Deep learning method can be used to automatically analyze electrocardiogram (ECG) data and rapidly implement arrhythmia classification, which provides significant clinical value for the early screening of arrhythmias. How to select arrhythmia features effectively under limited abnormal sample supervision is an urgent issue to address. This paper proposed an arrhythmia classification algorithm based on an adaptive multi-feature fusion network. The algorithm extracted RR interval features from ECG signals, employed one-dimensional convolutional neural network (1D-CNN) to extract time-domain deep features, employed Mel frequency cepstral coefficients (MFCC) and two-dimensional convolutional neural network (2D-CNN) to extract frequency-domain deep features. The features were fused using adaptive weighting strategy for arrhythmia classification. The paper used the arrhythmia database jointly developed by the Massachusetts Institute of Technology and Beth Israel Hospital (MIT-BIH) and evaluated the algorithm under the inter-patient paradigm. Experimental results demonstrated that the proposed algorithm achieved an average precision of 75.2%, an average recall of 70.1% and an average F ₁-score of 71.3%, demonstrating high classification accuracy and being able to provide algorithmic support for arrhythmia classification in wearable devices.
Humans ; Arrhythmias, Cardiac/diagnosis* ; Algorithms ; Electrocardiography/methods* ; Neural Networks, Computer ; Signal Processing, Computer-Assisted ; Deep Learning ; Classification Algorithms

[Objective]To explore the meaning of"the patients who vomited after taking Zhizichi Decoction should discontinue it",thereby providing evidence-based references for its clinical application.[Methods]By organizing,summarizing,and analyzing the diverse academic viewpoints of past medical practitioners regarding"the patients who vomited after taking Zhizichi Decoction should discontinue it",this study examines the medicinal properties and preparation of Gardenia jasminoides(Zhizi)and Sojae Semen Praeparatum(Douchi)found in mainstream pharmacological texts.It also investigates the specific connotations of"the patients who vomited after taking Zhizichi Decoction should Discontinue it"from three perspectives:drug-induced vomiting,misconceptions,and post-medication reactions,combining insights from ZHANG Zhongjing's original text and relevant medical cases by YE Tianshi.[Results]There are primarily three different academic viewpoints regarding"the patients who vomit after taking Zhizichi Decoction should discontinue it":the drug-induced vomiting theory,the misconceptions theory and the post-medication reaction theory.The drug-induced vomiting theory posits that Zhizi or Douchi can lead to vomiting,vomiting is a method and objective of treatment,categorizing Zhizichi Decoction as an emetic.The misconceptions theory argues that Zhizichi Decoction does not induce vomiting and that"the patients who vomit after taking Zhizichi Decoction should discontinue it"does not align with the original intention of Treatise on Febrile Diseases.The post-medication reaction theory claims that Zhizichi Decoction is not an emetic;rather,vomiting is a post-medication reaction,with the key factor being the stagnation of Qi in the upper-Jiao.Therefore,Zhizi and Douchi are used in combination to create a mild bitter and spicy effect to regulate the ascent and descent of Qi,allowing the stagnated heat to be expelled.[Conclusion]The post-medication reaction theory aligns most closely with ZHANG Zhongjing's original intention.Zhizichi Decoction has the efficacy of dispersing and removing obstruction,it functions by promoting the circulation of Qi through its slightly bitter and mildly spicy properties to regulate the ascent and descent of Qi,clearing stagnated heat,which should be classified as an diffusing formula within the"ten prescriptions".Accurate clinical application of this formula hinges on identifying the pathogenic mechanism of Qi stagnation in the uppert-Jiao.

Thiamethoxam belongs to the second-generation neonicotinoid insecticides, mainly acting on nicotinic acetylcholine receptors (nAChR) . Severe poisoning cases can lead to respiratory failure, shock, and even death. There are relatively few reports on thiamethoxam poisoning, and few literature reports on concurrent rhabdomyolysis cases have been found so far. This article reviews the treatment process of a case of oral thiamethoxam poisoning. The patient developed mild rhabdomyolysis (CK: 1581 U/l) and renal dysfunction (creatinine: 127 μmol/L) immediately after taking the medication, reaching its peak on the second day (CK: 16329 U/l) . After active treatment (such as Blood purification, drainage, gastrointestinal decompression and organ support) , the symptoms of rhabdosis gradually improved and the patient was discharged. It is suggested that when treating thiamethoxam poisoning, the occurrence of rhabdomyolysis syndrome should be concerned.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To investigate the diagnostic value of peripheral blood trimethylamine N-oxide(TMAO)combined with neutrophil-to-lymphocyte ratio(NLR)in patients with acute ische-mic stroke(AIS).Methods A total of 100 AIS patients were selected as study group,and 100 non-stroke study objects who underwent physical examinations during the same period were selected as con-trol group.Blood samples were collected from all participants,and plasma TMAO levels were meas-ured using high-performance liquid chromatography-tandem mass spectrometry.TMAO levels and NLR were compared between two groups,and Spearman correlation analysis,multivariate logistic regression analysis,and receiver operating characteristic(ROC)curve were applied to evaluate the diagnostic val-ue of TMAO and NLR in AIS.Results Compared with the control group,the AIS group had signifi-cantly higher TMAO levels and NLR(P＜0.05).Spearman correlation analysis indicated that TMAO and NLR were positively correlated with the occurrence of AIS(P＜0.05).Multivariate Logistic re-gression analysis revealed that age,TMAO,NLR,and hypertension were independent influencing fac-tors for the occurrence of AIS(P＜0.05).The ROC curve showed that the optimal cut-off values for TMAO and NLR in predicting AIS were 3.749 μmol/L and 2.210,respectively.The area under the curve for TMAO combined with NLR in predicting AIS was 0.902,which was higher than that of TMAO or NLR alone(0.808 and 0.801,respectively),and the Youden index for combined prediction was greater.Conclusion Peripheral blood TMAO and NLR are positively correlated with the occurrence of AIS,and the combination of TMAO and NLR can significantly improve the diagnostic efficacy of AIS,providing a basis for early clinical identification of AIS.

Thiamethoxam belongs to the second-generation neonicotinoid insecticides, mainly acting on nicotinic acetylcholine receptors (nAChR) . Severe poisoning cases can lead to respiratory failure, shock, and even death. There are relatively few reports on thiamethoxam poisoning, and few literature reports on concurrent rhabdomyolysis cases have been found so far. This article reviews the treatment process of a case of oral thiamethoxam poisoning. The patient developed mild rhabdomyolysis (CK: 1581 U/l) and renal dysfunction (creatinine: 127 μmol/L) immediately after taking the medication, reaching its peak on the second day (CK: 16329 U/l) . After active treatment (such as Blood purification, drainage, gastrointestinal decompression and organ support) , the symptoms of rhabdosis gradually improved and the patient was discharged. It is suggested that when treating thiamethoxam poisoning, the occurrence of rhabdomyolysis syndrome should be concerned.

[Objective]To explore the meaning of"the patients who vomited after taking Zhizichi Decoction should discontinue it",thereby providing evidence-based references for its clinical application.[Methods]By organizing,summarizing,and analyzing the diverse academic viewpoints of past medical practitioners regarding"the patients who vomited after taking Zhizichi Decoction should discontinue it",this study examines the medicinal properties and preparation of Gardenia jasminoides(Zhizi)and Sojae Semen Praeparatum(Douchi)found in mainstream pharmacological texts.It also investigates the specific connotations of"the patients who vomited after taking Zhizichi Decoction should Discontinue it"from three perspectives:drug-induced vomiting,misconceptions,and post-medication reactions,combining insights from ZHANG Zhongjing's original text and relevant medical cases by YE Tianshi.[Results]There are primarily three different academic viewpoints regarding"the patients who vomit after taking Zhizichi Decoction should discontinue it":the drug-induced vomiting theory,the misconceptions theory and the post-medication reaction theory.The drug-induced vomiting theory posits that Zhizi or Douchi can lead to vomiting,vomiting is a method and objective of treatment,categorizing Zhizichi Decoction as an emetic.The misconceptions theory argues that Zhizichi Decoction does not induce vomiting and that"the patients who vomit after taking Zhizichi Decoction should discontinue it"does not align with the original intention of Treatise on Febrile Diseases.The post-medication reaction theory claims that Zhizichi Decoction is not an emetic;rather,vomiting is a post-medication reaction,with the key factor being the stagnation of Qi in the upper-Jiao.Therefore,Zhizi and Douchi are used in combination to create a mild bitter and spicy effect to regulate the ascent and descent of Qi,allowing the stagnated heat to be expelled.[Conclusion]The post-medication reaction theory aligns most closely with ZHANG Zhongjing's original intention.Zhizichi Decoction has the efficacy of dispersing and removing obstruction,it functions by promoting the circulation of Qi through its slightly bitter and mildly spicy properties to regulate the ascent and descent of Qi,clearing stagnated heat,which should be classified as an diffusing formula within the"ten prescriptions".Accurate clinical application of this formula hinges on identifying the pathogenic mechanism of Qi stagnation in the uppert-Jiao.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To explore the risk factors of electrocardiogram abnormalities in patients with primary liver cancer and its value in predicting prognosis. Methods A total of 120 primary liver cancer patients with transcatheter arterial chemoembolization (TACE) were selected as the research objects, and they were divided into abnormal group (n=32) and non-abnormal group (n=88) according to incidence of electrocardiogram abnormalities at 7 days after operation. Baseline data and changes in 24-hour QT interval variability (24-hour QTV), standard deviation of the normal R-R interval from the beginning of atrial depolarization to ventricular depolarization (SDNN), standard deviation of the normal R-R interval for 5 consecutive minutes (SDANN-index), and mean value of the standard deviation of the normal R-R interval for 5 consecutive minutes (SDNN-index) were compared between two groups; a binary Logistic regression model was used to analyze the influencing factors of electrocardiogram abnormalities in patients with primary liver cancer; the receiver operating characteristic (ROC) curve was used to analyze the area under the curve (AUC), sensitivity and specificity of 24 h QTV, SDNN, SDANN-index and SDNN-index in predicting ECG abnormalities in patients with primary liver cancer. Results Of the 120 primary liver cancer patients with TACE treatment, 32 cases had electrocardiogram abnormalities, including 13 cases of sinus tachycardia with T-wave changes, 2 cases of ST-T changes, 4 cases of supraventricular tachycardia, 4 cases of QT interval prolongation, 4 cases of ventricular premature beats, and 5 cases of atrial premature beats. There were no significant differences in gender, age, super-selective hepatic artery catheterization, gelatin sponge embolization, use of chemotherapy drugs, postoperative vomiting, and blood uric acid on the third day after surgery between the abnormal group and the non-abnormal group (P>0.05); there were significant differences in tumor diameter, liver function classification, dosage of iodized oil, postoperative body temperature, and blood potassium on the third day after surgery between the two groups (P < 0.05). Logistic regression model showed that tumor diameter ≥10 cm, grade A of liver function classification, iodized oil dose ≥10 mL, postoperative body temperature ≥38 ℃, and decreases of 24 h QTV, SDNN, SDANN-index and SDNN-index were the independent factors affecting electrocardiogram abnormalities in patients with primary liver cancer (P < 0.05). ROC curve analysis showed that the values of AUC of 24 h QTV, SDNN, SDANN-index, SDNN-index and comprehensive electrocardiogram parameters in predicting electrocardiogram abnormalities in patients with primary liver cancer were 0.682, 0.651, 0.632, 0.752 and 0.786 respectively, with statistically significant differences (P < 0.05). Conclusion Tumor diameter, liver function classification, dose of iodide oil and postoperative body temperature can affect electrocardiogram abnormalities in patients with primary liver cancer, and electrocardiogram monitoring before and after TACE treatment is conducive to timely detection of electrocardiogram abnormalities.