经纤维支气管镜应用冷冻治疗仪行儿童支气管异物取出术的有效性及安全性

目的探讨经纤维支气管镜应用冷冻法行儿童支气管异物取出术的有效性及安全性。方法对72例支气管异物的患儿进行纤维支气管镜下应用冷冻治疗仪行异物取出术,并对患儿在术中和术后并发症进行观察。结果所有患儿支气管异物均顺利取出。72例患儿中,术中并发症以一过性低氧血症最常见,共37例,以小年龄组最高,随年龄增大而降低;术后并发症则以咳嗽加重最常见,共20例。术后随访未发现严重并发症。结论纤维支气管镜下应用冷冻治疗仪行儿童支气管异物取出术,虽然具有一定的并发症,但操作时间短,并发症轻微。具有较高的应用价值及安全性。     

Surgical myectomy versus alcohol septal ablation for obstructive hypertrophic cardiomyopathy: A propensity score–matched cohort

Objectives

In patients with hypertrophic cardiomyopathy, obstruction of the left ventricular outflow tract can be relieved by surgical septal myectomy or alcohol septal ablation, but uncertainty remains regarding long-term results and comparative effectiveness of alcohol septal ablation. This study aims to compare short- and long-term outcomes of the 2 procedures.

基于超声影像组学的乳腺癌预测模型的诊断性能研究

目的评估并比较基于不同机器学习算法建立的乳腺癌超声影像组学预测模型的诊断性能。 方法回顾性收集2017年1月至2019年4月就诊皖南医学院第一附属医院、有明确病理结果的乳腺肿块病例828例，以2018年8月31日为节点将其分为训练集（526例）和验证集（302例），提取肿块的超声影像组学特征并进行特征筛选，运用k最近邻（kNN）、逻辑回归（LR）、朴素贝叶斯（NB）、随机森林（RF）和支持向量机（SVM）5种机器学习算法分别建立预测模型，使用重复交叉验证方法做内部验证，计算比较各模型的敏感度、特异度、阳性预测值（PPV）和阴性预测值（NPV），并实施外部验证，绘制ROC曲线并比较ROC曲线下面积（AUC）以评价模型的鉴别诊断性能，绘制校准曲线评价模型校准度。 结果从提取的109个影像组学特征中筛选出19个特征建立了5种机器学习算法模型。在内部验证中，5种模型的敏感度、特异度、PPV、NPV比较，总体差异均有统计学意义（P均＜0.001）。LR模型的特异度、PPV、NPV中位数分别为0.769、0.816、0.778，3项指标均高于其他4种模型；敏感度中位数为0.824，高于kNN、RF和SVM模型。此外，SVM模型的特异度、PPV、NPV中位数分别为0.706、0.774、0.759，虽均低于LR模型，但均高于其他3种模型。在外部验证中，LR、SVM、RF、kNN和NB的AUC依次为0.890、0.832、0.821、0.746和0.703，其中LR与SVM的AUC差异有统计学意义（P=0.012）；此外，各模型在校准性能上表现并不一致，LR和SVM模型的校准曲线显示乳腺癌实际概率与预测概率之间的一致性较好。 结论以超声影像组学特征为基础，运用不同机器学习算法建立的乳腺癌超声预测模型，均表现出较高的诊断性能，其中LR模型表现最为突出；选择合适的机器学习算法有助于进一步提高预测模型的诊断性能，提供更加准确的量化预测结果。     

Effects of Combination of Calcium and Aspirin on Azoxymethane-Induced Aberrant Crypt Foci Formation in the Colons of Mice and Rats

Human intervention studies have suggested an exciting synergistic action between calcium supplementation and aspirin intake in reducing the risk of colorectal cancer. The aim of this study was to determine whether such a synergy can be demonstrated on azoxymethane (AOM)-induced colon aberrant crypt foci (ACF) formation in mice and rats. Female CF-1 mice and male F344 rats were injected subcutaneously with AOM and then received diet treatments for 8 wk. The basal control diet contained high fat (20% mixed lipids by weight) and low calcium (1.4 mg/g diet) to mimic the average Western diet. The treatment diets contained enriched calcium (5.2 mg calcium/g diet), aspirin (0.2 mg aspirin/g diet), or calcium plus aspirin (5.2 mg calcium plus 0.2 mg aspirin/g diet). Treatment with calcium, aspirin, or their combination significantly decreased the number of total ACF and aberrant crypt per mouse (by 43–59%) or rat (by 23–38%), but statistically significant differences among the 3 groups were not observed. A hint of additivity between calcium and aspirin was observed in mice but not in rats. These results indicate that the combination of calcium and aspirin did not produce a synergistic effect on the ACF formation in AOM-treated mice and rats.     

Outcome predictors of cirrhotic patients with spontaneous bacterial empyema

Background: Spontaneous bacterial empyema (SBE) is a complication of cirrhotic patients in which a pre‐existing pleural effusion becomes infected. This retrospective study was designed to investigate the bacteriology and outcome predictors of SBE in cirrhotic patients. Methods: Medical records of cirrhotic patients treated in a tertiary care university hospital from December 2004 to December 2008 were retrospectively reviewed. Results: Of 3390 cirrhotic patients seen during the study period, 81 cases of SBE were diagnosed. The incidence of SBE was 2.4% (81/3390) in cirrhotic patients and 16% (81/508) in patients with cirrhosis with hydrothorax. There were 46 monomicrobial infections found in 46 SBE patients. Aerobic Gram‐negative organisms were the predominant pathogens (n=29, 63%), and Escherichia coli (n=9, 20%) was the most frequently isolated sole pathogen. The mortality rate of SBE was 38% (31/81). Univariate analysis showed that Child–Pugh score, model for end‐stage liver disease (MELD)–Na score, concomitant bacteraemia, concomitant spontaneous bacterial peritonitis, initial intensive care unit (ICU) admission and initial antibiotic treatment failure were predictors of poor outcomes. Multivariate regression analysis demonstrated that the independent factors related to a poor outcome were initial ICU admission [odds ratio (OR): 4.318; 95% confidence interval 1CI) 1.09–17.03; P=0.037], MELD–Na score (OR: 1.267; 95% CI 1.08–1.49; P=0.004) and initial antibiotic treatment failure (OR: 13.10; 95% CI 2.60–66.03). Conclusion: Spontaneous bacterial empyema in cirrhotic patients is a high mortality complication. The independent factors related to poor outcome are high MELD–Na score, initial ICU admission and initial antibiotic treatment failure. High MELD–Na score may be a useful mortality predictor of SBE in cirrhotic patients.     

一种基于FPGA控制的多路并行数据采集设计方法

目的：为生物电阻抗成像设备设计出一个高精度、高速率，并能进行同步采集的多路信号采集模块。方法：通过在FPGA上定制一个NiosII软核来作为系统的微控制器，然后通过对FPGA编程实现对多路A／D并行采集的时序控制，最后通过UART总线实现采集板与上位机之间的数据传输。结果：该系统成功地实现了对4路A／D转换器的并行控制，并实现了在100Hz～100kHz激励下对64路信号进行同步采集及初步的处理。结论：该设计方案达到了研究目的，能够满足EIS成像系统的数据采集需求。