Deformable R-CNN for Detection of Electron Dense Deposits in Glomerular Transmission Electron Microscopy Images

Membranous nephropathy (MN) is a common pathological type of nephrotic syndrome. The characteristic of MN is the presence of immune complex deposits containing immunoglobulin G (IgG), called electron-dense deposits (EDD), which can be observed by transmission electron microscopy (TEM). Quantitative analysis of the morphology and location of EDD can provide an essential reference for diagnosing and staging MN. However, accurately identifying and quantifying EDD is challenging due to their different morphologies, sizes, and locations with varying amounts. This paper proposes a two-stage Deformable R-CNN detector that overcomes these challenges, which has two characteristics: 1) The detector employs InternImage as the feature extractor, which extracts different morphological features of EDD using the core operator deformable convolution v3 (DCNv3). 2) The detector utilizes the multi-scale deformable attention model (MSDAM) as the attention mechanism to detect EDD of different sizes and locations effectively. The proposed Deformable R-CNN was tested on the Electron-Dense Deposit Detection for Membranous Nephropathy (EDDD-MN) dataset and outperformed other popular detectors, including two-stage, one-stage, and transformer-based detectors in detection and quantification. It also exhibited excellent performance in TIDE error analysis. Thus, this method would enable precise detection and rapid quantification of EDD, thereby reducing the workload of pathologists and helping them gain a comprehensive understanding of MN

Ameliorating Effect of Transcutaneous Electroacupuncture on Impaired Gastric Accommodation in Patients with Postprandial Distress Syndrome-Predominant Functional Dyspepsia: A Pilot Study

Patients with functional dyspepsia (FD) have both reduced gastric accommodation and impaired gastric motility that are difficult to treat. The aim of this study was to investigate the therapeutic potential of transcutaneous electroacupuncture (TEA) for both of these disorders in FD patients. Acute experiments were performed in FD patients to study the effect of TEA and sham-TEA on gastric accommodation assessed by a nutrient drink test and gastric motility assessed by the measurement of the electrogastrogram (EGG). TEA or sham-TEA was performed via cutaneous electrodes at acupoints ST36 and PC6 or sham-points nonacupoints. It was found that (1) gastric accommodation (maximum tolerable volume) was reduced in FD patients compared with the controls P<0.03. TEA improved gastric accommodation in FD patients P<0.02. (2) Acute TEA significantly increased the percentage and power of normal gastric slow waves in the fed state assessed in the FD patients by the EGG in comparison with sham-TEA. (3) TEA increased vagal activity assessed by the spectral analysis of the heart rate variability in the fed state in FD patients. It was concluded that needleless method of transcutaneous electroacupuncture may have a therapeutic potential for treating both impaired gastric accommodation and impaired gastric motility in patients with FD

Association of Cardiac Biomarkers in Combination With Cognitive Impairment After Acute Ischemic Stroke

Background Poststroke cognitive impairment is a severe and common clinical complication that constitutes a substantial global health burden. We aimed to evaluate the association of 3 cardiac biomarkers in combination with poststroke cognitive impairment and their prognostic significance. Methods and Results This prospective study included 566 patients with ischemic stroke. Cardiac biomarkers, including sST2 (soluble suppression of tumorigenicity‐2 receptor), GDF‐15 (growth differentiation factor‐15), and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide), were measured. Cognitive impairment was defined as a Mini‐Mental State Examination score of <27 or a Montreal Cognitive Assessment score of <25 at 3 months after ischemic stroke. Odds of cognitive impairment 3 months after ischemic stroke increased with the number of elevated cardiac biomarkers (sST2, GDF‐15, and NT‐proBNP; Ptrend<0.001). The multivariable adjusted odds ratios (95% CIs) of cognitive impairment defined by the Mini‐Mental State Examination and Montreal Cognitive Assessment were 2.45 (1.48–4.07) and 1.86 (1.10–3.14) for the participants with ≥2 elevated cardiac biomarkers, respectively, compared with those without any elevated cardiac biomarker. Additionally, higher cardiac biomarker scores were associated with an increased risk of cognitive impairment (Ptrend<0.05). Simultaneously adding all 3 cardiac biomarkers to the basic model with traditional risk factors significantly improved the risk prediction of Mini‐Mental State Examination‐defined cognitive impairment (net reclassification improvement=34.99%, P<0.001; integrated discrimination index=2.67%, P<0.001). Similar findings were observed using the Montreal Cognitive Assessment scores. Conclusions An increased number of elevated novel cardiac biomarkers were associated with an increased odds of poststroke cognitive impairment, suggesting that a combination of these cardiac biomarkers may improve the risk prediction of cognitive impairment. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT01840072

The polycomb group protein EZH2 induces epithelial–mesenchymal transition and pluripotent phenotype of gastric cancer cells by binding to PTEN promoter

Abstract Background The influences of oncogenic Ezh2 on the progression and prognosis of gastric cancer (GC) and the underlying mechanisms are still poorly understood. Here, we aimed at investigating clinicopathological significance of Ezh2 in GC and the mechanisms underlying its function in GC development. Methods The expression level of Ezh2 was determined by qRT-PCR, immunoblot, and immunohistochemistry analysis in 156 pairs of GC tissues and adjacent normal gastric mucosa tissues. The biological functions of Ezh2 were assessed by in vitro and in vivo functional experiments. Chromatin immunoprecipitation (ChIP), luciferase, and Western blotting analyses were utilized to identify the relationship between Ezh2 and the PTEN/Akt signaling. Results The expression of Ezh2 was higher in gastric cancer tissues in comparison with para-nontumorous epithelium. High expression of Ezh2 was associated with more aggressive biological behavior and poor prognosis in GC. In vitro studies indicated that Ezh2 promoted GC cells’ proliferation and clonogenicity. Besides, Ezh2 led to the acquisition of epithelial–mesenchymal transition (EMT) phenotype of GC cells and enhanced GC cell migration and invasion capacity. In particular, Ezh2 strengthened sphere-forming capacity of GC cells, indicating its role in the enrichment of GC stem cells. Furthermore, we found that PTEN/Akt signaling contributed to the effects of Ezh2 on cancer stem cells (CSC) and EMT phenotype in GC cells, and blocking PTEN signaling significantly rescued the effects of Ezh2. Conclusions Taken together, Ezh2 has a central role in regulating diverse aspects of the pathogenesis of GC in part by involving PTEN/Akt signaling, indicating that it could be an independent prognostic factor and potential therapeutic target

Additional file 1: of The polycomb group protein EZH2 induces epithelial–mesenchymal transition and pluripotent phenotype of gastric cancer cells by binding to PTEN promoter

Materials and Methods. Table S1. Relationship between EZH2 expression and clinicopathologic parameters of gastric cancer patients. Table S2. Univariate and multivariate analysis of clinicopathological factors for disease-free survival in gastric cancer (qRT-PCR cohort). Table S3. Univariate and multivariate analysis of clinicopathological factors for overall survival in gastric cancer (qRT-PCR cohort). Table S4. Univariate and multivariate analysis of clinicopathological factors for overall survival in gastric cancer (IHC cohort). Table S5. Correlation analysis of expression of stem cell related factors with EZH2. Table S6. Primers and siRNA sequences used in this study. (DOCX 67 kb