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Objective:This stndy aims to analyze the influence of ChatGPT on medical research and give suggestions on GhatGPT.Methods:This paper expounded the background of ChatGPT, analyze the connection between ChatGPT and medical research management, application and threats of ChatGPT , and gave suggestions to avoid GhatGPT′s damage.Results:Technology will promote the evolution of medical research management. It is recommended to strengthen the supervision of the ChatGPT and research integrity education.Conclusions:It is urgent to establish a scientific management mechanism to take usage the advantages of GhatGPT.
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Objective:To analyze the preventive effect of Caprini model on venous thromboembolism (VTE) in coma patients after severe craniocerebral trauma.Methods:A total of 190 patients with severe craniocerebral trauma who received treatment in Lishui City People's Hospital, China between January 2015 and April 2019 were randomly divided into a control group and an observation group ( n = 95/group). Patients in the control group underwent the conventional strategy to prevent lower extremity VTE. Patients in the observation group were subjected to individualized strategies to prevent lower extremity VTE based on Caprini model assessment. The drop-out rate and treatment outcome were compared between the control and observation groups. The proportion of patients developing VTE during treatment in Department of Intensive Care Unit and the changes in coagulation indexes relative to before treatment were compared between the two groups. Results:There was no significant difference in drop-out rate between the control and observation group [10.53% (10/95) vs. 8.42% (8/95), χ2 = 0.245, P < 0.05]. The proportion of patients developing VTE in the observation group was significantly lower than that in the control group [2.30% (2/87) vs. 10.59% (9/85), χ2 = 4.935, P < 0.05]. At 7 days after surgery, the coagulation indices D-dimer, platelet count, prothrombin time, activated partial thromboplastin time in the observation group were (2.27 ± 0.43) mg/L, (281.62 ± 37.29) × 10 9/L, (12.93 ± 2.87) seconds and (34.35 ± 7.19) seconds, respectively, which were (3.31 ± 0.68) mg/L, (303.28 ± 39.96) × 10 9/L, (11.24 ± 2.46) seconds and (31.16 ± 6.82) seconds, respectively in the control group. The coagulation indices in the observation group were significantly superior to those in the control group ( t = 10.013, 3.070, -3.463, -2.493, all P < 0.05). Conclusion:The Caprini model is effective in preventing VTE in patients with coma after surgery for severe traumatic brain injury. It deserves to be clinically applied.
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Objective:To construct a scientific research performance evaluation index system for specialized hospitals based on disciplinary development.Methods:Building a preliminary evaluation index framework of scientific research performance through literature review and expert consultation meetings, combined with the strategic goals of strengthening specialization and weakening generalization; Delphi method was adopted to conduct two rounds questionnaires survey to collect the importance scores for each index, which confirmed the content of the index system; finally, applied the analytic hierarchy process to calculate the weight coefficient of each index.Results:The responding rates of the two rounds questionnaire survey reached 95%, and the authoritative coefficients were 0.75 and 0.76, respectively. The research results were reliable. The coordination coefficients of all levels of the two surveys were greater than 0.1, according to the significance testing, the P values were less than 0.05, and the expert opinions were well coordinated. Finally, we developed a three-level scientific research performance evaluation system under the guidance of disciplinary development, which including 3 first-level indicators, 20 second-level indicators, as well as 56 third-level indicators. Conclusions:A scientific research performance evaluation system was constructed based on scientific theories. This system combined relevant indicators, such as the development of special disciplinary of specialized hospitals with scientific validity and operability. Besides, it could serve as a tool to evaluate the scientific research performance of specialized hospitals taking into account of the practical application value for guiding scientific research development and disciplinary improvement.
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Development of medical alliances can provide patients of wound ostomy with cost-effective, safe and effective continuing specialized care at their community, gradually homogenizing hospital-community specialized care. By means of establishing a nurse advice referral and specialist nurses consultation mechanism, Shenzhen Luohu Hospital Group has achieved to share specialist nursing resources between hospitals and social health centers.This practice can reduce re-hospitalization rate of these patients, reduced their economic burden, save medical resources and improve patient satisfaction as well.
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Objective To evaluate the optimized efficacy of transversus abdominis plane (TAP) block combined with oxycodone in patients undergoing kidney transplantation.Methods Ninety patients of both sexes,aged 22-45 yr,weighing 45-75 kg,of American Society of Anesthesiologists physical status Ⅲ,scheduled for elective living donor kidney transplantation,were divided into 3 groups (n =30 each) using a random number table:blank control group (group C),TAP block group (group TAP) and TAP block combined with oxycodone group (group TAP+O).Ultrasound-guided lateral approach to TAP block was performed on the operated side with the mixture (20 ml) of 0.375％ ropivacaine and 5 rng dexamethasone at 30 min before induction of anesthesia in TAP and TAP+O groups.Anesthesia was induced by injecting midazolam,target-controlled infusion of remifentanil and propofol and injecting cisatracurium.The patients were mechanically ventilated after placement of the laryngeal mask airway,and the end-tidal pressure of carbon dioxide was maintained at 35-45 mmHg.Propofol and remifentanil were intravenously injected and sevoflurane was inhaled to maintain anesthesia,and cis-atracurium was intermittently injected to maintain muscle relaxation.Narcotrend value was maintained at 37-46 during operation.Oxycodone 0.1 mg/kg was intravenously injected at 20 min before the end of surgery in group TAP+O.Patient-controlled intravenous analgesia (PCIA) was performed with sufentanil 1.5 μg/kg in 100 ml of normal saline at the end of surgery,the PCIA pump was set up to deliver a 2 ml bolus dose,a 20 min lockout interval and background infusion at a rate of 1.5 ml/h,and visual analog scale score was maintained ≤4.The consumption of intraoperative remifentanil and effective pressing times of PCIA within 24 h after surgery were recorded.Blood samples were collected at 1 day before surgery and 2 and 5 days after surgery from the median cubital vein for determination of blood urea nitrogen and creatinine (Cr) concentrations in serum.The occurrence of nausea and vomiting,dizziness and headache,respiratory depression and TAP block-related complications (hematoma at puncture site,injury to abdominal organs,local anesthetic intoxication) was recorded within 24 h after surgery.Results Compared with group C,the consumption of intraoperative remifentanil was significantly reduced,the effective pressing times of PCIA within 24 h after surgery were decreased,and the concentrations of creatinine and blood urea nitrogen in serum were decreased at 2 days after surgery in TAP and TAP+O groups (P＜0.05).Compared with group TAP,the effective pressing times of PCIA within 24 h after surgery were significartly decreased,the concentrations of creatinine and blood urea nitrogen in serum were decreased at 2 days after surgery,and no significant change was found in the consumption of intraoperative remifentanil in group TAP+O (P＞0.05).TAP block-related complications were not found in TAP and TAP+O groups (P＞0.05).There was no significant difference in the incidence of nausea and vomiting or dizziness and headache among three groups (P＞0.05).Conclusion TAP block combined with oxycodone can reduce the intraoperative consumption of opioids,inhibit postoperative hyperalgesia and be helpful for early recovery of transplanted kidney function in patients undergoing kidney transplantation.
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Objective To investigate the diagnostic value of digital breast tomosynthesis (DBT) plus full-field digital mammography (FFDM) in benign and malignant breast disease.Methods The prospective study enrolled 46 consenting women with a clinical suspicious of breast lesion confirmed by pathology. All the patients underwent DBT, FFDM and dedicated breast magnetic resonance image (DB-MRI) examinations before surgery or biopsy. To observe the manifestation of breast disease in different examinations according to breast imaging reporting and data system (BI-RADS), and to evaluate the visibility grade of disease between DBT plus FFDM and FFDM alone. Using receiving operating characteristic(ROC) and Z test to analysis the diagnostic efficiency of three examinations.Results Forty-six cases included 14 benign cases and 32 malignant cases. Compared with FFDM, 35 cases showed increased visibility in DBT plus FFDM, that the malignant lesion manifested mass with speculated and architectural distortion(23/27) and the benign lesion manifested mass with halo sign(6/8). Eleven cases didn't show increase visibility in both DBT plus FFDM and FFDM alone. The ration of BI-RADS 0 in FFDM was 23.9%(11/46), meanwhile in other two examination were 0. The ration of BI-RADS 3 in DBT plus FFDM was the lowest(6.5%, 3/46). When the lesion in DBT plus FFDM showed mass or speculated, in MRI showed similar morphology with mass or mass-like enhancement. According pathology as the gold standard, excluded 11 cases with BI-RADS 0 in FFDM, there was significant statistical difference between DBT plus FFDM and FFDM alone in 35 cases (Z=2.132, P=0.033) to differentiate benign and malignant breast disease, the area of ROC curve were respectively 0.955, 0.878. There is no statistical difference between DBT plus FFDM and MRI in 46 cases (Z=0.502, P=0.616), the area of ROC curve were respectively 0.887, 0.908.Conclusion DBT combined with FFDM can improve both detection of breast lesion and diagnostic efficiency, while the performance value between DBT and MRI are equal.
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In order to investigate the effect of deep brain stimulation on diseases such as epilepsy, we developed a closed-loop electrical stimulation system using LabVIEW virtual instrument environment and NI data acquisition card. The system was used to detect electrical signals of epileptic seizures automatically and to generate electrical stimuli. We designed a novel automatic detection algorithm of epileptic seizures by combining three features of field potentials: the amplitude, slope and coastline index. Experimental results of rat epileptic model in the hippocampal region showed that the system was able to detect epileptic seizures with an accuracy rate 91.3% and false rate 8.0%. Furthermore, the on-line high frequency electrical stimuli showed a suppression effect on seizures. In addition, the system was adaptive and flexible with multiple work modes, such as automatic and manual modes. Moreover, the simple time-domain algorithm of seizure detection guaranteed the real-time feature of the system and provided an easy-to-use equipment for the experiment researches of epilepsy control by electrical stimulation.
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Animals , Rats , Algorithms , Deep Brain Stimulation , Disease Models, Animal , Electroencephalography , Epilepsy , Diagnosis , Equipment Design , Seizures , DiagnosisABSTRACT
To evaluate the influence of 3- and 5-megapixel medical professional monitors in detecting the micro-calcifications on high- and low-resolution breast images, we performed a retrospective study in low- (n = 100) and high-resolution (n = 100) data, including 40 micro-calcification patients in a group and 60 normal ones in control group respectively. Two doctors, one junior, and the other senior, reviewed all the images without knowing the clinical data and histology, and their observations of each image with different monitors were calculated. The areas under the ROC curves (Az) were compared. Finally, the interpretation consistency of the two doctors was assessed using Kappa analysis. In the low resolution data group, the two doctors' detection performance of breast micro-calcifications were very similar in the 3M and 5M medical professional monitors (P = 0.451 and 0.559). In the high resolution group, however, the senior doctor's recognition rate on the 5M monitor was significantly higher than that on the 3M (P = 0.022), while the junior's recognition rate had no significant difference (P = 0.141) between the two readings. The two doctors' interpretation consistency on 5M monitor was better than that on 3M monitor. For the high-resolution images on the 5M monitor, the interpretation of the two doctors had extremely great consistency (K = 0.862). Therefore, different breast images of different resolutions should match corresponding resolution monitor. Interpretation of high-resolution images with 5M monitor has more advantages in the micro-calcification detection for senior doctors.
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Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Breast , Pathology , Breast Neoplasms , Diagnostic Imaging , Calcinosis , Diagnostic Imaging , Mammography , Observer Variation , ROC Curve , Radiographic Image Interpretation, Computer-Assisted , Reproducibility of Results , User-Computer InterfaceABSTRACT
Objective To discuss the values of three screening methods for the detection of early breast cancer,and to analyze the features of the screening cancer.Methods The first screening of breast cancer were performed in 5307 women who aged from 20 to 76 years with median age of 49 years.The three screening methods included physical examination with ultrasound and mammography,physical examination with mammography and mammography only.The rate of recall,biopsy,cancer detection of three methods were analyzed and the mammographic findings were reviewed Chi-square test or Fisher's exact test were used for the statistics.Results The recall rates were 4.90% (49/1001),6.90%(166/2407)and 4.48% (85/1899) in three methods respectively,the biopsy rates were 1.60% (16/1001),1.04% (25/2407) and 0.63%(12/1899),the cancer detection rates were 0.50% (5/1001),0.17% (4/2407) and 0 (0/1899).There were statistical differences among the three groups (X2=12.99,6.264,8.764,P < 0.05).Physical examination with ultrasound and mammnography had the highest cancer detection rate,ten breast cancers were detected and 8 were early stage breast cancer.Of seven cancers detected by mammography,only two were found by ultrasound.A cluster of calcifications were found in 2 cases,linear calcifications in 2 cases.One case presented as a asymmetric density,one as a asymmetric density with calcifications,one as multiple nodules with a duster of calcifications.Two breast cancers presented as asymmetric density were missed on mammography and diagnosed correctly after retrospective review.Conclusion Physical examination with ultrasound and mammography is the best method for breast cancer screening.The breast cancer can be detected by mammography earlier than other methods.
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The rapid development of silicon microelectrode arrays provides an ideal means for the study of spatio-temporal features of neuronal activity in the brain. The stability of the linear silicon electrode array (LSEA) in recording neuronal potentials and its validity in recording unit activity are investigated. The experimental results showed that during the recording of field potentials in the hippocampal CA1 region of anesthetized rats, upward and downward movements of the recording probe for a distance of 200 ?m did not affect the orthordromic and antidromic evoked potentials significantly. The data indicated that the probe movements caused very small damage to the neurons, and the recording was stable. The contact sites that located in the pyramidal cell layer acquired CA1 neuronal unit activity validly. Different types of unit activity from independent neurons were easily distinguished in epochs of recording from a same recording site. These results demonstrated the features of the LSEA, including the facility of probe manipulation, the stability of recording and the abundance of data acquirement. The data will be helpful to the researchers involved in the application of microelectrode array for neuroscience researches.
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Objective To investigate the effects and mechanism of nerve growth factor(NGF)on the airway inflammation of asthmatic mice.Methods Male SD rats(n=24)were randomly divided into the control group(group A),the asthmatic group(group B),the anti-NGF group(group C),8 mice in each group.The total cell count and classified count of cells in the bronchoalveolar lavage fluid(BALF)were performed.The pathological changes of the lung tissues were detected by HE staining.The concentrations of IL-4,IFN-? and NGF in BALF were measured by ELISA.The mRNA expression of IL-4,IFN-? and NGF in the lung tissues were detected by RT-PCR.Results Compared with the group A,not only the number of the total cells and classified cells in BALF significantly increased(P0.05).Conclusion NGF may play a key role in the formation of airway inflammation in the asthmatic rats by promoting the secretion of Th2 cytokines.
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Through two years of experimental trials,a species of fresh snail rich in protein containing 0. 45mg/kg selenium was obtained