OBJECTIVE: To investigate the independent risk factors for short-term mortality in patients with spontaneous cerebellar hemorrhage (SCH) based on Mimics software of medical image control system. METHODS: The clinical data of SCH patients treated at Shengjing Hospital of China Medical University from January, 2010 to December, 2021 was retrospectively analyzed and compared, including gender, age, underlyin g diseases, Glasgow coma scale (GCS) and blood pressure at admission, laboratory indicators, imaging data, and short-term (3 weeks after onset) survival status. The imaging examination parameters were accurately calculated using Mimics software, including hematoma volume, longest diameter, and maximum cross-sectional area of cerebellar hemorrhage. Multivariate Logistic regression analysis was used to evaluate the independent risk factors for short-term death in SCH patients. Receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive value of the four significant factors on short-term mortality in SCH patients. RESULTS: A total of 202 patients with SCH were included, of which 42 patients (20.8%) died within 3 weeks of onset and 160 patients (79.2%) survived. Univariate analysis showed that, compared with the survival group, the death group had significantly higher blood glucose, hematoma volume, hematoma longest diameter, hematoma maximum cross-sectional area, the ratio of hematoma maximum cross-section area and the corresponding posterior cranial fossa area, while GCS score was significantly lower, the distance from hematoma edge to the cerebral aqueduct center, and the distance from hematoma edge to the edge of brainstem were significantly shorter, the differences were statistically significant. Multivariate Logistic regression analysis showed that GCS score at admission [odds ratio (OR) = 0.875, 95% confidence interval (95%CI) was 0.767-0.998], hematoma volume (OR = 1.068, 95%CI was 1.022-1.115), the longest diameter of hematoma (OR = 1.086, 95%CI was 1.049-1.124), and the ratio of hematoma maximum cross-section area and the corresponding posterior cranial fossa area (OR = 1.119, 95%CI was 1.060-1.181) were independent risk factors for short-term mortality in SCH patients (all P < 0.05). ROC curve analysis showed that the area under the ROC curve (AUC) for predicting short-term death of patients with SCH were 0.738, 0.839, 0.728 and 0.727, respectively. When the GCS score was 12 at admission, the sensitivity was 85.0% and the specificity was 57.1%. When the hematoma volume was 8.40 mL, the sensitivity was 95.2% and the specificity was 65.0%. When the longest diameter of the hematoma was 47.10 mm, the sensitivity was 57.1% and the specificity was 80.6%. When the ratio of hematoma maximum cross-section area and the corresponding posterior cranial fossa area was 0.11, the sensitivity was 88.1% and the specificity was 48.7%. CONCLUSIONS GCS score < 12 on admission, hematoma volume > 8.40 mL, hematoma longest diameter > 47.10 mm, the ratio of hematoma maximum cross-section area and the corresponding posterior cranial fossa area > 0.11 suggest a higher risk of short-term mortality in SCH patients.
Humans ; Male ; Female ; Risk Factors ; Retrospective Studies ; Middle Aged ; Aged ; Software ; Adult ; Cerebral Hemorrhage/diagnosis* ; Logistic Models

Objective:To explore the association between self-perception of aging and physical activity in elderly colorectal cancer patients, so as to provide reference for clinical physical activity intervention programs.Methods:From July 2022 to March 2023, convenience sampling was used to select 234 colorectal cancer patients in three Class Ⅲ Grade A hospitals in Jinan, Shandong Province as participants. Cross-sectional survey was conducted using the General Information Questionnaire, Brief Ageing Perceptions Questionnaire (B-APQ), and Physical Activity Measurement Scale for Cancer Patients. Multiple linear regression was used to explore the influencing factors of physical activity in elderly patients with colorectal cancer.Results:A total of 234 questionnaires were distributed, and 221 valid questionnaires were collected, with a valid response rate of 94.44% (221/234). Among 221 elderly patients with colorectal cancer, the score of B-APQ was (46.28±11.89), and physical activity was 52.50 (30.00, 77.75) hours per week. Multiple linear regression showed that self-perception of aging, regular physical activity before illness, self-evaluation of physical health, and disease stage were the influencing factors of physical activity in elderly colorectal cancer patients ( P<0.05) . Conclusions:Elderly patients with colorectal cancer tend to have a negative perception of aging and low levels of physical activity. Medical and nursing staff should attach importance to the assessment and intervention of patients' self-perception of aging to improve their physical activity.

Objective:To explore the association between self-perception of aging and physical activity in elderly colorectal cancer patients, so as to provide reference for clinical physical activity intervention programs.Methods:From July 2022 to March 2023, convenience sampling was used to select 234 colorectal cancer patients in three Class Ⅲ Grade A hospitals in Jinan, Shandong Province as participants. Cross-sectional survey was conducted using the General Information Questionnaire, Brief Ageing Perceptions Questionnaire (B-APQ), and Physical Activity Measurement Scale for Cancer Patients. Multiple linear regression was used to explore the influencing factors of physical activity in elderly patients with colorectal cancer.Results:A total of 234 questionnaires were distributed, and 221 valid questionnaires were collected, with a valid response rate of 94.44% (221/234). Among 221 elderly patients with colorectal cancer, the score of B-APQ was (46.28±11.89), and physical activity was 52.50 (30.00, 77.75) hours per week. Multiple linear regression showed that self-perception of aging, regular physical activity before illness, self-evaluation of physical health, and disease stage were the influencing factors of physical activity in elderly colorectal cancer patients ( P<0.05) . Conclusions:Elderly patients with colorectal cancer tend to have a negative perception of aging and low levels of physical activity. Medical and nursing staff should attach importance to the assessment and intervention of patients' self-perception of aging to improve their physical activity.

Objective:To investigate the dynamic functional connectivity (dFC) of bilateral precuneus at resting-state in obsessive-compulsive disorder (OCD).Methods:Fifty patients with OCD who matched the criteria of ICD-10 and 50 healthy controls (HCs) were examined by the resting-state functional magnetic resonance imaging scanning. Voxel-based whole-brain dFC method was used to analyze the dFC of bilateral precuneus at resting-state in OCD; Pearson correlation analyses was used to analyze the relationship between the abnormal dFC values and clinical symptoms in OCD; support vector machine analyses was used to explore whether abnormal dFC could be used to identify OCD.Results:Compared with HCs, patients with OCD showed decreased dFC values between left precuneus and left medial prefrontal cortex (MPFC) (0.23±0.02 vs. 0.26±0.03, t=-6.23, P<0.05, GRF corrected), left cuneus (0.24±0.03 vs. 0.28±0.04, t=-5.30, P<0.05, GRF corrected), and left paracentral lobule (0.23±0.03 vs. 0.27±0.04, t=-5.36, P<0.05, GRF corrected); and decreased dFC values between right precuneus and left postcentral gyrus (0.23±0.04 vs. 0.27±0.04, t=-5.12, P<0.05, GRF corrected). The decreased dFC values between left precuneus and left MPFC was positively correlated with the total score of Yale-Brown obsessive compulsive scale (Y-BOCS)( r=0.289, P<0.05, uncorrected); the decreased dFC values between right precuneus and left posterior central gyrus was positively correlated with Y-BOCS total scores ( r=0.292, P<0.05, uncorrected) and obsessive subscale scores ( r=0.304, P<0.05, uncorrected). The area under the curve value of the decreased dFC values between right precuneus and left posterior central gyrus was 0.856; the Youden Index was 0.52; the sensitivity was 100%, and the specificity was 52%. Conclusions:The dFC of bilateral precuneus decreases at resting-state in patients with OCD. The abnormal dFC value between the right precuneus and the left posterior central gyrus may have implications to identify OCD.

Objective:To investigate the dynamic functional connectivity (dFC) of bilateral precuneus at resting-state in obsessive-compulsive disorder (OCD).Methods:Fifty patients with OCD who matched the criteria of ICD-10 and 50 healthy controls (HCs) were examined by the resting-state functional magnetic resonance imaging scanning. Voxel-based whole-brain dFC method was used to analyze the dFC of bilateral precuneus at resting-state in OCD; Pearson correlation analyses was used to analyze the relationship between the abnormal dFC values and clinical symptoms in OCD; support vector machine analyses was used to explore whether abnormal dFC could be used to identify OCD.Results:Compared with HCs, patients with OCD showed decreased dFC values between left precuneus and left medial prefrontal cortex (MPFC) (0.23±0.02 vs. 0.26±0.03, t=-6.23, P<0.05, GRF corrected), left cuneus (0.24±0.03 vs. 0.28±0.04, t=-5.30, P<0.05, GRF corrected), and left paracentral lobule (0.23±0.03 vs. 0.27±0.04, t=-5.36, P<0.05, GRF corrected); and decreased dFC values between right precuneus and left postcentral gyrus (0.23±0.04 vs. 0.27±0.04, t=-5.12, P<0.05, GRF corrected). The decreased dFC values between left precuneus and left MPFC was positively correlated with the total score of Yale-Brown obsessive compulsive scale (Y-BOCS)( r=0.289, P<0.05, uncorrected); the decreased dFC values between right precuneus and left posterior central gyrus was positively correlated with Y-BOCS total scores ( r=0.292, P<0.05, uncorrected) and obsessive subscale scores ( r=0.304, P<0.05, uncorrected). The area under the curve value of the decreased dFC values between right precuneus and left posterior central gyrus was 0.856; the Youden Index was 0.52; the sensitivity was 100%, and the specificity was 52%. Conclusions:The dFC of bilateral precuneus decreases at resting-state in patients with OCD. The abnormal dFC value between the right precuneus and the left posterior central gyrus may have implications to identify OCD.

Objective:To investigate the predictive value of early indicators changes in blood test on the prognosis of patients with acute paraquat poisoning.Methods:The clinical data of patients with acute paraquat poisoning admitted to emergency department of Shengjing Hospital of China Medical University from January 2012 to June 2019 were retrospectively analyzed. The changes of blood test indexes within 24 hours after admission were collected, including white blood cell count (ΔWBC), neutrophils count (ΔNE), lymphocytes count (ΔLY), monocytes count (ΔMO), arterial partial pressure of oxygen (ΔPaO 2), arterial partial pressure of carbon dioxide (ΔPaCO 2), arterial blood pH (ΔpH), bicarbonate radical (ΔHCO 3-), base excess (ΔBE), lactate (ΔLac), total protein (ΔTP), albumin (ΔALB), alanine aminotransferase (ΔALT), aspartate aminotransferase (ΔAST), total bilirubin (ΔTBil), direct bilirubin (ΔDBil), blood urea nitrogen (ΔBUN), serum creatinine (ΔSCr), serum calcium concentration (ΔCa 2+), and serum potassium concentration (ΔK +). Multivariate Logistic regression was used to analyze the risk factors of prognosis in patients with acute paraquat poisoning, and receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of ROC curve for the death of patients with paraquat poisoning. Results:A total of 251 patients with acute paraquat poisoning were included, with 99 cases dead, and the mortality was 39.4%. The increase of the markers including ΔWBC, ΔLac, ΔALT, ΔAST, ΔTBil, ΔDBil, ΔBUN, ΔSCr and ΔK + within 24 hours of admission in the death group were significantly higher than that in the survival group; the decrease of the markers including ΔPaCO 2, ΔHCO 3-, ΔBE, ΔTP, and ΔALB in the death group were significantly greater than those in the survival group. The variables with statistical significance in the above single factor analysis were included in the multivariate Logistic regression analysis. The results showed that ΔLac, ΔSCr and ΔK + were independent risk factors for the prognosis of patients with acute paraquat poisoning [odds ratio ( OR) and 95% confidence interval (95% CI) were 1.662 (0.997-2.772), 1.045 (1.010-1.083) and 4.555 (1.190-17.429), respectively, all P < 0.05]. The area under the ROC curve (AUC) of ΔLac, ΔSCr and ΔK + for predicting death of patients with acute paraquat poisoning was 0.639 (95% CI was 0.505-0773), 0.811 (95% CI was 0.704-0.917), and 0.649 (95% CI was 0.519-0.779), respectively. When the cut-off of ΔLac was 1.85 mmol/L, the sensitivity was 87.9%, the specificity was 47.7%, and the diagnostic accuracy was 70.2%; when the cut-off of ΔSCr was 37.75 μmol/L, the sensitivity was 84.4%, the specificity was 77.9%, and the diagnostic accuracy was 80.5%; when the cut-off of ΔK + was 0.42 mmol/L, the sensitivity was 36.6%, the specificity was 90.7%, and the diagnostic accuracy was 68.3%. The efficiency of combination of ΔLac, ΔSCr, and ΔK + was greater than a single indicator in predicting death of patients with acute paraquat poisoning, with AUC of 0.911, and 95% CI of 0.834-0.989. Conclusions:ΔLac, ΔSCr, ΔK + within 24 hours of admission were all independent risk factors for the prognosis of patients with acute paraquat poisoning. ΔSCr > 37.75 μmol/L within 24 hours of admission would predict a poor prognosis in the patients with acute paraquat poisoning. Combined analysis of ΔLac, ΔSCr, and ΔK + can predict the prognosis of paraquat poisoning patients more accurately than single index.

The research on brain functional mechanism and cognitive status based on brain network has the vital significance. According to a time-frequency method, partial directed coherence (PDC), for measuring directional interactions over time and frequency from scalp-recorded electroencephalogram (EEG) signals, this paper proposed dynamic PDC (dPDC) method to model the brain network for motor imagery. The parameters attributes (out-degree, in-degree, clustering coefficient and eccentricity) of effective network for 9 subjects were calculated based on dataset from BCI competitions IV in 2008, and then the interaction between different locations for the network character and significance of motor imagery was analyzed. The clustering coefficients for both groups were higher than those of the random network and the path length was close to that of random network. These experimental results show that the effective network has a small world property. The analysis of the network parameter attributes for the left and right hands verified that there was a significant difference on ROI2 ( = 0.007) and ROI3 ( = 0.002) regions for out-degree. The information flows of effective network based dPDC algorithm among different brain regions illustrated the active regions for motor imagery mainly located in fronto-central regions (ROI2 and ROI3) and parieto-occipital regions (ROI5 and ROI6). Therefore, the effective network based dPDC algorithm can be effective to reflect the change of imagery motor, and can be used as a practical index to research neural mechanisms.

Objective: To investigate the clinical value of the serum new molecular markers, soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and soluble hemoglobin scavenger receptor(sCD163), in the diagnosis of sepsis in elderly patients with burns. Methods: A total of 58 inpatients with burns from Jun 2017 to June 2018 were enrolled in the study.Patients were divided into three groups: the sepsis group(n=12), the localized infection group(n=21)and the non-infection group(n=29). The levels of sTREM-1 and sCD163 were determined by enzyme-linked immunosorbent assays(ELISAs). The clinical diagnostic value of sTREM-1 and sCD163 was assessed by receiver operating characteristic(ROC)curve analysis. Results: There was a statistically significant difference in the levels of sTREM-1 and sCD163 at day 1 between the three groups(F=20.994 and 38.363, P<0.01). Serum levels of sTREM-1 and sCD163 were higher in the sepsis group than in the localized infection group and the non-infection group.Serum levels of sTREM-1 and sCD163 were higher in the localized infection group than in the non-infection group.Serum levels of sTREM-1 and sCD163 were lower at day 7 than those at day 1 in all groups(F=21.242 and 41.035, P<0.01). Serum sTREM-1 levels were positively correlated with serum sCD163 levels(r=0.609, P=0.000). The AUC of sTREM-1 and sCD163 for the diagnosis of sepsis was 0.880(95%CI: 0.816~0.926). Conclusions Serum levels of sTREM-1 and sCD163 are elevated with increasing degrees of infection.Monitoring serum sTREM-1 and sCD163 levels is helpful for the diagnosis of sepsis in elderly patients with burns.

Objective    To investigate the feasibility of video-assisted thoracoscopic surgery (VATS) lung resection in the treatment of tuberculosis. Methods    We retrospectively analyzed the clinical data of 164 tuberculosis patients who underwent lung resection in Xi'an Chest Hospital from 2013 to 2017. Patients were divided into two groups according to the surgical procedure: a VATS group (85 patients, 56 males and 29 females) and a thoracotomy group (79 patients, 52 males and 27 females). The clinical effect of the two groups was compared. Results     Compared to the thoracotomy group, the VATS group had less operation time (151.59±76.75 min vs. 233.48±93.89 min, P<0.001), amount of intraoperative blood loss (200.00 ml vs. 600.00 ml, P<0.001), the postoperative drainage (575.00 ml vs. 1 110.00 ml, P=0.001), extubation time (4 d vs. 6 d, P<0.001) and hospital stay (13.00 d vs. 17.00 d, P<0.001). There was no statistical difference in postoperative complications (10 patients vs.17 patients, P=0.092) between the two groups. A total of 97 patients underwent lobectomy, including 36 of the VATS group and 61 of the thoracotomy group. The operation time (211.39±70.88 min vs. 258.20±87.16 min, P=0.008), the intraoperative blood loss (400.00 ml vs. 700 ml, P<0.010), the postoperative drainage (800.00 ml vs. 1 250.00 ml, P=0.001), extubation time (5.00 d vs. 8.00 d, P=0.002) and hospital stay (13.11±4.45 d vs. 19.46±7.74 d, P<0.010) in the VATS group were significantly better than those in the thoracotomy group. There was no statistical difference in postoperative complication rate (4 patients vs. 14 patients, P=0.147) between the two[1]，groups. Conclusion    Compared with conventional thoracotomy, VATS lung resection has obvious advantages in treatment of tuberculosis, which may be the preferred technique.

Objective To improve the first-aid ability of emergency residents by using simulated clinical practice skills training combined with scenario analysis in standardized residency training. Methods 218 residents who participated in standardized residency training in Shengjing Hospital of China Medical University were randomly distributed to two groups. The experimental group (n=134) was trained with the teaching methods of simulated clinical practice skills training combined with scenario analysis; the control group (n=84) was trained with traditional teaching methods combined with teaching video. The theoretical test scores and clinical practice skills results of the two groups were compared, and a questionnaire survey was also conducted after comparing the two teaching modes. T test and rank-sum test were performed by using SPSS 19.0. Results There was no significant difference in the theoretical test scores between the experimental group (85.27 ±5.59) and the control group (84.11 ±7.43) (P>0.05). However, the clinical practice skills scores of the experimental group (89.42±6.63) were significantly higher than those of the control group (71.36±4.41) (P<0.05), which showed the statistical significance. Student's satisfactions with teachers and teaching methods in the experimental group were 70.90% and 80.60%, respectively, which were extremely higher than those in the control group (23.81% and 33.33%). Student's satisfaction with self-learning in the experimental group (64.93%) was significantly higher than that in the control group (39.29%). Conclusions The application of simulated clinical practice skills training combined with scenario analysis could improve the first-aid ability of emergency residents. This teaching method is expected to be applied in standardized residency training in emergency medicine in the future.