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In recent years, the artificial intelligence machine learning and deep learning technology have made leap progress. Using clinical decision support system for auxiliary diagnosis and treatment is the inevitable developing trend of wisdom medical. Clinicians tend to ignore the interpretability of models while pursuing its high accuracy, which leads to the lack of trust of users and hamper the application of clinical decision support system. From the perspective of explainable artificial intelligence, the authors make some preliminary exploration on the construction of clinical decision support system in the field of liver disease. While pursuing high accuracy of the model, the data governance techniques, intrinsic interpretability models, post-hoc visualization of complex models, design of human-computer interactions, providing knowledge map based on clinical guidelines and data sources are used to endow the system with interpretability.
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ObjectiveTo investigate the application of Mengchao Liver Disease-Brain System version 2.0 in clinical diagnosis and treatment. MethodsThis study was conducted among 160 patients who were admitted to the internal medicine and surgical departments from June 9 to 21， 2021， and their data were automatically captured by the intelligent information system of Southeast Big Data Institute of Hepatobiliary Health， Mengchao Hepatobiliary Hospital of Fujian Medical University. The completeness and accuracy of Mengchao Liver Disease-Brain System version 2.0 were evaluated based on the intelligent diagnostic tools such as auxiliary diagnosis of chronic hepatitis B， interpretation of liver fibrosis， staging model of chronic hepatitis B， auxiliary diagnosis of liver cirrhosis， auxiliary staining of liver cirrhosis， auxiliary diagnosis of primary liver cancer， BCLC stage of primary liver cancer， Chinese staging of primary liver cancer， Child-Pugh score， and APRI score. ResultsAll auxiliary diagnostic tools had a complete rate of 94.17% in terms of the extraction of correct key dimensions within the test period. The artificial intelligence report had a structured accuracy of 97.55% in capturing data and an accuracy rate of 91.61% in text processing. ConclusionMengchao Liver Disease-Brain System version 2.0 provides an innovative mode for the construction of big data platform in medical specialties and has a high accuracy as an auxiliary diagnostic tool in clinical diagnosis and treatment.
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ObjectiveTo analyze the correlation between the changes of swallowing function and aspiration in stroke patients using videofluroscopic swallowing study. MethodsFrom January, 2014 to December, 2021, 240 stroke patients who underwent videofluroscopic swallowing study in the radiology department of Xuzhou Central Hospital were retrospectively analyzed. They were divided into aspiration group (n = 108, ≥ grade 5) and non-aspiration group (n = 132, < grade 5) according to Rosenbek Penetration/Aspiration Scale (PAS). The swallowing function changes in the oral and pharyngeal phases were compared between two groups according to Videofluoroscopic Dysphagia Scale, the risk factors of aspiration were analyzed using Logistic multivariate regression. ResultsThere were significant differences in incomplete lip closure, impaired bolus formation, apraxia, incomplete tongue-to-palate contact, premature bolus loss, prolonged oral transit time, delayed triggering of pharyngeal swallow, epiglottis folding dysfunction, pyriform sinus residue, and coating of pharyngeal wall (χ2 > 5.802, P < 0.05). Prolonged oral transit time (OR = 3.964, P = 0.036), delayed triggering of pharyngeal swallow (OR = 5.684, P < 0.001), epiglottis folding dysfunction (OR = 11.571, P < 0.001) and pyriform sinus residue (OR = 4.524, P = 0.002) were correlated with aspiration. ConclusionProlonged oral transit time, delayed triggering of pharyngeal swallow, epiglottis folding dysfunction and pyriform sinus residue are risk factors of aspiration after stroke.
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Objective:To develop and validate a model for predicting death risk in septic shock patients using LASSO-Logistic methods.Methods:A retrospective cohort study was conducted. Based on the open-source database Medical Information Mart for Intensive Care-Ⅲ v1.4 (MIMIC-Ⅲ v1.4), the septic shock patients meeting the Sepsis-3 criteria were included, and the data on demographic characteristics, major signs, laboratory examinations, hospitalization, and outcomes were extracted. Predictive variables were selected by LASSO regression and predictive models were derived using Logistic regression. The calibration of the model was evaluated using the Hosmer-Lemeshow test and discrimination was evaluated using the receiver operator characteristic curve (ROC curve).Results:A total of 693 patients with septic shock were enrolled, in which 445 patients survived and 248 patients dead within 30 days and the mortality was 35.8%. Logistic regression model was constructed according to nine predictive variables and outcome variables screened by LASSO regression method, which showed that advanced age, Elixhauser index, blood lactic acid (Lac), K + level and mechanical ventilation were associated with increased 30-day mortality [odds ratio ( OR) and 95% confidence interval (95% CI) was 1.023 (1.010-1.037), 1.047 (1.022-1.074), 1.213 (1.133-1.305), 2.241 (1.664-3.057), 2.165 (1.433-3.301), respectively, all P < 0.01], and reduced systolic blood pressure (SBP), diastolic blood pressure (DBP), body temperature, and pulse oxygen saturation (SpO 2) were also associated with increased 30-day mortality [ OR (95% CI) was 0.974 (0.957-0.990), 0.972 (0.950-0.994), 0.693 (0.556-0.857), 0.971 (0.949-0.992), respectively, all P < 0.05]. The calibration curve showed that the predicted risk of septic shock death risk prediction model had good agreement with the real situation. ROC curve analysis showed that the area under the ROC curve (AUC) of the prediction model was 0.839 (95% CI was 0.803-0.876), which could distinguish patients at risk of death from those at risk of survival. Conclusions:The septic shock death risk prediction model has a good ability to identify the 30-day mortality risk of septic shock patients, including nine hospital readily variables (age, Elixhauser index, mechanical ventilation, Lac, K +, SBP, DBP, body temperature and SpO 2). The model could be used by clinicians to calculate the risk of death in septic shock individuals.
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Objective:To explore the difference of theory of mind between adolescent depressive disorder patients with and without suicide attempt and its correlation with depression severity.Methods:From September 2019 to April 2021, totally 56 cases of attempted suicide adolescent depression patients(suicide attempted group), and 78 non-attempted suicide adolescent depression patients (non-suicide attempted group) and 23 healthy controls (healthy control group) with matched sex, age and years of education were included.The 17-item Hamilton depression scale(HAMD-17) and mini-international neuropsychiatric interview (M. I. N. I. ) were evaluated in all the subjects for depression severity and suicide trait related clinical psychological scale, theory of mind-picture sequencing task (ToM-PST) includes primary belief, primary false belief, secondary belief, secondary false belief, third-level false belief, sense of reality, reciprocity, deception and deception detection, which were used to test the theory of mind of the three groups. SPSS 25.0 software was used to statistically analyze the data, compare the differences of ToM of the three groups, and Pearson correlation analysis was used to analyze the correlation between ToM of the attempted suicide group and the clinical behavior scale.Results:The suicide attempted group was significantly lower in understanding primary false belief ((2.46±0.63) vs (2.87±0.46)) than the healthy control group( P<0.05), and the understanding of deception((2.84±0.42) vs (2.63±0.61)) was significantly higher than the non-suicide attempted group( P<0.05), and the non-suicide attempted group was significantly lower in understanding primary false belief((2.48±0.72) vs ( 2.87±0.46)) and ToM total scores((50.86±6.60) vs (54.91±5.12)) than the healthy control group(both P<0.05). Pearson correlation analysis showed that the secondary false belief of the attempted suicide group were negatively correlated with the cognitive impairment( r=-0.267, P<0.05), and third-level false belief was negatively correlated with the cognitive impairment, retardation, and depressiontotal score( r=-0.331, r=-0.319, r=-0.269, all P<0.05). There was no significant correlation between primary belief, primary false belief, secondary belief, sense of reality, reciprocity, deception, deception detection, total score of picture ranking, total score of ToM and depression in suicide attempt group(all P>0.05). Conclusion:The ability to understand deception is different between depression adolescents with and without suicide attempt, and it is not correlated with the severity of depression.
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Deep learning is a process in which machine learning obtains new knowledge and skills by simulating the learning behavior of human brain through massive data training and analysis. With the development of medical technology, a large amount of data has been accumulated in the medical field, and the research on data may help to understand the relationships and rules within data and predict the onset and prognosis of human diseases. Deep learning can find the hidden information in data and has been increasingly used in the medical field. Primary liver cancer is a malignant tumor with high incidence and mortality rates, poor prognosis, and a high recurrence rate, and early diagnosis, timely treatment, and prediction of recurrence have always been the research hotspots in recent years. This article reviews the advances in the application of deep learning in the diagnosis and recurrence of liver cancer from the aspects of risk prediction, postoperative recurrence, and survival risk prediction.
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@#Objective To investigate the effects of telmisartan on the proliferation, migration and apoptosis of non-small cell lung cancer A549 and the mechanism of regulating Wnt signaling pathway. Methods Non-small cell lung cancer cell line A549 was cultured in vitro. Cell counting kit-8 (CCK-8) assay was used to detect the effect of telmisartan at different concentrations on the proliferative activity of A549 cells. The survival fraction of A549 treated with different concentrations of telmisartan was determined by colony-formation assay. The effect of telmisartan at different concentrations on the migration ability of A549 cells was examined in the wounding healing assay. Hoechst staining was used to detect the effects of telmisartan at different concentrations on the apoptosis of A549. Western bloting was used to detect the expressions of β-actin, proliferating cell nuclear antigen (PCNA), Bax, Bcl-2, Wnt-3a, Beta-catenin (β-catenin), serine protein kinase 3β (p-GSK-3β), glycogen synthase kinase-3β (GSK-3β) and c-myc. Results Different concentrations of telmisartan treatment inhibited the proliferation activity, colony-formation rate and migration of A549 cells, and reduced the expression of PCNA in a concentration-dependent manner. Telmisartan treatment promoted the apoptosis of A549 cells, significantly increased the expression of pro-apoptotic protein Bax and decreased the expression of anti-apoptotic protein Bcl-2. The expression levels of Wnt-3a, β-catenin, p-GSK-3β, and c-myc in A549 cells increased after treatment with telmisartan, while the expression levels of GSK-3β decreased. Conclusion Telmisartan may play a role in the proliferation, migration and apoptosis of non-small cell lung cancer A549 cells, and inhibiting the Wnt/β-catenin signaling pathway may be one of the mechanisms.
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ObjectiveTo analyze the coping style and its relationship with anxiety status among middle school students aged 13 to 18 in Anhui province during the COVID-19 epidemic. MethodsFrom February 13 to 19， 2020， a cross-sectional survey was conducted among middle school students in Anhui province by using convenience sampling method and network questionnaire. The assessment tools included the Coping Style Scale for Middle School Students （CSSMSS） and the Screen for Child Anxiety Related Emotional Disorders （SCARED）. ResultsThe results of the CSSMSS evaluation showed that female students scored higher in emotion abreaction than male students ［（8.27±2.98） vs. （7.84±2.91）］. The scores of tolerance ［（9.74±2.73） vs. （9.11±2.60）］， escape ［（7.82±2.79） vs. （7.26±2.44）］， emotion abreaction ［（8.48±2.97） vs. （7.91±2.93）］ and fantasy/denial ［（9.79±3.56） vs. （9.26±3.47）］ of senior high school students were higher than those of junior high school students， and the score of problem solving ［（19.38±4.07） vs. （20.33±4.54）］ was lower than that of junior high school students， with statistical significance （P<0.05 or 0.01）. Correlation analysis results showed that the scores of tolerance， escape， emotion abreaction and fantasy/deny in CSSMSS were positively correlated with the scores of SCARED of middle school students in Anhui province （r=0.348， 0.287， 0.390， 0.501， P<0.01）. ConclusionDuring COVID-19 epidemic， students of different genders and grades in Anhui province have different coping styles， and some coping styles may induce anxiety status.
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Objective:To explore the difference of brain structure between patients with early-onset depression with and without suicidal ideation and its relationship with the severity of depression.Methods:Totally 37 patients with early-onset depressive disorder with suicidal ideation and 23 patients with early-onset depressive disorder without suicidal ideation were examined by psychological assessment and magnetic resonance imaging(MRI)from 2019 to 2020.Voxel-based morphometry (VBM) technology was used to compare the differences in brain structure between the two groups of subjects, and further analyze the relationship between the gray matter volume of the different brain areas and the severity of depression. The demographic and clinical data were analyzed by SPSS 24.0 statistical software package. The comparison between the two groups was performed by double sample t-test and chi square test. SPM8 software was used for VBM statistical analysis, and double sample t test was used for image analysis and comparison between the two groups. Pearson correlation analysis was performed between the mean gray matter volume of the two groups and the scores of HAMD-17 and Beck scale for suicide ideation(BSI). Results:Compared with the group without suicide ideation, the volume of gray matter in the right middle frontal gyrus(MNI: x, y, z=28.5, 33.0, 43.5, FWE correction for mass level, P<0.05)and left angular gyrus of the suicide idea group increased(MNI: x, y, z=-37.5, -73.5, 48.0, FWE correction for mass level, P<0.05). There was no significant correlation between the gray matter volume of the right middle frontal gyrus and the HAMD-17 scale, BSI scale in patients with early-onset depression ( r=0.073, r=-0.153, both P>0.05). Conclusion:There are structural differences in the right middle frontal gyrus and left angular gyrus between patients with early-onset depression with suicidal ideation and patients with early-onset depression without suicidal ideation, and there was no significant correlation between gray matter volume and depression severity.
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To evaluate the efficacy and safety of left atrial appendage occlusion (LAAO) in patients with atrial fibrillation (AF) over 75 years. A total of 82 patients with AF who underwent LAAO successfully in Beijing Anzhen Hospital from March 2014 to March 2019 were divided into two groups according to age: the elderly group (aged>75 years) and the young group (aged ≤75 years). Risk of perioperative complications and incidence of ischemic stroke and major bleeding during follow-up were retrospectively analyzed. The results showed that there were no significant differences in procedure-related ischemic stroke(0 vs.1.6%, P=0.768) and major bleeding (0 vs.1.6%, P=0.768) during perioperative period between the two groups. No complications as death or pericardial tamponade occurred in the two group. During a (25.9±15.9) months period of followed up, ischemic stroke event rate was 3.6/100 person-years in the elderly group and 4.9/100 person-years in the young group, respectively. Major bleeding event rate was 2.5/100 person-years in the elderly group and 0/100 person-years in the young group, respectively. Compared with the expected ones, the relative risk reduction (RRR) of stroke in the elderly group was more profound than that in the young group (32.0% vs. 25.0%), while the risk of major bleeding in the young group was significantly lower than that in the elderly group (RRR 100% vs. 56.9%). Therefore, LAAO might be suitable for stroke prevention in the elderly AF patients.
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Objective:To investigate the effects of miRNA-143-3p on the proliferation, migration and invasion of keloid fibroblasts (KFB) and the possible mechanism.Methods:KFB and normal skin fibroblasts (NFB) were isolated and cultured. The expression of miRNA-143-3p and integrin β5 (ITGB5) at mRNA level in KFB and NFB were detected by RT-qPCR. Western blot was performed to measure the expression of ITGB5 at protein level. After overexpressing miRNA-143-3p or suppressing ITGB5 expression in KFB cells, MTT assay, Transwell assay, RT-qPCR and Western blot were used to detect the effects on the proliferation, migration and invasion of KFB and the expression of related proteins. Dual-luciferase reporter gene assay was used to validate the targeting relationship between miRNA-143-3p and ITGB5.Results:Compared with NFB, KFB showed down-regulated miRNA-143-3p expression and up-regulated expression of ITGB5 at both mRNA and protein levels. The proliferation, migration and invasion of KFB were inhibited after overexpressing miRNA-143-3p or suppressing ITGB5 expression. Moreover, miRNA-143-3p could negatively regulate ITGB5 expression and overexpression of ITGB5 reversed the effects of miRNA-143-3p overexpression on KFB proliferation, migration and invasion.Conclusions:This study suggested that miRNA-143-3p could inhibit the proliferation, migration and invasion of KFB through down-regulating ITGB5 expression.
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Objective:To investigate the application value of machine learning algorithms for preoperative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 277 patients with HCC who were admitted to Mengchao Hepatobiliary Hospital of Fujian Medical University between May 2015 and December 2018 were collected. There were 235 males and 42 females, aged (56±10)years, with a range from 33 to 80 years. Patients underwent preoperative magnetic resonance imaging examination. According to the random numbers showed in the computer, all the 277 HCC patients were divided into training dataset consisting of 193 and validation dataset consisting of 84, with a ratio of 7∶3. Machine learning algorithms, including logistic regression nomogram, support vector machine (SVM), random forest (RF), artificial neutral network (ANN) and light gradient boosting machine (LightGBM), were used to develop models for preoperative prediction of MVI. Observation indicators: (1) analysis of clinicopathological data of patients in the training dataset and validation dataset; (2) analysis of risk factors for tumor MVI of the training dataset; (3) construction of machine learning algorithm prediction models and comparison of their accuracy of preoperative tumor MVI prediction. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the paired t test. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Univariate and multivariate analyses were performed using the Logistic regression model. Results:(1) Analysis of clinicopathological data of patients in the training dataset and validation dataset: there were 157 males and 36 females in the training dataset, 78 males and 6 females in the validation dataset, showing a significant difference in the sex between the training dataset and validation dataset ( χ2=6.028, P<0.05). (2) Analysis of risk factors for tumor MVI of the training dataset: of the 193 patients, 108 had positive MVI, and 85 had negative MVI. Results of univariate analysis showed that age, the number of tumors, tumor diameter, satellite lesions, tumor margin, alpha fetaprotein (AFP), alkaline phosphatase (ALP), fibrinogen were related factors for tumor MVI [ odds ratio ( OR)=0.971, 2.449, 1.368, 4.050, 2.956, 4.083, 2.532, 1.996, 95% confidence interval ( CI): 0.943-1.000, 1.169-5.130, 1.180-1.585, 1.316-12.465, 1.310-6.670, 2.214-7.532, 1.016-6.311, 1.323-3.012, P<0.05]. Results of multivariate analysis showed that AFP>20 μg/L, multiple tumors, larger tumor diameter, unsmooth tumor margin were independent risk factors for tumor MVI ( OR=3.680, 3.100, 1.438, 3.628, 95% CI: 1.842-7.351, 1.334-7.203, 1.201-1.721, 1.438-9.150, P<0.05). Larger age was associated with lower risk of preoperative tumor MVI ( OR=0.958, 95% CI: 0.923-0.994, P<0.05). (3) Construction of machine learning algorithm prediction models and comparison of their accuracy of preoperative tumor MVI prediction: ①machine learning algorithm prediction models involving logistic regression nomogram, SVM, RF, ANN and LightGBM were constructed based on results of multivariate analysis including age, AFP, the number of tumors, tumor diameter, tumor margin, and consistency analysis of the logistic regression nomogram prediction model showed a good stability. For the training dataset and validation dataset, the area under curve (AUC) of logistic regression nomogram model, SVM model, RF model, ANN model, LightGBM model was 0.812, 0.794, 0.807, 0.814, 0.810 and 0.784, 0.793, 0.783, 0.803, 0.815, respectively, showing no significant difference between SVM model and logistic regression nomogram model, between RF model and logistic regression nomogram model, between ANN model and logistic regression nomogram model, between LightGBM model and logistic regression nomogram model [(95% CI: 0.731-0.849, 0.744-0.860, 0.752-0.867, 0.747-0.862, Z=0.995, 0.245, 0.130, 0.102, P>0.05) and (95% CI: 0.690-0.873, 0.679-0.865, 0.702-0.882, 0.715-0.891, Z=0.325, 0.026, 0.744, 0.803, P>0.05)]. ② Clinicopathological factors were selected using RF, LightGBM machine learning algorithm to construct corresponding prediction models. According to importance scale of factors to prediction models, factors with importance scale>0.01 were selected to construct RF model, including age, tumor diameter, AFP, white blood cell, platelet, total bilirubin, aspartate transaminase, γ-glutamyl transpeptidase, ALP, and fibrinogen. Factors with importance scale>5.0 were selected to construct LightGBM model, including age, tumor diameter, AFP, white blood cell, ALP, and fibrinogen. Due to lack of factor selection ability, factors based on results of univariate analysis were secected to construct SVM model and ANN model, including age, the number of tumors, tumor diameter, satellite lesions, tumor margin, AFP, ALP, and fibrinogen. For the training dataset and validation dataset, the AUC of SVM model, RF model, ANN model, LightGBM model was 0.803, 0.838, 0.793, 0.847 and 0.810, 0.802, 0.802, 0.836, respectively, showing no significant difference between SVM model and logistic regression nomogram model, between RF model and logistic regression nomogram model, between ANN model and logistic regression nomogram model, between LightGBM model and logistic regression nomogram model [(95% CI: 0.740-0.857, 0.779-0.887, 0.729-0.848, 0.789-0.895, Z=0.421, 0.119, 0.689, 1.517, P>0.05) and (95% CI: 0.710-0.888, 0.700-0.881, 0.701-0.881, 0.740-0.908, Z=0.856, 0.458, 0.532, 1.306, P>0.05)]. Conclusion:Machine learning algorithms can predict MVI of HCC preoperatively, but its application value needs to be further verified by large sample data from multi centers.
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Glutamine is the most abundant amino acid found in plasma and cells. It is the preferred fuel for enterocytes in the small intestine, macrophages, and lymphocytes. After serious burn, increased requirement of glutamine by the gastrointestinal tract, kidney and lymphocytes, and relatively insufficient self synthesis likely contribute to the rapid decline of glutamine in circulation and cells. Glutamine supplementation can not only protect intestinal mucosa, maintain normal intestinal barrier function, reduce bacterial translocation, and enhance the intestinal immune function, but also increase the number of lymphocytes, enhance the phagocytic function of macrophage, promote the synthesis of immunoglobulin, and reduce the body′s inflammatory response, so as to enhance the immune function. Therefore, glutamine supplementation can improve and enhance the immune function, reduce complications and promote the prognosis of severely burned patients.
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Objective To investigate the correlation and significance between miRNA-802 and inflammato-ry factors in the patients with inflammatory bowel disease (IBD) ,and to understand pathologic mechanisms of IBD.Methods 80 patients with active IBD ,who were hospitalized in Department of Gastroenterology ,Taizhou People's Hospital ,from August 2015 to February 2017 ,were selected as active IBD group.Another 40 inactive IBD patients and 40 healthy persons who underwent the healthy assessment during the same period were se-lected as inactive IBD group and healthy control group.The expression level of miRNA-802 in intestinal muco-sa and peripheral blood mononuclear cells of each group was detected by fluorescence quantitative PCR (RT-qPCR).In addition ,the relative expression of miRNA-802 in the intestinal mucosa and peripheral blood mono-nuclear cells of 43 patients with Crohn's disease (CD) treated by IFX (IFX) was detected and the correlation with the serum TNF-α was analyzed.Results The expression level of miRNA-802 in the intestinal mucosa and peripheral blood mononuclear cells of active IBD patients was significantly higher than that of inactive IBD pa-tients and healthy control group ,and the difference was statistically significant (P＜0.01).After 12 weeks of IFX treatment ,the expression level of miRNA-802 in the intestinal mucosa and peripheral blood mononuclear cells of CD patients was significantly lower than that before treatment ,and the difference was statistically sig-nificant (P＜0.01).The results of correlation analysis have shown that the expression level of serum TNF-α was positively correlated with miRNA-802 expression in peripheral blood monocytes ,and the expression of miRNA-802 mRNA was significantly increased after the stimulation of TNF-α on peripheral blood monocytes cultured in vitro.Conclusion The increased expression level of miRNA-802 in IBD patients is closely correla- ted with the expression level of TNF-α ,and miRNA-802 could be a new treatment target for IBD.
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Objective To evaluate the therapeutic efficacy and safety of micro-invasive craniopuncture scavenging technique (MPST) for treatment of intracranial hematoma in patients with hypertensive cerebral hemorrhage (HICH).Methods All the clinical randomized controlled trial (RCT) studies published on MPST and internal medicine conservative treatment of HICH were searched via computer screening of databases including Cochrane clinical trials database, the Chinese biomedical literature database (CBM), Chinese periodical network full-text special topic database, Chinese science and technology periodical database and electronic periodicals database of Wanfang from January 2006 to January 2017. The study group was given the MPST plus basic treatment, and the control group was given conservative treatment. The studies collected meeting the eligible criteria were sorted and analyzed by the software RevMan 5.0, the differences in therapeutic effect and mortality were compared between the two groups, and a funnel chart was plotted to analyze the potential publication bias.Results A total of 13 RCTs published studies consistent with the eligible criteria were found, including1556 patients. The Meta-analysis showed that the effective rate in the study group was significantly higher than that in the control group [odds ratio (OR) = 4.29, 95% confidence interval (95%CI) 3.33 - 5.53,P < 0.01]; the fatality rate was markedly lower than that of the control group (OR = 0.25, 95%CI 0.19 - 0.35,P < 0.01). The funnel graph showed that each study had asymmetrical scatter plot of the variable quantity of research results, indicating a publication bias being present, which might be related to the subjectivity of the researchers in publishing their results.Conclusions Using MPST to treat HICH can significantly improve the therapeutic efficiency and reduce deterioration rate. However, due to the low quality of clinical research, it is necessary to carry out rigorous andmulti-center randomized controlled studies to further confirm the results.
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OBJECTIVE@#To discuss the effect of age on hyoid movement and the openness of UES in swallowing process, and to investigate the correlation between hyoid movement and openness of UES.@*METHOD@#The X-ray dynamic swallowing videofluoroscopy was performed on 100 healthy adult volunteers(20-74 years). They were divided into three groups: young (ages 20 to 45), middle-aged (45 to 65) and older (65 and up). Then the software Avidemux 2. 5 and Image J were used to measure the time and distance of hyoid movement, and the maximal opening of the UES in swallowing process.@*RESULT@#The time of hyoid moving to the maximal displacement was delayed along with the ages, and there were significant differences among the three groups (P0. 05), however, the antedisplacement of hyoid had significant relation to UES opening in the three groups (P<0. 05).@*CONCLUSION@#In swallowing process, the time and space parameters of hyoid movement and the maximal degree of UES opening were related to age. There was significant difference between the antedisplacement of hyoid and the openness of UES (P<0. 05).
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Adulto , Anciano , Humanos , Persona de Mediana Edad , Adulto Joven , Deglución , Esfínter Esofágico Superior , Fisiología , Hueso Hioides , Fisiología , Movimiento , Programas InformáticosRESUMEN
OBJECTIVE@#To observe the short and long-term efficacy of quick repositioning maneuver for posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV) in different age groups.@*METHOD@#The clinical data of 113 adult patients with single PC-BPPV who underwent quick repositioning maneuver from July 2009 to February 2015 were retrospectively analyzed. The quick repositioning maneuver was to roll the patient from involved side to healthy side in the coronal plane for 180° as quickly as possible. The patients were divided into 3 groups according to different ages: young group ( 0.05). The recurrence rate of the three groups was 5.0%, 6.4% and 15.4% respectively, also no significant difference (P > 0.05).@*CONCLUSION@#The quick repositioning maneuver along the coronal plane for PC-BPPV has a definite effect for every age groups. The method is simple, rapid and easy to master, and the patients are tolerated the maneuver well without evident side effect.
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Adulto , Humanos , Persona de Mediana Edad , Vértigo Posicional Paroxístico Benigno , Terapéutica , Posicionamiento del Paciente , Estudios Retrospectivos , Canales SemicircularesRESUMEN
according to the difference of femoral eccentricity on the affected and healthy sides. In the reduction group (30 cases), the difference value was 5 mm. Femoral stem and femoral prosthesis type were compared among different groups. SF-12 scale score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Harris score were evaluated and compared before and after replacement. RESULTS AND CONCLUSION:Standard eccentricity of femoral prosthesis mainly accounted for 77%, 63% and 73% in the reduction group, normal group and increased group, respectively (P > 0.05). No significant difference in average eccentricity was detected in each group between the affected and healthy sides (P> 0.05). WOMAC score was significantly higher after replacement than that before replacement in three groups (P 0.05). No significant differences in pain and stiffness were detected among three groups after replacement (P > 0.05), and significant differences in physical function were found (P 0.05). The physical ability score was elevated after replacement in the three groups (P < 0.05). Mental scores were significantly elevated in reduction and normal groups (P < 0.05). The excelent and good rate of Harris score was significantly higher in the increased group (96%) than in the reduction group (70%) and normal group (87%) (P < 0.05). These findings indicate that the increased eccentricity contributed to the pain easement after total hip arthroplasty and promoted functional recovery. The decreased eccentricity could worsen patient’s pain, and was not conducive to the restoration of joint function after replacement.
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Objective To investigate the application of the straight head-hanging test in the diagnosis of the benign paroxysmal positional vertigo (BPPV ) .Methods The clinical manifestations of 324 patients with benign paroxysmal positional vertigo treated in our department from July 2009 to April 2014 were retrospectively analyzed . All of the patients were tested by Dix -Hallpike and roll test first ,then the straight head-hanging test was carried out .Results Of the 324 cases ,53 cases(16 .36% ) had signs of simultaneous multiple canal involvement ,and 27 ca‐ses of them could be triggered the symptom of vertigo in the straight head -hanging test .In patients with single semicircular canal BPPV ,85 cases (26 .2% )were evoked vertigo with or without positional nystagmus by Dix -Hallpike tests and 120 cases (37 .04% )were triggered the symptom of vertigo with or without nystagmus through roll test ,another 66 cases(20 .37% ) were induced vertigo with or without nystagmus in the straight head-hanging test .66 patients with positive straight head-hanging test were rotated along the sagittal plane for repositional treat‐ment .When these patients were re-evaluated at one week and 3 months ,the total improvement were 86 .36% (57/66) and 83 .33% (55/66) ,respectively .Conclusion The straight head -hanging test can improve the diagnostic rate and it is especially helpful for the diagnosis of superior semicircular canal benign paroxysmal positional vertigo . In patients with a history of typical vertigo ,the straight head -hanging test should be performed if they showed negative Dix -Hallpike test and roll test.
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BPPV is the most common cause of dizziness in adults, and the symptoms, causes, behavior of adult patients are clearly defined. Pregnant woman may also suffer from BPPV. To our knowledge, there are few reports on BPPV in pregnant women. In this paper, the clinical characteristics and results of 3 pregnant women with BPPV are reported.