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In recent years, artificial intelligence-related technologies have been deeply combined with many medical fields, and the intersection of medicine and engineering has become a hot topic. There are problems with heavy data and difficulty making decisions in orthopedic disease diagnosis and treatment. Machine learning is an important method of artificial intelligence. Since it can automatically analyze and predict medical big data, it is widely used in the field of orthopedics. It also assists physicians in completing disease diagnosis and treatment efficiently. In this review paper, the application and progress of machine learning in preoperative, intraoperative, and postoperative diagnosis and treatment in orthopedics are reviewed, providing new ways for exploring more rational diagnosis and treatment strategies.
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Multiple injuries caused by trauma have high rates of disability and mortality and are difficult to treat, which have a negative impact on the patients, their families and the society. At present, the medical model of trauma treatment is still inadequate, and the treatment of trauma patients faces great challenges. Artificial intelligence (AI) is an intelligent technology based on machine learning, reinforcement learning and deep learning algorithm, and it has been applied to the treatment of patients with trauma. Its efficient and accurate computer vision, planning and decision-making, and big data statistical analysis not only improve the safety and efficiency in the treatment of trauma, but also reduce the workload of clinicians, which makes up for the deficiency of the traditional model of trauma care. After screening the recent studies of AI in trauma care, the authors review its application in emergency triage, diagnosis, treatment and prevention of war trauma, in order to introduce the latest research progress of AI in trauma care and provide references for future developments.
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<p><b>OBJECTIVE</b>On the basic therapy, to assess the clinical effects of dynamic scalp acupuncture, scalp acupuncture combined with proprioceptive neuromuscular facilitation (PNF) therapy and simple PNF therapy for upper limb motor impairment in ischemic post-stroke spastic hemiplegia.</p><p><b>METHODS</b>A total of 90 cases were randomly assigned into a PNF group, a dynamic scalp acupuncture group and a scalp acupuncture group, 30 cases in each group. Basic therapy and PNF therapy were applied in the three groups. PNF therapy was used during scalp acupuncture in the dynamic scalp acupuncture group. PNF therapy was applied after scalp acupuncture in the scalp acupuncture group. The points were the upper 1/5 and middle 2/5 of (MS 6) and (MS 7) at the lesion side, the hemiparalysis contralateral side. The treatment was given for 6 months, once a day and 1 month as a course. The modified Ashworth scale (MAS), the Fugl-Meyer motor assessment (FMA) and Barthel index (BI) were observed before treatment and 2 weeks, 1 month, 3 months, and 6 months after treatment.</p><p><b>RESULTS</b>The MAS 1 month, 3 months and 6 months after treatment were improved compared with those before treatment in the three groups ( all <0.05), and the MAS results in the dynamic scalp acupuncture group were better than those in the PNF and scalp acupuncture group (all <0.05). The FMA and BI scores 1 month, 3 months and 6 months after treatment were higher than those before treatment (all <0.05). The FMA Scores in the 3 time points and after treatment in the dynamic scalp acupuncture group were higher than those in the other two groups (all <0.05).</p><p><b>CONCLUSION</b>PNF therapy during scalp acupuncture can relieve the spasmodic condition of patients with upper limb motor impairment in ischemic post-stroke spasmodic hemiplegia, and improve the limb function and life activity, which is better than PNF therapy after scalp acupuncture and simple PNF therapy.</p>
Subject(s)
Humans , Acupuncture Therapy , Brain Ischemia , Rehabilitation , Combined Modality Therapy , Hemiplegia , Rehabilitation , Therapeutics , Scalp , Stroke , Stroke Rehabilitation , Treatment Outcome摘要
Objective To discuss the radiation quality control in county based on regional medical imaging platform. Methods Based on regional medical imaging platform with the combination of PACS technology and telecommunication broadband network, we established the database, unified the radiological image quality standards and the regional medical imaging platform templates of the radiological examination report, built the evaluation standards, objectives, methods and processes of radiological quality, and observed the good rate of image quality and diagnostic report quality, in order to build a county-based radiation quality control system based on regional medical imaging platform. Results The good rate of the image quality and the diagnostic report quality increased and reached the target of examination(≥ 90%). Conclusion Through the regional medical imaging platform, changing the quality control mode of traditional radiation can improve the quality of radiation examination in the region and increase management efficiency and time efficiency.
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Objective To reduce the incidence of peritoneal dialysis related peritonitis for patients in rural area and to improve management quality of peritoneal dialysis center.Methods We established multidisciplinary collaborative research group involving departments of nephrology,nutrition,infection,and quality control.Risk factors of peritoneal dialysis related peritonitis in rural patients were analyzed,and prevention measures were designed.The rate of peritoneal dialysis related peritonitis in 89 patients after implementation was analyzed.Results The rate of peritoneal dialysis related peritonitis was decreased from 43 patient·month per time to 67 patient ·month per time.Conclusion The compound pathway can effectively reduce the rate of peritonitis,improve patient satisfaction,and prolong dialysis age.
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Targeted replacement genome editing refers to DNA modification and engineering technology that could induce and achieve mutations of targeted gene replacement or knockin at a target gene or DNA region. In this review, the principles, implementation methods, factors that influence efficiency and accuracy, and applications of gene replacement editing were summarized and discussed. It provides the reference for gene functional characterization and genetic improvements through gene replacement strategies in higher plant especially crops.
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BACKGROUND/OBJECTIVES: Dietary pattern and its association with cardio-cerebrovascular disease have not been studied in Baoji city by now. This study was aimed to identify the dietary patterns among Chinese adults in Baoji, and explore the association between these dietary patterns and cardio-cerebrovascular disease. SUBJECTS/METHODS: A total of 4,968 participants were included in this study at 12 counties. With multistage stratified random sampling and semi quantitative food frequency questionnaire, the prevalence of cardio-cerebrovascular disease and dietary intake were investigated in 2013. We used factor analysis to establish dietary patterns. RESULTS: A total of 4,968 participants over 15 years old were included in this study. Five dietary patterns were identified in Baoji: protein, balanced, beans, prudent, and traditional patterns. The protein dietary pattern mainly included animal and plant proteins and was negatively associated with hypertension as well as stroke. The balanced pattern included carbohydrates, protein, and fat and was negatively associated with hypertension as well as stroke. The beans pattern was mainly beans and beans products and was negatively associated with hypertension. The prudent pattern only included staple foods and pickled vegetables and was positively associated with hypertension as well as coronary heart disease. The traditional pattern was representative of local Baoji traditional recipes and was positively associated with hypertension. CONCLUSIONS: The protein, balanced, and beans dietary patterns showed many protective effects on cardio-cerebrovascular disease. Based on these results, Baoji city residents should be encouraged to choose protein, balanced, and beans dietary patterns and abandon prudent and traditional patterns to prevent incidence of hypertension, coronary heart disease, and stroke.
Subject(s)
Adult , Animals , Humans , Asian People , Carbohydrates , Coronary Disease , Fabaceae , Factor Analysis, Statistical , Hypertension , Incidence , Plant Proteins , Prevalence , Surveys and Questionnaires , Stroke , Vegetables摘要
BACKGROUND:After entering the aging society, improving the balance function to prevent fals and reduce incidence of fractures in the elderly has received widespread attentions in al aspects. OBJECTIVE: To design a training program for the elderly, involving static stretching and strength exercise of lower limb, in order to study the combined effect on the balance function of the elderly. METHODS: Static stretching and strength training of the lower limbs were carried out in 28 elderly persons who met the inclusion criteria for 3 months, three times a week, once for 60 minutes. Before and after exercise training, the static balance ability with foot standing, eyes open and eyes closed was evaluated using the PRO-KIN balance instrument; the dynamic balance ability and lower limb strength were evaluated using treadmil test with eyes closed and chair-stand test. Evaluation results before and after exercise were compared and anayzed. RESULTS AND CONCLUSION:In the eyes open state, the average X-axis coordinate and exercise-induced elipse area at the center of pressure were significant different before and after exercise (P < 0.01); the mean velocities at the left and right direction were of significant difference before and after exercise (P < 0.05); the results of treadmil test with eyes closed and chair-stand test also presented very significant differences before and after exercise (P < 0.01). Static stretching combined with lower limb strength exercise can effectively improve the balance function and lower limb strength of the elderly, which can be used as an effective exercise way to prevent the fals in the elderly.
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Objective To explore the function of the regional medical image network consultation system in propelling the quality control of regional medical image.Methods Based on the regional medical image network con-sultation system,the unified standard of quality control was implemented to reach the integrated management of the imaging quality control in region.The imaging specialists checked the quality of image and report in real time.In addi-tion,the specialists and inspectors monthly examined the quality of image and report.Subsequently,the unqualified causes were analyzed and the improvement measures were used.Finally,the quality of image and report were continu-ously improved.Results After the homogeneity management was applied for one year,the rates of remaking photos and returning the report were significantly decreased from 10% to 2%,and 12% to 4% respectively.Additionally,the rates of good image and report were significantly increased from 83% to 98%,and 89% to 100% respectively.The objective of good rate ≥90% was excellently achieved.Conclusion Based on the regional medical image network consultation system,the management in quality control of the networking hospitals has been uniform,and the technique of examination and the report format have been consistent.The standardability and accuracy of image examination have been realized.
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Background and purpose: Radiation therapy is still the most primary treatment of brain metastases, and prognosis is affected by many factors. The aim of this study was to identify the prognostic factors and to establish a prognostic index model in patients with brain metastases after whole-brain radiotherapy (WBRT). Methods: We reviewed the clinical date of 140 patients with brain metastases radiotherapy in our hospital from Jan. 2008 to Jul. 2011. The signiifcance of prognostic variables in the survival was resulted from both univariate analysis and multivariate analysis. The prognostic index (PI) was established based on Cox regression analysis and subgrouping values. It was assessed whether recursive partitioning analysis classes (RPA), basic score for brain metastases (BS-BM) and the graded prognostic assessment index (GPA) were related to prognosis. Results:The median survival time was 222 days. The univariate analysis showed that the independent prognostic factors were KPS performance status, number of brain metastases, presence of extracranial metastases, primary tumor status, radiation dose, hemoglobin. The multivariate analysis showed that KPS performance status (P=0.002, Wald=9.700), presence of extracranial metastases (P=0.018, Wald=5.604) and primary tumor status (P=0.001, Wald=10.212) were signiifcantly correlated with overall survival. RPA, BS-BM and GPA were closely related to their prognosis by Log-rank test. In predicting 3 months and 6 months of survival for patients, PI was better than other modes. Conclusion:Our data suggest that the 3 indexes RPA,BS-BM and GPA are valid prognostic index models, but PI model is better.
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The prognosis of patients with brain metastases from non-small cell lung cance (NSCLC) is dismal,and whole brain radiation therapy(WBRT) cannot simultaneously control the extracranial lesions.Study results of Tyrosine kinase inhibitor(TKI) for brain metastases in patients with lung cancer are encouraging,and treatment efficacy is related to EGFR mutation status.The sensitizing theoretical foundation exists in utilizing erlotinib combined with WBRT for the treatment in brain metastases patients with lung cancer.Currently,a small clinical trial data shows that erlotinib combined with WBRT has better efficacy compared to erlotinib alone,and the toxicity can be tolerated.
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Objective To study the expressions and significances of matrix metalloproteinases-3 (MMP-3) and tissue-inhibitor of matrix metalloproteinase-3 (TIMP-3) in transitional cell carcinoma of bladder.Methods Immunohistochemistry was used to detect the expressions of MMP-3 and TIMP-3 in 48 cases of transitional cell carcinoma of bladder and 20 normal bladder tissues.Results MMP-3 and TIMP-3 in normal bladder tissues did not express.The more grading and staging,the more MMP-3 expression,but no statistical significance(P >0.05),by contrast,TIMP-3 expression decreased and has statistically significant in the tumor grading (P < 0.05).Conclusions High expression of MMP-3 and low expression of TIMP-3 is related to the malignancy of transitional cell carcinoma of bladder and may play an important role in the development of transitional cell carcinoma of bladder,as an important reference to judge the degree of malignancy of transitional cell carcinoma of bladder and prognostic indicator.
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Therapies for malignant glioma include surgery,radiotherapy and chemotherapy.In recent years,the overall effective rate of temozolomide is better than other chemotherapy drugs,but partly patients have resistance to temozolomide.Angiogenesis inhibitors show promising activity,but it is expensive.Celecoxib has antiangiogenic activity,which has become a new option.
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Objective To evaluate the clinical value of MSCT in the diagnosis of unexplained aseites.Methods 113 patients with unexplained ascites were retrospectively reviewed by CT、clinical data and continous observation.Results Large ascites in 50 cases(44.3%),moderate amount aseites in 10 cases(8.8%),small ascites in 53 cases(46.9%);Parietal peritoneum changed in 51 cases(45.1%);Mesentery changed in 44 cases(38.9%);Grerter omentum changed in 20 eases(17.7%);Enlargement of lymph nodes in 67 cases(59.3%).Conclusion Malignant tumor was the most common cause of unexplained ascites.MSCT could help in identifying tumors and the tumor lesion,forecast malignant ascites,and had great value in etiology and diagnosis of ascites.
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Objective To evaluate the diagnostic value of sonographic score in the diagnosis of salivary gland involvement in patients with Sj(o)gren's syndrome(SS). Methods One hundred and three cases (44 cases of SS group and 59 cases of control group) were involved in the study. Parotid and submandibular glands of all the cases were examined by a doctor unawaring of the clinical information. All the off-line images were scored by two doctors seperately. The best threshold and the according diagnostic efficiency were determined by statistical analysis. Results The Kappa coefficient between the two doctors was 0.80.The parotid score,submandibular score and total score of SS group were significantly higher than those of the control group (5.79 ± 2.40 vs 0.46 ± 0.97,5.93 ± 1.58 vs 1.32 ± 1.84,11.64 ± 3.27 vs 1.78 ± 2.33,respectively). According to the ROC curve for the parotid score, submandibular score and total score, the area under the curve were 0.98,0.95,0.99, respectively. The best diagnostic threshold for total score was 8 and under this threshold, the diagnostic sensitivity, specificity, positive and negative predictive values were 93%, 97%, 95%, 95%, respectively. Conclusions The sonographic score including both parotid and submandibular glands is a reliable method with high reproductivity and diagnostic accuracy in the diagnosis of SS salivary gland involvement.
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[Objective]To induce TGF-?1 gene which can increase ECM synthesis into adipose tissue derived stem cells(ADSCs) by employing gene transfer techniques and observe whether TGF-?1 gene could expresse continuously and whether type II collagen and aggrecan are synthesized in order to provide experimental data for constructing tissue-engineering cartilage. [Method]ADSCs were transferred with TGF-?1 gene ,TGF-?1,FN,ColⅡ and aggrecan were detected with RT-PCR and TGF-?1 protein was detected with Western-blot.[Result]RT-PCR demonstrated that the expression of TGF-?1,FN,ColⅡ and aggrecan in the TGF-?1 gene transferred groups increased more evidently than non-gene groups and control groups (P
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BACKGROUND:The construction of the Changjiang Three-Gorges project may cause significant change in both natural and social environments;consequently,it may have profound impact on population's physical and mental health.OBJECTIVE:To investigate the potential impact from the change of social environments in Three Gorges dam on population health and also to explore the associated causes.DESIGN: Cross-sectional study SETTING:School of Public Health of Chongqing University of Medical Sciences, CDCs of Kaixian, Yunyang and Wanzhou counties.PARTICIPANTS: This research was conducted in Kaixian, Yunyang and Wanzhou of Chongqing from February to December of 2004.Data,which were about disease monitoring of overall population in the three counties in Three-Gorges areas mentioned above, were analyzed. METHODS: Data on disease monitoring of overall population in Yunyang,Kaixian and Wanzhou were collected and sorted,and the data on disease monitoring of non-Three-Gorges areas were taken as a control,all of these data were analyzed with the combination of quantitative and qualitative methods,as well as actuality and predicting methous and a number of literatures were referred to.MAIN OUTCOME MEASURES: ① Indicators of socio-economical development;② current situation of psychological health problems of migrants; ③ status of occurrence of emergent public health events.RESULTS: ① In Three-Gorges dam areas, local socio-economy development greatly lags behind, which consequently results in poor income in local people.② In recent years, the incidence of floating people-related diseases greatly in creased in Three-Gorges areas. ③ Migration had resulted in socio-psychological health problems of migrants. ④ The public health system in reservoirs is very weak, which may result in possible emergent publichealth events.CONCLUSION: It is urgent to closely study the existing problems, and to take active preventive measures to reduce the impact of socio-environmental factors on population health as possible.
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Objective To investigate the effects of Wortmannin combined with mitomycin C (MMC) on the proliferation,apoptosis and expressions of related genes Cyclin D1 and Bad in liver cancer cell line HepG-2. Methods HepG-2 cells (104/ml) were treated with 0,25,50,100,200 or 400 nmol/L Wortmannin,0,1.75,3.75,7.5,15 or 30 nmol/L MMC,or combined concentrations (0,26.875,53.75,107.5,215 or 430 nmol/L) respectively. Cell suppression rate were detected by MTT assay. Nucleus apoptosis of Hep-G-2 cells were examined by Hochest 33258 fluorescent staining. Change of cell cycle and apoptosis in HepG-2 cells were detected by flow cytometry (FCM). Expressions of PI3K/Akt signaling transduction pathway related genes and proteins were tested by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot analysis. Results The inhibition ratio of cell proliferation was significant higher in combined groups than in either single groups (P
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Objective To investigate the role of matrix metalloproteinase 2, 9 (MMP 2, MMP 9) and tissue inhibitor of matrix metalloproteinases 2, 1(TIMP 2, TIMP 1 ) in human amniochorionic membrane Methods Amniochorionic membranes were collected from the following groups of women: (1) women with spontaneous premature rupture of membrane (PROM) before onset of labor (PROM group, n =8), (2) Women with term labor after vaginal delivery (vaginal delivery group, n =8), (3) Women undergoing elective cesarean section (C section group, n =8) Messenger ribonucleic acid expression for MMP 2, MMP 9, and their specific inhibitors TIMP 2 and TIMP 1 were studied with reverse transcriptase polymerase chain reaction Results (1)MMP 2 level in PROM group was 0 849?0 037;in vaginal delivery group 0 327?0 023;in C section group 0 307?0 028 Expression in PROM group was highest, with significant difference compared with the other groups ( P 0 05) (2)MMP 9 level in PROM group was 0 026?0 004;in vaginal delivery group 0 008?0 001,with significant difference between the two groups ( P 0 05) Conclusions In PROM group,the expression of MMP 2, MMP 9 and their inhibitors TIMP 2, TIMP 1 is imbalanced, leading to increased extracellular matrix degradation, and weakening of the fetal membranes, and eventually premature rupture of the membranes
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0.05).Conclusions RFA treatment of PHC patients does not lead to hematogenous tumor dissemination.