RESUMO
Data analysis models may assist the transmission of traditional Chinese medicine （TCM） experience and clinical diagnosis and treatment， and the possibility of constructing a “data-knowledge” dual-drive model was explored by taking gastric precancerous state as an example. Data-driven is to make clinical decisions around data analysis， and its syndrome-differentiation decision-making research relies on hidden structural models and partially observable Markov decision-making processes to identify the etiology of diseases， syndrome elements， evolution of pathogenesis， and syndrome differentiation protocols； knowledge-driven is to make use of data and information to promote decision-making and action processes， and its syndrome-differentiation decision-making research relies on convolutional neural networks to improve the accuracy of local disease identification and syndrome differentiation. The “data-knowledge” dual-driven model can make up for the shortcomings of single-drive numerical simulation accuracy， and achieve a balance between local disease identification and macroscopic syndrome differentiation. On the basis of previous research， we explored the construction method of diagnostic assisted decision-making platform for gastric precancerous state， and believed that the diagnostic and decision-making ability of doctors can be extended through the assistance of machines and algorithms. Meanwhile， the related research methods were integrated and the core features of gastric precancerous state based on TCM syndrome differentiation and endoscopic pathology diagnosis and prediction were obtained， and the elements of endoscopic pathology recognition based on TCM syndrome differentiation were explored， so as to provide ideas for the in-depth research and innovative application of cutting-edge data analysis technology in the field of intelligent TCM syndrome differentiation.
RESUMO
Objective To determine ED50 and ED9 5 of etomidate for combined remifentanil used in elderly patients in gastroscope.Methods Twenty-three patients were scheduled to receive gastros-copy aged 65-78 years old including males 13 and females 10,weighting 45-76 kg and ASA Ⅰ-Ⅲ. They were slowly injected remifentanil 0.3 μg/kg,and then etomidate 0.20 mg/kg,gastroscopy was performed after their eyelash reflex disappeared.The dosage of etomidate were determined by modified up-and-down methods,0.20 mg/kg was initial dosage.During the gastroscope,restlessness, frowning,swallowing,choking cough could be seen.The adjacent experimental interval dosage was 0.05 mg/kg,the trial was ended when there was the seventh cross-sectional,and determined the ED50 and ED9 5 of etomidate and (95%confidence interval)of them for gastroscope with probability a-nalysis methods.Results The ED50 of etomidate was 0.1 7 mg/kg and 95%CI 0.14-0.21 mg/kg,and the ED9 5 was 0.23 mg/kg,95%CI 0.20-0.42 mg/kg respectively.Conclusion The ED50 and ED9 5 of etomidate combined with remifentanil used for elderly patients for gastroscope respectively are 0.1 7 mg/kg and 0.23 mg/kg.
RESUMO
Objective To observe the effects of flurbiprofen on tourniquet-induced lower extremity ischemia-reperfu-sion (I/R) injury. Methods Ninety ASA I or II patients, aged 30-59 years, scheduled for elective orthopedic operation on CSEA,were randomly assigned into 3 groups (n=30 each):control group (group C),low dose flurbiprofen (group D1) and flurbiprofen (group D2). A tourniquet was applied after affected limb blood droved and inflated (80kPa) and dura-tion of less than 90 min. Patients in group D1 were infused flurbiprofen 1mg/kg slowly on 10 min before the tourniquet inflated and patients in group D2 infused flurbiprofen 2mg/kg. Patients in group C received normal saline 5mL.Blood samples were taken before operation (T0) and taken 30min(T1),2h(T2) after tourniquet release to determine the plasma concentrations of MDA, SOD, TNF-α,IL-6,IL-8.Results The plasma concentrations of MDA, SOD, TNF-α,IL-6,IL-8 in these three group was lower at T1 and T2 than it at T0(P<0.05). The plasma concentrations of MDA, SOD, TNF-α, IL-6,IL-8 in group D1and D2 was lower at T1 and T2 than it at T0(P <0.05). The plasma concentrations of MDA was lower at T2 than it at T1(P<0.05). Conclusion Flurbiprofen can reduce inflammation on tourniquet-induced lower ex-tremity ischemia-reperfusion injury.