Objective:To study the effects of various parameters in the structural design and usage methods of insulin pen needles on their performance.Methods:Twenty-one conventional needles and five self-destructive needles were selected. A testing machine was used to clamp the needle and make it vertically puncture the test material with a constant speed of 50, 100, 150, 200, and 250 mm/min, respectively. The influence of the needle insertion speed on the puncture force was analyzed. The deformation of the needle on the small contact surface and the large contact surface at 4 N was recorded by a Photron high-speed digital camera. The penetration depth at 1 N and 3 N was measured by an indirect measurement and a direct measurement method, respectively, and the maximum damage width of the damage area was recorded. The tilt resistance of the needle at 6°, 9° and 12° under 2 N pressure was obtained by the testing machine. SPSS 27.0 software was used for statistical analysis of the experimental data, and the LSD multiple comparison method was used for one-way analysis of variance.Results:The difference in puncture force between the needle insertion speed of 50 mm/min and the other four needle insertion speeds was statistically significant (all P < 0.05), while the differences between the other groups were not statistically significant (all P > 0.05). The small contact surface needle was significantly deformed, with a large penetration depth, a large maximum damage width, and low anti-tilting resistance. The large contact surface needle was deformed slightly, with a smaller penetration depth, a smaller maximum damage width, and greater resistance to tilting. Conclusions:The influence of the usage method on the large contact surface of the needle is relatively small. The hexagonal and cross-shaped needle seats have stronger anti-tilt ability than the circular needle seat. The hexagonal needle seat is not easy to change with the rotation axis, and the performance is optimal. In the structural design, the size of the connection part should be reduced, and the appropriate shape of the needle base should be selected.

Objective:To establish and validate a gallstones classification method based on deep learning.Methods:A total of 618 gallstones samples were collected from East Hospital Affiliated to Tongji University, and 1 023 high-definition cross-sectional gallstones profile images were captured to construct a cross-sectional gallstones profile image dataset. Based on the traditional eight-category gallstones classification method, a lightweight network model, MobileNet V3, was trained using deep learning and transfer learning methods. The classification performance of MobileNet was evaluated using a confusion matrix with metrics such as accuracy rate, precision rate, F1 score, and recall rate. The MobileNet V3 was improved and further validated using accuracy and loss values.Results:The accuracy rate (94.17%), precision rate (94.03%), F1 score (92.96%) and recall rate (92.99%) of the improved MobileNet V3 model were better than other networks. The improved MobileNet V3 model achieved the highest accuracy rate (94.17%) in gallstones profile classification and was validated by the test set. The confusion matrix showed a weighted average of accuracy rate (92.0%), precision rate (92.6%), and F1 score (92.2%) for each category of gallstones.Conclusions:Based on deep learning, a high-accuracy gallstones classification method is proposed, which provides a new idea for the intelligent identification of gallstones.

During the chemotherapy phase, patients with acute leukemia exhibit a myriad of symptoms. These symptoms are interconnected and mutually influential, forming symptom clusters that severely impact the patient's quality of life. This article summarizes the concept of symptom clusters, types of symptom clusters in acute leukemia patients undergoing chemotherapy, influencing factors, and non-pharmacological intervention measures. The aim is to provide a foundation for medical professionals in designing management plans for symptom clusters in acute leukemia patients undergoing chemotherapy.

Magnetic resonance (MR) imaging is an important tool for prostate cancer diagnosis, and accurate segmentation of MR prostate regions by computer-aided diagnostic techniques is important for the diagnosis of prostate cancer. In this paper, we propose an improved end-to-end three-dimensional image segmentation network using a deep learning approach to the traditional V-Net network (V-Net) network in order to provide more accurate image segmentation results. Firstly, we fused the soft attention mechanism into the traditional V-Net's jump connection, and combined short jump connection and small convolutional kernel to further improve the network segmentation accuracy. Then the prostate region was segmented using the Prostate MR Image Segmentation 2012 (PROMISE 12) challenge dataset, and the model was evaluated using the dice similarity coefficient (DSC) and Hausdorff distance (HD). The DSC and HD values of the segmented model could reach 0.903 and 3.912 mm, respectively. The experimental results show that the algorithm in this paper can provide more accurate three-dimensional segmentation results, which can accurately and efficiently segment prostate MR images and provide a reliable basis for clinical diagnosis and treatment.
Male ; Humans ; Prostate/diagnostic imaging* ; Image Processing, Computer-Assisted/methods* ; Magnetic Resonance Imaging/methods* ; Imaging, Three-Dimensional/methods* ; Prostatic Neoplasms/diagnostic imaging*

Objective:To explore the risk factors and preventive strategies of pancreatitis after percutaneous transhepatic biliary drainage (PTBD) in patients with pancreatic cancer and obstructive jaundice.Methods:A total of 241 patients were retrospectively analyzed from May 2001 to October 2014 in Tianjin Medical University Cancer Institute and Hospital. The possibly correlated 9 factors were analyzed, including gender, age, hemoglobin level, total bilirubin level, degree of pancreatic duct dilatation, degree of pancreatic atrophy, degree of biliary stenosis, the pancreatic duct visualization, and drainage mode.Results:Univariate analysis suggested that pancreatic duct dilatation, pancreatic atrophy, visualized pancreatic duct and drainage mode were associated with the incidence of pancreatitis after PTBD ( P<0.05). Logistic regression analysis showed that visualization of pancreatic duct ( OR=6.33) was a risk factor for pancreatitis, while pancreatic duct dilatation ( OR=0.14), pancreatic atrophy ( OR=0.12) and external drainage ( OR=0.11) were protective factors for pancreatitis. Conclusion:In pateints with pancreatic cancer and obstructive jaundice, pancreatic duct dilatation and pancreatic atrophy predict low risk of pancreatitis after PTBD,while intraoperative pancreatic duct visualization and internal or external drainage may increase the incidence of postoperative pancreatitis.

Objective:To study the changes of food characters in early swallowing recovery in patients with different laryngeal function preservation surgery.Methods:Collected patients with laryngeal cancer hypopharyngeal cancer who underwent laryngeal function preservation surgery in Lihuili Hospital of Ningbo Medical Center from January 2019 to March 2020. By fiberoptic endoscopic evaluation of swallowing (FEES) combined with Penetration and Aspiration Scale (PAS), prospectively observed the aspiration and invasion of solid, paste, fluid and other food in the early stage of trial feeding in patients with laryngeal hypopharyngeal cancer undergoing open laryngeal function preservation.Results:Among the 69 patients, 21 had vertical partial laryngectomy and 19 had partial pharyngeal partial laryngectomy. 15 days after the operation, 2 groups of patients after solid and paste food adaptability scored (1.14±0.36), (1.29±0.56) and (2.53±2.04), (2.84±2.31) points, Friedman Mtest for comparison difference had statistical significance ( Mvalues were 23.463 and 22.227, P<0.01); the liquid food for adaptability scored (2.10±1.09), (4.42±2.24) points, the pairwise comparison of liquid, solid and paste showed statistically significant differences ( tvalues were-0.976 to 1.105, P<0.05). The pairwise comparison of the adaptability of the two groups on 20 days after surgery showed no statistically significant difference ( P>0.05).Throat on the cricoid cartilage resection-ring hyoid epiglottis anastomosis (SLCP-CHEP) was 17 cases, laryngeal glottis level partial resection was 12 cases; postoperative 15 days the adaptability on the behavior of three kinds of food grade 2 groups of patients (4.65±1.90), (5.59±1.46), (6.53±1.13) points and (6.67±1.07), (4.50±2.07), (6.92±0.79) points, respectively; Minspection differences were statistically significant ( Mvalues were 29.525, 22.136, P<0.01).The pairwise comparison of solid and paste food in the two groups 20 days after the operation showed no statistically significant difference ( P>0.05), while the difference of liquid and paste was statistically significant ( tvalues were-1.375 to-0.853, P<0.05). Conclusion:In the early recovery of patients undergoing laryngeal function preservation surgery, the vertical group and the partial pharyngeal partial laryngectomy group has better adaptability to solid and paste food. The horizontal group has better adaptability to paste, the CHEP group has better adaptability to solid, and the four groups has the worst adaptability to convection, the recovery time of convective mass between the CHEP group and the horizontal group was longer. To understand the adaptability of patients with different surgical methods to food traits at the early stage of trial feeding can help to implement targeted rehabilitation programs, carry out progressive diet training, and reduce the complications of misinvasion, aspiration, aspiration pneumonia and other complications in the recovery cycle.

Objective:To systematically evaluate the effect of psychosocial intervention on the post-traumatic growth (PTG) and emotional state of trauma patients.Methods:Randomized controlled trials (RCTs) on the effect of psychosocial intervention on PTG of trauma patients were searched in Cochrane Library, Web of Science, PubMed, China National Knowledge Infrastructure (CNKI) , China Biology Medicine Literature Service System (CBM) , VIP Database and Wanfang Data by computer. The search time limit was from the establishment of the database to August 2020. The Cochrane randomized controlled trial bias risk assessment tool was used for quality evaluation, and the data that met the quality standards were extracted and included in the final Meta-analysis.Results:A total of 11 RCTs were included, with 919 research subjects. Meta-analysis results showed that the group psychosocial intervention [ WMD=8.49, 95% CI (2.74, 14.25) , P<0.01] and individual psychological intervention [ WMD=6.78, 95% CI (2.13, 11.44) , P<0.01] could improve the PTG level of trauma patients. Psychosocial intervention could improve the emotional state of trauma patients, increase the level of optimism [ WMD=1.87, 95% CI (1.18, 2.56) , P<0.01], and reduce the level of depression [ SMD=-0.76, 95% CI (-1.03, -0.49) , P<0.01]. Subgroup analysis of different follow-up time found that when the follow-up time was <3 months, 3-6 months, >6 months, the PTG of trauma patients all had a tendency to increase, but the difference was statistically significant when the follow-up time was only within 3 months [ WMD=7.16, 95% CI (2.70, 11.62) , P=0.002]. Conclusions:Psychosocial intervention can improve the PTG and the emotional control ability of trauma patients, which is conducive to the physical and psychological recovery of trauma patients.

Objective To analyze the influence of different geometric parameters on flexibility of the commonly used Z-shaped stent-grafts for treating thoracic aortic aneurysm, as well as the primary and secondary order of such influence. Methods The three-dimensional models of the stent-grafts with different strut numbers, wire diameters, crest height, bending radius were established by SolidWorks and imported to ANSYS software for finite element analysis．The 60° rotation of X-axis was applied to the stent-grafts, and the flexibility of the stent-grafts was evaluated according to 3 evaluation parameters (Von Mises stress, reaction force and bending torque)． Results After bending of the stent-grafts, the maximum stress was concentrated on the inside of the bend；reducing the wire diameter, crest height and strut number of the stent-grafts, the flexibility of the stent-grafts would increase; increasing the bending radius， the flexibility of the stent grafts would increase; the effect of the wire diameter and strut number on flexibility of the stent-grafts was stronger than that from the bending radius and crest height． Conclusions The strut number, wire diameter, crest height, bending radius had a significant impact on flexibility of the stent-grafts. The research findings can provide theoretical references for the selection and optimal design of the stent-grafts in clinic, and have a positive influence on reducing the incidence rate of complications such as new entry.

Objective To explore the value of new and fused conventional texture features extracted from mammograms using improved local ternary patterns (LTP) in predicting risk of breast cancer.Methods Mammograms were segmented.Based on improved LTP,the new and conventional texture features were extracted from segmented mammograms of bilateral breasts.Then the features of bilateral breasts were merged.The high dimensional characteristics were reduced with principal component analysis (PCA).Finally,the new texture features were classified with k-nearest neighbor (KNN),and the fusion features were clustered with logistic alternating decision tree (LADTree) algorithm.Results The area under ROC curve (AUC) of new texture features for predicting breast cancer was 0.732 4 ±0.042 8,and the sensitivity,specificity and prediction accuracy was 72.04％ (67/93),74.51％ (76/102) and 73.33％ (143/195),respectively.Furthermore,AUC of fusion features was 0.865 5± 0.014 8,the sensitivity,specificity and prediction accuracy was 84.95％ (79/93),88.23％ (90/102) and 86.67％ (169/195),respectively.Conclusion The new texture features based on improved LTP have high prediction accuracy for breast cancer,and the prediction efficacy can be improved after fusion with conventional features.

Objective To investigate the value of improving the prediction accuracy of near-term risk for developing breast cancer by transforming the original mammography image and fusing the different types of image features using the algorithm of machine learning.Methods The craniocaudal (CC) full-field digital mammography (FFDM) of 185 women were downloaded from the clinical database at the university of Pittsburgh medical center.Firstly,the original gray images were segmented and transformed into virtual optical density images.Then the asymmetry features were separately extracted from original gray images and virtual optical density images.Two decision tree classifiers of the first stage were trained based on the features extracted from two types of image.And the scores output from the two classifiers were used as input to train the second stage of one decision tree classifier.Leave-one-case-out method was used to validate the prediction performance of near-term risk of breast cancer.Results Using two-stage decision tree fusion method to predict breast cancer,the area under the ROC curve (AUC) was 0.9612±0.0132.And the sensitivity,specificity and prediction accuracy were 96.63％(86/89),91.67％(88/96) and 94.05％(174/185).Conclusion The features extracted from virtual optical density image have higher discriminatory power of predicting breast cancer.Fusing the two kinds of image features twice by two-stage decision tree method can help to improve the prediction accuracy of near-term risk of breast cancer.