In order to meet the accuracy requirements of hospitals for abnormal detection of fetal monitor data,a hospital fetal monitor data anomaly detection method based on Euclidean distance was proposed.In this method,according to the abnormal detection method of fetal monitor data in hospitals,the ultrasound Doppler detector was used to collect fetal heart rate signal data,and the fetal heart rate signal denoising method based on adaptive filtering was used to remove the noise components of the collected fetal heart rate signal.The denoised fetal heart rate signal was used as the identification sample of the abnormal fetal heart rate signal identification method based on Euclidean distance method.The Euclidean distance Euclidean distance between the denoised fetal heart rate signal and the normal fetal heart rate signal was analyzed by combining the Euclidean distance method and the strong classifier to analyze whether the virtual sinusoidal distance between the denoised fetal heart rate signal and the normal fetal heart rate signal was greater than the tuned Euclidean distance threshold.Fetal heart rate signal samples greater than the threshold were classified and diagnosed as abnormal monitoring data.The fetal heart rate information collected by the fetal monitor in the hospital was accurate,and the abnormal detection results were valid and reliable.

BACKGROUND: Infant adipose-derived mesenchymal stem cells (ADSCs) collected from excised polydactyly fat tissue, which was surgical waste, could be cultured and expanded in vitro in this study. In addition, the collecting process would not cause pain in the host. In this study, the proliferation, reduction of senescence, anti-oxidative ability, and differentiation potential in the infant ADSCs were compared with those in the adult ADSCs harvested from thigh liposuction to determine the availability of infant ADSCs. METHODS: Proliferation was determined by detecting the fold changes in cell numbers and doubling time periods.Senescence was analyzed by investigating the age-related gene expression levels and the replicative stress. The superoxide dismutase (SOD) gene expression, adipogenic, neurogenic, osteogenic, and tenogenic differentiation were compared by RTqPCR. The chondrogenic differentiation efficiency was also determined using RT-qPCR and immunohistochemical staining. RESULTS: The proliferation, SOD (SOD1, SOD2 and SOD3) gene expression, the stemness-related gene (c-MYC) and telomerase reverse transcriptase of the infant ADSCs at early passages were enhanced compared with those of the adults’Cellular senescence related genes, including p16, p21 and p53, and replicative stress were reduced in the infant ADSCs. The adipogenic genes (PPARγ and LPL) and neurogenic genes (MAP2 and NEFH) of the infant ADSC differentiated cells were significantly higher than those of the adults’ while the expression of the osteogenic genes (OCN and RUNX) and tenogenic genes (TNC and COL3A1) of both demonstrated opposite results. The chondrogenic markers (SOX9, COL2 and COL10) were enhanced in the infant ADSC differentiated chondrogenic pellets, and the expression levels of SODs were decreased during the differentiation process. CONCLUSION Cultured infant ADSCs demonstrate less cellular senescence and replicative stress, higher proliferation rates, better antioxidant defense activity, and higher potential of chondrogenic, adipogenic and neurogenic differentiation.

Most important international guidelines recommend the use of CHA 2 DS 2 -VASc and HASBLED scores for stroke and bleeding risk assessments in atrial fibrillation (AF) patients, respectively. The 2020 AF guidelines of European Society of Cardiology have revised the definition of “C: congestive heart failure (HF)” component, and now patients with either HF with reduced ejection fraction or preserved ejection fraction should be assigned 1 point.Hypertrophic cardiomyopathy was also included. Besides, the revised “V: vascular diseases” component included both prior myocardial infarction and “angiographically significant coronary artery disease”. It is important to understand that the stroke and bleeding risks of AF patients were not static and should be re-assessed regularly. A high HAS-BLED score itself should not be the only reason to withhold or discontinue oral anticoagulants, but remind physicians for the corrections of modifiable bleeding risk factors and more regular follow up. In the future, the AF duration and left atrial function may play an important role for personalized evaluation of individual stroke risk while more studies are necessary.

Most important international guidelines recommend the use of CHA 2 DS 2 -VASc and HASBLED scores for stroke and bleeding risk assessments in atrial fibrillation (AF) patients, respectively. The 2020 AF guidelines of European Society of Cardiology have revised the definition of “C: congestive heart failure (HF)” component, and now patients with either HF with reduced ejection fraction or preserved ejection fraction should be assigned 1 point.Hypertrophic cardiomyopathy was also included. Besides, the revised “V: vascular diseases” component included both prior myocardial infarction and “angiographically significant coronary artery disease”. It is important to understand that the stroke and bleeding risks of AF patients were not static and should be re-assessed regularly. A high HAS-BLED score itself should not be the only reason to withhold or discontinue oral anticoagulants, but remind physicians for the corrections of modifiable bleeding risk factors and more regular follow up. In the future, the AF duration and left atrial function may play an important role for personalized evaluation of individual stroke risk while more studies are necessary.

Objective: The relationship of antipsychotics and the risk of refracture in treated patients is unclear. The aim of this study is to evaluate the association between prolonged antipsychotic and the incidences of bone fractures and refractures in schizophrenia. Methods: This is a retrospective nested case-control study using Taiwan National Health Insurance Research Database recorded from 2000 to 2005, with cases followed up to end of 2011. Total of 7,842 schizophrenic patients, 3,955 had developed bone fractures were compared with 3,887 control subjects matched in age, sex, and index date.Antipsychotic drug exposure was classified based on the drug type and medication duration. Conditional logistic regression analyses were performed. Odds ratio (OR) and confidence interval (CI) were calculated. Results: We found (after adjustments) higher risks of developing fractures under continued use of typical (OR = 1.70; 95% CI, 1.51−1.91) or atypical antipsychotics (OR = 1.43; 95% CI, 1.28−1.60) were found. Additionally, continued use typical (OR = 1.84; 95% CI, 1.35−2.50) or atypical antipsychotics (OR = 1.44; 95% CI, 1.06−1.95) was positively associated with refracture risks. Moreover, refractures were associated with continuous use of chlorpromazine (one typical antipsychotics, OR = 2.45; 95% CI, 1.14−5.25), and risperidone (OR = 1.48; 95% CI, 1.01−2.16) or zotepine (OR = 2.15; 95% CI, 1.06−4.36) (two atypical antipsychotics). Conclusion Higher risks of bone fracture and refracture were found in schizophrenia under prolonged medication with typical or atypical antipsychotics. We therefore recommend that clinicians should pay more attention on bone density monitoring for patients using long-term antipsychotics.

PURPOSE: The purpose was to explore the breastfeeding experiences of mothers of infants with breast-feeding or breast milk jaundice. METHODS: In-depth qualitative interviews and content analysis were conducted with nine mothers of newborns with breastfeeding and/or breast milk jaundice who breastfed their babies during the first year postpartum. RESULTS: Mothers' experiences can be described in four phases and six themes. (1) Prenatal stage: build breastfeeding belief, i.e., breastfeeding is best and a natural behavior, without awareness of neonatal jaundice; (2) stage after neonatal jaundice started to appear: include two themes, questioning beliefs in breastfeeding and happiness in being a mother. Mothers lacked knowledge and ignored the threat of neonatal jaundice, mainly focused on their physical discomforts and worried about insufficient breast milk; they also felt an intimate mothereinfant bond through breastfeeding; (3) stage when newborns had confirmed diagnosis of breastfeeding or breast milk jaundice that required medical attention: include two themes, diagnosis of breastfeeding or breast milk jaundice and phototherapy caused negative emotions and regaining original beliefs about breastfeeding. They struggled through emotional swings and inconsistent advices about whether phototherapy and formula supplementation are needed. Then, they decided breastfeeding or breast milk jaundice is only temporary and retrieved initial beliefs of breastfeeding. (4) Stage after neonatal jaundice faded and mothers continued breastfeeding: insisting and adapting. CONCLUSION: Breastfeeding mothers were unaware of neonatal jaundice until medical attention was required; they experienced physical and mental distress and gradually learned to manage jaundice while insisting on breastfeeding through their breastfeeding beliefs and happiness in being mothers.
Anxiety ; Breast Feeding ; Breast ; Diagnosis ; Happiness ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Jaundice, Neonatal ; Milk, Human ; Mothers ; Phototherapy ; Postpartum Period ; Qualitative Research

Objective    To develop a novel methylene blue staining technique to localize small esophageal leiomyomas ( small esophageal leiomyomas ( and 4 females with an average age of 51 years. We preoperatively injected 0.5–1.0 ml methylene blue in the submucosa adjacent to the tumors under the guidance of gastroscope. Then, we transferred the patients to the operating room. Results    Staining was successful in 9 patients. The unstained tumor was exposed after the blue-stained mediastinal pleura and overlying muscle were incised longitudinally during ideo-assisted thoracoscopic surgery via one utility port. No abnormalities were detected in the esophageal mucosa. No major complications, such as esophageal leakage or esophageal diverticulum occurred. Conclusion    Endoscopic methylene blue staining is safe and feasible for localizing small esophageal leiomyomas during video-assisted thoracoscopic surgery via one utility port. This method will enable enucleation precise and easy.

Objective: To analyze and design the information system of chest pain center so as to improve the overall treatment level for patients with chest pain in emergency department,and to shorten the waiting time of diagnosis and treatment after they achieved hospital.Methods: Using 4G network,internet of things,virtual private dial-up networks(VPDN)and information system of chest pain to send real-timely medical data of patient from ambulance to hospital.And then doctors of electrocardiographic room,emergency department and cardiology department implemented analysis report,first-aid guidance,preparation of surgery and treatment and other series of operation.Results: Patient's condition has been preliminarily confirmed before they arrived the hospital,and the doctors has completed preparation of interventional operation.When the patient arrived at the hospital,he could directly were sent into the catheterization room to receive treatment but need not be confirmed again by emergency room.Conclusion:This system can supplement the shortage of technical force of pre-hospital first-aid team,and shorten the treatment time of patients with chest pain,and improve the success rate of rescue.

The paper introduces the current status of chroic disease management,builds chronic disease management information system of medical association,analyzes the system framework,elaborates system function and effect.The chronic disease managment system of medical association operates in a reasonble and orderly hierarchical medical mode,realizing the effective connention between disease managment and health management.

Objective:To design real-time transmission system for pre-hospital emergency electrocardiogram(ECG) so as to provide specialty and accurate diagnostic analysis about ECG before patient achieved at hospital and to shorten the waiting time for diagnosis and treatment after they achieved at hospital.Methods: 4G network and virtual private dial-up network(VPDN) were used to real-time transmit ECG data of patient from ambulance to hospital so as to doctors of ECG department and emergency room can analyze the detecting reporter, choose plan of emergency guidance and prepare operation and treatment for patientsaccording to the received ECG data in time.Results: The situations of emergency patients have been grasped and been primarily confirmed before they achieved hospital, therefore, the doctors could made relative preparation for fast and specially treating patients after they once achieved hospital.Conclusion: The real-time transmission system of pre-hospital emergency ECG can remedy the shortage of technical strength of pre-hospital emergency team, and shorten the treating time of emergency patients, and increase the success rate of rescue.