Performance of common imaging techniques vs serum biomarkers in assessing fibrosis in patients with chronic hepatitis B: A systematic review and meta-analysis

BACKGROUND Noninvasive biomarkers have been developed to predict hepatitis B virus(HBV)related fibrosis owing to the significant limitations of liver biopsy.Both serum biomarkers and imaging techniques have shown promising results and may improve the evaluation of liver fibrosis.However,most of the previous studies focused on the diagnostic effects of various imaging techniques on fibrosis in all chronic liver diseases.AIM To compare the performance of common imaging methods and serum biomarkers for prediction of significant fibrosis caused only by HBV infection.METHODS A systematic review was conducted on the records available in PubMed,EMBASE,and the Cochrane Library electronic databases until December 2018.We systematically assessed the effectiveness of two serum biomarkers and three imagine techniques in predicting significant fibrosis solely caused by HBV infection.The serum biomarkers included aspartate aminotransferase-to-platelet ratio index(APRI)and fibrosis index based on the 4 factors(FIB-4).The three imaging techniques included acoustic radiation force impulse(ARFI),FibroScan,and magnetic resonance elastography(MRE).Three parameters,the area under the summary receiver operating characteristic curve(AUSROC),the summary diagnostic odds ratio,and the summary sensitivity and specificity,were used to examine the accuracy of all tests for liver fibrosis.RESULTS Out of 2831 articles evaluated for eligibility,204 satisfied the predetermined inclusion criteria for this current meta-analysis.Eventually,our final data contained 81 studies.The AUSROCs of serum biomarkers of APRI and FIB-4 were both 0.75.For imaging techniques(ARFI,FibroScan,and MRE),the areas were 0.89,0.83,and 0.97,respectively.The heterogeneities of ARFI and FibroScan were statistically significant(I2>50%).The publication bias was not observed in any of the serum biomarkers or imaging methods.CONCLUSION These five methods have attained an acceptable level of diagnostic accuracy.Imaging techniques,MRE in particular,demonstrate significant advantages in accurately predicting HBV-related significant fibrosis,while serum biomarkers are admissible methods.

Gadoxetic acid-enhanced magnetic resonance imaging for the detection of small hepatocellular carcinoma(≤ 2.0 cm) in patients with chronic liver disease:A meta-analysis

AIM To perform a meta-analysis assessing the value of gadoxetic acid-enhanced magnetic resonance imaging(Gd-EOB-MRI)in detecting small hepatocellular carcinoma(HCC)(≤2.0 cm)in patients with chronic liver disease.METHODS Databases,including MEDLINE and EMBASE,were searched for relevant original articles published from January 2008 to February 2015.Data were extracted,and summary estimates of diagnostic accuracy indexes such as sensitivity,specificity,diagnostic odds ratio,predictive value,and areas under summary receiver operating characteristic curve were obtained using a random-effects model,with further exploration employing meta-regression and subgroup analyses.RESULTS In 10 studies evaluating 768 patients,pooled perlesion sensitivity of Gd-EOB-DTPA was 91%(95%CI:83%-95%),with a specificity of 95%(95%CI:87%-98%).Overall positive likelihood ratio was 18.1(95%CI:6.6-49.4),for negative likelihood ratio(NLR)of 0.10(95%CI:0.05-0.19)and diagnostic odds ratio of182(95%CI:57-581).Subgroup analysis suggested that diagnostic performance of Gd-EOB-MRI for sub-centimeter HCC(≤1.0 cm)detection was low,with a sensitivity of69%(95%CI:59%-78%).In studies with both Gd-EOBMRI and diffusion-weighted imaging(DWI)performed,Gd-EOB-MRI/DWI combination was more sensitive than Gd-EOB-DTPA alone,whether for small lesions(86%vs77%)or sub-centimeter ones(80%vs 56%).CONCLUSION A limited number of small studies suggested that GdEOB-MRI has good diagnostic performance in the detection of small HCC(≤2.0 cm)among patients with chronic liver disease,but relatively lower performance for detection of sub-centimeter HCC(≤1.0 cm).Combination of Gd-EOB-MRI and DWI can improve the diagnostic sensitivity of MRI.

Recent advances in computerized imaging and its vital roles in liverdisease diagnosis, preoperative planning, and interventional liversurgery: A review

The earliest and most accurate detection of the pathological manifestations of hepatic diseases ensures effective treatments and thus positive prognostic outcomes.In clinical settings,screening and determining the extent of a pathology are prominent factors in preparing remedial agents and administering approp-riate therapeutic procedures.Moreover,in a patient undergoing liver resection,a realistic preoperative simulation of the subject-specific anatomy and physiology also plays a vital part in conducting initial assessments,making surgical decisions during the procedure,and anticipating postoperative results.Conventionally,various medical imaging modalities,e.g.,computed tomography,magnetic resonance imaging,and positron emission tomography,have been employed to assist in these tasks.In fact,several standardized procedures,such as lesion detection and liver segmentation,are also incorporated into prominent commercial software packages.Thus far,most integrated software as a medical device typically involves tedious interactions from the physician,such as manual delineation and empirical adjustments,as per a given patient.With the rapid progress in digital health approaches,especially medical image analysis,a wide range of computer algorithms have been proposed to facilitate those procedures.They include pattern recognition of a liver,its periphery,and lesion,as well as pre-and postoperative simulations.Prior to clinical adoption,however,software must conform to regulatory requirements set by the governing agency,for instance,valid clinical association and analytical and clinical validation.Therefore,this paper provides a detailed account and discussion of the state-of-the-art methods for liver image analyses,visualization,and simulation in the literature.Emphasis is placed upon their concepts,algorithmic classifications,merits,limitations,clinical considerations,and future research trends.

Value of Texture Analysis on Gadoxetic Acid-enhanced MR for Detecting Liver Fibrosis in a Rat Model

Objective To explore the ability of texture analysis of gadoxetic acid-enhanced magnetic resonance imaging(MRI) T1 mapping images, as well as T1-weighted(T1 W), T2-weighted(T2 W) and apparent diffusion coefficient(ADC) maps for distinguishing between varying degrees of hepatic fibrosis in an experimental rat model.Methods Liver fibrosis in rats was induced by carbon tetrachloride intraperitoneal injection for 4–12 weeks(n = 30). In the control group(n = 10) normal saline was applied. The MRI protocol contained T2 W, diffusion weighted imaging, pre-and post-contrast image series of T1 W and T1 mapping images. METAVIR score was used to grade liver fibrosis as normal(F0), mild fibrosis(F1–2), and advanced fibrosis(F3–4). Texture parameters including mean gray-level intensity(Mean), standard deviation(SD), Entropy, mean of positive pixels(MPP), Skewness, and Kurtosis were obtained. Nonparametric Mann-Whitney U test was used to compare the average value of each texture parameter in each sequence for assessing the difference between F0 and F≥1 as well as F0–2 and F3–4. Receiver operating characteristic(ROC) curves were obtained to assess the diagnosing accuracy of the parameters for differentiating no liver fibrosis from liver fibrosis and rats with liver fibrosis grading F0–2 from those with grading F3–4. The area under ROC curve(AUC) was calculated to evaluate the diagnostic efficiency of texture parameters.Results Finally, 20 rats completed MR T1 mapping image scan. The pathologic staging of these 20 rats was no fibrosis(F0, n = 6), mild fibrosis(F1–2, n = 5) and advanced fibrosis(F3–4, n = 9). On pre-contrast T1 mapping image, Entropy was seen to be statistically significant higher in the F≥1 group than that in the F0 group at each spatial scaling factor(SSF) setting(P = 0.015, 0.015, 0.015, 0.013, 0.015 and 0.018 respectively to SSF = 0, 2, 3, 4,5, 6), and Mean of the F≥1 rats was statistically significant higher than that of the F0 rats at SSF 4, 5, 6(P = 0.004, 0.006, and 0.013, respectively). Entropy and Mean showed a moderate diagnostic performance in most SSF settings of T1 mapping pre-contrast images for differentiation of normal liver from liver fibrosis.Conclusion Certain texture features of gadoxetic acid-enhanced MR images, especially the Entropy of noncontrast T1 mapping image, was found to be a useful biomarker for the diagnosis of liver fibrosis.

Contrast-enhanced ultrasonography in the evaluation of incidental focal liver lesions: A cost-effectiveness analysis

AIM To determine whether contrast-enhanced ultrasonography(CEUS) as the first-line method is more costeffective in evaluating incidentally discovered focal liver lesions(FLLs) than is computed tomography(CT) and magnetic resonance imaging(MRI). METHODS Between 2010 and 2015, our prospective study enrolled 459 patients with incidentally found FLLs. The biological nature of FLLs was assessed by CEUS in all patients. CT or MRI examinations were added in unclear cases. The sensitivity and specificity of CEUS were calculated. The total costs of CEUS examinations and of the added examinations performed in inconclusive cases were calculated. Afterwards, the theoretical expenses for evaluating incidentally discovered FLLs using CT or MRI as the first-line method were calculated. The resultswere compared. RESULTS The total cost of the diagnostic process using CEUS for all enrolled patients with FLLs was 75884 USD. When the expenses for additional CT and MRI examinations performed in inconclusive cases were added, the total cost was 90540 US dollar(USD). If all patients had been examined by CT or MR as the first-line method, the costs would have been 78897 USD or 384235 USD, respectively. The difference between the cost of CT and CEUS was 3013 USD(4%) and that between MRI and CEUS was 308352 USD(406.3%). We correctly described 97.06% of benign or malignant lesions, with 96.99% sensitivity and 97.09% specificity. Positive predictive value was 94.16% and negative predictive value was 98.52%. In cases with 4 and more lesions, malignancy is significantly more frequent and inconclusive findings significantly less frequent(P < 0.001).CONCLUSION While the costs of CEUS and CT in evaluating FLLs are comparable, CEUS examination is far more costeffective in comparison to MRI.

Assessment of liver fibrosis by a noninvasive method of transient elastography and biochemical markers

AIM： To assess the correlation between the fibrotic area （FA） as calculated by a digital image analysis （DIA）, and to compare the diagnostic accuracy of FibroScan to the other existing Liver fibrosis （LF） markers using the receiver operating curve analysis.METHODS： We recruited 30 patients who underwent a liver resection for three different etiologies including normal liver, hepatitis B, and hepatitis C. Liver stiffness was measured by using a FibroScan. The FA was then calculated by DIA to evaluate LF in order to avoid any sampling bias. RESULTS： The FA negatively correlated with Prothrombin time （PT）, platelet count, lecithin-cholesterol acyltransferase （LCAT）, and pre-albumin （ALB）. On the other hand, the findings of FibroScan correlated with similar markers. The FA positively correlated with FibroScan, serum hyaluronate level, and type Ⅳ collagen level, and aspartate transaminase to platelet ratio index （APRI）. The area under the receiver operating curve for FibroScan was higher than that for the other markers, even though the statistical significance was minimal. CONCLUSION： Our findings suggest that FibroScan can initially be used to assess LF as an alternative to a liver biopsy （LB） and serum diagnosis, because it is a safe method with comparable diagnostic accuracy regarding the existing LF markers.

Metrically measuring liver biopsy:A chronic hepatitis B and C computer-aided morphologic description

AIM： To describe a quantitative analysis method for liver biopsy sections with a machine that we have named ＂Dioguardi Histological Metriser＂ which automatically measures the residual hepatocyte mass （including hepatocytes vacuolization）, inflammation, fibrosis and the loss of liver tissue tectonics.METHODS： We analysed digitised images of liver biopsy sections taken from 398 patients, The analysis with Dioguardi Histological Metriser was validated by comparison with semi-quantitative scoring system.RESULTS： The method provides： （1） the metrical extension in two-dimensions （the plane） of the residual hepatocellular set, including the area of vacuoles pertinent to abnormal lipid accumulation; （2） the geo- metric measure of the inflammation basin, which distinguishes intra-basin space and extra-basin dispersed parenchymal leukoo/tes; （3） the magnitude of collagen islets, （which were considered truncated fractals and classified into three degrees of magnitude）; and （4） the tectonic index that quantifies alterations （disorders） in the organization of liver tissue. Dioguardi Histological Metriser machine allows to work at a speed of 0.1 mm^2/s, scanning a whole section in 6-8 min.CONCLUSION： The results are the first standardized metrical evaluation of the geometric properties of the parenchyma, inflammation, fibrosis, and alterations in liver tissue tectonics of the biopsy sections. The present study confirms that biopsies are still valuable, not only for diagnosing chronic hepatitis, but also for quantifying changes in the organization and order of liver tissue structure.

Liver fibrosis and tissue architectural change measurement using fractal-rectified metrics and Hurst's exponent

AIM： To provide the accurate alternative metrical means of monitoring the effects of new antiviral drugs on the reversal of newly formed collagen. METHODS： Digitized histological biopsy sections taken from 209 patients with chronic C virus hepatitis with different grade of fibrosis or cirrhosis, were measured by means of a new, rapid, user-friendly, fully computeraided method based on the international system meter rectified using fractal principles. RESULTS： The following were described： geometric perimeter, area and wrinkledness of fibrosis; the collation of the Knodell, Sheuer, Ishak and METAVIR scores with fractal-rectified metric measurements; the meaning of the physical composition of fibrosis in relation to the magnitude of collagen islets; the intra- and inter-biopsy sample variability of these parameters; the ＂staging＂ of biopsy sections indicating the pathway covered by fibrosis formation towards its maximum known value; the quantitative liver tissue architectural changes with the Hurst exponent. CONCLUSION： Our model provides the first metrical evaluations of the geometric properties of fibrosis and the quantitative architectural changes of the liver tissue. The representativeness of histological sections of the whole liver is also discussed in the light of the results obtained with the Hurst coefficient.

NEW SAR IMAGE INTERPRETATION METHOD OF AIRCRAFT BASED ON JOINT TIME-FREQUENCY ANALYSIS

With the continuous improvement of Synthetic Aperture Radar(SAR) resolution, interpreting the small targets like aircraft in SAR images becomes possible and turn out to be a hot spot in SAR application research. However, due to the complexity of SAR imaging mechanism, interpreting targets in SAR images is a tough problem. This paper presents a new aircraft interpretation method based on the joint time-frequency analysis and multi-dimensional contrasting of basic structures. Moreover, SAR data acquisition experiment is designed for interpreting the aircraft. Analyzing the experiment data with our method, the result shows that the proposed method largely makes use of the SAR data information. The reasonable results can provide some auxiliary support for the SAR images manual interpretation.

Some Biopathological Characteristices of Small Hepatocellular Carcinoma and Their Clinical Significances

A gross morphological classification of 66 small hepatocellular carcinomas (SHCC,≤3 cm in diameter)and a determination of the DNA-content in 20 SHCC and 26 LHCC(larger hepatocellular carcinoma,】3 cm in diameter)by image analysis technology were studiedin this paper.It was showed that SHCC could be divided into three types:Type I,non-capsule type (n=13,19.7％);type II,capsule type(n=47,71.2％) and Type III,infiltrative type (n=6,9.1％).The Type I and Type II SHCC mainly had diploid DNAstem line,while Type III SHCC mainly haa aneuploid DN A stem line.In patients with≤3cmSHCC,the postoperative 5-year survival rate was 75％,significantly higher than that of 42.3％in patients with】3 cm LHCC (P【0.05).There was no positive correlation between the tu-mor size and serum AFP level in this series.The results suggest that SHCC of≤3 cm in sizebasicaily reflects the relatively berugn btotogical characteristics of early hepatocellular carcinomaand is the best opportunity to acmeve the best curative results.But a small part of SHCC ex-presses markediy increased malignant biological behaviours due to the acceleration of stem lineselection.Up to now,as to the atscovery of the SHCC,the quantitative measurement of serumAFP level is still an effective and generally accepted method.

Morphometric Measurement of Collagen in Liver Tissue with Posthepatitis Liver Cirrhosis Portal Hypertension

A correct estimation of the collagen content in cirrhosis liver tissue and analysis of its relation to the degree of liver function injury are important to the clinician in the establishment of the diagnosis in the liver diseases. The author has performed the morphometric measurement of collagen with liver tissue pathological section by using TJTY-300 image analysis system. It was found that the cirrhotic liver tissue's collagen area and collagen average grey degree were notably higher than those in normal men (P<0.05),average optical density was markedly lower than that in normal men (P<0. 05),integral optical density had no significant difference(P>0.05) between patients and normal controls,but the integral optical density in cirrohtic liver was 1. 21 times that of normal men.It suggests that the collagen content in cirrhotic liver tissue increased obviously,the average density of the increased collagen was lower than that in the normal liver tissue and the density of increased collagen was not homogeneous.Comparison between normal controls and patients with different Child-Pugh liver function grades in liver tissue collagen parameters revealed that the cirrhotic liver's collagen content can,to different degree , directly reflect the function status of cirrhotic liver.

Classification and structural characteristics of amorphous materials based on interpretable deep learning

Defining the structure characteristics of amorphous materials is one of the fundamental problems that need to be solved urgently in complex materials because of their complex structure and long-range disorder.In this study,we develop an interpretable deep learning model capable of accurately classifying amorphous configurations and characterizing their structural properties.The results demonstrate that the multi-dimensional hybrid convolutional neural network can classify the two-dimensional(2D)liquids and amorphous solids of molecular dynamics simulation.The classification process does not make a priori assumptions on the amorphous particle environment,and the accuracy is 92.75%,which is better than other convolutional neural networks.Moreover,our model utilizes the gradient-weighted activation-like mapping method,which generates activation-like heat maps that can precisely identify important structures in the amorphous configuration maps.We obtain an order parameter from the heatmap and conduct finite scale analysis of this parameter.Our findings demonstrate that the order parameter effectively captures the amorphous phase transition process across various systems.These results hold significant scientific implications for the study of amorphous structural characteristics via deep learning.

白术的法象药理及其临床意义

“以象释药”是中医象思维在中药学研究与应用中的极好体现。白术为“后天培土圣药”,但在《神农本草经》等本草经典中,古人常以之治疗痃癖、结肿、山岚瘴气等诸多疑难怪证。对此,按药性常论往往难以理解。但若以“法象药理”“象性合参”的角度,这些功效应用可以从白术独特的“药象”中找到答案。古代本草著作对于白术特殊药象多有详尽阐释,称之为“盘结丑怪,有兽之形”,以及“桴蓟”“多刺有风象”等。笔者结合传统本草和现代药学研究,将白术的药象特点概括为:叶裂羽刺,团根瘤皱,肉白辛香。而这些药象均与其“逐风水结肿”“痃癖气块”“主大风在身面”等特殊药效密切相关。正如徐灵胎所言:“因形以求理,则其效可知矣。”由此认识白术的“象-效”相关性,可帮助我们理解古人的药学智慧,弘扬传统本草理论的现代应用价值。

视频侦查技术关键及其发展展望

视频侦查技术的核心是通过视频图像的提取、查看、分析和研判来获取侦查线索、固定涉案证据。多年来经过在实战应用中不断地发展创新,视频侦查技术形成了自己独特的关键技术体系:视频信息分析解读技术是侦查应用和证据固定的基础和核心;视频证据固定保全技术的规范是审判中心主义的客观要求,可以获取视频侦查记录报告、视频检验鉴定报告或视频数据关联报告;低质量视频图像的增强恢复技术专业性强,应用范围窄,技术成熟度高,然而它不断面临新的挑战。目前,视频数据的智能应用在大数据背景下变得越来越重要,仍需进一步突破视频自动识别技术的应用范畴,建立完善多层次的视频数据综合应用体系,打造适应不同业务需要的视频数据实战应用模型。

Extravasated contrast volumetric assessment on computed tomography angiography in gastrointestinal bleeding:A useful predictor of positive angiographic findings

BACKGROUND Gastrointestinal bleeding(GIB)is a severe and potentially life-threatening condition,especially in cases of delayed treatment.Computed tomography angiography(CTA)plays a pivotal role in the early identification of upper and lower GIB and in the prompt treatment of the haemorrhage.AIM To determine whether a volumetric estimation of the extravasated contrast at CTA in GIB may be a predictor of subsequent positive angiographic findings.METHODS In this retrospective single-centre study,35 patients(22 men;median age 69 years;range 16-92 years)admitted to our institution for active GIB detected at CTA and further submitted to catheter angiography between January 2018 and February 2022 were enrolled.Twenty-three(65.7%)patients underwent endoscopy before CTA.Bleeding volumetry was evaluated in both arterial and venous phases via a semi-automated dedicated software.Bleeding rate was obtained from volume change between the two phases and standardised for unit time.Patients were divided into two groups,according to the angiographic signs and their concordance with CTA.RESULTS Upper bleeding accounted for 42.9%and lower GIB for 57.1%.Mean haemoglobin value at the admission was 7.7 g/dL.A concordance between positive CTA and direct angiographic bleeding signs was found in 19(54.3%)cases.Despite no significant differences in terms of bleeding volume in the arterial phase(0.55 mL vs 0.33 mL,P=0.35),a statistically significant volume increase in the venous phase was identified in the group of patients with positive angiography(2.06 mL vs 0.9 mL,P=0.02).In the latter patient group,a significant increase in bleeding rate was also detected(2.18 mL/min vs 0.19 mL/min,P=0.02).CONCLUSION In GIB of any origin,extravasated contrast volumetric analysis at CTA could be a predictor of positive angiography and may help in avoiding further unnecessary procedures.

透射槽波技术在煤田勘探中的应用研究

槽波地震勘探技术可以有效探查煤层中小断层、陷落柱等地质异常体,在探测精度和距离上明显优于其他煤矿井下勘探方法。透射法作为基本的槽波地震探测方法,具有简单灵活、探测范围大、准确率高等优势。采用透射槽波方法对实际煤矿工作面内断层构造进行探测研究,通过滤波、频散分析、波场及速度分析、能量分析以及透射CT成像等关键技术对实际透射槽波数据进行精细处理,获得准确的透射槽波成像剖面。根据槽波在煤层中受到断层阻断或遇到煤层破碎时其能量将急剧降低的特征,利用透射槽波能量CT剖面,并结合实际揭露情况,解释出12条可靠断层。通过实际煤层工作面透射槽波勘探方法测试,验证了透射槽波方法的有效性以及在煤田断层等构造探测中的实用价值。

膈下动脉参与肝脏肿瘤供血的影像与介入治疗效果

目的研究膈下动脉参与肝脏肿瘤供血影像学表现以及介入治疗的效果、安全性。方法选择2020年1月—2022年12月在福建省龙岩市第二医院接受血管造影检查,被确诊为肝脏肿瘤的患者80例为研究对象,对肿瘤供血的膈下动脉分支实施栓塞治疗,其中74例患者采用5F Cobra型导管,另外6例实施同轴微导管。随后将患者治疗后的并发症发生率、肿瘤位置分布情况、治疗前后甲胎蛋白(alpha fetoprotein,AFP)水平以及治疗成功率进行分析。结果入组的80例患者中,有6例患者(7.50%)肿瘤位于肝脏深部,其他74例患者(92.50%)肿瘤接近或已经累及到肝表面。80例患者中,均表现为右隔下动脉参与肝肿瘤供血,其临床特征以主干显著增粗为主;共有6例患者发生了膈肌痉挛,其并发症发生率为7.5%,且该并发症于30 min后自行缓解。其中1例患者发生了顽固性呃逆,3 d后自行消退,占1.25%。80例患者均栓塞成功,其中54例一次性成功,另外26例二次膈下动脉栓塞成功;此外,治疗后,患者的AFP水平显著低于治疗前(P<0.05)。结论本研究开展了膈下动脉介入肝脏肿瘤的血管造影研究,取得了较好的疗效,尤其是在靠近肝被膜或横膈膜的部位,采用右侧膈下动脉为其提供血液,实现了高效率的化学栓塞,但同时也要注意难治性呃逆及膈肌痉挛等并发症,其疗效明显。

基于大数据分析的高分辨率可见光遥感卫星影像解译能力评估

高分辨率可见光遥感卫星影像应用范围的不断扩大,对其解译能力提出了更高的要求。为了能够选取最佳的遥感卫星影像解译技术,需要对解译能力进行精准的评估与判断。本文结合海量影像数据,进行基于大数据分析的高分辨率可见光遥感卫星影像解译能力评估研究。深入分析遥感卫星影像解译能力影响因素,以此为基础,联合遥感卫星影像解译实际情况,选取适当的解译能力评估指标,应用大数据分析技术—模糊C均值(FCM)聚类算法对指标数据进行分类处理及其分析,基于熵权法计算解译能力评估指标的权重系数,结合当前解译能力评估指标数值,采用加权求和方法计算遥感卫星影像解译能力综合评估数值,从而实现了遥感卫星影像解译能力的有效评估。实验结果显示:应用该方法获得的遥感卫星影像解译能力评估时间最小值为16 s,解译能力评估结果与实际结果保持一致,充分证实了该方法解译能力评估性能较佳。

双重血浆置换术联合补肝利脂汤治疗重度高甘油三酯血症合并非酒精性脂肪性肝病患者的疗效分析

目的探究双重血浆置换术(double filtration plasmapheresis,DFPP)联合补肝利脂汤治疗重度高甘油三酯血症合并非酒精性脂肪性肝病的临床疗效。方法本研究为随机对照试验。选取2021年6月至2022年6月安康市中医医院收治的68例重度高甘油三酯血症合并非酒精性脂肪性肝病患者为研究对象,采用随机数字表法分为对照组与观察组,每组34例。对照组男18例,女16例,年龄(42.62±8.55)岁,采用DFPP+苯扎贝特治疗,DFPP治疗后第1天开始口服苯扎贝特,每次0.2 g,每日3次,持续治疗24周。观察组男20例,女14例,年龄(43.43±7.25)岁,采用DFPP+补肝利脂汤治疗,DFPP治疗后第1天开始口服补肝利脂汤,每次200 ml,每日1剂,饭前30 min内服用,持续治疗24周。对比治疗前后两组甘油三酯、载脂蛋白A-Ⅰ(ApoA-Ⅰ)、载脂蛋白B(ApoB)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等血脂指标以及丙氨酸转氨酶(ALT)、白蛋白(ALB)、天冬氨酸转氨酶(AST)等肝功能生化指标,并比较两组肝脏影像学结果。采用χ^(2)检验、t检验进行统计分析。结果治疗24周后,观察组甘油三酯、LDL-C、ApoB均低于对照组[(4.13±1.09)mmol/L比(6.03±1.65)mmol/L、(3.13±0.58)mmol/L比(3.91±0.75)mmol/L、(0.76±0.23)g/L比(0.86±0.17)g/L],HDL-C、ApoA-I均高于对照组[(1.88±0.53)mmol/L比(1.42±0.43)mmol/L、(1.81±0.39)g/L比(1.58±0.32)g/L],差异均有统计学意义(t=5.602、4.797、2.039、3.930、2.658,均P<0.05);观察组ALT、AST均低于对照组[(28.62±3.23)U/L比(34.32±1.68)U/L、(21.29±4.34)U/L比(35.44±5.72)U/L],ALB高于对照组[(49.21±4.31)g/L比(45.34±4.28)g/L],差异均有统计学意义(t=9.138、11.488、3.715,均P<0.05);肝脏影像学检查结果显示,观察组的肝脏肋下斜径小于对照组[(9.98±3.54)cm比(12.05±4.78)cm],差异有统计学意义(t=2.029,P=0.046);对照组患者轻、中、重度肝脂肪浸润分别为7例(20.59%)、15例(44.12%)、12例(35.29%),观察组分别为20例(58.82%)、11例(32.35%)、3例(8.82%),差异有统计学意义(χ^(2)=12.275,P=0.002)。结论DFPP联合补肝利脂汤能有效改善重度高甘油三酯血症合并非酒精性脂肪性肝病患者的生化指标和肝脏功能,对肝脏影像学表现有积极影响,对重度高甘油三酯血症合并非酒精性脂肪性肝病的治疗具有潜在应用价值。

图片分类的卷积神经网络可解释性分析

为了理解卷积神经网络在图片分类任务中做出决策的依据,进而优化模型,降低调参成本,对卷积神经网络进行可解释性分析是十分有必要的。为此,文章以水果图片分类任务为切入点,使用了多种类激活图,从多个角度分析模型所给出结果的原因。文章采用Res Net模型先进行微调,在取得较好的分类性能后,进行了语义特征的基础分析、遮挡性分析,以及基于CAM的可解释性分析和LIME可解释性分析,为卷积神经网络提供一定的可解释性。实验结果表明,卷积神经网络做出决策的依据与人类理解的语义是一致的。