Objective:To assess the values of computed tomography(CT)equipment in whole life cycle and operation status from multi-dimension based on real world data,and to quantify the performance,operation status,and benefit analysis of medical equipment,so as to assist to grasp the operation status of CT equipment for hospital.Methods:Depended on the viewpoint of real-world data,economic benefits,metrology and performance data of 5 pieces of CT equipment,which included type A,type B,type C,type D and type E,used in hospitals in the last 4 years were collected.Type A,type B and type C were all imported CT equipment,and type A and type B were the same model.Both type D and type E were domestic CT equipment.The analytic hierarchy process(AHP)was used to assign the weights of each data,and form effectively multi-dimensional evaluation system.Results:The value of consistency ratio(CR)of the hierarchical weight allocation matrix was 0.042 that was less than 0.1,which met the requirement of consistency test.The scores of the comprehensive values the 5 pieces of CT equipment of type A,type B,type C,type D and type E were respectively 68.10,30.35,39.50,60.99 and 39.76.There was a significant difference between the two pieces of imported CT equipment of type A and type B of the same model in different use environments.The score of type D of domestic CT equipment was higher than those of the type B and type C of imported CT equipment,respectively.Conclusion:Under suitable use environments,domestic CT equipment can replace imported equipment.The AHP method can be used in the assessment of CT equipment value.

Denoising methods based on wavelet analysis and empirical mode decomposition cannot essentially track and eliminate noise, which usually cause distortion of heart sounds. Based on this problem, a heart sound denoising method based on improved minimum control recursive average and optimally modified log-spectral amplitude is proposed in this paper. The proposed method uses a short-time window to smoothly and dynamically track and estimate the minimum noise value. The noise estimation results are used to obtain the optimal spectrum gain function, and to minimize the noise by minimizing the difference between the clean heart sound and the estimated clean heart sound. In addition, combined with the subjective analysis of spectrum and the objective analysis of contribution to normal and abnormal heart sound classification system, we propose a more rigorous evaluation mechanism. The experimental results show that the proposed method effectively improves the time-frequency features, and obtains higher scores in the normal and abnormal heart sound classification systems. The proposed method can help medical workers to improve the accuracy of their diagnosis, and also has great reference value for the construction and application of computer-aided diagnosis system.
Algorithms ; Heart Sounds ; Humans ; Signal Processing, Computer-Assisted ; Signal-To-Noise Ratio ; Wavelet Analysis

Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.

Objective: To investigate the efficacy, safety, and traditional Chinese medicine (TCM) medication patterns of rituximab (RTX) combined with TCM on treating children with steroid-dependent nephrotic syndrome (SDNS). Methods: One hundred and forty-three children with SDNS who visited the Pediatric Nephrology Department of the First Affiliated Hospital of Henan University of Chinese Medicine from January 2018 to December 2022 were enrolled. A cohort study design was adopted, with " RTX treatment" as the exposure factor. Children who met this exposure factor were assigned to the RTX cohort (RTX, glucocorticoid, immunosuppressive agent, combined with traditional Chinese medicine syndrome differentiation treatment), whereas those who did not were assigned to the basic treatment cohort (glucocorticoid, immunosuppressive agent, combined with traditional Chinese medicine syndrome differentiation treatment ), and followed up for 6 months. The frequency of urinary protein recurrences, urinary protein remission duration, proportion and duration of steroid reduction and cessation, cumulative usage of steroids, proportion of recurrence, recurrence amount of steroid used, efficacy of TCM syndrome, and laboratory and safety indicators after treatment, and height and CD19+ B cell count before and after treatment were compared between the two cohorts. The medication patterns of TCM in the two cohorts were analyzed using frequency statistics, association rule analysis, and systematic clustering analysis. Results: Compared with the basic treatment cohort, the RTX cohort showed a decrease in the frequency of urinary protein recurrence, extended sustained remission of urinary protein, an increase in the proportion of steroid reduction and cessation, a shorter duration of steroid reduction and cessation, a decrease in cumulative steroid dosage, a lower recurrence rate, a decrease in CD19+ B cell count, and a decrease in 24-h urinary total protein quantification and the level of cholesterol (P<0.05). No significant difference in the recurrence amount of steroid used, height, TCM syndrome efficacy, albumin, aspartate transaminase, blood urea nitrogen, platelet count, and safety indicators between the two cohorts. Children with SDNS were mostly characterized by qi and yin deficiency syndrome, followed by spleen and kidney yang deficiency syndrome. A total of 175 TCMs were included, including 28 high-frequency drugs such as Huangqi, Fuling, Gancao, Baizhu, Dangshen, and Jiuyurou. The primary use of medication is to nourish the qi and spleen, nourish the kidney, and warm yang. The analysis of association rules yielded eight binary associations and ten three-phase associations, with Huangqi, Baizhu, Fuling, and Dangshen, being the most closely related. Cluster analysis identified four TCM combinations, primarily focusing on tonifying kidney and replenishing essence, benefiting qi and nourishing yin, and removing blood stasis. Conclusion RTX combined with TCM syndrome differentiation treatment can reduce the recurrence frequency of SDNS, prolong the remission period, reduce the glucocorticoid dosage, and have no marked effect on height growth. No apparent adverse reactions were observed. TCM should focus on nourishing qi and yin while removing blood stasis.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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