Accurate diagnosing of pneumonia and recognizing Anteroposterior and Posteroanterior in pediatric patients through chest X-ray (CXR) are critical components of contemporary computer-aided medical imaging systems. However, a prevalent issue in current methodologies is the suboptimal representation due to class imbalance, which is particularly pronounced in medical images, given the limited quantitative data for certain classes. Furthermore, despite the promising performance of deep learning models, they often face challenges when confronted with various manifestations of pediatric pneumonia and other lung diseases, aside from pneumonia itself. Thus, enhancing model generalization becomes imperative. To address these limitations, this paper presents a novel approach that combines weight adaptive contrast learning and knowledge governor distillation, namely SEACC. Firstly, we employ self-knowledge distillation, leveraging sample-level soft targets to enhance the model’s generalization without incurring additional computational overhead. Secondly, we incorporate supervised contrastive learning, introducing innovative contrast weights among positive samples based on feature similarity. This technique promotes feature representations that exhibit intra-class compactness and inter-class dispersion. Experimental evaluations are conducted on a publicly Guangzhou Women and Children’s Medical dataset, showing an improvement in Recall by ↑3.3%, in AUC by ↑10.1%, surpassing the existing SOTA methods.

Olfactory dysfunction is increasingly recognized as an early indicator of Alzheimer's disease (AD). Aberrations in GABAergic function and the excitatory/inhibitory (E/I) balance within the olfactory bulb (OB) have been implicated in olfactory impairment during the initial stages of AD. While the neuregulin 1 (NRG1)/ErbB4 signaling pathway is known to regulate GABAergic transmission in the brain and is associated with various neuropsychiatric disorders, its specific role in early AD-related olfactory impairment remains incompletely understood. This study demonstrated that olfactory dysfunction preceded cognitive decline in young adult APP/PS1 mice and was characterized by reduced levels of NRG1 and ErbB4 in the OB. Further investigation revealed that deletion of ErbB4 in parvalbumin interneurons reduced GABAergic transmission and increased hyperexcitability in mitral and tufted cells (M/Ts) in the OB, thereby accelerating olfactory dysfunction in young adult APP/PS1 mice. Additionally, ErbB4 deficiency was associated with increased accumulation of Aβ and BACE1-mediated cleavage of APP, along with enhanced CDK5 signaling in the OB. NRG1 infusion into the OB was found to enhance GABAergic transmission in M/Ts and alleviate olfactory dysfunction in young adult APP/PS1 mice. These findings underscore the critical role of NRG1/ErbB4 signaling in regulating GABAergic transmission and E/I balance within the OB, contributing to olfactory impairment in young adult APP/PS1 mice, and provide novel insights for early intervention strategies in AD. This work has shown that ErbB4 deficiency increased the burden of Aβ, impaired GABAergic transmission, and disrupted the E/I balance of mitral and tufted cells (M/Ts) in the OB, ultimately resulting in olfactory dysfunction in young adult APP/PS1 mice. NRG1 could enhance GABAergic transmission, rescue E/I imbalance in M/Ts, and alleviate olfactory dysfunction in young adult APP/PS1 mice. OB: olfactory bulb, E/I: excitation/inhibition, Pr: probability of release, PV: parvalbumin interneurons, Aβ: β-amyloid, GABA: gamma-aminobutyric acid.

Based on single-cell sequencing of the hippocampi of 5x familiar Alzheimer's disease (5x FAD) and wild type mice at 2-, 12-, and 24-month of age, we found an increased percentage of microglia in aging and Alzheimer's disease (AD) mice. Blood brain barrier injury may also have contributed to this increase. Immune regulation by microglia plays a major role in the progression of aging and AD, according to the functions of 41 intersecting differentially expressed genes in microglia. Signaling crosstalk between C=C motif chemokine ligand (CCL) and major histocompatibility complex-1 bridges intercellular communication in the hippocampus during aging and AD. The amyloid precursor protein (APP) and colony stimulating factor (CSF) signals drive 5x FAD to deviate from aging track to AD occurrence among intercellular communication in hippocampus. Microglia are involved in the progression of aging and AD can be divided into 10 functional types. The strength of the interaction among microglial subtypes weakened with aging, and the CCL and CSF signaling pathways were the fundamental bridge of communication among microglial subtypes. (c) 2023 The Author(s). Published by Elsevier B.V. on behalf of Xi'an Jiaotong University. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

目的 了解黄连解毒汤加减方对阿尔茨海默病(AD)模型小鼠学习记忆功能的影响并探索相关机制.方法 4月龄5×FAD小鼠分别灌胃给予黄连解毒汤加减方、黄连解毒汤原方治疗3个月,采用水迷宫等行为学方法检测小鼠学习记忆功能,采用膜片钳等电生理学方法检测神经元及突触功能,采用免疫印迹、免疫组化及电镜等检测小鼠脑内Aβ沉积及神经血管单元变化情况.结果 与模型组相比,黄连解毒汤加减方治疗能提高5×FAD小鼠的学习记忆功能,改善海马及皮层区突触结构及功能,减少Aβ沉积和星形胶质细胞增殖,上调ZO-1/Occludin等紧密连接蛋白表达,下调IL-1β、TNF-α等炎性因子及RAGE/NF-κB等信号分子表达,改善微血管超微结构;且加减方作用优于原方.结论 黄连解毒汤加减方可能通过抑制5×FAD小鼠脑内Aβ沉积、RAGE/NF-κB通路介导的神经炎症,改善神经血管单元损伤,从而改善AD模型小鼠的学习记忆功能.

Alzheimer’s disease (AD) is a neurodegenerative disease with subtle onset, early diagnosis remains challenging. Accumulating evidence suggests that the emergence of retinal damage in AD precedes cognitive impairment, and may serve as a critical indicator for early diagnosis and disease progression. Salvianolic acid B (Sal B), a bioactive compound isolated from the traditional Chinese medicinal herb Salvia miltiorrhiza, has been shown promise in treating neurodegenerative diseases, such as AD and Parkinson’s disease. In this study we investigated the therapeutic effects of Sal B on retinopathy in early-stage AD. One-month-old transgenic mice carrying five familial AD mutations (5×FAD) were treated with Sal B (20 mg·kg−1·d−1, i.g.) for 3 months. At the end of treatment, retinal function and structure were assessed, cognitive function was evaluated in Morris water maze test. We showed that 4-month-old 5×FAD mice displayed distinct structural and functional deficits in the retinas, which were significantly ameliorated by Sal B treatment. In contrast, untreated, 4-month-old 5×FAD mice did not exhibit cognitive impairment compared to wild-type mice. In SH-SY5Y-APP751 cells, we demonstrated that Sal B (10 μM) significantly decreased BACE1 expression and sorting into the Golgi apparatus, thereby reducing Aβ generation by inhibiting the β-cleavage of APP. Moreover, we found that Sal B effectively attenuated microglial activation and the associated inflammatory cytokine release induced by Aβ plaque deposition in the retinas of 5×FAD mice. Taken together, our results demonstrate that functional impairments in the retina occur before cognitive decline, suggesting that the retina is a valuable reference for early diagnosis of AD. Sal B ameliorates retinal deficits by regulating APP processing and Aβ generation in early AD, which is a potential therapeutic intervention for early AD treatment.

Olfactory dysfunction is among the earliest non-motor symptoms of Parkinson’s disease (PD). As the foremost pathological hallmark, α-synuclein initiates the pathology in the olfactory pathway at the early stage of PD, particularly in the olfactory epithelium (OE) and olfactory bulb (OB). However, the local neural microcircuit mechanisms underlying olfactory dysfunction between OE and OB in early PD remain unknown. We observed that odor detection and discrimination were impaired in 6-month-old SNCA-A53T mice, while their motor ability remained unaffected. It was confirmed that α-synuclein increased and accumulated in OB but not in OE. Notably, the hyperactivity of mitral/tufted cells and the excitation/inhibition imbalance in OB were found in 6-month-old SNCA-A53T mice, which was attributed to the impaired GABAergic transmission and aberrant expression of GABA transporter 1 and vesicular GABA transporter in OB. We further showed that tiagabine, a potent and selective GABA reuptake inhibitor, could reverse the impaired olfactory function and GABAergic signaling in OB of SNCA-A53T mice. Taken together, our findings demonstrate potential synaptic mechanisms of local neural microcircuit underlying olfactory dysfunction at the early stage of PD. These results highlight the critical role of aberrant GABAergic signaling of OB in early diagnosis and provide a potential therapeutic strategy for early-stage PD.

阿尔茨海默病(AD),即老年性痴呆,是一种起病隐匿、进行性发展的神经系统退行性疾病,尽早诊断与治疗有利于延缓疾病进程.AD的病因及病理机制复杂,其中特异性细胞毒性病理改变及应激/炎症反应、脑微血管病变及代谢失衡、神经微环路兴奋/抑制失衡等因素导致退行性改变进行性发展,尤其值得关注.我们认为上述病理改变在微观层面具有中医"虚痰瘀毒"特征,其中"浊毒损络"可作为AD的核心病机和治疗的关键切入点,且在AD早期就存在"浊毒损络"核心病机.AD疾病进程中,嗅觉、视觉等外周感觉功能异常早于认知功能障碍,上述外周感觉功能异常可作为AD早期病理进程的重要预警指标.我们探索了开心散加味优化方、黄连解毒汤加减方等经典名方及其有效成分早期干预对AD模型认知功能及视觉、嗅觉等功能的影响,并探索了相关机制,希望为中医药治疗早期AD提供现代生物医学依据.