By combining the ability of SMOTE data augmentation method to process complex audio data with the accurate prediction ability of GA-SVM,a GA-SVM model based on SMOTE data augmentation algorithm is proposed and applied to the diagnosis of thyroid diseases.The results demonstrate the excellent performance of the proposed method in the classification and diagnosis of thyroid diseases.Compared with other methods,the proposed method has better diagnostic efficacy and higher applicability in the classification and diagnosis of thyroid diseases.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Objective To investigate the clinical characteristics of patients with chronic myeloid leukemia (CML) in chronic phase with deletion and non-deletion of the argininosuccinate synthesis gene (ASS gene) on the derivative chromosome 9. Methods The clinical data of patients with CML initially treated with imatinib and BCR/ABL1/ASS1 3-color fusion probe to detect ASS gene deletion were analyzed. The patients were divided into deletion group (n=27) and non-deletion group (n=92). Clinical characteristics, treatment effects, and prognosis were analyzed. Results The average age of 119 patients was 37.22±12.72 years old. The sokal score differed between the deletion and non-deletion groups (χ²=4.304, P=0.038). No statistically significant difference in other general characteristics was found (P > 0.05). The 3-month CCyR rate, 6-month CCyR rate, and BCR-ABL^IS≤ 1% rate in the deletion group were lower than those in the non-deletion group (P < 0.05). The median follow-up of 119 patients was 35.0 (3.0-60.0) months. The PFS in the deletion group was lower than that in the non-deletion group (χ²=4.293, P=0.038). Overall survival was not significantly different between the two groups (χ²=0.008, P=0.931). Conclusion The deletion of the ASS gene in patients with chronic CML is related to the poor efficacy of imatinib treatment, poor prognosis, and high risk of disease progression.

OBJECTIVE To study the vasorelaxant effects and mechanism of polyphenol compound 2，4′，5′-trihydroxy-5，2′- dibromo-diphenyl-methanone（LM49）on isolated aortic rings of rats. METHODS Thoracic aortic vascular rings of rats were collected. Using the diastolic rate as index ， the effects of different concentrations of LM 49 on endothelium-intact and endothelium-denuded aortic rings pre-contracted by norepinephrine （NE，1×10－6 mol/L）or KCl （60 mmol/L）were investigated. After pre-culturing vascular rings by nitric oxide synthase inhibitor L-nitro-arginine methyl ester （L-NAME，0.1 mmol/L） and cyclooxygenase inhibitor indomethacin （1×10－5 mol/L），as well as pre-culturing vascular rings by 4 potassium channel blockers [BaCl 2（0.1 mmol/L），tetraethylammonium（TEA，5 mmol/L），4-aminopyridine（4-AP，0.1 mmol/L）and glibenclamide （1×10－5 mol/L）]，the vasorelaxant effect of different concentrations of LM 49 on the vascular rings were investigated by using the same method. With the percentage of vasoconstriction as the index ，using KCl （60 mmol/L），NE（1×10－6 mol/L），calcium channel blocker verapamil （1×10－6 mol/L）and sarcoplasmic Δ 基金项目 重大新药创制国家科技重大专项 （No.2018ZX097- reticulum Ca 2 +-adenosine triphosphate （ATP） enzyme pump inhibitor thacarotene （TG，1×10－6 mol/L）to induce the release of calcium in vascular rings in the absence of calcium. CaCl was added cumulatively ，and the effect of LM 49 on the cxyw06，vasoconstriction caused by calcium influx induced by CaCl 2 was investigated. RESULTS 3×10－6，5×10－6，1×10－5 mol/L LM49 had a significant relaxation effect on NE and KCl precontracted vascular rings （P＜0.01）； whether the endothelium was removed or not had no significant effect on the vasodilation of LM 49（P＞0.05）. After L-NAME ，indomethacin， TEA and 4-AP was pre-incubated ，different concentrations of LM 49 had no significant effects on aortic rings precontracted by NE （P＞0.05）. Glibenclamide and BaCl 2 could inhibit the vasorelaxant effects of LM 49 on aortic rings precontracted by NE （P＜0.01）. In the absence of calcium ，LM49 could inhibit the contraction caused by calcium influx induced by accumulated CaCl 2 after pre-incubation with KCl ，NE，verapamil and TG （P＜0.01）. CONCLUSIONS LM49 evokes significant relaxation of isolated aortic vascular rings without endothelium dependence ；the mechanism of which is inducing ATP-sensitive potassium channel ， inward rectifier potassium channel open and restraining extracellular Ca 2 + influx via voltage-gated calcium channel ， receptor-operated calcium channel and store-operated calcium channel.

Objective To investigate the postoperative complications of ex vivo liver resection combined with autologous liver transplantation in the treatment of end-stage hepatic alveolar echinococcosis at high altitude and related prevention and treatment strategies. Methods Surgical data and follow-up data were collected from 11 patients with end-stage hepatic alveolar echinococcosis who underwent autologous liver transplantation in Qinghai People's Hospital from January 2013 to March 2019, and intraoperative and postoperative conditions were analyzed. Results All 11 patients underwent autologous liver transplantation successfully, without intraoperative death, among whom 2(18.18%) underwent hemi-extracorporeal hepatectomy and 9 (81.82%) underwent total extracorporeal hepatectomy. For the reconstruction of the retrohepatic inferior vena cava, 2 patients (18.18%) underwent reconstruction with the autologous great saphenous vein, 4 patients (36.36%) underwent reconstruction with artificial vessels, and the autologous retrohepatic inferior vena cava was preserved in 5 patients (45.45%). For biliary reconstruction, 8 patients (72.73%) underwent choledochoenterostomy and 3 (27.27%) underwent choledochocholedochostomy. The main postoperative complications of the 11 patients included bleeding in 2 patients (18.18%), bile leakage and abdominal infection in 4 patients (36.36%), bilioenteric anastomotic stenosis in 1 patient (9.09%), thrombus in 2 patients (18.18%), pulmonary infection and pleural effusion in 2 patients (18.18%), and echinococcosis recurrence in 1 patient (9.09%). Of all 11 patients, 2 (18.18%) died during the perioperative period, and the other 9 patients (81.82%) were improved and discharged. Conclusion Bleeding, biliary complications, and infection are the main causes of death in patients undergoing autologous liver transplantation at high altitude. An accurate understanding of surgical indication, careful multidisciplinary evaluation before surgery, superb operation during surgery, standardized surgical procedures, and fine perioperative management are the key to reducing perioperative mortality, avoiding and reducing postoperative complications, and achieving good long-term survival in patients undergoing autologous liver transplantation.

In order to more accurately and effectively understand the intermuscular coupling of different temporal and spatial levels from the perspective of complex networks, a new multi-scale intermuscular coupling network analysis method was proposed in this paper. The multivariate variational modal decomposition (MVMD) and Copula mutual information (Copula MI) were combined to construct an intermuscular coupling network model based on MVMD-Copula MI, and the characteristics of intermuscular coupling of multiple muscles of upper limbs in different time-frequency scales during reaching exercise in healthy subjects were analyzed by using the network parameters such as node strength and clustering coefficient. The experimental results showed that there are obvious differences in the characteristics of intermuscular coupling in the six time-frequency scales. Specifically, the triceps brachii (TB) had relatively high coupling strength with the middle deltoid (MD) and posterior deltoid (PD), and the intermuscular function was closely connected. However, the biceps brachii (BB) was independent of other muscles. The intermuscular coupling network had scale differences. MVMD-Copula MI can quantitatively describe the relationship of multi-scale intermuscular coupling strength, which has good application prospects.
Arm ; Electromyography ; Exercise ; Humans ; Muscle, Skeletal ; Upper Extremity

Model informed precision dosing (MIPD) is a new concept to guide precision dosing for individual patient by modeling and simulation based on the available information about the individual patient, medications and the disease. Compared to the empirical dosing, MIPD could improve the efficacy, safety, economics and adherence of the pharmacotherapy according to the individual's pathophysiology, genotyping and disease progression. This consensus report provides a brief account of the concept, methodology and implementation of MIPD as well as clinical decision supporting systems for MIPD. The status and future advancing of MIPD was also discussed to facilitate the appropriate application and development of MIPD in China.

The clinical trial of OBCA (OCALIVA) in the treatment of primary biliary cirrhosis (PBC) shows its efficacy. As it is difficult to conduct sufficient clinical studies in moderate and severe hepatic impairment population, the applicant and the FDA theorem have different opinions based on the same model, such as population PK, exposure-response and physiologically-based PK (PBPK). The applicant considers that the increase in the exposure of drug in liver tissue is limited, and there is no need for dose adjustment, that is, 5 mg, once a day. FDA believes that the influencing factors of the PBPK model have not been fully taken into account and the validation of the PBPK is not robust with a wide variability, and there is also a risk of high blood drug exposure in patients. It is recommended to significantly reduce the dose, that is, 5 mg, once a week, no more than 10 mg, per week at least 3 days interval, and accordingly written into the medication instructions. After approval many patients with hepatic impairment did not take medicine according to the instructions, therefore overdosed, resulting in death. The results fully prove that the original considerations and decisions of FDA have been verified, and the experience and lessons of this example once again suggest that modeling and simulation need bold assumptions and careful verification.

Objective: To compare the changes in liver function in patients with different types of hepatic alveolar echinococcosis after radiofrequency ablation. Methods: The data of 32 patients with hepatic alveolar echinococcosis treated by radiofrequency ablation from December 2016 to December 2018 at the Qinghai Provincial People's Hospital were retrospectively analyzed. There were 12 males and 20 females. The patients were divided into the single lesion group (n=17) and the multiple lesions group (n=15) according to the number of hydatid lesions. The lesions were further divided into the small lesion group (n=12) and the large or medium lesion group (n=20). The operation time, changes in AST and ALT were compared among these groups. Results: The operation time of the single lesion group was 1.5 (1.0, 1.8) hour, and that of the multiple lesions group was 3.0 (1.5, 3.5) hour. The difference was statistically significant (P<0.05). On the 1st and 3rd day after treatment, ALT in the multiple lesions group was significantly higher than that in the single lesion group (P<0.05). Compared with the 1st day after operation, ALT of the two groups decreased on the 5th day after treatment, and the difference was statistically significant (P<0.05). The changes in AST in the two groups were basically the same as that of ALT. The operation time of the small lesion group was 1.0 (1.0, 1.9) hour, and of the large and medium lesion group was 2.5 (1.5, 3.0) hour. The difference was statistically significant (P<0.05). On the 1st, 3rd and 5th day after treatment, ALT in the small lesion group was significantly lower than the large or medium lesion group (P<0.05). Compared with the 1st day after treatment, ALT of the two groups decreased on the 5th day after treatment, and the difference was statistically significant (P<0.05). There was a significant difference in AST between the small lesion group and the large or medium lesion group only on the 1st day after operation (P<0.05). Conclusion Radiofrequency ablation for hepatic alveolar echinococcosis with a single lesion and a small lesion had shorter operation time with less changes in liver function after treatment.

Objective: To evaluate the efficacy and safety of reduced volume hepatectomy in treatment of advanced hepatic alveolar echinococcosis. Methods: The clinical data of 90 patients with advanced hepatic alveolar echinococcosis treated at the Qinghai Provincial People's Hospital from January 2017 to January 2019 were retrospectively analyzed. There were 41 males and 49 females, with an average age of 32 (range 11 to 58) years. The locations of the lesions, operations, complications and follow-up were analyzed. Results: 90 patients were treated with reduced volume focal hepatectomy, 38 with radical resection and 52 with quasi radical resection. The operation time was (361±22) min. The hospital stay was (22±2) day, and the blood loss was (781±37) ml. Red blood cells were transfused in 19 patients and plasma in 39 patients. Pringle’s maneuver was used in 12 patients, regional hepatic blood flow occlusion in 42 patients, and Glisson sheath occlusion in 26 patients. The total bilirubin, alanine aminotransferase and aspartate aminotransferase returned to normal in 3 to 14 days after operation. There were 12 patients who developed bile leakage, 41 pleural effusion and 26 effusion in the operation sites. A total of ninety patients were followed up for 2 to 24 months. There was no recurrence of echinococcosis after radical resection and no enlargement of residual lesions after quasi-radical resection. Conclusion Reduced-volume hepatectomy reduced the risk and difficulty of operation. The follow-up results were good. This approach provides a feasible scheme for treatment of advanced hepatic alveolar echinococcosis.