It is very important for epilepsy treatment to distinguish epileptic seizure and non-seizure. In this study, an automatic seizure detection algorithm based on dual density dual tree complex wavelet transform (DD-DT CWT) for intracranial electroencephalogram (iEEG) was proposed. The experimental data were collected from 15 719 competition data set up by the National Institutes of Health (NINDS) in Kaggle. The processed database consisted of 55 023 seizure epochs and 501 990 non-seizure epochs. Each epoch was 1 second long and contained 174 sampling points. Firstly, the signal was resampled. Then, DD-DT CWT was used for EEG signal processing. Four kinds of features include wavelet entropy, variance, energy and mean value were extracted from the signal. Finally, these features were sent to least squares-support vector machine (LS-SVM) for learning and classification. The appropriate decomposition level was selected by comparing the experimental results under different wavelet decomposition levels. The experimental results showed that the features selected in this paper were different between seizure and non-seizure. Among the eight patients, the average accuracy of three-level decomposition classification was 91.98%, the sensitivity was 90.15%, and the specificity was 93.81%. The work of this paper shows that our algorithm has excellent performance in the two classification of EEG signals of epileptic patients, and can detect the seizure period automatically and efficiently.
Algorithms ; Electroencephalography ; Epilepsy/diagnosis* ; Humans ; Seizures/diagnosis* ; Signal Processing, Computer-Assisted ; Support Vector Machine ; Wavelet Analysis

ObjectiveTo investigate the clinical value of acoustic radiation force impulse (ARFI) elastography in predicting esophageal variceal bleeding in patients with liver cirrhosis. MethodsA retrospective analysis was performed for the clinical data of 271 patients with liver cirrhosis who attended the Fifth Medical Center of Chinese PLA General Hospital from October 2014 to May 2017, and ARFI elastography was performed for all patients to measure the elasticity of the liver and the spleen. According to the presence or absence of esophageal variceal bleeding, the patients were divided into bleeding group and non-bleeding group, and related indices were compared between the two groups. The receiver operating characteristic (ROC) curve was used to evaluate the value of ARFI elasticity in the diagnosis of esophageal variceal bleeding in liver cirrhosis. The t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. ResultsThe bleeding group had a significantly higher ARFI elasticity of the spleen than the non-bleeding group ［3.89(349-4.11) m/s vs 3.46(2.93-3.80) m/s, Z=-4.941, P＜0.001］, and there was no significant difference in the ARFI elasticity of the liver between the bleeding group and the non-bleeding group ［2.08 (1.57-2.74) m/s vs 1.98 (1.49-2.70) m/s, Z=-1.025, P=0.305］. The areas under the ROC curve for ARFI elasticity values of the spleen and the liver were 0.714 and 0.544, respectively, in predicting esophageal variceal bleeding in patients with liver cirrhosis (P=0.002 5). At the cut-off value of 3.71 m/s, the ARFI elasticity of the spleen had a sensitivity of 0.68 and a specificity of 0.69 in predicting esophageal variceal bleeding. ConclusionThe ARFI elasticity value of the spleen has a better value than that of the liver in predicting the risk of esophageal variceal bleeding and thus holds promise for clinical application.

OBJECTIVETo evaluate clinical manifestations and pathology in children with massive proteinuria with Henoch-Schonlein purpura nephritis (HSPN).

METHODThe data of the 52 children with massive proteinuria with Henoch-Schonlein purpura nephritis who were hospitalized in the department of nephrology in our hospital from January 2008 to January 2013 were retrospectively studied. Clinical manifestation and pathologic characteristics were summarized and compared. The relationship between clinical manifestations and pathologic characteristics were evaluated.

RESULT(1) Among the children, 16 (31%) cases had positive symptoms and signs including gross hematuria, edema, oliguria and hypertension, and in only 7 (13%) cases serum levels of albumin were below 25 g/L. (2) Children with pathological grade >III accounted for 72%. Children with crescent formation, glomerular capsule adhesion, segmental glomeralosclerosis, endocapillary proliferation and lesions in the walls of arterioles accounted for 56%, 52%, 19%, 67%, 62%, respectively, and 42% of the children suffered from severe mesangial proliferation or mesangial sclerosis. The frequencies of severe mesangial proliferation and changes in the walls of arterioles in children with pathological grade ≥ III was significantly higher than those in children with pathological grade

CONCLUSIONThe clinical manifestations of children with massive proteinuria with HSPN were relatively severe but the symptoms were not typical. The pathological manifestations wer variable, of which severe mesangial proliferation and lesions in arterioles are the most common in children with higher pathological grade. Clinical manifestations in children with HSPN are associated with formation of crescent, segmental glomeralosclerosis, glomerular capsule adhesion, and endocapillary proliferation.

Objective To investigate the clinical value of the acoustic radiation force impulse imaging (ARFI) in the quantitative evaluation of fibrosis staging in chronic hepatitis B .Methods A total of 373 patients with chronic hepatitis B were grouped in accordance with the depth of the right anterior lobe and posterior lobe of the liver and underwent ARFI to measure ARFI values .Liver biopsy was performed in all patients to investigate the relationship between liver fibrosis stages and ARFI values in different groups . Results The ARFI values in different pathological grades with the same depth of the right anterior and right posterior lobe of the liver were statistically significant ( P < 0 0.01);the ARFI values between the middle and deep parts of the right anterior lobe and the same location of the right posterior lobe were statistically significant ( P <0 0.1);for the right anterior lobe ,the ARFI value of the shallow part showed statistical significance from that of the middle and the deep part ( P < 0 0.5 ) .Receiver operating characteristic (ROC) curve analysis for different sampling locations showed that the largest area under the ROC curve ,which was 0 8.18 ,existed in the middle part of the right anterior lobe ,indicating that it could be the optimal sampling location for the measurement of ARFI values .Liver stiffness at ARFI imaging was significantly correlated with liver fibrosis stage in chronic hepatitis B and spearman coefficient of correlation was 0 5.30 ( P <0 0.01) .The areas under the ROC curves for the chronic hepatitis B patients with severe liver fibrosis (≥ S3) and early cirrhosis (= S4) were 0 8.18 and 0 8.60 ,respectively .Conclusions ARFI imaging was promising for clinical application and could be utilized as a noninvasive method for the quantitative evaluation of fibrosis staging in chronic hepatitis B .

Objective To summarize the imaging features of hepatic tumors contained lipid by contrast enhanced ultrasound (CEUS), and compare with MRI ifndings. Methods From July 2010 to December 2012, 17 patients of hepatocellular carcinoma containing lipid component in the 302nd Hospital of the People′s Liberation Army underwent dual-echo sequence MRI imaging. Fifteen patients were conifrmed by enhanced MRI and contrast-enhanced CT, while the other 2 patients were confirmed by pathology. The features of ultrasonography, CEUS and MRI were analyzed. Kappa analysis test was analyzed for the consistency of CEUS and MRI ifndings. Results In the two-dimensional ultrasound of 17 lesions, 9 were hypoechoic heterogeneous lesions, 5 were hypoechoic lesions;13 lesions with clear boundaries, 4 lesions with unclear boundaries;peripheral blood lfow signal in 5 lesions and rich blood lfow in 1 lesion were observed by color Doppler ultrasound, 11 lesions had no signiifcant blood lfow signal;15 lesions showed fast high enhancement in CEUS arterial phase, 1 lesion with synchronization enhancement, 1 lesion with mild enhancement;10 lesions showed portal clearance, 1 lesion showed an enhanced synchronization, 1 lesion with mild enhancement;16 lesions showed clearance in delay phase, 1 enhanced lesion showed isoenhancement;6 lesions presented intra-lesion or surrounding patchy, irregular non-enhancement areas. CEUS diagnostic accuracy was 82%(14/17), the diagnostic accuracy of MRI was 88%(15/17). The Kappa consistency test was 0.628, while CEUS and MRI results were in good agreement. Conclusions Performance of hepatocellular lipid-containing ultrasound contrast arterial phase shows non-enhancement areas. Contrast enhanced ultrasound features of lipid-containing hepatocellular carcinoma are valuable for the clinical diagnois.

Objective To investigate the diagnostic value of the acoustic radiation force impulse (ARFI) technology and AST/PLT ratio index (APRI） for the assessment of the liver fibrosis in chronic hepatitis C patients.Methods 107 patients with chronic hepatitis C were included,the subjects were underwent liver biopsy,liver function,blood count,as well as real-time acoustic elastography examination.The APRI was calculated according the following formula,APRI =AST (ULN)/PLT (109/L).ARFI and APRI were compared by correlation with liver fibrosis stage in chronic hepatitis C.Referring to the histologic fibrosis stage on liver biopsy,all the ARFI and the APRI value were assessed by using ROC curve analysis.The corresponding cut-off values,sensitivity and specificity were also calculated and compared.Results The mean values of ARFI and APRI were (1.26 ± 0.27)m/s and 0.30 ± 0.46 for the patients with S1,(1.45 ± 0.51)m/s and 0.29 ± 0.21 for those with S2,(2.03 ± 0.54) m/s and 0.59 ± 0.56 for those with S3,(2.29 ± 0.82) m/s and 0.63 ± 0.35 for those with S4,respectively.ARFI (r =0.61,P ＜0.001) had a better correlation with liver fibrosis stage in chronic hepatitis C than APRI (r =0.49,P ＜0.001).Cut-off points of ARFI and APRI were 1.529 m/s and 0.170 for S≥2,1.780 m/s and 0.277 for S≥3,1.780 m/s and 0.446 for S =4,respectively.Accordingly,the areas under the ROC curves for ARFI and APRI were 0.779 and 0.724 for S≥2,0.866 and 0.786 for S≥3,0.790 and 0.779 for S=4,respectively.Conclusions As a non-invasive technology,ARFI is more accurate when applied to evaluate liver fibrosis in patients with chronic hepatitis C than APRI.ARFI technology has potential value for quantitatme evaluation of the liver fibrosis for chronic hepatitis C.

Objective To explore the clinical value of virtual touch quantification (VTQ) technique in assessing the hepatic fibrosis. Methods A total of 115 inpatients with chronic liver disease receiving liver biopsy were enrolled in this study, all patients liver tissue was checked by VTQ technique, and the results were compared with those of the control group including 80 healthy subjects. Results VTQ value was significantly different between the two groups (P = 0.0000).The VTQ value among different degree of hepatic fibrosis but between S0 and S1 had statistical significances (P = 0.0212, P = 0.0000).ROC curve displayed that VTQ value of 1.4 m/s could be used to diagnose middle-high-grade liver fibrosis, the sensitivity and specificity were 85.4 % and 64.7%, respectively. Conclusions VTQ can be used as a noninvasive and effective means for assessing the degree of hepatic fibrosis.