Polysomnography (PSG) monitoring is an important method for clinical diagnosis of diseases such as insomnia, apnea and so on. In order to solve the problem of time-consuming and energy-consuming sleep stage staging of sleep disorder patients using manual frame-by-frame visual judgment PSG, this study proposed a deep learning algorithm model combining convolutional neural networks (CNN) and bidirectional gate recurrent neural networks (Bi GRU). A dynamic sparse self-attention mechanism was designed to solve the problem that gated recurrent neural networks (GRU) is difficult to obtain accurate vector representation of long-distance information. This study collected 143 overnight PSG data of patients from Shanghai Mental Health Center with sleep disorders, which were combined with 153 overnight PSG data of patients from the open-source dataset, and selected 9 electrophysiological channel signals including 6 electroencephalogram (EEG) signal channels, 2 electrooculogram (EOG) signal channels and a single mandibular electromyogram (EMG) signal channel. These data were used for model training, testing and evaluation. After cross validation, the accuracy was (84.0±2.0)%, and Cohen's kappa value was 0.77±0.50. It showed better performance than the Cohen's kappa value of physician score of 0.75±0.11. The experimental results show that the algorithm model in this paper has a high staging effect in different populations and is widely applicable. It is of great significance to assist clinicians in rapid and large-scale PSG sleep automatic staging.
Humans ; Polysomnography ; China ; Sleep Stages ; Sleep ; Algorithms

Objective:A case-control association analysis was performed to investigate if the single nucleotide polymorphisms (SNPs) of N-cadherin(CDH2) gene is implicated in schizophrenia in a Han Chinese population.Methods:A total of 528 patients with paranoid schizophrenia and 528 healthy controls were recruited from northern Henan province to analyze 25 SNPs located in CDH2 gene.The clinical symptoms of 267 first-episode schizophrenia patients were evaluated with positive and negative syndrome scale (PANSS), and the correlation between CDH2 gene and clinical symptoms was analyzed by SNPStats software online.Results:Allele frequencies of rs9951577 and rs1231268 were significantly correlated with schizophrenia( P<0.05), genotype frequency of rs1639387 was significantly correlated with schizophrenia( P=0.044). After gender classification, SNPs rs1789470 and rs28365328 were found to be significantly correlated with schizophrenia in female patients ( P=0.044, 0.019). In addition, the study found that CDH2 was correlated with the clinical characteristics of schizophrenia( P<0.05), and the negative factor score of patients between GG type rs1231268 and the other two genotypes (AG+ AA) ((21.12±8.41) vs (18.87±7.52)) was statistically significant ( P<0.05). Conclusion:CDH2 gene may be one of the susceptibility genes to SZ, and has definite correlation with clinical negative symptoms.

BACKGROUND: Although newly formed constructs of feasible pressure-preadjusted bone marrow mesenchymal stem cells (BMSCs) and platelet-rich fibrin (PRF) showed biomechanical flexibility and superior capacity for cartilage regeneration, it is still not very clear how BMSCs and seed cells feel mechanical stimuli and convert them into biological signals, and the difference in signal transduction underlying mechanical and chemical cues is also unclear. METHODS: To determine whether mechanical stimulation (hydrostatic pressure) and chemical cues (platelet-rich fibrin, PRF) activate canonical or noncanonical Wnt signaling in BMSCs, BMSCs cocultured with PRF were subjected to hydrostatic pressure loading, and the activation of the Wnt signaling molecules and expression of cartilage-associated proteins and genes were determined by western blotting and polymerase chain reaction (PCR). Inhibitors of canonical or noncanonical Wnt signaling, XVX-939 or L690,330, were adopted to investigate the role of Wnt signaling molecules in mechanically promoted chondrogenic differentiation of BMSCs. RESULTS: Hydrostatic pressure of 120 kPa activated both Wnt/b-catenin signaling and Wnt/Ca2+ signaling, with the the maximum promotion effect at 60 min. PRF exerted no synergistic effect on Wnt/b-catenin signaling activation. However, the growth factors released by PRF might reverse the promotion effects of pressure on Wnt/Ca2+ signaling. Real-time PCR and Western blotting results showed that pressure could activate the expression of Col-II, Sox9, and aggrecan in BMSCs cocultured with PRF. Blocking experiment found a positive role of Wnt/b-catenin signaling, and a negative role of Wnt/ Ca2+ signaling in chondrogenic differentiation of the BMSCs. Mutual inhibition exists between canonical and noncanonical Wnt signaling in BMSCs under pressure. CONCLUSION Wnt signaling participates in the pressure-promoted chondrogenesis of the BMSCs co-cultured with PRF, with canonical and noncanonical pathways playing distinct roles during the process.

Objective: To explore the effects of exposure of pregnant rats to radio frequency electromagnetic field on the ultrastructure of hippocampus and the levels of obesity related protein (FTO) and nerve growth factor (NGF) in offspring rats. Methods: In September 2019, 36 healthy 7-week-old Wistar rats were selected, including 24 female rats (150-200 g) and 12 male rats (200-250 g) . The male and female mice were mated in the cage at 2: 1 ratio at 18: 00 every night. The smear results showed that the sperm was positive and the mating was successful. The day was regarded as the 0 day of pregnancy. Pregnant rats were randomly divided into 3 experimental groups and 3 control groups, with 4 rats in each group. The experimental group was exposed to 1 800 MHz, Wi-Fi and 1 800 MHz+Wi-Fi respectively, and the three control groups were exposed to virtual exposure. 12 hours a day for 21 days in three batches. After the end of exposure, the offspring of each group were raised for 7 weeks. The ultrastructural changes of the hippocampus were observed by transmission electron microscopy, the FTO level in the hippocampus was determined by Western blot, and the NGF level in the brain tissue was determined by ELISA. Results: Transmission electron microscopy showed that the nuclei of hippocampal tissue of female and male rats in the 1800 MHz group were slightly contracted, the cytoplasm was slightly edema, and the nuclei of male rats were obviously irregular. In the offspring of male and female rats in the Wi-Fi group, the nucleus of hippocampal tissue contracted seriously, the cell membrane was irregular, and the cytoplasm appeared obvious edema. In the 1800 MHz+Wi-Fi group, the nuclei of hippocampal tissue of both male and female offspring rats were severely contracted, the nuclear membrane was irregular, and the cytoplasm was severely edema. there was no significant difference in FTO level among the groups (P>0.05) . Compared with other groups, NGF content in hippocampus of offspring rats in the 1800 MHz+Wi-Fi group was significantly higher (P<0.05) . Conclusion: Exposure to radio frequency electromagnetic fields will damage the morphological structure of hippocampal tissue of offspring and stimulate the increase of NGF expression in the hippocampus.
Animals ; Electromagnetic Fields ; Female ; Hippocampus ; Male ; Mice ; Nerve Growth Factor ; Pregnancy ; Rats ; Rats, Wistar ; Semen

Pressure injury is a common problem faced by global health care institutions, which seriously threatens the lives and health of patients. The treatment and care of pressure injuries need people in multiple professional fields to work together. This article interprets the assessment and planning part of the clinical practice guideline for the third edition of " Assessment and Management of Pressure Injuries for the Interprofessional Team" developed by the Registered Nurses' Association of Ontario, Canada. This article aims at helping the interprofessional team conduct accurate, comprehensive, and full-process assessments of patients with pressure injuries, formulate a reasonable diagnosis and treatment plan, and providing a basis for the implementation of correct treatment measures, so as to promote the improvement and healing of pressure injuries.

Objective: To analyze the influencing factors of hospitalization cost by back propagation(BP)neural network. Methods: Inpatients with a total of 50 611 were collected from the hospital information system in a tertiary hospital. BP Neural network modeling was developed by SPSS 22.0 software to study the factors which influence the hospitalization cost. Results: The hospitalization expenses prediction accuracies of training sample and test sample were 81.1% and 79.0% respectively. The top three factors were pharmaceutical cost(100.0%), general medical operation cost(88.8%)and disposable medical materials cost(60.7%). Conclusions The results show that BP model is suitable for dependent variable with the hospitalization expenses. The pharmaceutical cost, disposable medical materials cost and general medical operation cost were greater influencing factors than others. We should take actions by improving the treatment level and measures, so as to reduce the economic burden of patients and society

Depleted uranium (DU) has been widely applied in industrial and military activities, and is often obtained from producing fuel for nuclear reactors. DU may be released into the environment, polluting air, soil, and water, and is considered to exert both radiological and chemical toxicity. In humans and animals, DU can induce multiple health effects, such as renal tubular necrosis and bone malignancies. This review summarizes the known information on DU's routes of entry, mechanisms of toxicity, and health effects. In addition, we survey the chelating agents used in ameliorating DU toxicity.
Animals ; Chelating Agents ; pharmacology ; Humans ; Inactivation, Metabolic ; Radiation-Protective Agents ; pharmacology ; Uranium ; metabolism ; toxicity

Objective Clinicians are very cautious on operationsof laparoscopic cholecystectomy(LC) in patients with cirrhosis because of its high risk.And few researches were carried out on this situation.This article aimed to summarize the LC in cirrhotic patients with cholecystolithiasis and cholecystitis, observe the clinical therapeutic effect and analyze the feasibility of this treatment.Methods The clinical data of 112 operation cases of cholecystolithiasis and cholecystitiswith cirrhosis were retrospectively analyzed from January 2012 to December 2015 in Department of General Surgery, Changzhou Third People's Hospital.According to different surgical methods, all patients were divided into laparoscopic cholecystectomy group (n=56) and open cholecystectomy group (n=56).Peroperative period indicators including operation time, intraoperative blood loss, Postoperative exhaust time, postoperative hospital stay and complications were recorded, data were analyzed to evaluate the clinical effect.Results Compared with open cholecystectomy group, laparoscopic cholecystectomy group had shorter operative time[(54.28±15.34)min vs (91.63±20.09)min,P=0.000];less intraoperative blood loss[(73.42±4.28)mL vs (98.54±7.16)mL,P=0.000], shorter Postoperative exhaust time and postoperative hospital stay(P=0.000).The complication incidence in laparoscopic cholecystectomy group were lower than that in open cholecystectomy group(7.14% vs 21.43%, P<0.05).Conclusion Operation of laparoscopic cholecystectomy on cirrhotic patients has a high clinical efficacy.It is safe and feasible to carry out such an operation on the basis of strict indication and reasonable risk assessment.

Objective To explore the value of the combination of personality responsibility theory and motivation theory in the evaluation of the ability of criminal responsibility of the patients with mental disorders. Methods A retrospective analysis of our hospital in 2013 and 2014 the implementation of identification of 101 cases of patients with mental disorders of the criminal responsibility, analysis indicators include: the reflection of the basic characteristics of personality; motive; identification of illegal behavior evaluation; the capacity of criminal responsibility. Results different symptoms reflects abnormal consistency and specificity of personality integrity; when the symptoms are not at the same time, with the implementation of the illegal behavior of the motivation also has realistic and non realistic differences; personality integrity can not damage the normal and correct evaluation of the illegal act, almost all favorable personality particularity of affected persons can recognize the illegality of the behavior; the integrality and consistency of the affected personality criminal responsibility were incomplete; special personality influence for full criminal responsibility. Conclusion The combination of personality responsibility theory and motivation theory is applied to the identification of the criminal responsibility ability of the patients with mental illness. To define the identity of the actor as the actor, to identify the patient's behavior is "not control" or "no control", it is worth promoting the application in the work of mental illness judicial identification.

Objective To explore the problems that should be paid attention to during the process of the identification of the mental illness of the judiciary.Methods The process and conclusion of 22 cases of forensic psychiatric expertise were reviewed and analyzed in the Department of psychiatric disorders,Beijing Anding Hospital,Capital Medical University from August 1,1982 to July 31,2016.The analysis indexes mainly include:(1) the time of the implementation of the identification;(2) the matters entrusted by the Commission;(3) the identification materials provided by the client;(4) the conclusion of the appraisal.Results (1) from July 31,1999 to August 1,1982,7 cases were identified from to August 1,1999,and 15 cases were identified from to July 31,2016.(2) from August 1,1982 to July 1999 31 during the day mainly identification issues for 6 cases (85.7％,6/7) mental state and the ability of criminal responsibility and 1 cases (14.3％,1/7) mental state and sexual self defensive ability,from August 1,1999 to July 2016 31 during the day in 15 cases of all matters for identification of mental state and civil capacity.(3) including the authentication materials provided by a client:Previous expert opinions and description of mental state of medical records,effective during the testimony of witnesses and / or detention,public security organs information records,audio-visual materials.(4) most of the identified people can be identified in the clinical diagnosis of mental illness and to determine the legal capacity,individual identification can not come to the conclusion.Conclusion The identification number and the difficulty of life;for his identification of civil capacity increased;should focus on ensuring the identification data of the authenticity,integrity,adequacy and validity;"conclusion" is also a kind of expert conclusion,it is suggested to use three cent method civil capacity rating was identified.