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Inferior myocardial infarction is an acute ischemic heart disease with high mortality, which is easy to induce life-threatening complications such as arrhythmia, heart failure and cardiogenic shock. Therefore, it is of great clinical value to carry out accurate and efficient early diagnosis of inferior myocardial infarction. Electrocardiogram is the most sensitive means for early diagnosis of inferior myocardial infarction. This paper proposes a method for detecting inferior myocardial infarction based on densely connected convolutional neural network. The method uses the original electrocardiogram (ECG) signals of serially connected Ⅱ, Ⅲ and aVF leads as the input of the model and extracts the robust features of the ECG signals by using the scale invariance of the convolutional layers. The characteristic transmission of ECG signals is enhanced by the dense connectivity between different layers, so that the network can automatically learn the effective features with strong robustness and high recognition, so as to achieve accurate detection of inferior myocardial infarction. The Physikalisch Technische Bundesanstalt diagnosis public ECG database was used for verification. The accuracy, sensitivity and specificity of the model reached 99.95%, 100% and 99.90%, respectively. The accuracy, sensitivity and specificity of the model are also over 99% even though the noise exists. Based on the results of this study, it is expected that the method can be introduced in the clinical environment to help doctors quickly diagnose inferior myocardial infarction in the future.
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From August 1st to 7th, 2017, the breastfeeding knowledge of medical staff were collected from 52 medical health institutions in 29 provinces through a network system. A total of 35 243 questionnaires were included in the study to analyze the current status of breastfeeding knowledge and related factors. The qualified rate of breastfeeding knowledge questionnaires for medical staff in this study was 75.3% (26 546/35 243). Compared with those in the eastern region and those who were mothers, the qualified rate of breastfeeding knowledge of medical staff in the central region or the western region and medical staff who were fathers or expectant parents was lower, with OR (95%CI) values about 0.71 (0.67-0.75), 0.66 (0.61-0.72), 0.63 (0.55-0.72) and 0.87 (0.80-0.95), respectively. Compared with those attaining high school education or below and those with children aged<1 month, the qualified rate of breastfeeding knowledge was higher in medical staff with bachelor′s degree, graduate degree or above, and with children aged 1-5, 6-23 and ≥24 months, with OR (95%CI) values about 1.92 (1.80-2.05), 2.16 (1.94-2.42), 2.28 (1.93-2.70), 2.41 (2.06-2.83) and 1.99 (1.72-2.32), respectively.
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ObjectiveTo determine thallium in whole blood by atomic absorption detection method, and to investigate the eliminating effect of hemoperfusion (HP) for thallium in blood.Methods The blood of Beagle dogs which had not exposed to thallium before were obtained for preparation of thallium nitrate (TlNO3)-containing solution in three concentrations according to the conversion formula based on animal weight and volume of blood. HP was performed in the simulated in vivo environment. The content of TlNO3 in blood of the next group was determined on the amount of TlNO3 for the last HP of the former dose group. Thallium quantity in different samples was measured with atomic absorption spectrometer blood samples before and after HP. Finally, the thallium concentration in blood was analyzed statistically.Results Thallium concentrations showed a good linear relationship in the range of 0-200μg/L (r = 0.998 4). The intra-day precision (RSD) was lower than 4.913%, the intra-day recovery rate was 96.2%-111.9%; the inter-day precision (RSD) was lower than 7.502%, the inter-day recovery rate was 89.6%-105.2%. The concentration of thallium in blood was significantly reduced after HP per time in high, middle, and low dose groups [(453.43±27.80) mg/L to (56.09±14.44) mg/L in high dose group,F = 8.820,P = 0.003;(64.51±13.60) mg/L to (3.19±0.23) mg/L in middle dose group,F = 36.312,P = 0.000; (5.40±0.98) mg/L to (0.38±0.25) mg/L in low dose group,F = 46.240,P = 0.000]. The adsorption rate of four times of HP in high, middle and low dose group were (87.63±2.48)%, (95.06±1.54)% and (92.76±4.87)%, respectively, without significant difference (F = 4.231,P = 0.070 ).Conclusions The method for measuring thallium was established, and it shows a very stable, simple, sensitive for determination of thallium. HP can effectively remove thallium from blood. Thallium concentration can be reduced by 90% after four times of HP. HP is also effective even when thallium concentration is not high.
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OBJECTIVE The antagonism of obidoxi me on sarin induced miosis and visual impair-ment was evaluated and its antagonistic mechanism was investigated.METHODS ① 30 min after sarin (2 μg /0.1 mL per eye)was given as an eyedrop,the ability of the 2.5%,5.0%,7.5% obidoxi me and 1 .0% atropine to reverse effects of sarin on pupil dia meter and light reflex were evaluated at different ti mes.② Another 36 rabbits received sarin and at 30 min afer sarin exposure,the drugs above were ad-ministrated and their effects on pupillary light reflex,as well as the AChE activity of cornea,iris and reti-na were recorded 4h after the treatment.RESULTS ① Miosis and impaired pupillary light reflex oc-curred soon after sarin exposure but the abnormal pupil width and pupillary light reflex had disappeared by 48 h after sarin exposure;Subcequent to 1 .0% atropine treatment,the pupil dilatedinstead while the impaired light reflex did not i mprove significantly;unlike atropine,soon after ad ministration of 2.5%, 5.0%,7.5% obidoxi me,the pupil dia meter and light reflex were significantly increased(P <0.01 )and then had beco me normal totally by 24 h post-dose,much faster than those of the control and atropine treatment group.However,there was no significant difference in the recovery ti me between the different dose groups of obidoxi me.② 4h after treatment,the AChE activity in cornea and irisof sarin-treated group were (42 ±4)%,(26 ±2)%,respectively;the AChE activity in cornea of 2.5%,5.0%,7.5%obidoxi me were (74 ±1 1 )%,(81 ±10)% and (74 ±7)%,respectively,and the AChE activity in iris were(39 ±10)%,(43 ±8)% and (43 ±8)%,respectively ,co mpared with sarin-treated group,AChE activities of cornea and iris as well as light reflex of the obidoxi me-treated group were significantly increased(P<0.01 ).But there was no difference in light reflex and AChE activity between the sarin-treated and atropine-treated groups.CONCLUSION Obidoxi me showed better antagonism of sarin-induced ocular effects than that of the commonly used drug,atropine;the antagonistic mechanism is likely closely related to its rapid reactivation of the inhibited AChE in the cornea and iris.
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OBJECTIVE@#To explore the feature of nasal mucosa remodeling in chronic rhinosinusitis without nasal polyps (CRSsNP).@*METHOD@#Histological specimens from 30 selected patients with CRSsNP who underwent endoscopic sinus surgery and 10 control subjects were studied. The paraffin sections were stained with hematoxylin-eosin(HE), alcian blue-periodic acid-Schiff (AB-PAS), Masson trichrome (MT) and Picric acid-Sirius red. The damage of epithelium, goblet cells and gland hyperplasia, deposition of collagen in extracellular matrix, the thickness of basement membrane and the type of collagen were observed respectively.@*RESULT@#Grade 0, Grade 1, Grade 2 and Grade 3 of epithelial damage were significantly different in the CRSsNP group when compared with the control group (P < 0.01 or P < 0.05). Evident mucus gland hyperplasia and collagen deposition in extracellular matrix were observed in CRSsNP group (P < 0.01). The number of goblet cells and the thickness of basement membrane were increased obviously in CRSsNP group (P < 0.01). The collagen deposited in extracellular matrix was mainly composed of collagen type I. Collagen type III and collagen type IV was much less than collagen type I.@*CONCLUSION@#The nasal mucosa remodeling was observed in CRSsNP group and was characterized by epithelial damage, basement membrane thickening, deposition of collagen in extracellular matrix, goblet cells and mucus gland hyperplasia.
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Case-Control Studies , Chronic Disease , Nasal Mucosa , Pathology , Nasal Polyps , Sinusitis , PathologyРеферат
Objective To investigate the effects of a new sling exercise treatment combined with injections of sodium hyaluronate on the radiographic findings and clinical variables of patients with patellofemoral pain.Methods Seventy patients with patellofemoral pain syndrome were divided into a group which was treated using a new sling exercise therapy combined with injections of sodium hyaluronate (the combined therapy group,n=34) and another which received only sodium hyaluronate injections (the control group,n=36).The patients of both groups were assessed pre-and post-treatment.The clinical assessment modalities were pain scores (using a visual analogue scale,VAS),quadriceps and hamstring strength and range of motion in the active flexion and extension of the knee.Q angles were measured supine and standing.Patellofemor tilt angle and congruence and sulcus angle were determined by CT scanning.Results After 5 weeks the average VAS pain score of the combined therapy group was significantly lower than that of the control group.Muscle strength and range of motion in the combined therapy group were both significantly higher than pro-treatment,the Q angles were significantly smaller,and the congruence and sulcus angles were significantly better.Conclusion Five weeks of practicing the new sling exercise therapy combined with injections of sodium hyaluronate can yield satisfactory clinical and radiologic outcomes in patients with patellofemoral pain syndrome.
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Objective To investigate the effects of sensorimotor therapy on patients with knee osteoarthritis.Methods Ninety-two patients with knee osteoarthritis were divided into a treatment group and a control group by using random digits table. Both groups received conventional rehabilitation therapy, including knee isometric and isotonic contraction training, ultrashort wave diathermy as well as aerobic exercise. The treatment group was also administered with sensorimotor training, in addition to the conventional training,including the muscle strengthening and control training of quadriceps and hamstring muscle using sling exercise therapy system and on the Thera-band mattress. The visual analogue scale (VAS) for pain, manual muscle testing and knee range of motion as well as the Japanese Orthopedic Association knee function evaluation form were used to evaluate the patients. Results There was no statistic difference between the 2 groups before treatment, with regard to the evaluation parameters used in this study. After 2 months of treatment, both groups improved significantly (P <0.05),with the treatment group improved to a significantly greater extent (P <0.05). Conclusions Sensorimotor training in addition to the conventional rehabilitation treatment can further relieve the pain of patients with knee osteoarthritis joints arthritis and improve the function of patients with knee osteoarthritis.
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Objective To evaluate the impact of the percentage of residual blasts in bone marrow at the end of induction chemotherapy ( T1 ) or during myelosuppression phase (T2) on prognosis of de novo acute myeloid leukemia(AML) (non M3) in 105 cases.To refine AML risk-stratification by combining the percentage of residual blast cells (T1 or/and T2) with cytogenetic data based the South West Oncology Group (SWOG) criteria.Methods The data of 105 de novo AML ( non M3 ) patients hospitalized between January 1st 1999 and February 1st 2008 were retrospectively reviewed.Results were analyzed with SPSS15.0 software.Results ( 1 ) Patients were divided into two subgroups by a cutoff of 5% residual bone marrow blasts at T1 or 12 time point.Patients with percentage of residual bone marrow blast cells <5% had better complete remission (CR) rate,relapse-free survival (RFS) and overall survival (OS) than the patients with percentage ≥5% at T1 or T2.The percentage of residual bone marrow blast cells at T1 was correlated with that at T2.(2) The prognosis of patients with intermediate karyotypes with percentage < 5 % at T1 or T2 was similar to that of the patients with favorable karyotypes.The patients with intermediate karyotypes and percentage of residual bone marrow blasts ≥5% at TI or T2 are defined as a subgroup with prognosis similar to that of patients with unfavorable karyotypes.(3) COX regression analysis showed that the percentage of residual bone marrow blasts at T1 or T2 is an independent prognostic factor of AML.The percentage of residual bone marrow blasts at T1 may be more helpful in prognostification than that at T2.Conclusion AML patients with percentage of residual bone marrow blasts < 5% after induction chemotherapy ( T1 or T2) have better CR rate,RFS,OS than the patients with percentage ≥5% at the same time point.Combination of cytogenetics and percentage of residual bone marrow blasts at T1 or T2 is helpful to divide patients with intermediate karyotypes into two subgroups with different prognosis.Thus,a better decision of treatment strategy can be designed.
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Objective To study the relationship between the six-minute walking test (6-MWT) and pulmonary function in the diagnosis course of chronic bronchitis converting into chronic obstructive pulmonary disease (COPD). Methods Pulmonary function was detected in 360 patients with chronic bronchitis.Based on the results and diagnosis standard of COPD by Chinese Medical Association in 2002, the patients were divided into COPD group and pulmonary function normal group.Tbe walking distance in 6-MWT (6-MWD) was measured, and the mean value of twice tests was calculated to study the correlation between 6-MWT and pulmonary function, and 50 healthy volunteers were selected as control group. Results Most 6-MWD in COPD group were less than 420 meters(95.95%, 142/148 ), but those in pulmonary function normal group were more than or equalled to 420 meters mostly (97.17%, 206/212 ). However in patients with the 6-MWD more than or equalled to 420 meters , pulmonary function indexes such as the ratio of forced expiratory volume in one second and forced vital capacity( FVC ), FEV_1%, maximal ventilatory volume(MVV)were all significantly greater than those in patients with 6-MWD less than 420 meters, and there were significant differences (P<0.05). Compared with chronic bronchitis, the results of 6-MWD in control group was more than or equalled to 420 meters, but there was no significant difference (P>0.05 ). Conclusions 6-MWT is simple and feasible. However, it is a better indicator of the patients pulmonary function. The test would be an effective selecting examination for chronic bronchitis patients who are not willing to do puhnonary function test.
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Objective To investigate the feasibility of Chelex DNA extraction from thin blood smears for genetic analysis, and to develop smear-based nested polymerase chain reaction (PCR) of the 18S RNA of Plasrnodium falciparum. Methods Chelex-100 which was chelating ion exchange resin was used to extract DNA from Giemsa-stained or unstained thin blood smears of different concentrations of Plasmodium falciparum. With the extracted DNA as the template, 18S RNA gene was amplified by nested PCR to test the susceptibility of Chelex method. Results Positive band of 205bp appeared in nested PCR with DNA extracted from Giemsa-stained or unstained thin blood smears of patient with falciparum malaria. Using the Chelex method, the detection limits of the smear-based nested PCR were 1.5 × 101 parasite/μL blood for Giemsa-stained and 1.5×10-1 parasite/μL blood for unstained thin blood smears. Conclusions Chelex DNA extraction is a simple and efficient method for extracting trace amount of DNA from thin blood smear. The smear-based nested PCR developed in this study is feasible to identify the gene from reserved thin blood smears and will provide a new approach for clinical diagnosis and study of molecular epidemiology.
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Objective To evaluate proton MR spectroscopy (1H-MRS) for detection of the motor cortex and adjacent brain in amyotrophic lateral sclerosis (ALS) patients with apparent upper motor neuron involvement after olfactory ensheathing cells(OECs) transplantation. Methods From December 2004 to February 2005, 7 patients with clinically definite ALS who could safely undergo MRS were admitted into the perspective study. The neurological status, ALS functional rating scale (ALSFRS), EMG, and 1H-MRS taken before and 2 weeks after operations were carefully analyzed. The NAA/Cr and Cho/Cr ratios were measured in the cerebral peduncle, genu and posterior limb of the internal capsule, corona radiata and precentral gyrus. Results The ALSFRS in 2 cases improved obviously whose ALSFRS increased from 30 to 33 and from 29 to 34 respectively. And 5 cases remained stable 2 weeks after OECs transplantation. Statistical analyses for all seven cases showed both the NAA/Cr and Cho/Cr ratios decreased, but in the two cases with ALSFRS improvement the NAA/Cr increased in the certain anatomic position which confirmed the neurological and EMG findings. Conclusion The proton MR spectroscopy is a suitable noninvasive measure for ALS evaluation. The preliminary study suggests that two of the seven ALS cases improved apparently short-term after OECs transplantation. More patients are required for the clinical study and longer follow-up duration is needed for future research.
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<p><b>OBJECTIVE</b>To study the relationship between soluble resistance-related calcium-binding protein (sorcin) gene and multidrug resistance gene (mdr1), and their significance in clinical drug resistance and prognosis of acute myeloid leukemia (AML).</p><p><b>METHODS</b>Amplification of sorcin gene and mdr1 gene in K562/A02 cell detected by Northern blot, were monitored by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) in 65 AML patients and 27 normal controls, with their relationship and clinical outcame analyzed.</p><p><b>RESULTS</b>The amplification of sorcin gene and mdr1 gene in AML patients were significantly higher than that in the normal control, which were related to clinical drug resistance and prognosis. The amplification of sorcin gene was related to the amplification of mdr1 gene in the two groups. The clinical drug resistance incidence rate and complete remission rate were 92.9% and 7.1% in sorcin(+)/mdr1(+) group. They were 8.6% and 91.4% in the sorcin(-)/mdr1(-) group (P < 0.001).</p><p><b>CONCLUSION</b>The co-amplification of sorcin and mdr1 gene can be taken as a good indicator of clinical drug resistance and prognosis of AML.</p>
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Humans , ATP Binding Cassette Transporter, Subfamily B, Member 1 , Genetics , Acute Disease , Blotting, Northern , Methods , Calcium-Binding Proteins , Genetics , Drug Resistance, Multiple , Drug Resistance, Neoplasm , Gene Expression , K562 Cells , Leukemia, Myeloid , Genetics , Neoplasm Proteins , Genetics , PrognosisРеферат
<p><b>OBJECTIVE</b>To study the relationship between the expression of soluble drug resistance-related calcium-binding protein (sorcin) gene and the clinical multidrug resistance in acute leukemia (AL).</p><p><b>METHODS</b>A semi-quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) was used to investigate the transcription levels of the human sorcin gene in 95 AL patients and 27 controls.</p><p><b>RESULTS</b>Sorcin gene expression was significantly higher in AL patients than in normal contrls (P < 0.001), and higher in relapsed/refractory acute myeloid leukemia (AML) patients than in those newly diagnosed or in complete remission. Sorcin gene overexpression was significantly lower in non-resistant patients than in resistant ones (P < 0.001). CR rates of these two groups were 20.0% and 80.0%, respectively. Sorcin gene expression was higher in AML-M(5) patients than M(2), M(3), M(4) patients.</p><p><b>CONCLUSION</b>Sorcin gene overexpression is significantly associated with clinical multidrug resistance and prognosis, it is one of the indicators for predicting prognosis of AL patients.</p>