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Review of historical literature showed that the understanding of the indicated disease location of Modified FuMai Decoction （复脉汤加减方） has evolved from the upper jiao （焦） to the middle and lower jiao. Initially， it is used for the treatment of yin deficiency of both yin and yang in the upper jiao， changes to supplement stomach and produce fluids in the middle jiao， and is used to protect yin， clear the pathogens， conslidate yin and subdue yang so as to store the true yin of lower jiao. The unchanging principle of Fumai Decoction modifications is nourishing yin， while the changing aspects are determining the secondary treatment methods based on disease location of sanjiao， concomitant disease natures， internal injury or external contraction， warm disease or cold damage， thereby choosing the corresponding added or subtracted herbs， and providing reference for the application of classical formulas.
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BACKGROUND@#Sarcopenia is an age-related progressive skeletal muscle disorder involving the loss of muscle mass or strength and physiological function. Efficient and precise AI algorithms may play a significant role in the diagnosis of sarcopenia. In this study, we aimed to develop a machine learning model for sarcopenia diagnosis using clinical characteristics and laboratory indicators of aging cohorts.@*METHODS@#We developed models of sarcopenia using the baseline data from the West China Health and Aging Trend (WCHAT) study. For external validation, we used the Xiamen Aging Trend (XMAT) cohort. We compared the support vector machine (SVM), random forest (RF), eXtreme Gradient Boosting (XGB), and Wide and Deep (W&D) models. The area under the receiver operating curve (AUC) and accuracy (ACC) were used to evaluate the diagnostic efficiency of the models.@*RESULTS@#The WCHAT cohort, which included a total of 4057 participants for the training and testing datasets, and the XMAT cohort, which consisted of 553 participants for the external validation dataset, were enrolled in this study. Among the four models, W&D had the best performance (AUC = 0.916 ± 0.006, ACC = 0.882 ± 0.006), followed by SVM (AUC =0.907 ± 0.004, ACC = 0.877 ± 0.006), XGB (AUC = 0.877 ± 0.005, ACC = 0.868 ± 0.005), and RF (AUC = 0.843 ± 0.031, ACC = 0.836 ± 0.024) in the training dataset. Meanwhile, in the testing dataset, the diagnostic efficiency of the models from large to small was W&D (AUC = 0.881, ACC = 0.862), XGB (AUC = 0.858, ACC = 0.861), RF (AUC = 0.843, ACC = 0.836), and SVM (AUC = 0.829, ACC = 0.857). In the external validation dataset, the performance of W&D (AUC = 0.970, ACC = 0.911) was the best among the four models, followed by RF (AUC = 0.830, ACC = 0.769), SVM (AUC = 0.766, ACC = 0.738), and XGB (AUC = 0.722, ACC = 0.749).@*CONCLUSIONS@#The W&D model not only had excellent diagnostic performance for sarcopenia but also showed good economic efficiency and timeliness. It could be widely used in primary health care institutions or developing areas with an aging population.@*TRIAL REGISTRATION@#Chictr.org, ChiCTR 1800018895.
Subject(s)
Humans , Aged , Sarcopenia/diagnosis , Deep Learning , Aging , Algorithms , BiomarkersABSTRACT
Objective To evaluate the effects of the project of ditching for drain on Oncomelania hupensis snail control and flood prevention security and explore the optimal engineering design plan in Dongting Lake region. Methods A retrospective study was performed on the previous studies about the project of ditching for drain. The reference values of project indices were determined. The outside levee of Nanhu New Distinct of Yueyang City in Dongting Lake region was selected as the study area , and the cross section of marshland perpendicular to the center line of the levee was extracted to research. According to the situa?tions of various water levels,a dynamic simulation was performed on the effect and security of the project of ditching for drain through the software FLAC3D. Results The retrospective study showed that the project would be effective when the relatively subsoil water level decreased by 0.35 m,and the soil water content decreased correspondingly. The dynamic simulation by FLAC3D showed that the minimum safe distances between transverse ditch 1,vertical ditch and levee toe should be 25 m and 13 m respectively. The digging depth of transverse ditch and vertical ditch should be 1.2 m and 1.0 m respectively. If the width of marshland in drought period was less than 500 m,one transverse ditch was efficient. Otherwise,more transverse ditches should be set with the intervals of 300 m. Conclusions The project of ditching for drain is an effective ecological snail elimination method. Optimizing the digging depth of ditches and distances between transverse ditches,vertical ditch and levee toe will en?sure the effects and security of the project.
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Objective To explore the effect of task-driven teaching methodology based on the action research on cardiopulmonary resuscitation training. Methods The 80 nurses recruited in 2011 were assigned in the control, receiving routine training while another 80 nurses recruited in 2012 were in the study group, where task-driven teaching methodology was used based on the action research. The two groups were compared in terms of results of theoretical and operational examinations. Result The study group was significantly better than the control group in the scores of theoretical and operational examinations ( P < 0 . 05 ) . Conclusion The task-driven teaching methodology based on the action research not only increases the examination results, but also improves the effect of teaching.
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Objective To investigate the frustration-confronting ability training on adversity quotient(AQ)of nursing graduates.Methods One hundred and fifty nursing graduates were received the frustration-confronting ability training.The adversity quotient scale was used in the investigation before and after the training.Result The total scores of AQ and other scores on all factors in AQ after training were significantly higher than before the training(all P<0.01).Conclusion The frustration-confronting ability training may be effective for the improvement of nursing graduates’AQ.
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Objective To determine the prevalence and clinical characteristics of orthostatic hypotension (OH) and orthostatic hypertension (OHT) in the elderly patients with hypertension.Methods 489 elderly patients with hypertension were enrolled and divided into the OH group,the OHT group and the non-OH-OHT group,which represents no or symptom.The orthostatic blood pressure was measured in supine position after resting for more than 5 minutes and at 3 min standing.Results The prevalence of OH in the 60～79 years old group was lower than that in ≥ 80 years old group.The morbility of coronary heart disease,diabetes and ischemic stroke was significantly higher in the OH and OHT group than that in the non-OH-OHT group.Conclusions OH and OHT are common disease in the elderly patients with hypertension and associated with increased risk of cardiovascular disease and diabetes mellitus.To strengthen nursing and health education for elderly patients with hypertension could prevent the incidence of malignant cardiovascular events due to OH and OHT.
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Objective To discuss the influence of nursing intervention on sleep quality and postoperative comfort of patients with percutaneous coronary intervention(PCI). Methods We divided 96 patients who were to receive PCI into the test group and control group with 48 patients in each group.The control group received routine nursing while the test group were given systemic nursing intervention based on routine nursing intervention.The sleep quality and incidence rate of complications were compared. Results The sleep quality in the test group was better than that of the control group (P ＜ 0.01 ).The ineidience of waist-back pain,dysuria,induced emiction,eatheter emietion,anaesthesia of lower limbs,fidget in the test group also decreased compared with the control group(P ＜ 0.05). Conclusions Systemic nursing intervention could improve the sleep quality and postoperative comfort for PCI patients