基于小波变换的心电信号基线矫正方法

本文介绍一种基于小波变换的心电信号基线漂移去除方法。该方法利用小波变换多分辨分析的特性,将含噪声及基线漂移心电信号进行多尺度分解,结果表明,某尺度下的分解信号较好地反映了心电信号基线漂移,在重构过程中可直接将其去除。     

中国国家出生队列研究调查对象的基线特征分析

目的 探讨生命早期环境因素、遗传因素和遗传与环境交互作用对子代近期和远期健康的影响以及系统评价和比较辅助生殖受孕和自然受孕人群的妊娠结局和子代健康相关结局。方法 中国国家出生队列（CNBC）研究是一项覆盖辅助生殖受孕家庭和自然受孕家庭的多中心前瞻性出生队列研究。2016年,CNBC项目陆续在我国12个省（自治区、直辖市）的24所医院启动,以家庭为单位纳入研究对象,并在辅助生殖治疗前、胚胎移植、孕早期、孕中期、孕晚期及分娩时以及出生后第42天、6个月、12个月、36个月多个时点采集数据信息和生物样本。结果 截至2020年6月,CNBC共纳入27 044个辅助生殖受孕家庭,29 589个自然受孕家庭,CNBC的研究人群中绝大部分为城市居民。在辅助生殖受孕家庭中,男女双方分别有65.5%和63.7%为大学及以上文化程度,年龄为（33.83±5.52）和（32.38±4.67）岁;女方83.2%为初产妇,吸烟率为0.8%,饮酒率为2.1%。在自然受孕家庭中,男女双方分别有81.5%和86.5%为大学及以上文化程度,年龄为（32.06±5.09）和（30.40±4.27）岁,女方67.2%为初产妇,吸烟率为0.1%,饮酒率为2.2%。不同地区的辅助生殖受孕家庭和自然受孕家庭的基线特征均有差异。结论 CNBC的建立将为研究生命早期遗传、环境因素、遗传-环境交互作用以及辅助生殖技术治疗相关因素对出生后子代健康的影响提供了重要资源。     

基于胸部CT分析基线骨骼肌含量对ICU患者预后的影响

目的 探讨危重患者入ICU时基线骨骼肌含量与病情危重程度及预后的相关性。方法 纳入在ICU治疗时间≥48 h的危重患者79例,测量其入ICU时胸部CT第七胸椎（T7）水平横断面胸肌面积（PMA）,分析PMA与90 d病死率、90 d内生存率、28 d内非ICU生存日数、28 d内无机械通气生存日数、ICU病死率、院内病死率等指标的相关性。结果 在校正性别、危重症营养风险评分、 Charlson共病指数、血红蛋白等因素后,基线PMA较大患者90 d病死率更低,90 d内生存率更高,28 d内非ICU生存日数更多,院内病死率也更低,与基线PMA较小患者比较差异均具有统计学意义（P均< 0.05）。结论 危重患者入ICU时的基线骨骼肌含量可用于预测病情严重程度、需要体外生命支持和ICU治疗的时间和临床预后。     

Background rates of all-cause mortality,hospitalizations, and emergency department visits among nursing home residents in Ontario,Canada to inform COVID-19 vaccine safety assessments

BackgroundNursing home (NH) residents are prioritized for COVID-19 vaccination. We report monthly mortality, hospitalizations, and emergency department (ED) visit incidence rates (IRs) during 2010–2020 to provide context for COVID-19 vaccine safety assessments.MethodsWe observed outcomes among all NH residents in Ontario using administrative databases. IRs were calculated by month, sex, and age group. Comparisons between months were assessed using one-sample t-tests; comparisons by age and sex were assessed using chi-squared tests.ResultsFrom 2010 to 2019, there were 83,453 (SD: 652.4) NH residents per month, with an average of 2.3 (SD: 0.28) deaths, 3.1 (SD: 0.16) hospitalizations, and 3.6 (SD: 0.17) ED visits per 100 residents per month. From March to December 2020, mortality IRs were increased, but hospitalization and ED visit IRs were reduced (p < 0.05).ConclusionWe identified consistent monthly mortality, hospitalization, and ED visit IRs during 2010–2019. Marked differences in these rates were observed during 2020, coinciding with the COVID-19 pandemic.     

Pre-surgical cortical activation to food pictures is associated with weight loss following bariatric surgery

BackgroundRecent research suggests that preintervention functional magnetic resonance imaging (fMRI) data may predict weight loss outcomes among patients who participate in a behavioral weight loss plan. No study has examined whether presurgical brain activation can predict outcomes following bariatric surgery.MethodThe aim of the present study was to determine if brain activations during a presurgical fMRI food-motivation paradigm are associated with weight loss 3 and 6 months following laparoscopic adjustable gastric banding (LAGB). Nineteen participants viewed food and nonfood pictures from a well-established food motivation paradigm during an fMRI scanning session before LAGB surgery. Weight was assessed presurgery and 3 and 6 months postsurgery; data for all participants was available at each time point. fMRI data were analyzed using the BrainVoyager QX statistical package. Whole brain voxelwise correlations of presurgery (food–nonfood) brain activation and weight, corrected for multiple comparisons, were performed to analyze the relationship between presurgical brain activation and subsequent weight loss. The settings were a medical university brain imaging center and 2 surgical weight loss centers in a major metropolitan area.ResultsIncreased activity in frontal regions associated with cognitive control (medial, middle, superior frontal gyrus) and posterior cingulate cortex was associated with weight loss following LAGB.ConclusionWe found that neural activity in previously established regions associated with cognitive and behavioral self-regulation predicts weight loss following bariatric surgery. These preliminary findings highlight the role of neural circuitry in the success and maintenance of weight loss and suggest a possible future use of fMRI in screening LAGB surgery candidates.     

Baseline characterization of patients aged 70 years and above with hepatocellular carcinoma

AIM: To characterize the baseline profiles of patients aged 70 years and above with hepatocellular carcinoma (HCC). METHODS: A series of 127 consecutive patients with HCC were enrolled between 2000 and 2004, and none of them had been diagnosed as having HCC previously. Baseline profiles, including parameters of hepatic function such as serum transaminase and prothrombin time [PT (% activity)] were compared between patients aged ≥70 and <70 years. RESULTS: Patients ≥70 years old showed significantly lower levels of aspartate aminotransferase (P=0.04) and alanine aminotransferase (P= 0.01), and significantly higher PTs (P = 0.04) and platelet counts (P = 0.02). Concomitantly, among ≥70-year-old patients, HCC was more common in non-cirrhotics, whereas among patients <70 years old, HCC was more common in cirrhotics. There was no significant difference between the groups in the number or size of tumors. CONCLUSION: Older HCC patients showed less inflammation and better preservation of hepatic function, indicating that not only cirrhotic patients but also non-cirrhotic patients should be considered as a high-risk group among the elderly.     

苯作业工人职业防护知识的基线调查及干预效果分析

目的开展防护知识基线调查,制订相对应的干预措施,探讨一套对涉苯作业企业、工人健康防护知识教育和职业病防治行之有效的方法,以提高苯作业工人对职业防护知识知晓度及职业卫生防护的依从性,减少职业中毒危害,降低职业病发生率。方法发放《职业防护知识调查表》,对2013年3月～2014年3月本市某钓鱼竿厂339名苯作业工人的职业防护知识知晓度及行为依从性进行基线调查,并进行统计分析。结果 339名苯作业工人干预后的职业防护知识知晓度及职业依从性均高于干预前,差异有统计学意义（P〈0.05）。结论实施职业卫生健康教育、健康促进及行为干预,对提高苯作业工人职业防护依从性,保护从业工人身心健康,减少职业中毒的发生具有积极的意义。     

Association Between Clinical Tumor Burden and Efficacy of Immune Checkpoint Inhibitor Monotherapy for Advanced Non–Small-Cell Lung Cancer

BackgroundProgrammed cell death 1 (PD-1) inhibitors have become a standard treatment, albeit not completely effective, for patients with advanced non–small-cell lung cancer (NSCLC). Previous studies of advanced melanoma have revealed that the tumor burden predicted the response to PD-1 inhibitors, although this relationship has remained unclear for NSCLC.Patients and MethodsThe present single-center retrospective study evaluated 163 patients with advanced NSCLC who had received PD-1/programmed cell death ligand 1 (PD-L1) inhibitor monotherapy from December 2015 to December 2018. The clinical tumor burden was estimated using the baseline sum of the target lesions’ longest diameters (BSLDs), measured according to the Response Evaluation Criteria for Solid Tumors, and the baseline number of metastatic lesions (BNMLs).ResultsThe optimal cutoff values for predicting progression-free survival (PFS) were 5 for the BNMLs and 76 mm for the BSLDs, using the minimum P value method. The low-BNML group included 73 patients (44.8%). The median PFS was 12.2 months in the low-BNML group and 2.8 months in the high-BNML group (hazard ratio, 0.51; P = .0005). The low-BSLD group included 92 patients (56.4%). The median PFS was 9.6 months in the low-BSLD group and 3.4 months in the high-BSLD group (hazard ratio, 0.52; P = .0006). Multivariable analysis revealed that low-BSLD, low-BNML, nonsquamous histologic type and a PD-L1 tumor proportion score of ≥ 50% were independently associated with prolonged PFS.ConclusionsPD-L1 expression and the clinical tumor burden can predict the efficacy of PD-1/PD-L1 inhibitor monotherapy for NSCLC.     

福建新型农村合作医疗基线调查20万住院病例基本规律研究

[目的]分析福建省新型农村合作医疗(新农合)基线调查住院病例基本信息,为补偿方案测算提供依据。[方法]颁发和培训2种住院病例基线调查数据库模版(Excel与SPSS),在19个县市收集2004年和2005年206969例数据,用SPSS软件包统计分析。[结果]乡、县及县以上3级医院平均住院费为711、2702和9387元,病例数分别占38.3%、48.3%和13.4%;医院级别越高住院天数越多(3.3、6.6与13.8天,平均6.1天);获得一些单病种平均住院费数据。[结论]我省2007年扩大试点时,有关县市可不再进行重复性的入户调查和基线调查;可供参考的补偿方案是(设住院率为5%):3级医院的起付线可定为100、300和800元;补偿比分别可达60%、40%和35%;封顶线均为2万元。单病种平均住院费数据可供参考。