In order to accurately evaluate the similarity of motions during daily rehabilitation training for stroke patients, this paper proposed a novel quantitative assessment method based on dynamic time warping (DTW) algorithm. Firstly, the raw accelerometer signals were preprocessed to eliminate the noise. Secondly, the similarity between the accelerometer signals and four standard task templates was calculated respectively, and then the motion was recognized based on the similarity measurements. Finally, the corresponding quantitative assessment model was used to compute the result. The clinical experimental results showed that there were significant differences in the shortest path distance (R value) of DTW between different tasks, and the classification accuracy could be up to 91% when the R value was selected as the classification feature. Additionally, with the process of rehabilitation, the R value decreased gradually, which means that the R value can be taken as the assessment index to evaluate the quality of designated tasks for stroke patients. It also indicated that the R value could be applied into the scene of automatic prescription generation and interactive gaming to determine whether it is needed to change the rehabilitation plan or adjust the game difficulty level, so as to implement the individualized rehabilitation services.
ObjectiveTo evaluate the changes of the flow parameters before and after the anastomotic port exploration and dredging during coronary artery bypass grafting by using the transit time flow measurement (TTFM).MethodsA total of 167 patients who underwent continuous coronary artery bypass grafting and anastomotic port exploration and dredging surgery in Beijing Anzhen Hospital from 2018 to 2019 were enrolled in this study. There were 136 male and 31 female patients aged 41-82 (58.35±17.26) years. If the probe entered and exited the anastomotic port smoothly, it was recorded as a non-resistance group; if the resistance existed but the probe could pass and exit, it was recorded as a resistance group; if the probe could not pass the anastomotic port for obvious resistance, it was recorded as the stenosis group. In the stenosis group, the grafts were re-anastomosed and the flow parameters were re-measured by TTFM.ResultsA total of 202 anastomotic ports were carried out by exploration and dredging. Among them, 87 anastomosis (43.1%) were in the non-resistance group, and there was no significant change in the blood flow volume (BFV) and pulsatility index (PI) before and after exploration and dredging (6.16±3.41 mL/min vs. 6.18±3.44 mL/min, P=0.90; 7.06±2.84 vs. 6.96±2.49, P=0.50). Sixty-four anastomosis (31.7%) were in the resistance group, the BFV was higher after exploration and dredging than that before exploration and dredging (17.11±7.52 mL/min vs. 4.96±3.32 mL/min, P<0.01), while the PI was significantly smaller (3.78±2.20 vs. 8.58±2.97, P<0.01). Fifty-one anastomosis (25.2%) were in the stenosis group, and there was no significant change in the BFV and PI before and after exploration and dredging (3.44±1.95 mL/min vs. 3.48±2.11 mL/min, P=0.84; 10.74±4.12 vs. 10.54±4.11, P=0.36). After re-anastomosis, the BFV was higher (16.48±7.67 mL/min, P<0.01) and the PI deceased (3.43±1.39, P<0.01) than that before exploration and dredging.ConclusionThe application of anastomotic exploration and dredging can reduce the occurrence of re-anastomosis, and promptly find and solve the stenosis of the distal coronary artery, improve the poor perfusion of distal coronary, and thus improves the prognosis of patients.
It has always been an important policy of the Chinese government to provide aid and assistance for the development of Tibet. With nearly one-eighth of China’s total land areas and about 0.002% of China’s total population, the Tibet Autonomous Region lags behind the domestic average level in medical education and is in bad need for medical professionals. The West China Center of Medical Sciences (WCCMS) of Sichuan University has managed to introduce US projects to set up the West China–Tibet Telemedical Education System to transmit medical courses in a real-time and interactive way. Based on this system, WCCMS has established a model for assisting the Tibet University Medical College through transmitting medical courses, training their medical faculty, sending WCCMS faculty to work in Tibet and admitting medical teachers and students from Tibet to study and be trained at West China Medical School and Hospital.
Objective This study utilized the 2021 Global Burden of Disease database to systematically analyze global liver cancer mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALY) from 1990 to 2021. It focuses on differences across genders and age groups to reveal epidemiological patterns of liver cancer attributable to high BMI, providing reference for global liver cancer prevention and control. MethodBased on the 2021 Global Burden of Disease database, the Global Health Data Exchange query tool was used to extract the total number of global liver cancer deaths, DALY, age-standardized mortality rate (ASMR), and age-standardized DALY rate from 1990 to 2021. These metrics were assessed using estimated annual percentage change. Joinpoint regression analysis was employed to calculate annual percentage change and average annual percentage change , comparing differences in subtype composition from 1990 to 2021. Smooth curve regression analysis was applied to assess the correlation between liver cancer mortality and DALY rates attributable to high BMI and the socio-demographic index (SDI). ResultsFrom 1990 to 2021, the cumulative number of liver cancer deaths attributable to high BMI increased from 10 282.12 cases in 1990 ［95%UI (4 196.72, 16 721.85)］ to 46 200.88 cases［95%UI (38 606.14, 77 983.02)］ in 2021, representing a 3.5-fold increase. DALYs attributable to high BMI-related liver cancer increased from 292,696.35 years in 1990［95%UI (119 094.56, 475 962.67)］ to 1 273 312.58 years［95%UI (504 391.1, 2,101,957.87)］ in 2021, representing a 3.2-fold increase.② Cumulative deaths attributable to high BMI: For males, deaths increased from 5,913.45 cases [95% UI (2,479.64, 9,717.69)] in 1990 to 28,511.99 cases［95%UI (11 721.81, 49 277.60)］ in 2021, representing a 3.8-fold increase. For women, the cumulative number increased from 4,368.66 cases［95%UI (1 707.64, 7 078.83)］in 1990 to 17 691.88 cases［95%UI (7 169.44, 29 573.18)］in 2021, representing a threefold increase.③ Cumulative mortality values increased across all SDI income regions to varying degrees. ASMR and death counts steadily rose with increasing age, mirroring the growth trend in DALYs attributable to liver cancer associated with high BMI. Correlation analysis and slope index results demonstrated a significant positive correlation between SDI and both death counts and DALYs. The mortality concentration index rose from –0.277 (1990) to –0.258 (2021), while the DALY concentration index increased from –0.222 (1990) to –0.208 (2021). The mortality slope index increased from 0.284 (1990) to 0.881 (2021), while the DALY rate slope index rose from 7.002 (1990) to 19.244 (2021). ConclusionsThe burden of liver cancer associated with high BMI remains substantial and varies significantly across different age groups, genders, and geographic locations worldwide. The global disease burden of liver cancer linked to high BMI is projected to remain severe in the future, necessitating sustained attention and the development of more targeted prevention and control measures tailored to current circumstances.
Objective To compare the therapeutic effect of cannulated screws fixation at different time points through different reduction methods on the heal ing of displaced femoral neck fractures. Methods From January 1997 to September 2007, 240 patients with displaced femoral neck fracture were treated, including 121 males and 119 females aged 22-79 years old (average 56 years old). All cases were fresh and close fractures. According to the fractured part, there were 133cases of subcapital fracture, 64 of transcervical fracture and 43 of basal fracture. According to Garden classification, there were 105 cases of type III and 135 of type IV. Cannulated screws fixation was performed on all the patients, and the time from injury to operation was 6 hours to 7 days. Fifty-five cases received closed reduction and 59 cases received l imited open reduction as emergency treatment, while 65 cases received closed reduction and 61 cases received l imited open reduction as selective operation. Different groups were compared in terms of the heal ing rate of fracture, the excellent and good rate of reduction as well as the excellent and good rate of fixation. Results There was no significant difference between the closed reduction and the l imited open reduction in terms of operation time and bleeding volume (P gt; 0.05). Postoperatively, all wounds healed by first intention, no infection was observed, avascular necrosis of femoral head occurred in 44 cases, and the rate of avascular necrosis of femoral head in the l imited open reduction at emergency group was less than that of other 3 groups (P lt; 0.01). All the patients were followed up for 12-72 months (average 38 months), 193 cases got fracture heal ing at 10-23 months after operation (average 14 months). For the closed reduction as emergency operation group, the l imited open reduction as emergency operation group, the closed reduction as selective operation group, and the l imited open reduction as selective operation group, the heal ing rate of fracture was 74.55%, 91.53%, 69.23% and 86.89%, respectively; the excellent and good rate of reduction was 73.73%, 94.92%,70.77% and 91.80%, respectively; the excellent and good rate of fixation was 76.36%, 93.22%, 73.85% and 88.52%, respectively. The heal ing rate of fracture, the excellent and good rate of reduction as well as the excellent and good rate of fixation in the l imited open groups were higher than that of the closed reduction groups (Plt; 0.01), and there was no significant difference between the emergency operation groups and the selective operational groups (Pgt; 0.05). Conclusion The reduction methods have significant influences on the heal ing of fractures after cannulated screws fixation of the displaced femoral neck fracture, and the operation time has no obvious effect on fracture heal ing.
Objective To detect the serum protein fingerprint in gastric cancer patients by using the surface-enhanced laser desorption-ionization time-of-flight mass spectrometry (SELDI-TOF-MS) and protein chip array technology, screen biomarker candites, build diagnostic models and evaluate its clinical significance. Methods The serum proteomic patterns were detected in 40 patients with gastric cancer, 20 patients with gastric ulcer and 20 healthy blood donors. The diagnostic models were developed and valited by discriminant analysis. Results The peak intensity of differential expression proteins was not found in healthy blood donors, and 1 case was found in patient with gastric ulcer (m/z: 5 910,4 095). The peak intensity of 5 329, 4 095, 5 910, 8 691 and 3 300 (m/z) proteins were significantly higher in 40 gastric cancer patients than those in 20 gastric ulcer patients and 20 healthy blood donors ( P ＜0.05）. Three differential expression proteins were set up a diagnostic model together to diagnose gastric cancer. The diagnostic model made up of the differential expression proteins of 4 095, 5 910 and 8 691 had a sensitivity of 92.5% and a specificity of 97.5% . Conclusion Using SELDI-TOF-MS shows great potential to detect, and screen novel and better biomarkers for gastric cancer.
Objective To research the expressions of miR-196b and HoxB8 mRNA in colorectal cancer and theircorrelation with clinicopathologic features，and to explore the relationship between miR-196b and HoxB8 in vivo. Methods Expressions of RNA （including miR-196b and HoxB8 mRNA） and HoxB8 protein were detected respectively by using quantitative real-time reverse transcriptase PCR and Western blot in 30 cases of colorectal cancer and corresponding normalmucous membrane tissues. Results In colorectal cancer tissues，expressions of miR-196b and HoxB8 mRNA were higher than those of the corresponding normal mucous membrane tissues （P＜0.05）. Expression of miR196b mRNA was assoc-iated with lymph node metastasis，neoplasm stages （Ⅰ＋ⅡandⅢ＋Ⅳ），and distant metastasis （P＜0.05），on the otherhand，no significant differences were observed regarding tumor site，size，gross type，depth of invasion，tissue differentiation，age，and sex （P＞0.05）. Expression of HoxB8 mRNA was no significant differences concerning lymph node metastasis，tumor stages （Ⅰ＋Ⅱ，Ⅲ＋Ⅳ），distant metastasis，tumor site，size，gross type，depth of invasion，tissue differentiation，age，and sex （P＞0.05）. The expression of miR-196b mRNA was negatively correlated with HoxB8 mRNA expression （r=-0.458，P＜0.05），and HoxB8 protein expression with no obvious correlation （r=-0.236，P＞0.05） in colorectal cancer tissues. Conclusions The expressions of miR-196b and HoxB8 mRNA in colorectal cancer tissues are higher，the high expression of miR-196b mRNA is related to the tumorigenesis and progression of colorectal cancer as well as correlated with prognosis in colorectal cancer. The miR-196b inhibits the expression of HoxB8 mRNA by binding to the3′-UTR of target HoxB8 mRNA.
ObjectiveTo investigate the variations in patient hospitalization expenses before the enforcement of the centralized procurement policy, after the implementation of the drug centralized procurement policy, and after the introduction of the consumables centralized procurement policy. The efficacy of the centralized procurement policy will also be examined. MethodsThis retrospective study utilizes data obtained from the medical records homepage of the Health Information Statistics Center under the Health Commission of Gansu Province. It included 32 938 inpatients who underwent PCI surgery for coronary heart disease in Gansu province between January 1, 2018, and December 31, 2022. A double-breakpoint interrupted time series model was employed to analyze the fluctuation trends in hospitalization costs among patients across various stages of the centralized procurement policy's implementation. ResultsThroughout the three phases of implementing the centralized procurement policy, the average total hospitalization costs were RMB 46 149.49 yuan, RMB 46 629.12 yuan, and RMB 28 771.76 yuan, respectively. After the centralized procurement policy with a focus on drug volume was initiated, there was an immediate reduction in average total hospitalization costs, drug costs, consumable costs, and medical service fees by 4.64%, 5.62%, 18.12%, and 8.85%, respectively. However, there was a subsequent increase of 25.28% in average medical service fees. Following this phase, average out-of-pocket costs, treatment costs, and other expenses exhibited a consistent upward trajectory, increasing by an average of 2.23%, 1.51%, and 1.21% per month. Upon the introduction of the centralized procurement policy for consumables, there was an immediate surge of 23.75% in average medical service fees, while average total hospitalization costs, out-of-pocket costs, consumable costs, treatment costs, and rehabilitation costs experienced a gradual decline. ConclusionThe enforcement of centralized procurement policies for drugs and consumables has effectively managed to reduce hospitalization costs for patients undergoing PCI surgery due to coronary heart disease, thereby easing the financial burden on patients. However, changes in consumable costs and average medical service fees were relatively modest. Going forward, it is essential to refine the centralized procurement policy concerning consumables, improve the compensation mechanism for medical service pricing, and enhance the overall value proposition of medical services.
Objective To observe the effect of gefitinib on expression of epidermal growth factor receptor (EGFR) in bile duct epithelial cells, and the feasibility of inhibiting hyperplasia of bile duct epithelial cells with gefitinib. Methods Sixty-one patients with hepatolithiasis having to be in hospital for surgery from the First People’s Hospital of Shuangliu county were selected, with 25-65 years old, average 46.92 years. The patients were randomly divided into therapy group and control group. There were 30 cases in therapy group, in which fine duct was placed on lesion bile duct during operation, and through whom gefitinib solution was perfused after operation. There were 31 cases in control group with only T tube drainage after operation. The bile duct sample was obtained respectively during the operation and 6 weeks and 12 weeks after operation. The histology and expression change of EGFR were observed by HE staining, immunohistochemistry and RT-PCR method respectively. Results There were no significant differences in pathohistology changes of bile duct and the EGFR protein and mRNA expression between therapy group and control group during operation. The hyperplasia of epithelium mucosae and submucosal gland in the therapy group were obviously decreased as compared with those in control group, the EGFR mRNA and protein expression in therapy group were weaker than those of control group （Plt;0.05） 6 weeks and 12 weeks after gefitinib treatment. Conclusion EGFR is overexpressed in the chronic proliferative cholangitis, and continuously local application of gefitinib after operation can specifically interrupt the activation and expression of EFGR and then effectively inhibit the hyperplasia of bile duct epithelial cells.
Objective To investigate the effects of different inspiratory rise time during noninvasive positive pressure ventilation ( NPPV) on work of breathing in patients with acute exacerbation of chronic obstructive pulmonary disease ( COPD) . Methods Eleven patients with acute exacerbation of COPD received different inspiratory rise time ( 0. 1sec, 0. 3sec, 0. 5sec) during NPPV. The changes of inspiratory muscle effort and breathing pattern of the patients were observed. Results The average respiratory rate,minute ventilation, and tidal volume were higher during NPPV compared with spontaneous breathing. But the changes of average minute ventilation and tidal volume were not significant ( P gt; 0. 05) . The pressure time product ( PTP) , transdiaphragmatic pressure ( Pdi) , and work of breathing of inspiratory muscle reduced significantly during different inspiratory rise time as compared with spontaneous breathing ( P lt;0. 01) . PTP,Pdi, and work of breathing reduced 59. 2% , 62. 7% , and 49% respectively when inspiratory rise time was 0. 1sec. They reduced more significantly during inspiratory rise time of 0. 1sec. Conclusions The present study confirms NPPV can unload inspiratory muscles in patients with acute exacerbation of COPD. It is more effective to reduce inspiratory load when inspiratory rise time is set at 0. 1sec while the patients feel most comfortable.
