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Objective:To explore the detection and segmentation of ischemic core infarct volume of the acute stroke in diffusion weighted imaging (DWI) images using cascaded VB-Net.Methods:MRI data of 1 500 patients (2 456 lesions) with acute ischemic stroke in Henan Provincial People′s Hospital from December 2016 to December 2018 were retrospectively analyzed. Firstly, manual segmentation of ischemic core was performed on DWI images (b=1 000 s/mm 2), and then all data were divided into training set, validation set and independent test set by 8∶1∶1. Then, the cascaded VB-Net was constructed, and the core infarct was automatically detected and segmented in the test set. Interclass correlation coefficient (ICC) was used to evaluate the consistency of volume size measured by manual segmentation and cascaded VB-Net. The patients were divided into large ischemic core lesion group (ischemic core volume ≥10 ml) and small ischemic core lesion group (ischemic core volume<10 ml), and the Dice coefficient difference between the two groups was compared using Mann-Whitney U test. Results:In independent test set, cascaded model had the detection rate of 94.6% (243/257) with Dice coefficient of 0.76 (0.68, 0.84). The agreement of cacade VB-Net segmented [4.19(1.21,14.13)ml] and manual segmented ischemic core infarct volume [4.08(1.19,17.92)ml] was high (ICC=0.97, P<0.001). There was no significant difference in Dice coefficient between large and small lesion groups [0.76 (0.69, 0.85), 0.76 (0.67, 0.84), Z=-0.44, P=0.657]. Conclusions:The cascaded VB-Net model provided a tool to realize automatic detection, segmentation, and calculation of ischemic core infarct volume. It has good segmentation accuracy and high consistency with manual segmentation, which can provide an auxiliary decision-making tool for the selection of treatment plans.
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Objective:To explore the application of perioperative nutrition management strategy in patients with hepatic cystic echinococcosis.Methods:From October 2017 to February 2019, 53 patients with hepatic cystic echinococcosis who met the inclusion criteria were selected as the control group. Another 53 patients from June 2018 to January 2019 were collected as the experimental group, the nutritional index, liver function, complication rate and postoperative recovery were compared between the two groups.Results:The levels of retinol-binding protein, prealbumin and transferrin were (24.32 ± 3.76) μg/L, (167.00 ± 24.12) mg/L, (2.08 ± 0.43) μg/L on the day of admission in the experimental group, and one day before the operation were (27.78± 4.98) μg/L, (245.00 ± 22.02) mg/L,(2.47 ± 0.54)μ g/L, there was no significant difference ( t=0.576-3.552, P < 0.05). The incidence of infection, biliary leakage and hemorrhage in the experimental group were 0, 1.89% (1/53) and 0 respectively, which were lower than 9.43% (5/53), 13.21% (7/53), 11.32% (6/53) in the control group ( χ2 value was 4.867, P < 0.05). The aspartate aminotransferase and alanine aminotransferase of the experimental group on the 7th day after operation were (51.50 ± 6.30), (29.54 ± 2.03) U/L, which were significantly different from (69.53 ± 7.07), (43.72±3.67) U/L of the control group ( t value was 2.032, 2.015, P<0.05). Anal exhaust, defecation time, hospitalization time and expenses in the experimental group were (15.89±8.34) h, (49.12±10.56) h, (8.69 ± 1.69) d, (2.84±1.37) thousand yuan, which were significantly different from (34.13±7.13) h, (63.45±11.03) h, (11.51±4.18) d, (3.76±1.53) thousand yuan in the control group. There was statistical significance ( t values were 3.372-12.592, P<0.05). Conclusions:The application of perioperative nutrition management strategy in patients with hepatic cystic echinococcosis can improve the nutritional status of patients during perioperative period, promote the recovery of liver function and reduce the occurrence of postoperative complications.
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Objective To translated the Male Osteoporosis Assessment Questionnaire (OPAQTM) into Chinese and test the validity and reliability of it.Methods Translation and cross-cultural adaptation of the original OPAQTM was performed according to the published guidelines.A total of 122 male osteoporosis patients in Xi'an city were included in item analysis,exploratory factor analysis and criterion-related validity and reliability analysis of this Chinese version of OPAQTM.Results A 7-factor structure with 37 items was identified through item analysis and exploratory factor analysis,which explained 73.943％ of the total variance.The ratio of convergent validity of each dimension was exceeded 0.90 and exceeded 0.95 for discriminant validity.The Cronbach's α coefficient for the total OPAQTM score was 0.956.The split-half for the overall scale was 0.858.The test-retest reliability was 0.760 for the overall scale.In relation to criterion validity,the Spearman correlation coefficients ranged from 0.485 to 0.867 between the Chinese version of OPAQTM and the corresponding dimensions of 12-Item Short-Form Health Survey Questionnaire (SF-12),which were significantly correlated,P ＜ 0.01.Conclusions The Chinese version of OPAQTM appears to possess adequate validity and internal consistency.The newly translated Chinese version of OPAQTM may be used to assess the quality of life of male osteoporosis patients in China.
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Objective:To seek the short term standardization study nurses training education content and the ap-proach to learning, provide theoretical basis for improving the study effect of nurse training.Methods:Choosing 3 ~6 months in 2014 in our hospital study questionnaire survey was conducted among 114 nurses, questionnaire by general in-formation, content of training needs, demand method of three parts and using SPSS19.0 to analyze the collected data. Results:The 82.7%of study nurses think pre-service training is very necessary.Pre-service training demand of the top three comprises:occupational protection (82.7%), health care, with communication skills (80.0%) and infection prevention and control (78.2%).Refresher training needs during the top three in turn:specialized rescue of critically ill patients and cooperation (88.2%), clinical application and nursing adverse event processing (79.1%), effective communication nurses and patients (79.1%).Demand content score between the different degree and the title of ad-vanced nurse was statistically difference (P<0.05).The training methods, in the first three order practice (89.10%), seminar (74.5%), case analysis and discussion (67.30%).Conclusion:According to the study demand of nurse stand-ardized training content and ways of learning, considering the influence factors such as education, job title, targeted training plan, improve the effect of short-term training.