Electrocardiogram signal classification based on fusion method of residual network and self-attention mechanism / 生物医学工程学杂志

In the diagnosis of cardiovascular diseases, the analysis of electrocardiogram (ECG) signals has always played a crucial role. At present, how to effectively identify abnormal heart beats by algorithms is still a difficult task in the field of ECG signal analysis. Based on this, a classification model that automatically identifies abnormal heartbeats based on deep residual network (ResNet) and self-attention mechanism was proposed. Firstly, this paper designed an 18-layer convolutional neural network (CNN) based on the residual structure, which helped model fully extract the local features. Then, the bi-directional gated recurrent unit (BiGRU) was used to explore the temporal correlation for further obtaining the temporal features. Finally, the self-attention mechanism was built to weight important information and enhance model's ability to extract important features, which helped model achieve higher classification accuracy. In addition, in order to mitigate the interference on classification performance due to data imbalance, the study utilized multiple approaches for data augmentation. The experimental data in this study came from the arrhythmia database constructed by MIT and Beth Israel Hospital (MIT-BIH), and the final results showed that the proposed model achieved an overall accuracy of 98.33% on the original dataset and 99.12% on the optimized dataset, which demonstrated that the proposed model can achieve good performance in ECG signal classification, and possessed potential value for application to portable ECG detection devices.

Systematic review and Meta-analysis of incidence of oral feeding intolerance in acute pancreatitis / 国际外科学杂志

Objective To systemically review andquantify the incidence of oral feeding intolerance in acute pancreatitis. Methods Randomized controlled trials that reported the oral feeding intolerance rates of acute pancreatitis were searchedfrom PubMed, EMBASE, Medline, Cochrane Library, WanFang, CNKI, CMCC and VIP dal,abase wilh the" Acute pancreatitis " " Feeding intolerance" " Incidence" " Meta- analysis "from January 2002 to May 2017. Date were analyzed by using R 3. 4. 0 software. The heterogeneity of data were analyzed using 12test. Results Eleven randomized controlled trials including 658 cases were enrolled in Meta-analysis. The incidence of oral feeding of intolerance was 12. 2% . The result of subgroup analysis showed that there were no significant difference in the incidence of oral feeding intolerance when region, sample size and published year were taken into analysis (P > 0. 05). The oral feeding intolerance rate of mild acute pancreatitis was lower than that when moderately severe acute pancreatitis and severe acute pancreatitis were, included (8. 2% and 19. 9% , respectively; P = 0. 002 7). Conclusion Oral feeding intolerance affects approximately l in 8 patients with acute pancreatitis. The incidence of oral feeding intolerance of patients with severe acute pancreatitis is higher than that of patients with mild acute pancreatitis

A preliminary exploration of the application of 3D modeling and printing technology for the con-struction of clinical teaching models in the department of orthopedic trauma / 中华医学教育探索杂志

Objective To explore the feasibility and effect of 3D modeling and printing technology in constructing bone fracture models and assisting clinical teaching at the department of traumatic orthope-dics. Methods CT scan images of bone fractures were reconstructed by Mimics software. The digital 3D bone fracture models were constructed and the interactive multimedia teaching videos were output. More-over, all bone fracture models were printed by using fusion deposition modeling (FDM). At the end of the teaching course, a questionnaire survey was conducted to evaluate the teaching effect. Results The digital models of common bone fractures at the department of traumatic orthopedics were established, and the in-teractive multimedia teaching videos were output. A traumatic orthopedic teaching model with a 1∶1 scale was printed out. The questionnaire survey indicated that the application of 3D modeling and printing tech-nology to build bone fracture model with PPT teaching can obviously improve students' understanding and mastery of relevant theoretical knowledge. They helped students better remember the type of bone fractures and how to choose the correct internal fixation methods. The teaching effect was satisfactory. Conclusions 3D modeling and printing technology was applied to build bone fracture models to assist clinical teaching at the department of traumatic orthopedics. It was found that the printed 3D bone fracture models can stimulate students' enthusiasm for learning and improve their learning effect. This method has good application value.

The analysis of chest,abdominal and pelvic primary occupying lesions by whole-body PET-like imaging / 实用放射学杂志

Objective To study the application value of 1.5T MRI whole-body PET-like imaging in the chest,abdominal and pelvic primary occupying lesions.Methods Whole-body PET-like imaging were performed in 5 7 patients with chest,abdominal and pelvic primary occupying lesions.The detection rate of whole-body PET-like in chest,abdominal and pelvis primary occupying lesions were compared.Apparent diffusion coefficient (ADC)values for benign and malignant lesions were compared and analyzed.Results (1) All of 71 cases of chest,abdominal and pelvic primary occupying lesions,67 lesions (94.4%)were diagnosed by whole-body PET-like imaging. Among them,31(93.9%)of malignant lesions were detected and 36(94.7%)benign lesions were detected.There was not statistically significant of detection rate between benign and malignant lesions(P>0.05).(2)The range of ADC value:malignant tumor was (0.83-1.57)× 10-3mm2/s,among which 27 lesions ADC value less than 1.1×10-3mm2/s,accounting for 87.1%;The benign lesion was (1.41-3.16)× 10-3mm2/s,among which the total 32 lesion ADC values of liver cyst(13),hepatic hemangioma(9)and renal cyst(10)were greater than 2.0×10-3mm2/s,accounting for 88.9%.There was significantly different of ADC values between benign and malignant lesions (P<0.05).Conclusion There is higher detection rate on primary chest,abdominal and pelvic space occupying lesions for whole-body PET-like imaging,which is suitable for tumor screening in healthy population.It is helpful to differentiate benign and malignant tumors by quantitative analysis of ADC value.

Private medical institutions in China:Status quo, dilemma and rethinking / 中国卫生政策研究

In recent years , the increasing number of private medical institutions in China has not led to the re-sponding increase in medical services , capital asset scales .The competitive situation between public and private medical institutions has not yet been formed .This paper discusses the difficulties that Chinese private medical institu-tions have encountered in overseas capital inflow , in order to foster local private medical Institutions , as well as the development of private non-profit hospitals .Based on a systematic analysis of the key points in policy , suggestions were proposed in regarding with enhancement of top-level design of the policies , encouragement of the development of off-shore or on-shore small-scale private medical institutions , as well as facilitation of the productive factors flow in medical institutions'operation.The suggestions on the policies are to be referenced in decision making for a healthy development of Chinese private medical institutions .

Safety and efficacy of therapeutic endoscopic retrograde cholangiopancreatography in very elderly patients (85 years or older) with common bile duct stones / 临床肝胆病杂志

ObjectiveTo evaluate the safety and efficacy of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in very elderly patients (85 years or older) with common bile duct stones. MethodsA retrospective study was conducted on 150 patients with common bile duct stones who underwent ERCP in the Second Affiliated Hospital of Nanjing Medical University between January 2013 and December 2014. The subjects were divided into two groups: very elderly group of 50 patients aged 85 or above and non-elderly group of 100 patients aged 60 or below. Postoperative vital signs were closely monitored. Symptoms such as fever and abdominal pain were recorded. Blood test was performed and the level of serum amylase was determined at 3 and 24 h after ERCP. The treatment success rate, success rate of stone removal in one setting, and incidence rate of complications in the two groups were compared by chi-square test. ResultsThe treatment success rate in very elderly group (98.0％) was similar to that in non-elderly group (99.0％) (χ2=0.253, P＞0.05). The success rate of stone removal in one setting in very elderly group (70.0％) was significantly lower compared with that in non-elderly group (91.0％) (χ2=10.938, P＜0.05). The incidence rate of complications in very elderly group (8.0%) was similar to that in non-elderly group (120％) (χ2=0.560, P＞0.05). ConclusionTherapeutic ERCP is an effective and safe method for the treatment of common bile duct stones in very elderly patients and can be recommended as the first choice of treatment.

Safety and efficacy of therapeutic endoscopic retrograde cholangiopancreatography in very elderly patients (85 years or older) with common bile duct stones / 临床肝胆病杂志

ObjectiveTo evaluate the safety and efficacy of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in very elderly patients (85 years or older) with common bile duct stones. MethodsA retrospective study was conducted on 150 patients with common bile duct stones who underwent ERCP in the Second Affiliated Hospital of Nanjing Medical University between January 2013 and December 2014. The subjects were divided into two groups: very elderly group of 50 patients aged 85 or above and non-elderly group of 100 patients aged 60 or below. Postoperative vital signs were closely monitored. Symptoms such as fever and abdominal pain were recorded. Blood test was performed and the level of serum amylase was determined at 3 and 24 h after ERCP. The treatment success rate, success rate of stone removal in one setting, and incidence rate of complications in the two groups were compared by chi-square test. ResultsThe treatment success rate in very elderly group (98.0％) was similar to that in non-elderly group (99.0％) (χ2=0.253, P＞0.05). The success rate of stone removal in one setting in very elderly group (70.0％) was significantly lower compared with that in non-elderly group (91.0％) (χ2=10.938, P＜0.05). The incidence rate of complications in very elderly group (8.0%) was similar to that in non-elderly group (120％) (χ2=0.560, P＞0.05). ConclusionTherapeutic ERCP is an effective and safe method for the treatment of common bile duct stones in very elderly patients and can be recommended as the first choice of treatment.

Research progress in c-Met and hepatocellular carcinoma / 临床肝胆病杂志

c-Met plays a pivotal role in the development and progression of hepatocellular carcinoma (HCC), which can lead to proliferation, survival, cytoskeleton reorganization, separation and diffusion, and angiogenesis of tumor cells. Moreover, c-Met is an important prognostic factor for HCC. In HCC, c-Met acts as an activator of a series of signaling pathways, including PI3K/AKT/mTOR, ERK/MAPK, and Rac-Pak. In recent years, it has been reported that small-molecule kinase inhibitors can abolish phosphorylation at the intracellular carboxyl terminal of c-Met, and then inhibit the recruitment of signal convertors and downstream signaling pathways, which finally achieve anti-tumor activities. Based on the carcinogenic activity of c-Met in HCC, this paper points out that selective inhibitors of c-Met hold promise for targeted therapies for HCC.

System design flaws in the supervision of private non-profit hospitals:Based on Hubei, Guang-dong and Jiangsu Provinces / 中国卫生政策研究

There are still some flaws in the private non-profit hospital supervision system since those hospitals recently began to grow in China. The paper aims to analyze the access and changing processes from the non-profit to profit hospitals and the non-profit character supervision of the private non-profit hospitals based on the literature and survey data in Hubei, Guangdong and Jiangsu Provinces. It also puts forward some suggestions on the private non-profit hospitals development including how to optimize the access process, increase taxes or liquidation in the chan-ging process, and establish the coordination supervision mechanism for the non-profit Character in China.

Estrogen effects on interleukin-1 expression in alveolar bone remodeling of osteoporotic rats / 中国组织工程研究

BACKGROUND:Currently rats are the most frequently used animal for the models of osteoporosis and ovariectomized rat models have been widely applied due to ovariectomized female rats are similar to human body in bone mineral density changes and response after estrogen administration. OBJECTIVE:To establish rat models of osteoporotic tooth extraction wound healing, and to investigate the effect of estrogen on the interleukin-1 expression and distribution in the remodeling of osteoporotic alveolar bone. METHODS:Sixty-five purebred female rats, 3 months old, were randomly divided into two groups:osteoporosis model group (n=40;ovariectomy under general anesthesia) and sham operation group (n=25;fat tissue around ovary was removed). After 8-week feeding, osteoporosis models were established and the left upper molar was pul ed out under general anesthesia. Histomorphomeric parameters test was performed on the jaw bone. In osteoporosis model group, 15 rats were randomly selected to give subcutaneous injection of estradiol benzoate, as the estrogen treatment group. Immunohistochemical method was applied to observe the interleukin-1 expression in the remodeling of osteoporotic alveolar bone. RESULTS AND CONCLUSION:After ovariotomy, the amount of trabecula decreased and the medul ary cavity of the bone became larger, the jaw bone intensity decreased. After administration of estrogen, the positive expression of interleukin-1 was reduced as compared with osteoporosis model group. Experimental findings indicate that, osteoporosis can be detected in Sprague-Dawley female rats aged 3 months at 8 weeks after ovariotomy, and administration of estrogen can obviously decrease interleukin-1 positive expression in the remodeling of osteoporotic alveolar bone.

Inhibition of Newcastle disease virus (NDV) replication by RNA interference targeting phosphoprotein (P) gene in CEF / 中国兽医学报

A plasmids of continuous expressing shRNAs targeting the NDV NA-1 Phosphoprotein (P) gene was designed.Virus titration,Real Time RT-PCR,CPE indicated that P-specific siRNA could inhibit virus replication at 36 h post-virus infection.In future studies,a combination of siRNAs targeting the NP and L gene may be used as a tool to study NDV replication and antiviral therapy.

Injured attention networks in patients with cerebellum lesion:28 cases report / 中华神经科杂志

Objective To investigate the characteristics of attention networks impairment in patients with lesion in the cerebellum.Methods The attention network test was used to compare patients with lesion in the cerebellum(n=28)with normal controls(n=3.1)on the efficiency of three anatomically defined attention networks:alerting,orienting,and executive control. Results The orienting network effect was significantlyworse(Z=-2.309,P＜0.05)in patients with lesion in the cerebellum((36.32±30.58) ms)than in normal controls((54.39±22.17)ms).The executive control network in patients((160.05± 83.25)ms)with lesion in the cerebellinn was worse than those of controls((93.42±37.41)ms,Z= -3.500,P＜0.01).The alerting networks effects was higher in patients((35.14±45.59)ms)than in normal controls((28.81±26.09)ms),without significant difference.The average reaction time was longer in patients than in normal controls,but there was no significant difference.The wrong rate of attention network testwas significantly higher(Z=-2.119,P＜0.05)in patients(6.57%±9.84%)than in normal controls(3.38%±5.42%).Conclusion The patients with lesion in the cerebellum may be selectively impaired of the orienting and executive networks,while the alering network is spared.

The characteristics of the attention networks impairment in patients with localized brain injury / 中华神经科杂志

Objective To determine attention networks impairmnet in patients with localized brain injury and to examine the characteristics of the impairment.Methods The attention network test was used to compare patients(n=59)with controls(n=53)on the efficiency of 3 anatomically defined attention networks:alerting,orienting,and executive control.Results Firstly,patients with frontal lobe injury showed a significant deficit in the executive network(frontal lobe injury,controls:(143.7±46.6),(91.6±46.4)ms,Z=-4.714,P＜0.01)and also a significant deficit in the orienting network(frontal lobe injury,controls:(71.2±35.2),(55.1±21.8)ms,Z=-2.125,P＜0.05).There was no deficit in the alerting network(Z=-0.901,P＞0.05).Secondly,the orienting network effect was significantly lower in patients with parietal lobe injury((34.9±25.2)ms)than in normal controls((55.1±21.8)ms.Z=-2.418.P＜0.05).However,there were no significant difierences between the other two networks and between the patients and the controls(Z=-1.873,-0.186.P＞0.05).Thirdly,patients with temporal lobe injury showed no deficit in the three networks(Z=-0.037,-1.224,-0.718,all P＞0.05)as well as in overall RT and accuracy(Z=-1.385,-0.699,all P＞0.05).Conclusions These results suggest that there are selective impairments of the orienting and executive networks in patients with the frontal lobe and the parietal lobe injury,while the alerting network is spared.Furthermore,the frontallobe plays a key role in the executive control.meanwhile,the orienting network is closely related with the parietal lobe.

Effects of cueing on crossover effect in line bisection in hemispatial neglect / 中华神经科杂志

Objective To investigate the relationship of attentional orientation,sensory disorder or magnitude estimation with cross-over effect in the line bisection of hemispatial neglect patients and to evaluate the influences of the length of lines and cueing on the performance of line bisection of neglect patients.Methods Fifteen patients with hemispatial neglect and 15 age and education-level-matched healthy controls underwent line bisection experiment.in which difierent types of cues and difierent length of bisected lines were given to observe their effects on the deviation.Analyses of variance (ANOVAs)were used to analyze the data in each group.Results When the lengths of lines were 4,6,8,10,12 cm,percentages of line bisection deviation(%)without cue were-5.71±5.13,-2.48±8.83,-1.18±10.90.0.43±8.12,2.17±7.04 respectively.The experiment showed that deviation was related to the length of lines ( F=12.5,P＜0.01).Nine patients exhibited cross-over effect when the lines were shorter than 10 cm.Another interesting result was that ipsilesional cues led to a reduction in bisection errors ( percentages of line bisection deviation(%)were-3.93±7.04,2.43±6.34,4.93±5.19,6.49±3.36,6.38±4.18,P＜0.01),however,contralesional ones resulted in a reverse effect(percentages of bisection deviation(%)were-10.93±8.85,-7.95±8.44,-4.14±8.37,-2.60±9.96,-1.57±10.67,P=0.03).As for bilateral cues,both cueing had no influence on line bisection(percentages of bisection deviation(%)were -5.93±7.76,-0.52±8.20,0.54±6.34.2.57±5.02,2.79±3.92,P=0.35).The length of cues had no influence on line bisection(F=1.94.P=0.1 4).Condusions The subjective midpoint excurses toward left when the length of line is relatively short.which is referred as crossover effect.indicating magnitude estimation a factor of crossover effect.Unilateral cues affects the performance of line dissection of neglect patients.which may be accounted for attentional orientational biases.No effect of the cue length suggested sensory disorder does not play a role in the crossover effect.

Molecular genetics analysis and frequency survey of H deficient phenotype / 中国输血杂志

Objective To survey the frequency of H deficient phenotype in blood donor population and analyze the serological and genetic characteristics of these individuals.Methods The H deficient phenotype was screened with anti-H monoclonal antibody.The ABO type was screened with serological method and with sequence specific primer polymerase chain reaction(PCR-SSP).FUT1 and FUT2 gene sequences were analyzed with direct sequencing of PCR products and gene cloning products.Result Of 85 390 blood donors,ten individuals were identified to be para-Bombay phenotype.Four h alleles were found in 14 para-Bombay phenotype individuals,h1(nt547-552?ag),h2(nt880-882?tt),h3(nt658c→t),and h_(new-2)(nt328g→a).The FUT1 genotypes of these para-Bombay individuals were h1/h1(6 individuals),h1/h2(7 individuals) and h3/h_(new2)(1 individual),and the frequency of 4 allele were 67.85%(h1),25%(h2),3.57%(h3),and 3.57%(h_(new-2)),respectively.FUT2 gene was analyzed in 12 para-Bombay phenotype individuals,and a mutation of nt357c→t was detected in all FUT2 gene,another mutation of nt716g→a were heterozygous in 5 individuals with h1/h2 genotype.No null FUT2 gene was detected.In serological analysis,all atypical anti-A or anti-B antibody of 14 para-Bombay individuals were inactive at 37℃,7 individuals had active anti-H antibody at 37℃.Conclusion The frequency of H deficient phenotype in Fujian population is about 1:8 500.The h1 and h2 alleles are predominant in Fujian H deficient individuals on h1-Se~(357) and h2-Se~(357,716) haplotype background.

Application and Analysis of Attention Network Test for Chinese Adult / 中国临床心理学杂志

Objective: The study has been testing the efficiency of attention networks in Chinese adults. Methods: The study has used "ANT" to examine 76 normal Chinese adults and analysed the effect on alerting, orienting and executive attention. Results: The reaction time across whole ANT is 502-940(706?105)ms, and the correct ratio is 93%-100%(0.97?0.07).The alerting effect is 30?20ms, orienting effect 51?24ms, and conflict effect 106?32ms. Correlation analyses demonstrate no correlation between alerting, orienting, and conflict resolution. Conclusion: ANT produces reliable subject estimates of alerting, orienting and executive attention function.

A Case Report of Memory Functions in Hippocampal Infarction Patient / 中国临床心理学杂志

Objective:To investigate memory disorder in hippocampal infarction patient. Methods: A hippocampal infarction patient was examined by the MMSE and the WMS-RC. Results: Patient's performance on MMSE was within the normal range, but the short-term memory was impaired. Conclusion: Hippocampal plays an important role in encoding and storing new information.

Pure Word Deafness after Cerebral Hemorrhage in the Right Temporal and Parietal Lobe: a Psychophysical Analysis / 中国临床心理学杂志

Objective:To study the neuropsychological features and explore possible mechanisms in pure word deafness.Methods:A case of a 55 year-old right-handed woman was analysed,who presented with a long lasting pure word deafness following subcortical and cortical hemorrhage in right temporal and parietal lobe.Results:There was no sign of aphasia. The auditory deficit was sepecific for language, while recognition of music and environmental sounds was normal. CT examinations showed that the lesion was due to right cerebral hemisphere hemorrhage, mainly the white matter of temporal and parietal lobe. Conclusion:It is proposed that pure word deafness was consequent to the isolation of Wernicke's area from incoming auditory information due to the interruption both of the association fibers from the right auditory area traveling across the corpus callosum and of the left auditory radiations.