Objective To develop a Matlab toolbox to improve the efficiency of musculoskeletal kinematics analysis while ensuring the consistency of musculoskeletal kinematics analysis process and results. Methods Adopted the design concept of “Batch processing tedious operation”, based on the Matlab connection OpenSim interface function ensures the consistency of musculoskeletal kinematics analysis process and results, the functional programming was applied to package the five steps for scale, inverse kinematics analysis, residual reduction algorithm, static optimization analysis, and joint reaction analysis of musculoskeletal kinematics analysis as functional functions, and command programming was applied to analyze musculoskeletal movements in large numbers of patients. A toolbox called LLMKA (Lower Limbs Musculoskeletal Kinematics Analysis) was developed. Taking 120 patients with medial knee osteoarthritis as the research object, a clinical researcher was selected using the LLMKA toolbox and OpenSim to test whether the analysis process and results were consistent between the two methods. The researcher used the LLMKA toolbox again to conduct musculoskeletal kinematics analysis in 120 patients to verify whether the use of this toolbox could improve the efficiency of musculoskeletal kinematics analysis compared with using OpenSim. Results Using the LLMKA toolbox could analyze musculoskeletal kinematics analysis in a large number of patients, and the analysis process and results were consistent with the use of OpenSim. Compared to using OpenSim, musculoskeletal kinematics analysis was completed in 120 patients using the LLMKA toolbox with only 2 operations were needed to enter the patient body mass data, operating steps decreased by 99.19%, total analysis time by 66.84%, and manual participation time by 99.72%, just need 0.079 1 hour (4 minutes and 45 seconds). Conclusion The LLMKA toolbox can complete a large number of musculoskeletal kinematics analysis in patients with one click in a way that is consistent in process and results with using OpenSim, reducing the total time of musculoskeletal kinematics analysis, and liberating clinical researchers from cumbersome steps, making more energy into the clinical significance of musculoskeletal kinematics analysis results.
ObjectiveTo construct an intelligent ultrasound diagnosis system for breast nodules in patients with thyroid dysfunction using deep learning algorithms. MethodsA retrospective analysis was collected breast ultrasound images of 178 patients with thyroid dysfunction from the ultrasound database of the First Affiliated Hospital of Xinjiang Medical University from January 2023 to February 2024, which served as the training set. The deep learning algorithm was used to construct an intelligent ultrasound diagnosis system for breast nodules in patients with thyroid dysfunction. In addition, a retrospective analysis was collected breast ultrasound images of 81 patients with thyroid dysfunction from the ultrasound database of the First Affiliated Hospital of Xinjiang Medical University from March 2024 to January 2025, which served as the validation set. The above system was used as validation set to diagnose whether patients with thyroid dysfunction had breast nodules, and the diagnostic efficacy of imaging physicians’ diagnosis and the intelligent ultrasound diagnosis system for breast nodules in patients with thyroid dysfunction was analyzed. The consistency between the diagnosis of ultrasound physicians, intelligent ultrasound diagnosis system and the “gold standard” was tested by Kappa test. ResultsThere was no statistically significant difference in age, type of thyroid dysfunction, disease duration, number of breast nodules, and other clinical data between the training set and the validation set (P>0.05). The time required for the training set intelligent ultrasound diagnostic system to diagnose a single breast ultrasound image was (0.04±0.01) min, which was lower than that of an ultrasound specialist [(12.36±2.58) min], t=63.709, P＜0.001. The sensitivity, specificity, accuracy, and area under the curve (AUC) of detecting breast nodules in patients with thyroid dysfunction using an intelligent ultrasound diagnostic system were 97.87% (46/47), 100% (34/34), 98.77% (80/81), and 0.997 [95%CI: (0.951, 1.00)], respectively. The sensitivity, specificity, accuracy, and AUC of detecting breast nodules by ultrasound physicians were 89.36% (42/47), 91.18% (31/34), 90.12% (73/81), and 0.904 [95%CI: (0.818, 0.958)], respectively. The AUC of the intelligent ultrasound diagnosis system was higher than that of the ultrasound physician (Z=2.673, P=0.008). The detection results of breast nodules in patients with thyroid dysfunction diagnosed by ultrasound physicians were generally consistent with the “gold standard” (Kappa value=0.799, P＜0.001), while the intelligent ultrasound diagnosis system was in good agreement with the “gold standard” (Kappa value=0.975, P＜0.001). The confusion matrix results showed that the number of false positives was 3 and 0 for the ultrasound department physicians and the intelligent ultrasound diagnostic system, respectively, while the number of false negatives was 5 and 1. The calibration curve results indicated a high consistency between the diagnostic probability and the actual probability of the intelligent ultrasound diagnostic system, with the calibration curve fitting well with the ideal curve (Hosmer-Lemeshow test: χ2=1.246, P=0.997). ConclusionThe intelligent ultrasound diagnosis system for breast nodules in patients with thyroid dysfunction constructed by deep learning algorithm has good diagnostic efficacy, which can help ultrasound physicians improve screening efficiency and accuracy.
Objective To evaluate the teaching effect of case-based learning (CBL) combined with team-based learning (TBL) pedagogy in laboratory diagnostics education. Methods The data of the undergraduate clinical-medical students who completed the laboratory diagnostics course between September 2021 and July 2023 at West China School of Medicine of Sichuan University were retrospectively collected. Among them, the undergraduates of grade 2020 adopted the CBL+TBL combined pedagogy, while the undergraduates of grade 2019 assumed the traditional lecture-based learning (LBL) teaching method. Based on the cluster sampling method with the whole grade as the sampling unit, comparative effectiveness was assessed via examination scores and questionnaire feedback. Results A total of 303 students received the CBL+TBL teaching method (CBL+TBL group), while 289 students received the LBL teaching method (LBL group). Compared with the LBL group, the CBL+TBL group had higher scores on the clinical case discussion (90.28±4.05 vs. 88.39±5.19, P<0.001) while lower scores on the theoretical quiz (83.89±12.55 vs. 88.77±10.46, P<0.001). The overall performance of the CBL+TBL group was worse than the LBL group (61.28±3.83 vs. 61.98±3.98, P=0.028). A total of 161 valid copies of questionnaire were collected from the CBL+TBL group. Among them, more than 70% of the students believed that CBL+TBL pedagogy could improve learning motivation, independent learning ability, and team communication and assistance ability. Compared with the LBL teaching mode, 74.5% of the students preferred the CBL+TBL pedagogical approach. Conclusion The CBL+TBL pedagogy can help to improve autonomic learning, teamwork, and problem-solving ability, and a combination with LBL teaching may be utilized to enhance theoretical scores.
ObjectiveTo measure the operational efficiency and explore the phenomenon of the economy of scale in secondary public general hospitals of China for improving the health service efficiency.MethodsFrom February to August 2019, the data set of two input indicators (the number of employees and actual open beds) and two output indicators (the numbers of outpatients and discharges) in 511 secondary general hospitals of Shandong, Anhui, Shanxi, Hubei and Hainan provinces in 2018 were collected for data envelopment analysis. The analysis processes were three folds: First, the technical efficiency, pure technical efficiency, scale efficiency and scale compensation status of the sample hospitals were calculated respectively. Second, the comparative analysis of efficiency value and scale compensation status was carried out in 5 groups according to the bed scale. Finally, the input and output projection analysis was carried out on the ineffective decision making units.ResultsThe medians of technical efficiencies, pure technical efficiencies, and scale efficiencies of the 511 secondary general hospitals were 0.472, 0.531, and 0.909, respectively. In the 511 hospitals, 493 hospitals (96.5%) were in ineffective state, of which 321 hospitals (62.8%) were in the state of decreasing return to scale. The staff redundancy of the group with beds >100 and ≤300 was 23.86%, and its service quantity could be increased by 39.37%.ConclusionsThe overall operating efficiencies are inefficiency in secondary general hospitals of China and the optimal scale of actual open beds is between 300 and 500 beds from the perspective of scale efficiency.
Objective To analyze the dynamic efficiency of township hospitals. Methods Based on the DEA-Malmquist index, this research analyzed the change of the total factor productivity indices and the decomposition items of 281 township hospitals in Hunan province with panel data from 2000 to 2008. Results Among 281 township hospitals, less than half increased their scale efficiency, while more than half increased their total factor productivity, technology, whole efficiency and technical efficiency. Increasing technology and whole efficiency was the best way to improve total factor productivity. Besides, increasing technical efficiency and scale efficiency was the best way to improve whole efficiency. Conclusions The improvement of scale efficiency is key to developing the central township hospitals, while the improvement of technology is the key to developing general township hospitals.
The antitumor activity of hyperthermia combined with mitomycin(MMC),5-fluorouracil(5-Fu)was observed in human gastric carinoma cell line MGC-803.The study was aimed at understanding the percentage of living carcinoma cell,plating efficiency and survival fraction.The results showed that hyperthermia combinedwith MMC had a synergistic antitumor activity which was enhanced with temperature increasing,but it was not the same as hyperthermia combined with 5-Fu.In comparison with simple hyperthermia,the antitumor activity of hyperthermia combined with 5-Fu was enhanced at lower temperture.This results raises a basis of clinical practice.
With chronic kidney disease becoming a public health problem in the world, dialysis treatment model has also become the focus of attention from all walks of life. Sustained low-efficiency dialysis, which adopts the mode of low blood flow and low dialysis volume, is a kind of hybrid renal replacement therapy combining continuous renal replacement therapy and intermittent hemodialysis. It has unique advantages in the treatment of patients with acute and severe renal injury, as well as the dialysis duration, patient activity range and cost. It is the most widely used hybrid renal replacement therapy too. This review summarizes the clinical application and nursing points of sustained low-efficiency dialysis to provide guidance for clinical practice.
ObjectiveTo explore the value of magnetic resonance diffusion weighted imaging (DWI) in preoperative Bismuth-Corlette classification of hilar cholangiocarcinoma (HCCA). MethodsA total of 53 HCCA patients confirmed by postoperative pathology were retrospectively included. The accuracy of two sequence combinations, namely dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) + magnetic resonance cholangiopancreatography (MRCP) and DCE-MRI + MRCP + DWI, in evaluating the longitudinally involved bile duct segments and Bismuth-Corlette classification of HCCA was compared. Additionally, the correlation between apparent diffusion coefficient (ADC) values and tumor Bismuth-Corlette classification as well as degree of differentiation was analyzed. ResultsThere were 318 bile duct segments in 53 HCCA patients. The accuracy rate of DCE-MRI + MRCP was 93.7% (298/318), the sensitivity was 91.5% (161/176), and the specificity was 96.5% (137/142). The accuracy rate of DCE-MRI + MRCP + DWI was 96.5% (307/318), the sensitivity was 96.0% (169/176), and the specificity was 97.2% (138/142). Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve (AUC) of DCE-MRI + MRCP + DWI was 0.966 [95%CI (0.940, 0.983), P＜0.001], and its diagnostic efficacy was superior to that of DCE-MRI + MRCP [AUC=0.940, 95%CI (0.908, 0.963), P＜0.001]. The DeLong test indicated a statistically significant difference in AUC between the two sequences (Z=2.633, P＜0.01). The accuracy rates of preoperative Bismuth-Corlette classification of HCCA evaluated by DCE-MRI + MRCP and DCE-MRI + MRCP + DWI were 86.8% (46/53) and 94.3% (50/53), respectively. After adding the DWI sequence, the consistency between Bismuth-Corlette classification results and surgical pathological classification results (Kappa=0.922, P<0.001) was higher than that of DCE-MRI + MRCP sequence (Kappa=0.820, P<0.001), with a statistically significant difference (χ2=160.370, P<0.001). In addition, the ADC value of HCCA was negatively correlated with tumordegree of differentiation (rs=–0.524, P<0.001), but had no significant correlation with its Bismuth-Corlette classification (rs=–0.058, P=0.682). ConclusionsDCE-MRI + MRCP + DWI sequence can effectively improve the accuracy in preoperative evaluation of the involvement of bile duct segments and Bismuth-Corlette classification of HCCA, which provides guidance for precise preoperative surgical planning in clinical practice. In addition, the ADC value can provide additional information required for non-invasive preoperative prediction of the prognosis of HCCA patients.
There are few researches on the modulation effect of transcranial direct current stimulation(tDCS) on complex spatial cognition. Especially, the influence of tDCS on the neural electrophysiological response in spatial cognition is not yet clear. This study selected the classic spatial cognition task paradigm (three-dimensional mental rotation task) as the research object. By comparing the changes in behavior and event-related potentials in different modes of tDCS before, during and after the application of tDCS, this study analyzed the behavioral and neurophysiological effects of tDCS on mental rotation. The comparison between active-tDCS and sham-tDCS showed no statistically significant difference in behavior between different stimulation modes. Still, the changes in the amplitudes of P2 and P3 during the stimulation were statistically significant. Compared with sham-tDCS, the amplitudes of P2 and P3 in active-tDCS mode showed a greater decrease during the stimulation. This study clarifies the influence of tDCS on the event-related potentials of the mental rotation task. It shows that tDCS may improve the brain information processing efficiency during the mental rotation task. Also, this study provides a reference for an in-depth understanding and exploration of the modulation effect of tDCS on complex spatial cognition.
ObjectiveTo investigate the perioperative hemodynamic changes of off-pump coronary artery bypass grafting (OPCABG) patients monitored by pulse recorded analysis method (MostCare/PRAM devices) and its relationship with the prognosis.MethodsA total of 89 patients who underwent OPCABG from October 2016 to January 2017 in Beiijng Anzhen Hospital were included, including 53 males and 36 females aged 60.50±8.40 years. The hemodynamic changes were recorded. The patients were divided into two groups (a major adverse cardiovascular events group and a stable group) according to whether major adverse cardiovascular events occurred or not. The difference of hemodynamic changes between the two groups was analysed.ResultsThe mean percentage increases of stroke volume (SV) in the passive leg raising (PLR) test before opening chest and after chest closure were 23.00%±3.20% and 29.40%±3.70%, respectively. Hemodynamic data were analysed seven times, namely, anaesthesia, opening chest, heparin administration, coronary artery bypass grafting, protamine administration, thoracic closure and after operation. SV was significantly decreased during above periods, while systemic vascular resistance index (SVRI) was significantlyincreased. Cardiac circle efficiency (CCE) and maximum pressure gradient (dP/dT) were decreased after anaesthesia, and decreased to the lowest value during the procedure of bypass grafting, and then they began to increase gradually after the manipulation of bypass grafting was finished. Stroke volume variation (SVV) and pulse pressure variation (PPV) were slightly decreased during anaesthesia, then increased significantly through the whole surgery. Major adverse cardiovascular events occurred in 9 patients and 4 of them died. The basic mean values of SVRI, SVV and PPV of patients in the major adverse cardiovascular events group before opening chest were significantly higher than those of patients in the stable group. There was no significant difference in the mean values of CCE, dP/dT or SV between the two groups. There was no significant correlation between the prognosis and the mean values of SVRI, SVV, PPV, CCE, dP/dT or SV.ConclusionThe hemodynamic indexes are not stable, thus, it is necessary to monitor the perioperative hemodynamic changes of OPCABG patients timely by MostCare/PRAM device and adjust treatment measures accordingly.