Objective To explore the efficiency of artificial intelligence and radiomics-assisted X-ray in diagnosis of lumbar osteoporotic vertebral compression fractures(OVCF).Methods The clinical data of 455 patients diagnosed as lumbar OVCF by MRI in our hospital were selected.The patients were divided into the training group(n=364)and the validation group(n=91),X-ray films were extracted,the image delineation,feature extraction and data analysis were carried out,and the artificial intelligence radiomics deep learning was applied to establish a diagnostic model for OVCF.After verifying the effectiveness of the model by receiver operating characteristic(ROC)curve,area under the curve(AUC),calibration curve,and decision curve analysis(DCA),the efficiencies of manual reading,model reading,and model-assisted manual reading of X-ray in the early diagnosis of OVCF were compared.Results The ROC curve,AUC and calibration curve proved that the model had good discrimination and calibration,and excellent diagnostic performance.DCA demonstrated that the model had a higher clinical net benefit.The diagnostic efficiency of the manual reading group:the accuracy rate was 0.89,the recall rate was 0.62.The diagnostic efficiency of the model reading group:the accuracy rate was 0.93,the recall rate was 0.86,the model diagnosis showed good predictive performance,which was significantly better than the manual reading group.The diagnostic efficiency of the model-assisted manual reading group:the accuracy rate was 0.92,the recall rate was 0.72,and the recall rate of the model-assisted manual reading group was higher than that of the manual reading group,but lower than that of the model reading group,indicating the superiority of the model diagnosis.Conclusion The diagnostic model established based on artificial intelligence and radiomics in this study has reached an ideal level of efficacy,with better diagnostic efficacy compared with manual reading,and can be used to assist X-ray in the early diagnosis of OVCF.

Objective To develop a clinical prediction model for predicting risk factors for prolonged hospital stay after anterior cervical discectomy and fusion(ACDF).Methods The clinical data of 914 patients underwent ACDF treatment for cervical spondylotic myelopathy(CSM)were retrospectively analyzed.According to the screening criteria,800 eligible patients were eventually included,and the patients were divided into the development cohort(n=560)and the validation cohort(n=240).LASSO regression was used to screen variables,and multivariate Logistic regression analysis was used to establish a prediction model.The prediction model was evaluated from three aspects:differentiation,calibration and clinical effectiveness.The performance of the model was evaluated by area under the curve(AUC)and Hosmer-Lemeshow test.Decision curve analysis(DCA)was used to evaluate the clinical effectiveness of the model.Results In this study,the five factors that were significantly associated with prolonged hospital stay were male,abnormal BMI,mild-to-moderate anemia,stage of surgery(morning,afternoon,evening),and alcohol consumption history.The AUC of the development cohort was 0.778(95%CI:0.740 to 0.816),with a cutoff value of 0.337,and that of the validation cohort was 0.748(95%CI:0.687 to 0.809),with a cutoff value of 0.169,indicating that the prediction model had good differentiation.At the same time,the Hosmer-Lemeshow test showed that the model had a good calibration degree,and the DCA proved that it was effective in clinical application.Conclusion The prediction model established in this study has excellent comprehensive performance,which can better predict the risk of prolonged hospital stay,and can guide clinical intervention as soon as possible,so as to minimize the postoperative hospital stay and reduce the cost of hospitalization.

Objective To explore the risk factors for surgical site infection(SSI)after transforaminal lumbar interbody fusion(TLIF)for the treatment of lumbar degenerative diseases.Methods A total of 1 000 patients who underwent TLIF for lumbar degenerative diseases in our hospital were included and divided into the infection group(n=23)and the non-infection group(n=977)according to whether the surgical incision was infected.General data,surgical and laboratory indicators of patients were collected,and potential risk factors of SSI were screened by univariate analysis and multivariate regression analysis,a nomogram model was established,and its predictive efficiency was validated by the receive operating characteristic(ROC)curve.Results The incidence of SSI in patients after TLIF was 2.3％.The results of univariate analysis showed that age,operative time,intraoperative blood loss,preoperative C-reactive protein(CRP),smoking,and diabetes mellitus were the significant risk factors for the occurrence of SSI.Multivariate regression analysis showed that older age,longer operation time,more intraoperative blood loss,smoking and diabetes mellitus were the independent risk factors for postoperative SSI.ROC curve showed that the nomogram model established in this study has good predictive efficiency.Conclusion Older age,longer operation time,more intraoperative blood loss,smoking,and diabetes mellitus were independent risk factors for postoperative SSI.For patients with these high risk factors,corresponding intervention measures should be taken before operation to reduce the incidence of SSI.

Objective:To explore the etiology and treatment of craniopharyngioma with aneurysm.Methods:Seven cases of craniopharyngioma with aneurysm from March 2014 to October 2019 treated in Sanbo Brain Hospital, Capital Medical University were retrospectively analyzed. Among the 7 patients, there were 5 males and 2 females. There were 4 cases of recurrent craniopharyngiomas, 1 case of primary tumor and 2 cases of non-recurrence tumor. Three patients with blood blister-like aneurysms were treated with microsurgical suture after craniopharyngioma resection. Among the three cases with internal carotid artery fusiform aneurysm, 1 case underwent craniopharyngioma resection after internal maxillary artery-radial artery-middle cerebral artery bypass and isolation of the aneurysm; 1 case only underwent internal maxillary artery-radial artery-middle cerebral artery bypass and isolation of the aneurysm for non-recurrence tumor; 1 case underwent craniopharyngioma resection and dynamic observation of aneurysm. One case with a cystic aneurysm of the middle cerebral artery was clipped and the craniopharyngioma did not relapse.Results:All patients had no serious postoperative complications. During the follow-up period, there was no recurrence of craniopharyngioma, no recurrence of treated aneurysms, and the stability of aneurysms was observed.Conclusions:Inflammatory stimulation of craniopharyngioma cystic fluid and operation itself are the important reasons for the occurrence of aneurysms after craniopharyngioma surgery. Choosing appropriate surgical methods can complete the removal of craniopharyngioma and the treatment of aneurysms at one time.

Objective To explore the surgical treatment of spindle aneurysms in V4 segment of vertebral artery. Methods The clinical data, surgical methods and prognosis of 6 patients with V4 spindle aneurysms of vertebral artery admitted from 2011 to November 2018 in Sanbo Brain Hospital were retrospectively analyzed,Results There were 4 males and 2 females aged from 45 to 65 years. Aneurysm rupture and bleeding occurred in 3 cases. Far lateral approach was used in all patients. One case was clipped with window aneurysms, 2 cases were treated with occipital artery (OA)- posterior inferior cerebellar artery (PICA) bypass, and 3 cases were treated with vertebral artery occlusion. Postoperative patients were generally in good condition. Postoperative CT arteriography confirmed that the bypass vessels were unobstructed in 2 cases. All vertebral aneurysms were treated satisfactorily and PICA arteries were preserved. Tracheotomy was performed in 5 patients (1 case was incised before operation). Three patients were removed 3 months after operation. The Glasgow Prognosis Score (GOS) was 4 points. Long-term tracheotomy was performed in 1 case, and GOS score was 3 points. Two patients died 4 months and 3 years after operation. Conclusions Craniotomy is an important method for the treatment of spindle aneurysm of V4 segment of vertebral artery. Different surgical methods should be selected according to the size of the aneurysm, the relationship between the location of the aneurysm and PICA, and the compensation of the vertebral artery.

Objective To investigate the distribution and antimicrobial resistance of Pseudomonas aeruginosa (P.aeruginosa) from intensive care units(ICUs) and general wards of a hospital,and provide scientific basis for rational use of antimicrobial agents in clinic.Methods Identification and antimicrobial susceptibility testing of clinically isolated bacteria in this hospital in 2016 were performed by VITEK 2 Compact automatic microbial analysis system,difference in antimicrobial resistance of P.aeruginosa between ICUs and general wards was compared.Results The tested specimens were mainly sputum in both ICUs and general wards,accounting for 78.7％ and 66.5％ respectively.There was no significant difference in the isolation rate of P.aeruginosa between ICUs and general wards (11.7％ vs 11.0％,P＞0.05).P.aeruginosa isolated from ICUs had the highest resistance rate to aztreonam (73.8％),resistance rates to piperacillin/tazobactam,cefoperazone/sulbactam,ceftazidime,imipenem,and meropenem were all up to more than 50％;P.aeruginosa detected in general wards had the highest resistance rate to aztreonam(59.6 ％),followed by piperacillin/tazobactam and imipenem,accounting for 48.0 ％ and 44.3 ％ respectively;resistance rates of P.aeruginosa isolated from ICUs to 12 kinds of antimicrobial agents were all higher thanthose of general wards(P＜0.05).Conclusion Resistance rate of P.aeruginosa from ICUs is higher than that in general wards,which should be paid attention,antimicrobial agents should be selected for clinical treatment of infection according to the results of antimicrobial susceptibility testing result.

Objective To design a self-service terminal for hyperbaric oxygen therapy in order to improve the orderliness and efficiency of hyperbaric oxygen therapy.Methods The hardware included mainframe and cabinet,and the software used human-computer interface.Network database was connected with ADO technology,and Delphi 7.0,Pascal compiling code were applied to code compilation.Results The self-service terminal involved the patient into the information chain of hyperbaric oxygen therapy to enhance the working efficiency and therapy orderliness.Conclusion The terminal behaves well in hardware,software,network database and human-computer interaction,and thus is worthy promoting to medium and large hyperbaric oxygen chambers.

Objective To design and develop an information management system based on network database for hyperbaric oxygen therapy to solve the problems in repeated operation,excessive data,copying and etc.Methods Network database was used to establish the information storage unit,design software and hardware architecture as well as develop information treatment units for medical terminal,self service,hand-hold intelligent terminal,appointment App program and etc.Results The system realized rapid printing and recognition of patient information,quick response of server,high accuracy of charging module,and high efficiency of self service terminal and appointment registration.Conchusion The system optimizes hyperbaric oxygen therapy flow,enhances working efficiency of medical staffs and gains high patient satisfaction,and thus is worthy promoting clinically.