Anxiety is usually generated because of the threatened feeling. The data of electrocardio, respiration, blood volume pulse and skin conductance signals were collected. The arithmetic of Relief were used for the feature selection and combined with k-Nearest Neighbor (kNN) arithmetic and Support Vector Machine (SVM) arithmetic for classification. The results show that the combination of Relief-SVM is better than combination of Relief-kNN on the recognition of anxiety state. The emotion recognition based on multi-physiological signals is superior to that based on one single signal.
Algorithms ; Anxiety ; Artificial Intelligence ; Humans ; Pattern Recognition, Automated ; Support Vector Machine

Objective To investigate the knowledge awareness of medical staff in department of Obstetrics and Gynecology,on prevention of mother-to-child transmission of hepatitis B virus(HBV).Methods Medicatl staff,who attended national or local medical conferences of Obstetrics and Gynecology from July 29th to October 25th in 2011,were invited to complete a questionnaire containing questions on clinical implications of HBV serologic markers,relevant prevention measures and including intervention measures for both pregnant women and infants.Data were collected and analyzed by Chi-square test or Fisher's exact test.Results A total of 559 answers were analyzed.Of the 559 staff,85.0％(n=475) were doctors and 15.0％(n=84) were nurses.The percentages ofstaff from primary,secondary and tertiary hospitals were 13.2％(n=74),36.9％(n=206) and 49.9％ (n=279).Overall,90.0％ (503/559) participants agreed that positive hepatitis B surface antigen (HBsAg) was contagious,but 27.5％ (154/559) mistook that the presence of antibody against hepatitis B e antigen (anti-HBc) and/or antibody against hepatitis B core antigens (anti-HBc) with negative HBsAg was contagious.Totally,96.3％ (519/539) respondents knew that pregnant women should be screened for HBV infection,and those from secondary hospitals had more consciousness of HBV screening for pregnant women than those from tertiary hospitals [99.0％ (201/203) vs94.7％(250/264),x2=6.466,P=0.011].Although,95.3％ (511/536) realized that infants of mothers with positive HBsAg should receive hepatitis B immunoglobulin (HBIG) and vaccination,but 61.6％ (330/536) and 80.4％ (427/531) of the enrolled medical staff knew the exact regimen.With the available immunoprophylaxis,13.8％ (74/536) participants mistakenly believed that cesarean section may prevent HBV mother-to-child transmission,and only 13.0％ (69/532) correctly answered that neonates of women with positive HBsAg can be breast-fed.Additionally,54.4％ (290/533) participants mistakenly believed that HBsAg positive pregnant women needed HBIG injection during pregnancy to reduce HBV mother to-child transmission.Conclusions Medical staff in obstetric and gynecological department has essentially mastered the strategies of prevention of mother-to-child transmission of HBV,but much more details should be stressed.

Objective To investigate the value of percutaneous transhepatic cholangiobiopsy (PTCB) in the diagnosis of obstructive jaundice.Methods The clinical data of 826 patients with obstructive jaundice who received PTCB at the First Affiliated Hospital of Zhengzhou University from April 2001 to December 2011 were retrospectively analyzed.The pathological results,positive rates of PTCB and complications were analyzed.The safety and efficacy of PTCB and the pathological features of malignancy causing obstructive jaundice were summarized.The difference in the positive rates of PTCB for biliary and non-biliary malignancies was analyzed by chi-square test.Results A total of 826 patients received PTCB,and the success rate was 100％.Eighty-six patients had complications postoperatively,including transit bilhaemia in 47 patients,bile leakage in 11 patients,temporary biliary hemorrhage in 28 patients,no severe complications occurred.There were 740 patients were with malignant biliary stricture and 86 with benign biliary stricture.Seven Hundred and twenty-seven patients were with positive results of PTCB (641 were with cancerous stricture and 86 with inflammation of biliary tract or fibrogenesis),and 99 patients were with false negative results.The overall positive rate of PTCB was 88.01％ (727/826).Malignant neoplasm accounted for 89.59％ (740/826) of the factors causing obstructive jaundice,and well-,moderate-and poor-differentiated neoplasms were accounted for 57.88％ (371/641),19.97％ (128/641) and 22.15％ (142/641).Biliary adenocarcinoma was the main pathologic type,which was accounted for 96.41％ (618/641).The positive rates of PTCB for biliary and non-biliary neoplasms were 89.50％ (469/524)and 79.63％ (172/216),with significant difference (x2 =12.87,P ＜ 0.05).Conclusions PTCB is a safe,feasible and easy way to diagnose obstructive jaundice.Biliary neoplasms are the best indications for PTCB.Well differentiated neoplasm is the main pathological type causing the obstructive jaundice.

Objective:To explore the impact of the number of pathological lymph node metastasis areas on the prognosis of patients with thoracic esophageal squamous cell carcinoma (ESCC) after radical surgery.Methods:The clinicopathologic data of 153 patients with ESCC treated by radical surgery at the Department of Thoracic Surgery of the Affiliated Taixing People′s Hospital of Yangzhou University from January 2012 to December 2014 were retrospectively analyzed. Among these patients, 76 had no adjuvant therapy, and 77 received adjuvant radiotherapy or chemoradiotherapy after surgery. According to the lymph node classification criteria of American Thoracic Association and the number of pathological lymph node metastasis areas, the patients were divided into non-regional lymph node metastasis group ( n=68), oligo-regional lymph node metastasis group (1-2 regional lymph node metastasis, n=54) and multi-regional lymph node metastasis group (≥3 regional lymph node metastasis, n=31). Kaplan-Meier method was used to calculate survival rate and survival comparison was performed by log-rank test. The Cox proportional hazards model was used to analyze prognostic factors, receiver operating characteristic (ROC) curve was used to analyze the predictive value of the number of lymph node metastasis areas. Results:The median overall survival (OS) was 37.0 months for the 153 patients, and the 1-, 3- and 5-year OS rates were 97.4%, 51.0% and 30.7% respectively. In the non-regional lymph node metastasis group, the median OS was 46.0 months, and the 1-, 3- and 5-year OS rates were 97.1%, 58.8% and 39.7% separately. In the oligo-regional lymph node metastasis group, the median OS was 39.0 months, and the 1-, 3- and 5-year OS rates were 94.4%, 55.6% and 35.2% respectively. In the multi-regional lymph node metastasis group, the median OS was 26.0 months, and the 1-, 3- and 5-year OS rates were 98.1%, 25.8% and 3.2% separately. There was a statistically significant difference among the three groups ( χ2=18.257, P<0.001). Among the 76 patients without adjuvant treatment, the 1-, 3- and 5-year OS rates were 94.7%, 50.0% and 34.2% in patients with non-regional lymph node metastasis, 90.9%, 36.4% and 9.1% in patients with oligo-regional lymph node metastasis, 97.4%, 18.8% and 0 in patients with multi-regional lymph node metastasis, and there was a statistically significant difference ( χ2=8.201, P=0.017). Among the 77 patients with adjuvant therapy, the 1-, 3- and 5-year OS rates were 97.7%, 66.7% and 46.7% in patients with non-regional lymph node metastasis, 96.9%, 68.8% and 53.1% in patients with oligo-regional lymph node metastasis, 93.3%, 26.7% and 6.7% in patients with multi-regional lymph node metastasis, and there was a statistically significant difference ( χ2=18.083, P<0.001). Univariate analysis showed that age ( HR=1.534, 95% CI: 1.041-2.260, P=0.030), T stage ( HR=1.757, 95% CI: 1.197-2.579, P=0.004), N stage ( HR=1.548, 95% CI: 1.043-2.297, P=0.030), TNM stage ( HR=1.392, 95% CI: 1.114-2.459, P=0.015), adjuvant therapy ( HR=0.545, 95% CI: 0.370-0.803, P=0.002) and number of lymph node metastasis areas (multi-regional lymph node metastasis versus non-regional lymph node metastasis: HR=0.385, 95% CI: 0.238-0.624, P<0.001; multi-regional lymph node metastasis versus oligo-regional lymph node metastasis: HR=0.442, 95% CI: 0.269-0.726, P=0.001) were closely related to OS in patients with ESCC after operation. Multivariate analysis showed that T stage ( HR=1.699, 95% CI: 1.143-2.525, P=0.009), adjuvant therapy ( HR=0.577, 95% CI: 0.386-0.864, P=0.008) and number of lymph node metastasis areas (multi-regional lymph node metastasis versus non-regional lymph node metastasis: HR=0.553, 95% CI: 0.411-0.996, P=0.011; multi-regional lymph node metastasis versus oligo-regional lymph node metastasis: HR=0.550, 95% CI: 0.328-0.924, P=0.024) were independent prognostic factors for OS. The number of lymph node metastasis areas (AUC=0.648, 95% CI: 0.560-0.735, P=0.004) was better than the number of lymph node metastasis (AUC=0.595, 95% CI: 0.497-0.694, P=0.061) in predicting OS of patients with ESCC after radical surgery. Conclusion:The number of postoperative pathological lymph node metastasis areas in thoracic ESCC has important value in predicting survival prognosis, and adjuvant therapy can significantly improve the OS of patients with oligo-regional lymph node metastasis.

Objective To explore the appropriate treatment according to the grading system of adolescent idiopathic cervical kyphosis.Methods A retrospective study was performed in 115 adolescent patients with idiopathic cervical kyphosis.The patients were divided into 4 groups according to the magnitude of kyphosis.The initial Cobb angle of 4 groups were 12.7°±1.4° 25.4°±4.8°,47.2°±4.4° and 62.6°±5.7° respectively.The patients in group I were treated with the collar support for 4-8 weeks.The patients in group Ⅱ were treated with skull traction (3-5 kg) and then fixed by cranio-cervical-thoracic plaster.According to the angles between the tangents of posterior vertebral body at each level on lateral cervical radiograph in extension,the anterior fusion levels of the group Ⅲ and angles and range of osteotomy in the group Ⅳ were decided.In group Ⅳ,the patients were treated by two steps.The anterior release and posterior osteotomy were performed firstly.Then skull traction (1/10 body weight) was maintained in order to correct the deformity for 7-10 days,fusion and anterior fusion with autologous bone graft and internal fixation was completed.Results Post-operative radiograph showed that Cobb angle were -5.5°±2.0°,-8.2°±6.1°,-4.5°±6.6° and -2.9°±7.9° in Ⅰ-Ⅳ group after treatment.The deformed appearance of the patients improved significantly.A improvement neck pain and neurologic function were found in all patients.Post-operative MRI showed that physiological curve of the cervical spine was restored,and the cerebrospinal fluid line was clear in the previous kyphosis area.Conclusion Adolescent idiopathic cervical kyphosis has specific characteristics.Surgical strategy is determined by the severity of deformity.

Objective To investigate the feasibility, safety and efficacy of transarterial embolization with low concentration of n-butyl cyanoacrylate(NBCA) in rabbit VX2 liver tumor models. MethodsTwenty-four rabbits were implanted with VX2 hepatic tumors into the left hepatic lobes, and were scanned with CT to measure the volume of the tumor after 14 days. They were randomly divided into three groups with 8 rabbits assigned to each group. Transarterial embolization was conducted with physiological saline in control group A, with pure Lipiodol in group B, with 2.5% NBCA in group C. Hepatic toxicity was evaluated by blood biochemical analysis of the plasma alanine aminotransferase (ALT) and aspartate aminotransferase (AST). One week later, the volumes of the tumors were measured by CT again. Tumor growth rate was the ratio of tumor's volume at 7th day after embolization to the tumors' volume before embolization. The survival periods of the rabbits of the three groups after treatment were also recorded. The data of ALT and AST mean values from each group were analyzed with repeated measurement analysis of variance (ANOVA). Tumor growth rates and survival periods were analyzed by using one-way ANOVA. Results All animal models were successfully established and underwent interventional catheterization. Both ALT and AST mean values of the rabbits in group A, B and C at each time point before and after embolization were significantly different (ALT F=10.508, 16.443, 19.828, respectively; AST F=23.696, 23.334, 15.594, respectively)(P＜0.05). ALT in group A, B, C were (49.4±13.5), (115.2±48.8), (124.7±49.4)U/L, while AST in group A, B, C were (52.3±12.0), (128.3±50.1), (137.0±66.9)U/L 4 days after embolization. The ALT and AST mean values were significantly elevated 4 days after embolization in group B and group C compared with those before embolization and those of group A 4 days after treatment(P＜0.05). However, the ALT and AST mean values showed no statistically significant difference in all the groups before embolization and 7 days after embolization. On the other hand, the growth rates of the tumors differed significantly among the three groups(F=110.865, P=0.000). The group C showed significantly lower tumor growth rate (0.839±0.144)% than the group A(2.978±0.547)%(P=0.000), but no significantly different tumor growth rate compared with group B(0.871±0.0725)%( P=0.845). Consequently, the survival period of the animals in group C(38.9±4.0) days was significantly longer than that in group A(32.1±3.1)days (P=0.006), while it was not significantly different from that in group B(36.9±4.8)days(P=0.366). ConclusionsTransarterial embolization with low concentration of NBCA was feasible and safe. It could be a new option of treatment for HCC and might have potential further clinical value.

Objective To explore the efficacy and safety of percutaneous transhepatic portal vein or transjugular intrahepatic portosystemie shunt (TIPS)to implant the portal vein metallic stent in treatment of cavernous transformation of portal vein (CTPV).Methods Clinical and imaging data of 8 patients with CTPV were retrospectively analyzed who were treated in our hospital.All patients were treated with metallic stent implantation in portal vein including 3 patients by TIPS and 5 by percutaneous transhepatic portal vein.Results All patients were successful in the stent implantation without any occurrence of serious complications such as intra-abdominal hemorrhage and so on.Intraoperative angiography showed blood circulated freely in these stents.1 day-2 weeks later,the patients symptoms of abdominal pain and gastrointestinal bleeding were obviously relieved or disappeared.Follow up 1 month-3 years,1 patient with stent occlusion after one year of operation,the blood flow recovery after stent reimplantation,and the remaining patients,color doppler ultrasound reflected patency of blood flows in their stents.No one suffered from gastrointestinal bleeding or abdominal pain again.Conclusion Implantation of portal vein metallic stent via percutaneous transhepatic portal vein or via TIPS in treatment of cavernous transformation of portal vein is safe and effective.

Objective To investigate the clinical efficacy of induced membrane technique for reconstruction of large tibia bone defects in adults.Methods From February 2010 to February 2014,28 cases with tibia bone defect (16 cases caused by traumatic,9 cases caused by chronic osteomyrlitis,and 3 cases caused by tumor resrction)were treated in our deparment.There were 21 males and 7 females,with a mean age of 36.7 years old.The mean bone loss after final debridement and tumor resrction was (6.2 ±2.6)cm,and the maximum length of bone loss was 16 cm in this series.All the patients were treated by induced membrane technique,and the healing rate,occurrence of complications and limb function were recorded.The bone union was assessed by Paley scores.Results The average duration of follow-up ranged from 12 to 37 months,averagely (23.4 ±4.7)months.The healing rate was 85.7% at a mean time of 5.2 months.According to the Paley scores,there were 20 cases of excellent,6 cases of good,2 cases of moderate.There were 2 patients with pin site infection,2 patients with deep infection re-quiring operative debridement,1 patient with superficial iliac incision infection,1 patient with nonunions of one ends of the bone gap,and 1 patient suffered the implant failure due to fullweight-bearing early.Conclusion The induced membrane technique is a valid option for the management of large tibia bone defects in adults caused by traumatic,tumor resection and removal of chronic osteomyelitis lesions,which sig-nificantly shorten treatment cycle,provide satisfactory results with minimal complications,and promote good recovery of limb function.

The onset of hepatocelluar carcinoma, one of the serious complications of primary Budd-Chiari syndrome, is associated with poor prognosis.Although so, the diagnosis and treatment of such disease has still not been standardized at recent.In this paper, we overviewed the recent advances on Budd-Chiari syndrome associated with hepatocelluar carcinoma.

Objective To discuss the clinical effect of intertrochanteric fracture treated with InterTan intramedullary nail. Methods Between Jan 2011 and June 2006 , 100 consecutive patients with intertrochanteric fracture were treated with a new nail (InterTan). We recorded the operation time, blood loss, blood transfusion volume and the modified Harris hip score was used to evaluate outcomes. Results All cases were received follow-up of 6 to 15 months. All cases got bone healing and did not appear various complications. The modified Harris hip score were (75.1 ± 13.4) points. Conclusion The InterTan device appears to be a reliable implant for treatment of intertrochanteric femoral fractures.