A heart sound classification method based on joint decision of extreme gradient boosting and deep neural network / 生物医学工程学杂志

Heart sound is one of the common medical signals for diagnosing cardiovascular diseases. This paper studies the binary classification between normal or abnormal heart sounds, and proposes a heart sound classification algorithm based on the joint decision of extreme gradient boosting (XGBoost) and deep neural network, achieving a further improvement in feature extraction and model accuracy. First, the preprocessed heart sound recordings are segmented into four status, and five categories of features are extracted from the signals based on segmentation. The first four categories of features are sieved through recursive feature elimination, which is used as the input of the XGBoost classifier. The last category is the Mel-frequency cepstral coefficient (MFCC), which is used as the input of long short-term memory network (LSTM). Considering the imbalance of the data set, these two classifiers are both improved with weights. Finally, the heterogeneous integrated decision method is adopted to obtain the prediction. The algorithm was applied to the open heart sound database of the PhysioNet Computing in Cardiology(CINC) Challenge in 2016 on the PhysioNet website, to test the sensitivity, specificity, modified accuracy and F score. The results were 93%, 89.4%, 91.2% and 91.3% respectively. Compared with the results of machine learning, convolutional neural networks (CNN) and other methods used by other researchers, the accuracy and sensibility have been obviously improved, which proves that the method in this paper could effectively improve the accuracy of heart sound signal classification, and has great potential in the clinical auxiliary diagnosis application of some cardiovascular diseases.

Clinical Efficacy of Budesonide and Formoterol Fumarate Powder in the Treatment of Patients with Bronchial Asthma and Its Effect on the Serum Levels of Inflammatory Factors / 现代生物医学进展

Objective:To explore the clinical efficacy of Budesonide and Formoterol Fumarate Powder in the treatment of patients with bronchial asthma and its effect on the serum levels of inflammatory factors.Methods:123 cases treated and diagnosed as bronchial asthma in our hospital from February,2014 to February,2016 were randomly divided into the observation group (65 cases) and control group (58 cases).The serum levels of IL-17,IL-33,MMP-9,pulmonaryfunction,quality of life,total effective rate and incidence of adverse reactions were compared between the two groups.Results:The total effective rate of observation group was 92.3％,which was significantly higher than that of the control group (81.03％,P＜0.05).After therapy,the serum level ofIL-17,IL-33 in both groups were largely decreased compared with those before therapy (p＜0.05),and those of observation group were significantly lower than the control group (p ＜0.05);the serum level of MMP-9 in both groups showed no statistical difference compared with that of before therapy.Similarly,the level of FEV1,PEF and FEV1/FVC of observation group were obviously increased compared with those before therapy (p＜0.05) and were significantly higher than those of the control group (p＜0.05);the quality of life in the observation group was better than that of the control group based on the SGRQ score (p ＜0.05).Conclusion:Budesonide and Formoterol Fumarate Powder was effective on the patients with chronic bronchial asthma,which could control the inflammatory reactions,improve the pulmonary function as well as the quality of life.

Knowledge, attitude and behavior on blood lipid among people participated in health examination in Changsha and the influential factors / 中南大学学报(医学版)

Objective: To evaluate the knowledge, attitude and behavior on blood lipid among people in Changsha and to provide evidences for prevention and control of blood lipid abnormality. Methods: A total of 400 cases were randomly selected on the questionnaire of the knowledge, attitude and behavior on blood lipid in ordinary adults who participate in health examination in Xiangya Hospital. Blood lipid related physical examination was conducted at the same time. hTe health examination participants were divided into several groups according to their sex, age, degree of education, marriage and family income. The influential factors for knowledge, attitude and behavior were analyzed. Results: hTe knowledge score of blood lipid for health examination participants was 18.33±8.67 (total score 37), the attitude score was 6.63±2.45 (total score 9) and the behavior score was 8.32±2.65 (total score 16). hTe scores of female was higher than that of male in the terms of knowledge and behavior (bothP<0.05); the scores in the 40–49 age group were lower than those in the other age groups (all P<0.05); the scores in the junior high school group were lower than those in the other education groups (allP<0.05); the scores in the family group with less than 2 000 yuan income were lower than those in other family groups with different income (allP<0.05). The multiple stepwise regression analysis showed that: 1) the knowledge on blood lipid score was inlfuenced by ages and education background (bothP<0.05); 2) while the attitude of blood lipid was inlfuenced by four factors such as education background, systemic blood pressure, blood sugar and triglyceride(allP<0.05); 3) the behavior on blood lipid was inlfuenced by ifve factors such education background, triglyceride, systemic blood pressure, blood sugar and ages (allP<0.05). Conclusion: The knowledge, attitude and behavior on blood lipid among health examination participants were mostly influenced by education background, gender and ages. Thus, clinical medical staff should prevent the blood lipid abnormality through the health education and improve the knowledge in normal people. hTe group of 40–49 age male should be thought as the primary intervention subjects. hTe knowledge, attitude and behavior on blood lipid among the general population is also related to individual’s blood pressure, blood sugar and triglyceride. So the clinical medical staff should also improve the knowledge of blood lipid, blood pressure and blood sugar in general population for improving their attitude and unhealthy habits. In addition, the active control of blood sugar and blood pressure can enhance the overall health status of the general population.

Indwelling position and bacterial colonization of peripheral venous indwelling needles in patients with cardiovascular diseases / 中南大学学报(医学版)

OBJECTIVE@#To study the characteristics of infections associated with peripheral venous indwelling needles and to explore the best indwelling position in patients with cardiovascular diseases from the perspective of bacteriology.@*METHODS@#A total of 240 hospitalized patients from the Department of Cardiovascular Diseases, Xiangya Hospital, Central South University between November 2009 to July 2010 were randomly selected, and were divided into 3 groups according to the indwelling position and the indwelling time: a back of hand group (n=80), a forearm group (n=80) and a foot group (n=80). The above 3 groups were also divided into 4 subgroups according to the indwelling time (T1: 48 h ≤ t < 72 h; T2: 72 h ≤ t ≤ 96 h; T3: 96 h < t ≤ 120 h; and T4: 120 h < t ≤ 168 h) (20 patients in each subgroup). The bacteria of samples from puncture position of the skin were respectively cultured and identified after skin disinfection, needle pulling out and sample puncture from the indwelling needle catheters, respectively.@*RESULTS@#1) After the skin disinfection, there was no bacterium in the skin samples of puncture position. 2) When the needles were pulled out, there was bacterial growth in the skin samples of puncture position in 41 patients in the 3 groups, and the bacterium was not detected in samples of the 3 groups at T1 and T2 period. There was no significant difference in the positive rate of bacterial culture in the 3 groups at T3 and T4 period (P<0.05). 3) When the needles were pulled out. There was bacterial growth in the samples of indwelling needle catheters in 10 patients in the 3 groups; no bacterium was detected in the back of hand group and the forearm group at T1, T2, T3 and T4 period. In the foot group, there was no bacterium growth in the samples of indwelling needle catheters at T1 and T2 period, but there was bacterial growth in 4 patients at T3 period and in 6 patients at T4 period. There was significant difference in the positive rate of bacterial culture in the samples of indwelling needle catheters in the 3 groups (P<0.05).@*CONCLUSION@#The best indwelling position for peripheral venous indwelling needles is the forearm in patients with cardiovascular diseases.

Expression of stomatin like protein-2 in gastric adenocarcinoma and its effects on the migration and invasion of SGC7901 cell / 中华消化杂志

Objective To investigate the expression of stomatin like protein 2 (SLP-2) in gastric adenocarcinoma and its effects on migration and invasion of SGC7901 cell line.Methods The expression of SLP-2 in 60 pairs of gastric adenocarcinoma tissue specimens and corresponding adjacent tumor tissue specimens was detected by immunohistochemistry,and its relation with clinical pathological characteristics was also analyzed.SGC7901 cells were transient transfected with SLP-2 siRNA.After transfection,the expression of SLP-2 in SGC7901 cells at mRNA and protein level was detected by reverse transcripton-polynerase chain reaction (RT-PCR) and Western blot.The changes of migration and invasion of SGC7901 cells after transfection were observed through Transwell test and Matrigel in vitro invasion test.The data were analyzed by x2 test and LSD-t test.Results The high expression percentage of SLP-2 in gastric adenocarcinoma tissue was 68.3％ (41/60),which was significantly higher than that of the adjacent tumor tissues (25.0％,15/60; x2 =22.634,P＜0.01).The expression of SLP-2 in late stage gastric adenocarcinoma tissues was higher than that of early stage gastric adenocarcinoma tissues (x2 =4.962,P＜0.05).The expression of SLP-2 in gastric adenocarcinoma tissues with lymph nodes metastasis was higher than that in gastric adenocarcinoma tissues without lymph nodes metastasis (x2 =3.994,P＜0.05).There was no correlation between the expression and gender,age,tumor size and differentiation degree (all P＞0.05).After SLP-2 siRNA transfection,the expression of SLP-2 in SGC7901 cells significantly decreased at both mRNA and protein level.At 48 h after SLP-2 siRNA transfection,the cell migration ability was significantly lower (migrated cell number 53.0± 10.8) than that of negative control group (75.8±13.4) and blank control group (78.4± 15.2) (t=22.778 and 25.444,both P＜0.01).The in vitro invasion ability of SGC7901 cells (migrated cell number 36.3 ± 8.9) was also significantly lower than that of negative control group (53.9±12.1) and blank control group (49.8±9.0) (t=17.556 and 13.444,both P＜0.01).Conclusions The expression of SLP-2 was high in gastric adenocarcinoma tissues.SLP-2 may involve in the metastasis of gastric adenocarcinoma through promoting the migration and invasion ability of gastric adenocarcinoma cell.

Nosocomial Infection in ICU / 中华医院感染学杂志

OBJECTIVE To investigate the site of nosocomial infection in ICU,distribution and resistance of bacteria in order to make the intervention strategy.METHODS Antimicrobial susceptibility of pathogenic bacteria isolated from nosocomial infection patients in ICU from Jul 2006 to Jul 2008 was performed by Kirby-Bauer method.RESULTS The main pathogens of nosocomial infection in ICU were Gram-negative organisms(48.09%),Gram-positives(38.93%),and fungi(12.98%).The most common pathogens were Staphylococcus aureus,Acinetobacter baumannii,Pseudomonas aeruginosa,fungi,and S.haemolyticus.All strains of S.aureus and S.haemolyticas were antimicrobial sensitive to vancomycin,teicoplanin and linezolid.All A.baumannii strains were antimicrobial sensitive to cefoperazone/sulbactam.They were resistant to other antimicrobial agents.CONCLUSIONS Gram-negative organisms are the main pathogenic bacteria of nosocomial infection in ICU,but the percentage of Gram-positives and fungi is increasing,S.aureus is the most main pathogenic bacterium of nosocomial infection in ICU.S.haemolyticus is also a main pathogenic bacterium.The pathogenic bacteria of nosocomial infection in ICU are highly resistant to the most antimicrobial agents.

The clinical significance of serum apolipoprotein A-I to the diagnosis of acute respiratory infection / 中华急诊医学杂志

Objective To investigate the changes of serum apolipoprotein A-I and its clinical significance to acute respiratory infection.Method Totally 44 patients with acute respiratory infection were divided into three groups according to various concentration of Serum apolipoprotein A-I.They were procaleitonin(PCT)＜0.5 ng/ml group,0.5 ng/ml≤PCT＜2 ng/ml group and PCT≥2 ng/ml group.We measured apolipoprotein A-I,C-reactive protein,procalcitonin and albumin within 24 hours after admission.Results With the increase of serumPCT,the production of ApoA-I and albumin were down-regulated,while CRP up-regulated.Conclusions Apolipoprotein A-I has a sound relationship with the acute respiratory infection.It can be used as one of the diagnostic criteria in severe infection patients who have disorders of lipometabolism.

Preparation of thin hydroxyapatite layers on cp titanium through anodic oxidation followed with hydrothermal treatment / 生物医学工程学杂志

To study the method of anodic oxidation followed by hydrothermal treatment for cp titanium and to know bone response to thin hydroxyapatite layers in vivo, commercially pure titanium plates were anodized at 200 V-400 V with direct electric current density no more than 50 mA/cm2 for 15 minutes in the electrolytic trough. beta-glycerophosphate sodium(0.03-0.04 M) and calcium acetate(0.2-0.3 M) were used as electrolytes. Then, titanium plates were hydrothermal treated in the autoclave for 2 hours at 280 degrees C-300 degrees C. Polishing and grit-blasting surface was used as control to learn bone response to thin layers. Twelve rabbits were evenly divided into 3 groups, each group was implanted with 12 implants into the rabbits femoral bone. After 4, 8 and 16 weeks, implants were taken out and collected respectively and were made grinding slices. The bone-implant interface was observed with light microscope. And the bone-implant interface of polishing and layered implants after 8 weeks implantation was observed with scanning electron microscope. The element contents at the interface of polishing and layered implants before and after 8 weeks implantation were detected with EDAX. Results showed that there was hydroxyapatite(HA) precipitated on the titanium surfaceamellae bone in 8 weeks for thin HA coatings, and no HA debris were found at the interfacial zone. In addition, Ca and P content on the hydrothermal treated implant surface increased much more after implantation than that of polished implants. It was concluded that anodic oxidation followed by hydrothermal treatment could precipitate thin hydroxyapatie layer on the surface of cp titanium, which could improve early formation of woven bone and accelerate woven bone transferring to lamellae bone at the implanted site.

FUNGAL INFECTION IN ACUTE LEUKEMIA PREVENTED AND TREATED WITH FLUCONAZOLE / 中国医师进修杂志

Objective To observe curative and side effects of fluconazole in preventing and treating fungal infection in patients with acute leukemia.Methods 112 cases patients with acute leukemia were divided into two groups.Group A was prevented group (25 cases).These patients had fluconazole by oral administration with 100 mg/d for 7 days when the peripheral white blood cell were less than 2.0×109/L.Group B was treated group (87 cases).These patients had intravenous drip fluconazole with 200 mg/d if they reach the fungal infection diagnosis standard.To observe the characters of fungal infection in acute leukemia,the occurrence ratio of fungal infection in these two groups and the side effects of fluconazole.Results The occurrence ratio of fungal infection in Group A and B had obvious difference.(χ2=4.21,P<0.05);Patients with acute leukemia were easily infected by fungal in gastrointestinal,respiratory and urinary systems.There is no sereve side effect observed in using fluconazole.Conclusion:Taking fluconazole by oral administration can safely and effectively prevent fungal infection in patients with acute leukemia.

Differential gene analysis and expression of GST-? mRNA in esophageal cancerous and noncancerous tissues / 中华消化杂志

Objective To investigate the role of GST-? mRNA in the development and pathogenesis of esophageal cancer. Methods Twenty two matched pairs of esophageal cancerous and noncancerous tissues were obtained from 22 patients with esophageal cancer in an endemic region. AP-PCR was used for determining the differential gene fragments and RT-PCR for detecting the expression of GST-? mRNA. Results Differential random amplified fragments were found in 6 cancerous tissues, and none of the noncancerous tissues. The 5T differential gene fragments were of 1.0 kb, and by cloning, sequencing, and sequence homology analysis, no homologous sequence was found in the gene library. The expression rates of GST-? mRNA in cancerous and noncancerous tissues were 54.5%(12/22) and 18.2%(4/22), respectively. Conclusions Whether the 5T differential gene fragment is a new gene candidate or is a marker of oncogene remains to be further studied. The expression of GST-? mRNA in esophageal cancerous tissue was markedly enhanced.

FIVE YEAR SURVIVAL RATE AND PROGNOSTIC FACTORS OF PATIENTS WIT HEARLY CARCINOMA OF THE ESOPHAGUS AND THE GASTRIC CARDIA TREA -TED WITH ENDOSCOPIC LASER / 中华消化内镜杂志

In order to evaluate the factor. which affect the five year survival rate and prognosti c factors of the early carcinoma of the esophagus and the gastric cardia treated with endoscopic Nd : YAG laser therapy , thirty-three patients were followed. Of the 33 patients , 32 ( 97% ) cases were cured , resul- ting in the disappearance of the cancer cells. They were followed up for 3 3- 78 months , with a mean of 55. 3 months. The survival rate of the 32 patients treated with endoscopic laser was computed with the Product limit estimate method ,and was compared with the natural history of early superficial carcinoma . of the esophagus and the gastric cardia. The five year survival rate was in 97% of the 32 patients treated with laser therapy ,in contrast to 67% (P