Base on the data of blood pressure, plasma lipid, Glu and UA by physical test, Support Vector Machine (SVM) was applied to identify coronary heart disease (CHD) in patients and non-CHD individuals in south China population for guide of further prevention and treatment of the disease. Firstly, the SVM classifier was built using radial basis kernel function, liner kernel function and polynomial kernel function, respectively. Secondly, the SVM penalty factor C and kernel parameter sigma were optimized by particle swarm optimization (PSO) and then employed to diagnose and predict the CHD. By comparison with those from artificial neural network with the back propagation (BP) model, linear discriminant analysis, logistic regression method and non-optimized SVM, the overall results of our calculation demonstrated that the classification performance of optimized RBF-SVM model could be superior to other classifier algorithm with higher accuracy rate, sensitivity and specificity, which were 94.51%, 92.31% and 96.67%, respectively. So, it is well concluded that SVM could be used as a valid method for assisting diagnosis of CHD.
Algorithms ; China ; Coronary Artery Disease ; diagnosis ; Discriminant Analysis ; Humans ; Models, Theoretical ; Neural Networks (Computer) ; Sensitivity and Specificity ; Software ; Support Vector Machine

Objective To investigate and analyze the risk factors of the occurrence of hepato renal syndrome (Hepatorenal syndrome,HRS) for patients with acute on chronic hepatitis B liver failure.Methods Sixty cases of patients with acute on chronic hepatitis B liver failure from January 2009 to December 2013 in our hospital were selected as the research objects.The single factor and multi-factor regression analyses were in patients with the basic clinical data,and the complications and the baseline clinical testing index of patients.The independent risk factors of the occurrence of HRS for patients with acute on chronic hepatitis B liver failure were screened.Results The cases of the occurrence of HRS for patients with acute on chronic hepatitis B liver failure was 17 among 60 cases with a incidence of 28.3 ％ ; The results of multivariable logistic regression analysis showed that serum albumin,serum sodium,liver function grade (Child-Pugh score),model for end-stage liver disease (MELD) index,primary bacterial peritonitis,upper gastrointestinal hemorrhage,ascites,and hepatic encephalopathy were the risk factors of the occurrence of HRS for patients with acute on chronic hepatitis B liver failure (P ＜ 0.05).Conclusions The occurrence of HRS for patients with acute on chronic hepatitis B liver failure is higher.The various sensitive indicators should be monitored dynanically,and the relevant prevention and treatment measures should be taken in time.It has a significantly scientific merit to improve the prognosis of patients.

The repair of massive bone defect is one of the challenges to clinical performance. The therapeutic efficacy of classic methods, such as repair with autograft, alograft and biomaterial-filling and so on, is not optimal and hinders its widely clinical use. Bone tissue engineering has provided a promising way to solve this problem, and has become one of the hotspots nowadays. However, the key technology of vascularization hasn’t been solved ideally yet. Obviously, the routine train of thoughts is faced up with big challenge in repaiering large bone defect. In order to find a clinically applicable bone tissue engineering approach, we brought forward and set up a microcirculation system of osteogenesis inducted by perfusion in vivo.

Objective To investigate the time-course of mRNA and protein expression of inducible nitric oxide synthase (iNOS) in pulmonary artery and thoracic aorta and the difference in mRNA and protein expressions of iNOS between pulmonary artery and thoracic aorta induced by endotoxemia in rats. Methods Forty-eight Wistar rats of both sexes weighing 350-450g were randomly divided into 2 groups: control group in which animals received normal saline intraperitoneally (ip) and were killed 3h later by dislocation of cervical vertebrae (n=12); test groups in which animals were injected intraperitoneally lipopolysaccharide (LP) 4mg-kg-1 in 2ml of normal saline and were killed after 3h ( n = 12), 8h ( n = 12) , and 48h( n = 12) . Chest was opened immediately and pulmonary artery (PA) and descending thoracic aorta ( TA) were removed. mRNA and protein expression of iNOS in PA and TA were measured by RT-PCR and Western blot.Results The mRNA and protein expressions of iNOS in PA peaked at 8h and that in TA at 3h after ip LPS injection. The levels of mRNA and protein expressions of iNOS in both PA and TA returned to control level at 48h after ip LPS injection. The levels of mRNA and protein expressions of iNOS in PA at 3h and 8h after ip LPS injection were significantly higher than those in TA.Conclusion The mRNA and protein expressions of iNOS in PA and TA after LPS injection are time-dependent. The mRNA and protein expressions of iNOS in TA after LPS injection are earlier than those in PA but the level of mRNA and protein expressions of iNOS in PA after LPS injection is higher than that in TA.

Objective To assess the immune tolerance of allogeneic T cells induced by dendritic cells genetically engineered to express I?B? mutant. Methods DCs were prepared from WF rat bone marrow cells and modified by I?B?M gene wit h adenovirus vector, and then the expression of I?B? and I?B?M was detected by Western-blot. The cell-surface expression of costimulatory molecules (CD80, CD86 and CD40) was detected by flow cytometry, and the production of IL-12 in DCs culture supermatant was determined by ELISA. The ability to stimulate the pr oliferation of Lewis rat T cells was analyzed by mixed leukocyte reactions (MLR) . The antigen-specific T cell hyporesponsiveness was tested by secondary MLR. Results I?B?M suppressed the cell-surface expression of costimulatory molecules and i nhibited the production of IL-12. I?B?M-DC showed reduced ability to stimula te T cells proliferation, and potential to induce antigen-specific T cell hypo responsiveness. Conclusion Immune tolerance of T cells can be induced by dendritic cells genetically engine ered to express I?B? mutant.

OBJECTIVE To investigate the resistance status of pathogens from surgical incision infection.METHODS The secretion of infected wounds was cultured to detect pathogens by routine methods from Jan 2001 to Dec 2006.The identifications and antimicrobial-susceptible tests of pathogens causing incision infection were determined by Full Automated Analyzer.All data were analyzed retrospectively.RESULTS A total of 246 pathogen strains were cultured from the secretion of surgical incision infection in 6 years,of which Gram-negative bacilli,Gram-positive cocci and fungi accounted for 57.7%,34.1% and 8.2%,respectively.The first place of isolates was Escherichia coli,followed by Staphylococcus aureus,Pseudomonas aeruginosa,Klebsiella pneumoniae,Acinetobacter baumannii,etc.74.5% of S.aureus isolates and 83.3% of S.epidermidis isolates were resistant to oxacillin.45.1% of E.coli of the isolates and 35.0% of isolates of K.pneumoniae were extended-spectrum ?-lactamases producing.Almost all of the detected resistant strains showed serious multiple resistance.Vancomycin and imipenem still had better activity for antimicrobial multiple resistant bacteria.CONCLUSIONS Surgical incision infection is serious.Infection surveillance should be taken to control surgical infection.Pathogens infected surgical incision are multi-resistant to antibiotics.

Objective To evaluate the improvement of diagnostic accuracy with background region of interest(ROI)rectification for 99mTc-DTPA renography in patients with GFR≤plasma sampling method). Methods Thirty-three patients(age＞20 years,male/female=13/20)dose of 111 MBq/0.5 ml of 99mTc-DTPA was injected into an antecubital vein.The background ROI was selected below the kidney(Gates method,method a)or around the kidney(method b),then these two different GFR(GFRa,GFRb)were automatically estimated by computer.Meanwhile,3 ml blood samples were collected 2 h and 4 h after injection respectively,and radioactivity of 1 ml plasma was measured.GFR was calculated by dual plasma sampling method(GFRp)and the results were all standardized with the body surface area.The accuracies and correlations of GFRa and GFRb were compared to GFRp respectively. Results The correlation coefficients were ra=0.602 and rb=0.834.The median of difference of GFRa and GFRb was 8.33,-4.41.The median of absolute difference of GFRa and GFRb was 8.33,4.49.The accuracies within±15%,±30%and±50%of GFRa were 24.2%,30.3%and 48.5%,and those of GFRb were 33.3%,51.5%and 81.8%.Conclusion The background ROI around kidney can obviously improve the diagnostic accuracy of 99mTc-DTPA renography in patients with severe renal insufficiency.

OBJECTIVEIn order to adapt the rapid development of modern medicine, this paper is aimed to analyze the application of in vitro diagnostic reagents (IVD Reagents) in hospital management and improve the overall level of hospital management.

METHODSBy groping the management experience of IVD reagents, we discuss the internal hospital management mode of IVD reagents in reality.

RESULTSWith the continuous improvements on the information platform of IVD reagents,we can realize benefit analysis of IVD reagents within the process of management.

CONCLUSIONReasonable management on IVD reagentscan improve the working efficiency in hospitals and provide swifter and better medical service for patients.

Objective To discuss the clinical value of procalcitonin (PCT) in guiding antibiotics use in children with severe diseases. Methods The clinical data of patients admitted to intensive care unit from January 2012 to July 2012 were retrospectively analyzed. The patients without antibiotics use before admission and with procalcitonin level less than 0.5 ng/ml on admission were selected. The body temperature, infection indicators and prognosis were compared between patients with and without antibiotics use during hospitalization. Results There was no difference in body temperature, PCT, C-reactive pro-tein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell count (WBC) on admission between patients with and without antibiotics use during hospitalization. The PCT level was increased signiifcantly (P<0.05) on the day of starting the an-tibiotics when compared with that on admission in 60 patients while there was no change in the levels of WBC and CRP. Com-pared with the day of starting the antibiotics, body temperature declined (P<0.05) and PCT level in 56 patients reexamined was decreased (P<0.05) at 3 days after antibiotics use. Two hundred and eleven patients (98.14%) had favorable prognosis. Conclu-sions Monitoring PCT can guiding the clinical use of antibiotics.

ObjectiveTo determine optimal positive end expiratory pressure (PEEP) in mechanical ventilation in children with severe asthmatoid disease based on the quasistatic pressure-volume (P-V) curve.MethodsA serf-control study was done on 23 children with severe asthmatoid disease in the pediatric intensive care unit( PICU ).Quasistatic lung P-V curve of these patients was analyzed and the lower inflection point (LIP) from P-V curve was determined.Three different PEEP (0 cm H2O,LIP,LIP+2 cm H2O,1 mm H2O =0.098 kPa) were given to the patients.The effects of PEEP at different levels on gas exchange,hemodynamic and airway pressure were observed.ResultsThe quasistatic LIP were (2.70 ±2.00)cm H2O.When PEEP was increased to the level of LIP + 2 cm H2O,PaO2 / FiO2 and lung compliance improved significantly (P ＜ 0.01 ) and dynamic lung compliance was the highest,peak inspiratory pressure was (22.30 ± 3.00) cm H2O and mean airway pressure was( 14.11 ± 1.01 ) cm H2O,without obvious adverse effects on mean arterial blood pressure and heart rate.There was no difference in PaCO2,when compared PEEP =0 cmH2O to PEEP =LIP + 2 cmH2O.ConclusionThe application of PEEP is safe.LIP + 2 cm H2O from quasistatic P-V curve could be set as the optimal PEEP under which mechanical ventilation has the best efficacy and do not aggravate CO2 retention and abnormality of hemodynamics in children with severe asthmatoid disease.