To address the limitations of the existing automatic electrocardiogram(ECG)diagnosis models in learning long-term dependencies,an automatic 12-lead long-term ECG signal diagnosis model which combines bidirectional selective state space model(bidirectional mamba,BiMamba)with residual multi-scale receptive field block(RMSF)is proposed:(1)designing a multi-scale receptive field module with residual connections to realize more extensive feature extraction and fusion;(2)introducing BiMamba block to enhance the model's temporal modeling capability by employing both forward and backward temporal processing;(3)using the classifier to process features from BiMamba for accomplishing multi-label ECG classification.Five major diagnostic categories from the PTB-XL dataset are extracted and subjected to 5-fold cross-validation experiments.The experimental results from the comparative study show that BiMamba-RMSF achieves an average accuracy of 89.42%,an average AUC of 0.9356,and an average F1 score of 72.85%,outperforming the other 4 automatic ECG diagnosis models.Additionally,ablation study further validates the effectiveness of BiMamba block.It is demonstrated that the proposed model has a high precision in the multi-label classification for 12-lead long-term ECG signals.

OBJECTIVES: We propose a myocardial infarction (MI) detection and localization model for improving the diagnostic accuracy for MI to provide assistance to clinical decision-making. METHODS: The proposed model was constructed based on multi-scale field residual blocks fusion modified channel attention (MSF-RB-MCA). The model utilizes lead II electrocardiogram (ECG) signals to detect and localize MI, and extracts different levels of feature information through the multi-scale field residual block. A modified channel attention for automatic adjustment of the feature weights was introduced to enhance the model's ability to focus on the MI region, thereby improving the accuracy of MI detection and localization. RESULTS: A 5-fold cross-validation test of the model was performed using the publicly available Physikalisch-Technische Bundesanstalt (PTB) dataset. For MI detection, the model achieved an accuracy of 99.96% on the test set with a specificity of 99.84% and a sensitivity of 99.99%. For MI localization, the accuracy, specificity and sensitivity were 99.81%, 99.98% and 99.65%, respectively. The performances of the model for MI detection and localization were superior to those of other comparison models. CONCLUSIONS The proposed MSF-RB-MCA model shows excellent performance in AI detection and localization based on lead II ECG signals, demonstrating its great potential for application in wearable devices.
Myocardial Infarction/diagnosis* ; Humans ; Electrocardiography/methods* ; Signal Processing, Computer-Assisted ; Algorithms ; Sensitivity and Specificity

To address the limitations of the existing automatic electrocardiogram(ECG)diagnosis models in learning long-term dependencies,an automatic 12-lead long-term ECG signal diagnosis model which combines bidirectional selective state space model(bidirectional mamba,BiMamba)with residual multi-scale receptive field block(RMSF)is proposed:(1)designing a multi-scale receptive field module with residual connections to realize more extensive feature extraction and fusion;(2)introducing BiMamba block to enhance the model's temporal modeling capability by employing both forward and backward temporal processing;(3)using the classifier to process features from BiMamba for accomplishing multi-label ECG classification.Five major diagnostic categories from the PTB-XL dataset are extracted and subjected to 5-fold cross-validation experiments.The experimental results from the comparative study show that BiMamba-RMSF achieves an average accuracy of 89.42%,an average AUC of 0.9356,and an average F1 score of 72.85%,outperforming the other 4 automatic ECG diagnosis models.Additionally,ablation study further validates the effectiveness of BiMamba block.It is demonstrated that the proposed model has a high precision in the multi-label classification for 12-lead long-term ECG signals.

Objective:To evaluate the role of the nuclear factor E2-related factor 2 (Nrf2) signaling pathway in hydrogen sulfide (H 2S)-induced inhibition of inflammatory responses in the brain tissues of mice with sepsis-associated encephalopathy (SAE). Methods:Fifty-four wild-type C57BL/6J mice and thirty-six Nrf2 -/-C57BL/6J mice, weighing 20-25 g, were divided into 5 groups ( n=18 each) using a random number table method: wild-type sham operation group (wild-type Sham group), wild-type SAE group, wild-type SAE+ NaHS group, Nrf2 -/-SAE group, and Nrf2 -/-SAE+ NaHS group.After the model of SAE was established by cecal ligation and puncture in anesthetized mice.NaHS 50 μmol/kg was intraperitoneally injected at 3 h after the model was successfully established.The mice were sacrificed at 24 h after surgery, and brain tissues were obtained for examination of the phathological changes and for determination of the number of viable neurons, the expression of NLRP3 (by Western blot), contents of tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β) and IL-6 (by enzyme-linked immunosorbent assay), and percentage of Iba-1 + CD86 + , Iba-1 + CD206 + and Iba-1 + cells (by flow cytometry). Results:Compared with wild-type Sham group, NLRP3 expression was significantly up-regulated, contents of TNF-α, IL-1β and IL-6 and percentage of Iba-1 + CD86 + and Iba-1 + cells were increased, and the percentage of Iba-1 + CD206 + cells and neuron survival rate were decreased in wild-type SAE group ( P<0.05). Compared with wild-type SAE group, NLRP3 expression was significantly down-regulated, contents of TNF-α, IL-1β and IL-6, percentage of Iba-1 + and Iba-1 + CD86 + and neuron survival rate were decreased, and the percentage of Iba-1 + CD206 + cells was increased in wild-type SAE+ NaHS group ( P<0.05). There was no significant difference in each parameter between Nrf2 -/-SAE group and Nrf2 -/-SAE+ NaHS group ( P>0.05). Compared with wild-type SAE+ NaHS group, NLRP3 expression was significantly up-regulated, the percentage of Iba-1 + and Iba-1 + CD86 + and contents of TNF-α, IL-1β and IL-6 were increased, and the percentage of Iba-1 + CD86 + cells and neuron survival rate were decreased in Nrf2 -/-SAE+ NaHS group ( P<0.05). Conclusion:Nrf2 signaling pathway is involved in H 2S-induced inhibition of inflammatory responses in the brain tissues of mice with SAE.

Objective To evaluate the effect of hydrogen on the mitochondrial function in brain tis-sues of mice with sepsis-associated encephalopathy(SAE).Methods Two hundred and sixty-eight healthy male C57 mice,aged 6 weeks,weighing 20-25 g,were divided into 4 groups(n＝67 each)using a ran-dom number table method: sham operation group(group SH),sham operation plus hydrogen gas group(group SH+H2),group SAE,and SAE plus hydrogen gas group(group SAE+H2).Sepsis was produced by cecal ligation and puncture in anesthetized mice.The mice in group SH+H2 and group SAE+H2 inhaled 2％hydrogen gas for 1 h starting from 1 and 6 h after operation,respectively.The postoperative 7-day sur-vival rate was recorded.Brain tissues were obtained at 24 h after operation to count the normal neurons in hippocampal CA1 region.At 6,12 and 24 h after operation,hippocampal mitochondria were isolated for determination of mitochondrial membrane potential(MMP)by fluorescence spectrophotometry and ATP con-tent by a bioluminescence assay.Y-maze(spontaneous alternation)test was performed at days 3,5 and 7 after operation.Results Compared with group SH,the 7-day survival rate was significantly decreased,the number of normal neurons in hippocampal CA1 region,MMP,mitochondrial ATP content and sponta-neous alternation percentage in Y-maze test were significantly decreased in group SAE and group SAE+H2(P＜0.05).Compared with group SAE,the 7-day survival rate,the number of normal neurons in hipp-ocampal CA1 region,MMP,mitochondrial ATP content and spontaneous alternation percentage in Y-maze test were significantly increased in group SAE+H2(P＜0.05).Conclusion The mechanism by which hy-drogen reduces SAE is probably associated with improving mitochondrial function in brain tissues of mice.

Objective: To evaluate the effect of hydrogen on the mitochondrial function in brain tissues of mice with sepsis-associated encephalopathy (SAE). Methods: Two hundred and sixty-eight healthy male C57 mice, aged 6 weeks, weighing 20-25 g, were divided into 4 groups (n=67 each) using a random number table method: sham operation group (group SH), sham operation plus hydrogen gas group (group SH+ H₂), group SAE, and SAE plus hydrogen gas group (group SAE+ H₂). Sepsis was produced by cecal ligation and puncture in anesthetized mice.The mice in group SH+ H₂ and group SAE+ H₂ inhaled 2% hydrogen gas for 1 h starting from 1 and 6 h after operation, respectively.The postoperative 7-day survival rate was recorded.Brain tissues were obtained at 24 h after operation to count the normal neurons in hippocampal CA1 region.At 6, 12 and 24 h after operation, hippocampal mitochondria were isolated for determination of mitochondrial membrane potential (MMP) by fluorescence spectrophotometry and ATP content by a bioluminescence assay.Y-maze (spontaneous alternation) test was performed at days 3, 5 and 7 after operation. Results: Compared with group SH, the 7-day survival rate was significantly decreased, the number of normal neurons in hippocampal CA1 region, MMP, mitochondrial ATP content and spontaneous alternation percentage in Y-maze test were significantly decreased in group SAE and group SAE+ H₂ (P<0.05). Compared with group SAE, the 7-day survival rate, the number of normal neurons in hippocampal CA1 region, MMP, mitochondrial ATP content and spontaneous alternation percentage in Y-maze test were significantly increased in group SAE+ H₂ (P<0.05). Conclusion The mechanism by which hydrogen reduces SAE is probably associated with improving mitochondrial function in brain tissues of mice.

Objective: To evaluate the effect of hydrogen on mitochondrial biosynthesis in the hippocampus of mice with sepsis-associated encephalopathy (SAE). Method: Two hundred and twenty-four healthy clean-grade male C57BL/6J mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups (n=56 each) using a random number table method: sham operation group (group SH), sham operation plus hydrogen group (group SH+ H₂), group SAE, and SAE plus hydrogen group (group SAE+ H₂). The model of SAE was established by cecal ligation and puncture in anesthetized mice.Group SH+ H₂ and group SAE+ H₂ inhaled 2% hydrogen for 1 h starting from 1 and 6 h after operation, respectively.Twenty mice were selectde to record the postoperative 7-day survival rate.The remaining animals were sacrificed at 24 h after operation, and brain tissues were taken for examination of the pathological changes in hippocampal CA1 region (with a light microscope) and for determination of neuronal apoptosis (by TUNEL), mitochondrial membrane potential (MMP) (by fluorescence spectrophotometry) and ATP content (by a bioluminescence assay). The apoptosis rate was calculated.The expression of peroxisome proliferator-activated receptor gamma coactivator 1α (PGC-1α) in hippocampus was determined by Western blot at 6, 12 and 24 h after operation. Results: Compared with group SH, the postoperative 7-day survival rate was significantly decreased, the apoptosis rate of hippocampal neurons was increased, the contents of MMP and ATP were decreased, and the expression of PGC-1α was up-regulated in SAE and SAE+ H₂groups (P<0.05), and no significant change was found in the parameters mentioned above in group SH+ H₂(P>0.05). Compared with group SAE, the postoperative 7-day survival rate was significantly increased, and the apoptosis rate of hippocampal neurons was decreased, the contents of MMP and ATP were increased, and the expression of PGC-1α was up-regulated (P<0.05), and the pathological changes of hippocampal tissues were significantly attenuated in group SAE+ H₂. Conclusion The mechanism by which hydrogen mitigates SAE may be related to promoting mitochondrial biosynthesis in mice.

Objective T o observe the changes of cystathionine β-synthase (C B S ) expression in the cere-bral cortex after brain contusion at different tim es. Methods A n experim ental m odel of traum atic brain injury (T B I) in m ice w as established by an im proved w eight-drop device. T hen W estern blotting and im m unohistochem ical exam ination w ere used to detect the C B S expression in cerebral cortex around in-jury at different tim e points (1 h, 6 h, 12 h, 1 d, 2 d, 3 d, 7 d). Results T he results of W estern blotting revealed that the expression level of C B S w as dow n-regulated and reached its low est level at the 3rd days after injury, and then restored to norm al level after 7 days. T he results of im m unohistochem istry show ed that C B S w as present in the norm al brain cortex. C B S expression gradually decreased at the 3rd days after injury, and then restored to norm al level after 7 days. Conclusion C B S has the potential to be a reference index for tim e estim ation after brain contusion in forensic practice.

The zinc finger protein A20 exists in many kinds of ceils in the body and plays multiple roles in physiological and pathological processes such as regulation of immune response,inflammatory diseases and cancers by inhibiting cell apoptosis induced by tumor necrosis factor (TNF) and restricting NFKB signaling pathway.Recently,the role of A20 in generation and development of tumors draws wide attention,hence,we summarized recent research progress of the relation between A20 and cancer in this review.

BACKGROUNDThe purpose of this retrospective study was to compare the surgical outcomes of simple discectomy and instrumented posterior lumbar interbody fusion (iPLIF) in patients with lumbar disc herniation and Modic endplate changes. Our hypothesis was that iPLIF could provide better outcome for patients with refractory lumbar disc herniation and Modic changes (LDH-MC).

METHODSNinety-one patients with single-segment LDH-MC were recruited. All patients experienced low back pain as well as radicular leg pain, and low back pain was more severe than leg pain. Forty-seven patients were treated with discectomy and 44 were treated with iPLIF. The outcomes of both low back pain and radicular leg pain using visual analogue scale (VAS) as well as the clinical outcome related to low back pain using Japanese Orthopaedic Association (JOA) score were assessed before and 18 months after surgery, respectively.

RESULTSBoth low back and leg pain were significantly improved 18 months after simple discectomy and iPLIF. Compared to patients undergoing simple discectomy, low back pain was significantly reduced in patients undergoing iPLIF, but there was no significant difference in leg pain between two groups. Solid fusion was achieved in all patients who underwent iPLIF.

CONCLUSIONSIn patients with LDH-MC, iPLIF can yield significantly superior outcome on the relief of low back pain compared to simple discectomy. Simple discectomy can relieve radicular leg pain as efficient as iPLIF. Accordingly, iPLIF seems to be a reliable treatment for patients with LDH-MC and predominant low back pain.

Adult ; Diskectomy ; standards ; Female ; Humans ; Intervertebral Disc Displacement ; surgery ; Low Back Pain ; surgery ; Lumbar Vertebrae ; surgery ; Middle Aged ; Retrospective Studies ; Spinal Fusion ; standards