ObjectiveTo propose an X-Gait motor rehabilitation assessment system based on a perception-cognition decoupling architecture to jointly achieve high-accuracy gait recognition and clinical interpretability for low clinical credibility and opaque decision-making workflows in existing intelligent gait assessment models. MethodsIn the perception layer, YOLOv11-Pose and PoseFormerV2 were integrated for 2D-to-3D human pose reconstruction. A long short-term memory network was adopted for temporal classification of normal, abnormal and pathological gaits. The layer-wise relevance propagation algorithm was used to identify discriminative joints and automatically quantify biomechanical indices including trunk forward inclination angle, stance phase percentage and stride symmetry. In the cognition layer, rehabilitation-oriented prompt engineering and prior knowledge graphs were combined to drive large language models, converting quantitative biomechanical measurements into clinically reasonable structured reports. Eight subjects were enrolled for bedside clinical validation to evaluate classification performance and clinical consistency. ResultsThe overall gait classification accuracy of X-Gait reached 94.1%. The 2D pose detection achieved 100% valid detection rate with an average confidence of 0.819. The mean per-joint position error of 3D pose reconstruction was 105.97 mm. In clinical validation of eight cases, outputs generated by explainable artificial intelligence combined with large language models showed high consistency with manual assessments from experienced rehabilitation physicians. ConclusionThe proposed X-Gait system based on perception-cognition decoupling realizes high-precision gait identification and clinically interpretable outputs.

Objective To analyze the prognosis of elderly patients with community-acquired pneumonia (CAP) and its correlation with serum angiopoietin 2 (Ang-2), activated protein C (APC) and pentraxin 3 (PTX3) levels. Methods A total of 508 elderly patients with CAP in the hospital from March 2021 to March 2024 were divided into death group (n=104) and survival group (n=404) according to the survival status at 28 days after admission. Another 110 healthy subjects with physical examination were included in the control group. The levels of serum Ang-2, APC and PTX3 were compared, and their correlation with prognosis was explored by Pearson correlation analysis. Results In this study, 404 cases survived after 28 days and 104 cases died. The levels of C-reactive protein, procalcitonin and interleukin-8 and the proportion of severe condition in the survival group were lower than those in the death group (P<0.05). The level of serum APC in the case group and the death group was lower than that in the control group and the survival group (P<0.05), while the levels of Ang-2 and PTX3 were higher than those in the control group and the survival group (P<0.05), respectively. Serum APC level was negatively correlated with community-acquired pneumonia in the elderly CAP (r=-0.476, P<0.05), while Ang-2 and PTX3 were positively correlated with prognosis (r=0.489, 0.502, P<0.05). Conclusion Serum levels of Ang-2 and APC in elderly patients with CAP are decreased and the level of PTX3 is increased. Serum Ang-2 and APC levels are negatively correlated with elderly CAP, and PTX3 is positively correlated with prognosis.

Arrhythmia is a significant cardiovascular disease that poses a threat to human health, and its primary diagnosis relies on electrocardiogram (ECG). Implementing computer technology to achieve automatic classification of arrhythmia can effectively avoid human error, improve diagnostic efficiency, and reduce costs. However, most automatic arrhythmia classification algorithms focus on one-dimensional temporal signals, which lack robustness. Therefore, this study proposed an arrhythmia image classification method based on Gramian angular summation field (GASF) and an improved Inception-ResNet-v2 network. Firstly, the data was preprocessed using variational mode decomposition, and data augmentation was performed using a deep convolutional generative adversarial network. Then, GASF was used to transform one-dimensional ECG signals into two-dimensional images, and an improved Inception-ResNet-v2 network was utilized to implement the five arrhythmia classifications recommended by the AAMI (N, V, S, F, and Q). The experimental results on the MIT-BIH Arrhythmia Database showed that the proposed method achieved an overall classification accuracy of 99.52% and 95.48% under the intra-patient and inter-patient paradigms, respectively. The arrhythmia classification performance of the improved Inception-ResNet-v2 network in this study outperforms other methods, providing a new approach for deep learning-based automatic arrhythmia classification.
Humans ; Arrhythmias, Cardiac/diagnostic imaging* ; Cardiovascular Diseases ; Algorithms ; Databases, Factual ; Electrocardiography

OBJECTIVE: To investigate the prevalence of Echinococcus infections in wild carnivores in Serthar County, Sichuan Province, so as to provide insights into echinococcosis control in local areas. METHODS: Stool samples were collected from wild carnivores in Serthar County, Sichuan Province in May 2021, and the host sources of stool samples and Echinococcus infections were identified using PCR assays. The prevalence of E. multilocularis, E. granulosus and E. shiquicus infections was estimated in different hosts. RESULTS: A total of 583 stool samples were collected from wild carnivores, including 147 stool samples from fox, 154 from wolf, 227 from wild dogs and 11 from lynx. The overall prevalence of E. multilocularis, E. granulosus and E. shiquicus infections was 5.68%, 0.19% and 14.20% in canine stool samples, and no E. granulosus infection was detected in fox stool samples, while the prevalence of E. multilocularis and E. shiquicus infections was 0.68% and 47.62% in fox stool samples (χ² = 88.41, P < 0.001). No E. granulosus or E. shiquicus infection was detected in wolf stool samples, and the prevalence of E. multilocularis infection was 10.39% in wolf stool samples. The prevalence of E. multilocularis, E. granulosus and E. shiquicus infections was 5.73%, 0.44% and 2.20% in canine stool samples (χ² = 12.13, P < 0.01). In addition, the prevalence of E. multilocularis infections was significantly higher in wolf stool samples than in canine and fox stool samples (χ² = 13.23, P < 0.01), and the prevalence of E. shiquicus infections was significantly higher in fox stool samples than in canine and wolf stool samples (χ² = 187.01, P < 0.001). No Echinococcus infection was identified in 11 lynx stool samples. CONCLUSIONS The prevalence of Echinococcus infections is high in wild canines in Serthar County, Sichuan Province. Wolf, wild dog and fox all participate in the wild life cycle of E. multilocularis in Serthar County, and wolf and wild dogs may play a more important role.
Animals ; Dogs/microbiology* ; China/epidemiology* ; DNA, Helminth/genetics* ; Echinococcosis/veterinary* ; Feces ; Foxes/microbiology* ; Lynx/microbiology* ; Prevalence ; Wolves/microbiology* ; Carnivora/microbiology*

Objective To analyze the levels of IgE,TNF-α and FeNO in children with acute attack of bronchial asthma and their correlation with the severity of bronchial asthma, so as to provide theoretical basis for clinical evaluation of bronchial asthma. Methods A total of 547 children with acute bronchial asthma treated in Chengdu Women and Children's Central Hospital from January 2020 to December 2020 were selected and divided into mild group (n=287), moderate group (n=186) and severe group (n=74) according to the severity of their disease. All the children's symptoms were controlled after treatment. The serum IgE, TNF-α and FeNO levels in the experimental group were compared between the acute attack stage and the clinical control stage. Spearman correlation analysis was used to analyze the correlation between the serum IgE, TNF-α and FeNO levels and the severity of the disease. ROC curve of children with bronchial asthma was drawn to analyze the differential diagnosis value of serum IgE, TNF-α and FeNO levels in children with acute bronchial asthma. Results The levels of IgE, TNF-α and FeNO in acute stage were significantly higher than those in clinical control stage (P<0.05). The levels of serum IgE, TNF-α and FeNO in severe group were higher than those in mild and moderate groups significantly (P<0.05). The levels of serum IgE, TNF-α and FeNO in moderate group were higher than those in mild group significantly (P<0.05). Spearman correlation analysis showed that serum IgE, TNF-α and FeNO water were positively correlated with the severity of bronchial asthma (r=0.419 , 0.438 , 0.502 , P<0.05). ROC curve analysis showed that the AUC, sensitivity, accuracy and specificity of serum IgE, TNF-α and FeNO levels combined in diagnosing the severity of bronchial asthma in patients with acute attack was 0.938 (95% CI: 0.912-0.982 ), 83.47%, 92.06%, 94.28%. Conclusion The level of serum IgE, TNF-α and FeNO in children with acute attack of bronchial asthma is closely related to the severity of the disease, and combined detection of the three can be used to evaluate the severity of the disease in children.

Objective To investigate the epidemiology of echinococcosis in Serthar County, Sichuan Province, so as to provide insights into optimization of echinococcosis control measures. Methods The prevalence of human echinococcosis was surveyed among permanent residents living in Serthar County at ages of over 2 years from 2016 to 2019, and the prevalence of Echinococcus infections was surveyed in owned dogs, yaks and rodents in 2019. The epidemiological features of echinococcosis in humans and animals were descriptively analyzed. Results The overall prevalence of human echinococcosis was 3.72% (1 613/43 362) in Serthar County from 2016 to 2019, and the prevalence rates of cystic echinococcosis, alveolar echinococcosis and mixed infections of cystic echinococcosis and alveolar echinococcosis were 1.72% (745/43 362), 1.98% (860/43 362) and 0.02% (8/43 362), respectively. The prevalence of human echinococcosis was higher in pastoral areas (4.13%, 1 577/38 149) than in semi-agricultural and semi-pastoral areas (0.69%, 36/5 213) (χ² = 151.82, P < 0.05); however, there was no significant difference in the prevalence between men (3.76%, 819/21 787) and women (3.68%, 794/21 575) (χ² = 0.19, P > 0.05). Cystic echinococcosis was the predominant type in students with echinococcosis (93.78%, 422/450), while alveolar echinococcosis was the predominant type in herders with echinococcosis (72.16%, 801/1 110). There was a significant difference in the constituent ratio of echinococcosis types between students and herders (χ² = 588.57, P < 0.05). In addition, higher prevalence of echinococcosis was detected in nomadic populations (4.58%, 1 008/22 021) than in community-dwelling populations (2.83%, 605/21 341) (χ² = 91.88, P < 0.05). The Echinococcus copro-antigen-positive rate was 0.19% (4/2 157) in owned dogs, and the detection rate of echinococcosis was 8.00% (16/200) in yaks and 3.10% (31/1 000) in rodents in 2019. Conclusions Echinococcosis is highly prevalent in Serthar County, Sichuan Province. Sustained management of source of Echinococcus infections, improved treatment of echinococcosis patients and timely health education for nomadic populations are recommended.

BACKGROUND:As a new kind of bone repair material, NovaBone has a unique biological activity and good biocompatibility. It has a good binding role in the clinical repair of bone defects, so as to effectively promote the bonding of soft tissue and bone tissue.
OBJECTIVE: To explore the clinical effect of NovaBone in the repair of bone defects due to limb fractures.
METHODS: Sixty-seven patients with bone defects due to limb fractures were enroled, 37 males and 30 females, aged 17-81 years. Al the patients underwent NovaBone repair. Three days after repair, routine blood test, heart and kidney function, serum complement C3, complement C4, immunoglobulin G, immunoglobulin A, immunoglobulin M were detected; 12 months after repair, X-ray observation was performed for bone graft fusion effect.
RESULTS AND CONCLUSION:Al patients presented with stage I healing, and there was no incision infection, rejection or non-specific inflammation. Patients felt no discomfort or developed symptoms in the bone graft region. Laboratory indexes showed no abnormity. At 12 months after treatment, bony union was seen in al patients, and there was 1 case of nonunion, 1 case of possible nonunion, 2 cases of uncertain nonunion, 33 cases of possible union, 30 cases of strong union, with a bone fusion rate of 94%. These findings suggest that NovaBone materials for repair of bone defect due to limb fractures have good biocompatibility and obtain good clinical effect.

This study is designed to test the agreement in measuring left ventricular systolic function between transthoracic two-dimensional echocardiography (2DTTE) and "gold standard" of non-invasive cardiac imaging, magnetic resonance imaging (CMRI) and their impacts on the classification of patients according to the left ventricular ejection fraction (EF). 32 patients who were suspected with heart disease were evaluated by CMRI and 2DTTE examinations. End diastolic volume (EDV), end systolic volume (ESV), EF and left ventricular function category were then calculated and compared. There was no significant difference (P=0.504) for EDV, while ESV of CMRI was significantly higher than that of 2DTTE (P=0.049), and EF of CMRI was significantly lower than that of 2DTTE (P= 0.018). There was no significant difference (P=0.077) in left ventricular functional category. Bland-Altman analysis of LV volumetric data and EF measurements showed a good agreement between two methods. The 2DTTE over-estimated I (n=5) or II (n=1) degrees of functional classification when compared with the CMRI. Both CMRI and 2DTTE are of great clinical value in evaluating left ventricular systolic function, while CMR may be more beneficial to patients with abnormal LV functions.
Adolescent ; Adult ; Aged ; Echocardiography ; Female ; Heart Diseases ; physiopathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Systole ; physiology ; Ventricular Function, Left ; physiology ; Young Adult

OBJECTIVETo explore the safety and short-term efficacy of laparoscopic transhiatal proximal gastrectomy in patients with adenocarcinoma of the esophagogastric junction.

METHODSFrom Aug 2008 to May 2011, 98 patients with adenocarcinoma of the esophagogastric junction underwent laparoscopic transhiatal proximal gastrectomy. Clinical data were analyzed retrospectively including operative time, estimated bleeding, length of resection, lymph node dissection, and short-term postoperative complications.

RESULTSNinety-six patients underwent laparoscopic transhiatal proximal gastrectomy successfully and 2 were converted to open operation (one for combined splenectomy and the other combined splenectomy and resection of the tail of the pancreas). The mean operative time was (224.1±33.7) min and the mean blood loss was (69.4±26.1) ml. The mean length of esophageal resection was (4.0±0.6) cm and the resection margin was negative. The number of lymph node removed was 16.4±5.7. Pleural laceration occurred in 14 cases and spleen injury occurred in 3 case during operation. There was one anastomotic leakage. There were no postoperative mortalities, bleeding, anastomotic stenosis and wound infection. After follow-up ranging from 3 to 30 months, the value of reflux diagnostic questionnaire (RDQ) was 9.9±4.4 at 1 month and 9.3±4.3 at 3 months postoperatively. No incision metastasis was found and 5 patients died.

CONCLUSIONLaparoscopic transhiatal proximal gastrectomy is safe for patients with adenocarcinoma of the esophagogastric junction and the short-term clinical outcomes are favorable.

Adenocarcinoma ; surgery ; Adult ; Aged ; Aged, 80 and over ; Esophagogastric Junction ; pathology ; Female ; Follow-Up Studies ; Gastrectomy ; methods ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome