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Objective:To analyze the current situation of the specialty setting and training program of Intelligent Medical Engineering (IME) in China.Methods:The information about the schools' name, year of opening, enrollment plan, training objective and curriculum was obtained by the website investigation and was statistically analyzed by Excel.Results:(1)A total of 48 universities set an IME major from 2018 to 2021, mainly in developed areas. The number of talent training was nearly 2 400 per year. (2)The information of colleges which established IME was acquired from 47 universities. Among them, 59% (13/22) of the comprehensive universities set the IME major in medical-related colleges. (3)The information concerning professional training objectives was collected from 40 universities and they highlighted the capabilities of big data intelligent processing and software research and development, and 12 of them also required students to master the capability of hardware research and development. (4)Computer science and technology, preclinical medicine, clinical medicine and biomedical engineering were the main disciplines of IME. The professional core curriculum mainly included computer language and artificial intelligence (AI) related courses.Conclusion:IME education has sprung up rapidly with the development of AI technology in medical and health field. However, the cultivation of IME professionals is still at exploratory stage. It is recommended that the national related departments should publish some relevant guidelines on the training orientation of IME.
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Objective:To compare the risk assessment capability of model for end-stage liver disease (MELD), glasgow-blatchford score (GBS), and the AIMS65 scoring system for liver cirrhosis patients with esophageal and gastric variceal bleeding (EGVB).Methods:A retrospective analysis was made on data of 182 cirrhosis patients with EGVB admitted to the Department of Gastroenterology, General Hospital of Tianjin Medical University from January 1, 2015 to March 1, 2018. According to the MELD, GBS and AIMS65 scoring system, the corresponding scores of each patient were calculated to evaluate the ability of the three scoring systems to correctly classify EGVB as a " high-risk patient" . The receiver operating characteristic curve was drawn to compare the predictive value of three scoring systems for different clinical outcomes (blood transfusion, rebleeding, and death). The area under curve (AUC)>0.7 was believed to have higher accuracy.Results:The clinical outcomes of 182 patients included blood transfusion in 113 (62.1%) cases, rebleeding in 31 (17.0%) cases, and death of 11 (6.0%) cases. The MELD score was 7-25, GBS was 3-16, and AIMS65 score was 0-3. There were 4 (2.2%) patients with MELD score < 9, 139 (76.4%) patients with AIMS65 score 0-1, including 68 patients with AIMS65 score of 0 and 71 patients with AIMS65 score of 1. The AUC of MELD, GBS and AIMS65 for predicting blood transfusion was 0.514 (95% CI: 0.439-0.589), 0.681 (95% CI: 0.608-0.748), and 0.669 (95% CI: 0.596-0.737), respectively. When predicting rebleeding, the AUC of MELD, GBS and AIMS65 was 0.525 (95% CI: 0.449-0.599), 0.528 (95% CI: 0.453-0.602) and 0.580 (95% CI: 0.505-0.652), respectively. When predicting in-hospital mortality, the AUC of MELD, GBS and AIMS65 was 0.642 (95% CI: 0.567-0.711), 0.581 (95% CI: 0.505-0.653) and 0.786 (95% CI: 0.719-0.843), respectively. AIMS65 was superior to MELD ( P=0.083 6) and GBS ( P=0.047 0). Conclusion:GBS can correctly classify cirrhosis patients with EGVB as " high-risk group" , and is better than AIMS65 and MELD scoring system. MELD, GBS and AIMS65 all have poor accuracy in predicting blood transfusion and rebleeding, AIMS65 has a higher predictive value for death.
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0.05). Similarly, no significant difference was detected in retinal arteriolar tortuosity (Z=0.91) and venular tortuosity (Z=1.31) (both p>0.05). However, the retinal arteriolar FD (mean difference: −0.03, 95% CI: −0.05, −0.01) and venular FD (mean difference: −0.03, 95% CI: −0.05, −0.02) were associated with cognitive impairment.CONCLUSIONS: A smaller retinal microvascular FD might be associated with cognitive impairment. Further large-sample and well-controlled original studies are required to confirm the present findings.
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Cognition Disorders , Fractals , Publication Bias , Retina , Retinal Artery , Retinal Vessels , RetinaldehydeABSTRACT
Objective@#To investigate the prognostic value of albumin-to-bilirubin scores in the assessment of autoimmune hepatitis-related cirrhosis.@*Methods@#The receiver operating characteristic curve was used to evaluate the accuracy of ALBI, Child-Pugh and model for end-stage liver disease (MELD) for prognosis prediction. Survival analysis was performed according to the ALBI classification. Spearman correlation analysis was performed on the ALBI score and the Child-Pugh score. Survival curves were plotted by Kaplan-Meier method, and Log-rank method was used to compare the survival difference curves between different groups.@*Results@#149 patients were recruited in the study. The ROC analysis showed that the ALBI scores (0.861, 0.826, 0.779, 0.744)was superior to Child-Pugh scores(0.703, P = 0.006; 0.672, P < 0.001; 0.613, P < 0.001; 0.583, P < 0.001)and MELD score(0.774, P = 0.031; 0.731, P = 0.007; 0.669, P < 0.001; 0.631, P < 0.001) for predicting 6, 12, 24, and 36 months mortality. Patients with ALBI grade 3 had a significantly lower survival rate than those with ALBI grade1 and grade 2.@*Conclusion@#ALBI score may be useful to evaluate the long-term prognosis of patients with autoimmune hepatitis-related cirrhosis.
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Objective To investigate and analyze the applications of liver grafts from donation after death children (≤5 kg) in pediatric liver transplantation.Methods A retrospective analysis was conducted on 18 cases of pediatric recipients using liver grafts from donation after death children (≤5 kg) during January 2013 to December 2015.The survival rate of patients,recovery of liver function,incidence of lung infection,vascular complications and biliary complications were observed,and the causes of deaths were analyzed.Results The median follow-up time of all the patients was 28.4 months (0.06-52.2 months).The 1-and 3-year cumulative survival rate was the same 88.9％,the incidence of lung infection was 22.2％,of vessel complications was 33.3％,and biliary complication rate was 11.1％.Two cases died after liver transplantation.Conclusion The applications of liver donation after death children (≤5 kg) were satisfactory,but there is still relatively limited experience,and further observation and research are needed.
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Objective To evaluate the predictive value of Admission-Rockall Score (aRS), Full-Rockall Score ( fRS ), Glasgow-Blatchford Score ( GBS ) and AIMS65 scoring systems for rebleeding, mortality, transfusion and clinical intervention of patients with acute nonvariceal upper gastrointestinal bleeding ( ANVUGIB). Methods A retrospective study was performed on the data of 294 ANVUGIB inpatients in the Department of Gastroenterology of Tianjin Medical University General Hospital from January 2015 to September 2016. Each patient was graded using the four scoring systems. The area under the receiver-operating characteristic curve ( AUC) about rebleeding, mortality, blood transfusion and clinical intervention was calculated using each system. Results For predicting rebleeding, fRS (AUC＝0. 696) and GBS (AUC＝0. 697) were both superior to aRS (AUC＝0. 609, P＜0. 05) and AIMS65 (AUC＝0. 571, P＜0. 05), and there was no significant difference on AUC between fRS and GBS (P＞0. 05). For predicting mortality, the AUC of aRS, fRS, GBS and AIMS65 were 0. 755, 0. 791, 0. 818, and 0. 780, respectively, and there were no significant differences (P＞0. 05). There were no significant differences in the predicting transfusion among four scoring systems, and the AUC was 0. 625, 0. 626, 0. 697 and 0. 658, respectively. Regarding clinical intervention treatment, fRS (AUC＝0. 661) was superior than that of aRS (AUC＝0. 520, P＜0. 05) and AIMS65 (AUC＝0. 545, P＜0. 05), and the AUC of GBS and three other scoring systems had no significant differences (P＞0. 05). Conclusion The four scoring systems are all with good predicting value on mortality of patients with ANVUGIB, while not on other aspects including rebleeding, transfusion and clinical intervention. fRS has a slightly better value on prediction of rebleeding and clinical intervention, and GBS is slightly better on prediction of rebleeding.
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Objective To investigate the diagnostic value of endoscopic ultrasonography(EUS)for esophageal submucosal tumor(SMT). Methods Clinical data of 388 patients with esophageal SMT, who underwent EUS and endoscopic treatment in Tianjin Medical University General Hospital were collected from May 2010 to September 2016. The golden standard for the origin of esophageal SMT was the diagnosis during endoscopic treatment, and the golden standard of pathological type was the combination of postoperative pathological and immunohistochemical findings. The diagnostic accuracy of EUS for esophageal SMT was evaluated. Results The conventional endoscopy revealed that 31.70%(123/388)and 43.81%(170/388)esophageal SMTs were located in the middle and lower segments of esophagus,respectively. The diagnostic consistency of EUS for the origin of lesion was 71.51%(251/351), while the diagnostic consistency of EUS for lesion originated from the muscularis mucosae, submucosa and muscularis propria layer was 92.90%(170/183), 34.38%(11/32), and 51.47%(70/136), respectively. The diagnostic consistency of EUS for the type of lesion was 81.00%(260/321), while the diagnostic consistency of leiomyoma, esophageal cyst, and lipoma were 88.42%(252/285), 14.81%(4/27), and 80.00%(4/5), respectively. Conclusion EUS can preliminarily diagnose the origin and pathological type of esophageal SMT,but there are limitations on the diagnosis of uncommon lesions,which need combination of pathological and immunohistochemical findings.
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OBJECTIVE: To obtain the microcrystal agents of sorafenib and examine the in vivo anti-tumor efficiency of sorafenib-microcrystal on hepatocellular carcinoma cells. METHODS: The solubilizing solution or microcrystal of sorafenib was obtained. A highly aggressive HCC cell line, MHCC97-H, was used to form the subcutaneous or intra-hepatic tumor model in nude mice. Sorafenib-solution or microcrystal was injected into tumors. The clearance curve or anti-tumor efficiency of solubilizing solution or microcrystal was identified. Endogenous of EMT related indicators was identified by qPCR. RESULTS: Sorafenib slowly released in tumor tissues by sorafenib-microcrystal but not sorafenib-solution. Treatment of sorafenib-microcrystal inhibited the in vivo growth of MHCC97-H cells. CONCLUSION: The microcrystal agents of sorafenib is prepared. This work also establishes the in vivo anti-tumor efficiency of sorafenib-microcrystal on HCC cells.
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Based on the introduction to the clinical phenotype extraction technique,the paper conducts systematic review on the extraction of clinical phenotype from Electronic Medical Records (EMR) of diabetes by taking advantages of the clinical decision support technique,natural language processing technique and machine learning method,and indicates that the deep learning method can be used to extract clinical phenotype from the EMR data more effectively and accurately,help clinical researchers better conduct clinical tests,and improve the medical care level.
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Objective To investigate the effects of intestinal microbiota of patients with chronic constipation on the expression of serotonin transporter (SERT) and the bowel movement in mice.Methods Fecal samples of patients with slow transit constipation met Rome Ⅲ criteria and healthy normal controls were collected and made into fecal microbiota solution.Twenty specfic pathogen free (SPF) mice were divided into experiment group and control group.The mice of two groups were both pre-treated with streptomycin to establish the germ-free mice model.The mice of control group were gavaged with mixed fecal microbiota solution of healthy normal controls and the mice of experiment group were gavaged with mixed fecal microbiota solution of patients with chronic constipation.Mice were sacrificed after fed for 15 days.Defecation parameters and ink discharge time of mice were detected.The expressions of SERT mRNA and SERT protein in mice intestinal tissues were detected with real time-polymerase chain reaction and Western blotting.The 5-hydroxytryptamine (5-HT) levels of mice intestinal tissues were evaluated by enzyme-linked immunosorbent assay (ELISA) and double immunofluorescent staining.The methods of t test and Chi-square test were performed for statistical analysis.Results On the 15th day,the total number of the feces within 2 h of the experiment group and control group was 8.55±1.83 and 12.14±2.90,respectively,and the difference was statistically significant (t=3.33,P＜0.05).The weight of feces were (151.90 ± 32.42) mg and (246.72 ± 64.01) mg,respectively,and the difference was statistically significant (t=4.18,P＜0.01).The dry weight of feces were (65.52±11.76) mg and (92.93±23.07) mg,respectively,and the difference was statistically significant (t=3.37,P＜0.05).The water content of feces were (56.63 ± 3.01) ％ and (61.95 ± 3.70) ％,respectively,and the difference was statistically significant (t=3.57,P＜0.05).The defecating time of first black feces of the experiment group and control group were (83.24±11.31) min and (69.06±2.72) min,respectively,and the difference was statistically significant (t=-2.74,P＜0.05).The expressions of SERT mRNA and SERT protein levels in mice intestine tissues of the experiment group were significantly higher than those of the control group (t =2.61,-6.89;both P＜0.05).5-HT level of mice intestinal tissues of the experimental group and control group were (151.69± 10.18) ng/mL and (198.77 ± 25.99) ng/mL,respectively,and the difference was statistically significant (t=-4.13,P＜0.01).Conclusion Intestinal microbiota of patients with chronic constipation may influence the expression of SERT in the mice intestinal tissues,and then decrease the level of 5-HT,slowing the bowel movement in mice.
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Objective To retrospectively analyze the status quo of health education for domestic hypertensive patients in the past 10 years.Methods Papers on health education for domestic hypertensive patients, retrieved from Wanfang Database and CNKI, were analyzed according to the Excel.Results The number of studies on health education for domestic hypertensive patients showed a tendency to increase in 2005-2015.The commonly used health education methods for hypertensive patients were face to face education, distributing education materials, holding lectures, and follow-up.The main health education contents included hypertension-related knowledge, physical exercises, rational diet, emotion control, compliant behaviors, giving up smoking and limiting drinking, and body weight control.The index of lifestyle of patients was improved after health education.Conclusion Great achievements are made in health education for hypertensive patients in our country.Stress should be placed on the rational planning for health education and building electronic health education platform in future.
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The unbalanced allocation and sharing of medical and health information resources have retrained the medical and health information construction in China. The current allocation of medical and health information re-sources was thus summarized in this paper by analyzing the CNKI. net-covered literature on medical and health in-formation, the number of undergraduates in colleges and universities, the number of employed medical and health information professionals in Eastern, Central and Western China, and in different provinces of China using the RSR, and suggestions were put forward for the development of medical and health cause in our country.
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Objective To investigate the clinical features,therapeutic methods,therapeutic effect and prognosis of a case of bladder urothelial carcinoma patients in combination with trophoblast.Methods The pathological data of a patient with bladder high grade urinary epithelial carcinoma in combination with trophoblast was retrospectively analyzed and the related literatures were reviewed.It was a male patient,69 years old,presenting with total painless gross hematuria.The CT scan showed irregular nodules on the anterior wall of bladder.Results Cystoscopy showed 1.5 cm cauliflower mass on the anterior wall of bladder,and transurethral resection of bladder tumor was performed.The pathology and immunohistochemistry showed urothelial carcinoma.Lung metastases was found due to hemoptysis,and increased serum beta human chorionic gonadotropin (β-HCG) was detected simuhaneously.Pathology was double checked and bladder urothelial carcinoma with trophoblast cell differentiation was considered.Three cycles gemcitabine + cisplatin (GC regimen) and 2 cycles etoposide + methotrexate + vincristine + cyclophosphamide (modified EMA-CO regimen) therapies were given,and the disease was stable at that time.The patient died on June 10,2016,and the total survival period was 9 months.Conclusions The clinical and imaging of urothelial carcinoma with trophoblast differentiation is not special.Diagnosis must depend on the pathological and immunohistochemistry examinations.The efficacy can be evaluated by combining imaging with serumβ-HCG.Treatment should be systemic venous chemotherapy.
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Objective To more effectively prevent hypertension and provide better health care for college and university teachers and staff by keeping abreast with the epidemiology of hypertension. Methods The data were extracted from the selected Chinese and English papers on epidemiology of hypertension, which was followed by a meta-analysis of the prevalence, awareness rate, cure rate, and control rate of hypertension in college and university teachers and staff of China. Results A total of 73 papers were included in this study. The total prevalence of hypertension was 23. 3% (95%CI=21. 1%-25. 6%), the prevalence of hypertension was 27. 2% (95%CI=24. 4%-30. 0%) in male hypertensive teachers and staff and was 18. 6% (95%CI=16. 6%-20. 6%) in female hypertensive teachers and staff. The prevalence of hypertension increased with the increasing age and tended to increase with the year of investigation in college and university teachers and staff of China, and was the lowest in East China followed by Central China and West China. The awareness rate, cure rate and control rate of hypertension were 68. 3% (95%CI=59 . 7%-76 . 8%) , 63 . 7% ( 95%CI=55 . 5%-71 . 9%) , and 37 . 7% ( 95%CI=28 . 0%-47 . 5%) respec-tively in college and university teachers and staff of China. Conclusion The prevalence of hypertension is different in college and university teachers and staff of China due to different sexes, ages and areas.
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Objective To more effectively prevent hypertension and provide better health care for college and university teachers and staff by keeping abreast with the epidemiology of hypertension. Methods The data were extracted from the selected Chinese and English papers on epidemiology of hypertension, which was followed by a meta-analysis of the prevalence, awareness rate, cure rate, and control rate of hypertension in college and university teachers and staff of China. Results A total of 73 papers were included in this study. The total prevalence of hypertension was 23. 3% (95%CI=21. 1%-25. 6%), the prevalence of hypertension was 27. 2% (95%CI=24. 4%-30. 0%) in male hypertensive teachers and staff and was 18. 6% (95%CI=16. 6%-20. 6%) in female hypertensive teachers and staff. The prevalence of hypertension increased with the increasing age and tended to increase with the year of investigation in college and university teachers and staff of China, and was the lowest in East China followed by Central China and West China. The awareness rate, cure rate and control rate of hypertension were 68. 3% (95%CI=59 . 7%-76 . 8%) , 63 . 7% ( 95%CI=55 . 5%-71 . 9%) , and 37 . 7% ( 95%CI=28 . 0%-47 . 5%) respec-tively in college and university teachers and staff of China. Conclusion The prevalence of hypertension is different in college and university teachers and staff of China due to different sexes, ages and areas.
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The paper discusses the evidence-based decision-making framework for medical insurance reimbursement based on big data concept through expert consultation,defines the dimension of decision-making,analyzes the evidence-based decision-making steps in combination with big data resources,proposes suggestions on how to make full use of big data resources around medical insurance decision-making practice.
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Using the concept and method of evidence-based medicine,the paper systematically analyzes the functions and shortage of intelligent health Application (App) in disease diagnosis,treatment and self-management,and describes the functions of health and disease management App,so as to promote the development of App and enable App to better assist in health management.
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By using the software CiteSpace Ⅱ,the paper makes a quantitative analysis and interpretation of research literatures on telemedicine in SCIE of Web of Science from three perspectives,namely the research hotspots,knowledge base and research fronts.The research hotspots of telemedicine mainly include tele-diagnosis,tele-monitoring and evaluation of the application effects of telemedicine.It sets forth key literatures representing the knowledge base one by one and reveals that most of them focus on clinical applications.The analysis of burst terms indicates that more attention has been paid to tele-monitoring and distance education of chronic diseases in recent years and mobile technology is one of the greatest driving forces for the development of telemedicine at the present stage.
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Objective To explore the necessity of colonoscopy in young patients with chronic constipation.Methods Data of patients aged 18-50 underwent colonoscopy at Tianjin Medical University General Hospital with chronic constipation as the sole indication between April 2003 and May 2014 were analyzed.Endoscopic and pathologic reports were analyzed.Results During the study period,a total of 563 patients were included,who were aged 18-50 with chronic constipation as the sole indication,of which 260 patients were aged 18-35,and 303 patients were aged 36-50.No lesion was found during colonoscopy in 167 (29.7％) patients,whereas in other 396 (70.3 ％) patients positive findings were reported,including polyps in 45 patients (of which 13 were with multiple polyps),adenomas in 20(17 in distal colon,3 in proximal colon).In patients aged 18-35,3 cases of adenomas(3/260,1.2％) were found,of which 1 patient (1/260,0.4％)had advanced adenoma.In patients aged 36-50,17 cases of adenomas(17/303,5.6％) were found,of which 4 (4/303,1.3％) were advanced ones.Colorectal cancers were found in 2 patients (0.7％,2/303),both in patients aged 36-50.The detection rate for colorectal neoplasms (including adenoma and cancer) in patients with chronic constipation aged 18-35 was significantly lower than that in patients aged 36-50[1.2％(3/260) VS 6.3％(19/303),P=0.002,95％CI:0.05-0.60].Conclusion The detection rate for colorectal neoplasms in patients aged 18-35 years with chronic constipation is relatively low,and colonoscopy is not recommended for them.
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Objective To explore the function and significance of caudal type homeobox transcription factor-2 (CDX)-2,heparin-binding epidermal growth factor-like growth factor (HB-EGF) and bone morphogenetic protein 4 (BMP-4) of esophageal stromal tissues in the pathogenesis of Barrett's esophagus (BE).Methods A total of 116 patients were divided into groups according to gastroscopic finds and hematoxylin-eosin (H &E) staining of biopsy samples.They were divided into control group (n=29),RE group (n=32),BE group (n=35),RE treatment group (n=10) and BE treatment group (n=10).The expression of CDX 2,HB-EGF and BMP-4 in different esophageal mucosal lesions was detected by immunohistochemical staining and the changes of positive expression levels of CDX-2,HBEGF and BMP 4 were compared among groups.Variance analysis and chi-square analysis were performed to analyze the correlation among the three factors.Results The CDX-2 positive cell number of control group ((0.0±0.0)/high power field(HPF)),RE group ((43.1±10.6)/HPF),and BE group ((67.8±11.3)/HPF) increased in turn,and the differences among three groups were statistically significant (F=67.664,P＜0.01).The HBEGF positive ((6.4±1.4)/HPF,(39.4±13.5)/HPF,(55.8±13.9)/HPF) and BMP 4 positive ((0.0±0.0)/HPF,(22.6±6.4)/HPF and ((25.1± 10.3)/HPF) cell number of three groups had the same trend and the differences among three groups were statistically significant (F HB-EGF =22.925,FBMP-4 =10.463,both P＜0.01).Except the expression of BMP-4 between RE group and BE group,there were significant differences between every other two groups (LSD test,all P＜ 0.01).The expression of CDX 2,HB EGF,BMP-4 in RE treatment group ((21.7±1.7)/HPF,(16.6±5.0)/HPF and (9.2±1.0)/HPF) and BE treatment group ((51.4±8.7)/HPF,(31.0± 10.4)/HPF and (12.7±3.9)/HPF) were lower than those in RE group and BE group respectively,the differences were also statistically significant (LSD test,all P＜0.05).In RE group,the positive rate of CDX-2 (31.2％ (10/32)) was significantly lower than that of HBEGF and BMP4 (62.5％ (20/32) and 56.2％(18/32)),and the differences were statistically significant (x2=6.275 and 4.063,both P＜0.05).However in BE group,there was no statistically significant difference in the positive rate among CDX-2(85.7％(30/35)),HB-EGF (88.6％(31/35)) and BMP-4 (74.3％(26/35),all P＞0.05).Conclusions CDX-2,HB-EGF and BMP-4 may play an important role in the pathogenesis of RE and BE.HB-EGF and BMP-4 may be involved in the early episodes of BE genesis and have promotion effects on CDX-2 expression.HB-EGF and BMP-4 may be the new target in the research and treatment of BE.