Objective To evaluate the efficacy and safety of transcatheter arterial chemoembolization(TACE)combined with per-cutaneous microwave ablation(MWA)in treatment of large-sized hepatic carcinoma.Methods A total of 84 patients with large-sized hepatic carcinoma were randomly and equally divided into the study group(n=42)and control group(n=42).TACE combined with MWA was carried out in the patients of the study group,while only TACE was performed in the patients of the control group.Results The effective rate of the study group and the control group was 71.4% and 42.8% respectively,and the difference between the two groups was statistically significant(P <0.05).In the study group,the survival rates at 6,12,18,24 months after the treatment were 88.1%,73.8%,52.3% and 33.3% respectively,while in the control group the survival rates were 76.2%,57.1%,30.9% and 9.5%respectively.There was no statistically significant differences in the postoperative complications between the two groups.Conclusion TACE combined with MWA appears to be an effective approach for the treatment of large-sized hepatic carcinoma.The effect of combined therapy is obviously superior to the only TACE.

Objective To investigate the impairment and the effect factors of encoding of episodic memory in patients with cerebral infarction. Methods 112 cases cerebral infarction patients and 115 healthy elders as controls were tested for episodic memory encoding with episodic pictures accomplished in computer, and compare the differences of encoding of episodic memory between the two groups. Results The remember indexes ( REM )of encoding memory test in patient group was significantly lower than that in control group( (70.81 ± 6.08 )vs (84.67 ± 4.49), P ＜ 0.01 ). The REM in patients with different impaired areas was significantly different ( (65.88 ± 5.73 ), (68.92 ± 4.65 ), (73.39 ± 6.20), ( 73.53 ± 3.44), P ＜ 0. 01 ). The REM in frontal lobe infarction group was significantly lower than that in temporal lobe infarction group (P ＜ 0.05 ), and in temporal lobe infarction group was significantly lower than that in basal ganglia infarction group and corona radiate infarction group (P＜0.05, P＜0. 01). The REM in cortex infarction group was significantly lower than that in under cortex group ( ( 67.37 ± 5.40 ), ( 73.46 ± 4.99 ), P ＜ 0.01 ). The REM in small cerebral infarction group was significantly higher than that in large cerebral infarction group( (72.67 ±4.47 ), (67.56 ± 6.18 ), P＜0.01 ). The size of cerebral infarction diameter was related with the REM( r= -0.39, P＜0. 01 ). The REM among control group,infarction with atrophy group, and infarction without atrophy group were significantly different( (67.03 ± 6. 17 ),( 72.84 ± 5. 00 ), ( 84.67 ± 4.49 ), P ＜ 0. 01 ). The REM in infarction with atrophy group was significantly lower than that in infarction without atrophy group and control group( both P＜0.01 ) ,The REM in infarction without atrophy group was significantly lower than that in control group (P ＜ 0.01). Conclusion The encoding of episodic memory was impaired in cerebral infarction patients. The infarction parts,size of infarction area and atrophy was related with the impairment of encoding of episodic memory.

Objective To collect the demographic,lifestyle and clinical factors of patients with cerebrovascular disease,and analyze the vascular cognitive impairment(VCI) factors and set up high-risk factors model.methods 505 patients with cerebrovascular disease hospitalization in department of geriatrics and neurology in hospital from October 2014 to October 2016 were enrolled.According to the questionaire survey data of demographics,lifestyle and clinical factors,the patients were divided into training set (421 cases) and test set (84 cases),and training set were divided into the non-VCI set (225 cases) and VCI set (196 cases).Analyzed the influence factors of VCI in patients with cerebrovascular disease by decision tree algorithm,and compared it with the Logistic regression analysis and chi-square and established the decision tree model for risk factors of VCI.Result sAccording to the VCI decision tree model,cross validation model recognition accuracy was 73.63%,while test set prediction accuracy was 73.81%.Alcoholism,hobbies,education level,tea drinking,diabetes,hypertension,diet,age,sleep and physical exercise were classification of node variables,while drinking was the root.The probability of VCI had significant difference (P<0.05) in the crowds with different risk factors.According to Result s of Logistic regression analysis,education level,drinking,exercise and diabetes were independent risk factors for VCI,while the model prediction accuracy was 66.98%,and test set prediction accuracy was 53.57%.According to the ROC curve of the decision tree model and the Logistic regression model,the decision tree model AUC was 0.737 (95%CI 0.688 to 0.786),and the Logistic regression model AUC was 0.664 (95%CI 0.612 to 0.717).Conclusion It is suggested that the decision tree model might be superior to logistic regression model in the prediction accuracy for VCI of patients with cerebrovascular disease.The alcoholism,diabetes,high blood pressure,high fat diet and insomnia are risk factors of VCI,while hobbies,high level of education,physical exercise and drinking tea can be the protective factors of the VCI.

Objective To observe the effect of electroacupuncture at the beginning and ending points of bicipital muscle on the superficial electromyography (sEMG) of the spastic limb in hemiplegia.Method Forty patients with spastic hemiplegia after cerebral stroke were divided by the random number table into a group of electroacupuncture at the beginning and ending points (group A) and a group of electroacupuncture at antagonistic muscles (group B). The former selected Ashi points at the beginning and ending points of bicipital muscle, while the latter selected points at the antagonistic muscles [Tianjing (TE10), Qinglingyuan (TE11), etc.], to receive perpendicular puncturing. The needles were retained for 30 min, and the sEMG of bicipital muscles in resting state was detected after the removal of the needles. The spastic bicipital muscle was examined by sEMG prior to the acupuncture treatment, and respectively after 2-week and 4-week acupuncture treatment, and the detected parameters included root mean square (RMS) and integrated electromyography (IEMG).ResultThe EMG and IEMG declined gradually in the two groups after the acupuncture treatment; the intra-group comparisons of the RMS and IEMG values at three time points, e.g. prior to acupuncture treatment, after 2-week acupuncture treatment and after 4-weekacupuncture treatment, showed that the values changed significantly compared to those at the previous time point (P<0.05); the between-group comparisons showed that there were no significant differences in comparing the RMS and IEMG values regardless of different time points (P>0.05). The RMS and IEMG values presented same changing tendencies after 4-week acupuncture treatment in the two groups.ConclusionAcupuncture at the beginning and ending points and at the points on antagonistic muscles both can decrease the resting-state muscle tension in hemiplegia patients; sEMG is of certain significance in evaluating the treatment of hemiplegia.

It is important to simulate the excitation propagation process of cardiac bio-electricity in the research of ECG forward problem. Traditional methods describe them with wave simulation algorithm such as LFX simulation algorithm and vector propagation algorithm etc, these methods have some problems to certain extent, due to the presence of discreteness of space and time and asymmetry of the myocardium. This paper discussed the simulation algorithm in 2-dimension space under the circumstance of layered and non-layered structure of myocardium. By calculating the theoretic values of simulating time based on Huygen's principle, we found that there were errors in LFX algorithm and no errors in vector propagation algorithm under the circumstance of non-layered structure of the myocardium, no mater what myocardium is isotropic or anisotropic. However, there exist errors from both algorithms when the myocardium has the layered structure. An improved algorithm is proposed and the simulations have been performed to examine the efficacy of the new algorithm, and the errors are reduced obviously. By increasing the number of myocardial blocks in the model, we also analyzed its influence on the error of simulation algorithm.
Algorithms ; Computer Simulation ; Heart ; physiology ; Models, Cardiovascular

Objective To investigate the changes in serum levels of angiopoietin-like protein 4(ANGPTL4)and ubiquitin carboxyl terminal hydrolase-1(UCH-L1),and CHA2DS2-VASc score in patients with non-valvular atrial fibrillation(NVAF)and acute cerebral infarction(ACI),and their diagnostic value.Methods A total of 162 NVAF patients treated in our hospital from Janu-ary 2021 to January 2023 were enrolled and divided into a combined group(45 cases)and a non-combined group(117 cases)according to having ACI or not.General clinical information,CHA2DS2-VASc scores,and serum levels of ANGPTL4 and UCH-L1 were collected and detected.Spearman correlation analysis was applied to evaluate the correlation of ANGPTL4,UCH-L1 and CHA2DS2-VASc score.Multivariate logistic regression analysis was performed to identify the in-fluencing factors of NVAF combined with ACI.ROC curve was plotted to evaluate the diagnostic value of serum ANGPTL4,UCH-L1,and CHA2DS2-VASc score for NVAF combined with ACI.Results The ANGPTL4 level was significantly lower,and the UCH-L1 level and CHA2DS2-VASc score were obviously higher in the combined group than the non-combined group(P＜0.05).In the patients with NVAF combined with ACI,serum ANGPTL4(r=-0.548,P＜0.05)and UCH-L1(r=0.400,P＜0.05)levels were negatively and positively correlated with CHA2DS2-VASc score,respectively.ANGPTL4,UCH-L1 and CHA2DS2-VASc were the risk fac-tors for ACI in NVAF patients(P＜0.05,P＜0.01).The AUC value of combined serum ANGPTL4 and UCH-L1 levels and CHA2DS2-VASc score for diagnosing NVAF complicated with ACI was 0.926(95％CI:0.874-0.961).Conclusion Combined detection of serum AUCH-L1 and NGPTL4 levels and CHA2DS2-VASc score can significantly improve the diagnostic value of NVAF patients with ACI.