Cardiotocography (CTG) is a non-invasive and important tool for diagnosing fetal distress during pregnancy. To meet the needs of intelligent fetal heart monitoring based on deep learning, this paper proposes a TWD-MOAL deep active learning algorithm based on the three-way decision (TWD) theory and multi-objective optimization Active Learning (MOAL). During the training process of a convolutional neural network (CNN) classification model, the algorithm incorporates the TWD theory to select high-confidence samples as pseudo-labeled samples in a fine-grained batch processing mode, meanwhile low-confidence samples annotated by obstetrics experts were also considered. The TWD-MOAL algorithm proposed in this paper was validated on a dataset of 16 355 prenatal CTG records collected by our group. Experimental results showed that the algorithm proposed in this paper achieved an accuracy of 80.63% using only 40% of the labeled samples, and in terms of various indicators, it performed better than the existing active learning algorithms under other frameworks. The study has shown that the intelligent fetal heart monitoring model based on TWD-MOAL proposed in this paper is reasonable and feasible. The algorithm significantly reduces the time and cost of labeling by obstetric experts and effectively solves the problem of data imbalance in CTG signal data in clinic, which is of great significance for assisting obstetrician in interpretations CTG signals and realizing intelligence fetal monitoring.
Humans ; Pregnancy ; Female ; Cardiotocography/methods* ; Deep Learning ; Neural Networks, Computer ; Algorithms ; Fetal Monitoring/methods* ; Heart Rate, Fetal ; Fetal Distress/diagnosis* ; Fetal Heart/physiology*

BACKGROUND:Hemivertebra deformity should be treated surgically at an early age,but the risk factors for progression of deformity after hemivertebral resection have not been established.OBJECTIVE:To investigate the curative effect of one-stage posterior hemivertebrae resection and pedicle screw fixation in the treatment of congenital scoliosis,and to further explore the risk factors causing the progression of postoperative deformity.METHODS:The medical records of patients who underwent pedicle screw-rod fixation for unilateral hemivertebral deformity from January 2012 to February 2020 and were followed up for at least 2 years were retrospectively analyzed,and a total of 116 patients met the inclusion criteria.All patients were treated with standing anterior and lateral spinal radiographs taken before,after and at each follow-up time point.The segment Cobb angle,the total scoliosis Cobb angle,the proximal complementary Cobb angle,the distal complementary Cobb angle,and the coronal balance distance,apical vertebra distance,upper instrumented vertebra tilt,upper instrumented vertebra disc angle,lower instrumented vertebra tilt,lower instrumented vertebra disc angle,segmental kyphosis/lordosis,thoracic kyphosis,lumbar lordosis and sagittal vertical axis were measured.The progression of deformity and complications were also recorded.RESULTS AND CONCLUSION:(1)Segment Cobb,total scoliosis Cobb,segmental kyphosis,proximal complementary Cobb,and distal complementary Cobb were significantly corrected after operation(P＜0.05),and remained corrected at the last follow-up.Thoracic kyphosis,lumbar lordosis,coronal balance distance,and sagittal vertical axis were all in the normal range pre-operation,after operation and at the last follow-up.(2)During follow-up,10 patients developed coronary decompensation,which was characterized by abnormal progression.(3)Independent sample t-test showed that preoperative total scoliosis Cobb,preoperative apical vertebra distance,age,Risser sign,postoperative upper instrument vertebra tilt and postoperative lowest instrumented vertebra tilt were correlated with postoperative malformation progression(P＜0.05).(4)Multivariate Logistic regression analysis showed that postoperative lowest instrumented vertebra tilt was an independent risk factor for postoperative malformation progression(P=0.002,OR=1.526).(5)Receiver operating characteristic curve analysis showed that a postoperative lowest instrumented vertebra tilt of 8.14° was the optimal threshold for deformity progression after hemivertebrae resection and pedicle rod fixation(sensitivity 0.900,specificity 0.906,area under curve:0.926).(6)It is indicated that the treatment of congenital scoliosis with one-stage posterior hemivertebrae resection and pedicle nail fixation can achieve satisfactory orthopedic effect.Postoperative lowest instrumented vertebra tilt greater than 8.14° was an independent risk factor for postoperative coronal decompensation.

Objective The identification of TCM constitution plays an important role in"treating and preventing diseases"of TCM.At present,the identification of damp-heat constitution and balanced constitution is mostly determined by questionnaire,and subjective factors have a great influence.Aiming at the identification of damp-heat constitution and balanced constitution in TCM,this paper utilizes voice signal to automatically realize the constitution identification task,in order to provide assistance for the clinical identification of TCM constitution.Methods Based on deep learning Transformer and transfer learning,a pure attentional mechanism model was designed for the identification of constitution in TCM sound diagnosis.We collected 700 voices from 34 subjects,pre-processed the voice data to obtain the corresponding Mayer spectrum diagram,and used the Transformer model pre-trained based on the public data set to improve the performance of the model for audio classification.Results The accuracy of the experimental results was 83.33%,the AUC was 92.16%,the sensitivity was 80.25%,and the specificity was 87.03%.Compared with the Convolutional Neural Network(CNN),the performance of the deep learning model was better.Conclusion In this paper,the damp-heat constitution and balanced constitution identification model Transformer has achieved better identification effect,indicating that it can improve the efficiency of TCM acoustic diagnosis of constitution identification,and promote the objective and intelligent development of constitution identification.

BACKGROUND:Hemivertebra deformity should be treated surgically at an early age,but the risk factors for progression of deformity after hemivertebral resection have not been established.OBJECTIVE:To investigate the curative effect of one-stage posterior hemivertebrae resection and pedicle screw fixation in the treatment of congenital scoliosis,and to further explore the risk factors causing the progression of postoperative deformity.METHODS:The medical records of patients who underwent pedicle screw-rod fixation for unilateral hemivertebral deformity from January 2012 to February 2020 and were followed up for at least 2 years were retrospectively analyzed,and a total of 116 patients met the inclusion criteria.All patients were treated with standing anterior and lateral spinal radiographs taken before,after and at each follow-up time point.The segment Cobb angle,the total scoliosis Cobb angle,the proximal complementary Cobb angle,the distal complementary Cobb angle,and the coronal balance distance,apical vertebra distance,upper instrumented vertebra tilt,upper instrumented vertebra disc angle,lower instrumented vertebra tilt,lower instrumented vertebra disc angle,segmental kyphosis/lordosis,thoracic kyphosis,lumbar lordosis and sagittal vertical axis were measured.The progression of deformity and complications were also recorded.RESULTS AND CONCLUSION:(1)Segment Cobb,total scoliosis Cobb,segmental kyphosis,proximal complementary Cobb,and distal complementary Cobb were significantly corrected after operation(P＜0.05),and remained corrected at the last follow-up.Thoracic kyphosis,lumbar lordosis,coronal balance distance,and sagittal vertical axis were all in the normal range pre-operation,after operation and at the last follow-up.(2)During follow-up,10 patients developed coronary decompensation,which was characterized by abnormal progression.(3)Independent sample t-test showed that preoperative total scoliosis Cobb,preoperative apical vertebra distance,age,Risser sign,postoperative upper instrument vertebra tilt and postoperative lowest instrumented vertebra tilt were correlated with postoperative malformation progression(P＜0.05).(4)Multivariate Logistic regression analysis showed that postoperative lowest instrumented vertebra tilt was an independent risk factor for postoperative malformation progression(P=0.002,OR=1.526).(5)Receiver operating characteristic curve analysis showed that a postoperative lowest instrumented vertebra tilt of 8.14° was the optimal threshold for deformity progression after hemivertebrae resection and pedicle rod fixation(sensitivity 0.900,specificity 0.906,area under curve:0.926).(6)It is indicated that the treatment of congenital scoliosis with one-stage posterior hemivertebrae resection and pedicle nail fixation can achieve satisfactory orthopedic effect.Postoperative lowest instrumented vertebra tilt greater than 8.14° was an independent risk factor for postoperative coronal decompensation.

Objective The identification of TCM constitution plays an important role in"treating and preventing diseases"of TCM.At present,the identification of damp-heat constitution and balanced constitution is mostly determined by questionnaire,and subjective factors have a great influence.Aiming at the identification of damp-heat constitution and balanced constitution in TCM,this paper utilizes voice signal to automatically realize the constitution identification task,in order to provide assistance for the clinical identification of TCM constitution.Methods Based on deep learning Transformer and transfer learning,a pure attentional mechanism model was designed for the identification of constitution in TCM sound diagnosis.We collected 700 voices from 34 subjects,pre-processed the voice data to obtain the corresponding Mayer spectrum diagram,and used the Transformer model pre-trained based on the public data set to improve the performance of the model for audio classification.Results The accuracy of the experimental results was 83.33%,the AUC was 92.16%,the sensitivity was 80.25%,and the specificity was 87.03%.Compared with the Convolutional Neural Network(CNN),the performance of the deep learning model was better.Conclusion In this paper,the damp-heat constitution and balanced constitution identification model Transformer has achieved better identification effect,indicating that it can improve the efficiency of TCM acoustic diagnosis of constitution identification,and promote the objective and intelligent development of constitution identification.

Objective: To understand the current situation of college students emotional regulation and its correlation with perceived social support, so as to provide a reference for improving emotional regulation ability among college students. Methods: From September 15 to October 15, 2022, a total of 15 560 students from 27 colleges and universities in Guangdong, Jiangsu, Shandong, Shanghai, Anhui, Hebei, Yunnan, Shanxi and Gansu were enrolled by stratified random sampling method. The Perceived Social Support Scale (PSSS) and the Emotion Regulation Questionnaire (ERQ) were used to investigate, and multiple stepwise regression was used to explore the relationship between perceived social support and emotion regulation of college students. Results: The scores of emotion regulation, cognitive reappraisal and expression inhibition were 44(40, 50), 24(20, 28) and 20(19, 24) respectively. There were significant differences in the scores of emotion regulation, cognitive reappraisal and expression inhibition by age, grade, household registration, only child status,cost of living, and sleep ( H/Z =77.72, 49.73, -5.10, -9.77, 7.68, 168.27 ; 204.55, 317.32, -5.96, -7.60, 131.20, 968.08; 82.18, 148.04, -2.30, -8.03, 64.82, 188.08, P <0.05). In addition, the multiple stepwise regression found that family support, friend support, and other support in perceived social support all had a positive impact on the emotional regulation state of college students ( β =0.137,0.207,0.090), and family support and friend support had a significant positive effect on expression inhibition( β =0.079,0.053) and cognitive reappraisal( β =0.153,0.296)( P <0.01). Conclusion The perceived social support can directly affect the emotional regulation of college students, and improving the emotional regulation ability has a positive significance to promote the mental health level among college students.

Objective To investigate the mechanism and clinical significance of miR-18a-5p and retinoid acid receptor-related orphan receptor-α(RORA)in the proliferation and progression of colorectal cancer(CRC)cells.Methods The expressions of miR-18a-5p and RORA in CRC cells and tissues were detected via qRT-PCR,FISH,and IHC.Cell proliferation capability was detected through EdU and CFSE assay,cell apoptosis by flow cytometry assay,and cell migration and invasion abilities by cell scratch and Transwell invasion assays,respectively.The targeted regulation of miR-18a-5p on RORA was further verified via dual-luciferase reporter assay,cell function rescue test,RT-PCR,and Western blot assay.Finally,bioinformatics was used to explore the molecular mechanism of miR-18a-5p promoting malignant proliferation,invasion,and progression of CRC via regulating RORA.Results miR-18a-5p exhibited a high expression in CRC tissues and cells(P<0.05)and promoted the proliferation,migration,and invasion of CRC cells(P<0.05).In addition,RORA served as the target gene of miR-18a-5p,and its overexpression effectively reduced the promoting function of miR-18a-5p in the malignant biological phenotype of CRC cells(P<0.05).The expression of RORA in CRC tissues showed a significantly positively correlation with the infiltration of CD8+T cells and the expression of its surface marker protein CD8A.Conclusion The targeted regulation of RORA by miR-18a-5p promotes the proliferation and progression of CRC.The miR-18a-5p/RORA regulatory pathway possibly contributes to the immune microenvironment of CRC,which can be a potential therapeutic target for CRC.

Objective To explore the effect of zirconium oxide porcelain teeth on treating patients with restoration of anterior teeth.Methods A total of 124 patients with restoration of anterior teeth were divided into observation group and control group,62 cases in each group.The control group was treated with nicochrome porcelain teeth,while the observation group was treated with zirconium oxide porcelain teeth.The repair effect,complications and tooth function were compared between two groups.Results In the two groups,A,B and C ratios of repair body shape and the grade B of marginal fitness,grade B of color matching and grade B of gingival coloration showed no significant differences (P ＞ 0.05).In the observation group,the grade A of marginal fitness,grade A of color matching and grade A of gingival coloration were significantly higher than the control group (P ＜ 0.05),while the grade C of marginal fitness,grade C of color matching and grade C of gingival coloration and the total incidence rate of complications were significantly lower than the control group (P ＜ 0.05).Score of teeth function after treatment in the observation group was significantly higher than the control group (P ＜ 0.05).Conclusion Zirconium oxide porcelain teeth can effectively improve the repair effect of the patients with restoration of anterior teeth,reduce the complications and improve the function of the teeth.

Objective To explore the effect of zirconium oxide porcelain teeth on treating patients with restoration of anterior teeth.Methods A total of 124 patients with restoration of anterior teeth were divided into observation group and control group,62 cases in each group.The control group was treated with nicochrome porcelain teeth,while the observation group was treated with zirconium oxide porcelain teeth.The repair effect,complications and tooth function were compared between two groups.Results In the two groups,A,B and C ratios of repair body shape and the grade B of marginal fitness,grade B of color matching and grade B of gingival coloration showed no significant differences (P ＞ 0.05).In the observation group,the grade A of marginal fitness,grade A of color matching and grade A of gingival coloration were significantly higher than the control group (P ＜ 0.05),while the grade C of marginal fitness,grade C of color matching and grade C of gingival coloration and the total incidence rate of complications were significantly lower than the control group (P ＜ 0.05).Score of teeth function after treatment in the observation group was significantly higher than the control group (P ＜ 0.05).Conclusion Zirconium oxide porcelain teeth can effectively improve the repair effect of the patients with restoration of anterior teeth,reduce the complications and improve the function of the teeth.