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Objective To establish a hybrid deep learning lung sound classification model based on convolutional neural network(CNN)-long short-term memory(LSTM)for electronic auscultation.Methods Wavelet transform was used to extract features from the dataset,transforming lung sound signals into energy entropy,peak value and other features.On this basis,a classification model based on hybrid algorithm incorporating CNN and LSTM neural network was constructed.The features extracted by wavelet transform were input into CNN module to obtain the spatial features of the data,and then the temporal features were detected through LSTM module.The fusion of the two types of features enabled the classification of lung sounds through the model,thereby assisting in the diagnosis of pulmonary diseases.Results The accuracy rate and F1 score of CNN-LSTM hybrid model were significantly higher than those of other single models,reaching 0.948 and 0.950.Conclusion The proposed CNN-LSTM hybrid model demonstrates higher accuracy and more precise classification,showcasing broad potential application value in intelligent auscultation.
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Objective:To explore the method and effect in repairing the defect of fingertip with lateral V-Y advancement flap with one side palmar proper digital artery.Methods:From October 2014 to May 2019, Department of the Hand and Foot Surgery, the Third People's Hospital of Jining(Yanzhou District People's Hospital of Jining City) treated 34 digits of 27 cases with a defect area of 0.5 cm×0.5 cm-1.5 cm×2.0 cm. A lateral V-Y advancement flap with one side palmar proper artery was used to repair the fingertip defect, and the flap size was 1.7 cm×1.0 cm-4.5 cm×1.5 cm. Twenty cases entered long-time follow-up after operation, with 7 cases lost in follow-up, 16 cases were reviewed at outpatient and 4 by WeChat.Results:All the flaps of 34 digits of 27 cases survived. The color of the flaps were close to or completely normal to the surrounding tissue, the texture was soft and the appearance was good. The TPD of the flap was 2.0-6.0 mm. The follow-up time ranged from 22 to 77 months, with an average of 31.45 months. The flexion and extension function of the digits were good with total range of motion(ROM) of the thumb was > 90 °; total active motion (TAM) of the fingers was 260 °-200 °. The fingers of 1 case had hook nail or hook finger deformity. According to the Evaluation Trial Standard of Upper Limb Partial Function of Hand Surgery of Chinese Medical Association, 18 cases were excellent and 2 cases were good.Conclusion:The lateral V-Y advancement flap with one side palmar proper digital artery is easy to operate. The blood supply of the flap is reliable, with good sensation. The flexion and extension of the digits are good, and the appearance and texture of the flap are good.
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Objective:To explore the predictability cytokines in aqueous humor affecting optical coherence tomography angiography (OCTA) parameters after anti-vascular endothelial growth factor (VEGF) treatment in patients with polypoidal choroidal vasculopathy (PCV).Methods:A cross-sectional study was carried out.Twenty eyes of 20 patients with PCV were included in Xuzhou First People's Hospital from July 2017 to July 2020.All PCV eyes were treated by intravitreal injection of conbercept (IVC) following 3+ PRN regimen.One hundred μl of aqueous humor was collected before treatment and before the third injection, respectively.Thirteen kinds of cytokines in the aqueous humor were detected with Luminex bead-based multiplex array.The aqueous humor of 16 eyes of 16 cataract patients with age and gender matched were collected in the same way during phacoemulsification surgery as control.The values of center macular thickness (CMT), subretinal fluid height (SRFH), pigment epithelial detachment height (PEDH) and pigment epithelial detachment diameter (PEDD) of the eyes in the PCV group were examined with OCTA system.The target cytokines in aqueous humor affecting OCTA parameter change values (the difference between before and after treatment) was analyzed.This study protocol was approved by an Medical Ethic Committee of Xuzhou First People's Hospital (No.xyyll[2020]27) and complied with Declaration of Helsinki.Written informed consent was obtained from each patient prior to any medical invention.Results:The concentration of interleukin-8 (IL-8), Leptin, hepatocyte growth factor (HGF), fibroblast growth factor-2 (FGF-2), angiopoietin-2 (Ang-2), endothelin-1 and vascular endothelial growth factor-A (VEGF-A) were significantly higher in aqueous humor of the PCV group before treatment than those in the cataract group (all at P<0.05). After treatment, the concentration of VEGF-A in aqueous humor of the PCV group was significantly lower than that before treatment ( P<0.001). The values of CMT, SRFH, PEDH and PEDD were significantly reduced in comparison with before treatment, showing statistical significances (all at P<0.05). The concentration of VEGF-A in aqueous humor was positively correlated and endothelin-1 in aqueous humor was negatively correlated with the change value of CMT ( r=0.592, -0.485, both at P<0.05). The concentration of IL-8 and HGF were positively correlated with SRFH change value ( r=0.492, 0.466, both at P<0.05). VEGF-A and IL-8 concentraions of aqueous humor before treatment were the risk factor of the change value of CMT and SRFH.Every 1pg/ml increase of baseline VEGF-A, the CMT change value reduced 0.836 μm ( P=0.006), and every 1pg/ml increase of baseline IL-8, the SRFH change value reduced 12.522 μm ( P=0.028). Conclusions:The concentrations of VEGF-A and IL-8 in aqueous humor might predict the CMT and SRFH improvement in PCV eyes after anti-VEGF therapy.
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Objective To observe the clinical efficacy of Jiawei Yanghe Decoction on prevention of the neurotoxicity of oxaliplatin. Methods 60 patients with colorectal cancer who met the inclusion criteria were randomLy divided into treatment group and control group with 30 cases in each group. The two groups were both given chemotherapy with oxaliplatin, and the treatment group added Jiawei Yanghe Decoction. For the two groups, 1 cycle included 21 days and they both received the treatments for 4 cycles. The incidence rate and the degree of neurotoxicity and the hemodynamic changes in the two groups after treatment were observed. Results The incidence rate of neurotoxicity in the treatment group was significantly lower than that in the control group(P＜0. 05). The hemodynamic indexes of the two groups were significantly improved after treatment(P＜0. 05), and the three indexes in the treatment group were lower than those in the control group with the differences being statistically significant(P＜0. 05). Conclusion Jiawei Yanghe Decoction has effect on prevention of the neurotoxicity of oxaliplatin, which improves the hemodynamic index and prevents and reduces the peripheral neurotoxicity.
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Objective To establish an acurate and convenient method to distinguish human platelet antigen(HPA) SNPs based on Target Enriched Multiplex-PCR(TEM-PCR),fluorescent probe melting curve analysis and blood direct PCR.Methods Design TEM-PCR primers and probes of HPA1-17,Cab alleles,amplify target sequences of all 18 alleles by blood direct PCR and distinguish different SNPs by melting curve of probes.Results The TEM-PCR could amplify all target sequences of 18 alleles and the melting curve analysis could distinguish those SNPs,the accuracy was equal to PCR-SSP method and the process was more convenient without blood genomic DNA extraction and subsequent gel electrophoresis thus decrease the cross-contamination risk.Conclusion Successfully established a HPA1-17,Cab alleles distinguishing method based on TEM-PCR,blood direct PCR and fluorescent probe melting curve analysis technique.
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<p><b>OBJECTIVE</b>To develop a new experimental animal model of different a single perforating vessel as its pedicle, and to investigate this vessel can captures how many adjacent angiosomes in different directions.</p><p><b>METHODS</b>Thirty-six Sprague-Dawly rats of both sexes were used. The rats were divided into group A, group B and group C. Group A: the unilateral deep circumflex iliac perforator artery- based flap. Group B: the unilateral posterior intercostal perforator artery-based flap. Group C: the unilateral lateral thoracic perforator artery-based flap. An extended dorsal perforator flap measuring up to 13 cm x 6 cm was designed in 36 rats to assess the viability of the flap. The upper margin was located at the level of the tip of the scapula and the lower margin at a level 1 cm below the iliac crest. All flaps were observed for 7 days postoperatively, 72 hours after flap elevation, observe flap dyeing conditions through the vivo fluorescein injection, the surviving flap area was calculated as a percentage of total flap dimensions and the angiosome's structure of the flap was displayed by radiopaque microangiography.</p><p><b>RESULTS</b>No fluorescence was visible in the distal flap of groups A and C, the whole flap show bright fluorescence in group B. Survival rate of C, A, B were improved in order. Statistic difference is significant (P < 0.01) between group and group. In group A, lead oxide-gelatin angiography shows the cephalic flap necrosis occurred in the bilateral lateral thoracic territories, and the vascular architecture partly disappeared in the necrotic area. In group B, the vascular architecture of flap is unbroken. In group C, the caudal flap necrosis occurred in the bilateral deep circumflex iliac perforator artery territories, and the vascular architecture partly disappeared and disordered in the necrotic area.</p><p><b>CONCLUSIONS</b>The perforator flap is based centrally on a single perforator, this vessel can capture multiple the second vascular territory. In a direction, the longest distance that the blood supply can reach is the point of the third perforator vessel puncture into skin, which can provide certain theoretical guidance for designing of perforator flap.</p>
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Animals , Female , Male , Rats , Angiography , Graft Survival , Models, Animal , Perforator Flap , Rats, Sprague-DawleyABSTRACT
Objective To investigate the outcome between endoscopically assisted and routine anterior transposition of the ulnar nerve for treatment of cubital tunnel syndrome.Methods From Februray 2008 to June 2010, forty-four patients with cubital tunnel syndrome were treated with routine anterior subcutaneous transposition (routine group,28 cases) and endoscopically assisted anterior subcutaneous transposition (endoscope group,16 cases).The operate time,drug administration,scar and postoperative hospital stay were compared.The patients were followed 1-12 month postoperatively,postoperative time back to work and function of ulner nerve were recorded.Results The results of endoscope group were as follows: operative time was (67.20 ± 19.69)min; postoperative scar length was (1.5％ ± 0.58) cm; rate of administration of anodyne was 6.3％; postoperative hospital stay was (2.4％ ± 1.42) days; postoperative time back to work,(14.6 ± 4.69)days; the results of open surgery group were as follows:operative time (62.8％ ± 11.06) min; postoperative scar length was (8.7％ ± 1.42) cm; rate of administration of anodyne was 42.8％; postoperative hospital stay was (5.7％ ± 2.53) days; postoperative time back to work was (29.40 ± 8.75) days; all differences of the results were significant between two groups (P ＜ 0.05).According to function of ulner nerve scoring system,one year postoperatively, excellent or good results were 82.14％ in routine group and 81.25％ in endoscope group,no significant difference between two groups (P ＞ 0.05). Conclusion Compared with routine anterior transposition of the ulnar nerve,endoscopically assisted anterior transposition has the following advantages: smaller incision and less tissue damage,less postoperative pain and sooner returning to work.And similar outcome was achieved from the two group.
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【Objective】 To investigate the effect of Weishu Powder (WP) on acute liver injury induced by carbon tetrachloride (CCl_4) in mice. 【Methods】 Fifty mice were randomized to normal control group (group A), model group (group B), bifendate pills group (group C), low-dose WP group (group D) and high-dose WP group (group E). The mice in the above groups were fed with the corresponding drugs by gastric infusion for 7 days. On the 8th day of feeding, the mice except those in group A were given 0.5% CCl_4 peanut oil solution (10 mL/kg) by intraperitoneal injection. Sixteen hours later, liver weight, serum level of alanine aminotransferase (ALT), malondialdehyde (MDA) content and necrotic focus amount in the liver were observed. 【Results】 As compared with the normal group, liver weight, serum ALT level and necrotic focus amount were increased in model mice with CCl_4-induced acute liver injury (P
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Objective To observe the protective effect of Weishu Powder(WP) on hepatic injury induced by pentachloronitrobenzene(PCNB).Methods SD rats were randomized into 4 groups: normal group,model group,high-dosage WP group(in the dose of 2.50 g?kg-1 ?d-1) and low-dosage WP group(in the dose of 1.25 g?kg-1 ?d-1).Except the normal group,the other three groups received gastric gavage of PCNB 400 mg?kg-1 ?d-1 for 15 continuous days.After treatment,hepatic index was assayed,serum glutamic-oxalacetic transaminase(GOT) and alkaline phosphatase(ALP) levels and hepatic malondialdehyde(MDA) content were detected,and hepatic pathological examination was also carried out.Results Hepatic index,serum GOT and ALP levels,and hepatic MDA content were increased(P