Atrial fibrillation (AF) is a common arrhythmia, which can lead to thrombosis and increase the risk of a stroke or even death. In order to meet the need for a low false-negative rate (FNR) of the screening test in clinical application, a convolutional neural network with a low false-negative rate (LFNR-CNN) was proposed. Regularization coefficients were added to the cross-entropy loss function which could make the cost of positive and negative samples different, and the penalty for false negatives could be increased during network training. The inter-patient clinical database of 21 077 patients (CD-21077) collected from the large general hospital was used to verify the effectiveness of the proposed method. For the convolutional neural network (CNN) with the same structure, the improved loss function could reduce the FNR from 2.22% to 0.97% compared with the traditional cross-entropy loss function. The selected regularization coefficient could increase the sensitivity (SE) from 97.78% to 98.35%, and the accuracy (ACC) was 96.62%, which was an increase from 96.49%. The proposed algorithm can reduce the FNR without losing ACC, and reduce the possibility of missed diagnosis to avoid missing the best treatment period. Meanwhile, it provides a universal loss function for the clinical auxiliary diagnosis of other diseases.
目的 观察盐酸氨基葡萄糖对Pilon骨折的辅助治疗作用。 方法 2007年6月－2010年9月，将43例接受手术治疗的Pilon骨折患者随机分成两组，A组术后口服盐酸氨基葡萄糖，B组作为对照组（仅服用安慰剂）。A组21例患者，平均年龄（35.7± 8.0）岁，B组22例患者，平均年龄（36.7 ± 7.1）岁。两组患者年龄、性别、骨折分型及手术时机相比较，无统计学差异（P＞0.05）。定期随诊（术后6、12、18个月），根据美国足与踝关节协会踝与后足功能评分（AOFAS）评分系统对患者进行功能评分，进行前瞻、对照、双盲研究。 结果 术后6、12、18个月，A组患者的AOFAS评分均明显高于B组，差异有统计学意义（t=2.530，2.856，2.881；P=0.015，0.007，0.006）；术后18个月，A组临床疗效优良率为95.2%，B组优良率为72.3%，差异有统计学意义（χ2=3.995，P=0.046）。A组2例患者分别发生轻度头晕及恶心，无严重不良反应发生。 结论 盐酸氨基葡萄糖辅助治疗Pilon骨折可改善踝关节功能，减少创伤性骨关节炎的发生。
【摘要】 目的 探讨胸膜活检在结核性胸膜炎中的诊断价值。 方法 将2009年1-11月收治的52例结核性胸膜炎患者随机分为常规组（40例）和胸膜活检组（12例）。常规组采用常规方法诊断结核性胸膜炎，胸膜活检组采用胸膜活检进行诊断，比较两组诊断结果。 结果 常规组均未获得细菌学、病理学依据，病原病理学诊断率为0.0%；胸膜活检组有5例获得细菌学病理学依据，病原病理学诊断率为41.7%；两组比较，差异有统计学意义（Plt;0.05）。常规组平均诊断时间为60 d，胸膜活检组平均诊断时间为5 d；两组比较，差异有统计学意义（Plt;0.05）。胸膜活检组无并发症发生。 结论 胸膜活检在结核性胸膜炎诊断中具有重要价值。【Abstract】 Objective To explore the value of pleural biopsy in the diagnosis of tuberculous pleurisy. Methods From January to November 2009, Fifty-two patients with tuberculous pleurisy were randomly divided into conventional group (40 patients) and pleural biopsy group (12 patients), in order to compare the results of conventional diagnostic methods and tuberculous biopsy methods in the diagnosis of tuberculous pleurisy. Results Conventional group was unable to obtain the final bacteriological, pathological basis which obstained the diagnostic rate of 0, but in the pleural biopsy group, five patients got diagnosis basing on bacteriological and pathology tests, and the diagnostic rate was 41.7%;there was significant difference when compared the results of the two groups (Plt;0.05). The average diagnosis time were 60 days in the conventional group, and five days in the pleural biopsy group, there was significant difference when compared the results of the two groups (Plt;0.05). Pleural biopsy group had no complications occurred. Conclusion Pleural biopsy methods in the diagnosis of tuberculous pleurisy are of great value.