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Objective To establish a hybrid deep learning lung sound classification model based on convolutional neural network(CNN)-long short-term memory(LSTM)for electronic auscultation.Methods Wavelet transform was used to extract features from the dataset,transforming lung sound signals into energy entropy,peak value and other features.On this basis,a classification model based on hybrid algorithm incorporating CNN and LSTM neural network was constructed.The features extracted by wavelet transform were input into CNN module to obtain the spatial features of the data,and then the temporal features were detected through LSTM module.The fusion of the two types of features enabled the classification of lung sounds through the model,thereby assisting in the diagnosis of pulmonary diseases.Results The accuracy rate and F1 score of CNN-LSTM hybrid model were significantly higher than those of other single models,reaching 0.948 and 0.950.Conclusion The proposed CNN-LSTM hybrid model demonstrates higher accuracy and more precise classification,showcasing broad potential application value in intelligent auscultation.
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Objective To investigate the clinical application of self-made snare in laparoscopic appendectomy. Methods The clinical datas of 197 cases who were acute appendicitis under laparoscopic appendectomy in the first people's hospital of Fuyang in Hangzhou from June 2015 to June 2017 were collected, then they were divided into self-made snare group (85) and Hem-o-lok group (112). Variations of operation time, operation bleeding, first postoperative anal exhaust time and length of stay above two groups were analyzed. Variations of incision infection, abdominal abscess and intestinal obstructionabove two groups were analyzed. Results Two groups of patients were compared with operation time [self-made snare group(43. 71±5. 54)min: Hem-o-lok group(42. 29±5. 34)min], operation bleeding[self-made snare group(l 1. 60±2. 44)mL: Hem-o-lok group(l 1. 00±2. 56)mL],first postoperative anal exhaust time [self-made snare group (10. 01±2. 27)h: Hem-o-lok group(9. 60±2. 32)h] and length of stay[self-made snare group(5. 19±0. 95)d: Hem-o-lok group (4. 99±0. 85)d], the differences were not statistically significant(P＞0. 05). Two groups of patients were compared with incision infection[self-made snare group 2 cases(2. 35％): Hem-o-lok group 3 cases(2. 68％)], abdominal abscess [self-made snare group 1 case(1. 18％): Hem-o-lok group 2 cases (1. 79％)] and intestinal obstructionabove [self-made snare group 3 cases(3. 53％): Hem-o-lok group 5 cases(4. 46％)], the differences were not statistically significant(P＞0. 05). Conclusion Self-made snare in laparoscopic appendectomy is safe and feasible.
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Objective To study insulin resistance and colorectal cancer (CRC) clinical features, pathological characteristics and hazards. Methods A total of 322 cases of CRC patients and 200 healthy subjects divided into CRC group and control group, BMI, WHR, SBP, DBP, FPG, FINS, HOMA-IR, TC, TG, HDL-C, LDL-C, adiponectin of two groups were compared, and to analyze the risk factors of CRC and insulin resistance and pathological features of CRC. Results CRC group, WHR, SBP, FPG, FINS, HOMA-IR, TG values were significantly higher (P<0.05), HDL-C, adiponectin were significantly lower than the control group (P<0.05). Two BMI, DBP, TC, LDL-C values, the difference were not statistically significant (P> 0.05). Family history, metabolic syndrome, FINS, HOMA-IR were risk factors for CRC(P<0.05). Insulin resistance and TNM stage(P<0.05), and not related to tumor location, differentiation, lymph node metastasis, distant metastasis (P>0.05). Conclusion Insulin resistance, family history, prevalence of metabolic syndrome and colorectal cancer is closely related to the degree of insulin resistance may be associated with the progression of colorectal cancer.
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The cardinal features of Turner syndrome(TS) are short stature,congenital abnormalities,gonadal dysgenesis.The sex hormone insufficiency lead to infertility and lack of proper development of secondary sex characteristics,it also involves in the frequent osteoporosis and increased cardiovascular risk,state of physical fitness,insulin resistance,body composition,and may play a role in the increased incidence of autoimmunity.Recent researches emphasize the TS patients need for proper sex hormone replacement therapy to improve their quality of life.This review summarizes the effects of estrogen and androgen insufficiency as well as the effects of sex hormone replacement therapy on the whole body of Turner syndrome.
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Objective To investigate the epidemiological information of patients in pre-hospital medical care for our large and medium-sized cities and probe the patients' characteristic. Method The data in 2008 were exported from the computer databases of 8 large and medium-sized cities' emergency medical centers in our country.The thorough records of data were conducted to statistical analysis. Results ( 1 ) The scheduling time, running time, rescue time, returning time, total time and service radius in the pre-hospital medical care group were 2.16± 1.10(min), 14.01 ±6.82(min), 12.12±5.96(min), 14.08± 6.85(min), 42.34± 20.21(min)and 8.50±4.18(km), and the above parameter in the non-death group were 2.19 ± 1.13(min), 14.15 ± 7.14(min),11.60±6.72(min), 14.92 ±6.89(min), 41.86± 19.53(minutes) and 8.63±4.31(Km), and the above parameter in the death group were 2.10± 1.08(min), 13.68 ± 7.14(min), 25.25 ± 12.34(min), 13.75±6.48(min), 54.74 ± 25.47(min) and 7.86± 3.91(Km), and the above parameter in the non-sudden cardiac death group were2.09± 1.03(min), 13.58±6.78(min), 25.53± 12.34(min), 13.60± 6.54(min), 53.79±23.77(min) and 7.67 ± 3.86(Km), and the above parameter in the sudden cardiac death group were 2.12 ±1.02(min), 14.10±7.05(min), 24.79± 12.08(min), 13.79±6.61(min), 54. 80 ± 25. 36( min) and 7.90±3.92(Km) respectively. The scheduling time, running time, returning time and service radius in the death group were less than those of the non-death group, but the rescue time and total time of the former were more than those of the latter respectively ( P ＜ 0.05 or P ＜ 0. 001 ). The scheduling time and returning time didn' t have significant difference between the sudden cardiac death group and the non-sudden cardiac death group respectively ( P ＞ 0.05), but the running time, total time and service radius of the sudden cardiac death group were more than those of the non-sudden cardiac death group, and the rescue time of the former was less than that of the latter respectively ( P ＜ 0.05 or P ＜ 0.001 ). (2)The patients' amount in pre-hospital medical care group, the non-death group, the death group, the non-sudden cardiac death group and the sudden cardiac death group were at most in first quarter, and the least time slice of patients' amount were 4:00～ 6:00, 4:00～6:00, 4:00～ 6:00, 22:00～ 24:00, 2:00～4:00 respectively, and the most time slice of patients' amount were 20:00～ 22:00, 20:00～22:00, 8:00～ 10:00, 2:00 ～ 4:00, 8:00 ～ 10:00 respectively. (3)In 241 876 cases of pre-hospital medical care group, the patients' amount of trauma was at most, whose age grades was by far among21 ～50, and the others in sequence were nervous system, circulatory system, other group, digestive system, respiratory system and poisoning group respectively, whose age grades in nervous system, circulatory system and respiratory system was by far above 51, especially above 70. The patients' age grades in other group and digestive system had two climax age groups, which the one was 21 ～ 30, and the other was above 70. The patients' age grades in poisoning group was by far among 21 ～ 50, which the patients' amount of acute alcoholism was at the most. (4) In 12 568 cases of death group, the death amount of circulatory system, other group, respiratory system, nervous system and digestive system ranked at the lst,2nd,4th,5th 8th respectively, whose age grades was by far above 51, especially above 70,and the patients' amount of sudden cardiac death was at the most in the death amount of circulatory system. The death amount of trauma and poisoning group ranked at the 3rd, 6th respectively, whose age grades was by far among 21 ～ 50. (5)The total amount, the death amount and the sudden cardiac death amount of male patients were more than those of female patients. (6)The percentage of the death group to the pre-hospital medical care group was 5.20%, and the percentage of the sudden cardiac death group to the pre-hospital medical care group was 1.29%,and the percentage of the sudden cardiac death group to the death group was 24.87 %, and the percentage of the sudden cardiac death group to the circulatory system group was 67.33 %. Conclusions ( 1 )The trauma and the sudden cardiac death are the overriding reason of disease and the overriding reason of death in our large and medium-sized cities respectively. (2) It is very important to cut the death rate of the middle-old age patients by strengthening prevention and cure of cardiovascular and cerebrovascular diseases, discerning the critical illness early and improving the level of pre-hospital medical care. (3)It is a strong method to decrease the total amount and the death amount of the trauma, especially in traffic accident, by strengthening safety in production, observing traffic regulation and enhancing the legal awareness.
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Background and purpose:Gastric cancer is one of the leading causes of cancer death throughout the world.When compared with optimal supportive care alone,combination chemotherapy yields a significant advantage in the management of advanced gastric cancer.However,no single regimen has emerged or been accepted as being clearly superior over another.Here we investigated the efficacy and safety of "docetaxel+ cisplatin + fluorouracil" 5-day combination chemotherapy as treatment in patients with advanced gastric cancer.Methods:Between 2004 January and 2005 July,we enrolled 30 patients [males 22,median age 53 years(range 28-72)] with advanced gastric cancer.The regimen consisted of docetaxel 75 mg/m~(2) on day 1,cisplatin 15 mg/ m~(2) on days 1-5,and fluorouracil 500 mg/ m~(2) on days 1-5,every 3 weeks.All patients received over two cycles of this regimen.Results:A total of 99 cycles were administered.Mean cycle number per patient was 3.3.The administered dose intensity of docetaxel was 23.5 mg/m~(2)/week,fluorouracil 735 mg/ m~(2)/week and cisplatin 14.7 mg/ m~(2)/week,which corresponded to 94%,97.5% and 92.3% of planned doses.Of these patients,16(53.3%) achieved a partial response,8(26.6%) stable disease,and 6 patients(20%) showed progressive disease.The median time to progression was 5.1 months.(95% CI 4.1-6.0 months).Median overall survival was 9.9 months.(95% CI 8.1-11.6 months).Leukopenia occurred during 36.7% of cycles(36 of 99 cycles);18.2% grade Ⅰ,10.1% grade Ⅱ,5.0% grade Ⅲ and 3.0% grade Ⅳ.Anemia occurred in 12.1%(12 of 99 cycles);7.1% grade Ⅰ and 5.0% grade Ⅱ.Thrombocytopenia was 15.2%(15 of 99 cycles) and all were grade Ⅰ or Ⅱ.Diarrhea,stomatitis and hypersensitivity occurred in 16.7%(5 out of 30 patients),respectively.Neutropenic fever occurred in two patients(6.7%) and myalgia in nine(30%).Conclusions:Docetaxel combined with fluorouracil and cisplatin is an active and tolerable regimen for the treatment of patients with advanced gastric cancer.