ObjectiveTo evaluate the efficacy of different non-pharmacological interventions on cognitive function in elderly patients with mild cognitive impairment by the network meta-analysis. MethodsThe PubMed, Embase, Cochrane Library, CINAHL, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect randomized controlled trials (RCTs) related to the objectives from inception to November 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. The network meta-analysis was then performed by using Stata 16.0 and Open BUGS 3.2.3 software. ResultsA total of 43 RCTs involving 2 986 patients were included, which involved 8 non-drug intervention methods. The best probability ranking results of the network meta-analysis showed that on the simple mental state scale (MMSE) scores: rTMS > acupressure > acupuncture therapy > exercise therapy > cognitive training > multicomponent intervention > VR > conventional care > health education, and on the Montreal cognitive assessment scale (MoCA) scores: VR > exercise therapy > rTMS > acupuncture therapy > acupressure > cognitive training > health education > conventional care. Conclusion Current evidence shows that rTMS, acupressure, VR, exercise therapy and acupuncture may be effective interventions to improve cognitive function in elderly patients with mild cognitive impairment. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
The human skeletal muscle drives skeletal movement through contraction. Embedding its functional information into the human morphological framework and constructing a digital twin of skeletal muscle for simulating physical and physiological functions of skeletal muscle are of great significance for the study of "virtual physiological humans". Based on relevant literature both domestically and internationally, this paper firstly summarizes the technical framework for constructing skeletal muscle digital twins, and then provides a review from five aspects including skeletal muscle digital twins modeling technology, skeletal muscle data collection technology, simulation analysis technology, simulation platform and human medical image database. On this basis, it is pointed out that further research is needed in areas such as skeletal muscle model generalization, accuracy improvement, and model coupling. The methods and means of constructing skeletal muscle digital twins summarized in the paper are expected to provide reference for researchers in this field, and the development direction pointed out can serve as the next focus of research.
Objective To evaluate the effectiveness of Medicated γ-IUD compared with other IUDs for contraception. Methods CBMdisc （1986 -2005）, VIP （1989 -2005） , CNKI （1994-2005） , The Cochrane Library （Issue 4, 2005 ） and 10 related journals were searched for randomized controlled trials （R.CTs） and quasi-randomized controlled trials （quasi-RCTs） on the comparison between γ-IUD and other IUDs. The quality of included trials was critically appraised. RevMan 4.2.8 software was used for statistical analysis. Results Ten published studies with 8 381 participants were included. The results of meta-analysis were expressed with Peto OR （ cumulative pregnancy rate, cumulative expulsion rate, cumulative rate of removing for medical reasons） or OIL （ cumulative continuation rate ） and 95% CI. Compared with MSSR-165, Medicated γ-25,200 resulted in lower pregnancy rate at 1, 2, 3 years of follow-up [ with the OR （95% CI） 0. 31 （0.15,0.64） , 0. 31 （0. 17,0.54） , 0. 31 （0.19,0. 51） , respectively], lower cumulative expulsion rate in5 year follow-up [0.26 （0.17,0.40）, 0.28 （0.20,0.41）, 0.30 （0.21,0.42）, 0.29 （0.19,0.44）, 0.32 （0.21, 0. 48 ）, respectively], lower cumulative rate of removing for medical reasons.after 4 year follow-up [0.57 （0.36,0. 92 ） ], and higher rate of cunmlative continuation in 5 years of follow-up 13.35 （ 2.29,4.89 ） , 2.76 （ 2.06,3, 69 ） , 2.41 （1.89,3.08）, 2.22 （1.69,2.91）, 1.99 （1.55,2.55）, respectively]. Compared with TCu220, Medicated γ-25,200 resulted in lower cumulative pregnancy rate after follow-up 2, 3 years [ 0.46 （0.25 ,0.87 ） ; 0.48 （0.27,0. 85 ） ], lower cumulative expulsion rate after 1 year follow-up [ 0. 58 （0.35,0.97） ] , lower cumulative rate of being removed for medical reasons in5 year follow-up [0.37 （0.23,0.59）, 0.38 （0.26,0.56）, 0.45 （0.32,0.64）, 0.47 （0.30,0.73）, 0.58 （0.39,0.87）, respectively ] and higher rate of cumulative continuation in 5 years of follow-up [ 2. 15 （ 1.61,2.87 ）, 2.02 （ 1.56,2.63）, 1.72 （ 1.34,2.20）, 1.44 （ 1.08,1.91 ）, 1, 39 （ 1.07,1.80）, respectively]. Compared with Uterus-Cu, Medicated γ-25,200 resulted in higher rate of cumulative continuation after follow-up 1 year [ 0.51 （0.34, 0.77） ]. Compared with MLCu375, Medicated γ-25,200 resulted in lower cumulative rate of being removed for medical reasons and higher rate of cumulative continuation after follow-up for 3 years [ 0. 22 （0.09,0.52） , 2.84 （ 1.64,4. 94 ）]. Compared with TCu380A, Medicated γ-25, 200 resulted in lower cumulative rate of being removed for medical reasons and higher rate of cumulative continuation in follow-up for 2 years [ 0.36 （ 0.18,0.73 ）, 0.29 （ 0. 12,0.70 ） ; 3.06 （ 1.72,5.44）, 3.61 （1.75,7.47） ]. Conclusions Available evidence shows that Medicated γ-IUD has better or equal effectiveness when compared with other IUDs. However, more RCTs with high quality and longer follow up period are needed to confirm the conclusion.
To better use the phase information to compensate the influence of blood flow, the phase unwrapping problem in susceptibility weighted imaging (SWI) is studied in this paper. In order to improve the accuracy of unwrapping, this paper proposes a magnitude image-guided phase unwrapping algorithm of SWI. The basic idea is as follows: (1) reduce the influence of noise by improving the rotational invariant non-local principal component analysis method (PRI-NL-PCA); (2) extract the corresponding solid region in the phase image to avoid the influence of the background noise on the phase unwrapping method; (3) use the phase compensation method to constrain the phase image reconstructed by the K-space. Finally, the reliability of the unwrapping method is evaluated by using four kinds of statistics as quantification index: the number, mean (M), variance (Var), and positive percentage (Pos) and negative percentage (Neg) of phasic error points. By comparing the simulated data with 226 sets of true head SWI data, the results show that the proposed algorithm has high accuracy compared with the classical branch cut method and the least squares method.
ObjectiveTo explore the risk factors for death within 7 days after admission in trauma patients undergoing surgery under general anesthesia, and provide evidence for predicting the outcomes of those patients and guidance for clinical practices.MethodsThe basic information and perioperative data of trauma patients who underwent surgery under general anesthesia between January 1st 2019 and December 31st 2020 were collected from the Hospital Information System and the Anesthesia Information Management System. Patients who died within 7 days after admission were assigned into the case group and the others were assigned into the control group, and then propensity-score matching method was used based on age, sex, and injury types. Univariate analyses and multivariate binary logistic regression analysis were used to identify the risk factors for death within 7 days after admission in these patients.ResultsThere were 2 532 patients who met the inclusion criteria, of whom 96 patients with missing follow-up information were excluded, and 2 436 patients remained for the study. After propensity-score matching, there were 19 patients in the case group and 95 patients in the control group. The result of multivariate logistic regression analysis showed that the coma state at admission [odds ratio (OR)=9.961, 95% confidence interval (CI) (1.352, 73.363), P=0.024], perioperative body temperature<36℃ [OR=23.052, 95%CI (1.523, 348.897), P=0.024], intraoperative mean arterial pressure<60 mm Hg (1 mm Hg=0.133 kPa) [OR=12.158, 95%CI (1.764, 83.813), P=0.011], serum calcium concentraion<2.0 mmol/L [OR=33.853, 95%CI (2.530, 452.963), P=0.008], and prothrombin time [OR=1.048, 95%CI (1.002, 1.096), P=0.042] increased the risk of death within 7 days after admission.ConclusionThe coma state, coagulopathy, perioperative hypothermia, intraoperative hypotension, and hypocalcemia are 5 independent risk factors for death in trauma patients after surgery under general anesthesia.