Multiple organ dysfunction syndrome (MODS) is a serious complication with higher mortality in patients with burns and trauma. It is important to study the mechanism of MODS for prevention and control of it. Mesenteric lymph mechanism of MODS is a new viewpoint of gut-derived mechanism of MODS in recent years. In this review, we elucidate the mechanism of gut-derived origin of MODS and role of mesenteric lymph path in development of MODS after burns and trauma injury.
Burns ; complications ; pathology ; Humans ; Lymphatic System ; Mesentery ; Multiple Organ Failure ; etiology ; pathology

<p>OBJECTIVETo investigate the point mutations and polymorphisms of transforming growth factor beta-induced gene (TGFBI) in Chinese patients with keratoconus and discuss the relationship between the feature of gene mutations and single nucleotide polymorphisms of TGFBI gene and keratoconus.p><p>METHODSPolymerase chain reaction single strand conformation polymorphism and DNA direct sequencing were performed in 30 keratoconus cases and 30 healthy controls. All 17 exons of the TGFBI gene were analyzed for point mutations and single nucleotide polymorphisms.p><p>RESULTSTotally two heterozygous nucleotide changes were identified in exon 12 of the TGFBI gene. The codon 535 is changed from GGA to TGA in 1 patient, leading to a substitution of glycine to a stop codon at the protein level (G535X). The codon 540 is changed from TTT to TTC in 2 patients and 1 control individual, resulting in a nonsense mutation (F54F), and is a single nucleotide polymorphism of the gene.p><p>CONCLUSIONMutation and polymorphisms of the TGFBI gene were detected in Chinese patients with keratoconus in this study. The results suggest that TGFBI gene might play an important role in the pathogenesis of keratoconus.p>
Adolescent ; Adult ; Case-Control Studies ; Child ; China ; Extracellular Matrix Proteins ; genetics ; Female ; Glycine ; deficiency ; genetics ; Humans ; Keratoconus ; genetics ; Male ; Middle Aged ; Point Mutation ; Polymerase Chain Reaction ; methods ; Polymorphism, Single Nucleotide ; Polymorphism, Single-Stranded Conformational ; Sequence Analysis, DNA ; methods ; Transforming Growth Factor beta ; genetics ; Young Adult

With the development of the research in human genomics, it is well known that genetic polymorphisms(mainly single nucleotide polymorphisms) of the genes encoding drug-metabolizing enzymes, transporters, receptors and other drug target proteins are relative to interindividual differences in the efficacy and toxicity of many medications. On the basis of functional genomics and molecular pharmacology, pharmacogenomics is elucidating the inherited nature of these differences in drug response mainly by means of analyzing the genetic variations of DNA and monitoring the gene expression pattern. It can not only improve disease diagnosis and predict the potential drug response but also speed up drug discovery and its development which will be instructive for clinical drug therapy ultimately.
Drug Therapy ; methods ; Genome, Human ; Humans ; Pharmacogenetics ; methods

South Africa is an ethnically and culturally diverse presidential republic country. The medical and health system consists of public and private medical care. AIDS, lower respiratory infections, neonatal diseases, and interpersonal violence and road injuries are the leading causes of adult death. South Africa has rich herbal resources, and a long history of traditional medicine, which is mainly black African traditional medicine. Until the establishment of diplomatic relations between China and South Africa in 1998, the development of TCM was significantly improved, and legislation of TCM was adopted by the government in 2000. Chinese herbal medicine has not yet formed industrial standardization, the TCM application and TCM education are insufficient. Therefore, it is suggested to accelerate the standardization of TCM, to strengthen the TCM education for professional TCM practitioners, and to form a large-scale, industrial and standardized development model. Only in these ways can TCM provide good medical services for residents in South African.

An auxiliary dining robot is designed in this paper, which implements the humanoid feeding function with theory of inventive problem solving (TRIZ) theory and aims at the demand of special auxiliary nursing equipment. Firstly, this robot simulated the motion function of human arm by using the tandem joints of the manipulator. The end-effector used a motor-driven spoon to simulate the feeding actions of human hand. Meanwhile, the eye in hand installation style was adopted to instead the human vision to realize its automatic feeding action. Moreover, the feeding and drinking actions of the dining robot were considered comprehensively with the flexibility of spatial movement under the lowest degree of freedom (DOF) configuration. The structure of the dining robot was confirmed by analyzing its stresses and discussing the specific application scenarios under this condition. Finally, the simulation results demonstrate high-flexibility of the dining robot in the workspace with lowest DOF configuration.
Computer Simulation ; Equipment Design ; Hand ; Humans ; Movement ; Robotics/methods*

Myocardial infarction (MI) has the characteristics of high mortality rate, strong suddenness and invisibility. There are problems such as the delayed diagnosis, misdiagnosis and missed diagnosis in clinical practice. Electrocardiogram (ECG) examination is the simplest and fastest way to diagnose MI. The research on MI intelligent auxiliary diagnosis based on ECG is of great significance. On the basis of the pathophysiological mechanism of MI and characteristic changes in ECG, feature point extraction and morphology recognition of ECG, along with intelligent auxiliary diagnosis method of MI based on machine learning and deep learning are all summarized. The models, datasets, the number of ECG, the number of leads, input modes, evaluation methods and effects of different methods are compared. Finally, future research directions and development trends are pointed out, including data enhancement of MI, feature points and dynamic features extraction of ECG, the generalization and clinical interpretability of models, which are expected to provide references for researchers in related fields of MI intelligent auxiliary diagnosis.
Humans ; Electrocardiography ; Myocardial Infarction/diagnosis* ; Recognition, Psychology

<p>OBJECTIVETo evaluate the effectiveness and safety of hydroxyethyl starch (HES 130/ 0.4, 60 g/L) in resuscitation during shock stage of burns.p><p>METHODSSixty-six burn patients who were admitted to hospital within 2 hours after burn injury requiring fluid resuscitation were enrolled into this study, and they were randomized into HES( n = 33, with HES as a component of fluid resuscitation) and plasma (P, n = 33, with plasma as a component of fluid resuscitation) groups. HES or plasma was given as colloid within 48 postburn hours (PBH), and only albumin [( 111 +/- 4) , ( 105 +/- 5 ) g for each group] were given to the patients during 3 to 7 postburn days (PBD). Heart rate, blood pressure, central venous pressure (CVP) , urine output per hour were measured, gain/loss of body fluid during the first and second 24 PBH were recorded, serum total protein, albumin, hemoglobin( Hb) , prothrombin time (PT) , fibrinogen; platelet ( PLT) , as well as liver and renal function, allergy and bleeding tendency were determined and observed at corresponding time-points.p><p>RESULTSThere were no obvious differences in heart rate, blood pressure, CVP and urine output per hour within 24 PBH between the two groups (P > 0.05). Also there was no difference in gain/loss of body fluid during the first and second 24 PBH. The content of hemoglobin on 1 ,3, 7,14 PBD ,and the PT, the content of fibrinogen, the number of PLT on 1,3,14 PBD also exhibited no difference between the two groups (P > 0.05). The serum contents of total protein and albumin in HES group were [(31 +/- 3) g/L, (30 +/- 3)g/L ] on 1 PBD, and [(20.4 +/- 3.6) g/L, (18.4 +/-2.3) g/L] on 3 PBD, which were obviously lower than those in P group [(45 +/- 4) g/L, (39 +/- 3) g/L on 1 PBD, and 1 (24.5 +/- 4.3) g/L, (21.3 +/- 3.9) g/L) on 3 PBD, (P <0. 01). Though the serum content of albumin on 7 PBD was similar in the two groups (P > 0.05), the serum total protein in HES group (40 +/- 4) g/L was markedly lower than that in P group [(45 +/- 4) g/L, P < 0.01] . Within 7 PBD, no abnormal bleeding was found in the two groups, and the liver function and renal function were similar. There were 4 cases showing allergic reaction in plasma group while none in HES group.p><p>CONCLUSIONNew type of HES can partially substitute plasma and be used in fluid resuscitation for burn patients. However, plasma protein replenishment should still be emphasized.p>
Adult ; Burns ; therapy ; Female ; Humans ; Hydroxyethyl Starch Derivatives ; therapeutic use ; Male ; Middle Aged ; Resuscitation ; methods ; Shock ; therapy

bjective    To use machine learning technology to predict the recurrence of atrial fibrillation (AF) after radiofrequency ablation, and try to find the risk factors affecting postoperative recurrence. Methods    A total of 300 patients with valvular AF who underwent radiofrequency ablation in West China Hospital and its branch (Shangjin Hospital) from January 2017 to January 2021 were enrolled, including 129 males and 171 females with a mean age of 52.56 years. We built 5 machine learning models to predict AF recurrence, combined the 3 best performing models into a voting classifier, and made prediction again. Finally, risk factor analysis was performed using the SHApley Additive exPlanations method. Results    The voting classifier yielded a prediction accuracy rate of 75.0%, a recall rate of 61.0%, and an area under the receiver operating characteristic curve of 0.79. In addition, factors such as left atrial diameter, ejection fraction, and right atrial diameter were found to have an influence on postoperative recurrence. Conclusion    Machine learning-based prediction of recurrence of valvular AF after radiofrequency ablation can provide a certain reference for the clinical diagnosis of AF, and reduce the risk to patients due to ineffective ablation. According to the risk factors found in the study, it can provide patients with more personalized treatment.

Transcatheter aortic valve replacement (TAVR) for severe aortic stenosis is growing rapidly. The use of new heart valves prosthesis has improved surgical safety and efficacy. This report described a 72-year-old male patient with severe aortic stenosis combined with severe aortic regurgitation, who was evaluated at moderate-high risk of surgery and received a transapical TAVR using the Ken-Valve heart valve. The transcatheter operation time was 8 min, and the blood loss was 50 mL. The tracheal intubation was removed immediately after the surgery. Transesophageal echocardiography on the 4th postoperative day showed that the aortic valve leaflets worked well, and there was no valve orifice and paravalvular leakage. The patient was discharged on the 5th day after the surgery without complications. Transapical TAVR using Ken-Valve was an easy surgical procedure for aortic valve disease, and had short operation time.

The design of wall filter in ultrasonic microvascular imaging directly affects the resolution of blood flow imaging. We compared the traditional polynomial regression wall filter algorithm and two algorithms based on singular value decomposition (SVD), Full-SVD algorithm and RS-RSVD algorithm (random sampling based on random singular value decomposition) through experiments with simulated data and human renal entity data imaging experiments. The experimental results showed that the filtering effect of the traditional polynomial regression wall filter algorithm was limited, however, Full-SVD algorithm and RS-RSVD algorithm could better extract the micro blood flow signal from the tissue or noise signal. When RS-RSVD algorithm was randomly divided into 16 blocks, the signal-to-noise ratio was the same as that of Full-SVD algorithm, reduces the contrast-to-noise ratio by 2.05 dB, and reduces the execution time by 90.41%. RS-RSVD algorithm can improve the operation efficiency and is more conducive to the real-time imaging of high frame rate ultrasound microvessels.
Algorithms ; Humans ; Microvessels/diagnostic imaging* ; Signal-To-Noise Ratio ; Ultrasonics ; Ultrasonography/methods*