基于小波能量谱的先天或风湿性心脏病异常心音分类算法研究

目的为解决先天性心脏病或风湿性心脏病异常心音分辨问题,应用离散小波频带能量对异常心音分类算法进行研究。方法采集22人的正常心音和116人的异常心音,对心音信号做离散小波变换,根据病理性心杂音在频域内的分布范围划分5层频带,计算得到各层频带的能量占比,根据单因素方差分析方法,提出了基于小波能量谱的心音分类指标。结果对正常心音和异常心音的4个听诊区域进行了分类,最优分类准确率为92%。区分动脉导管未闭和其余异常心音的最优分类准确率为81.9%。结论基于小波能量谱的心音分类算法无需对心音信号进行分割,提取特征值少,可准确有效地对心音信号进行分类,相较于传统的心音听诊,算法的引入能够在异常心音临床诊断中提供参考数据。     

益肾化湿颗粒辅助治疗慢性肾小球肾炎的效果研究

目的 探究慢性肾小球肾炎患者应用益肾化湿颗粒辅助治疗的临床疗效。方法 选择2017年3月1日—2019年3月1日在河南科技大学第一附属医院接受治疗的慢性肾小球肾炎患者120例作为临床研究对象,随机投掷硬币法分组。对照组60例患者应用氯沙坦钾片治疗,观察组60例患者应用氯沙坦钾片与益肾化湿颗粒联合治疗,比较所有患者治疗后的临床疗效以及对血清中白细胞诱素-1(LKN－1)、肿瘤坏死因子α(TNF－α)和白细胞介素13(IL－13)水平的影响情况。结果 经治疗后,观察组患者的治疗总有效率为96.67%,高于对照组患者的73.33%(P<0.05);观察组患者的尿红细胞为(4.09±1.01)个/HP、24 h尿蛋白定量为(0.79±0.35)g/L、血尿素氮(BUN)为(9.11±2.65)mmol/L以及血肌酐(Scr)为(119.44±48.99)umol/L,均低于对照组患者水平(P<0.05):尿红细胞(6.20±1.98)个/HP、24 h尿蛋白定量(1.25±0.39)g/L、血尿素氮(BUN)(10.60±3.18)mmol/L以及血肌酐(Scr)(137.01±55.43)umol/L;观察组患者血清中IL-13水平为(12.08±2.24)ng/L、TNF-α为(13.57±4.34)ng/L、LKN－1为(70.43±33.88)pmol/L,均低于对照组患者水平,差异均具有统计学意义(P<0.05)。结论 应用益肾化湿颗粒治疗慢性肾小球肾炎患者,可有效消除炎症,改善肾功能,提高临床治疗效果,值得推广应用。     

2018年某高校新生体质指数及生活习惯的调查分析

目的 了解江苏某高校2018级新生体质指数及生活习惯,分析生活习惯对体质指数的影响,为指导大学生养成健康生活习惯、塑造良好身体素质提供依据。方法 入学体检测量新生身高、体重,随机抽取部分专业学生完成生活习惯调查。结果 完成调查问卷的350名新生,体质指数正常、过轻、过重、肥胖者占比分别为57.71%、28%、10.29%和4%。男生体质指数高于女生(P<0.01),男生过重及肥胖检出率高于女生(P<0.05),女生过轻检出率高于男生(P<0.01)。完成调查问卷的新生中,65.43%每日规律三餐饮食,69.14%有每周运动的习惯。规律饮食组体质指数正常检出率高于非规律饮食组(P<0.05),每周运动3次及以上学生体质指数正常检出率高于其他学生(P<0.05)。超重学生睡眠满意度低于其他学生(P<0.05)。结论 新入学大学生体质指数过轻与超重问题并存,饮食及运动习惯有待改善,高校需重视体质指数监测,有针对性开展饮食及运动健康教育。     

2012-2017年南京市肺结核流行特征分析

目的 分析2012-2017年间南京市肺结核病流行病学特征，为制定结核病防治策略及医疗服务资源的分布与优化提供科学依据。方法 利用2012到2017年间全国结核病管理信息系统报告的南京市肺结核发病信息，采用描述性流行病学、季节指数法对肺结核时空流行病学特征进行分析。结果 时间分布上，南京市肺结核报告发病率季节性变化不明显，年报告发病率及病例数总体呈下降趋势，年均下降率为1.05/10万。地区分布上，根据充计，肺结核病例报告多集中在经济发达的中心城区，但年报告肺结核发病率最高为经济发展较为落后的高淳区，约为67.44/10万人。人群分布上，流动人口的报告发病率（59.72/10万人）明显高于本地人口（25.72/10万人）；各年龄段均有疫情报告，60岁以上老年组报告发病率最高，约为69.34/10万人；农民和离退休人员位居肺结核病患者职业分布的前两位，分别占总报告发病数的24.09%和16.53%；男性患者报告发病率约为女性患者的2.19倍。结论 南京市肺结核疫情无明显的季节性变化，年报告发病率整体呈下降趋势，患者男性为多，农民和老年人是结核病防治工作的重点，经济发达的中心城区为结核病高负担聚集区，经济相对落后的高淳区为结核病高风险传播聚集区。     

The role of protein intake in the relationship between egg consumption and body composition in young adults. A mediation analysis

Background & aimsTo date, the literature examining the effects of whole-egg consumption on health outcomes focuses primarily on cardiovascular health markers; however, a significant gap exists in the literature about how egg consumption may influence body composition indicators. The aim of this study was to estimate the association between egg consumption and body composition indicators and to examine whether this relationship is mediated by protein intake in young adults.MethodsA cross-sectional study was conducted involving 355 first-year university students (aged 18–30 years) from a Spanish public university. Body composition was measured using bioimpedance and dual-energy X-ray absorptiometry (DXA) and fitness components were determined using the course-navette test. Egg consumption and protein intake (both in g/day/kg of body weight) were determined using a 137-item Food-Frequency Questionnaire. ANCOVA models were used to test the mean differences in body composition indicators (body mass index [BMI], ratio waist circumference/height [WC/height], body fat mass percentage, and body lean mass percentage) by egg consumption categories (<1 egg/week, 1–4 eggs/week, ≥5 eggs/week). Hayes's PROCESS macro was used for mediation analyses.ResultsParticipants reporting high egg consumption (≥5 eggs/week) showed significantly lower BMI, WC/height and body fat mass percentage values and higher body lean mass percentage values than those reporting low egg consumption (<1 egg/week) (p < 0.05). However, these relationships were not maintained after adjusting for protein intake. Protein intake acted as a full mediator of the relationships of egg consumption with BMI (indirect effect [IE] = ?1.19; 95% CI [?3.33; ?0.36]), WC/height (IE = ?0.01; 95% CI [?0.04; ?0.01]) and body lean mass percentage (IE = 2.99; 95% CI [1.26; 5.73]) as a partial mediator of the relationship be-tween egg consumption and body fat mass percentage (IE = ?2.19; 95% CI [?4.92; ?0.46]).ConclusionsThe association between egg consumption and body composition is mediated by protein intake. This finding is important from a public health perspective, suggesting that higher egg consumption (≥5 eggs/week) may lead to a healthier body composition, especially due to higher protein intake.     

Subclinical Pulmonary Congestion and Abnormal Hemodynamics in Heart Failure With Preserved Ejection Fraction

ObjectivesThe authors hypothesized that quantitative computed tomography (QCT) imaging would reveal subclinical increases in lung congestion in patients with heart failure and preserved ejection fraction (HFpEF) and that this would be related to pulmonary vascular hemodynamic abnormalities.BackgroundGross evidence of lung congestion on physical examination, laboratory tests, and radiography is typically absent among compensated ambulatory patients with HFpEF. However, pulmonary gas transfer abnormalities are commonly observed and associated with poor outcomes.MethodsPatients referred for invasive hemodynamic exercise testing who had undergone chest computed tomography imaging within 1 month were identified (N = 137). A novel artificial intelligence QCT algorithm was used to measure pulmonary fluid content.ResultsCompared with control subjects with noncardiac dyspnea, patients with HFpEF displayed increased mean lung density (–758 HU [–793, –709 HU] vs –787 HU [–828, –747 HU]; P = 0.002) and a higher ratio of extravascular lung water to total lung volume (EVLWV/TLV) (1.25 [0.80, 1.76] vs 0.66 [0.01, 1.03]; P < 0.0001) by QCT imaging, indicating greater lung congestion. EVLWV/TLV was directly correlated with pulmonary vascular pressures at rest, with stronger correlations observed during exercise. Patients with increasing tertiles of EVLWV/TLV demonstrated higher mean pulmonary artery pressures at rest (34 ± 11 mm Hg vs 39 ± 14 mm Hg vs 45 ± 17 mm Hg; P = 0.0003) and during exercise (55 ± 17 mm Hg vs 59 ± 17 mm Hg vs 69 ± 22 mm Hg; P = 0.0003).ConclusionsQCT imaging identifies subclinical lung congestion in HFpEF that is not clinically apparent but is related to abnormalities in pulmonary vascular hemodynamics. These data provide new insight into the long-term effects of altered hemodynamics on pulmonary structure and function in HFpEF.     

Higher mass meningococcal group C-tetanus toxoid vaccines conjugated with carbodiimide correlate with greater immunogenicity

To examine the link between meningococcal C (MenC) vaccine size and immunogenic response, a panel of MenC glycoconjugate vaccines were prepared differing in chain length, molar mass and hydrodynamic volume. The preparations consisted of different lengths of MenC polysaccharide (PS) covalently linked to monomeric purified tetanus toxoid (TT) carrier protein using the coupling reagent ethylcarbodiimide hydrochloride (EDC). Size exclusion chromatography with multi-angle light scattering (SEC-MALS) and viscometry analysis confirmed that the panel of MenC-TT conjugates spanned masses of 191,500 to 2,348,000 g/mol, and hydrodynamic radii ranging from 12.1 to 47.9 nm. The two largest conjugates were elliptical in shape, whereas the two smallest conjugates were more spherical. The larger conjugates appeared to fit a model described by multiple TTs with cross-linked PS, typical of lattice-like networks described previously for TT conjugates, while the smaller conjugates were found to fit a monomeric or dimeric TT configuration. The effect of vaccine conjugate size on immune responses was determined using a two-dose murine immunization. The two larger panel vaccine conjugates produced higher anti-MenC IgG1 and IgG2b titres after the second dose. Larger vaccine conjugate size also stimulated greater T-cell proliferative responses in an in vitro recall assay, although cytokines indicative of a T-helper response were not measurable. In conclusion, larger MenC-TT conjugates up to 2,348,000 g/mol produced by EDC chemistry correlate with greater humoral and cellular murine immune responses. These observations suggest that conjugate size can be an important modulator of immune response.