影响2型糖尿病老年患者并发周围神经病变的logistic分析

目的 探讨2型糖尿病老年患者并发周围神经病变的影响因素。方法 选取2016年2月—2018年7月本院治疗的2型糖尿病老年患者120例作为研究对象,统计并发周围神经病变发生情况,根据有无发生周围神经病变分为DPN组57例和非DPN组63例,并对其影响因素进行调查分析。结果 DPN组患者与非DPN组患者的年龄、糖尿病病程、吸烟史、饮酒史、高血压病史、高血脂病史、BMI指数、FPG、HbA1c、UA水平差异有统计学意义(P<0.05),DPN组患者与非DPN组患者的性别、ALT、AST水平差异无统计学意义(P>0.05);Logisitic回归分析结果显示,年龄、糖尿病病程、吸烟史、饮酒史、高血压病史、高血脂病史、BMI指数、FPG、HbA1c、UA水平是2型糖尿病老年患者并发周围神经病变的影响因素。结论 年龄、糖尿病病程、吸烟史、饮酒史、高血压病史、高血脂病史、BMI指数、FPG、HbA1c、UA水平是2型糖尿病老年患者并发周围神经病变的影响因素,应积极采取有效措施进行控制糖尿病周围神经病变的发生与发展,提高2型糖尿病老年患者的生活质量。     

Publishing in open access era: focus on respiratory journals

We have entered an open access publishing era. The impact and significance of open access is still under debate after two decades of evolution. Open access journals benefit researchers and the general public by promoting visibility, sharing and communicating. Non-mainstream journals should turn the challenge of open access into opportunity of presenting best research articles to the global readership. Open access journals need to optimize their business models to promote the healthy and continuous development.     

基于Faster-RCNN的肺结节检测算法

针对目前的肺结节检测中存在的个体差异、同病异影、同影异病的问题,提出一种大样本条件下的基于Faster-RCNN的肺结节检测算法,对比研究目前的深度学习模型的适应性,给出一种通用的随着样本数量增加肺结节检测率持续提升的策略。首先搭建深度学习的软硬件环境,设置影像数据接口与Faster-RCNN的网络接口匹配;然后搭建Faster-RCNN的单类分类网络,并对网络结构的参数进行调整优化;最后用包含2 000例病人的肺结节数据集,通过不同的卷积神经网络模型 (包括ZF和VGG),计算CT图像在各自模型中的特征。对测试结果进行分析评估,分别统计其漏检率、检测准确率,并探讨不同训练数量和数据增广类型对最终检测准确率的影响。最终ZF模型的检测准确率为90.82%,准确率的波动方差为13.30%;VGG模型的检测准确率为87.02%,准确率的波动方差为37.10%。ZF模型的波动方差小,检测精确度高,综合考虑,ZF模型对肺结节的检测效果优于VGG模型的检出效果。所提出的肺结节检测技术具有良好的理论价值和工程应用价值。     

基于回转器理论的电流模式控制型DC-DC变流器统一大信号模型

随着新能源技术的大力发展，直流分布式系统以其独特的优势得到了越来越广泛的关注，逐渐成为业界的研究热点。虽然系统中每个模块都能够单独稳定运行，但由于模块之间复杂的相互作用，系统的稳定性特别是在大信号扰动下的暂态稳定性情况仍是令人困扰的一大难题，且目前该领域的理论研究成果相对缺乏。简单、有效、统一的大信号模型是进行大信号稳定性理论分析的基础。由于电流模式控制方法应用较为广泛，故本文基于回转器理论提出了一种适用于电流模式控制型DC-DC变流器的统一大信号模型。该模型实现了降阶，表达式简单，且仅需修改其中一个模型参数值即可实现对不同拓扑变流器的建模分析，为理论分析系统的大信号稳定性奠定了良好的基础，也为解析形式大信号稳定性判据的提出提供了可能。仿真和实验分别基于Buck、Boost及Buck-Boost变流器对该模型的有效性进行了验证。同时，为验证该大信号模型的完备性，对其稳态工作点附近的小信号特性也进行了分析，并与目前公认的比较精确的电流模式控制小信号模型进行了对比，得到了较好的结果。     

Stathmin and phospho-stathmin protein signature is associated with survival outcomes of breast cancer patients

Currently, Stathmin1 (STMN1) and phospho-STMN1 levels in breast cancers and their clinical implications are unknown. We examined the expression of STMN1 and its serine phospho-site (Ser16, Ser25, Ser38, and Ser63) status by immunohistochemistry. Using Cox regression analysis, a STMN1 expression signature and phosphorylation profile plus clinicopathological characteristics (STMN1-E/P/C) was developed in the training set (n = 204) and applied to the validation set (n = 106). This tool enabled us to separate breast cancer patients into high- and low-risk groups with significantly different disease-free survival (DFS) rates (P < 0.001). Importantly, this STMN1-E/P/C model had a greater prognostic value than the traditional TNM classifier, especially in luminal subtype breast cancer (P = 0.002). Further analysis showed that patients in the low-risk group would benefit more from adjuvant paclitaxel-based chemotherapy (P = 0.002). In conclusion, the STMN1-E/P/C signature is a reliable prognostic indicator for luminal subtype breast cancer and may predict the therapeutic response to paclitaxel-based treatments, potentially facilitating individualized management.     

Outcome prediction for Bonebridge candidates based on audiological indication criteria

ObjectiveTo re-evaluate current indication criteria and to estimate the audiological outcomes of patients with Bonebridge bone conduction implants based on preoperative bone conduction thresholds.MethodsWe assessed the outcome of 28 subjects with either conductive or mixed hearing loss (CMHL) or single-sided deafness (SSD) who were undergoing a Bonebridge implantation. We used linear regression to evaluate the influence of preoperative bone conduction thresholds of the better/poorer ear, indication group, and language (German- and French-speaking patients) on aided sound field thresholds. In addition, aided word recognition scores at 65 dB sound pressure level were fit with a logistic model that included preoperative bone conduction thresholds of the better/poorer ear, indication group, and language as effects.ResultsWe found that both aided sound field thresholds and word recognition were correlated with the preoperative bone conduction thresholds of the better hearing ear. No correlation between audiological outcomes and the preoperative bone conduction thresholds of the poorer ear, language, or indication group was found.ConclusionBone conduction thresholds of the better hearing ear should be used to estimate the outcome of patients undergoing Bonebridge implantation. We suggest the indication criteria for Bonebridge candidates considering maximal bone conduction thresholds of the better ear at 38 dB HL to achieve an aided sound field threshold of at least 30 dB hearing level and an aided word recognition score of at least 75% for monosyllabic words.     

Number of Segments Within Musculoskeletal Foot Models Influences Ankle Kinematics and Strains of Ligaments and Muscles

Multi‐segment foot models (MFMs) are becoming a common tool in musculoskeletal research on the ankle‐foot complex. The purpose of this study was to compare ankle joint kinematics as well as ligament and muscle strains that result from MFM with a different number of segments during vertical hopping. Ten participants were recruited and performed double‐limb vertical hops. Marker positions and ground reaction forces were collected. Two‐segment (2MFM), three‐segment (3MFM), and five‐segment MFM (5MFM) were used to calculate ankle kinematics and the strains of the anterior talofibular and calcaneofibular ligaments and of the soleus and gastrocnemius muscles. Ranges of motion and peak strains were analyzed with Kruskal–Wallis and post hoc tests, whereas the time‐series of the ankle kinematics and ligament and muscle strains were analyzed with statistical parametric mapping. There were significant main effects for MFM in the talocrural joint range of motion and peak strains of ligaments and muscles. In addition, there were significant main effects for MFM in time‐series data of the talocrural joint angle as well as for ligament and muscle strains. In all cases, the post hoc analyses showed that the 2MFM consistently overestimated the range of motion and tissue strains compared to the 3MFM and 5MFM, while 3MFM and 5MFM did not differ from each other in the most variables. This study showed that the number of segments in MFM significantly affects the biomechanical estimates of joint kinematics and tissue strains during hopping. Clinical significance: MFM that combine all foot structures beyond the talus into one segment likely overestimate ankle joint biomechanics. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2231–2240, 2019