Reactive oxygen species (ROS) are the weapons of neutrophiles against bacterial pathogens, and also the central effectors in reactive oxygen therapy for skin and soft tissue infection. Nanozymes that spontaneously generate ROS under physiological conditions are new antibacterials that hold promise towards multidrug resistant pathogens. The clinical use of the nanozymes is however limited by their low biocompatibility and toxicity in vivo. Here, we develop an oleic acid (OA) nanoemulsion template method for the one-pot synthesis of OA-manganese dioxide (MnO₂) nanozyme. The OA-MnO₂ nanozyme showed high stability and biocompatibility under physiological conditions with marked oxidase-like activity. The ROS generated by the OA-MnO₂ nanozyme effectively kill the Gram-positive Staphylococcus aureus and the Gram-negative Escherichia coli strains. Moreover, the OA-MnO₂ nanozyme shows promising abilities to prevent and destruct biofilm formation by Staphylococcus aureus, and result in superior in vivo antibacterial performance as compared to vancomycin. The reactive oxygen therapy based on OA-MnO₂ nanozyme cures the infected skin and promotes wound healing in mice, manifesting its potential use in skin and soft tissue infection.

Objective: To develop high-quality synthetic CT (sCT) generation method from low-dose cone-beam CT (CBCT) images by using attention-guided generative adversarial networks (AGGAN) and apply these images to dose calculations in radiotherapy. Methods: The CBCT/planning CT images of 170 patients undergoing thoracic radiotherapy were used for training and testing. The CBCT images were scanned under a fast protocol with 50% less clinical projection frames compared with standard chest M20 protocol. Training with aligned paired images was performed using conditional adversarial networks (so-called pix2pix), and training with unpaired images was carried out with cycle-consistent adversarial networks (cycleGAN) and AGGAN, through which sCT images were generated. The image quality and Hounsfield unit (HU) value of the sCT images generated by the three neural networks were compared. The treatment plan was designed on CT and copied to sCT images to calculated dose distribution. Results: The image quality of sCT images by all the three methods are significantly improved compared with original CBCT images. The AGGAN achieves the best image quality in the testing patients with the smallest mean absolute error (MAE, 43.5 ± 6.69), largest structural similarity (SSIM, 93.7 ± 3.88) and peak signal-to-noise ratio (PSNR, 29.5 ± 2.36). The sCT images generated by all the three methods showed superior dose calculation accuracy with higher gamma passing rates compared with original CBCT image. The AGGAN offered the highest gamma passing rates (91.4 ± 3.26) under the strictest criteria of 1 mm/1% compared with other methods. In the phantom study, the sCT images generated by AGGAN demonstrated the best image quality and the highest dose calculation accuracy. Conclusions: High-quality sCT images were generated from low-dose thoracic CBCT images by using the proposed AGGAN through unpaired CBCT and CT images. The dose distribution could be calculated accurately based on sCT images in radiotherapy.

Skin lesion segmentation is a fundamental procedure in computer-aided melanoma diagnosis. However, due to the diverse shape, variable size, blurry boundary, and noise interference of lesion regions, existing methods may struggle with the challenge of inconsistency within classes and indiscrimination between classes. In view of this, we propose a novel method to learn and model inter-pixel correlations from both global and local aspects, which can increase inter-class variances and intra-class similarities. Specifically, under the encoder-decoder architecture, we first design a pyramid transformer inter-pixel correlations (PTIC) module, aiming at capturing the non-local context information of different levels and further exploring the global pixel-level relationship to deal with the large variance of shape and size. Further, we devise a local neighborhood metric learning (LNML) module to strengthen the local semantic correlations learning capability and increase the separability between classes in the feature space. These two modules can complementarily strengthen the feature representation capability via exploiting the inter-pixel semantic correlations, thus further improving intra-class consistency and inter-class variance. Comprehensive experiments are performed on public skin lesion segmentation datasets: ISIC 2018, ISIC2016, and PH2, and experimental results demonstrate that the proposed method achieves better segmentation performance than other state-of-the-art methods.