Objective To investigate different gases and hematocrits on cerebral injury during deep hypothermic circulatory arrest (DHCA) in a piglet model including monitoring by near-infrared spectroscopy (NIRS). Methods Twenty-four piglets were assigned to 4 groups with respect to different blood gas and hematocrit during DHCA. Group A: hematocrit was maintained between 0.25 to 0.30, pH-stat strategy during cooling phases and alpha stat strategy in other phases; group B: hematocrit was maintained between 0.25 to 0.30 and alpha stat strategy; group C: hematocrit was maintained between 0.20 to 0.25, pH-stat strategy during cooling phases and alpha stat strategy in other phases; group D: hematocrit was maintained between 0.20 to 0.25 and alpha stat strategy. Cerebral oxygenations of piglets were monitored continuously by NIRS. The brain was fixed in situ at 6 hours after operation and a histological score for neurological injury was assessed. Results Oxygenated hemoglobin (HbO2) and total hemoglobin (HbT) signals detected by NIRS were significantly lower in group D than those in group A and group B during cooling (Plt;0.05). Oxygenated hemoglobin nadir time was significantly shorter in group A(Plt;0.05). All piglets with oxygenated hemoglobin signal nadir time less than 25 minutes were free from histological evidence of brain injury. Conclusion Combination of pH-stat strategy and higher hematocrit reduces neurological injury after DHCA.
ObjectiveTo analyze the influence of different surgical methods on survival and relapse-free survival in colorectal liver metastases.
MethodsClinical data of 71 cases of colorectal liver metastases who treated in PLA General Hospital from January 2002 to may 2013 were collected retrospectively, to analyzed the effect of different surgical methods on survival and relapse-free survival of this kind of cases.
ResultsAll of primary lesions underwent radical resection. And for the liver metastases, 20 cases didn't received any intervention (non-intervention group), 20 cases underwent resection of liver metastases, 20 cases underwent radiofrequency ablation, and 11 cases underwent radiofrequency ablation and resection of liver metastases (all 61 cases who received intervention were classified to intervention group). Results of Cox proportional hazards model showed that, in the condition of controlling other confounding factors, intervention can improve the survival (HR=1.724, P=0.043) and relapse-free survival (HR=0.701, P=0.048) of cases of colorectal liver metastases, cases who received intervention had better survival situation and the relapse-free survival situation.
ConclusionFor cases of colorectal liver metastases, in condition of radical operation for colorectal cancer, the intervention for liver metastases can prolong the survival time and relapse-free survival time.
ObjectiveTo evaluate myocardial segmental motion function in left ventricular of patients with rheumatic mitral stenosis by using the technology of real-time three-dimensional echocardiography (RT-3DE).
MethodsWe retrospectively analyzed the clinical data of 14 patients with rheumatic mitral stenosis between October and November 2014 in our hospital as a trial group. There were 4 males and 10 females with a mean age of 50.9±9.0 years ranging from 34 to 64 years. We chose 11 healthy individuals as a control group. There were 7 males and 4 females with a mean age of 49.5±9.7 years ranging from 32 to 67 years. Both the two groups were subjected to myocardial performance evaluation using two-dimensional echocardiography (2DE) and real-time three-dimensional echocardiography (RT-3DE) to examine the left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), longitudinal strain, circumferential strain, area strain, and lateral strain of each left ventricular myocardial segments. Result RT-3DE detected that the trial group had significantly lower values of LVEF, LVEDV and LVESV than those of the control group (P < 0.05). RT-3DE also revealed that the trial group had a significantly weaker longitudinal strain than the control group (P < 0.05).
ConclusionRT-3DE is an accurate technology for assessing myocardial motion and function in patients with rheumatic mitral valve disease.
Vision is an important way for human beings to interact with the outside world and obtain information. In order to research human visual behavior under different conditions, this paper uses a Gaussian mixture-hidden Markov model (GMM-HMM) to model the scanpath, and proposes a new model optimization method, time-shifting segmentation (TSS). The TSS method can highlight the characteristics of the time dimension in the scanpath, improve the pattern recognition results, and enhance the stability of the model. In this paper, a linear discriminant analysis (LDA) method is used for multi-dimensional feature pattern recognition to evaluates the rationality and the accuracy of the proposed model. Four sets of comparative trials were carried out for the model evaluation. The first group applied the GMM-HMM to model the scanpath, and the average accuracy of the classification could reach 0.507, which is greater than the opportunity probability of three classification (0.333). The second set of trial applied TSS method, and the mean accuracy of classification was raised to 0.610. The third group combined GMM-HMM with TSS method, and the mean accuracy of classification reached 0.602, which was more stable than the second model. Finally, comparing the model analysis results with the saccade amplitude (SA) characteristics analysis results, the modeling analysis method is much better than the basic information analysis method. Via analyzing the characteristics of three types of tasks, the results show that the free viewing task have higher specificity value and a higher sensitivity to the cued object search task. In summary, the application of GMM-HMM model has a good performance in scanpath pattern recognition, and the introduction of TSS method can enhance the difference of scanpath characteristics. Especially for the recognition of the scanpath of search-type tasks, the model has better advantages. And it also provides a new solution for a single state eye movement sequence.
Objective
To investigate the risk factors of early allograft dysfunction (EAD) following C-Ⅱ donation after cardiac death (DCD) liver transplantation.
Methods
The data of 46 donors and recipients of C-ⅡDCD liver transplantation between March 2012 and August 2015 were retrospectively analyzed. The baseline data such as democracy, death cause, donor warm ischemic time (DWIT) and cold ischemic time (CIT) in EAD group and the non-EAD group (control group) was compared, and whether these factors were risk factors of EAD was investigated by univariate and multivariate analyses. Statistical cut-off values for significant factors of the unfavorable analysis were defined by receiver operating characteristics (ROC) analysis. The 6-month and 1-year graft survival rate were compared.
Results
The EAD group had a longer DWIT compared with the group [(17.6±4.7) and (12.7±6.2) minutes, P=0.009]; meanwhile, the EAD group had a longer CIT compared with the control group [(13.7±4.7) and (11.0±3.5) hours, P=0.020]. The other factors in both groups showed no statistical significance (P>0.05). The ROC curve revealed the cut-off values of DWIT and CIT were 17.50 minutes [area under the curve (AUC)=0.713, P=0.020] and 9.85 hours (AUC=0.723, P=0.015), respectively. The multivariate logistic regression analysis showed the DWIT [odds ratios (OR)=1.340, 95% confidence interval (CI)(1.042, 1.654), P=0.008] and CIT [OR=1.396, 95% CI (1.075, 1.698), P=0.015] were all independent risk factors of EAD. The 6-month and 1-year graft survival rate of the EAD group and the control group was 85.7% vs. 92.3% (P=0.607) and 71.4% vs. 84.6% (P=0.587), respectively.
Conclusions
EAD may occured in C-Ⅱ donors with DWIT≥17.50 minutes or CIT≥9.85 hours in DCD liver transplantation. The livers can be used as a resource for clinical use and also have a good outcome.
Objective To investigate the feasibility and indication of synchronous resection of colonic carcinoma and its hepatic metastasis. Methods Radical sigmoidectomy and right hemi-hepatectomy plus left lateral segment resection were performed at the same time in a 71-year-old patient with sigmoid carcinoma and multiple hepatic metastasis. Results The operation lasted for 5 hours and 10 minutes with 300ml blood lost during the procedure. The patient recovered smoothly and was discharged 2 weeks after operation. Follow-up showed no reoccurrence up to the day of this presentation(4 months).Conclusion The operation could be performed safely by experienced surgeon in good-equipment hospital.
Objective
To investigate the effects of autologous platelet-rich gel (APG) combined with intelligent trauma negative-pressure comprehensive therapeutic instrument on patients with refractory diabetic foot ulcer (DFU).
Methods
A total of 80 patients with refractory DFU treated in the hospital from January 2015 to January 2017 were divided into the trial group (n=40) and the control group (n=40) by the random number table method. The patients in the two groups were given routine treatment, and on the basis, the patients in the control group were treated with the intelligent trauma negative-pressure comprehensive therapeutic instrument while the ones in the trial group were treated with APG combined with intelligent trauma negative-pressure therapeutic instrument alternately. All patients were observed for 12 weeks. The cure rates, healing time and changes of wound volumes in the two groups before treatment and at 2, 4, 8, and 12 weeks after treatment were recorded.
Results
The total effective rate of treatment in the trial group was higher than that in the control group (87.5% vs. 67.5%, P<0.05). The wound volumes in the two groups at 4, 8 and 12 weeks after treatment were smaller than those before treatment and at 2 weeks after treatment (P<0.05). The wound volumes in the trial group at 4, 8 and 12 weeks after treatment were significantly smaller than those in the control group (P<0.05). The healing times of Wagner Ⅱ and Ⅲ DFU in the trial group were significantly shorter than those in the control group [(24.71±4.29)vs. (33.84±6.09) days, P<0.05; (33.04±5.97)vs. (45.29±7.05) days, P<0.05].
Conclusion
Alternate treatment with APG combined with intelligent trauma negative-pressure comprehensive therapeutic instrument for refractory DFU can promote wound healing, shorten wound healing time, and improve the clinical efficacy.
The acoustic detection method based on machine learning and signal processing is an important method of pathological voice detection and the extraction of voice features is one of the most important. Currently, the features widely used have disadvantage of dependence on the fundamental frequency extraction, being easily affected by noise and high computational complexity. In view of these shortcomings, a new method of pathological voice detection based on multi-band analysis and chaotic analysis is proposed. The gammatone filter bank was used to simulate the human ear auditory characteristics to analyze different frequency bands and obtain the signals in different frequency bands. According to the characteristics that turbulence noise caused by chaos in voice will worsen the spectrum convergence, we applied short time Fourier transform to each frequency band of the voice signal, then the feature gammatone short time spectral self-similarity (GSTS) was extracted, and the chaos degree of each band signal was analyzed to distinguish normal and pathological voice. The experimental results showed that combined with traditional machine learning methods, GSTS reached the accuracy of 99.50% in the pathological voice database of Massachusetts Eye and Ear Infirmary (MEEI) and had an improvement of 3.46% compared with the best existing features. Also, the time of the extraction of GSTS was far less than that of traditional nonlinear features. These results show that GSTS has higher extraction efficiency and better recognition effect than the existing features.
Objective To analyze the clinicopathological characteristics of thymoma patients and the influencing factors for prognosis. Methods Thymoma patients who received treatment in Sichuan Cancer Hospital from March 2015 to March 2021 were collected. Clinical data of the patients were analyzed using Kaplan-Meier and Cox regression analyses. Results A total of 177 patients were included. There were 89 males and 88 females aged 17-88 (52.3±13.0) years, including 160 surgical patients and 17 non-surgical patients. There were 160 patients survived, 17 died of thymoma, and 5 had recurrence and metastasis. Overall, the 1-year, 3-year and 5-year progression-free survival rates were 94.4%, 88.7%, 88.1%, respectively; the 1-year, 3-year and 5-year overall survival rates were 94.9%, 91.5%, 91.0%, respectively. The Kaplan-Meier analysis showed that World Health Organization classification, clinical symptoms, Masaoka-Koga staging, treatment methods and surgery were statistically associated with progression-free survival; clinical symptoms, age, treatment methods and surgery were statistically associated with overall survival (P<0.05). Patients with younger age (P=0.018), without clinical symptoms (P=0.039), and with surgical treatment (P=0.004) had higher overall survival rates; those patients undergoing surgery had a higher progression-free survival rate (P=0.002). Conclusion Age, clinical symptoms and surgical treatment are independent factors influencing the prognosis of patients with thymoma.
The multi-window time-frequency reassignment helps to improve the time-frequency resolution of bark-frequency spectral coefficient (BFSC) analysis of heart sounds. For this purpose, a new heart sound classification algorithm combining feature extraction based on multi-window time-frequency reassignment BFSC with deep learning was proposed in this paper. Firstly, the randomly intercepted heart sound segments are preprocessed with amplitude normalization, the heart sounds were framed and time-frequency rearrangement based on short-time Fourier transforms were computed using multiple orthogonal windows. A smooth spectrum estimate is calculated by arithmetic averaging each of the obtained independent spectra. Finally, the BFSC of reassignment spectrum is extracted as a feature by the Bark filter bank. In this paper, convolutional network and recurrent neural network are used as classifiers for model comparison and performance evaluation of the extracted features. Eventually, the multi-window time-frequency rearrangement improved BFSC method extracts more discriminative features, with a binary classification accuracy of 0.936, a sensitivity of 0.946, and a specificity of 0.922. These results present that the algorithm proposed in this paper does not need to segment the heart sounds and randomly intercepts the heart sound segments, which greatly simplifies the computational process and is expected to be used for screening of congenital heart disease.
