Objective:To construct an intelligent performance measurement system of gastrointestinal endoscopy and to analyze its value for endoscopic quality improvement.Methods:The intelligent gastrointestinal endoscopy performance measurement system was developed by using the deep convolutional neural network (DCNN) and deep reinforcement learning, based on the Digital Imaging and Communications in Medicine. Images were acquired of patients undergoing gastrointestinal endoscopy at Digestive Endoscopy Center of Renmin Hospital of Wuhan University from December 2016 to October 2018. The system applied cecum recognition model (DCNN1), images in vitro and in vivo recognition model (DCNN2), and identification model at 26 gastric sites (DCNN3) to monitor indices such as cecal intubation rate, colonoscopic withdrawal time, gastroscopic inspection time, and gastroscopic coverage. Images of 83 gastroscopies and 205 colonoscopies acquired at Digestive Endoscopy Center of Renmin Hospital of Wuhan University from March to November 2019 were randomly selected to examine the effectiveness of the system. Results:The intelligent gastrointestinal endoscopy performance measurement system consisted of quality analysis of both gastroscopy and colonoscopy, including all indices, and could be generated automatically at any time. The accuracy for cecal intubation rate, colonoscopic withdrawal time, gastroscopic inspection time, and gastroscopic coverage were 92.5% (172/186), 91.7% (188/205), 100.0% (83/83), 89.3% (1 928/2 158), respectively.Conclusion:The intelligent performance measurement system for gastrointestinal endoscopy can be recommended for the quality control of gastrointestinal endoscopy, from which endoscopists can get feedback and improve the quality of gastrointestinal endoscopy.

OBJECTIVETo evaluate incidence of postoperative delirium after hip surgery in elderly patients by meta-analysis.

METHODSFrom January 1, 2014 to December 31, 2013, clinical literatures about postoperative delirium after hip surgery in elderly patients,were searched from the Pubmed. Literature extract table were formed according to inclusion and exclusion criteria. Stata-12.0 was applied for Meta-analysis. P was used to test heterogeneity of study, random-effect model was performed when I2 > 50%. Subgroup analysis was used according to stage of age, assessment scale of delirium and statistical area of literature. Begg test was used to test publication bias.

RESULTSTwenty-one literatures were included. Incidence of postoperative delirium after hip surgery in elderly patients by weighted and combination was 17% [95% CI (16%, 18%)]. Incidence of postoperative delirium after optional hip surgery was decreased more than emergency operation in included 5 literatures [OR = 0.32, 95% CI (0.22, 0.45)]. Incidence of postoperative delirium in patients less than 80 years old was 21% [95% CI (19%, 23%)], while 21% [95% CI (19%, 24%)] in patients more than 80 years old. Incidence of postoperative delirium in CAM evaluation scale was 23% [95% CI (21%, 26%)], while 19% [95% CI (17%, 21%)] in other evaluation scales. Incidence of postoperative delirium in Asian area was 17% [95% CI (15%, 20%)], while 23% [95% CI (21%, 25%)] in European and American area. There was no publication bias tested by Begg test (P < 0.05).

CONCLUSIONIncidence of postoperative delirium after hip surgery in elderly patients increases higher, especially in emergency operation. A standardizing research method is benefit for evaluate incidence of postoperative delirium after hip surgery in elderly patients, decreasing heterogeneity and publication bias.

Aged ; Delirium ; epidemiology ; Hip Fractures ; surgery ; Humans ; Incidence ; Postoperative Complications ; epidemiology ; Publication Bias

Objective To compare the effect of using ambroxol hydrochloride combined with co-xuanju capsule,co-xuanju capsule and ambroxol hydroehloride in the treatment of semen liquefaction.Methods Sixty semen liquefaction patients were divided randomly into three groups.Clinical trials involving 20 who received ambroxol hydrochloride+co-xuanju capsule(group A),20 co-xuanju capsule(group B) and 20 ambroxol hydrochloride(group C),were carried out for 3 months.The changes of semen liquefaction time and semen quality were measured and assayed before and after treatment Results Compared withpretherapy,various parameters in the semen quality and semen liquefaction time after treatment all had a significantly difference in every group,and the patients of semen liquefaction time less than 60 minutes were 17 in group A,11 in group B and 14 in group C respectively.The results of semen liquefaction time andsemen quality in group A were significandy higher than the other groups(P<0.05),but the results between group B and group C had no significant difference.Conclusion The combination of ambroxol hydrochlorideand co-xuanju capsule can eridently improve the semen liquefaction time and semen quality and is an effective method in treating male infertility.

Objective To explore the effects of action observation therapy on upper-extremity motor function after ischemic stroke and on the motor cortex using functional magnetic resonance imaging (fMRI).Methods Forty patients with ischemic stroke were randomly assigned to an observational group (n =20) or a control group (n =20).Both groups received conventional rehabilitation,while the observational group was additionally provided with action observation therapy for 8 weeks.Both groups were assessed using the Fugl-Meyer assessment (FMA) and the Barthel index (BI) before and after the 8 weeks of treatment and functional magnetic resonance imaging was performed before treatment.Two months after the treatment,nine patients of the experimental group and 8 of the control group who continued to receive their respective treatments after discharge were again assessed using functional magnetic resonance imaging.Results After the treatment the average FMA score and BI score of both the observational group and the control group had increased significantly.The increase in the average FMA score of the observational group was significantly greater than that of the control group.However,there was no significant difference between the two groups in the increases in BI score after 8 weeks of treatment.The fMRI results showed that there was a significantly greater rise in activity in the bilateral precentral gyrus,parietal lobe and the supplementary motor area of the patients in the observational group after the treatment compared with the control group.Conclusion Action observation therapy can improve upper extremity motor function and performance in the activities of daily living after ischemic stroke and induce changes in the excitability of the cerebral motor cortex.

Objective To explore clinical application of single utility port or single port video-assisted thoracoscopic lobectomy.Methods Conducting a prospective study to 191 patients with lung disease who underwent complete video-assisted thoracoscopic surgery (VATS) lobectomy in Department of Thoracic Surgery of The People's Hospital of Wuhan University from June 2013 to Dec 2014.Results Of the 191 patients, 35 underwent left upper lobectomy, 42 underwent left lower lobectomy, 43 underwent right upper lobectomy, 11 underwent right middle lobectomy, 47 underwent right lower lobectomy, and 13 underwent bilobectomy.Operations were successful in all patients with 3 patients transferred for open thoracotomy for severe adhesion or bleeding.A total of 7 of 78 upper lobectomy and 8 of 113 middle or lower lobectomy was done with adding another incision for severe adhesion.The mean operative time was 50 ～ 190 (80.3 ±43.2) min.The mean blood losing was 90 ～ 350 (145.4 ± 56.2) ml.Thirty nine patients underwent upper lobectomy, who were placed two chest tubes, respectively.The upper chest drainage duration was (1.5 ±0.8) d, and the lower chest drainage duration was (4.2 ± 1.3) d.Forty eight patients underwent lower lobectomy, middle lobectomy, or bilobectomy, who were placed one chest tube, respectively.The chest drainage duration was(4.0 ± 1.7)d.The mean recovery time after operation was (6.1 ± 2.5) d.Seventy six patients were diagnosed with lung cancer, and the average number of dissected lymph nodes from each patient was (14.7 ±6.9).The lung cancer was classified as tumor node metastasis (TNM) stage Ⅰ A, Ⅰ B,ⅡA, ⅡB and ⅢA in 67, 61, 34, 22 and 7 cases, respectively.No serious complications, such as bronchopleural fistula or death, occurred in perioperation.Conclusions In consideration of placing two chest tubes after upper lobectomy and placing one chest tube after lower lobectomy, middle lobectomy, or middle and lower lobectomy, we think single utility port-VATS (2-port) for upper lobectomy and single port-VATS lobectomy for lower lobectomy, middle lobectomy, or middle and lower lobectomy are technically safe and have the advantages of drainage, lessening pain, rapid postoperative recovery, and have no significant difference in operation time, the incidence of complications and the number of removed lymph nodes, compared to traditional 3-port-VATS.

Child ; Child, Preschool ; Female ; Follicle Stimulating Hormone ; blood ; Gonadotropins ; blood ; Humans ; Infant ; Infant, Newborn ; Male ; Sex Factors ; Time Factors

OBJECTIVETo study the possibility of mandibular alveolar ridge augmentation by distraction osteogenesis using TiNi-SMA (shape memory alloy) distractor.

METHODSAll of the mandibular premolars and the first molar were extracted from ten adult mongrel canines. One month later, box-shaped osteotomies of the alveolar bone were performed out and TiNi-SMA distractors were buried in experimental group. The bone height was measured before and 1, 5, 13 weeks after the operation. The radiographs were taken on the day of, and 1, 5, 13 weeks after operation. The animals were killed at one or three months after distraction and examined histologically.

RESULTSThe bone segments were lifted up immediately after the insertion of distractors and the height achieved 7.5 - 11.5 mm one week after the operation. One month after distraction, the radiographs showed there was regeneration of bone in distraction gap. The new bone and the normal bone could not be differentiated clearly three months after distraction. No bone resorption was found during this period. In histological sections, there were collagen bundles in early distraction, then these bundles were calcified and became traeculaes.

CONCLUSIONIt suggests that the canine mandibular posterior alveolar ridge can be augmented by distraction osteogenesis using TiNi-SMA distractor, and the new bone is formed by intramembranous ossification.

Alloys ; Alveolar Ridge Augmentation ; Animals ; Dogs ; Male ; Nickel ; Osteogenesis, Distraction ; instrumentation ; Titanium

The Qinbai Qingfei concentrated pellets by traditional Chinese medicine theoryand party and group, the rats were given the drugs group, comparison of pharmacokinetics parameters changes of baicalin , discusses the rationality of Qinbai prescription. The rats were gavaged monarch drug group (Huang Qincu extract, mainly forbaicalin), and official medicine group, adjuvant group, medicine group and Qinbai group (Quan Fangzu) the content of baicalin equal as the monarch drug group, in the 28 h collection in rat plasma at different time point, application of HPLC determination of baicalin glycosides in rat plasmaconcentration time curve, with 3P97 practical pharmacokinetics program to process the data Based on the data analysis, baicalin in rat plasma of Qinbai group Cmax is 4 times as big as monarch druggroup, AUC is 6 times as big as monarch drug group; the content of baicalin in plasma of rats the highest is Qinbai group, the minister drug group, adjuvant group, medicine group of baicalin in rat plasma content of less than the Qinbai group, but was significantly higher than that of monarch drug group; the medicine group is slightly higher than that adjuvant the content of baicalin in plasma of rats. The pharmacokinetic results show that the measured plasma concentration in rats that Qinbai can significantly increase Cmax and AUC of baicalin, other components of qinbai can promoted the baicalin absorption in vivo. It showed that the reasonable of Qinbai compound compatibility. The minister drug can promote the absorption of baicalin in vivo.
Animals ; Area Under Curve ; Drugs, Chinese Herbal ; analysis ; pharmacokinetics ; Flavonoids ; blood ; pharmacokinetics ; Intestinal Absorption ; Male ; Rats ; Rats, Wistar

OBJECTIVETo observe the effect of Huatuo Zaizao extractum (HTZZ) on focal cerebral ischemia/reperfusion (I/R) neurogenesis in rats induced by middle cerebral artery occlusion (MCAO) and its mechanism.

METHODTotally 55 healthy adult male Sprague-Dawley rats were divided into the sham operation group, the MCAO model group and HTZZ high, middle and low dose groups (5, 2.5, 1.25 g x kg(-1)), with 11 rats in each group, and orally administered with drugs. The focal cerebral ischemia model was established by performing a middle cerebral artery occlusion (MCAO, 90 min) followed by a seven-day reperfusion (once a day). The neurogenesis and expressions of extracellular signal-regulated kinase (ERK) and cAMP response element binding protein (CREB) were detected by the immunofluorescent staining. The enzyme linked immunosorbent assay (ELISA) was adopted to determine the vascular endothelial growth factor (VEGF) and brain-derived neurotrophic factor (BDNF).

RESULTMCAO (90 min) followed by a seven-day reperfusion resulted in the significant increase in the number of penumbra cortex newborn neurons (BrdU(+) -NeuN(+)), which was accompanied by the growth of ERK and CREB phosphorylation and VEGF and BDNF levels. HTZZ could promote the generation of newborn neurons (BrdU(+)-NeuN(+)) and the ERK and CREB phosphorylation and increase VEGF and BDNF levels at the ischemic side.

CONCLUSIONHTZZ could promote the neurogenesis, which may be the interventional targets of effective traditional Chinese medicine Huatuo Zaizao extractum in promoting the self-repair function of the cerebral ischemic areas.

Animals ; Brain Ischemia ; drug therapy ; genetics ; metabolism ; physiopathology ; Brain-Derived Neurotrophic Factor ; genetics ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Male ; Neurogenesis ; drug effects ; Neurons ; cytology ; drug effects ; metabolism ; Rats ; Rats, Sprague-Dawley ; Reperfusion ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

OBJECTIVEDiet is an important factor influencing blood pressure and, increases in dietary carbohydrate intake can raise blood pressure in adult rats. A previous study showed that the blood pressure of the rats fed with high-carbohydrate was 5-20 mmHg higher than that of control rats. While the mechanism involved is not clear. This study aimed to investigate the effects of high-sucrose intake on blood pressure of young Wistar rats and the role that sympathetic nerve system in the process.

METHODSMale neonatal Wistar rats were performed sympathectomy operation with 6-hydroxydopamine (6-OHDA) and then divided into four groups: (1) 0.1% VitC saline-common diet group (VN), (2) 0.1% VitC saline-high sucrose (VS), (3) 6-OHDA-common diet group (OHN) and (4) 6-OHDA-high sucrose (OHS) after three week. The data on the body weight (BW), systolic blood pressure (SBP) and heart rate (HR) were recorded. Then the level of blood glucose, serum insulin and angiotensin II (AngII) were measured and the functional studies of the thoracic aorta was performed.

RESULTSThe VS group exhibited higher SBP than the OHS group from the 6th week (113.7 +/- 4.2 mmHg vs. 104.0 +/- 5.8 mmHg, P < 0.01) and the VN group from the 7th week (117.6 +/- 6.3 mmHg vs. 109.6 +/- 4.6 mmHg, P < 0.01), while the SBP of the VN group was similar to those of the OHN group and the OHS group (P > 0.05). No significant differences in blood glucose, serum insulin and insulin sensitive index (ISI) were found among the four groups. The thoracic aorta segments of the VS group had higher contractive response to AngII (P < 0.01) and NE (P < 0.05) than the VN group, but the relaxations to acetylcholine (ACh) and nitroglycerine (NTG) showed no difference among the four groups (P > 0.05).

CONCLUSIONThe high-sucrose diet might elevate the blood pressure in young Wistar rats and the sympathetic system may play an important role in this process.

Angiotensin II ; blood ; Animal Feed ; Animals ; Blood Glucose ; metabolism ; Blood Pressure ; drug effects ; physiology ; Body Weight ; drug effects ; Dietary Sucrose ; administration & dosage ; Insulin ; blood ; Male ; Oxidopamine ; administration & dosage ; blood ; Rats ; Rats, Wistar ; Sympathectomy