The primary aim of this research was to address the limitations observed in the medical knowledge of prevalent large language models (LLMs) such as ChatGPT, by creating a specialized language model with enhanced accuracy in medical advice. We achieved this by adapting and refining the large language model meta-AI (LLaMA) using a large dataset of 100,000 patient-doctor dialogues sourced from a widely used online medical consultation platform. These conversations were cleaned and anonymized to respect privacy concerns. In addition to the model refinement, we incorporated a self-directed information retrieval mechanism, allowing the model to access and utilize real-time information from online sources like Wikipedia and data from curated offline medical databases. The fine-tuning of the model with real-world patient-doctor interactions significantly improved the model's ability to understand patient needs and provide informed advice. By equipping the model with self-directed information retrieval from reliable online and offline sources, we observed substantial improvements in the accuracy of its responses. Our proposed ChatDoctor, represents a significant advancement in medical LLMs, demonstrating a significant improvement in understanding patient inquiries and providing accurate advice. Given the high stakes and low error tolerance in the medical field, such enhancements in providing accurate and reliable information are not only beneficial but essential.

Skull stripping is a crucial prerequisite step in the analysis of brain magnetic resonance images (MRI). Although many excellent works or tools have been proposed, they suffer from low generalization capability. For instance, the model trained on a dataset with specific imaging parameters cannot be well applied to other datasets with different imaging parameters. Especially, for the lifespan datasets, the model trained on an adult dataset is not applicable to an infant dataset due to the large domain difference. To address this issue, numerous methods have been proposed, where domain adaptation based on feature alignment is the most common. Unfortunately, this method has some inherent shortcomings, which need to be retrained for each new domain and requires concurrent access to the input images of both domains. In this paper, we design a plug-and-play shape refinement (PSR) framework for multi-site and lifespan skull stripping. To deal with the domain shift between multi-site lifespan datasets, we take advantage of the brain shape prior, which is invariant to imaging parameters and ages. Experiments demonstrate that our framework can outperform the state-of-the-art methods on multi-site lifespan datasets.

Accurate segmentation is a crucial step in medical image analysis and applying supervised machine learning to segment the organs or lesions has been substantiated effective. However, it is costly to perform data annotation that provides ground truth labels for training the supervised algorithms, and the high variance of data that comes from different domains tends to severely degrade system performance over cross-site or cross-modality datasets. To mitigate this problem, a novel unsupervised domain adaptation (UDA) method named dispensed Transformer network (DTNet) is introduced in this paper. Our novel DTNet contains three modules. First, a dispensed residual transformer block is designed, which realizes global attention by dispensed interleaving operation and deals with the excessive computational cost and GPU memory usage of the Transformer. Second, a multi-scale consistency regularization is proposed to alleviate the loss of details in the low-resolution output for better feature alignment. Finally, a feature ranking discriminator is introduced to automatically assign different weights to domain-gap features to lessen the feature distribution distance, reducing the performance shift of two domains. The proposed method is evaluated on large fluorescein angiography (FA) retinal nonperfusion (RNP) cross-site dataset with 676 images and a wide used cross-modality dataset from the MM-WHS challenge. Extensive results demonstrate that our proposed network achieves the best performance in comparison with several state-of-the-art techniques.