目的:探討米非司酮治療異位妊娠的療效,安全性及對患者生育的影響。方法:選取符合保守治療條件患者31例,觀察米非司酮治療異位妊娠過程中的臨床癥狀,各項試驗室指標的變化;出現不良反應的幾率及嚴重程度;治療后輸卵管的通暢情況,以判斷是否對患者生育造成影響。結果:治療成功率為87.09%;不良反應出現率為19.35%,均為輕度不適;成功病例中未育患者輸卵管通暢率為100%。結論:米非司酮是一種治療異位妊娠的高效藥物,具有安全性高,不良反應少,對生育無影響的優點。
Objective To study the clinical significance of gasdermin-D（GSDMD) and caspase-1 expressions in the invasive ductal breast carcinoma. Methods Seventy-seven female patients with invasive ductal carcinoma of breast performed radical resection in the 904th Hospital of Joint Logistic Support Force of PLA from January 2015 to June 2016 were selected as the research object. The expressions of GSDMD and caspase-1 protein in cancer tissues and 20 adjacent tissues were detected by immunohistochemistry, and their correlation with clinicopathological features was analyzed. Kaplan-Meier analysis was used to draw the survival curve, and log-rank test was used for univariate survival analysis, and Cox proportional hazards regression analysis of prognostic factors in patients with breast invasive ductal carcinoma. Results The proportion of high expression of GSDMD and caspase-1 protein in adjacent tissues were significantly higher than those in breast cancer tissues (P<0.05). Univariate analysis results showed that the survival time of patients with invasive ductal carcinoma of breast were correlated with lymphatic metastasis, TNM staging, and the expression status of progesterone receptor, GSDMD, caspase-1 and Ki-67 (P<0.05). Multivariate analysis results showed that the low expression of GSDMD protein [HR=4.096, 95%CI (1.102, 15.216), P<0.05] and low expression of caspase-1 protein [HR=3.945, 95%CI (1.062, 14.652), P<0.05] were the independent risk factor that affect the survival rate of patients with invasive ductal carcinoma of breast. Conclusion The low expression of GSDMD and caspase-1 protein in invasive ductal carcinoma of breast are independent risk factors for postoperative survival.
Objectives To systemically review and investigate the efficacy of intensive glucose control in Type 2 diabetes mellitus. Methods Database searches of MEDLINE, EMBASE, Cochrane Controlled Trials Register, VIP Database, CNKI, and CBM disc (from the date of establishment of the databases to June 2009) were conducted. Additional studies were retrieved via references of articles and direct contact with the authors to retrieve relevant data. Prospective, randomized controlled trials of intensive glucose control compared with standard therapy in diabetic patients were selected. We accessed the quality of included trials and extracted the relevant data. Statistical analysis was performed using The Cochrane Collaboration’s software RevMan 5.0. Results Eight trials with a total of 37 004 participants were included. The Meta-analysis showed: intensive glucose therapy was associated with a significant 9% reduction in the odds of cardiovascular events [OR=0.91, 95%CI (0.85, 0.98), P=0.007], and a 26% reduction in the microvascular events [OR=0.74, 95%CI (0.60, 0.91), P=0.005]. For the peripheral vascular events, no statistical difference was found between intensive therapy and standard therapy [OR=0.94, 95%CI (0.83, 1.07), P=0.35]. No statistical difference could be found in total mortality [OR=1.00, 95%CI (0.92, 1.08), P=0.98] and cardiovascular mortality [OR=1.03, 95%CI (0.83, 1.28), P=0.77]. Intensive therapy could increase more than 1.1-fold odds of hypoglycemia compared with standard-therapy [OR=2.12, 95%CI (1.24, 3.60), P=0.006]. Conclusions Findings from this meta-analysis suggest that intensive glucose control significantly reduces the risk of cardiovascular events and microvascular events, and increases the risk of hypoglycemia, while no prominent difference is found in mortality.
In order to overcome the shortcomings of high false positive rate and poor generalization in the detection of microcalcification clusters regions, this paper proposes a method combining discriminative deep belief networks (DDBNs) to automatically and quickly locate the regions of microcalcification clusters in mammograms. Firstly, the breast region was extracted and enhanced, and the enhanced breast region was segmented to overlapped sub-blocks. Then the sub-block was subjected to wavelet filtering. After that, DDBNs model for breast sub-block feature extraction and classification was constructed, and the pre-trained DDBNs was converted to deep neural networks (DNN) using a softmax classifier, and the network is fine-tuned by back propagation. Finally, the undetected mammogram was inputted to complete the location of suspicious lesions. By experimentally verifying 105 mammograms with microcalcifications from the Digital Database for Screening Mammography (DDSM), the method obtained a true positive rate of 99.45% and a false positive rate of 1.89%, and it only took about 16 s to detect a 2 888 × 4 680 image. The experimental results showed that the algorithm of this paper effectively reduced the false positive rate while ensuring a high positive rate. The detection of calcification clusters was highly consistent with expert marks, which provides a new research idea for the automatic detection of microcalcification clusters area in mammograms.
Abstract： Objective To investigate the cerebral protective effects of hyperoxia management during deep hypothermia circulatory arrest（DHCA） rabbit by the blood gas indexes, superoxide dismutase（ SOD） activity and malondialdehyde （MDA） levels of brain, and ratio of water to brain. Methods A DHCA and antegrade selective cerebral perfusion （ASCP） rabbit model was established. Twenty-four 11-13 week-old male New Zealand rabbits（ weighing 2.7 to 3.4 kg） were assigned to three groups with a random number table: a sham operation group （Sham group）, an ASCP group （S group）, and an ASCP ＋ hyperoxia management group （SH group）. There were eight rabbits in each group. We recorded the intraoperative values for arterial oxygen pressure （PaO2）, arterial oxygen saturation （SaO2）, jugular venous oxygen pressure（PjvO2）, jugular venous oxygen saturation（ SjvO2） and blood lactate level. The brain SOD activity, MDA levels, and ratio of water to brain were measured after the operation. Results Before initiating circulatory arrest, before initiating reperfusion and five minutes of reperfusion, levels of PaO2 , PjvO2 , and SjvO2 in the SH group were significantly higher than those of the S group and Sham group. SOD activity in the SH group was not significantly different from that of the S group[（213.53±33.52） U/mg. prot vs. （193.02±27.67） U/mg. prot] and Sham group[（213.53±33.52） U/mg. prot vs.（244.38±35.02）U/mg. prot], but the SOD activity in the S group was lower than that in the Sham group（ P ＜ 0.05）. MDA levels in the SH group were lower than that in the S group[（1.42±0.30） nmol/mg. prot vs. （2.37±0.55） nmol/mg. prot, P ＜ 0.05]. Conclusion Our data show that hyperoxia management during DHCA＋ASCP improves rabbits’PjvO2 and SjvO2, maintains brain SOD activity, and decreases brain MDA levels, demonstrating the neuroprotective effects of hyperoxia mangagement.
OBJECTIVE: To investigate the selection and manufacture of ideal extracellular matrix materials in bone tissue engineering. METHODS: The recent literatures about biodegradable polymers served as culture scaffolds of osteoblasts were widely reviewed, the advantages and disadvantages of biodegradable synthetic polymers and natural polymers were analysed. RESULTS: The ideal extracellular matrix material in bone tissue engineering should be made up of inorganic materials, synthetic polymers and natural polymers, which possesses morphological structure of three-dimensional foam with self-mediated drug slow delivery system of bone growth factors. CONCLUSION: The design and manufacture of combined extracellular matrix materials in bone tissue engineering is a very important and urgent challenge.
In order to improve the motion fluency and coordination of lower extremity exoskeleton robots and wearers, a pace recognition method of exoskeleton wearer is proposed base on inertial sensors. Firstly, the triaxial acceleration and triaxial angular velocity signals at the thigh and calf were collected by inertial sensors. Then the signal segment of 0.5 seconds before the current time was extracted by the time window method. And the Fourier transform coefficients in the frequency domain signal were used as eigenvalues. Then the support vector machine (SVM) and hidden Markov model (HMM) were combined as a classification model, which was trained and tested for pace recognition. Finally, the pace change rule and the human-machine interaction force were combined in this model and the current pace was predicted by the model. The experimental results showed that the pace intention of the lower extremity exoskeleton wearer could be effectively identified by the method proposed in this article. And the recognition rate of the seven pace patterns could reach 92.14%. It provides a new way for the smooth control of the exoskeleton.
Existing arrhythmia classification methods usually use manual selection of electrocardiogram (ECG) signal features, so that the feature selection is subjective, and the feature extraction is complex, leaving the classification accuracy usually affected. Based on this situation, a new method of arrhythmia automatic classification based on discriminative deep belief networks (DDBNs) is proposed. The morphological features of heart beat signals are automatically extracted from the constructed generative restricted Boltzmann machine (GRBM), then the discriminative restricted Boltzmann machine (DRBM) with feature learning and classification ability is introduced, and arrhythmia classification is performed according to the extracted morphological features and RR interval features. In order to further improve the classification performance of DDBNs, DDBNs are converted to deep neural network (DNN) using the Softmax regression layer for supervised classification in this paper, and the network is fine-tuned by backpropagation. Finally, the Massachusetts Institute of Technology and Beth Israel Hospital Arrhythmia Database (MIT-BIH AR) is used for experimental verification. For training sets and test sets with consistent data sources, the overall classification accuracy of the method is up to 99.84% ± 0.04%. For training sets and test sets with inconsistent data sources, a small number of training sets are extended by the active learning (AL) method, and the overall classification accuracy of the method is up to 99.31% ± 0.23%. The experimental results show the effectiveness of the method in arrhythmia automatic feature extraction and classification. It provides a new solution for the automatic extraction of ECG signal features and classification for deep learning.
Objective To systemically review the efficacy and safety of dopamine versus norepinephrine in patients with septic shock. Methods Database searches of MEDLINE, EMbase, Cochrane Controlled Trials Register, VIP, CNKI, and CBM (from the date of database establishment to June 2011) were conducted. Additional studies for collecting relevant data were retrieved via both references of articles and direct contact with authors. Prospectively, randomized controlled trials (RCTs) of dopamine compared with norepinephrine therapy in septic shock patients were selected. The quality of included trials was assessed and relevant data were extracted. Then statistical analysis was performed using RevMan 5.1. Results Nine trials with 3 179 participants were included. The results of meta-analysis showed: compared with norepinephrine, dopamine was associated with a significant 12% elevation in the risk ratio of in-hospital death events of septic shock patients (RR=1.12, 95%CI 1.04 to 1.21, P=0.002). The risk of arrhythmias in dopamine group was 2.63-fold than that in norepinephrine group (RR=2.63, 95%CI 1.51 to 4.55, P=0.000 6). The cardiac index of septic patients in dopamine group was higher than that in norepinephrine group (MD=0.42, 95%CI 0.21 to 0.63, Plt;0.000 1). No significant difference could be found in the heart rate (MD=17.05, 95%CI –0.71 to 34.81, P=0.06) and mean arterial pressure (MD= –0.87, 95%CI –24.97 to 7.62, P=0.30). Conclusion Findings from this meta-analysis suggest that compared with dopamine, norepinephrine significantly reduces both 28-day mortality of septic shock patients and incidence rate of arrhythmias. Norepinephrine is better than dopamine in aspects of efficacy and safety.
Objective To investigate the etiological distribution of the patients with optic neuritis in China and compare the results with those in western countries. Methods Ophthalmological and neurological detailed clinical and laboratorial examinations were performed on 204 patients with primarily diagnosed optic neuritis (ON). We determined the etiologies using international accepted diagnostic criteria. Results Among 113 patrents with ON, 83(73.5%) were considered as with idiopathic demyelinating optic neuritis ( IDON). Sinusitis was common in these patients but was considered to be the probable cause of ON only in 4. Tuberculo-meningitis caused ON was found in 2 cases and syphilitic ON in 1. The causes of 23 cases (20.4%) were unknown. Conclusions Idiopathic demyelinating ON is the most common pathogeny of ON. Despite of some minor differences of causes and prognosis, the etiology of presumed ON in our population is similar to that reported in western countries. (Chin J Ocul Fundus Dis,2006,22:367-369)