Application of fast susceptibility weighted imaging based on deep learning in assessment of acute ischemic stroke / 中华放射学杂志

Objective:To explore the value of fast susceptibility weighted imaging (SWI) generated by a deep learning model in assessment of acute ischemic stroke (AIS).Methods:From January 2019 to January 2021, 118 AIS patients [75 males and 43 females, aged 23-100 (66±14) years] who underwent MR examination and SWI sequence scanning within 24 h of symptom onset in the First Medical Center of PLA General Hospital were retrospectively analyzed. MATLAB ′s randperm function was used to divide 118 patients into a training set of 96 cases and a test set of 22 cases at a ratio of 8∶2. Fourty-seven AIS patients [38 males and 9 females, aged 16-75 (58±12) years] from one center of a multicenter study were selected to build the external validation set. SWI image and filtered phase image were combined into complex value image as full sampling reference image. Undersampled SWI images were obtained by retrospective undersampling of reference fully sampled images, and the undersampling multiple was five times which could save 80% of the scanning time, then the complex-valued convolutional neural network (ComplexNet) was used to develop reconstruct fast SWI. Interclass correlation coefficient (ICC) or Kappa tests were used to compare the consistency of image quality and the diagnostic consistency for the presence of susceptibility vessel sign (SVS), cerebral microbleeds and asymmetry of cerebral deep medullary veins (DMVs) in AIS patient on fully sampled SWI and fast SWI based on ComplexNet.Results:In test set, score of image quality was 4.5±0.6 for fully sampled SWI image and 4.6±0.7 for fast SWI based on ComplexNet, and coefficient was excellent (ICC=0.86, P<0.05). Full sampling SWI had good agreement with fast SWI based on ComplexNet in detecting SVS (Kappa=0.79, P<0.05), microbleeds (Kappa=0.86, P<0.05), and DMVs asymmetry (Kappa=0.82, P<0.05) in AIS patients. In the external validation set, score of image quality was 4.1±1.0 for fully sampled SWI image and 4.0±0.9 for fast SWI based on ComplexNet, and coefficient was excellent (ICC=0.97, P<0.05). Full sampling SWI had good agreement with fast SWI based on ComplexNet in detecting SVS (Kappa=0.74, P<0.05), microbleeds (Kappa=0.83, P<0.05), and DMVs asymmetry (Kappa=0.74, P<0.05) in AIS patients. Conclusions:Deep learning techniques can significantly accelerate the speed of SWI, and the consistency of image quality and detected AIS signs between fast SWI based on ComplexNet and fully sampled SWI is good. The fast SWI based on ComplexNet can be applied to the radiographic assessment of clinical AIS patients

Analysis of the monitoring data of fever clinic symptoms during the pandemic of new coronavirus pneumonia in Xiangyang City / 公共卫生与预防医学

Objective To analyze the monitoring data of the fever clinic during the epidemic period of COVID-19 in Xiangyang City, and to provide a scientific basis for the government to carry out the prevention and control of new coronavirus pneumonia in the next step. Methods Monitoring data from the "Symptom Monitoring System of Fever Outpatients in Xiangyang City" from February 11, 2020 to March 16, 2020 was obtained. The data combined with the confirmed cases was statistically analyzed. Results A total of 28 296 outpatients with fever were monitored and 38 confirmed cases were found. According to trend chi square test, the visit rate of the fever clinic (Z =629.11，P = 0.000＜0.005 ) decreased gradually from the second week. The analysis of the rate of the fever clinic visits (χ2=2819.54，P=0.000＜0.05 ) and the rate of confirmed cases in different areas ( χ2=7.80，P=0.005＜0.05) indicated that the diagnostic confirmation rate in the urban area was higher, while the rate of visits in counties was higher. The rate of visits to fever clinics (Z=2 261.99, P=0.000<0.008) and the rate of diagnostic confirmation (Z=10.69, P=0.001<0.008) in different age groups showed that the visit rate decreased with the increase of age, while the diagnostic confirmation rate increased with the increase of age. Conclusion The prevention and control of the new coronavirus in Xiangyang City had been effective. It is important to strengthen the screening of patients in fever clinics in key areas (urban areas) and key age groups (children and adolescents) in the next step.

Application of health portal in public health services and factors influencing its adoption / 公共卫生与预防医学

Objective To explore the current status of the application of health portals in the field of public health, and analyze the factors affecting users' adoption of health portals, so as to provide a theoretical basis for promoting the use of health portals and promoting health management. Methods Referring to domestic and foreign literature, integrating the technology acceptance model and the dual motivation factor theory, a comprehensive analysis framework was built, and the influencing factors of whether various groups of people adopt health portals were analyzed from multiple dimensions. Results The current status of health portal applications around special groups and specific purposes was analyzed. A comprehensive analysis dimension was constructed with perceived usefulness and perceived ease of use as the basic framework, service quality, social norms and users themselves as specific indicators, and positive and negative impacts as specific directions. Conclusion From the perspective of service, society and individuals, analyzing the positive and negative factors that affect users’ adoption of health portals, it is necessary to strengthen the use of health portals by special groups such as the elderly, to further improve disease prevention and control, deepen public health services, and promote the development of healthy China.

A systemic review on efficacy and safety of multi-oil fat emulsion injection in premature infant parenteral nutrition support based on the meta-analysis / 中华临床营养杂志

Objective To systemically analyze the efficacy and safety of multi-oil fat emulsion injection (SMOF) in the premature infant parenteral nutrition support.Methods Databases including EMbase,PubMed,Cochrane Library,CNKI,VIP and Wanfang,were searched from libraries establishment to November 2017 for randomized controlled trials (RCTs) focusing on the efficacy and safety of SMOF in the premature infant parenteral nutrition support.All the literatures were retrieved and screened according to inclusion and exclusion criteria by two researchers.The software RevMan 5.3 was used for meta-analysis after the evaluation of methodology of quality.Results A total of 7 articles including 7 RCTs were enrolled.Meta-analysis showed that there were no significant differences in body length (OR=-0.25,95％ CI=-1.80-1.30,P=0.75),weight (OR=-0.12,95％ CI=-0.20-0.04,P=0.14),head circumference (OR=0.07,95％ CI=-0.83-0.96,P=0.88),lowdensity lipoprotein,high-density lipoprotein,direct bilirubin,serum creatinine (OR=-0.16,95％ CI=-0.59-0.26,P=0.45) between the infants receiving SMOF or Intralipid.But compared with the infants receiving Intralipid,hemoglobin (OR=-0.75,95％ CI=-1.49-0.00,P=0.05),red blood cells (OR=-0.23,95％ CI=-0.45-0.00,P=0.05) decreased in the infants receiving SMOF,and white blood cells (OR=1.91,95％ CI=0.46-3.37,P =0.01) increased.Conclusions SMOF can control the hemoglobin content in serum,reduce the risk and degree of jaundice in premature infant,with better safety.

To analyse the rate of intraplaque hemorrhage in symptomatic vertebral artery stenosis by high-resolution MRI / 实用医学杂志

Objective To compare the rate of intraplaque hemorrhage between symptomatic and asymptom-atic vertebral artery stenosis groups using high-resolution magnetic resonance imaging(HR-MRI).Methods The patients diagnosed with PCI and with vertebral artery stenosis using HR-MRI were enrolled retrospectively. They were divided into symptomatic and asymptomatic groups according to whether they were detected with PCI by the re-sponsible vertebral artery stenosis before examination. All patients underwent 3D time of flight magnetic resonance angiography(3D TOF MRA)to detect the stenosis location of vertebral artery and the stenosis rate at the narrow-est. T1-weighted fat-suppressed images were positioned on the atherosclerotic plaque that the signal 150% higher than the surrounding muscle was confirmed to be intraplaque hemorrhage. Statistical significance was assessed by chi-square test or Student′s unpaired t test.Results A total of 60 patients were included in this study,28 patients in the symptomatic group and 32 patients in the asymptomatic group.The rate of vertebral artery stenosis in asymp-tomatic group was higher than symptomatic group,but there was no statistical significance[(72 ± 33)% vs.(65 ± 28)%,P=0.383];the number of intraplaque hemorrhage in symptomatic group was significantly higher than that in the asymptomatic group(9 vs.2,P=0.024).Conclusions There is a higher rate of intraplaque hemorrhage in symptomatic vertebral artery stenosis group than asymptomatic group.Intraplaque Hemorrhage could be one of risk factor of acute ischemic cerebral disease.