Objective:To combine automatic image segmentation technology and machine learning methods to accurately classify and recognize mammography images.Methods:Taking mammography images with clustered pleomorphic calcification as the research object, which were in BI-RADS4 class from the Digital Mammogram Database (DDSM). The region of interest (ROI) of the images was automatically segmented. The characteristic features extracted by wavelet transform, Gabor filter and gray level co-occurrence matrix method were fused. The fused feature parameters were screened based on sensitivity analysis. Using ensemble learning method, the polynomial kernel SVM, random forest and logistic regression classifiers were integrated to form a classifier for automatic classification of mammography images. The ensemble learning method was soft voting integration.Results:The proposed ensemble classifier can efficiently recognize and classify mammography images, and its classification sensitivity, specificity and accuracy on the training set were 99.1%, 99.6% and 99.3%, respectively.Conclusions:The proposed mammography image processing, classification and recognition method can provide assistant detection basis for doctors' clinical judgment, and provide a technical basis for subdividing BI-RADS4 class images.

Objective? To explore the low frequency pulsed electrical stimulation on improving limbs pain among patients with diabetic peripheral neuropathy so as to provide an effective clinical basis for treatment and nursing of those patients. Methods? From March 2017 to March 2018, we selected 75 diabetic peripheral neuropathy patients with limbs pain in Chinese Surgery, the Shangqiu First People＇s Hospital as subjects by convenience sampling. All of the patients were randomly divided into control group (n=38) and experimental group (n=37) with the random number table. Patients of control group received routine treatment and nursing. On the basis of routine treatment and nursing, patients of experimental group were given the low frequency pulsed electrical stimulation. Finally, we compared the pain condition and effects of pain therapy of patients between two groups. Results? Before intervention, there was no statistical difference in the pain of patients between two groups (P＞0.05). After intervention, the limbs pain of patients in experimental group was lower than that in control group with a statistical difference (P＜0.05);the effects of limbs pain of patients in experimental group was better than that in control group with a statistical difference (P＜ 0.05). Conclusions? Low frequency pulsed electrical stimulation in Sanyinjiao and Yongquan point can regulate arteries, veins and Qi-blood, dredge the channels and collateral to make Qi-blood unobstructed so as to play a role in relieving the limbs pain of diabetic peripheral neuropathy patients. It is worth to be widely used in clinical application.

Objective To investigate the status of sense of coherence(SOC) of the main caregivers of diabetic foot patients and explore the influencing factors. Methods Using convenient sampling method, 139 main caregivers of diabetic foot patients who were admitted to Shangqiu First People's Hospital from January 2018 to January 2019 and met the inclusion and exclusion criteria of this study were selected as the study objects. The patients were investigated with General Information Questionnaire, Zarit Caregiver Burden Interview(ZBI) and Sense of Coherence(SOC). The influencing factors of SOC were analyzed by multiple linear regression and single factor analysis. Results The score of SOC of the main caregivers of diabetic foot patients was (61.71±8.73) and the score of ZBI was (26.16±12.93). The course of disease, the average monthly income of the caregivers and the care burden were the main influencing factors of SOC of the main caregivers of diabetic foot patients (P＜0.05). Conclusions Clinical nurses should pay attention to the burden of care, improve the level of SOC of caregivers, and then improve the quality of life of diabetic foot patients and their main caregivers.

Objective·To investigate the correlation of single nucleotide polymorphism (SNP) of complement factor H (CFH) gene with schizophrenia in Chinese Han population.Methods·The genotype,allele,and haplotype frequencies of 5 SNP loci (rs800292,rs 1061170,rs 10801555,rs 10922096 and rs2019727) in CFH gene were compared between 418 patients with schizophrenia (case group) and 655 normal people (control group) by SNaPshot technique.Results·All SNP loci were well genotyped in the subjects.Correlation analysis showed that rs1061170 locus allele frequency distribution difference between case group and control group was statistically significant (corrected P=0.045),while genotype and allele frequencies of other SNP loci were not significantly different (all corrected P＞0.05).The frequency of haplotype C-A-T-A-A (rs800292-rs1061170-rs10801555-rs10922096-rs2019727) in case group was different from that in control group (corrected P=0.013).Conclusion·The allele polymorphisms of rsl061170 and the haplotype C-A-T-A-A of rs800292-rs 1061170-rs 10801555-rs 10922096-rs2019727 may be associated with schizophrenia in Chinese Han population.

Objective To investigate the Influence of beta-thalassemia minor on four different HbA1c detection systems.Methods All 65 blood samples from March 2014 to August 2014 were collected from Zhongshan Hospital of Sun Yat-sen University , and divided to normal control group ( 40 cases ) , no diabetic group(20 cases) and diabetic group (5 cases) combining with beta-thalassemia minor.The fresh mixed whole-blood samples were used for transferring value-assignment in order to improve the comparability of Bio-Rad variant ⅡTurbo, Primus Ultra2 ,Roche Modular PPI to Bio-Rad Variant Ⅱwhich was NGSP Ⅰlaboratory certificated.The whole-blood concentration of HbA 1c were measured by four detection systems . Differences between normal control group and no diabetic group were compared using the Independent Samples T Test.Then Taking the Primus Ultra 2 as comparable system and others as experimental system ,the HbA1c results from no diabetic group and diabetic group were compared by the standardization NGSP Ⅰlaboratory and statistical techniques of consistency test .Results Compared with Variant Ⅱ detection system, after transferring value-assignment, deviations of Variant Ⅱ, Modular PPI and Variant Ⅱ Turbo were -6%to +6%.The HbA1c testing results from normal control group and no diabetic group had no statistical significance (P>0.05).Linear regression analysis demonstrated that the correlation coefficient of Primus Ultra2 with Variant Ⅱ, Modular PPI, VariantⅡTurbo were 0.995, 0.999 and 0.995, respectively (P<0.01).The percentage deviation of the reference system and experimental system was -6.0% to+6.0%.Conclusion There was no obviously significant influence of beta-thalassemia minor on Bio-Rad Variant Ⅱ,Bio-Rad variant ⅡTurbo,Primus Ultra2,Roche Modular PPI detection systems.

Objective To investigate the interference of hyperlipidemia and hyperbilirubinaemia to HbA1c measurements by ion‐exchange high‐performance liquid chromatography(IE‐HPLC) method .Methods Fresh whole‐blood samples collected with EDTA‐K2 anticoagulant tubes were divided into four groups :control group(HbA1c<6 .2% ) ,diabetes group(HbA1c≥6 .2% ) ,hyperlipi‐demia group(TG 3 -20 mmol/L);hyperbilirubinaemis group (TBIL 21 -549 μmol/L) .HbA1c of these samples were measured with affinity chromatography(AC‐HPLC) and IE‐HPLC respectively .Results When HbA1c≤18 .7% ,r=0 .993 ;95% confidence interval(CI) of HbA1c results by using IE‐HPLC method was -0 .71 -0 .89 ;coefficient of variation was -5 .8% -6 .8% ;P=0 .198 and the difference was not statistically significant .When HbA1c< 16 .3% ,r= 0 .997;95% CI of HbA1c results with IE‐HPLC method is -0 .31-0 .67;coefficient of variation was -5 .8% -4 .3% .P=0 .000 and the difference was statistically signifi‐cant .No interference was detectded with the results ;When HbA1c was 16 .3% -18 .7% ,positive bias was observed with the re‐sults .When TG≤20 .78 mmol/L ,r=0 .995;95% CI of HbA1c results with IE‐HPLC method was -0 .26-0 .50 ;coefficient of var‐iation was -5 .5% -5 .8% .P=0 .000 and the difference was statistically significant .No interference was detectded with the re‐sults;When TBIL≤549 .3 μmol/L ,r=0 .990 ;95% CI of HbA1c results with IE‐HPLC method was -0 .08 -0 .63;coefficient of variation was -14% -4 .1% .P=0 .000 and the difference was statistically significant .When TBIL≤342 .1 μmol/L ,r= 0 .994 ;95% CI of HbA1c results with IE‐HPLC method was -0 .09-0 .50;coefficient of variation was -5 .5% -4 .1% .No interference was detectded with the results .When TBIL was 380 .7-549 .3 μmol/L ,negative bias was observed with the results .Conclusion Our data indicated that HbA1c measurement with IE‐HPLC method could resist the interference of hyperlipidemia;When TBIL≤380 .7 μmol/L and HbA1c<16 .3% ,the results could meet the needs of general clinical detection .Clinical staff should choose more specific HbA1c measurement method according to the patient's condition .

Objective To explore the expression of nuclear factor-erythroid 2-related factor 2(Nrf2) and the molecular chaperone of cytoplasmic Keap1 in premature newborn rats exposed to hyperoxia.Methods Completely randomized design method was performed,one-day old preterm SD rats were randomly divided into two groups:hyperoxia group and air group.The preterm SD rats in hyperoxia group were continuously exposed to oxygen(oxygen >0.85)and air group in room air.After 1 ,4,7,10,14 days of exposure,the pre-term SD rats of two groups were sacrificed,whole lung of these rats were isolated,the lung histological chan-ges were observed by HE staining.Total lung RNA was extracted,Nrf2 and Keap1 mRNA were detected by RT-PCR.Western-blot was used to detect the changes of Nrf2 protein expression.Results (1 )Compaired with air group,the expression of Nrf2 in lung tissue of hyperoxia group significantly increased after 4,7 days of exposure(4 d:0.314 ±0.064 vs.0.521 ±0.086,7 d:0.440 ±0.121 vs.0.658 ±0.076)(P <0.05 ),the general tendency decreased after 10 days,but the expression of Nrf2 became significantly weak after 14 days of exposure in hyperoxia group(P <0.05).(2)The expression of Keap1 mRNA in hyperoxia group signifi-cantly increased in 1 ,4 days(1 d:0.352 ±0.052 vs.0.547 ±0.075,4 d:0.363 ±0.074 vs.0.658 ±0.076) (P <0.05),the general tendency decreased after 7 days of exposure,but the expression of Keap1 mRNA in hyperoxia group became significantly weaker than its expression after 10,14 days of air group(P <0.05 ). (3)In comparison with air group,Nrf2 protein expression in hyperoxia group increased after 1 ,4 days of ex-posure with no significant difference(P >0.05),but had a tendency of decreasing after 7 days.On day 10, 14,its expression in hyperoxia group became significantly weak compared with that of air group(10 d:1.325 ±0.464 vs.0.755 ±0.348,14 d:1.662 ±0.474 vs.0.867 ±0.1 15 )(P <0.05 ).Conclusion Oxidation outbreak results in the abnormal expression of Nrf2 and Keap1 in the lung of premature SD rats induced by hyperoxia exposure,which adjusts the levels of oxidative stress in the body,these changes participate in the development of hyperoxia induced lung injury,the activity of Nrf2 may be increased by hyperoxia exposure, and alleviate hyperoxia lung injury in premature rats through antioxidation of Nrf2.

Objective To compare clinical efficacy and safety between standard double-and single-dose of basiliximab in renal transplantation.Methods A total of 121 patients undergoing allogeneic cadaveric renal transplantation in Department of Urology of Renmin Hopsital of Wuhan University from January 2008 to May 2011 were recruited as study subjects.Among them,53 patients were assigned into the double-dose of basiliximab group and they were intravenously administered with 20 mg of basiliximab before and 4 d after surgery according to product description.Sixty-eight cases were allocated in the single-dose of basiliximab group and they were given with 20 mg of basiliximab before renal transplantation.The changes of immune function in two groups during perioperative period were monitored.The incidence of adverse reactions including delayed graft function (DGF),acute rejection,pulmonary infection and the survival of patients and renal grafts were statistically compared between two groups.Results There was no significant difference in preoperative humoral immune and cellular immune function between two groups.Compared with preoperative period,cellular and humoral immune function in both groups were inhibited by varying degree at 5 d after surgery (both in P <0.05).Compared with patients in the single-dose group,cellular and humoral immune functions were evidently suppressed in the double-dose group (both in P <0.05).Compared with the parameters assessed at 5 d after surgery,cellular and humoral immune functions were restored to varying degree at 15 d after surgery,whereas still significantly lower than preoperative levels (CD3,CD4,IgM and IgA).Partial parameters (CD8 and IgG)were persistently inhibited and continued to decline compared with the levels at 5 d after surgery.The incidence of DGF was 8% in the double-dose group,and 7% in the single-dose group.During 1-year follow-up,the rejection rates in the double-and single-dose groups were 13% and 12%,and the incidence of pulmonary infection was 9% and 10%.No statistical significance was noted between two groups in terms of these parameters (all in P >0.05).The 1-year survival of patients in the double-and single-dose groups was 94% and 98%,93% and 96% for the survival of renal grafts.No statistical significance was found between two groups (both in P >0.05).Conclusions Both double-and single-dose of basiliximab are efficacious in renal transplantation and do not increase the incidence of adverse reaction.The 1-year survival rates of patients and renal grafts between two groups are almost equivalent.Detection of immune function during perioperative period effectively guides individualized immune induction therapy.

Objective: To analyze the essential medicines supply of medical institutions at county-level in Shaanxi Province and to provide empirical evidences and suggestions to improve relevant policies. Methods:A strati-fied cluster random sampling method was used to choose the institution samples. A survey was conducted to study the supply of essential medicines in 2012. Indicators include the variety and amount of essential medicines procured, the medicine shortage condition, and the rate of winning the bid for essential medicine. Results:Essential medicines ac-counted for 69 . 1% of all medicines;and procurement of essential medicines accounted for 42 . 4% of all procurement spending on medicines. Of the top 25 chemical products of essential medicines, provincial supplementary medicines accounted for 33. 9%;and among the top 25 traditional Chinese medicines of essential medicines, the provincial sup-plementary medicines accounted for 51. 9%. All 27 medical institutions faced a shortage of medicines. There were 47 kinds of essential drugs in urgent need were out of bid. Conclusion:Essential medicine supply of medical institutions at county-level is in good condition;however, more attention needs to be paid to medicine shortage. We should take measurements to standardize the process of bidding for essential medicines and strengthen the management of medi-cine shortage in order to better meet patients’ needs.

Objective To evaluate the precision,accuracy,linear range and anti-interference performance of HbA1c assay by u-sing Primus Trinity Ultra2 automated analyzer.Methods According to Document EP published in 2004 by American Clinical and Laboratory Standards Institution(CLSI)and relative literatures,the precision,accuracy,linear range and anti-interference perform-ance were evaluated.Results The within-run and between-run CVs of HbA1c determination were both less than that announced by manufacture.In the tests of samples with certain concentrations,all the results were within the verification range respectively.In the linear verification,regression equation between the theoretical and measured values demonstrated that r2 >0.95,and a value was within the range of 0.97-1.03.For Primus Trinity Ultra2 the limit of interference effect didn′t exceed the allowable error at the medical decision concentrations.Conclusion The precision,accuracy,linear range and anti-interference was evaluated of the Primus Trinity Ultra2 automating HbA1c all could meet the manufacture′s declaim and the clinical needs.