The conventional identification and prediction for failures of medical equipment mainly depend on experience and knowledge of manager for equipment,which are not able to be quantified and have lower efficiency. Therefore,it is obvious that the prediction for the failure of medical equipment is not accurate. With the technical development of computer and machine learning,the conventional identification and prediction that depend on experiences can deal with characteristics of failures through machine learning method to improve efficiency,which are hopeful in filling the gap of discipline about the identification and prediction for failures of medical equipment. This article summarized the application situation of machine learning in identifying and predicting failures of the medical equipment and the similarly electric equipment at home and abroad. Based on the key technique of identification and prediction,this article proposed suggestion about corresponding design architecture. According to the characteristics of the failure of medical equipment,this article summarized a series of information about algorithms of various machine learning in scene and accurate rate of identification and prediction,so as to provide references for relevant research of this field.

The conventional identification and prediction for failures of medical equipment mainly depend on experience and knowledge of manager for equipment,which are not able to be quantified and have lower efficiency. Therefore,it is obvious that the prediction for the failure of medical equipment is not accurate. With the technical development of computer and machine learning,the conventional identification and prediction that depend on experiences can deal with characteristics of failures through machine learning method to improve efficiency,which are hopeful in filling the gap of discipline about the identification and prediction for failures of medical equipment. This article summarized the application situation of machine learning in identifying and predicting failures of the medical equipment and the similarly electric equipment at home and abroad. Based on the key technique of identification and prediction,this article proposed suggestion about corresponding design architecture. According to the characteristics of the failure of medical equipment,this article summarized a series of information about algorithms of various machine learning in scene and accurate rate of identification and prediction,so as to provide references for relevant research of this field.

Objective:To analyze the effect of dapagliflozin tablet combined with creatine phosphate sodium on blood glucose and cardiac function in patients with type 2 diabetes mellitus (T2DM) complicated with heart failure.Methods:A total of 80 patients with T2DM complicated with heart failure who received treatment in the Rehabilitation University Qingdao Hospital (Qingdao Municipal Hospital) from October 2021 to October 2022 were selected prospectively as the subjects, and they were randomly divided into two groups with 40 cases in each group by envelope method. The control group was treated with conventional methods, and the observation group was treated with dapagliflozin tablet combined with sodium creatine phosphate on the basis of conventional methods. Both groups completed the treatment for 3 months. The clinical efficacy, blood glucose control effect, cardiac function and serum indexes of the two groups were compared between the two groups.Results:The total effective rate in the observation group was higher than that in the control group: 95.00%(38/40) vs. 75.00%(30/40), there was statistical difference ( χ2 = 6.28, P<0.05). After treatment, the levels of fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin in the observation group were lower than those in the control group: (6.98 ± 0.67) mmol/L vs. (7.81 ± 0.78) mmol/L, (7.87 ± 1.58) mmol/L vs. (9.58 ± 1.49) mmol/L, (6.95 ± 0.57)% vs. (7.41 ± 0.60)%, there were statistical differences ( P<0.05). After treatment, the levels of left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), serum interleukin6 (IL-6), C-reactive protein (CRP) and brain natriuretic peptide (BNP) in the observation group were lower than those in the control group: (61.76 ± 3.55) mm vs. (64.01 ± 3.87) mm, (45.45 ± 3.58) mm vs. (47.71 ± 3.62) mm, (8.99 ± 0.95) ng/L vs.(10.28 ± 1.16) ng/L, (4.28 ± 1.17) mg/L vs. (5.57 ± 1.31) mg/L, (199.90 ± 34.12) ng/L vs. (250.73 ± 35.11) ng/L; the cardiac output (CO) and left ventricular ejection fraction (LVEF) in the observation group were higher than those in the control group: (4.95 ± 1.06) L/min vs. (4.13 ± 0.92) L/min, (44.51 ± 3.68)% vs. (42.15 ± 3.73)%, there were statistical differences ( P<0.05). Conclusions:Dapagliflozin tablets combined with creatine phosphate sodium can improve the effective rate of patients with T2DM complicated with heart failure, reduce the level of blood sugar, help to improve the heart function, and reduce the levels of serum inflammatory factors.

Clamshell incision is widely used in the surgical resection of complex mediastinal tumors, but it is also controversial. Its advantages are the full exposure of the field of vision and the huge operating space, while its disadvantages are the destruction of chest wall muscles and respiratory function impairment. At present, there is a lack of norms for the selection and application of Clamshell incisions, and the definition of complex mediastinal tumors is ambiguous and the dimensions are single. Therefore, this article reviews the literature and combines practical experience to systematically summarize the application progress of Clamshell incisions in the surgical resection of complex mediastinal tumors, with the aim of providing guidance for clinical work.

Objective:To compare the efficacy of Ilizarov ring external fixation and unilateral rail external fixation in the treatment of infected bone defects following surgery for tibial fractures.Methods:A retrospective cohort study was conducted to analyze the clinical data of 50 patients with infected bone defects after surgery for tibial fractures, who were admitted to the 940th Hospital of the Joint Logistics Support Force of the PLA from August 2019 to November 2021, including 37 males and 13 females, aged 19-59 years [(42.2±8.8)years]. After debridement and osteotomy, 28 patients were treated with Ilizarov ring external fixation (Ilizarov group) and 22 with unilateral rail external fixation (unilateral fixation group). All the patients in the two groups had previously undergone internal fixation with plates or Kirschner wires for tibial fracture before bone transport. Bone transport started at one week for three stages after successful infection control and osteotomy and was conducted. The following parameters were compared between the two groups: frame-wearing time and healing index after bone transport, self-rating anxiety scale (SAS) grade at 6 months after bone transport, Paley score and Association for the Study and Application of the Method of Ilizarov (ASAMI) score at the last follow-up, Hospital for Special Surgery (HSS) knee score and Baird-Jackson ankle score on admission, after external fixator removal and at the last follow-up, and incidence of postoperative complications.Results:All the patients were followed up for 28-36 months [(32.5±1.6)months]. There were no significant differences in frame-wearing time or healing index between the two groups after bone transport ( P>0.05). At 6 months after bone transport, the SAS grade in the unilateral fixation group (13 patients with mild anxiety, 8 with moderate anxiety, and 1 with severe anxiety) was better than that in the Ilizarov group (6 patients with mild anxiety, 19 with moderate anxiety, 3 with severe anxiety) ( P<0.01). No significant differences were found in the Paley score or ASAMI score between the two groups at the last follow-up ( P>0.05). There were no significant differences in HSS knee score or Baird-Jackson ankle score between the two groups on admission, after external fixator removal or at the last follow-up ( P>0.05). No significant differences were observed in the incidence of pin tract infection, poor healing, infection in the bone elongation area, or re-fracture between the two groups ( P>0.05). The incidence of postoperative axial deviation was 0 in the Ilizarov group, lower than 18% in the unilateral fixation group (4/22) ( P<0.05). Conclusion:Although Ilizarov ring external fixation and unilateral rail external fixation demonstrate comparable efficacy in the treatment of infected bone defects after surgery for tibial fractures, the former provides superior mechanical stability and postoperative axial deviation correction, while the latter offers advantages in reducing psychological burden and enhancing treatment tolerance.

Objective:To analyze the effect of dapagliflozin tablet combined with creatine phosphate sodium on blood glucose and cardiac function in patients with type 2 diabetes mellitus (T2DM) complicated with heart failure.Methods:A total of 80 patients with T2DM complicated with heart failure who received treatment in the Rehabilitation University Qingdao Hospital (Qingdao Municipal Hospital) from October 2021 to October 2022 were selected prospectively as the subjects, and they were randomly divided into two groups with 40 cases in each group by envelope method. The control group was treated with conventional methods, and the observation group was treated with dapagliflozin tablet combined with sodium creatine phosphate on the basis of conventional methods. Both groups completed the treatment for 3 months. The clinical efficacy, blood glucose control effect, cardiac function and serum indexes of the two groups were compared between the two groups.Results:The total effective rate in the observation group was higher than that in the control group: 95.00%(38/40) vs. 75.00%(30/40), there was statistical difference ( χ2 = 6.28, P<0.05). After treatment, the levels of fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin in the observation group were lower than those in the control group: (6.98 ± 0.67) mmol/L vs. (7.81 ± 0.78) mmol/L, (7.87 ± 1.58) mmol/L vs. (9.58 ± 1.49) mmol/L, (6.95 ± 0.57)% vs. (7.41 ± 0.60)%, there were statistical differences ( P<0.05). After treatment, the levels of left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), serum interleukin6 (IL-6), C-reactive protein (CRP) and brain natriuretic peptide (BNP) in the observation group were lower than those in the control group: (61.76 ± 3.55) mm vs. (64.01 ± 3.87) mm, (45.45 ± 3.58) mm vs. (47.71 ± 3.62) mm, (8.99 ± 0.95) ng/L vs.(10.28 ± 1.16) ng/L, (4.28 ± 1.17) mg/L vs. (5.57 ± 1.31) mg/L, (199.90 ± 34.12) ng/L vs. (250.73 ± 35.11) ng/L; the cardiac output (CO) and left ventricular ejection fraction (LVEF) in the observation group were higher than those in the control group: (4.95 ± 1.06) L/min vs. (4.13 ± 0.92) L/min, (44.51 ± 3.68)% vs. (42.15 ± 3.73)%, there were statistical differences ( P<0.05). Conclusions:Dapagliflozin tablets combined with creatine phosphate sodium can improve the effective rate of patients with T2DM complicated with heart failure, reduce the level of blood sugar, help to improve the heart function, and reduce the levels of serum inflammatory factors.

Clamshell incision is widely used in the surgical resection of complex mediastinal tumors, but it is also controversial. Its advantages are the full exposure of the field of vision and the huge operating space, while its disadvantages are the destruction of chest wall muscles and respiratory function impairment. At present, there is a lack of norms for the selection and application of Clamshell incisions, and the definition of complex mediastinal tumors is ambiguous and the dimensions are single. Therefore, this article reviews the literature and combines practical experience to systematically summarize the application progress of Clamshell incisions in the surgical resection of complex mediastinal tumors, with the aim of providing guidance for clinical work.

Objective:To compare the efficacy of Ilizarov ring external fixation and unilateral rail external fixation in the treatment of infected bone defects following surgery for tibial fractures.Methods:A retrospective cohort study was conducted to analyze the clinical data of 50 patients with infected bone defects after surgery for tibial fractures, who were admitted to the 940th Hospital of the Joint Logistics Support Force of the PLA from August 2019 to November 2021, including 37 males and 13 females, aged 19-59 years [(42.2±8.8)years]. After debridement and osteotomy, 28 patients were treated with Ilizarov ring external fixation (Ilizarov group) and 22 with unilateral rail external fixation (unilateral fixation group). All the patients in the two groups had previously undergone internal fixation with plates or Kirschner wires for tibial fracture before bone transport. Bone transport started at one week for three stages after successful infection control and osteotomy and was conducted. The following parameters were compared between the two groups: frame-wearing time and healing index after bone transport, self-rating anxiety scale (SAS) grade at 6 months after bone transport, Paley score and Association for the Study and Application of the Method of Ilizarov (ASAMI) score at the last follow-up, Hospital for Special Surgery (HSS) knee score and Baird-Jackson ankle score on admission, after external fixator removal and at the last follow-up, and incidence of postoperative complications.Results:All the patients were followed up for 28-36 months [(32.5±1.6)months]. There were no significant differences in frame-wearing time or healing index between the two groups after bone transport ( P>0.05). At 6 months after bone transport, the SAS grade in the unilateral fixation group (13 patients with mild anxiety, 8 with moderate anxiety, and 1 with severe anxiety) was better than that in the Ilizarov group (6 patients with mild anxiety, 19 with moderate anxiety, 3 with severe anxiety) ( P<0.01). No significant differences were found in the Paley score or ASAMI score between the two groups at the last follow-up ( P>0.05). There were no significant differences in HSS knee score or Baird-Jackson ankle score between the two groups on admission, after external fixator removal or at the last follow-up ( P>0.05). No significant differences were observed in the incidence of pin tract infection, poor healing, infection in the bone elongation area, or re-fracture between the two groups ( P>0.05). The incidence of postoperative axial deviation was 0 in the Ilizarov group, lower than 18% in the unilateral fixation group (4/22) ( P<0.05). Conclusion:Although Ilizarov ring external fixation and unilateral rail external fixation demonstrate comparable efficacy in the treatment of infected bone defects after surgery for tibial fractures, the former provides superior mechanical stability and postoperative axial deviation correction, while the latter offers advantages in reducing psychological burden and enhancing treatment tolerance.

BACKGROUND:With the increasing number of tendon transplantation surgeries for tendon injuries,the demand for tendon tissue engineering scaffolds is increasing.Research has found that good pore size and porosity of implants contribute to tissue healing. OBJECTIVE:To review the types of materials currently published for tendon tissue engineering scaffolds and investigate the correlation between various tendon tissue engineering scaffold materials and pores. METHODS:Articles were retrieved on PubMed,Embase,and Web of Science databases,using keywords"tendon"or"ligament"and"tissue scaffold"as well as"porosity"or"permeability".A total of 84 articles meeting the criteria were included to summarize,discuss and anticipate future development directions. RESULTS AND CONCLUSION:The materials used in the research of tendon tissue engineering are mainly divided into two categories:natural tendon scaffold materials and artificial synthetic tendon scaffold materials.Natural scaffold materials include autologous tendons,allogeneic tendons,and xenogeneic tendons.Autogenous tendons and allogeneic tendons have been used in clinical practice for many years.During the preparation of allogeneic tendons and animal experiments,it was found that the process of acellular disinfection resulted in an increase in the pore size and porosity of both types of tendons,but the specific reasons and mechanisms have not been further studied.There are many types of artificial tendon scaffold materials currently being studied,among which artificial ligament products such as Leeds Keio and LARS(Ligament Advanced Reinforcement System)are still in use in some countries.Other materials have not been promoted in clinical practice due to immature technology and other issues.The pores and porosity of artificial tendon scaffold materials also show different trends due to their different materials and preparation techniques.

Objective:To investigate the current status of endoscopic treatment for gastroesophageal varices in portal hypertension in China, and to provide supporting data and reference for the development of endoscopic treatment.Methods:In this study, initiated by the Liver Health Consortium in China (CHESS), a questionnaire was designed and distributed online to investigate the basic condition of endoscopic treatment for gastroesophageal varices in portal hypertension in 2022 in China. Questions included annual number and indication of endoscopic procedures, adherence to guideline for preventing esophagogastric variceal bleeding (EGVB), management and timing of emergent EGVB, management of gastric and isolated varices, and improvement of endoscopic treatment. Proportions of hospitals concerning therapeutic choices to all participant hospitals were calculated. Guideline adherence between secondary and tertiary hospitals were compared by using Chi-square test.Results:A total of 836 hospitals from 31 provinces (anotomous regions and municipalities) participated in the survey. According to the survey, the control of acute EGVB (49.3%, 412/836) and the prevention of recurrent bleeding (38.3%, 320/836) were major indications of endoscopic treatment. For primary [non-selective β-blocker (NSBB) or endoscopic therapies] and secondary prophylaxis (NSBB and endoscopic therapies) of EGVB, adherence to domestic guideline was 72.5% (606/836) and 39.2% (328/836), respectively. There were significant differences in the adherence between secondary and tertiary hospitals in primary prophylaxis of EGVB [71.0% (495/697) VS 79.9% (111/139), χ2=4.11, P=0.033] and secondary prophylaxis of EGVB [41.6% (290/697) VS 27.3% (38/139), χ2=9.31, P=0.002]. A total of 78.2% (654/836) hospitals preferred endoscopic therapies treating acute EGVB, and endoscopic therapy was more likely to be the first choice for treating acute EGVB in tertiary hospitals (82.6%, 576/697) than secondary hospitals [56.1% (78/139), χ2=46.33, P<0.001]. The optimal timing was usually within 12 hours (48.5%, 317/654) and 12-24 hours (36.9%, 241/654) after the bleeding. Regarding the management of gastroesophageal varices type 2 and isolated gastric varices type 1, most hospitals used cyanoacrylate injection in combination with sclerotherapy [48.2% (403/836) and 29.9% (250/836), respectively], but substantial proportions of hospitals preferred clip-assisted therapies [12.4% (104/836) and 26.4% (221/836), respectively]. Improving the skills of endoscopic doctors (84.2%, 704/836), and enhancing the precision of pre-procedure evaluation and quality of multidisciplinary team (78.9%, 660/836) were considered urgent needs in the development of endoscopic treatment. Conclusion:A variety of endoscopic treatments for gastroesophageal varices in portal hypertension are implemented nationwide. Participant hospitals are active to perform emergent endoscopy for acute EGVB, but are inadequate in following recommendations regarding primary and secondary prophylaxis of EGVB. Moreover, the selection of endoscopic procedures for gastric varices differs greatly among hospitals.