Introduction: Osteoporosis is a bone metabolic disorder characterized by a decrease in bone mineral density (BMD) and strength, which increases the risk of low back pain, disc degeneration, or vertebral fracture.
Osteoporosis is a common and frequent disease in the aging population.
Osteoporosis is a bone metabolic disease characterized by a decrease in bone mineral density (BMD) and strength, which increases the risk of low back pain, disc degeneration, or vertebral fracture.
Therefore, early diagnosis of osteoporosis is very important to prevent disease progression.
Currently, conventional methods for evaluating osteoporosis include dual-energy X-ray absorption (DXA), quantitative computed tomography (QCT), and quantitative ultrasound (QUS), as well as emerging imaging technologies such as dual-energy spectrum CT, 1H-MRS, and positron emission tomography (PET).
BMD measurement is a reliable and ideal method for early diagnosis of osteoporosis.
DXA is a commonly used tool for measuring bone density in the spine.
However, DXA was unable to eliminate the effect of cortical, hyperosteogenic, and sclerosis on BMD measurements, which may underestimate the actual loss of bone mass.
QCT is a recognized 3D method for bone mineral density assessment.
Several studies have shown that the detection rate of QCT for osteoporosis is significantly higher than that of DXA.
However, compared with DXA, QCT is difficult to be widely used in clinic due to its high radiation dose and complex post-processing.
Each year, patients with other indications, such as urinary or digestive disorders, undergo a CT scan of part or all of the spine.
These CT scans can be used for opportunistic screening for osteoporosis without additional radiation exposure and expense.
At present, deep learning has been increasingly used in medical image analysis.
Recently, published in the European journal of Radiology of a study to explore the deep learning application in patients with primary osteoporosis, and developed a convolutional neural network based on depth (deep convolutional neural network, the DCNN) automatic CT image segmentation and bone mineral density and vertebral bodies (ipads mineral density, BMD) calculation method, designed to automatically from accuracy assessment methods lumbar vertebral BMD and calculate the positioning performance.
In this study, 1449 patients who underwent CT scans of the spine or abdomen for other indications between March 2018 and May 2020 were retrospectively selected for validation and analysis.
All data were obtained from three different CT providers.
Of these, 586 were used for training and 863 for validation.
The full convolutional neural network U-NET was used to segment the vertebral body automatically.
The manually drawn vertebral body area was used as the base map for comparison.
Bone mineral density was calculated using Densenet-121 convolutional neural network.
Quantitative computed tomography (QCT) post-processing values were used as the criteria for the analysis.
According to different CT providers, all test cases were divided into the following three test queues: test set 1 (n = 463), test set 2 (n = 200), and test set 3 (n = 200).
There was a good correlation between automatic segmentation and the four manually segmented lumbar spine (L1-L4) : the minimum average DICE coefficients of the three test sets were 0.823, 0.786, and 0.782, respectively.
For the test set from different suppliers, the mean BMD calculated by automatic regression showed a high correlation with the results obtained from QCT (R>
0.98) and consistency.
Fig. Visual comparison of automatic and manual segmentation results.
From top to bottom are the segmentation results of test set 1, 2 and 3 respectively.
CT sagittal images, manual segmentation and automatic segmentation are shown from left to right.
Red, green, yellow, and blue represent the vertebral bodies of L1, L2, L3, and L4, respectively
The correlation between manual and automatic segmentation was very good, with DSCs exceeding 0.90 for all four lumbar vertebrae.
This study shows that the DCNN-based method can accurately segment the lumbar vertebrae and automatically calculate the bone mineral density, making it an effective tool for clinicians to screen for opportunistic osteoporosis.

The 27 year old Ms. Mao groin director of a small package is not obvious, because the location is more private, has been embarrassed to see a doctor. Half a year later, she felt that the longer she grew, the bigger she became. After medical treatment, it turned out to be a slow-growing low-grade malignant skin tumor – dermatofibrosarcoma.
Ms. Mao recalled that as early as half a year ago, when she took a bath, she found that her left lower abdomen groin was covered with a piece the size of a nail plate, slightly protruding. Because it doesn’t feel painful and itchy, I didn’t care about it at the beginning. I thought it would disappear after a period of time. Later, it was found that the longer the lump, the bigger it became, and it became a little red. Slowly, the bulge disappeared. The surface of the skin seemed flat, but it seemed to develop under the skin, and there was a slight depression. Due to the location of the parcel is relatively secret, Ms. Mao has been avoiding medical treatment.
On February 24, Ms. Mao felt that the lump was getting bigger and bigger, and finally decided to go to Wuhan Central Hospital for treatment. Wu Bingwei, a doctor in the plastic surgery department of our hospital, made a careful examination. According to the examination report, it is more likely to be dermatofibrosarcoma. Then, the expert team of the Department operated on Ms. Mao in the daytime operation Department, implemented the left lower abdominal tumor and resection margin operation, and removed the subcutaneous tumor. The quick examination results showed that Ms. Mao’s tumor was indeed protuberant fibrosarcoma. In order to reduce the recurrence rate, the doctor expanded the resection along the boundary of the tumor, and carefully repaired the defect.
According to Bai Xinping, director of the plastic surgery department of Wuhan Central Hospital, fibrosarcoma protuberans is a slow-growing low-grade malignant skin tumor, which can occur in any part of the body. It is more common in the trunk skin. At the beginning, it is often just a painless protuberant plaque. It feels a little hard and will appear dark red. Due to its adhesion with subcutaneous fat, muscle and soft tissue, fibrosarcoma protuberans can be seen in the skin, Sometimes skin fibroma will also sag, dimple sign orange peel like change, early generally do not appear very strong physical discomfort, so it is often ignored. Dermatofibrosarcoma protuberans usually infiltrates into deep tissues and may metastasize to other organs or lymph nodes in the late stage. Bai Xinping reminded that when there are different lumps or black nevi in the skin tissue of the body, we must not let them go. We must pay attention to observe the color, size and development of the lumps, not to mention random rubbing and squeezing. If the lumps or black nevi have not been eliminated or changed for a long time, we should see a doctor as soon as possible to find out the causes and treat them symptomatically.

Viral hepatitis can be divided for armor b c ding wu 5 kinds, armor, vale hepatitis is via fecal mouth transmission, other is via blood transmission, sex transmission, close life contact transmission.

Common have armour second viral hepatitis, a hepatitis course shows self – limited, without chronic change, lifelong immunity can be obtained after infection.

Hepatitis B can be manifested as acute hepatitis, chronic hepatitis, severe hepatitis, cholestasis hepatitis, hepatitis B virus chronic carrier.
Chronic hepatitis can behave for complexion dark, spider mole, liver or liver spleen is big.
The clinical expression of heavy hepatitis has jaundice deepens rapidly, liver has sex to shrink, liver smelliness, haemorrhagic tendency, the ascites that appears rapidly, toxic bulge bowel.
Symptoms of hepatic encephalopathy, hepatorenal syndrome.

Second liver active immunity can be vaccinated second liver vaccine, passive immunity can be used for high efficiency value second liver immunoglobulin preparation.

Lounge is main measures of acute hepatitis treatment principle should stay in bed for a month after onset, after improved further, please casually, can gradually increase activity, to the patient does not feel tired to liver function is normal, until the liver function is normal after three months can resume normal activities and work, but still want to avoid excessive labor and heavy manual labor.

Patients with severe hepatitis limit their protein intake to low fat, low salt, high sugar, high vitamins, easy digestion, fluid or semicfluidic.