cited histological types. Conclusion: Head and neck cancers remain relatively common in our country. Improving prognosis depends on early diagnosis of the condition, resuscitation resources, and prompt management.

Multi-Head Attention Spatial-Temporal Graph Neural Networks for Traffic Forecasting

Accurate traffic prediction is crucial for an intelligent traffic system (ITS). However, the excessive non-linearity and complexity of the spatial-temporal correlation in traffic flow severely limit the prediction accuracy of most existing models, which simply stack temporal and spatial modules and fail to capture spatial-temporal features effectively. To improve the prediction accuracy, a multi-head attention spatial-temporal graph neural network (MSTNet) is proposed in this paper. First, the traffic data is decomposed into unique time spans that conform to positive rules, and valuable traffic node attributes are mined through an adaptive graph structure. Second, time and spatial features are captured using a multi-head attention spatial-temporal module. Finally, a multi-step prediction module is used to achieve future traffic condition prediction. Numerical experiments were conducted on an open-source dataset, and the results demonstrate that MSTNet performs well in spatial-temporal feature extraction and achieves more positive forecasting results than the baseline methods.

基于病因和国际骨微循环研究协会分期的股骨头坏死患者骨代谢水平研究

背景:目前缺乏大样本研究对不同病因、分期的股骨头坏死患者的骨代谢水平进行分析,这不利于制定更优的促坏死修复策略。目的:研究不同病因、国际骨微循环研究协会(ARCO)分期股骨头坏死患者的骨代谢水平。方法:回顾性纳入股骨头坏死的患者401例作为试验组,81例健康体检者作为对照组。试验组按照病因不同分为激素性股骨头坏死、酒精性股骨头坏死和创伤性股骨头坏死3组,并按ARCO分期的不同分为Ⅱ期/Ⅲ期/Ⅳ期。收集所有受试者的7项骨代谢相关指标,包括骨代谢调控激素25-羟基维生素D,骨转换标志物Ⅰ型前胶原N末端前肽、β-胶原降解产物、骨钙素N端中分子片段,骨代谢一般生化标记血清Ca、P、碱性磷酸酶。比较各组受试者的骨代谢水平,并应用二元Logistic回归分析与股骨头坏死发病相关的独立因素。结果与结论:①与对照组比较,试验组患者的β-胶原降解产物、Ⅰ型前胶原N末端前肽、骨钙素N端中分子片段、血清P、碱性磷酸酶水平均显著升高(均P<0.05);②以是否发病为结局,应用二元Logistic回归分析得出β-胶原降解产物、Ⅰ型前胶原N末端前肽、骨钙素N端中分子片段是与股骨头坏死发病相关的独立因素;③不同病因3组患者的β-胶原降解产物、Ⅰ型前胶原N末端前肽水平均高于正常参考值;酒精性股骨头坏死组患者的25-羟基维生素D、血清Ca水平均高于其他2组(P<0.05);激素性股骨头坏死、创伤性股骨头坏死组患者的25-羟基维生素D水平均低于正常值;④ARCOⅡ、Ⅲ、Ⅳ期股骨头坏死患者的7项骨代谢指标水平比较差异均无显著性意义(均P>0.05),但3组患者的β-胶原降解产物、Ⅰ型前胶原N末端前肽均高于正常参考值;ARCOⅡ期、Ⅳ期患者的25-羟基维生素D低于正常参考值;⑤结论:股骨头坏死患者的骨代谢水平异常,不同病因、ARCO分期的股骨头坏死患者的β-胶原降解产物、Ⅰ型前胶原N末端前肽均高于正常参考值,处于高骨转换状态;β-胶原降解产物、Ⅰ型前胶原N末端前肽、骨钙素N端中分子片段可能是股骨头坏死发病的危险因素。

股骨颈骨折空心钉内固定后股骨近端骨质疏松的有限元分析

背景:股骨颈骨折空心钉内固定术后由于患肢短期内常常不能负重,且高刚度的内植物对骨折断端存在应力遮挡效应,易导致患肢出现骨质疏松,股骨近端生物力学分布发生变化,术后股骨头坏死发病率较高,目前关于股骨颈骨折术后股骨近端骨质疏松对股骨近端及空心钉生物力学影响的研究较少。目的:通过有限元分析探讨股骨颈骨折术后发生骨质疏松对空心钉内固定治疗的生物力学影响,探究生物力学因素在股骨头坏死进程中的作用。方法:获取1例股骨颈骨折患者股骨CT扫描数据,利用Mimics 19.0、3-Matic、UG 11.0、Hypermesh 14.0、Abaqus软件建立空心钉治疗股骨颈骨折的股骨近端模型,利用Abaqus软件分析1种术后股骨近端无骨质疏松、3种术后股骨近端骨质疏松的有限元模型,测量分析4种模型不同部件的应力、接触压力、位移峰值及云图,对比分析股骨头内部应力变化及分布情况。结果与结论:股骨头及下前空心钉的应力、接触压力随骨质疏松程度变化较大,4种模型的位移峰值随着骨质疏松程度加重而缓慢增长。通过单因素方差分析,结果显示骨质疏松程度对不同部件的应力、接触压力、位移峰值无显著性影响,股骨头内部应力分布随骨质疏松发生相应变化,股骨近端的生物力学环境变化对股骨头坏死有着重要影响。

全球心血管疾病学术影响力评价(CAPE)体系的方法探索

目的:构建全球心血管疾病学术影响力评价(Cardiovascular Academic Performance Evaluation,CAPE)体系,并对全球医疗机构心血管疾病学术影响力进行排名。方法:由心血管疾病领域人员和图书情报人员提取医学主题词表(MeSH)、Embase同义词表、国际疾病分类(ICD)中心血管疾病相关术语,建立心血管术语词表(即阜外词表),设定缺血性心脏病、高血压、血管疾病、心律失常、肺血管疾病、心力衰竭、先天性心脏病、心肌病和瓣膜性心脏病等9个亚学科,实现亚学科分类、心血管术语词、入口词的映射。检索Web of Science、PubMed、Scopus数据库2016年1月1日至2022年12月31日的心血管领域论文,并对元数据进行去重融合;应用阜外词表对论文中主题词、题目、关键词、摘要等4个位置的内容进行检索匹配,生成论文“位置-心血管术语词-频次”的信息表,计算每一篇论文心血管学科相关度积分及亚学科积分。对论文的机构名、学者名进行规范化清洗,基于心血管强相关(相关度积分≥4分)原创性论文开展全球心血管疾病领域学术影响力的评价。针对全国医疗机构(心血管)的科技评价,还采集了国家自然科学基金项目、授权发明专利、获奖成果、科研平台、注册试验[国家药品监督管理局药品审评中心(CDE)药物临床试验登记数据]等数据。结果:检索到全球2016~2022年心血管领域论文1545103篇,剔除摘要、书籍、传记、新闻、视频、音频、撤稿、更正声明后为1178019篇,使用阜外词表标引“心血管强相关”论文518058篇。还采集到11143项心血管相关国家自然科学基金项目、19382项心血管相关有效授权发明专利、103项心血管相关国家级获奖成果、24个心血管相关国家科研平台、2084项CDE心血管相关药物临床试验登记等数据。经组织心血管疾病及其亚学科专家团队针对各自亚学科论文进行核对和验证,改进学科分类规则,最终锁定11项指标构建了心血管疾病和9个亚学科领域的综合评价指标体系。2016~2022年,中国发表心血管疾病研究论文数量增幅为123.5%,共发表约7.68万篇,平均每天约30篇,仅次于美国(约11.41万篇),居世界第二位。但中国期刊引证报告(JCR)分区和中国科学院分区论文占比仅居世界第八位。在2020~2022年全球医疗机构心血管原创研究论文影响力综合评估中,仅2家中国医疗机构进入前20名。结论:CAPE项目基于2016~2022年多源数据基础,首次探索建立了心血管领域机构学术影响力综合评价指标体系。

当归不同药用部位的化学成分及药理作用研究进展

当归作为“分根梢”理论的代表药材,其以不同药用部位分别入药起源于唐代,形成于金元,兴盛于明清;经历代医家临床实践总结,逐渐确立了归头止血、归身补血、归尾活血的作用功效。现代研究表明,当归中含有当归多糖、挥发油、有机酸、无机盐等药效部位及阿魏酸、绿原酸、欧前胡素、藁本内酯等药效成分;在当归头、当归身及当归尾等不同药用部位中,上述药效物质基础的种类分布均匀、区别不大,但含量及相关比例差异明显;多数学者认为,含量、比例差异可能是导致当归不同药用部位存在较大药理作用差异的主要原因。通过对相关文献的检索,梳理和总结近年来国内外对当归不同药用部位中药效物质基础分布情况及相关药理作用的研究,从当归不同药用部位中药效物质基础的种类分布和含量差异两个方面综合分析,并结合相关药效物质基础对应的药理作用研究,找寻当归不同药用部位间存在的“成分-效用”关系,以期为历代医家将当归按当归头、当归身、当归尾分别入药提供更强有力的佐证,同时为当归提出进一步研究的主要方向和思路。

头颈肿瘤围术期静脉血栓栓塞症防治中国专家共识

静脉血栓栓塞症(venous thromboembolism, VTE)是外科术后常见并发症和医院内非预期死亡的重要危险因素,也是恶性肿瘤患者的第二大死亡原因。晚期头颈部恶性肿瘤患者通常需要接受大范围的肿瘤根治手术和同期修复重建手术,又由于高龄兼长时间手术、术后长时间卧床以及肿瘤和化疗药物导致的血液高凝状态等多种危险因素,提示头颈部恶性肿瘤患者应是VTE的极高危群体,但相关文献对头颈部恶性肿瘤患者的VTE发生情况却很少关注,有关VTE在头颈肿瘤术后发生率的数据也有限。迄今为止,国内对于头颈肿瘤围术期静脉血栓栓塞症缺乏相关治疗共识或指南,不同单位对于头颈肿瘤围术期静脉血栓栓塞症的预防与管理水平参差不齐,缺乏统一、科学的诊疗标准及客观的预防与管理评价体系。为统一和规范头颈肿瘤围术期静脉血栓栓塞症的诊治,减少医疗资源浪费,提高治疗效果,国内该研究领域的专家经反复讨论,汇集全国14家著名医学院校及附属医院专家的诊治意见,同时借鉴和参考国内外近年来对头颈肿瘤围术期静脉血栓栓塞症的研究成果与诊治经验,制订本专家共识,供相关临床医师参考。

小转子重建人工股骨头置换治疗高龄Evans-Ⅲ型股骨转子间骨折

背景:人工股骨头置换是治疗高龄不稳定性股骨转子间骨折的有效方法,但是对于Evans-Ⅲ型股骨转子间骨折,人工股骨头置换术中同期行小转子重建与否对治疗效果的影响未见报道。目的:分析小转子重建对高龄Evans-Ⅲ型股骨转子间骨折患者长柄人工股骨头置换治疗效果的影响。方法:回顾性分析西安交通大学第二附属医院骨关节外科2017年6月至2021年5月因Evans-Ⅲ型股骨转子间骨折行双极长柄人工股骨头置换的45例高龄患者的病历资料,根据术中小转子是否重建(复位并固定)分为2组,小转子重建组25例,小转子非重建组20例。比较两组患者的手术时间、出血量、下床时间、住院时间、术后3,6个月的Harris评分以及随访期内的并发症发生情况。结果与结论:①小转子重建组需要的手术时间(99.72±13.41)min较非重建组(88.90±16.53)min更长(t=2.369,P=0.023),二者在出血量、下床时间和住院时间方面差异无显著性意义(P>0.05);②术后3个月时,重建组的Harris评分(69.06±5.64)分高于非重建组(63.35±5.93)分(t=2.982,P=0.005);术后6个月时,重建组的Harris评分(86.67±4.49)分也高于非重建组(82.34±5.68)分(t=2.782,P=0.009);③此外重建组和非重建组在随访期内的并发症发生率未见显著差异(χ2=0.008,P=0.927);④提示对于高龄Evans-Ⅲ型股骨转子间骨折患者,在人工股骨头置换过程中行小转子重建虽然延长了手术时间,但是明显改善了患者术后早期的髋关节功能,初步说明小转子重建在高龄Evans-Ⅲ型转子间骨折人工股骨头置换过程中的重要性。

基于CED-YOLOv5s模型的煤矸识别方法研究

由于煤矿井下高噪声、低照度、运动模糊的复杂工况和煤矸易聚集现象,导致煤矸目标检测模型特征提取困难及煤矸分类、定位不准确问题。针对该问题,提出一种基于CED-YOLOv5s模型的煤矸识别方法。首先,在YOLOv5s主干网络中引入坐标注意力(CA)机制,通过将坐标信息嵌入信道关系和长程依赖关系中对特征图进行编码,充分利用通道注意力信息和空间注意力信息,使模型更加关注重要特征,抑制无用信息。其次,在YOLOv5s的检测头部引入EIoU回归损失函数,将目标框与锚框的宽高差异最小化,以增强目标的位置和边界信息,提高模型在密集目标下的定位精度和收敛速度;最后,在YOLOv5s的检测头部引入轻量化解耦头,解耦出单独的特征通道,分别用于分类任务和回归任务,解决了原模型中耦合头部分类任务与回归任务的相互干扰问题,进一步提升了模型的并行运算效率与检测精度。实验结果表明:CED-YOLOv5s模型与其他YOLO系列目标检测模型相比,综合性能最佳,平均检测精度达94.8%,相较于YOLOv5s模型提升了3.1%,检测速度达84.8帧/s,可充分满足煤矿井下煤矸实时检测需求。

HEAD-US-C对血友病A患者临床分型的评估意义

目的探讨我国优化的血友病关节超声评估量表(HEAD-US-C)对血友病A(HA)患者临床分型的评估意义。方法130例HA男性患者根据血浆凝血因子Ⅷ(FⅧ)活性分为轻型(n=39)、中间型(n=31)及重型组(n=60),收集3组患者的临床资料,采用二维超声检查3组患者双侧踝关节、肘关节及膝关节的渗出、纤维隔膜、滑膜厚度、含铁血黄素沉积、软骨改变、骨侵蚀、骨赘及骨重建情况并进行HEAD-US-C评分,采用彩色多普勒超声检查3组患者关节滑膜增厚伴血管增生情况进行HEAD-US-C评分,采用Spearman相关分析HA患者HEAD-US-C各评价指标与总评分及FⅧ因子活性的相关性。结果不同分型HA患者膝关节的滑膜厚度检出率为75.8%、骨软骨改变检出率67.3%、滑膜增厚伴血管增生检出率为69.6%,踝关节滑膜增厚检出率为58.3%;不同分型的HA患者超声评价指标中,膝踝关节滑膜厚度、含铁血黄素沉积、滑膜增厚伴血管增生、膝关节的骨软骨改变及肘关节的含铁血黄素沉积,差异有统计意义(P<0.05);HEAD-US-C各评价指标与总评分呈正相关性,其中检出率较高的滑膜厚度、骨软骨改变及滑膜增厚伴血管增生与总评分的相关性较高(P<0.05);HEAD-US-C各评价指标与FⅧ因子活性呈负相关,其中膝关节的滑膜厚度、骨软骨改变及滑膜增厚伴血管增生与FⅧ因子活性的相关性较高(P<0.05)。结论HEAD-US-C评价指标中滑膜厚度、骨软骨改变及滑膜血管增生对HA患者临床分型的评估意义更大,评分越高,关节破坏越严重。

Esophagogastric Reconstruction in Cobra-Head Shape with Toupet-Like Partial Anti-Reflux Technique for Resection of Proximal Gastric Tumors. Experience with Three Cases from a Non-Asian Population

Background: Proximal gastrectomy is a rarely performed procedure but a feasible option in benign tumors and malignant neoplasms in the proximal third of the stomach since novel options of reconstructions are available nowadays with fewer long-term sequels. Methods: Report of three cases of proximal gastric gastrointestinal stromal tumors (GIST), with a description of its presentation, histological characteristics, and follow-up after being treated with proximal gastrectomy with cobra head reconstruction. Results: Case 1: A 62-year-old woman with epigastric pain of four months with endoscopic evidence of a cardia GIST. The surgery was performed without complications. The histopathological report confirmed a fusiform GIST of 3.2 × 3 × 2.5 cm, stage IA. No adjuvant treatment was considered. An esophagogram showed no evidence of reflux and no stenosis, and no disease recurrence after 40-months follow-up. Case 2: A 66-year-old woman with dyspepsia and a palpable tumor in the epigastrium. The surgery was performed without complications. The pathology report confirmed a proximal gastric GIST of 13 × 8 × 7 cm, staged II. She received adjuvant treatment with imatinib for 36 months without recurrence and no reflux or stenosis. Case 3: A 55-year-old woman with intermittent hematemesis and right subscapular pain. The surgery was performed without complications. The histopathological report concluded that a GIST tumor of the cardia, 1.4 × 1.2 cm, staged IA. She was left in observation. At a 6-month follow-up, she does not report dysphagia, reflux, or stenosis, and no locoregional recurrence. Conclusions: Open and laparoscopic proximal gastrectomy is a safe therapeutic option for GIST. Furthermore, the reconstruction of the esophagus-gastro anastomosis in the cobra head after proximal gastrectomy is feasible and secure in our population, with good functional results in a short follow-up.

Research Progress in Surgical Management of Head and Neck Tumors Involving the Carotid Artery

The surgeons adopt the comprehensive treatment method basing on surgery When head and neck tumors involve the carotid artery. At present, there are four surgical treatments, namely, dissection of carotid artery tumor, resection of carotid artery, revascularization after carotid resection, endoarterial implantation of covered stent combined with surgical resection. However, there is currently no consensus on the standard surgical approach to choose. This paper describes the four surgical methods, which are expected to be helpful for head and neck surgeons to choose the surgical methods for head and neck tumors involving the carotid artery.