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At present, deep learning has achieved great success in the field of computer vision, but small object detection is still a challenging problem in the field of object detection. Aiming at the problems of low resolution of small objects, blurred images, and less information carried, one object detector that introduces residual learning and multi-scale feature enhancement is proposed. Firstly, an enhanced feature mapping block based on residual learning is introduced into the backbone network. Through channel averaging and normalization, the model more focuses on the object area instead of the background, and it provides additional semantics information for the effective feature layer while taking into account the detection speed. Then the feature map increases the receptive field of the effective feature map through feature fusion block sensitive to context information, and fuses the shallow feature layer and the deep feature layer used for prediction to improve the detection performance at low resolution. Finally, a dual attention block is used to suppress background noise, and key features are embedded in attention. While preserving spatial information, it strengthens the information association between channels, thereby enhancing the expressive ability of features. In order to better detect small objects, the number of a priori boxes for shallow feature mapping is also adjusted. Experimental results show that on the dataset of PASCAL VOC2007, the detection accuracy (mAP) of the algorithm for 300×300 input scale is 79.9%, which is 2.7 percentage points higher than that of SSD, and the detection accuracy of small objects bird, bottle, chair, and plant is improved 5.1 percentage points, 7.5 percentage points, 3.9 percentage points, 7.2 percentage points，respectively. The detection accuracy (mAP) on the OAP self-made aerial dataset is 82.7%.

For the observation of a picture, people may instinctly pay more attention to the eye-catching objects in the picture. Usually such objects tend to occupy a larger proportion in the picture, which leads to small targets being ignored. Because the area where the small target is located is often a weak detection area, and the features that can be extracted in the process of extracting features by the detector are few and are easily lost in the process of feature information transmission after the feature is extracted, the effect of small target detection is not good. Therefore, on the basis of the single-order detector, this paper adds a cross-channel interaction mechanism to ensure the integrity of the information between layers, adopts target enhancement of training samples and designs a general loss function. Apart from this, this paper improves the sample weighting on the basis of the loss function to predict weight of samples. The mAP of this paper framework UWN (unified weighted network) on the VOC public dataset is 81.2% and the mAP on the self-made small target aerial photography dataset is 82.3%. Compared with the FSSD algorithm, some speed is sacrificed, and the accuracy is greatly improved.

In order to solve the problems of deadlock, slow convergence, easy to get into local optimum and uneven path when ant colony algorithm is applied to the path planning of mobile robots, a smooth path planning method combining improved A* ant colony algorithm and the rolling window method is proposed. Firstly, the improved A* algorithm is used to initialize the ant colony pheromone to solve the problem of low ant colony efficiency. Then, the state transition probability function is improved to consider the feasible path “activity” and the end position in the function to avoid deadlock phenomenon. At the same time, based on the mechanism of inequality principle, the pheromone of ant colony is updated to avoid falling into the local optimal path and accelerate the convergence speed of the algorithm. Secondly, based on the global path planning, local real-time path planning is carried out by integ-rating the rolling window method and the dynamic obstacle avoidance strategy. Finally, Bessel curve is used to process the smoothness of the planned path, so that the smoothed path is closer to the actual motion path. In order to ensure the best performance of the algorithm, genetic algorithm with elite strategy is used to optimize the parameters of the algorithm. Three sets of experimental results show that the proposed algorithm is effective in the presence of simple or complex, static or dynamic obstacles.

Magnesium is one of the most abundant essential minerals in the body. Magnesium supplements mostly have low bioavailability, except magnesium L-threonate. In 2010, a novel magnesium compound, magnesium L-threonate (Magtein®) was identified and was shown to raise the magnesium levels in the brain and neurons effectively. In this double-blind, placebo-controlled study, Magtein®PS, a magnesium L-threonate (Magtein®)- and phosphatidylserine-based formulation additionally containing vitamins C and D, was tested for its cognitive benefits in 109 healthy Chinese adults aged 18–65 years. Subjects were randomly assigned to receive either Magtein®PS or placebo (starch) capsules, at a dose of 2 g/day. "The Clinical Memory Test", the standard test commonly used in Chinese hospitals and academic institutes for cognitive evaluation, was administered before and 30 days after subjects received the supplement. Subjects receiving Magtein®PS showed significant improvements over the control group in all five subcategories of "The Clinical Memory Test" as well as the overall memory quotient scores. The older participants showed more improvement than younger participants. Results indicated significant benefits of Magtein®PS in improving memory and cognition in healthy Chinese adults. [ABSTRACT FROM AUTHOR]

In order to solve the problems of deadlock, slow convergence, easy to get into local optimum and uneven path when ant colony algorithm is applied to the path planning of mobile robots, a smooth path planning method combining improved A* ant colony algorithm and the rolling window method is proposed. Firstly, the improved A* algorithm is used to initialize the ant colony pheromone to solve the problem of low ant colony efficiency. Then, the state transition probability function is improved to consider the feasible path"activity"and the end position in the function to avoid deadlock phenomenon. At the same time, based on the mechanism of inequality principle, the pheromone of ant colony is updated to avoid falling into the local optimal path and accelerate the convergence speed of the algorithm. Secondly, based on the global path planning, local real-time path planning is carried out by integrating the rolling window method and the dynamic obstacle avoidance strategy. Finally, Bessel curve is used to process the smoothness of the planned path, so that the smoothed path is closer to the actual motion path. In order to ensure the best performance of the algorithm, genetic algorithm with elite strategy is used to optimize the parameters of the algorithm. Three sets of experimental results show that the proposed algorithm is effective in the presence of simple or complex, static or dynamic obstacles. [ABSTRACT FROM AUTHOR]

Background: A unified clinical approach to diagnose autoimmune encephalitis was published in Lancet Neurology in 2016. Purpose of our study is to examine the feasibility and reasonability of the 2016 "A clinical approach to diagnosis of autoimmune encephalitis" in China with a retrospective study.Methods: We retrospectively collected 95 cases of autoimmune encephalitis and non autoimmune encephalitis cases with detailed clinical data from Beijing Tongren Hospital and the China National Knowledge Infrastructure (CNKI). All cases were analysed stepwise according to the approach in Lancet Neurology to compare the new diagnosis with the final clinical diagnosis.Results: The disease course of these 95 cases ranged from 2 to 540 days. Initial symptoms include fever, headache, seizure, mental and behavioral disorders, memory deterioration and illusion. Based on symptoms and signs when the patient came to the hospital, the sensitivity and specificity of criteria were as follows: possible autoimmune encephalitis (pAE) 84% and 94%, definite autoimmune limbic encephalitis (dALE) 38% and 96%, probable anti-N-methyl-D-aspartate receptor encephalitis (prNMDARE) 49% and 98%. The sensitivities of the above three criteria and the specificity of pAE were low during early disease stage, while the specificities of dALE and prNMDAER remained relatively high in different time periods.Conclusions: This new autoimmune encephalitis diagnostic approach can recognize possible autoimmune encephalitis. The chances of a case being autoimmune-mediated following classification as autoimmune encephalitis with the new criteria are high. The flowchart is recommended to use as a whole. At the early disease stage, criteria with low sensitivity and high specificity, such as dALE and prNMDARE, lead most cases to enter subsequent diagnosis steps, namely autoantibody detection in the flowchart. Final diagnoses can only be made by autoantibody tests. These factors may make it challenging for clinicians to make diagnosis promptly and to begin immune-modulating therapy immediately. Moreover, the criteria for patients with paraneoplastic syndromes (PNSs) should be considered to avoid diagnosis omission. For Chinese patients, a multi-centre, prospective study on the clinical manifestations, laboratory diagnostic technology, therapy, and prognosis is greatly needed. [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of comprehensive nursing measures, based on the risk factors of dementia, in liver cancer patients, who accepted intervention therapy., Methods: 86 patients met the inclusion criteria, and exclusion criteria were divided into an experimental group (EG group) and a control group (CG group). The general baseline data of age, sex, and education level of groups were evaluated before intervention. CG group adopted routine nursing measures, while EG group gave comprehensive nursing measures on the basis of routine nursing measures. Cognitive function, severity, Barthel index (BI), and quality of life were evaluated on admission day, discharge day, and three months after discharge., Results: The scores of cognitive function, mental state, and self-care ability of daily life in the EG group were significantly higher than those in the CG group on the day of discharge and 3 months after discharge. Three months after discharge, the quality of life total score of EG group was significantly higher than that in CG group, and the scores in the family role, language, activity, self-care ability, social role, thinking and social function were also higher than those in CG group (P < .05). Three months after discharge, the readmission rate and retraining rate in the EG group were significantly lower than those in the CG group (P < .05), but there was no significant difference in mortality between the two groups(P > .05)., Conclusion: Comprehensive nursing measures based on prognostic factors in patients undergoing interventional therapy for hepatocellular carcinoma can more effectively enhance patient recovery.

Objective: The performance of anti-NMDAR Encephalitis One-Year Functional Status (NEOS) in predicting the 1-year functional status in Chinese patients with anti-NMDAR encephalitis is unknown., Methods: We recruited patients with anti-NMDAR encephalitis from the Multicenter and Prospective Clinical Registry Study of Anti-NMDAR Encephalitis in Beijing Area. Patients were followed up for 1 year. We defined the poor functional status as a modified Rankin Scale score of more than 2 and good functional status as a modified Rankin Scale score of no more than 2. We performed a receiver-operator characteristic analysis to assess the discriminatory power of the NEOS score in predicting the 1-year functional status by using the area under the curve (AUC). Calibration was assessed by Pearson correlation coefficient and Hosmer-Lemeshow tests., Results: Among the 111 patients with anti-NMDAR encephalitis recruited from 364 potentially eligible participants, 87 (78.4%) had good functional status at 1 year, whereas the remaining 24 (21.6%) had poor functional status. The AUC of the NEOS score for 1-year poor functional status was 0.86 (95% CI 0.78-0.93, p < 0.001). The increased NEOS was associated with higher risk of 1-year poor functional status in patients with anti-NMDAR encephalitis., Conclusions: The NEOS score is considered a reliable predictor of the risk of 1-year poor functional status in Chinese patients with anti-NMDAR encephalitis. This score could help to estimate the velocity of clinical improvement in advance., Clinicaltrialgov Identifier: NCT02443350., Classification of Evidence: This study provides Class III evidence that in patients with anti-NMDAR encephalitis, the NEOS score predicts 1-year functional status., (Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.)

Objective: To observe the effect of early enteral nutrition (EEN) on nutritional indicators and clinical outcomes in patients with severe heart failure undergoing mechanical ventilation., Methods: Thirty-four patients with severe heart failure (grade III-IV of cardiac function) and pulmonary infections undergoing mechanical ventilation admitted to intensive care unit (ICU) of Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from May 2017 to April 2018 were enrolled. They were randomly divided into EEN group and delayed enteral nutrition (DEN) group. Both groups were given routine treatment, including mechanical ventilation, improvement of cardiac function, anti-infection, protection of vital organ function, regulation of blood sugar and adjustment of electrolyte and acid-base balance. The patients in EEN group received enteral nutrition (EN) within 48 hours after ICU admission, and in DEN group, EN was started after the patients had spent the early stage of stress and had stable vital signs (48 hours after ICU admission). The changes in serum B-type natriuretic peptide (BNP), C-reactive protein (CRP), nutritional indicators and liver function indicators at ICU admission and 7 days after treatment were compared between the two groups. The time needed for patients to reach EN target, duration of mechanical ventilation, length of ICU stay, and the 28-day mortality were recorded, and complications were observed., Results: There was no significant difference in serum BNP, CRP, nutritional indicators or liver function indicators at ICU admission between the two groups. After treatment for 7 days, BNP and CRP in both groups were decreased significantly as compared with those at ICU admission [BNP (ng/L): 592.1±370.9 vs. 2 517.7±1 163.4 in EEN group, 621.9±418.8 vs. 2 251.5±1 006.8 in DEN group; CRP (mg/L): 46.0±19.6 vs. 59.8±22.5 in EEN group, 40.5±18.8 vs. 61.2±24.6 in DEN group, all P < 0.05], pre-albumin (PA) and transferrin (TF) were significantly increased [PA (g/L): 0.18±0.05 vs. 0.15±0.06 in EEN group, 0.17±0.04 vs. 0.12±0.06 in DEN group; TF (g/L): 1.6±0.4 vs. 1.5±0.4 in EEN group, 1.7±0.5 vs. 1.4±0.5 in DEN group, all P < 0.05]. However, there was no significant difference in the above indicators after treatment between the two groups (all P > 0.05). There was no significant change in liver function after treatment in both groups. The EN treatment was successfully completed in both groups. Some patients developed abdominal distension and diarrhea in varying degrees, which were alleviated by slowing down the infusion rate, supplemented by gastrointestinal motility drugs and intestinal flora adjustment drugs. The time needed to reach EN target in EEN group was significantly earlier than that in DEN group (hours: 42.4±10.2 vs. 53.8±17.1, P < 0.05), the duration of mechanical ventilation (days: 14.2±8.7 vs. 13.4±7.9), the length of ICU stay (days: 17.8±6.7 vs. 18.3±5.6) and 28-day mortality [5.9% (1/17) vs. 11.8% (2/17)] showed no significant difference as compared with those in DEN group (all P > 0.05), and it did not increase the incidence of aspiration pneumonia [23.5% (4/17) vs. 17.7% (3/17), P > 0.05]., Conclusions: EEN could help to achieve nutritional goals as soon as possible, improve the nutritional status of the body, and provide conditions and basis for further treatment of severe heart failure patients.

Objective: To investigate the clinical features of ocular syndromes in patients with neurobrucellosis., Method: This is a retrospective series case study. The clinical data of 5 patients with neurobrucellosis, who were treated in Department of Neurology, Beijing Tongren Hospital, Captical Medical Uinversity, from May 2009 to January 2015, were collected. Their epidemiological information, clinical manifestation, laboratory and radiologic examination, therapy and prognosis were analyzed., Results: Among the five patients, there were 3 males and 2 females, and their ages ranged from 20 to 67 years. The median age was 25 years. All patients had ever exposed to sheep. 1 patient lived close to a slaughterhouse and 2 patients lived in epidemic areas of brucellosis. 5 patients presented with binocular vision loss, 8 eyes with fundus edema, 3 patients with ophthalmoplegia;4 patients with fever,4 patients with headache,3 patients with neck stiffness,1 patient with movement and sensation disorders. Cerebrospinal fluid (CSF) pressure elevated, white cell number and protein increased with glucose reduction were detected respectively in 3 cases. While, CSF chloride decreased in 2 cases. Serum agglutination test for brucella was positive in 5 patients. Serum brucella culture was positive in 1 patient and CSF brucella culture was positive in 1 patient. Brain magnetic resonance imaging (MRI) showed that the optic nerve was involved in 3 patients,the meninges were involved in 1 patient and the brain white matter was involved in 1 patient. The combination of rifamycin, tetracycline, ceftriaxone sodium or quinolone were given to all patients and showed appreciated effects., Conclusions: The clinical features of ocular syndromes are atypical in patients with neurobrucellosis. Vision loss and ophthalmoplegia are more common to be seen. Neurobrucellosis should be considered when patients with ocular signs and other system symptoms without a definite diagnosis.