Network meta-analysis may be performed by fitting multivariate meta-analysis models with Stata software mvmeta command; however, there are various challenges such as preprocessing the data, parameterising the model, and making good graphical displays of results. A suite of Stata programs, network, may meet these challenges. In this article, we introduce how to use the network commands to implement network meta-analysis by the example of continuous data.
Microaneurysm is the initial symptom of diabetic retinopathy. Eliminating this lesion can effectively prevent diabetic retinopathy in the early stage. However, due to the complex retinal structure and the different brightness and contrast of fundus image because of different factors such as patients, environment and acquisition equipment, the existing detection algorithms are difficult to achieve the accurate detection and location of the lesion. Therefore, an improved detection algorithm of you only look once (YOLO) v4 with Squeeze-and-Excitation networks (SENet) embedded was proposed. Firstly, an improved and fast fuzzy c-means clustering algorithm was used to optimize the anchor parameters of the target samples to improve the matching degree between the anchors and the feature graphs; Then, the SENet attention module was embedded in the backbone network to enhance the key information of the image and suppress the background information of the image, so as to improve the confidence of microaneurysms; In addition, an spatial pyramid pooling was added to the network neck to enhance the acceptance domain of the output characteristics of the backbone network, so as to help separate important context information; Finally, the model was verified on the Kaggle diabetic retinopathy dataset and compared with other methods. The experimental results showed that compared with other YOLOv4 network models with various structures, the improved YOLOv4 network model could significantly improve the automatic detection results such as F-score which increased by 12.68%; Compared with other network models and methods, the automatic detection accuracy of the improved YOLOv4 network model with SENet embedded was obviously better, and accurate positioning could be realized. Therefore, the proposed YOLOv4 algorithm with SENet embedded has better performance, and can accurately and effectively detect and locate microaneurysms in fundus images.
Network plots can clearly present the relationships among the direct comparisons of various interventions in a network meta-analysis. Currently, there are some methods of drawing network plots. However, the information provided by a network plot and the interface-friendly degree to a user differ in the kinds of software. This article briefly introduces how to draw network plots using the network package and gemtc package that base on R Software, Stata software, and ADDIS software, and it also compares the similarities and differences among them.
Objective To evaluate the effectiveness of the dermal pedicled nasolabial flap with subdermal vascular network for repairing nasolabial skin defects. Methods Between July 2008 and July 2011, 43 cases of nasolabial defects wererepaired with dermal pedicled nasolabial flap with subdermal vascular network. There were 22 males and 21 females with a median age of 36 years (range, 6-68 years). All defects were caused by excision of lesions, including pigmented nevus in 23 cases, scar in 16 cases, and inflammatory granuloma in 4 cases. The disease duration was 3 months to 35 years. Lesions were located at the tip of the nose in 11 cases, at the alae of the nose in 10 cases, at the alae and tip of the nose in 10 cases, at the alar groove of the nose in 8 cases, and at upper l ip in 4 cases. The defect size ranged from 0.7 cm × 0.5 cm to 1.2 cm × 1.0 cm. The flap size ranged from 1.0 cm × 0.7 cm to 1.5 cm × 1.2 cm. Results All flaps survived and incisions at donors and wound healed by first intention. After operation, 34 patients were followed up 6-12 months (mean, 10 months). The texture and color of the flap were similar to adjacent skin. No obvious scar was observed at donor sites. Conclusion The dermal pedicled nasolabial flap with subdermal vascular network has the advantages of flexible flap transplantation, small damage to donor site, and low incidence of bloated subcutaneous tunnel.
OBJECTIVE: To investigate the clinical application of subdermal vascular network skin flap pre-fabricated by ultrasonic liposuction in reconstruction of digital avulsion. METHODS: Forty-seven injured fingers of 23 cases were treated from June 1997 to February 2000. Conventional abdominal skin flap was elevated, according to the size of digital avulsion, and subcutaneous fat was removed with scissors. Ultrasonic liposuction technology was adopted, in order to minimize the injury of subdermal vascular vessels, to remove the fat particles close to the vascular network. Finally, the pre-fabricated skin flap was used to repair the digital avulsion. The vascular pedicle was severed in 5 to 7 days after operation. The range of skin flap was 4 cm x 3 cm to 8 cm x 7 cm, and the ratio of length and width was (2 to 3) to 1. RESULTS: All the skin flaps were survived. Twenty-one patients were available for postoperative follow-up for 6 to 24 months. The motion of interphalangeal joint achieved functional recovery, and the sensation of pain, temperature and taction recovered well. CONCLUSION: Ultrasonic liposuction does not obviously injure the subdermal vascular network skin flap, it is a simple and safe method for treatment of digital avulsion.
OBJECTIVE: To explore the importance of the posterior and lateral arterial network of elbow in the application of the super-regional and mutual-pedicled axial flap. METHODS: Twenty-seven upper extremities of adult cadavers were prepared as casts of Acrylomintril Batradiene Styrene(ABS) resin and corroded in a b solution of NaOH according to natural layers of human tissue. The source, site and structure of the posterior and lateral arterial network of elbow were observed, the number and total sectional area of anastomosing branches crossing the line between two humeral epicondyles were measured and compared with the medial and anterior region. RESULTS: There are 8.64 +/- 2.74(36.42%) and 8.30 +/- 1.19(35.0%) anastomosing branches crossing the posterior and lateral regions, and total section areas are (0.48 +/- 0.11) mm2 and (0.37 +/- 0.03) mm2 respectively. So there is very rich arterial network around the elbow. CONCLUSION: The enough number of anastomosing branches and their section areas of the posterior and lateral region of the elbow make it possible to connect super-regional and mutual-pedicled axial flaps crossing the elbow.
OBJECTIVE In order to solve the difficult problem of one-stage repair of degloving injury of multiple fingers, the common pedicled ilio-inguinal-hypogastric subdermal vascular network skin flap was designed and the multi-lobes skin flap was performed subsequently. METHODS From 1993 to 1996, there were 5 cases with degloving injuries of multiple fingers were treated by this flap. There were 2 males and 3 females and the age ranged from 7 to 19 years old. RESULTS After operation, the pedicles of the flap was detached between 12 to 16 days and all of the flaps survived completely. Patients were followed up for 6-18 months. After repair, the contour and skin colour of the digits were excellent, and the motion of the interphalangeal joints and skin sensation were good. CONCLUSION The conclusion was as follows: The newly designed skin flap was characterized by the advantages of duration of treatment being short, excellent contour and more rapid recovery of function. It could be used for one-stage repair of degloving injury of multiple fingers.
OBJECTIVE To evaluate the clinical efficacy of thin flap with subdermal vascular network of the neck-pectoral region on repair of the contracture of the burn scar on the neck. METHODS From March 1990 to May 1998, 21 cases of deformity of neck due to burn scar were repaired with the thin flap ranging from 8 cm x 5 cm to 14 cm x 8 cm, and all of the cases were followed up for 6 to 42 months. RESULTS Except partial necrosis of the distal end of the flap in 1 case, the flaps in the other 20 cases all survived and presented a satisfactory appearance and function. CONCLUSION The thin flap with subdermal vascular network in neck-pectoral region may provide a large area of flap, and could be easily transferred. It’s an ideal flap for the repair of skin defect on the neck.
From Sept 1989 to Dec 1993, the auricular composite graft carrying a piece of postauriclar skin with subdermal vascular network was used to repair 7 cases having defects of nasal alar or tip and 1 having microtia. The width of the composite grafts ranged from 1.8cm to 2.6cm, and the size of the postauricular skin rangedfrom 0.08×1cm2 to 2.2×2.5cm2. All cases gained successful results. The mechanism of survival of the composite grafts, and the essential points in operation were detailed.
In this study, 8 pigs, weight ranged from 25 to 30kg, were used. Island skin flaps with the deep circumflex iliac artery were designed as pedicle on both buttocks. In the distal half of the island skin flap, which had been made on the right buttock, a subdermal vascular network island skin flap was made by preserving the subdermal vascular network. Blood supply between the two types of skin flap was compared by skin temperature, laser Doppler, fluorescent stain, histological examination, ink perfusion microangiography and transparent specimen technique. The observation showed thatthe blood supply of the subdermal vascular network island skin flap was decreased prominently in comparison with that of the conventional island skin flap. The subdermal vascular network skin flap was actually a combination of axial pattern skin flap with randomized skin flap.