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BACKGROUND@#Critical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving maximal medical support, have been noted to progress to irreversible fatal respiratory failure. Lung transplantation (LT) as the sole therapy for end-stage pulmonary fibrosis related to acute respiratory distress syndrome has been considered as the ultimate rescue therapy for these patients.@*METHODS@#From February 10 to March 10, 2020, three male patients were urgently assessed and listed for transplantation. After conducting a full ethical review and after obtaining assent from the family of the patients, we performed three LT procedures for COVID-19 patients with illness durations of more than one month and extremely high sequential organ failure assessment scores.@*RESULTS@#Two of the three recipients survived post-LT and started participating in a rehabilitation program. Pearls of the LT team collaboration and perioperative logistics were summarized and continually improved. The pathological results of the explanted lungs were concordant with the critical clinical manifestation, and provided insight towards better understanding of the disease. Government health affair systems, virology detection tools, and modern communication technology all play key roles towards the survival of the patients and their rehabilitation.@*CONCLUSIONS@#LT can be performed in end-stage patients with respiratory failure due to COVID-19-related pulmonary fibrosis. If confirmed positive-turned-negative virology status without organ dysfunction that could contraindicate LT, LT provided the final option for these patients to avoid certain death, with proper protection of transplant surgeons and medical staffs. By ensuring instant seamless care for both patients and medical teams, the goal of reducing the mortality rate and salvaging the lives of patients with COVID-19 can be attained.
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Aged , Humans , Male , Middle Aged , Betacoronavirus , Coronavirus Infections , Mortality , Extracorporeal Membrane Oxygenation , Lung Transplantation , Methods , Pandemics , Pneumonia, Viral , Mortality , Pulmonary Fibrosis , Mortality , General Surgery , Respiratory Distress Syndrome , Mortality , General SurgeryABSTRACT
OBJECTIVE@#To establish a digital subtraction angiography (DSA) information management and image analysis system to realize scientific management of DSA image information and efficient processing of image data.@*METHODS@#Based on Java Web under Windows 7 environment, a dynamic Browser/Server mode system was constructed by JSP and Servlet on the network. Eclipse and MySQL were used as development tool and database development platform. Tomcat network information service was used as application server. Matlab codes were embedded to analyze DSA image.@*RESULTS@#The system consists of five modules:image information management, image processing, image analysis, advanced retrieval and clinical data management. It may complete such process as storing, deleting, saving, analyzing of DSA image and basic information of patients.@*CONCLUSIONS@#The main interface of the system is user-friendly and easy to operate. The system will be helpful to the clinical, teaching and scientific research work related to DSA.
Subject(s)
Humans , Angiography, Digital Subtraction , Databases, Factual , Indonesia , Information Management , Internet , Software , User-Computer InterfaceABSTRACT
Mood disorders/psychosis have been associated with dysfunctions in the default mode network (DMN). However, the relative contributions of DMN regions to state and trait disturbances in pediatric bipolar disorder (PBD) remain unclear. The aim of this study was to investigate the possible mechanisms of PBD through brain imaging and explore the influence of psychotic symptoms on functional alterations in PBD patients. Twenty-nine psychotic and 26 non-psychotic PBD patients, as well as 19 age- and sex-matched healthy controls underwent a resting-state functional MRI scan and the data were analyzed by independent component analysis. The DMN component from the fMRI data was extracted for each participant. Spearman's rank correlation analysis was performed between aberrant connectivity and clinical measurements. The results demonstrated that psychotic PBD was characterized by aberrant DMN connectivity in the anterior cingulate cortex/medial prefrontal cortex, bilateral caudate nucleus, bilateral angular gyri, and left middle temporal gyrus, while non-psychotic PBD was not, suggesting further impairment with the development of psychosis. In summary, we demonstrated unique impairment in DMN functional connectivity in the psychotic PBD group. These specific neuroanatomical abnormalities may shed light on the underlying pathophysiology and presentation of PBD.
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Objective There are few studies on whether progesterone has neuroprotective effects on cerebral hemorrhage. This study aimed to observe the effects of different doses of progesterone on Matrix metalloproteinase-9（MMP-9）and Nuclear factor-κB （NF-κB）in cerebral hemorrhage in male rats, and to explore the neuroprotective effects and possible mechanism of progesterone on cerebral hemorrhage in rats. Methods We randomly divided 174 adult male rats into six groups of equal number with random number table. The models of cerebral hemorrhage were established. The low-, medium- and high-dose progesterone groups were administered with progesterone 4, 8, 16 mg/kg, respectively. The rats in the sham operation and model groups were given same volume of normal saline. We detected the expression of MMP-9 and NF-κB in the brain tissue of each group by Western blotting at 3 days. Moreover, we used the other rats to obtain the neurological severity scores（NSS），and measure the water content of brain tissue. Furthermore, we detected the expressions of MMP-9 and NF-κB by immunohistochemistry at 1, 3 and 7 days. Results The low-, medium- and high-dose progesterone groups could all improve the neurological function of rats after cerebral hemorrhage, and the middle dose group showed the best effects（P<0.05）. Moreover, the low-, medium- and high-dose progesterone groups can reduce the expression of MMP-9 and NF-κB, and the middle dose group also indicated the best effects （P<0.05）. Conclusion Progesterone might improve the neurological function and reduce edema in rats after cerebral hemorrhage, which may be related to the decrease of MMP-9 and NF-κB expression.
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Objective To analyze the expression change of PTGFR gene in hip joint tissues of development dysplasia of the hip (DDH) and its correlation with DDH pathogenesis .Methods Eight age-and gender-matched children with DDH (DDH group) and control children (control group) were enrolled for conducting the compaison .The real-time quantitative PCR method and West-ern-blot method were adopted to detect the PTGFR mRNA and protein expression levels .Results PTGFR mRNA expression level in the hip articular capsule and ligamentum teres of the DDH group were significantly decreased compared with those of the control group (t=3 .472 ,2 .887 ,P<0 .05 ,) .The PTGFR protein expression level in the hip articular capsule and ligamentum teres of the DDH group were significantly decreased compared with those of the control group (t=5 .488 ,3 .942 ,P<0 .05) .Conclusion PTG-FR could play an important role in DDH pathogenesis and may be one of DDH pathogenic genes .
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The increased incidence of diabetes, coupled with the introduction of alternative insulin delivery methods that rely on higher doses, is expected to result in a substantial escalation in the future demand for affordable insulin. Plant-based systems offer a safe and economical method for producing pharmaceutical proteins. We used peanut (Arachis hypogaea L.) as bio-reactors to express biosafe, stable proinsulin. We designed two proinsulin analogues (FAIA and LAIA) with substitutions in their amino acid sequences. The fast-acting insulin analogue (FAIA) contains a Gly inserted between Cys19 and Gly20, as well as a Pro28Asp substitution, in the B chain. The long-acting insulin analogue (LAIA) contains a Gly inserted between Cys19 and Gly20 and two Arg residues inserted into the terminus of the B chain, as well as an Asn21Gly substitution in the A chain. Four plasmids were constructed: pROKII-Flag-FAIA, pROKII-Flag-LAIA, pCAMBIA2301-Oleosin-FAIA and pCAMBIA2301-Oleosin-LAIA. These plasmids were transferred into peanut to produce recombinant proinsulin. Western blot and GUS staining analysis indicated that some transgenic peanut successfully expressed exogenous proinsulin. Peanut seeds can act as insulin storage sites, which is the foundation for further production of recombinant proinsulin from peanut seeds.
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<p><b>OBJECTIVE</b>In order to accurately reconstruct the acoustic source image, the application of transducer's receiving characteristics in magneto-acoustic tomography with magnetic induction (MAT-MI) is studied.</p><p><b>METHODS</b>The conductivity phantom model is built, and the magnetic acoustic signals are simulated and the acoustic sources are reconstructed according to the transducer's receiving characteristics.</p><p><b>RESULTS</b>The reconstructed image of acoustic source is consistent with the topographic shape and size of the phantom model.</p><p><b>CONCLUSION</b>MAT-MI based on the transducer's characteristics lays the foundation for further study.</p>
Subject(s)
Acoustics , Magnetic Phenomena , Magnetics , Tomography , TransducersABSTRACT
Complex segmental femoral fractures are usually not amenable to closed reduction. The purpose of this study was to evaluate a series of patients who had undergone four pins assisted reduction and intramedullary nail fixation to determine the therapeutic effect of this closed reduction technique. Between December 2010 and January 2013, 15 consecutive patients with segmental femoral fractures were treated with four pins assisted reduction at our hospital. The patient was placed in a supine position on a radiolucent fracture table and a gentle traction was attempted on the limb. Usually, the proximal fracture segment exhibited the typical deformity of flexion, external rotation, and abduction, the middle segment exhibited adduction and distal fracture segment exhibited flexion. Four Schanz pins were placed percutaneously to fix one cortex and did not penetrate into the medullary cavity, and the "T" sharp handles were fixed on the Schanz pins. The fragments were then reduced by reversing the deforming forces for segmental fractures by two assistants. And then, the reduction could be easily achieved and intramedullary nail fixation was performed. Radiographs were evaluated for the quality of the reduction and fracture union. Closed reduction was achieved in all patients using the four pins technology. All 15 fractures united uneventfully. No patient had a rotational malunion or limb length discrepancy at the time of the last follow-up. Thirteen of the fifteen (86.7%) patients had anatomic reduction and two of them (13.3%) had minor varus alignment of 3° and 5°. Knee stiffness was observed in 2 patients and no implant failure was observed. Surgical treatment of complex segmental femoral fractures with four pins assisted reduction and intramedullary nail fixation techniques can result in excellent reductions and a high union rate.
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Complex segmental femoral fractures are usually not amenable to closed reduction. The purpose of this study was to evaluate a series of patients who had undergone four pins assisted reduction and intramedullary nail fixation to determine the therapeutic effect of this closed reduction technique. Between December 2010 and January 2013, 15 consecutive patients with segmental femoral fractures were treated with four pins assisted reduction at our hospital. The patient was placed in a supine position on a radiolucent fracture table and a gentle traction was attempted on the limb. Usually, the proximal fracture segment exhibited the typical deformity of flexion, external rotation, and abduction, the middle segment exhibited adduction and distal fracture segment exhibited flexion. Four Schanz pins were placed percutaneously to fix one cortex and did not penetrate into the medullary cavity, and the "T" sharp handles were fixed on the Schanz pins. The fragments were then reduced by reversing the deforming forces for segmental fractures by two assistants. And then, the reduction could be easily achieved and intramedullary nail fixation was performed. Radiographs were evaluated for the quality of the reduction and fracture union. Closed reduction was achieved in all patients using the four pins technology. All 15 fractures united uneventfully. No patient had a rotational malunion or limb length discrepancy at the time of the last follow-up. Thirteen of the fifteen (86.7%) patients had anatomic reduction and two of them (13.3%) had minor varus alignment of 3° and 5°. Knee stiffness was observed in 2 patients and no implant failure was observed. Surgical treatment of complex segmental femoral fractures with four pins assisted reduction and intramedullary nail fixation techniques can result in excellent reductions and a high union rate.
Subject(s)
Adult , Humans , Male , Middle Aged , Bone Nails , Femoral Fractures , Diagnostic Imaging , General Surgery , RadiographyABSTRACT
With regard to the large amount of calculation in image mosaic algorithm, an image mosaic algorithm based on extended phase correlation of edge is presented. The improved wavelet edge detection algorithm is to detect edge of blood vessels. Then the image translation, rotation and scale changes are calculated by the extended phase correlation method. These parameters are utilized to stitch images. Finally, image fusion can be achieved by fade-in-fade-out method. It is proved by experiments that this algorithm is simple to calculate, and can effectively achieve the image mosaic.
Subject(s)
Algorithms , Fundus Oculi , Image Processing, Computer-Assisted , MethodsABSTRACT
In this study, ECG signals of normal sinus rhythm (NSR), ventricular tachycardia (VT) and ventricular fibrillation (VF) were taken out to extract the RR interval series. Approximate entropy (ApEn) values of the RR interval series were calculated and compared among the three groups by ANOVA methods. It was found that the values of ApEn were increased significantly from NSR to VT and then to VF. Approximate entropy may be regarded as an index to discriminate the ECG signals of different state.
Subject(s)
Humans , Electrocardiography , Methods , Entropy , Signal Processing, Computer-AssistedABSTRACT
According to fundus fluorescein angiography images characteristics, this paper proposes a feature based image mosaic vessel edge method. First, detect edge of blood vessels by carrying on the pretreatment to the fundus fluorescein angiography image in the foundation, wavelet edge detection algorithm. Then, the matching method based on chain code feature is described. Finally, a local area based on gray level information of the image fusion method is applied to angiographic image series. Data processing results show that the method can generate an ideal mosaic effect.
Subject(s)
Humans , Fluorescein Angiography , Methods , Image Processing, Computer-Assisted , Methods , Radiography , Retinal Vessels , Diagnostic ImagingABSTRACT
In this study, the automatic segmentation of the irregular lesion region in the image of fundus fluorescence angiography was actualized by means of the modified Back Propagation (BP) neural network method. Combining the transfer scaling coefficient between pixel of the image and the actual size, the area of the irregular lesion region was measured. The results may provide valuable data for the clinical diagnosis, treatment and prognostic evaluation.
Subject(s)
Algorithms , Fluorescein Angiography , Methods , Nerve Net , Retinal Diseases , Diagnosis , PathologyABSTRACT
In this paper, a phagaquosonogram acquisition, a module with TMS320C6713 as a core, and USB as communicating pattern is introduced based on VC++6.0. The structure of the module, hardware configuration, software design and the experiment of the real phagaquosonogram signal collection are presented. It is shown that the module can extract human phagaquosonogram signal reliably and availably.
Subject(s)
Diagnostic Techniques, Digestive System , Signal Processing, Computer-Assisted , Software , Software DesignABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical effects of treatment for superior tibial fracture complicating with crotch injury of distal popliteal artery by an alternative micro-surgical operation.</p><p><b>METHODS</b>During Feb. 2002 to Oct. 2007, there were 19 patients with superior tibial fracture complicating with crotch injury of distal popliteal artery included 15 males and 4 females aged from 21 to 48 years (means 35 years). There were 6 cases complicating with fracture of tibial plateau, 3 cases complicating with nerve injury. The tibial fracture were fixed with external fixator and the anterior tibial artery and vein and posterior tibial artery and vein were treated by transplantable great saphenous vein (Y-shape) combined with windowing for interosseous membrane by the posterior and anterolateral incision. Evaluations of clinical effect were performed according to Rasmussen functional score system.</p><p><b>RESULTS</b>All patients survived after operation. All fracture achieved bony union, the union time was from 3 to 14 months (means 5.5 months). All patients were followed-up for from 8 to 23 months (means 13 months). The mean Rasmussen functional score was (27.0 + 2.9). The results were excellent in 11 cases, good in 7, and fair in 1.</p><p><b>CONCLUSION</b>The surgical exploration should be done as soon as possible when diagnosis of injuries of large arteries is definite or highly suspected. Simultaneous reconstruction of both posterior tibial artery and anterior tibial artery associated with vein can reduce the rate of disability and recover function of limb.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Follow-Up Studies , Groin , General Surgery , Microsurgery , Popliteal Artery , Wounds and Injuries , General Surgery , Plastic Surgery Procedures , Tibial Fractures , Diagnosis , TherapeuticsABSTRACT
Chaos and fractals are ubiquitous phenomena of nature. A system with fractal structure usually behaves chaos. As a complicated nonlinear dynamics system, heart has fractals structure and behaves as chaos. The deeper inherent mechanism of heart can be opened out when the chaos and fractals theory is utilized in the research of the electrical activity of heart. Generally a time series of a system was used for describing the status of the strange attractor of the system. The indices include Poincare plot, fractals dimension, Lyapunov exponent, entropy, scaling exponent, Hurst index and so on. In this article, the basic concepts and the methods of chaos and fractals were introduced firstly. Then the applications of chaos and fractals theories in the study of electrocardial signal were expounded with example of how they are used for ventricular fibrillation.
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Humans , Electrocardiography , Methods , Fractals , Nonlinear Dynamics , Signal Processing, Computer-Assisted , Stochastic ProcessesABSTRACT
An online ECG signals analysis service system based on the network has been established and is introduced in this paper which integrates the advantages of the network, database and ECG analysis tools, providing on-line ECG signal analysis service. Users with the knowledge of general operation of a browser, can process the ECG data and get a real-time display of analysis results.
Subject(s)
Computer Systems , Database Management Systems , Databases, Factual , Electrocardiography , Methods , Signal Processing, Computer-Assisted , Software DesignABSTRACT
Based on the reconstruction of two-dimension phase space of time series of short ECG signals, the variation of the strange attractor geometry is described and two indices, VMI and VAI, are derived in this paper. The two indices can distinguish clearly the ECG signals of sinus rhythm, tachycardia and ventricular fibrillation. Stable results of VMI and VAI can be obtained by analyzing ECG signals of several seconds. They are expected to be used in the development of medical instruments for a fast realtime display of analysis results.
Subject(s)
Animals , Rabbits , Electrocardiography , Methods , Myocardial Infarction , Signal Processing, Computer-AssistedABSTRACT
Objective To definite the status of tone of autonomic nervous system during water immersion process by analyzing the nonlinear characteristic of ECG signals;To explore the relation of approximate entropy(ApEn),scaling exponent(?) changes and modulation function status of autonomic nervous system.Methods The ECG signals of rats during the process of restraint stress(RS),water-immersion restraint stress(WRS) and Vagotomy and Water-immersion restraint stress(vagotomy-WRS) were recorded.The ApEn and ? of RR intervals were calculated.Results After the stress,the differences of the value of ApEn and ? of RR intervals between RS and vagotomy-WRS groups and between different periods in vagotomy-WRS group were not significant.The value of ApEn increased in WRS group and decreased in RS group significantly.Compared with pre-stress,? showed decreased trend,all of the values smaller than 0.5 in WRS group and increased obviously,most values larger than 0.5 in RS group.Conclusion The increased ApEn and decreased ? indicates a higher intensity of parasympathetic activity.The parasympathetic activity is the predominant response of autonomic nervous system during water immersion process.
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Chronic kidney disease(CKD) is a major global health issue that leads to end-stage renal disease which untreated.The use of stem cell therapy provides a new perspective in this area.Reviewing the experimental studies of stem cell therapy on CKD,many different,and even contradictory reports in this area were found.In this paper,the recent reports,and present several key issues of experimental stem cell treatment on CKD were reviewed,including the source of stem cell,the sort of experimental animal,the time of treatment and other experimental details.Hoping these may lead more understanding in this area.