Electrocardiogram signal classification based on fusion method of residual network and self-attention mechanism / 生物医学工程学杂志

In the diagnosis of cardiovascular diseases, the analysis of electrocardiogram (ECG) signals has always played a crucial role. At present, how to effectively identify abnormal heart beats by algorithms is still a difficult task in the field of ECG signal analysis. Based on this, a classification model that automatically identifies abnormal heartbeats based on deep residual network (ResNet) and self-attention mechanism was proposed. Firstly, this paper designed an 18-layer convolutional neural network (CNN) based on the residual structure, which helped model fully extract the local features. Then, the bi-directional gated recurrent unit (BiGRU) was used to explore the temporal correlation for further obtaining the temporal features. Finally, the self-attention mechanism was built to weight important information and enhance model's ability to extract important features, which helped model achieve higher classification accuracy. In addition, in order to mitigate the interference on classification performance due to data imbalance, the study utilized multiple approaches for data augmentation. The experimental data in this study came from the arrhythmia database constructed by MIT and Beth Israel Hospital (MIT-BIH), and the final results showed that the proposed model achieved an overall accuracy of 98.33% on the original dataset and 99.12% on the optimized dataset, which demonstrated that the proposed model can achieve good performance in ECG signal classification, and possessed potential value for application to portable ECG detection devices.

Establish a diagnosis differential model for IgA nephropathy and non-IgA nephropathy by machine learning / 中华检验医学杂志

Objective:To establish a differential diagnosis model for IgA nephropathy and non-IgA nephropathy based on machine learning algorithms.Methods:Retrospective study adopted,from 2019 to 2020,260 patients were referred to the Department of Nephrology at the First Affiliated Hospital of Kunming Medical University, the First People′s Hospital in Yunnan province, and Yan′an Hospital of Kunming city. All patients were diagnosed by renal pathology, 130 cases of primary IgA nephropathy, the 130 cases of non-IgA nephropathy. Collection of materials, including gender and age, 28 clinical data, and routine laboratory test results,the sex ratio of IgA nephropathy group and non-IgA nephropathy group were 59∶71 and 64∶66 respectively, the ages were 37.20 (21.89, 53.78) and 43.30 (27.77, 59.18) years, respectively. 260 patients were divided into a training set (70%, 182 cases) and a test set (30%, 78 cases). Using the decision tree, random forests, support vector machine, extreme gradient boosting to establish a differential diagnosis model for IgA nephropathy and non-IgA nephropathy. Based on the true positive rate, true negative rate, false-positive rate, false-negative rate, accuracy, subjects features work area under the curve(AUC), the precision ratio, recall ratio, and F1 score, comprehensively evaluate the performance of each model, finally, the best performance of the model was chosen. Using SPSS 25.0 to analyze the data, P<0.05 was considered to be statistically significant. Results:The accuracy of the decision tree, support vector machine, random forests and extreme gradient boosting establish differential diagnosis model was 67.95%, 70.51%, 80.77% and 83.33%, respectively; AUC values was 0.74, 0.76, 0.80 and 0.83; Judgment for primary IgA nephropathy F1 score was 0.73, 0.72, 0.80 and 0.83, respectively. The efficiency of the extreme gradient boosting model based on the above evaluation indicators is the highest, its diagnosis of IgA nephropathy of the sensitivity and specificity respectively 89% and 79%. The variable importance from high to low was blood albumin, IgA/C3, serum creatinine, age, urine protein, urine albumin, high-density lipoprotein cholesterol, urea.Conclusion:The differential diagnosis model for IgA nephropathy was established successfully and non-IgA nephropathy and the efficiency performance of the extreme gradient boosting algorithm was the best.

The measurement of hemoglobin A1c and its application in diabetes mellitus diagnosis / 中华检验医学杂志

Although it has been widely used in the diagnosis and management of diabetes abroad , the application of hemoglobin A 1c ( HbA1c ) test is restricted due to the difference of test ability between various level laboratories in China.The methods, interference and standardization of HbA 1c are still worthy of continuous paying attention by laboratory physicians . How to choose the most economical and efficient method, and how to provide accurate and reliable results for patients are the priorities which can promote the application of HbA1c in diabetes diagnosis and management in China.

The application of quality control circle in quality management of pre-analytical phase / 中华检验医学杂志

Objective To explore the effect of quality control circle in decreasing the unqualified rate and improving quality of specimen in clinical laboratory during the pre-analytical phase.Methods The laboratory department of the First Affiliated Hospital of Kunming Medical University established quality control circle management model,since March 1 st to June 1 st 2016,following the steps of the theory and method of quality management.Used professional tools of quality control circle to solve existing problems before procedure.Then compared the disqualification rates before and after the implementation,and used chi-square test for statistical analysis.Results After activity of quality control circle,the unqualified rate of specimen in clinical laboratory declined from 0.565%to 0.220%.The difference was statistically significant (χ2=155.22,P<0.01), the goal achievement was 86.25%,the advance rate was 61.06%.And the ability of employees in using scientific means have improved.The ability of using quality control tools increased by 33.3%,the problem solving ability increased by 9.3%, the coordination and communication ability increased by 125%,the team cohesion increased by 56%and the enthusiasm increased by 20.7%. Conclusion With the application of quality control circle tools,the unqualified rate of specimen decreases and the ability of solving problems by applying of quality control circle tools.(Chin J Lab Med,2018,41:324-327)

Therapeutic Observation of Scalp plus Body Acupuncture for Urticaria / 上海针灸杂志

Objective To observe the clinical efficacy of scalp plus body acupuncture in treating urticaria.Method Eighty urticaria patients were randomized into a treatment group of 42 cases and a control group of 38 cases. The treatment group was intervened by scalp plus body acupuncture, while the control group was treated with conventional body acupuncture. The two groups were treated once every other day, 10 sessions as a treatment course. The symptoms and signs scores and serum immunoglobulin E (IgE) level were observed before the treatment and after 2 treatment courses, and the clinical efficacies were also compared between the two groups.Result The total effective rate and recovery rate were respectively 92.9% and 61.9% in the treatment group, versus 76.3% and 36.8% in the control group, and the between-group differences were statistically significant (P<0.05). After the treatment, the symptoms and signs scores significantly declined in both groups (P<0.05), and the symptoms and signs scores in the treatment group were markedly different from those in the control group (P<0.05). The serum IgE level in the treatment group after the intervention was significantly lower than that before the intervention (P<0.05). After the treatment, the serum IgE level in the treatment group was significantly different from that in the control group (P<0.05).Conclusion Scalp plus body acupuncture is an effective method in treating urticaria.

The monitoring and analysis results of 15 clinical laboratory quality indicators from 2011 to 2015 / 中华检验医学杂志

Objective To investigate how to improve test quality by monitoring and analyzing 15 clinical laboratory quality indicators from the National Health and Family Planning Commission .Methods Data were collected from clinical laboratory department of the First Affiliated Hospital of Kunming Medical University between January 2011 and August 2015.15 quality indicators were analyzed retrospectively , including the error rate of specimen type , the coefficient variation unqualified rate of internal quality control test, the reporting rate of critical value , et al.Results The monitoring results of quality indicators basically satisfied the quality goals , except that the median of turn around time in pre-analytical phase was not established, routine internal quality control was not conducted in some laboratory tests in analytical phase and the reporting rate and reporting timely rate of critical value should be further improved in post -analytical phase .Conclusion Medical laboratory quality system can be continuously improved by means of setting up the quality goals of 15 quality indicators referring to sub-specialty and laboratory tests , as well as automated monitoring, statistics and analysis in LIS.

Value and difficulties in the application of measurement uncertainty for routine HbA1c assay / 中华检验医学杂志

Diabetes mellitus has became a growing public health problem,its acute and chronic complications threaten the patient's dramatically.HbA1c is recognized as the gold standard for blood glucose evaluation in patients with diabetes It has reported that the incideut rafe of diabetes related will decline remarkably when HbA1c decline by 1％,so the detection accuracy of the HbA1c is very important in the diabetes patient's management.Uncertainty of measurement can reflect the detation accuracy,which will benifite the value of HbA1c.

The cut-point for glycosylated hemoglobin in different populations in the plateau region / 中华检验医学杂志

Objective To explore the optimal HbAlc diagnostic cutpoint in different glucose tolerance populations in the plateau region.Methods (1) 472 diabetes mellitus (DM) patients and highrisk groups accepting diabetes screening in the First Affiliated Hospital of Kunming Medical College (217 males and 255 females,≥20 years old,median age 54 years old) were collected,oral glucose tolerance test (OGTT) and HbAlc were tested.(2) the research subjects were divided into normal glucose adjustment group (NGT),Impaired fasting glucose group (IFG) and (or) Impaired glucose tolerance IGT group and diabetes mellitus (DM) group.The receiver-operating characteristic curve (ROC) was explored to determine the optimal HbA1c diagnostic cut point for IFG,IGT and DM status respectively.Results The average HbA1 c values of NGT,IFG and (or) IGT,DM groups were (6.06 ± 0.11) ％,(6.63 ± 0.11) ％,(8.70 ± 2.08)％ respectively,for IFG and IGT groups,the optimal HbA1c diagnostic cut points were 6.7％ and 6.6％,respectively; If use either FBG or 2 h PG to diagnose DM,the corresponding optimal HbA1 c diagnostic cut point was 7.1％ ; If use anyone of FBG or 2hPG to diagnose DM,the corresponding optimal HbA1c diagnostic cut point was 7.0％ ; If both FBG and 2hPG were used to diagnose DM,the corresponding optimal HbA1 c diagnostic cut point was 7.1％.Conclusion Preliminarily confirm the optimal HbA1c diagnostic cut point in different glucose tolerance populations in the plateau region of Kunming,and provide the evidence for further clinical application of HbA1c.

Patients with hyperlipidemia caused by atherosclerosis and thrombosis risk factor index of related research / 中国基层医药

ObjectiveTo study on the hyperlipidemia patient plasma cause atherosclerosis index and the blood,blood serum uric acid sticks and so on thrombosis risk factors of the relationship.Methods81 patients with hyperlipidemia patient and 80 cases of normal blood fat crowd as the research object,the two groups were measured blood fat including total bravery solid alcohol ( TC ),triglycerides (TG),high-density lipoprotein cholesterol ( hdl-c ),low dense white lipoprotein LDL( solid bravery alcohol-C) levd,blood uric acid,whole blood viscosity,platelet aggregation function and serum C-reactive protein(CRP) content,and according to the TG and hdl-c than of both the logarithm of conversion values calculated the two groups of the plasma to atherosclerosis values,and by using the DuoYuan linear regression analysis with the blood acid,whole blood viscosity,platelet aggregation function and serum levels of CRP relationship.ResultsObservation group AIP(2.25 ±0.18) was significantly higher( 1.31 ±0.15 ) ( t =46.71,P ＜ 0.05 ),and AIP and LDL-C,uric acid,whole blood viscosity,platelet aggregation was positively correlated ( r =0.86,0.85,0.79,0.81,0.77,all P ＜ 0.05 ),with HDL-C was negatively correlated ( r =-0.69,P ＜ 0.05 ).ConclusionPatients with hyperlipidemia plasma cause atherosclerosis index and patients,such as blood uric acid blood viscosity thrombosis dangerous close by,by early know patients plasma to atherosclerosis index,and monitor patients early blood uric acid and blood viscosity,thrombosis risk factors level,to facilitate accurate assessment of some patients with cardiovascular disease risk,and to guide to take reasonable early intervention measures,reduce cardiovascular events.

Expression of human spindle mitosis arrest deficiency gene in spontaneous abortion embryo tissues / 中华妇产科杂志

Objective To investigate the expression of human spindle mitosis arrest deficiency gene (hsMAD2)in spontaneous abortion embryos and the relationship between low expression of hsMAD2 and numerical chromosomal aberration. Methods Spontaneous abortion embryo tissues were collected,including 23 cases of once spontaneous abortion tissue and 10 cases of twice or more spontaneous abortion tissue and induced abortion embryos(35 cases)from the Department of Gynaecology and Obstetrics of the Affilisted Hospitals of Chongqing University of Medical Science during the period of March 2006 to March 2007.FQ-PCR and western blot were used to evaluate the endogenous expression level of hsMAD2 mRNA and hsMAD2 protein;primary culturing of cells from the induced abortion embryos was conducted and 5 embryonic cells were selected by chromosomes karyotype analysis.Recombinant shRNA plasmids targeting hsMAD2 gene were constructed to inhibit the expression of endogenous hsMAIY2 genes in embryonic cells which have normal karyotypes;the groups were defined as the first experimental group(transfeeted with pshRNA-hsMAD2-1),the second experimental group(transfected with pshRNA-hsMAD2-2),the third experimental group(transfected with pshRNA-hsMAD2-3),the first control group(transfected with nothing),the second control group(transfected with pTZU6+1)and the independent group(transfected with pshRNA-N1).Interference efficiency was demonstrated by FQ-PCR and western blot:cell prolireration was meagured by methyl thiazolyl tetrazolium(MTT)assay;cell-cycle was assessed by flow cytometry (FCM):the chromosome numbers were calculated to analyze the variation of chromosomes.Results(1) The mRNA levels of hsMAD2 in the once spontaneous abortion tissue,twice or more spontaneous abortion tissue and indueed abortion tissue were 0.00879±0.00035.0.00901±0.00033 and 0.00941±0.00026 respectively,and there Wag no significant ditierence(P＞0.05)compared with each other;however,the protein levels of hsMAD2 in three groups were 0.2791±0.0311.0.0431±0.0020 and 0.5790±0.0331 respectively,and there were significant difierences(P＜0.05)compared with each other.(2)Recombinant shRNA plagmids could significantly and specifically inhibit hsMAD2 gene expression in embryonic cells.Compared with the first control group(4%)and the second control group(3%),the recombinant shRNA could inhibit embryonic cell proliferation to 54% at 48 h after transfection(P＜0.05):compared with the first control group(8.2%)and the second control group(8.0%),the ratios of G2/M phase cells in the experimental group(17.9%)was significantly increased(P＜0.05);compared with the first control group (4.8%),the ratios of abnormal chromosomes in the experimental group was increased to 30.0%(P＜0.05).Conclusions Down-expression of hsMAD2 gene may be one of the mechanisms inducing numerical chromosome aberration,abnormal embryo development and the occurrence of spontaneous abortion.

Implication of budding uninhibited by benomyl gene in spontaneous abortion embryos with numerical chromosomal abnormality / 中华检验医学杂志

Objective To explore the mechanism of hBUB1 gene in the developing of spontaneous abortion embryos with numerical chromosomal abnormalitv.Methods Quantitative real-time RT-PCR and Western blot were used to determine the mRNA and protein level of hsMAD2 gene both in spontaneous abortion embryos with numerical chromosomal abnormality(experimental group)and with numerical chromosomal normality(control group).Recombinant shRNA plasmids targeting hBUB1 gene was constructed to inhibit the expression of endogenous hBUB1 genes in embryonic cells.Interference efficiency was demonstrated by fluorescent quantitative PCR and Western blot.The inhibitory rate of cell proliferation was measured by MTT assay and cells-cycle was assessed by flow cytometry.Resuns Western blot analysis showed that protein level of hBUB1 in the experimental group was decreased signifieandv(the rate of positivity and strong positivity were 8%and 93.5%,respectively,P＜0.05)compared with the control group.The expression of hBUB1 gene in embryonic cells was significantly and specially inhibited by shRNA plasmids (the mRNA level before and after treatment witll RNAi were 0.196±0.067 and 0.042±0.006,respectively,P＜0.05).The inhibitory rate of cell proliferation was increased to 62%from 4%at 48 h after transfection.The rate of G2/M phase cells was decreased after transfection with efficient shRNA(control group:40.2%and 41.3%,test group:21.3%).Conclusions Down-regulation of hBUB1 gene leads to the inhibition of cell proliferation and the arrest of cell-cycle.It also probably plays an important role in the development of spontaneous abortion embryos with numerical chromosomal abnormality.The clinical relevance warrant further investigation.

Down-regulated centromere protein-I arrests cell growth at G_2/M phase in human embryo kidney cells / 第三军医大学学报

Objective To construct the RNA interference eukaryotic expression vector targeting human centromere protein-I (CENP-I) and to observe its effect on the growth of human embryo kidney 293 cells (HEK 293). Methods The expression vectors of pGenesil-1/CENP-I-siRNA-1. pGenesil-1/CENP-I-siRNA-2 and pGenesil-1/CENP-I-siRNA-3 were constructed by gene recombination and then were transfected into the HEK293 cells by liposome. The expressions of CENP-I at the protein and mRNA levels were detected by Western blotting and fluorescence quality PCR (FQ-PCR). The effective vector and the best transfection time were selected. The growth and the cell cycle of the transfected cells were assessed by MTT assay and flow cytometry. Giemsa was used to stain the transfected cells to calculate the mitotic index. Results Sequence-specific siRNAs targeting CENP-I significantly down-regulated the expression of CENP-I in HEK293 cells. The recombinant plasmid of pGenesil-1/CENP-I-siRNA-3 was the effective vector. After transfecting for 72 h the best inhibited efficiency was achieved. In CENP-I-siRNA transfected cells,the rate of cell growth was decreased markedly. Cells at G 2/M phase and the mitotic index were increased conspicuous compared with the cells transfected with the blank vector or untransfected. Conclusion Down-regulation of CENP-I in HEK293 cells by sequence specific siRNA delays the cell growth and postpones the cell division.