Adolescent ; Adult ; Female ; Herbicides ; poisoning ; Humans ; Male ; Middle Aged ; Paraquat ; poisoning ; Rural Population ; Young Adult

Bronchi ; Diagnostic Errors ; Female ; Foreign Bodies ; Humans ; Middle Aged

In order to realize an individualized and specialized rehabilitation assessment of remoteness and intelligence, we set up a remote intelligent assessment system of upper limb movement function of post-stroke patients during rehabilitation. By using the remote rehabilitation training sensors and client data sampling software, we collected and uploaded the gesture data from a patient's forearm and upper arm during rehabilitation training to database of the server. Then a remote intelligent assessment system, which had been developed based on the extreme learning machine (ELM) algorithm and Brunnstrom stage assessment standard, was used to evaluate the gesture data. To evaluate the reliability of the proposed method, a group of 23 stroke patients, whose upper limb movement functions were in different recovery stages, and 4 healthy people, whose upper limb movement functions were normal, were recruited to finish the same training task. The results showed that, compared to that of the experienced rehabilitation expert who used the Brunnstrom stage standard table, the accuracy of the proposed remote Brunnstrom intelligent assessment system can reach a higher level, as 92.1%. The practical effects of surgery have proved that the proposed system could realize the intelligent assessment of upper limb movement function of post-stroke patients remotely, and it could also make the rehabilitation of the post-stroke patients at home or in a community care center possible.
Algorithms ; Arm ; physiopathology ; Artificial Intelligence ; Humans ; Movement ; Recovery of Function ; Reproducibility of Results ; Software ; Stroke Rehabilitation

Objective To systematically evaluate the safety and effectiveness of combined portal vein resection and reconstruction in the resection of hilar cholangiocarcinoma.Methods Literatures were researched using Cochrane Library,PubMed,Embase,China Biology Medicine disc,China National Knowledge Infrastructure,Wanfang database,VIP database from January 31,2006 to January 31,2016 with the key words including “hilar cholangiocarcinoma”“Klatskin tumor”“Bile duct neoplasm”“Vascular resection”“portal vein resection”“肝门部胆管癌”“血管切除”“门静脉切除”.The clinical studies of resection of hilar cholangiocarcinoma with portal vein resection and construction and without vascular resection and construction were received and enrolled.Two reviewers independently screened literatures,extracted data and assessed the risk of bias.Patients who underwent resection of hilar cholangiocarcinoma combined with portal vein resection and reconstruction were allocated into the portal vein resection group and patients who didn't undergo vascular resection were allocated into the no vascular resection group.Analysis indicators included (1) results of literature retrieval;(2) results of Meta-analysis:① incidence of postoperative complications (hepatic failure,biliary fistula,intra-abdominal hemorrhage),② postoperative mortality,③ patients' prognosis,④ related indicators of postoperative pathology (lymph node metastasis rate,moderate-and low-differentiated rate,nerve invasion rate,negative rate of resection margin).The heterogeneity of the studies was analyzed using the I2 test.The hazard ratio (HR) and 95％ confidence interval (CI) were used for assessing the prognostic indicators.The incidence of complications,mortality and pathological indicators were evaluated by the odds ratio (OR) and 95％ CI.Results (1) Results of literature retrieval:13 retrospective studies were eurolled in the meta-analysis,and the total sample size was 1 668 cases including 437 in the portal vein resection group and 1 231 in the no vascular resection group.(2) Results of Meta-analysis:① incidence of postoperative complications was respectively 39.86％ in the portal vein resection group and 35.27％ in the no vascular resection group,with no statistically significant difference between the 2 groups (OR =1.12,95％ CI:0.82-1.53,P ＞0.05).The results of subgroup analysis showed that hepatic failure,biliary fistula and intra-abdominal hemorrhage were postoperative main complications,and the incidences were 17.09％,8.79％,6.25％ in the portal vein resection group and 10.62％,9.69％,2.51％ in the no vascular resection group,respectively,with no statistically significant difference between the 2 groups (OR =0.48,1.13,0.82,95％ CI:0.23-1.02,0.45-2.83,0.21-3.12,P ＞ 0.05).② Postoperative mortality was respectively 5.38％ in the portal vein resection group and 3.88％ in the no vascular resection group,with no statistically significant difference between the 2 groups (OR =1.16,95％ CI:0.62-2.14,P ＞ 0.05).③ There was statistically significant difference in patients' prognosis between the 2 groups (HR =1.81,95％ CI:1.52-2.16,P ＜ 0.05).④ The related indicators of postoperative pathology:lymph node metastasis rate,moderate-and low-differentiated rate and negative rate of resection margin were 41.55％,76.42％,63.74％ in the portal vein resection group and 33.42％,66.75％,64.29％ in the no vascular resection group,respectively,with no statistically significant difference between the 2 groups (OR =1.45,1.59,0.67,95％ CI:0.95-2.21,0.97-2.61,0.37-1.20,P ＞ 0.05).The nerve invasion rate was 83.47％ in the portal vein resection group and 64.90％ in the no vascular resection group,with a statistically significant difference between the 2 groups (OR =2.61,95 ％ CI:1.45-4.70,P ＜ 0.05).Conclusion Combined portal vein resection and reconstruction is safe and feasible in the treatment of hilar cholangiocarcinoma,and the prognosis of patients with portal vein invasion is worse than that without portal vein invasion.

0.05).However,HCT2s of right side and left side were significantly negatively correlated to age(r=-0.606,-0.522;P=0.000,0.000).Conclusion HCT2s in healthy Chinese aged 10~59 year measured on SE dual echo images are quite stable,and age is an influencing factor of HCT2,but not side,sex and handedness.

Anion Exchange Protein 1, Erythrocyte ; metabolism ; Breast ; metabolism ; pathology ; surgery ; Cadherins ; metabolism ; Female ; Fibrocystic Breast Disease ; metabolism ; pathology ; surgery ; Follow-Up Studies ; Humans ; Middle Aged ; S100 Proteins ; metabolism

Objective To analyze the baseline clinical characteristics of the chronic kidney disease (CKD) in aged people in the clinic.Methods Patients aged 18 years or older in our CKD clinic from October 2003 to December 2012 were included in this study.According to their age patients were divided into 2 groups:aged CKD group:aged 65 or older and non-aged CKD group:younger than 65.A group of the elderly without CKD from health screening program were selected as aged non-CKD control group.Causes,distributions of stages and complications of CKD in three groups were analyzed.Results The major cause of the elderly CKD was hypertension,different from that of younger CKD.The distribution of CKD stage in the elderly was mainly in the G3b stage,different from that in the younger.Anemia and mineral bone disease presented in earlier CKD stage in the aged CKD patients and the prevalence was higher than in the aged non-CKD group.The prevalence of hypertension had no statistical difference between the two CKD groups,but hypertension control rate was lower in aged CKD patients.Conclusions The clinical characteristics including causes and renal stage are different between the young and aged CKD patients.Complications such as anemia and mineral bone disease presents in earlier renal stage in aged CKD patients which means we should monitor and interfere earlier.

Objective To evaluate the clinical value of multi-tomographic imaging mode of three-dimensional ultrasound combined with surface imaging in diagnosing and staging bladder tumors.Methods Seventy-five patients were examined with three-dimensional ultrasound and two-dimensional ultrasound.In addition,54 cases were undergone preoperative multislice spiral CT.All cases were proved by pathology after operation.Results The qualitation accuracy in the diagnosis of bladder tumor with two-dimensional ultrasound was 93.3%(70/75) and that of three-dimensional ultrasound was 98.7%(74/75).The staging accuracy rates with two-dimensional ultrasound and three-dimensional ultrasound were 83.5%(106/127) and 93.2%(123/132) respectively.The difference of bladder tumor staging between three-dimensional ultrasound and two-dimensional ultrasound was significant (P＜0.05).The qualitation accuracy in the diagnosis of bladder tumor with CT was 90.7%(49/54).The preoperative staging rate of CT was 79.7%(59/74),compared with that of three-dimensional ultrasound,the difference was significant(P＜0.05).Conclusions Multi-tomographic imaging mode of three-dimensional ultrasound combined with surface imaging can provide useful information and makes an improvement in detecting and staging bladder tumors.

Objective To investigate the diagnostic value of DTI anisotropy parameters in breast malignant tumors.Methods Fifty four patients,including 33 patients with malignant tumors and 21 patients with benign lesions,were retrospectively analyzed.The E1,MD and FA of lesions were measured and compared by paired t test between the malignant tumors and the contralateral healthy breast tissue.The difference between malignant tumors and benign lesions was analyzed by independent sample t test.Logistic regression analysis was made using E1,FA,MD as predictors in detecting and differentiating the malignant tumors,ROC curve analysis was performed to compare diagnostic performance based on the area under the curve (AUC).Results E1,MD and FA in malignant tumors were (0.99 ± 0.12) × 10-3mm2/s,(0.85 ±0.26) × 10-3mm2/s and 0.20 ±0.08 respectively,and those in normal breast tissues were(1.46 ± 0.55) × 10-3 mm2/s、(1.48 ± 0.44) × 10-3 mm2/s and 0.29 ± 0.17 respectively.Those parameters in benign lesions were (1.80 ±0.42) × 10-3mm2/s,(1.38 ±0.52) × 10-3mm2/s and 0.22 ± 0.10 respectively.Significant statistic differences were found between malignant tumors and normal breast tissues in E1,MD and FA (t =-4.889,-6.449,-2.842 ; P ＜ 0.01).Significant statistic differences were also found between malignant tumors and benign lesions in E1 and MD (t =-10.476,-4.394; P ＜ 0.01) with no difference found in FA (P ＞ 0.05).E1,MD and FA are independent predictors in malignant tumors' detection,and the combination of E1,MD and FA significantly improved discrimination between cancer and normal tissue over each one alone with the sensitivity 97.0％ (32/33),specificity 97.0％ (32/33),accuracy 97.0％ (64/66).Combination of E1 and MD had a similar AUC with E1 and a more AUC than MD and FA,with the sensitivity 97.0％ (32/33),specificity 100.0％ (21/21),accuracy 98.1％ (53/54).Conclusion The regression model combining E1,MD and FA is most valuable in breast cancer detection and E1 is the preferred index for the differentiation of breast cancers from benigin lesions.

Objective To investigate the trend of antimicrobial resistance and the prevalence of resistant genes in Pseudomonas aeruginosa strains isolated from Hangzhou First People's Hospital.Methods Antimicrobial susceptibilities of 1489 Pseudomonas aeruginosa strains isolated from 2003 to 2007 were statistically analyzed using WHONET.MICs of 11 antimicrobisis to 36 multi-drug-resistant Pseudomonas aerugionosa strains were determined by agar dilution method.Genes of β-lactamases(BLA)and aminoglycoside-modifying enzymes(AMEs)were detected by PCR and the PCR products were sequenced.Results The resistant rates to aztreonam,imipenem,ceftazidime,cefepime,piperacillin,piperacillin/tazobactam.cefoperazone/sulbactam,ciprofloxacin,levofloxacin,gentamicin and amikacin were increased from 13.4%,10.6%,8.7%,7.9%,12.7%,12.7%,6.7%, 15.8%,20.5%,24.7% and 10.9%in 2003 to 35.3%,40.9%,18.4%, 32.4%,32.9%,32.0%,21.9%,37.8%,38.6%, 39.4% and 34.8% in 2007.respectively.Hish MICs of 11 antimicrobiMs for multi-drug resistant Pseudomonas aerouginosa were determined with MIC90≥128 μg/mL.In 36 multi-drug resistant Pseudomonas aeruginosa strains,21(58.3%)strains carried β-lactamase genes and 32 strains(88.9%)carried aminoglycosidemodifying enzyme genes,while the deletion rate of oprD2 was 80.6%(29/36).Conclusions The resistant rates to common antibiotics of Pseudomonas aeruginosa have increased.resulting in multi-drug resistance.Genes of β-lactamases and aminoglycoside-medifying enzymes are prevalent in multi-drug resistant Pseudomonas aeruginosa strains,with the common deletion of oprD2.