Design and implementation of Internet of Things for emergency medical devices based on cloud-edge-device architecture / 生物医学工程学杂志

Internet of Things (IoT) technology plays an important role in smart healthcare. This paper discusses IoT solution for emergency medical devices in hospitals. Based on the cloud-edge-device architecture, different medical devices were connected; Streaming data were parsed, distributed, and computed at the edge nodes; Data were stored, analyzed and visualized in the cloud nodes. The IoT system has been working steadily for nearly 20 months since it run in the emergency department in January 2021. Through preliminary analysis with collected data, IoT performance testing and development of early warning model, the feasibility and reliability of the in-hospital emergency medical devices IoT was verified, which can collect data for a long time on a large scale and support the development and deployment of machine learning models. The paper ends with an outlook on medical device data exchange and wireless transmission in the IoT of emergency medical devices, the connection of emergency equipment inside and outside the hospital, and the next step of analyzing IoT data to develop emergency intelligent IoT applications.

The active lung microbiota landscape of COVID-19 patients

With the outbreak of COVID-19 causing by SARS-CoV-2, the interaction between the host and SARS-CoV-2 was widely studied. However, it is unclear whether and how SARS-CoV-2 infection affects lung microflora, which contributes to COVID-19 complications. Here, we analyzed the metatranscriptomic data of bronchoalveolar lavage fluid (BALF) of 19 COVID-19 patients and 23 healthy controls from 6 independent projects and detailed the active microbiota landscape in both healthy individuals and COVID-19 patients. The infection of SARS-CoV-2 could deeply change the lung microbiota, evidenced by the -diversity, {beta}-diversity and species composition analysis based on bacterial microbiota and virome. Pathogens (such as Klebsiella oxytoca causing pneumonia as well), immunomodulatory probiotics (such as Lactic Acid Bacteria and Faecalibacterium prausnitzii, a butyrate producer) and Tobacco mosaic virus (TMV) were enriched in the COVID-19 group, suggesting a severe microbiota dysbiosis. The significant correlation between Rothia mucilaginosa, TMV and SARS-CoV-2 revealed drastic inflammatory battles between the host, SARS-CoV-2 and other microbes in the lungs. Notably, TMV only existed in the COVID-19 group, while Human respirovirus 3 only existed in the healthy group. Our study provides insight into the active microbiota in the lungs of COVID-19 patients and will contribute to the understanding of the infection mechanism of SARS-CoV-2 and the treatment of the disease and complications.

Assisting Scalable Diagnosis Automatically via CT Images in the Combat against COVID-19

Introductory paragraphThe pandemic of coronavirus Disease 2019 (COVID-19) caused enormous loss of life globally. 1-3 Case identification is critical. The reference method is using real-time reverse transcription PCR (rRT-PCR) assays, with limitations that may curb its prompt large-scale application. COVID-19 manifests with chest computed tomography (CT) abnormalities, some even before the onset of symptoms. We tested the hypothesis that application of deep learning (DL) to the 3D CT images could help identify COVID-19 infections. Using the data from 920 COVID-19 and 1,073 non-COVID-19 pneumonia patients, we developed a modified DenseNet-264 model, COVIDNet, to classify CT images to either class. When tested on an independent set of 233 COVID-19 and 289 non-COVID-19 patients. COVIDNet achieved an accuracy rate of 94.3% and an area under the curve (AUC) of 0.98. Application of DL to CT images may improve both the efficiency and capacity of case detection and long-term surveillance.

Clinical significance of IgM and IgG test for diagnosis of highly suspected COVID-19 infection

Quick, simple and accurate diagnosis of suspected COVID-19 is very important for the screening and therapy of patients. Although several methods were performed in clinical practice, however, the IgM and IgG diagnostic value evaluation was little performed. 57 suspected COVID-19 infection patients were enrolled in our study. 24 patients with positive and 33 patients with negative nucleic acid test. The positive rate of COVID-19 nucleic acid was 42.10%. The positive detection rate of combination of IgM and IgG for patients with COVID-19 negative and positive nucleic acid test was 72.73% and 87.50%. The results were significantly higher than the nucleic acid or IgM, IgG single detection. hsCRP in the COVID-19 nucleic acid negative group showed significantly higher than the positive groups (P=0.0298). AST in the COVID-19 IgM negative group showed significantly lower than the positive groups (P=0.0365). We provided a quick, simple, accurate aided detection method for the suspected patients and on-site screening in close contact with the population.

Building a comprehensive health assessment indicators systems for health management of military officers / 中华医院管理杂志

In line with the new WHO definition for health and reference of comprehensive health assessments of elderly overseas, the paper screened and set the weight for comprehensive health assessment indicators for military officers, establishing a general health assessment model as a result 402 military officers were subject to Comprehensive Health Assessments, and the outcomes were compared with subjective assessment of experts. The results of both methods are highly coincidental. It proves Comprehensive Health Assessment as a scientific quantitative health assessment method, with promising perspectives in health management in the future.

Correlation between N-terminal Pro-brain Natriuretic Peptide and Cardiac Diastolic and Systolic Function / 中国康复理论与实践

@#Objective To study the correlation between N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac diastolic and systolic function. Methods 60 New Zealand male rabbits were randomly assigned to two groups. The abdominal aorta 1 cm just above right renal artery were constricted in operated group. The clinical manifestation of heart failure was observed, and cardiac structure and function were investigated with echocardiography. Concentration of serum NT-proBNP was determined regularly. Results The concentration of NT-proBNP was correlated with Sm（r=－0.635,P=0.000）, Em（r=－0.693,P=0.000）, E/Em（r=0.688,P=0.000）, E/Vp（r=0.707, P=0.000）, and EF（r=－0.395,P=0.001）. Conclusion Concentration of serum NT-proBNP could prognose the diastolic and long axis systolic function of left ventricle.

D-dimer is useful in assessing the vulnerable blood in elderly patients with coronary disease / 老年心脏病学杂志（英文版）

Background and objective The value of D-dimer in the risk stratification of patients with coronary artery diseas(CAD)and the relationship between D-dimer and the diseased coronary arteries remains controversial or unclear.especially in the elderly.Thisstudy was to evaluate the usefulness of D-djmer as a biomarker in assessing the vuinerable blood in the elderly patients with coronarydisease.Methods Sixty elderly (≥60 years old)male patients with suspected CAD were enrolled in this prospective study.Patients were divided into CAD group(n=41,10 with stable angina and 31 with unstable angina)and control group(n=19)according to their coronary angiography Results Clinicalinformation including age,body mass index(BMI),smoking index,and thecomplications of Primary hypertension or diabetes.and CAD family history was collected.Venous blood was sampled serially for thedetermination of total cholesterol,HDL cholesterol,LDL cholesterol,triglycerides,apoAl,apoB,glucose,uric acid,homocysteine(Hey),hs-CRP,soluble thrombomodulin(sTM),and marker of fibrinolytic system and hypercoagulability,such as D-dimer,fibrinogen,etc.The extent of coronary atherosclerosis was assessed.using the Gensini scoring system on the basis of coronary angiography.Results Compared with the controls.the patients with CAD had significantly higher levels of D-dimer.D-dimer level wassignificantly correlated to age.hs-CR P.Hcy,and PAI-1.Patients with D-dimer levels in the top triplicate of D-dimer level hadsignificantly higher prevalence of unstable angina compared with patients in the lowest triplicate(OR=4.8,Z=3.28,P=0.001).In anordinal logistic regression.the OR value ofdeveloping more serious CAD augmented 3.1-foid with each increasing triplicate of D-dimer.Patients with unstable angina had a significantly higher level of D-dimer than the controls(P=0.005),and an increasing trend comparedwith patients with stable angina (P=0.059).whereas there was no difference between the patients with stable angina and the controls(P=0.885).D-dimer was significantly correlated with Gensini scores(r=0.3930,P=0.0019).Ordinal logistic regression showed that theOR value ofincreasing one or two triplicates of Gensini's scores augmented 1.44.fold with each increasing triplicate of D-dimer(OR=2.44,Z=2.87,P=0.004). Conclusions D-dimer may be a helpful biomarker in identifying the severity of vulnerable blood in elderlypatients with CAD.

Changes of Systolic and Diastolic Function after Constriction of Abdominal Aorta (above Renal Artery) in New-Zealand Rabbit / 中国康复理论与实践

@#Objective To establish an animal model of heart failure with preserved ejection fraction(EF)resulting from hypertension.Methods35 male New-Zealand rabbits were randomly assigned to 2 groups:constriction was performed at the abdominal aorta 1 cm just above right renal artery in operated group(n=25),and the sham-operated animals were taken as control group(n=10).The clinical manifestations of heart failure were followed up carefully.Systolic and diastolic function,and systemic hemodynamics were investigated with echocardiography and left ventricle catheter.ResultsIn operated group,marked ventricular hypertrophy was observed 2 weeks after operation.4 weeks after operation,the clinical manifestations of heart failure presented,and IVRT and LVEDP increased,and-dp/dt max decreased.Tissue doppler image indicated that e/a ratio of annulus of mitral valve decreased(P<0.05).However,EF and +dp/dt max were preserved.ConclusionThe operated animals presented the clinical manifestation of heart failure,and diastolic function of left ventricle injured,however,ejection fraction was preserved,which corresponded with the character of heart failure with preserved ejection fraction resulting from hypertension.

MAPKs activity and c-fos mRNA in vascular tissues increased after coronary artery balloon injury in swine / 中国病理生理杂志

AIM: To observe the changes in mitogen-activated protein kinases (MAPKs) activity and gene expression of c-fos after coronary artery balloon injury in swine. METHODS: Six of the seventeen Chinese swine were as control group, and the others underwent coronary angioplasty to LAD or CLx. The animals were sacrificed at three and thirty days following the procedure. The cross-sections were stained hematoxylin-eosin, strichrome, and Verhoef-van Giesen after the target segments were dissected free from the hearts, and the morphologic characteristics were investigated by computer-assistant analysis system. The target segments were also processed to examine the gene expression of c-fos by reverse transcription-polymerase chain reaction (RT-PCR) and to measure the activity of MAPKs by biochemistry. RESULTS: MAPKs activity and gene expression of c-fos in the dilated segments were significantly higher than that of normal segments three days after coronary balloon injury (51.5%, P

EFFECTS OF ENDOVASCULAR RADIATION ON CELL PROLIFERATION AND APOPTOSIS AFTER CORONARY ARTERY BALLOON INJURY IN SWINE / 解放军医学杂志

This study examined the effects of endovascular irradiation on cell proliferation and apoptosis after overstretch balloon angioplasty in a normolipemic swine model of restenosi. Twenty five swine underwent oversized balloon angioplasty in the LAD and/or LCX,and in 13 of them the procedure was followed immediately by endovascular radiation using a guide wire with 3 cm long 192 Ir line source to deliver 20Gy to overdilated segments. All the animals were killed at 3 and 30 days. Cell proliferation was estimated by immunostaining for proliferation cell nuclear antigen (PCNA). Apoptosis was identified by the terminal uridine nick end labeling(TUNEL). The results showed that endovascular radiation significantly reduced the pcna positive cells compared with controls 3 days and 30 days after initial injury. There were no quantitative differences in the amount of TUNEL labeling cells among irradiated and control vessels in any region examined 3 days and 30 days after balloon injury. Endovascular radiation may reduce restenosis by inhibiting the cell proliferation, not by enhancing cell apoptosis.