Objective:To evaluate the detection performance of left ventricular ejection fraction (LVEF) in patients with chronic renal failure (CRF) by an artificial intelligence (AI) model based on yolox framework integrating left ventricular segmentation and critical point detection.Methods:From January 2019 to June 2023, a total of 4 284 echocardiographic images of 2 000 adults aged 18-80 years without segmental wall motion abnormalities, structural heart disease, cardiac surgery or cardiomyopathy were collected in Henan Provincial People′s Hospital to delineate the endocardial membrane, as a training set, an AI model based on yolox framework integrating left ventricular segmentation and critical point detection was established. The images were divided into the training set( n=1 675) and the test set( n=325) in a ratio of about 5∶1. All 228 echocardiographic images of 100 normal adult volunteers who were treated in Henan Provincial Chest Hospital from May 2020 to May 2021 were collected as external test set validation. All 792 echocardiographic images of 204 patients treated in Henan Provincial People′s Hospital from April 2019 to June 2023 were continuously enrolled to evaluate the measurement efficiency of AI model. Spearman correlation statistical method was used to analyze the consistency of AI model measurement with manual measurement and TomTec software measurement methods of 3 senior echocardiographic professionals. Subjects were divided into clear image group, unclear image group, normal LVEF group and reduced LVEF group, the differences of general data between the two groups were compared. The correlation coefficient(ICC) within the group was calculated to analyze the consistency, so as to evaluate the model performance. Results:LVEF measured by AI model was significantly correlated with both manual measurement and TomTec model measurement ( rs=0.834, 0.826; all P<0.01). ICC values of the clear image group and the unclear image group were 0.96 and 0.97, respectively. ICC values for all subjects, normal LVEF group and reduced LVEF group were 0.96, 0.90 and 0.96, respectively. Conclusions:The AI model based on yolox framework integrating left ventricular segmentation and critical point detection has good diagnostic performance in the automatic measurement of LVEF in patients with CRF.

Objective: Autism spectrum disorder (ASD) is a neurodevelopmental disorder with onset in infancy. Early intervention is critical to improve the prognosis for these children. E-health interventions have tremendous potential. This review aimed to determine the status and effectiveness of family interventions for parents of children aged 0–6 years with ASD in the context of e-health. Methods: The review methodology was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. PubMed, Web of Science, and China National Knowledge Infrastructure were searched from inception to June 2022. The searches were limited to children with ASD of the age range between 0 and 6 years. We collated the available information and used descriptive statistics to analyze the synthesized data. Results: Our initial search identified 3,672 articles, of which 30 studies met the inclusion criteria. The 30 articles selected were released between 2012 and 2022. All articles are in English. Most articles reviewed were from high-income countries (27/30, 90.0%), especially from the United States (16/30, 53.3%). Four major themes emerged from the 30 studies that matched the inclusion criteria, as follows: 1) type of e-health interventions, 2) duration of interventions, 3) clinical aspects of e-health interventions, and 4) evidence for intervention effectiveness, looking into the positive, negative, and mixed findings of previous studies. Conclusion These findings suggest that a wide variety of e-health interventions may actually help support both children with ASD aged 0–6 years and their parents.

Objective:To investigate the effect of outpatient cardiac rehabilitation on the quality of life and lifestyle changes in patients with coronary heart disease.Methods:A total of 135 patients with coronary heart disease who received exercise rehabilitation in the Cardiac Rehabilitation Center of Second Hospital of Shanxi Medical University were enrolled in the study. Among them, 63 cases seldom attended (≤12 sessions, low-attending group), 37 cases less frequently attended (13-24 sessions, medium-attending group) and 35 cases attended frequently (≥25 sessions, high-attending group). The clinical data, cardiac rehabilitation, Seattle Angina Scale (SAQ) score and SF-36 quality of life score before and after rehabilitation, and lifestyle changes such as out-of-hospital exercise were documented and compared among the three groups.Results:Compared with baseline, the 5-dimensional scores of SAQ and the 9-dimensional scores of SF-36 (except for role-emotional and health change) were not significantly improved after cardiac rehabilitation in low-attending group ( P>0.05), while the angina stability, angina frequency, treatment satisfaction of SAQ, and bodily pain, health change of SF-36 in medium-attending group were improved ( P<0.05), and both SAQ and SF-36 in high-attending group were increased ( P<0.05). After cardiac rehabilitation, the SAQ and SF-36 scores of patients in high-attending group were significantly higher than those of patients in low-attending group ( P<0.05). The lifestyle was changed in 77.14%(27/35)patients of high-attending group, which was higher and that of low-attending group(38.10%, 24/63) (χ 2=13.74, P<0.001). Conclusion:The outpatient exercise rehabilitation can improve the quality of life and change lifestyle of patients with coronary heart disease; and the effect of rehabilitation is associated with the attending frequency.

Lymphatic leakage and lymphatic cysts are common complications after radical resection of middle- and high-risk prostate cancer. There are many treatment methods but the effect is not accurate. This article reports two patients who were diagnosed by lipiodol lymphangiography under ultrasound guidance and used a mixture of n-butyl cyanoacrylate and lipiodol to embolize lymphatic leakage. Among them, one patient achieved success after one session of interventional embolization. Another patient achieved success after 3 interventions and embolization. Two patients had no complications related to lymphatic interventional therapy, and no lymphatic leakage recurred during the 3-month follow-up. Ultrasound-guided lymphangiography and lymphatic embolization through the inguinal lymph nodes are a feasible option for the treatment of refractory lymphoma leakage

Objective:To summarize the experience of Bacillus Calmette-Guerin(BCG) in the treatment of bladder cancer secondary to renal transplantation.Methods:The clinical data of 5 patients who underwent BCG bladder irrigation after secondary bladder cancer after kidney transplantation in Tianjin First Central Hospital from January 2015 to December 2019 were analyzed. There were 1 male and 4 female cases. During the period of immunosuppression after transplantation, 1 case developed secondary high-level non-muscular invasive bladder cancer (NMIBC), 3 cases developed secondary low-grade NMIBC, and 1 case developed secondary glandular cystitis (4 cases). The mean age of the 5 patients with secondary bladder cancer was 59.7±4.0 years. Case one with high level NMIBC was treated with transurethral resection of bladder tumor (TURBT) and postoperative irrigation of epirubicin. Case 3 and 5 with low-level NMIBC accepted regular postoperative irrigation of gemcitabine. No irrigative therapy was performed in case 2. Bladder cancer recurred in case 1, 2, 3 and 5 after 20.1±9.7 months. TURBT was observed in all the 4 patients, among which 3 were of high grade NMIBC and 1 was of low grade NMIBC. Four patients were irrigated with BCG 2 weeks after operation. Postoperative pathology indicated low-level NMIBC in case 4, and BCG was irrigated 2 weeks after the operation. During perfusion therapy, immunosuppressive agents were continued.Results:During BCG perfusion, 4 of the 5 cases showed BCG related local inflammation, among which 2 cases presented symptoms of bladder irritation, 1 case presented hematuria, and 1 case presented hematuria with low fever. Patients with frequent urination, pain in urine, hematuria and other symptoms improved after drinking plenty of water, taking bed rest and taking levofloxacin (0.5g/ day ×7 days). Patients with low fever were treated with antipyretic treatment. No antituberculous agents were used prophylactically during BCG perfusion. There were no symptoms of tuberculosis infection or sepsis. The function of transplantated kidney was normal and no tendency of rejection. The 5 patients were followed up for 7-24 months, 1 patient was lost to follow-up after 7 months of BCG bladder perfusion, and no tumor recurrence or metastasis was found in 5 patients during the follow-up.Conclusions:The use of immunosuppressive agents does not reduce the biological activity of BCG, and BCG does not increase the risk of systemic toxicity or affect the function of transplanted kidneys in immunocompromised patients. BCG is a treatment option for bladder cancer secondary to renal transplantation.

OBJECTIVE：To systematically evaluate therapeutic efficacy and safety of Breviscapine injection combined with routine treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD），and to provide evidence-based reference for clinical drug use. METHODS ：Retrieved from Cochrane Library ，PubMed，Embase，CBMdisc，CNKI，VIP and Wanfang database ，randomized controlled trials （RCTs）about Breviscapine injection combined with routine treatment （trial group ） versus routine treatment （control group ）in the treatment of AECOPD were collected. After literature screening and data extraction ， the qualities of literatures were evaluated with modified Jadad scale ；Meta-analysis was performed by using Rev Man 5.2 statistical software. RESULTS ：A total of 19 RCTs were included ，involving 1 930 patients. Results of Meta-analysis showed that total response rate [OR ＝2.80，95％ CI （1.96，4.01），P＜0.000 01]，FEV1[MD＝0.65，95％ CI（0.57，0.72），P＜0.000 01]， FEV1％[MD＝5.33，95％CI（0.31，10.35），P＝0.04]，FVC[MD＝0.69，95％CI（0.23，1.16），P＝0.004]， FEV1/FVC [MD ＝ 4.83，95％CI（0.98，8.67），P＝0.01]，PEF [M D＝0.95，95％CI （0.57，1.33），P＜0.001]，PaO2 [MD＝4.70，95％CI（2.02， No.81402991） + 7.37），P＜0.001]，CD3 level [MD ＝5.11，95％ CI（3.04， 7.18），P＜0.001] and CD 4+ level [MD ＝2.62，95％CI（1.78， qq.com 3.47），P＜0.001] of trial group were significantly higher than those of control group ；PaCO2 [MD＝－3.33，95％CI（－5.02， －1.65），P＜0.001]，CD8+ level [MD ＝－2.55，95％CI（－4.28，－0.82），P＜0.004]，cough relief time [MD ＝－1.93，95％CI （－2.24，－1.63），P＜0.001]，sputum remission time [MD ＝－2.19，95％CI（－2.48，－1.89），P＜0.001]，wheezing remission time [MD ＝－1.59，95％CI（－1.86，－1.32），P＜0.001] and hospital stay [MD ＝－1.73，95％CI（－2.06，－1.39），P＜0.001] of trial groups were significantly lower or shorter than those of control group ；there was no statistical significance in CD 4+/CD8+ between 2 groups [MD ＝－0.11，95％CI（－0.23，0.01），P＝0.06]. In terms of safety ，3 studies reported the occurrence of ADR ， and no serious ADR occurred. CONCLUSIONS ：Breviscapine injection can improve clinical efficacy and lung function ，enhance immunity in patients with AECOPD with good safety.

BACKGROUND: Inducing factors are currently used as a main method for the differentiation of bone marrow mesenchymal stem cells (BMSCs) into chondrocytes. OBJECTIVE: To investigate the collaborative stimulation of transforming growth factor beta1 (TGF-β1) and insulin-like growth factor 1 (IGF-1) to induce the directed differentiation of BMSCs to chondrocytes, and to explore the best inductive effect. METHODS: Rat BMSCs were isolated, cultured and purified using adherent culture. Then, different inducing factors were added in the induction medium: TGF-β1+IGF-1 group, TGF-β1 group, IGF-1 group, and control group without growth factors. Immunofluorescence was carried out at 21 days of induction. The expression of collagen type Ⅱ was evaluated by immuncytochemical staining at 7, 14 and 21 days of induction. RESULTS AND CONCLUSION: (1) Immunofluorescence detection of the TGF-β1+IGF-1 and TGF-β1 groups showed highly expressed collagen type Ⅱ (brown red-stained cytoplasm), while negatively expressed collagen type Ⅱ in the other two groups. (2) Findings from the immuncytochemical staining showed that the expression of collagen type Ⅱ was stronger in the TGF-β1+IGF-1 group than the TGF-β1 group (P < 0.01), and the expression was gradually enhanced with time. Meanwhile, there was also no expression of collagen type Ⅱ in the IGF-1 and control groups. To conclude, the combination of TGF-β1 and IGF-1 can achieve the better inductive effect on the chondrogenic differentiation of BMSCs in vitro.

BACKGROUNDHigh rate of in-stent restenosis (ISR) remained an unsolved clinical problem in clinical practice, especially among patients with diabetes mellitus (DM). Diabetic patients often had hypertriglyceridemia with elevated levels of very low-density lipoprotein cholesterol (VLDL-C). Increasing evidence suggested that VLDL-C was known as a significant risk factor for atherosclerosis and had been recommended as a treatment target by current dyslipidemia guidelines. However, the role of VLDL-C in the occurrence and development of ISR in coronary artery disease (CAD) patients with DM had not been studied. The aim of this study was to evaluate the association between the elevated levels of VLDL-C and the risk of ISR in CAD patients with DM.

METHODSA total of 1390 diabetic patients, who underwent coronary drug-eluting stent (DES) implantation at Beijing Anzhen Hospital and followed up by angiography within 6-24 months, were consecutively enrolled. Patients' demographic and clinical characteristics, including age, gender, CAD risk factors, family history, life style, medical history, and coronary angiographic information, were collected carefully at baseline percutaneous coronary intervention and follow-up angiography. Multivariate Cox's proportional hazards regression modeling using the step-wise method (entry, 0.05; removal, 0.05) was used to determine the independent risk associated with ISR in diabetic patients.

RESULTSFinally, 1206 of patients were included in this study. ISR occurred in 132/1206 diabetic patients (10.9%) by follow-up angiography. Patients with ISR had elevated median serum VLDL-C levels compared with those without ISR (0.65 mmol/L vs. 0.52 mmol/L, P = 0.030). The multivariate regression analysis showed that VLDL-C was significantly associated with the risk of ISR in diabetic CAD patients (hazard ratio [HR] = 1.15, 95% confidence interval [CI]: 1.03-1.29, P = 0.017). The HR for the risk of ISR associated with VLDL-C level ≥0.52 mmol/L was 3.01 (95% CI: 1.24-7.34, P = 0.015).

CONCLUSIONThe elevated level of serum VLDL-C was a significant and independent risk factor for ISR in diabetic CAD patients after coronary DES implantation.

Objective To discuss the influences of fasting on the embolism adverse reactions, sense of hunger, blood amylase, blood glucose and anxiety of patients with hemoptysis of pulmonary tuberculosis after embolism operation. Methods Selected 92 cases of patients with hemoptysis of pulmonary tuberculosis who have taken bronchial artery embolism in Pulmonary hospital of Changsha central hospital from June 2014 to December 2015,randomly divided the patients into three groups according to operating date, namely, the non-fasting group, 6h fasting group and 24h fasting group. The non-fasting group have routine diet after the operation; the 6h fasting group and 24h fasting group respectively fasted for 6 hours and 24 hours. Then compared the embolism adverse reactions, sense of hunger, blood amylase, blood glucose and anxiety of the patients in the three groups so as to check whether there is difference. Results Before operation, there was not significant difference in adverse reaction of embolism, sense of hunger, anxiety, blood glucose and amylase between the three groups (P > 0.05). After operation, there was significant difference in hunger sense of difference between the three groups(F=13.308,P<0.05), the hunger sense of 24 h fasting group was more serious than 6h fasting group than non-fasting group;the anxiety score of 24h fasting group is higher than the other two(F=6.509,P<0.05), and the value of the next morning fasting blood glucose in fasting group 24h is higher than other two(F=6.642,P<0.050). comparing the score of anxiety in 6h fasting group and non-fasting group, there was not significant difference, and comparing the post-embolism adverse reaction, 72 h blood amylase of all three groups and these groups one to one, there was also not significant difference ( P>0.05). Conclusion Fasting will cause and intensify the sense of hunger, anxiety and nutrition disorder of patients with hemoptysis of pulmonary tuberculosis after embolism.

Background: High rate of in?stent restenosis (ISR) remained an unsolved clinical problem in clinical practice, especially among patients with diabetes mellitus (DM). Diabetic patients often had hypertriglyceridemia with elevated levels of very low?density lipoprotein cholesterol (VLDL?C). Increasing evidence suggested that VLDL?C was known as a significant risk factor for atherosclerosis and had been recommended as a treatment target by current dyslipidemia guidelines. However, the role of VLDL?C in the occurrence and development of ISR in coronary artery disease (CAD) patients with DM had not been studied. The aim of this study was to evaluate the association between the elevated levels of VLDL?C and the risk of ISR in CAD patients with DM. Methods: A total of 1390 diabetic patients, who underwent coronary drug?eluting stent (DES) implantation at Beijing Anzhen Hospital and followed up by angiography within 6–24 months, were consecutively enrolled. Patients' demographic and clinical characteristics, including age, gender, CAD risk factors, family history, life style, medical history, and coronary angiographic information, were collected carefully at baseline percutaneous coronary intervention and follow?up angiography. Multivariate Cox's proportional hazards regression modeling using the step?wise method (entry, 0.05; removal, 0.05) was used to determine the independent risk associated with ISR in diabetic patients. Results: Finally, 1206 of patients were included in this study. ISR occurred in 132/1206 diabetic patients (10.9%) by follow?up angiography. Patients with ISR had elevated median serum VLDL?C levels compared with those without ISR (0.65 mmol/L vs. 0.52 mmol/L, P = 0.030). The multivariate regression analysis showed that VLDL?C was significantly associated with the risk of ISR in diabetic CAD patients (hazard ratio [HR] = 1.15, 95% confidence interval [CI]: 1.03–1.29, P = 0.017). The HR for the risk of ISR associated with VLDL?C level ≥0.52 mmol/L was 3.01 (95% CI: 1.24–7.34, P = 0.015). Conclusion: The elevated level of serum VLDL?C was a significant and independent risk factor for ISR in diabetic CAD patients after coronary DES implantation.