Recent studies have introduced attention models for medical visual question answering (MVQA). In medical research, not only is the modeling of “visual attention” crucial, but the modeling of “question attention” is equally significant. To facilitate bidirectional reasoning in the attention processes involving medical images and questions, a new MVQA architecture, named MCAN, has been proposed. This architecture incorporated a cross-modal co-attention network, FCAF, which identifies key words in questions and principal parts in images. Through a meta-learning channel attention module (MLCA), weights were adaptively assigned to each word and region, reflecting the model’s focus on specific words and regions during reasoning. Additionally, this study specially designed and developed a medical domain-specific word embedding model, Med-GloVe, to further enhance the model’s accuracy and practical value. Experimental results indicated that MCAN proposed in this study improved the accuracy by 7.7% on free-form questions in the Path-VQA dataset, and by 4.4% on closed-form questions in the VQA-RAD dataset, which effectively improves the accuracy of the medical vision question answer.
Objective To observe the functional state of the optic nerve and discover the injury of visual pathway function in time under general ane sthesia. The flash visual evoked potential (F-VEP) was used to monitor visual function during orbital surgery. Methods A total of 252 out of 282 patients undergoing orbital surgery under general anesthesia were successfully monitored by F-VEP during the surgery. All patients were monitored by this method under the following conditions:consious state before operation, under general anaesthesia, during and after dissection of orbital tumor and at the end of operation. Results ①There was no significant difference of wave amplitude and latency under general anesthesia and consciousness condition. ②The amplitude and latency of F-VEP were normal in the orbital surgery withou toptic nerve injury. ③Pulling and oppression of optic nerve could cause temporary wave loss, but the wave recovered after removal of the pull and oppression. ④ The wave loss of F-VEP would occur immedicately when optic nerve was severe injured and its blood supply was deficient. Since the application of the visual function monitoring, 24 cases were treated in time during disturbance of visual function and no patient has unexpected visual loss during orbital surgery. Conclusion The intraoperative monitoring of F-VEP during orbital surgery can decrease the proportion of permanent visual loss caused by orbit al surgery, and help the surgical procedures go to function-anatomy stage from experience-anatomy stage. (Chin J Ocul Fundus Dis, 2001,17:260-263)
Objective To observe the changes of amplitude and latency of mini visual evoked optential (mini VEP) examinations in infants at different age.Methods A total of 84 healthy infants and adults (168 eyes) were randomly selected to underwent mini VEP. According to the age, all the individuals were divided into seven groups: A, 0-3 months; B, 4-6 months; C: 7-12 months; D: 1-3 years; E: 4-6 years; F: 7-12 years; G: adults (control). There were 12 individuals (24 eyes) in each group. By using the stimulater of mini VEP, the flash VEP was performed and the changes of amplitude and latency of P100 wave were recorded and analyzed.Results The average value of amplitude in group A was（7.39plusmn;1.79）mu;V which was the lowest, and the average latency was （137.45plusmn;7.64）ms which was the largest.At the same time, the average amplitude of P100 increased from group A to E (F=359.56); the average latency decreased from Group A to D（F=326.64）; the difference was significant (P＜0.01). The amplitude in group E, F, and G was high and no significant difference was found (F=2.39，P＞0.05);the latency in group D,E,F,and G was short with no significant difference (F=2.64，P＞0.05）.Conclusions With the growth of the infants' age, the amplitude of miniVEP increases and latency decreases; moreover, the latency reaches the normal adult level in advance of the amplitude of miniVEP.
Objective To investigate the characteristic of the multifocal visual evoked potentials(MVEP)and the visual function across the visual field in anisometropic amblyopes and isometropic amblyopes. Methods MVEP from 32 anisometropic amblyopic eyes and 31 control eyes were tested. Results In anisometropic amblyopic eyes,the latencies of MVEP were significantly prolonged．The amplitudes of MVEP were significantly attenuated in the central region of the visual field,and these phenomena gradually reduced with the increase of the eccentricity． Conclusion The visual function of anisometropic amblyopic eyes is reduced more significantly in the central region than in the peripheral region of the visual field. (Chin J Ocul Fundus Dis,20000,16:27-29)
Objective To investigate the output of evidence-based medicine (EBM) researchers in China and elsewhere by examining the EBM domains they work within and the networks that exist among them; using visualization methods to analyze these relationships. This maps the current situation and helps with the identification of areas for future growth. Method We used co-citation matrixes with Pathfinder networks and hierarchical clustering algorithms, and constructed a co-author matrix which were analyzed with a whole network approach. The analyzed matrixes were visualized with the UCINET program. Result Much of the development of EBM has been centered around three authors, David Sackett, Gordon Guyatt and L Manchikanti, within three different clusters. The main authors of EBM articles in China were divided into nine academic domains. The relations among core authors of articles indexed by the Science Citation Index (SCI) was loose. There was a ber co-authorship network among core authors in the Chinese literature, with three groups and 21 cliques. Nine distinct academic communities appeared to have formed around Li Youping, Liu Ming and Zhang Mingming. Conclusion The EBM literature contains several key clusters, with universities in high-income countries being the source of the majority of articles. Outside China, McMaster University in Canada, the original home of EBM, is the dominant producer of EBM publications. In China, Sichuan University is the main source of EBM publications. The EBM cooperation network in China is comprised of three major groups, the largest and most productive in this sample is led by Li Youping with Liu Ming, Zhang Mingming, Li Jing, Wang Li, Wu Taixiang, and Liu Guanjian as central members.
Objective To verify the feasibility and accuracy of the "lung surface intersegmental constant proportion landmarks", developed by our center, in identifying intersegmental planes during pulmonary segmentectomy. MethodsWe prospectively enrolled the patients who planned to receive thoracoscopic segmentectomy in West China Hospital of Sichuan University and The Third People's Hospital of Chengdu from September 2021 to October 2021. We took a relatively objective and feasible method, intravenous injection of indocyanine green, in identifying intersegmental planes as standard control. We intraoperatively judged the consistency between "lung surface intersegmental constant proportion landmarks" and intravenous injection of indocyanine green in identifying intersegmental planes. We discerned main landmarks of intersegmental plane by the constant proportion segment module, which was built based on the "lung surface intersegmental constant proportion landmarks", as well as distinguished the planes with discrepant fluorescence by peripheral intravenous indocyanine green injection. When the distance between the landmarks determined by the "ung surface intersegmental constant proportion landmarks" and the segmental boundaries displayed by indocyanine green fluorescence staining was ≤1 cm, the landmarks were judged to be consistent with the planes with discrepant fluorescence. As long as one of the landmarks was judged to be consistent, the method was considered to be feasible and accurate. Results A total of 21 patients who underwent thoracoscopic segmentectomy were enrolled, with 5 male and 16 female patients. The median age was 55 years, ranging from 34 to 76 years. A total of 11 patients received left-side surgery, while 10 patients received right-side surgery. In the operations of 21 pulmonary segmentectomies, at least one intersegmental landmark determined by the "lung surface intersegmental constant proportion landmarks" was consistent with the intersegmental plane determined by indocyanine green fluorescence staining in each patient. ConclusionThe intersegmental landmarks determined by the "lung surface intersegmental constant proportion landmarks" are consistent with that determined by indocyanine green fluorescence staining. The method of "lung surface intersegmental constant proportion landmarks" is feasible and accurate in identifying intersegmental planes during pulmonary segmentectomy.
ObjectivesTo systematically review the incidence of various outcomes in non-visualization of the fetal gallbladder (NVFGB) fetuses by prenatal ultrasonography.MethodsPubMed, The Cochrane Library, Elsevier, ClinicalKey, CBM, CNKI and WanFang Data databases were electronically searched to collect studies on NVFGB fetuses by prenatal ultrasonography from January 1990 to March 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Then, meta-analysis was performed by using R 3.5.2 software.ResultsA total of 9 studies were included. The results of meta-analysis showed that: the incidence of fetal biliary atresia was 1.0%, with 2.0% in the isolated and 3.0% in the non-isolated. The incidence of cystic fibrosis was 6.0%, with 2.0% in the isolated and 9.0% in the non-isolated. The incidence of chromosomal abnormality was 5.0%, and 31.0% in non-isolated. The incidence of other malformations other than those described above was 13.0%, with 44.0% in the non-isolated. The incidence of gallbladder agenesis or absent gallbladder was 22.0%, with 28.0% in the isolated. The incidence of later visualization of gallbladder and normal fetal outcomes was 53.0%, with 63.0% in the isolated.ConclusionsCurrent evidence shows that most non-visualization of the fetal gallbladder can identify the presence of gallbladder during late gestation or neonatal ultrasonography. The exactly isolated non-visualization of the fetal gallbladder is highly related to the fetal gallbladder agenesis or the absence of the gallbladder. The non-isolated non-visualization of the fetal gallbladder is highly related to biliary atresia, cystic fibrosis (particularly in the presence of fetal bowel echogenicity), and chromosomal abnormalities (especially chromosome aneuploidy).
Objective To analyze the research hotspots and trends in the field of hyperkalemia in hemodialysis patients at home and abroad, and to provide reference for the research and prevention and control of hyperkalemia in hemodialysis patients. Methods China National Knowledge Infrastructure (CNKI) and Web of Science databases were searched by computer for literature about the hyperkalemia in hemodialysis patients published between January 1995 and January 2023. The included literature was analyzed using visualization analysis tools for visualization, including high-frequency keywords, keyword co-occurrence map, keyword emergence intensity and keyword time series prediction. Results A total of 10 275 articles were included. Among them, there were 10 036 articles from web of science and 239 articles from CNKI. The number of articles in this research field showed a trend of steady increase year by year. The United States was in a leading position in the research and development in this field, followed by China. At the same time, the research in this field presents the characteristics of multidisciplinary integration. The development trends of research hotspots in the next 5 years were risk and health education research. Conclusions The number of research articles related to hyperkalemia in hemodialysis patients is gradually increasing. Multidisciplinary approach and integration is a research hotspot and frontier in the development of hyperkalemia in hemodialysis patients both domestically and internationally.
Increasing the amplitude of event-related potential is one of the key methods to improve the accuracy of the potential-based brain-computer interface, e.g., P300-based brain-computer interface. The brain-computer interface systems often use symbols or controlled objects as vision stimuli, but what visual stimuli can induce more obvious event-related potential is still unknown. This paper designed three kinds of visual stimuli, i.e., a square, an arrow, and a robot attached with an arrow, to analyze the influence of concreteness degree of the graph on the N200 and P300 potentials, and applied a support vector machine to compare the performance of the brain-computer interface under different stimuli. The results showed that, compared with the square, the robot attached with arrow and the arrow both induced larger N200 potential (P = 1.6 × 10−3, P = 4.2 × 10−2) and longer P300 potential (P = 2.2 × 10−3, P = 1.9 × 10−2) in the frontal area, but the amplitude under the arrow condition is smaller than the one under the robot attached with arrow condition. The robot attached with arrow increased the N200 potential amplitude of the square and arrow from 3.12 μV and 5.19 μV to 7.21 μV (P = 1.6 × 10−3, P = 8.9 × 10−2), and improved the accuracy rate from 59.95%, 61.67% to 74.45% (P = 2.1 × 10−2, P = 1.6 × 10−2), and the information transfer rate from 35.00 bits/min, 35.98 bits/min to 56.71 bits/min (P = 2.6 × 10−2, P = 1.6 × 10−2). This study shows that the concreteness of graphics could affect the N200 potential and the P300 potential. The abstract symbol could represent the meaning and evoke potentials, but the information contained in the concrete robot attached with an arrow is more correlated with the human experience, which is helpful to improve the amplitude. The results may provide new sight in modifying the stimulus interface of the brain-computer interface.
Objective To compare the effect of electrode positions on multifocal visual evoked potential(mf-VEP). Methods Ten healthy individuals were tested with RETIscan multifocal VEP system 3.20, each individual was tested with four electrode positions: the active and reference electrode were placed 2.0 cm above and below the inion in Ch1；3.0 cm above and 4.5 cm below the inion in Ch2；2.0 cm on both right and left side of the inion in Ch3 and 4.0 cm on both right and left side of the inion in Ch4. The summed amplitudes of hemifield mf-VEP were analyzed and compared according to different electrode positions. Results The difference among summed amplitudes of the upper or lower hemifield mf-VEP recorded with Ch1、Ch2、Ch3 and Ch4 was statistically significant；and the difference between Ch2 and the other channels was statistically significant too. The difference among summed amplitudes of the horizontal sites whose amplitudes were small when recorded with Ch2 and summed amplitudes of the corresponding sites recorded with Ch3 and Ch4 were statistically significant；and the difference between Ch4 and the other channels was statistically significant too. Conclusions compared to Ch1、Ch3 and Ch4, Ch2 can make a better recording of mf-VEP. As for some sites, especially those along horizontal line, horizontal electrodes could improve the amplitudes of mf-VEP recorded with vertical electrodes，and Ch4 could do better to improve the mf-VEP recorded with Ch2 than Ch3. (Chin J Ocul Fundus Dis，2004，20：346-348)