东莞市流动儿童保健现状及对策

目的了解东莞市流动儿童保健情况,找出存在问题,分析原因,提出相应解决办法。方法对东莞市820名流动儿童和300名本地儿童的保健情况进行分层抽样调查。结果流动儿童在正规医院接生、体检率、保健建卡率、接种建证率、四苗接种率、患病后就医等情况均与本地儿童比较,分别经χ2,有显著性差异,P均<0.01。患病后就医于无牌医生与本地儿童比较经χ2检验,有显著性差异,P<0.01;流动儿童的家长对儿童保健知识知晓率、文化程度、家庭月平均收入均较低。结论加强对流动人口的管理,逐步把流动儿童纳入儿童保健网,建立体检、保健卡,提高接种建证、四苗接种率,建立贫困流动人口的妇幼保健扶贫基金,加强流动人口的健康教育,改变就医于无证医生的习惯:是保障流动儿童健康的有效措施。     

人工智能对胃肠疾病诊疗的推动作用

高速发展的计算机技术给日常生活及工作带来巨大变化。人工智能是计算机科学的一个分支,是让计算机去行使通常情况下具备智能生命才可能行使的活动,广义的人工智能涵盖机器学习和机器人等等,本文主要聚焦于机器学习与相关的医学领域,深度学习是机器学习中的人工神经网络,卷积神经网络(CNN)是深度神经网络的一种,是在深度神经网络基础上,进一步模仿大脑的视觉皮层构造和视觉活动原理而开发;目前在医疗大数据分析中应用的机器学习方式主要为CNN。在未来数年内,人工智能作为常规工具进入医学图像解读相关的科室是发展趋势。本文主要分享人工智能与生物医学的融合进展,并结合实际案例,重点介绍CNN在胃肠道疾病的病理诊断、影像学诊断及内镜诊断等方面的应用研究现状。     

Multi-Scale Deep Neural Network (MscaleDNN) Methods for Oscillatory Stokes Flows in Complex Domains

In this paper, we study a multi-scale deep neural network (MscaleDNN) as a meshless numerical method for computing oscillatory Stokes flows in complex domains. The MscaleDNN employs a multi-scale structure in the design of its DNN using radial scalings to convert the approximation of high frequency components of the highly oscillatory Stokes solution to one of lower frequencies. The MscaleDNN solution to the Stokes problem is obtained by minimizing a loss function in terms of $L^2$ norm of the residual of the Stokes equation. Three forms of loss functions are investigated based on vorticity-velocity-pressure, velocity-stress-pressure, and velocity-gradient of velocity-pressure formulations of the Stokes equation. We first conduct a systematic study of the MscaleDNN methods with various loss functions on the Kovasznay flow in comparison with normal fully connected DNNs. Then, Stokes flows with highly oscillatory solutions in a 2-D domain with six randomly placed holes are simulated by the MscaleDNN. The results show that MscaleDNN has faster convergence and consistent error decays in the simulation of Kovasznay flow for all three tested loss functions. More importantly, the MscaleDNN is capable of learning highly oscillatory solutions when the normal DNNs fail to converge.     

Is a Local Administration of Parathyroid Hormone Effective to Tendon-to-Bone Healing in a Rat Rotator Cuff Repair Model?

To evaluate the effect of local parathyroid hormone (PTH) administration on rotator cuff tendon-to-bone healing in a rat model compared with systemic PTH injection and untreated controls. PTH-alginate scaffold was prepared and sustained release of PTH was confirmed. Bilateral supraspinatus tendon repairs were performed in 39 rats (group 1, supraspinatus repair only; group 2, supraspinatus repair with systemic PTH injection; group 3, supraspinatus repair with local PTH administration via an absorbable scaffold; n = 13 each). Biomechanical (cross-sectional area, mode of failure, load to failure, and ultimate stress: right side) and histological analyses (hematoxylin and eosin stain, Masson's Trichrome stain Picrosirius red stain, Immunohistochemistry for BMP2, PTH1R, ColI, and ColIII: Left side) were performed to evaluate tendon-to-bone healing quality at 8 weeks after repair, and blood test (osteocalcin and procollagen type I N-terminal pro-peptide [PINP] levels) was performed in all rats. There was no intergroup difference in the healing failure rate (p = 0.910) or failure mode (p = 0.585). Biomechanically, subjects in groups 2 and 3 exhibited significantly larger cross-sectional areas and higher ultimate failure loads and ultimate stress than those in group 1 (all p < 0.05); however, no differences were noted between groups 2 and 3 (all p > 0.05). Histologically, groups 2 and 3 exhibited more organized tendon-to-bone interface structures with higher density, parallel orientation, and collagen fiber continuity than group 1 (all p < 0.05 except collagen fiber continuity in group 1 vs. 2); however, no differences in histological parameters between groups 2 and 3 (all p > 0.05). The protein levels of bone morphogenic protein 2, PTH 1 receptor, and collagen I and III and the serum level of PINP were increased in groups 2 and 3 versus group 1 (all p < 0.05) without showing differences between groups 2 and 3 (all p > 0.05). Local PTH administration using an absorbable scaffold improved the biomechanical and histological outcomes of rotator cuff tendon-to-bone healing comparable with systemic PTH injection at 8 weeks after repair in a rat model. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:82–91, 2020