ObjectiveTo analyze the influencing factors of acute exacerbation readmission in elderly patients with chronic obstructive pulmonary disease (COPD) within 30 days, construct and validate the risk prediction model.MethodsA total of 1120 elderly patients with COPD in the respiratory department of 13 general hospitals in Ningxia from April 2019 to August 2020 were selected by convenience sampling method and followed up until 30 days after discharge. According to the time of filling in the questionnaire, 784 patients who entered the study first served as the modeling group, and 336 patients who entered the study later served as the validation group to verify the prediction effect of the model.ResultsEducation level, smoking status, number of acute exacerbations of COPD hospitalizations in the past 1 year, regular use of medication, rehabilitation and exercise, nutritional status and seasonal factors were the influencing factors of patients’ readmission to hospital. The risk prediction model was constructed: Z=–8.225–0.310×assignment of education level+0.564×assignment of smoking status+0.873×assignment of number of acute exacerbations of COPD hospitalizations in the past 1 year+0.779×assignment of regular use of medication+0.617×assignment of rehabilitation and exercise +0.970×assignment of nutritional status+assignment of seasonal factors [1.170×spring (0, 1)+0.793×autumn (0, 1)+1.488×winter (0, 1)]. The area under ROC curve was 0.746, the sensitivity was 75.90%, and the specificity was 64.30%. Hosmer-Lemeshow test showed that P=0.278. Results of model validation showed that the sensitivity, the specificity and the accuracy were 69.44%, 85.71% and 81.56%, respectively.ConclusionsEducation level, smoking status, number of acute exacerbations of COPD hospitalizations in the past 1 year, regular use of medication, rehabilitation and exercise, nutritional status and seasonal factors are the influencing factors of patients’ readmission to hospital. The risk prediction model is constructed based on these factor. This model has good prediction effect, can provide reference for the medical staff to take preventive treatment and nursing measures for high-risk patients.
In the field of artificial intelligence (AI) medical imaging, data annotation is a key factor in all AI development. In the traditional manual annotation process, there are prominent problems such as difficult data acquisition, high manual labor intensity, strong professionalism and low labeling quality. Therefore, an intelligent multimodal medical image annotation system is urgently needed to meet the requirements of labeling. Based on the image cloud, West China Hospital of Sichuan University collected the multimodal image data of hospital and allied hospitals, and designed a multi-modal image annotation system through information technology, which integrated various image processing algorithms and AI models to simplify the image data annotation. With the construction of annotation system, the efficiency of data labeling in the hospitals is improved, which provides necessary data support for the AI image research and related industry construction in the hospital, so as to promote the implementation of artificial intelligence industry related to medical images in the hospital.
ObjectiveTo investigate whether Osteoglycin (OGN) gene inhibits the proliferation of Luminal breast cancer cells by up-regulating the expression of estrogen receptor (ER). Methods① Ualcan online database was used to analyze the expression of OGN in the breast cancer, and Kaplan-Meier Plotter was used to analyze the effect of OGN on the prognosis of patients with breast cancer. The median OGN mRNA expression level was taken as the cut-off point for high or low OGN expression. ② The expression of OGN mRNA in the Luminal breast cancer tissue of clinical case was examined using real time quantitative PCR (qRT-PCR). ③ Up-regulation of OGN expression in the Luminal breast cancer cell lines MCF-7 and T47D cells by transfection of overexpressing OGN plasmid, the expressions of OGN and ER were detected by qRT-PCR and Western blot, respectively. CCK8 assay and colony formation assay were applied to detect the cell proliferation and colony formation of Luminal breast cancer cells. ④ siRNA transfection was used to interfere with the expression of ER (ESR1) of breast cancer cells in the overexpressing OGN of breast cancer cells, then the CCK8 assay was used to detect the proliferation ability of the breast cancer cell lines after down-regulating the expression of ER in the overexpressing OGN patients. Results① The results of Ualcan online database showed that the expression of OGN mRNA in the breast cancer tissues of different types of breast cancer was lower than that in the normal breast tissues (P<0.001), and which was highest in the Luminal breast cancer tissues (P<0.001). The Kaplan-Meier Plotter prognosis analysis showed that in all breast cancer or Luminal breast cancer patients, the prognosis of patients with high OGN expression was better than those with low OGN expression (P=0.000 14, P=0.001 80). ② The OGN mRNA expression was decreased in the 30 Luminal breast cancer samples as compared with the corresponding adjacent normal breast tissues (t=4.774, P=0.000 019). ③ The expressions of OGN and ER in the MCF-7 and T47D cells were up-regulated after transfection of overexpressing OGN plasmid (P=0.000 002, P=0.000 001). The cell proliferation was inhibited (P<0.05) and the number of cell clones was decreased significantly (P<0.05). ④ After transient transfection of siRNA interfered with breast cancer cell lines of overexpressing OGN, ER mRNA level decreased (P<0.05), and cell proliferation ability increased significantly (P<0.05). Conclusion OGN could exert a tumor suppressor effect in Luminal breast cancer by mediating expression of ER.
Objective To discuss the epidemiological characteristics of young and middle-aged people infected with COVID-19 in Gansu province under the new epidemic policy. Methods A total of 1800 people were collected from two tertiary hospitals in Gansu province from November 8, 2022 to January 28, 2023. The vaccination status, nucleic acid antigen detection, the specific time of infection, main symptoms and severity of the disease were investigated. Results Among 1800 participants, 1685 (93.6%) were vaccinated and 1565 (86.9%) were infected with COVID-19. Among the 1565 infected persons, 523 (33.4%) completed both nucleic acid and antigen testing, 382 (24.4%) completed nucleic acid testing, 490 (31.3%) completed antigen testing, 170 (10.9%) received IgG testing. 1490 (95.2%) were slight ill, 75 (4.8%) were critical ill, and 96 (6.1%) were hospitalized, and no one died. In 2022, 92 cases (5.9%) were infected in the first half of November, 141 cases (9.1%) in the second half of November, 630 cases (40.3%) in the first half of December, and 553 cases (35.4%) in the second half of December. 109 cases (7.0%) were infected in the first half of January, 38 cases (2.2%) in the second half of January, and 2 cases (0.1%) in the first half of February of 2023. and no cases in the second half of February. Among the 1565 infected persons, 825 (52.7%) had respiratory symptoms, 293 (18.7%) had gastrointestinal symptoms, 257 (16.4%) had autonomic disorders, 140 (8.9%) had other symptoms such as decreased smell and taste, and 48 (3.3%) had no symptoms after infection. Conclusions The vaccination rate of young and middle-aged people in Lanzhou city of Gansu Province is high. Since the new policy, the infection rate of the novel coronavirus among young and middle-aged people is high, the number of antigen tests is more than nucleic acid tests, most of the infected patients are slight, with fewer critical patients, and the hospitalization rate is low. The peak of infection occurred in early December 2022, and the infection rate was basically zero by February 2023. The main symptoms of COVID-19 infection are mainly respiratory tract, followed by digestive tract and autonomic nervous system disorders, and few patients are completely asymptomatic.
Objective To investigate the current status and development of electronic health records (EHR) at home and abroad to grasp the development trends of EHR, so as to point out the direction of the development and relevant research on EHR. Methods Based on the Web of Science citation database and the principle of bibliometrics, we analyzed the retrieved literature in aspects of publication date, language, country/region, institution, author, etc. Results A total of 1 262 eligible studies were identified. The number of articles on EHR increased rapidly from only 2 in 1995 to 218 in 2012. In terms of country/region, the United States ranked the top in all countries (763 articles, accounting for 60.46%). In terms of institution, Harvard University ranked the top (135 articles, accounting for 10.70%). In terms of journal, the Journal of the American Medical Informatics Association ranked the top (106 articles, accounting for 8.40%). In terms of authors, David W. Bates ranked the top (45 articles, accounting for 3.57%). In terms of subject type, health care sciences services and medical informatics were mainly focused on. Conclusion The research on EHR has become a global hot spot and relevant bibliometrics will contribute to the timely and correctly grasp the whole picture of its development trends and main research direction.
ObjectiveTo investigate the relationship between peripheral T cell apoptosis and specific immune tolerance induced by T cell vaccination（TCV）. MethodsT cell vaccinations were made from the spleen cells of SD rats, which were induced by ConA and were challenged with the spleen cells of Wistar rats. Normal SD rats were vaccinated intraperitoneally with TCV (experimental group) or RPMI 1640 culture buffer (control group) respectively .Oneway mixed lymphocyte reaction (MLR) were performed,the apoptosis of peripheral T cell were assayed using flow cytometric analysis before and after vaccination.ResultsIn experimental group, the result of MLR showed that the response captivity of SD rat spleen cells were suppressed significantly after vaccination in comparison with prevaccination (Plt;0.01) and the percentage of peripheral T cell apoptosis was increased significantly after vaccination compared with prevaccination (Plt;0.01); In control group, there was no significant difference between prevaccination and postvaccination about MLR and peripheral T cell apoptosis. ConclusionT cell vaccination is capable of inducing Agspecific immune tolerance, the T cell apoptosis of peripheral blood induced by T cell vaccination may result in the depletion of Agspecific reactive T cells, which is vital in inducing specific immune tolerance.
Objective To study the effect of chitosan (CS) mediated insul in-l ike growth factor 1 gene (igf-1) transfection on the repair of articular cartilage defect. Methods Twelve 3-month-old healthy male rabbits weighting 2.0-2.5 kg were randomly divided into 2 primary groups, control and intervention groups (n=6 per group). Control group was further divided into normal control (left knee) and normal saline (NS) control (right knee) groups. While, intervention group was divided into CS (left knee) and CS/igf-1 intervention (right knee) groups. Cartilage defects were created in the knee joints except normalcontrol. Intra-articular injections of CS/igf-1 complex was administrated 2 times a week for 4 weeks in CS/igf-1 interventiongroup, 0.5 mL CS in CS intervention group, and 0.5 mL sal ine solution in normal control and sal ine control groups. At 28days after treatments, the cartilage samples were collected for histological observation and collagen type II and aggrecan mRNA evaluation. Results HE staining and toluidine blue staining revealed that CS/igf-1 and CS intervention could significantly stimulated cartilage regeneration accompanied with fibrosis and inflammatory cell infiltration, however, CS/igf-1 treatment resulted in the best repair of cartilage defect. In contrast, sal ine control group only showed fibrous tissue prol iferation and inflammatory cell infiltration without significant cartilage repairing. In terms of collagen type II and aggrecan gene expression, significant differences were observed in each pairwised comparison among 4 groups in the order of CS/igf-1 gt; CS gt; NS gt; normal control (P lt; 0.05). Conclusion In situ CS/ifg-1 complex transfection can enhance the formation of mesochondrium by upregulating collagen type II or aggrecan expression, which might enhance the repair of articular cartilage defect.
Error related negativity (ERN) is generated in frontal and central cortical regions when individuals perceive errors. Because ERN has low signal-to-noise ratio and large individual difference, it is difficult for single trial ERN recognition. In current study, the optimized electroencephalograph (EEG) channels were selected based on the brain topography of ERN activity and ERN offline recognition rate, and the optimized EEG time segments were selected based on the ERN offline recognition rate, then the low frequency time domain and high frequency time-frequency domain features were analyzed based on wavelet transform, after which the ERN single detection algorithm was proposed based on the above procedures. Finally, we achieved average recognition rate of 72.0% ± 9.6% in 10 subjects by using the sample points feature in 0~3.9 Hz and the power and variance features in 3.9~15.6 Hz from the EEG segments of 200~600 ms on the selected 6 channels. Our work has the potential to help the error command real-time correction technique in the application of online brain-computer interface system.
ObjectiveTo examine the effect of preoperative adverse emotion on rehabilitation outcomes in lung cancer patients undergoing thoracoscopic major pulmonary resection.MethodsWe retrospectively analyzed the clinical data of 1 438 patients with lung cancer who underwent thoracoscopic lobectomy and segmentectomy in West China Hospital of Sichuan University from February 2017 to July 2018 including 555 males and 883 females. All patients were assessed by Huaxi emotional-distress index scoring, and were divided into three groups including a non-negative emotion group, a mild negative emotion group, and a moderate-severe negative emotion group. All patients underwent thoracoscopic lobectomy or segmentectomy plus systematic lymph node dissection or sampling. The volume of postoperative chest drainage, postoperative lung infection rate, time of chest tube intubation and postoperative duration of hospitalization were compared among these three groups.ResultsThere were different morbidities of adverse emotion in age, sex, education level and smoking among patients before operation (P<0.05). Univariate analysis showed that there was no statistical difference in the duration of indwelling drainage tube, drainage volume, postoperative pulmonary infection rate or the incidence of other complications among these three groups, but the duration of hospitalization in the latter two groups was less than that in the first group with a statistical difference (P<0.05). After correction of confounding factors by multiple regression analysis, there was no statistical difference among the three groups.ConclusionYoung patients are more likely to develop bad emotions, women are more likely to develop serious bad emotions, highly educated patients tend to develop bad emotions, and non-smoking patients tend to develop bad emotions. There is no effect of preoperative adverse emotions on the rapid recovery of lung cancer patients after minimally invasive thoracoscopic surgery.
The brain-computer interface (BCI) systems used in practical applications require as few electroencephalogram (EEG) acquisition channels as possible. However, when it is reduced to one channel, it is difficult to remove the electrooculogram (EOG) artifacts. Therefore, this paper proposed an EOG artifact removal algorithm based on wavelet transform and ensemble empirical mode decomposition. Firstly, the single channel EEG signal is subjected to wavelet transform, and the wavelet components which involve EOG artifact are decomposed by ensemble empirical mode decomposition. Then the predefined autocorrelation coefficient threshold is used to automatically select and remove the intrinsic modal functions which mainly composed of EOG components. And finally the ‘clean’ EEG signal is reconstructed. The comparative experiments on the simulation data and the real data show that the algorithm proposed in this paper solves the problem of automatic removal of EOG artifacts in single-channel EEG signals. It can effectively remove the EOG artifacts when causes less EEG distortion and has less algorithm complexity at the same time. It helps to promote the BCI technology out of the laboratory and toward commercial application.