Establishment and evaluation of a method for identifying the random error in the quantitative measurement procedure based on back propagation neural network / 中华检验医学杂志

Objective:To establish and evaluate a new real-time quality control method that can identify the random errors by using the backpropagation neural network (BPNN) algorithm and taking blood glucose test as an example.Methods:A total of 219 000 blood glucose results measured by Siemens advia 2 400 analytical system from January 2019 to July 2020 and derived from Laboratory Information System of Beijing Chaoyang Hospital Laboratory Department was regarded as the unbiased data of our study. Six deviations with different sizes were introduced to generate the corresponding biased data. With each biased data, BPNN and MovSD algorithms were used and tested, and then evaluated by traceability method and clinical method.Results:For BPNN algorithm, the block size was pre-set to 10 and the false-positive rate in all biases was within 0.1%. For MovSD, however, the optimal block size and exclusive limit were 150 and 10% separately and its false-positive rate in all biases was 0.38%, which was 0.28% higher than BPNN. Especially, for the least two error factors of 0.5 and 1, all the random errors were not detected by MovSD; for the error factor larger than 1, random errors could be detected by MovSD but the MNPed was higher than that of BPNN under all deviations. The difference was up to 91.67 times. 460 000 reference data were produced by traceability procedure. The uncertainty of BPNN algorithm evaluated by these reference data was only 0.078%.Conclusion:A real-time quality control method based on BPNN algorithm was successfully established to identify random errors in analytical phase, which was more efficient than MovSD method and provided a new idea and method for the identification of random errors in clinical practice.

Application of routine laboratory data in combination with machine learning in the differential diagnosis of lung tuberculosis / 中华检验医学杂志

Objective:To investigate the application value of establishing the differential diagnosis model of pulmonary tuberculosis using routine laboratory data.Methods:The retrospective study was conducted. The routine laboratory data of newly diagnosed patients with pulmonary tuberculosis and other pulmonary diseases in Beijng Jishuitan Hospital and Beijing Hepingli Hospital from May 2015 to November 2021were collected. According to the random numbers showed in the computer, all the 11516 patients were divided into training dataset and test dataset with a ratio of 9∶1. Four machine learning algorithms, Support Vector Machine, Random Forest, K-Nearest Neighbor and Logistic Regression, were used to build models and select features. The diagnostic accuracy of each model was verified by using the 10-fold cross-validation method and the performance of each model was evaluated by using the receptor operator of characteristic (ROC) curve.Results:Random Forest was selected as the optimal machine learning algorithm to build the best feature model in the study. According to importance scale of factors, the differential diagnosis model of pulmonary tuberculosis consisting of 37 non-specific test indexes. In the validation set and test set the accuracy and area under curve (AUC) of the models were 0.747 and 0.736, the sensitivity, specificity and accuracy were 68.03% and 68.75%, 70.91% and 67.90%, 70.30% and 68.12%, respectively.Conclusion:A key tool in the differential diagnosis model of pulmonary tuberculosis was established by routine laboratory data in combination with machine learning. The results of this study need to be further verified by more data from medical institutions.

The clinical value of the logistic regression model with a combination of three-dimensional CT quantitative and qualitative parameters in predicting the invasiveness of pure ground glass nodules / 中华放射学杂志

Objective:To explore the value of the logistic regression model with three-dimensional CT quantitative parameters in combination with qualitative parameters in predicting the invasiveness of pure ground glass nodules (pGGN).Methods:The clinical data and image features of 191 patients (196 lesions) with pGGN on CT confirmed as lung adenocarcinoma by pathology from April 2019 to December 2019 in Anhui Chest Hospital were retrospectively analyzed. Totally, 196 lesions were divided into atypical adenomatous hyperplasia (AAH)+adenocarcinoma in situ (AIS)+minimally invasive adenocarcinoma (MIA) group ( n=128) and invasive adenocarcinoma (IAC) group ( n=68). CT quantitative parameters included the maximum diameter, volume, average CT value and quality of pGGN, and the qualitative parameters included the intrinsic vascular changes, abnormal air-bronchogram, lobulated signs, bubble-like sign, pleura-traction sign, and fuzzy tumor-lung interface sign. The Mann-Whitney U test was used to compare the quantitative parameters and the Pearson χ 2 test was used to compare the qualitative parameters between two groups. The independent predictors of IAC and predictive probability value were screened by univariate analysis in combination with multivariate logistic regression analysis. The ROC curves were drawn to compare the diagnostic probability of logistic regression prediction probability and each single parameter. Results:There were statistically significant differences in maximum diameter [0.92(0.77,1.14) cm vs. 1.41(1.12, 1.93) cm, Z=-7.366, P<0.001], volume[0.31(0.20, 0.53) cm 3 vs. 0.88(0.41, 2.00) cm 3, Z=-6.254, P<0.001], average CT value[-571.5(-637.2, -477.0) HU vs. -418.1(-532.4, -338.5) HU, Z=-5.882, P<0.001], quality[0.14(0.09, 0.25) g vs. 0.42(0.26, 1.21) g, Z=-7.438, P<0.001], intrinsic vascular changes(23 vs. 49, χ2=55.906, P<0.001), abnormal air-bronchogram(13 vs. 30, χ2=29.908, P<0.001) and pleura-traction sign(39 vs. 32, χ2=5.291, P=0.021) between the two groups. The logistic regression analysis showed that the maximum diameter, average CT value, intrinsic vascular changes and abnormal air-bronchogram were the independent risk factors of IAC, and the odds ratio value(95%CI) were 10.624(1.275-88.522), 1.004(1.000-1.008), 3.424(1.458-8.043) and 2.993(1.114-8.043), respectively. The ROC curve demonstrated that the area under the curve, sensitivity and specificity of the logistic regression model were 0.899, 0.912, and 0.711 respectively, which were better than separate analysis results from each single parameter. Conclusion:The logistic regression model with a combination of three-dimensional CT quantitative and qualitative parameters can predict the invasiveness of pGGN better.

Effects of electrophysiological heterogeneity on vulnerability to re-entry in human ventricular tissue: A simulation study.

In this study, we constructed a two-dimensional ventricular tissue sheet with cellular electrophysiology modified from the Ten Tusscher 2006 Model. Heterogeneity was created by dividing the tissue into endocardium, midmyocardium and epicardium, further enhanced by a central ischemic zone. Subsequently, we investigated how electrophysiological heterogeneity affects re-entry initiation and maintenance in this tissue. Furthermore, we analyzed the vulnerable window (VW) under several conditions and concluded that heterogeneity across various myocardia expands the VW further than the monolayer myocardium model does.

Mutation detection in a case of Costello syndrome complicated by cutis laxa / 中华皮肤科杂志

Objective To report a case of Costello syndrome complicated by curis laxa,and to make a molecular genetic diagnosis.Methods Clinical data were collected from a case of Costello syndrome complicated by cutis laxa.Skin tissues were resected from the patient,and peripheral blood samples were obtained from the patient's parents and 150 unrelated healthy controls.Genomic DNA was extracted from these samples,and all the exons and their flanking sequences of the HRAS gene were analyzed by DNA sequencing.Results The 13-month-old female patient presented with growth retardation,severe malnutrition,coarse facial appearance,severely loose skin over the limbs,and decrease or disappearance of subcutaneous fat.A heterozygous mutation c.34G ＞ T (p.Gly12Cys) was detected in exon 2 of the HRAS gene in the patient,but not in her parents or 150 unrelated healthy controls.Conclusion The c.34G ＞ T (p.Gly12Cys) mutation in exon 2 of the HRAS gene may be responsible for Costello syndrome in the patient.

Low-energy defibrillation research using a rabbit ventricular model: optimizing the potential gradient distribution using multiple epicardial electrodes.

Cardiac potential gradient distribution directly affects defibrillation efficacy, and the electrode configuration that ensures optimal distribution is yet to be determined. In this study, a rabbit ventricular finite element conductor model containing blood perfusion in ventricular cavities was developed. The electric field was solved on the model by using 95% myocardial volume potential gradient higher than 5 V/cm as the successful defibrillation threshold (DFT). Multiple epicardial electrodes (MEE) protocols and a SCAN protocol were used to identify the optimum defibrillation method. Results showed that when using the SCAN protocol, DFT energy reduced to 4.3% that of the control group which had the traditional implantable cardioverter defibrillator current path. Rapidly switching scanning stimuli generated using MEE pairs is a promising low-energy defibrillation method. For multiple electrodes defibrillation, the distribution of the electrode pairs determine the defibrillation efficacy, and the counteraction effect has negative effect on defibrillation. These findings can provide suggestions for clinical applications.

A study of CT perfusion imaging before and after radiotherapy for solid lung cancer / 中华放射肿瘤学杂志

Objective To analyze the perfusion status of lung cancer before radiotherapy and the relationship between changes in CT perfusion parameters after radiotherapy and the efficacy of radiotherapy.Methods Twenty-eight patients clinically and pathologically diagnosed with lung cancer were enrolled as subjects.Those patients received CT perfusion imaging scan and perfusion parameters including blood flow (BF),blood volume (BV),mean transit time (MTT),and permeability surface (PS) were calculated.We use linear correlation analysis for relation between value of CT perfusion imaging and the target volume of lung cancer before radiotherapy,t-test for difference between the remission groups and non-remission groups,compared paired sample t-test for value of CT perfusion imaging before and after radiotherapy.Results According to the efficacy of radiotherapy,28 patients with lung cancer were divided into response group (n=16) and non-response group (n=12).The response group had significantly smaller tumor sizes before and after radiotherapy than the non-response group (58.72±22.95 cm3 vs.24.53±13.79 cm3,P=0.000).However,there was no significant correlation of target volume before radiotherapy with any perfusion parameter (P=0.628).The response group had significantly larger BF and BV than the non-response group before radiotherapy (1.23±1.36 vs.6.42±2.57,P=0.024 and 1.23±0.31 vs.0.59±0.18,=0.041),suggesting a low perfusion state of tumor tissue in the non-response group.However,there were no significant differences in MTT and PS between the two groups (0.93±0.58 vs.0.93±0.66,P=0.851 and 1.46±0.83 vs.1.17±0.56,P=0.141).All the 28 patients had significantly smaller BF,BV,MTT,and PS after radiotherapy (9.81±3.56 vs.7.48±3.31,P=0.006;0.96±0.41 vs.0.64±0.38,P=0.003;0.93±0.60 vs.0.53±0.30,P=0.007;1.34±0.73 vs.0.74±0.44,P=0.001).Conclusions CT perfusion imaging can predict the efficacy of radiotherapy for lung cancer,which may guide the planning and implementation of precise radiotherapy for lung cancer.

Study on Accurately Controlling Discharge Energy Method Used in External Defibrillator / 中国医疗器械杂志

This paper introduces a new method which controls discharge energy accurately. It is achieved by calculating target voltage based on transthoracic impedance and accurately controlling charging voltage and discharge pulse width. A new defibrillator is designed and programmed using this method. The test results show that this method is valid and applicable to all kinds of external defibrillators.

Low-energy defibrillation with multi-electrodes stimulation: A simulation study.

The objective of this study is to explore the possible ways to reduce defibrillation energy and further reveal the mechanism of electric defibrillation. A bidomain simulation study was performed on a rabbit whole-ventricle electrophysiological model and the feasibility of the defibrillation strategy with multi-electrodes stimulation was verified. Simulation results indicate that the new approach is effective in low-energy defibrillation.

The Efficacy Analysis of U100plus Laser in Treatment of Incarcerated Gallbladder Stones / 天津医药

Objective To investigate the application of U100plus laser in treating incarcerated in gallbladder stones. Methods The clinical data of 52 patients accepted U100plus laser lithotripsy of gallbladder neck incarcerated were retrospective analyzed. Results All 52 patients were successful treated by surgery. Twelve patients with gallbladder wall edema, drainage tubes were used to prevent bile leakage after gallbladder surgery. After 2~4 d, the ultrasound examination showed that no abnormal drainage, and tube was removed. The mean operative time was 40 min. The mean intraoperative bleeding was 2 mL. Patients were able to get out of bed 1 day after surgery. The average length of hospital stay was 4 d. Pa-tients were followed up for 6 to 30 months, and no special discomfort, The ultrasonography showed no stone recurrence. Conclusion U100plus laser lithotripsy is a safe and effective method for treating incarcerated gallbladder stones.

Study on the clinical epidemiological features of acute cerebral stroke inducing systemic inflammatory response syndrome and multiple organ dysfunction syndrome / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the risks on acute cerebral stroke (ACS) inducing systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS).</p><p><b>METHODS</b>Data from 1751 patients with acute cerebral stroke were studied by prospective analysis.</p><p><b>RESULTS</b>In all of the ACS patients,the incidence rate (IR) of SIRS was 36.50% with 205 patients having ACS inducing MODS, to which the IR was 11.71%, and 93 deaths. The case fatality ratio (CFR) was 45.37%. The pathogeneses condition of patients and the MR after the occurrence of MODS had positive correlation with the numbers of dysfunction organs. Study on single factor analysis revealed that the incidence of MODS had some related risk factors in the ACS inducing MODS, including age, diseased region close to the mean line, GCS, level of blood sugar, blood white cell count and the chronic disease history etc. The IR of ACS inducing SIRS and MODS was much higher in the condition of the diseased region near the mean line and the ACS of the basilar artery system.</p><p><b>CONCLUSION</b>SIRS seemed the base for MODS while the probability and the development degree were not only involved ACS but also SIRS. MODS induced by ACS could be reduced through the second grade program of disease precaution. The detection of those risk factors in the early period of the ACS course could provide some prediction of the prognosis and turnover, thus some early use of intervention methods might be helpful in the treatment of the disease.</p>

The Effect of the Swimming Exercise on Functional Recovery after Experimental Contusive Spinal Cord Injury in the Rats

OBJECTIVE: This study was designed to see the effect of swimming exercise in the rats after experimental contusive spinal cord injury. METHOD: Twenty six Sprague-Dawley rats (weight, 300 to 350 g) were divided into control (n=9) and experimental swimming groups (n=17). With the Spinal Cord Dropping Device (NYU, U.S.A.), contusive injury to the spinal cord was induced at the eighth thoracic level in both groups. Rats of the experimental group put to swim for 5 minutes a day during the second week and then swimming times a day were increased in one number to each week. But the other ten rats were remained without swimming exercise as the control. Functional recovery of the hind limb was evaluated by the inclined board plane test, the Bassoe Beattie Bresnahan (BBB) locomotor rating scales and histological findings of injured spinal cord. RESULTS: 1) Upward maximal angles of the inclined plane test were significantly greater in experimental group than control group after 10 days post-injury (p<0.05). 2) BBB scores were higher in experimental group than control group at 14 days after injury (p<0.05). CONCLUSION: This study suggests that swimming applied from the early phase after spinal cord injury be beneficial in the early recovery of motor function.

Effects of H_2O_2 and 11,12-EET in EDHF mediated relaxation in the rat basilar arteries / 中国临床药理学与治疗学

AIM:To study the effects of Hydrogen Peroxide(H2O2)and 11,12-epoxyeicosatrienoic acid(11,12-EET)on EDHF-mediated relaxation in the rat basilar arteries.METHODS: The relaxant effects of acetylcholine(ACh),H2O2,11,12-EET,and catalase(CAT) on rat arteria basilaris in vitro were detected by vasomotoricity experiment in vitro.RESULTS: In the rat basilar arteries,preconstricted by 30 mmol/L KCl in vitro,ACh(10-7-10-4.5 mol/L) had the concentration-dependent relaxation effect.3?10-5 mol/L N?-nitro-L-arginine-methyl-ester(L-NAME) and 10-5 mol/L indomethacin(Indo) could partly inhibit the relaxation effect of ACh to the rat basilar arteries,but non-No/non-PGI2-mediated relaxation was still significant(P

Comparison of Four Commercially Available ELISA Kits for Detecting HSV-2 Type-specific IgG Antibodies / 中华皮肤科杂志

Objective To compare the validity of four commercially available ELISA kits for detecting HSV-2 type-specific IgG antibodies. Methods A total of 125 serum specimens were collected from 105 patients with genital ulcers and 20 normal individuals without history of STDs. Four ELISA kits which are commercially available in China for the detection of HSV-2 type-specific IgG antibodies were selected for the evaluation. Western blot assay was used as the gold standard. Results Based on the results of detection by Western blot assay, the sensitivity and specificity of these ELISA kits including home-made 1, home-made 2, improted 1 and improted 2 were 13.1% and 98.4%, 7.5% and 100%, 100% and 11.1%, 87.7% and 96.7%, respectively. The areas under the ROC curve of three kits including home-made 1, imported 1 and imported 2 were 0.885 (0.822 - 0.948), 0.852 (0.747 - 0.902), 0.947 (0.950 - 0.998), respectively. Conclusions The results of imported 2 are well consistent with those of Western blot, while the results of other 3 kits are poorly consistent with those of Western blot. It is also indicated that the commercially available ELISA kits for detecting HSV-2 type-specific antibodies should be re-evaluated in terms of their validity befor being applied for the clinical diagnosis as well as laboratory research.