OBJECTIVES: We propose a myocardial infarction (MI) detection and localization model for improving the diagnostic accuracy for MI to provide assistance to clinical decision-making. METHODS: The proposed model was constructed based on multi-scale field residual blocks fusion modified channel attention (MSF-RB-MCA). The model utilizes lead II electrocardiogram (ECG) signals to detect and localize MI, and extracts different levels of feature information through the multi-scale field residual block. A modified channel attention for automatic adjustment of the feature weights was introduced to enhance the model's ability to focus on the MI region, thereby improving the accuracy of MI detection and localization. RESULTS: A 5-fold cross-validation test of the model was performed using the publicly available Physikalisch-Technische Bundesanstalt (PTB) dataset. For MI detection, the model achieved an accuracy of 99.96% on the test set with a specificity of 99.84% and a sensitivity of 99.99%. For MI localization, the accuracy, specificity and sensitivity were 99.81%, 99.98% and 99.65%, respectively. The performances of the model for MI detection and localization were superior to those of other comparison models. CONCLUSIONS The proposed MSF-RB-MCA model shows excellent performance in AI detection and localization based on lead II ECG signals, demonstrating its great potential for application in wearable devices.
Myocardial Infarction/diagnosis* ; Humans ; Electrocardiography/methods* ; Signal Processing, Computer-Assisted ; Algorithms ; Sensitivity and Specificity

Objective:To explore the relationship between hematocrit, early fluid therapy, and clinical outcomes in patients with septic shock, and to provide evidence for fluid resuscitation therapy and prognosis assessment in these patients.Methods:The clinical information of patients with septic shock who were diagnosed and treated in the Emergency Intensive Care Unit (EICU) of the First Affiliated Hospital of Wenzhou Medical University from January 1, 2018 to December 31, 2020 were collected. Taking the survival or death of patients 28 days after admission as the end point of clinical research, the patients were divided into the survival and death groups. After analyzing the basic data of the two groups, the univariate and multivariate COX regression analyses were used to analyze the evaluation value of Δ Hematocrit (HCT) d2-d1 and ΔHCT d3-d1 on the prognosis of patients with septic shock. At the same time, the Kaplan-Meier survival curve was used to analyze the overall survival rate of patients with septic shock, and the smooth curve fitting graph was used to verify its relationship with net fluid intake and death. Results:There were 241 cases in the survival group and 67 cases in the death group. Univariate COX analysis showed statistically significant differences between the survival and death groups in acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) ( P=0.0006), red cell volume distribution width (RDW) ( P=0.0043), age ( P=0.0184), ΔHCT d2-d1 ( P=0.0136), ΔHCT d3-d1 ( P=0.0204), and white blood cell (WBC) ( P=0.0444). Multivariate COX analysis showed that ΔHCT d2-d1 ( P=0.0115) and ΔHCT d3-d1 ( P=0.0029) were independent risk factors for death in EICU patients with septic shock. ΔHCT d2-d1 and ΔHCT d3-d1 were divided into three groups according to the three-digit method. The Kaplan-Meier survival curve showed no significant difference among the three groups in the overall survival rate related to ΔHCT d2-d1 ( P=0.16), but there was a statistically significant difference in the overall survival rate among the three groups related to ΔHCT d3-d1 ( P=0.025). The smooth fitting curve of ΔHCT d3-d1, net fluid intake, and prognosis showed that ΔHCT d3-d1 was negatively correlated with net fluid intake, and the middle ΔHCT d3-d1 group had the best prognosis. Conclusions:The value of ΔHCT d3-d1 is related to the net fluid intake of patients with septic shock. An appropriate decrease in HCT on the third day can improve the prognosis of patients with septic shock. The dynamic changes of hematocrit can provide a certain basis for fluid resuscitation and prognosis evaluation in patients with septic shock.

Objective:To investigate the predictive value of the product of first plasmacolchicine concentration and poisoning time for the prognosis of colchicine poisoning patients, and to provide a basis for early prognosis assessment.Methods:October 2021, patients with colchicine poisoning admitted in the First Affiliated Hospitol of Wenzhou Medical University from January 2017 to September 2021 were collected, including general information such as patient gender, age, oral colchicine dose, poisoning time, the first laboratory test index andplasma colchicine concentration after admission. The patients were divided into survival group and death group according to their prognosis. The differences in clinical indicators such as admission plasma colchicine concentration, blood routine, blood biochemistry, coagulation function, and blood gas analysis were compared between the two groups, and their predictive value for the prognosis of patients were analyzed.Results:A total of 23 patients with colchicine poisoning, aged 20-85 years, were included in this study, of which 15 cases (65.22%) survived and 8 cases (34.78%) died. The first plasma colchicine concentration at admision were 0.42-53.61 ng/ml. The plasma colchicine concentration and the concentration-time product were 10.08-2147.04 h·ng/ml.Compared with the survival group, the plasma colchicine concentration and the concentration-time product in the death group were significantly increased, and the differences were statistically significant ( P<0.05). Univariate logistic regression analysis showed that first plasma concentration and poisoning time>132.48 h·ng/ml, high C-reactive protein, high D-dimer, high absolute value of BE were the risk factors for the prognosis of patients with colchicine poisoning ( OR=12.000, 95% CI: 1.1181-128.836; OR=1.053, 95% CI: 1.009-1.098; OR=1.219, 95% CI: 1.039-1.429; OR=1.360, 95% CI: 1.1.044-1.773; P<0.05). High prothrombin time activity was protective factor affecting the prognosis of colchicine poisoning patients ( OR=0.941, 95% CI: 0.892~0.993; P<0.05). ROC curve analysis showed that the areas under the curves of first plasma concentration and poisoning time, C-reactive protein, absolute value of BE, D-dimer for predicting the prognosis of patients with colchicine poisoning were 0.918, 0.888, 0.867, 0.837, respectively, and the areas under the curves of prothrombin time activityfor predicting the prognosis of patients with colchicine poisoning was 0.788 ( P<0.05) . Conclusion:The product of the first plasma colchicine concentration at admission and poisoning time is closely related to the prognosis of patients with colchicine poisoning, it can be used as a predictor for early evaluation of the prognosis of poisoned patients.

Objective:To investigate the predictive value of the product of first plasmacolchicine concentration and poisoning time for the prognosis of colchicine poisoning patients, and to provide a basis for early prognosis assessment.Methods:October 2021, patients with colchicine poisoning admitted in the First Affiliated Hospitol of Wenzhou Medical University from January 2017 to September 2021 were collected, including general information such as patient gender, age, oral colchicine dose, poisoning time, the first laboratory test index andplasma colchicine concentration after admission. The patients were divided into survival group and death group according to their prognosis. The differences in clinical indicators such as admission plasma colchicine concentration, blood routine, blood biochemistry, coagulation function, and blood gas analysis were compared between the two groups, and their predictive value for the prognosis of patients were analyzed.Results:A total of 23 patients with colchicine poisoning, aged 20-85 years, were included in this study, of which 15 cases (65.22%) survived and 8 cases (34.78%) died. The first plasma colchicine concentration at admision were 0.42-53.61 ng/ml. The plasma colchicine concentration and the concentration-time product were 10.08-2147.04 h·ng/ml.Compared with the survival group, the plasma colchicine concentration and the concentration-time product in the death group were significantly increased, and the differences were statistically significant ( P<0.05). Univariate logistic regression analysis showed that first plasma concentration and poisoning time>132.48 h·ng/ml, high C-reactive protein, high D-dimer, high absolute value of BE were the risk factors for the prognosis of patients with colchicine poisoning ( OR=12.000, 95% CI: 1.1181-128.836; OR=1.053, 95% CI: 1.009-1.098; OR=1.219, 95% CI: 1.039-1.429; OR=1.360, 95% CI: 1.1.044-1.773; P<0.05). High prothrombin time activity was protective factor affecting the prognosis of colchicine poisoning patients ( OR=0.941, 95% CI: 0.892~0.993; P<0.05). ROC curve analysis showed that the areas under the curves of first plasma concentration and poisoning time, C-reactive protein, absolute value of BE, D-dimer for predicting the prognosis of patients with colchicine poisoning were 0.918, 0.888, 0.867, 0.837, respectively, and the areas under the curves of prothrombin time activityfor predicting the prognosis of patients with colchicine poisoning was 0.788 ( P<0.05) . Conclusion:The product of the first plasma colchicine concentration at admission and poisoning time is closely related to the prognosis of patients with colchicine poisoning, it can be used as a predictor for early evaluation of the prognosis of poisoned patients.

Objective:To explore the effect of Dachengqi Decoction on the postoperative recovery of laparoscopic gastrectomy under general anesthesia.Methods:From March 2015 to May 2018, 96 patients with gastric cancer undergoing laparoscopic gastrectomy under general anesthesia in our hospital were selected as the study objects and divided into two groups according to the random number table method. The control group received routine nursing. The observation group received the intervention of Dachengqi Decoction with ultrasonic conductivity on the basis of the control group. The recovery of gastrointestinal function, the levels of gas (serum gastrin), MTL (plasma motilin) and Quality of Recovery 40 (QoR40) were compared between the two groups.Results:The gastrointestinal function indexes of the observation group were better than those of the control group ( P<0.05). Compared with one day before operation, the levels of gas and MTL in the two groups were lower 24 hours after operation, but the levels of GAS and MTL in the observation group were (92.56±5.12), (258.58±5.59) ng/L, which were higher than (52.12±3.15), (185.63±4.12) ng/L in the control group ( t values were 46.608, 72.782, P<0.01). Compared with the pre intervention group, QoR40 scores of the two groups were improved after intervention, and the observation group was (198.56±5.58) points, which was higher than (152.12±2.63) points of the control group ( t value was 52.157, P<0.01). Conclusion:Dachengqi Decoction can promote the recovery of patients after laparoscopic gastrectomy under general anesthesia.

Objective To investigate the influence of Simiao pill intervention on the life quality of patients with chronic pelvic inflammatory disease( CPID) . Methods Eighty-five cases of damp heat and blood stasis type of CPID were randomly divided into two groups:the treatment group( n=43) was treated with Simiao pill decoction combined with other Chinese herbs;the control group(n=42)was treated with Fuke Qianjin capsules.Three months after the treatment, clinical efficacy was evaluated and life quality was assessed by WHOQOL-BREF. Results The total effective rate was 90. 70% in the treatment group and 71.43% in the control group(P<0.05).Before the treatment, score of each dimension of WHOQOL-BREF in both groups was not significantly different(P>0.05).After the treatment, score of each dimension of WHOQOL-BREF in both groups were increased, and the total score was(104.21±6.67)in the treatment group and(89.60±7.31)in the control group(P<0.05). Conclusion Simiao pill decoction combined with other Chinese herbs can effectively treat damp heat and blood stasis type of CPID and improve the life quality of the patients.

AIM To study the influence of chronic stress on the level of CNTF and CNTF mRNA in hippocampal neurons of rats. METHODS The chronic stress model was established by chronic unpredictable mild stress, openfield test was performed to detect the behavior of rats. Immunohistochemistry and in situ hybridization were used to observe the level of CNTF and CNTF mRNA. RESULTS Compared to control group, the CNTF like immunoreactivity and signals of CNTF mRNA in situ hybridization in the hippocampal neurons of chronic stress group were significantly decreased. CONCLUSION These results show that chronic stress can significantly decrease the level of CNTF and CNTF mRNA in the hippocampal neurons of rats.

Objective:To elucidate the possible role of galanin in the development of experimental depression in rats. Methods:Openfield was performed to test the behavior of rats. The changes of the galanin level in different brain areas were determined by RIA. The effect of fluoxetine hydrochloride on galanin level were observed by intraperitoneal injection. Results:Compared to control group, the crossing times and rearing times decreased significantly in depressed rats, galanin level decreased remarkably in plasma, hypothalamus, hippocampus, forebrain, parietal lobe and temporal cortex of depressed rats. Intraperitoneal injection of fluoxetine hydrochloride obviously improved the depressed behavior in rats, increased the galanin level in the hippocampus and forebrain of depressed rats. Conclusion:Hippocampus and forebrain may be involved in the development of experimental depression and in the antidepressive effects of fluoxetine hydrochloride.