Objective To explore the cut-off value of three dimensional(3D)vena contracta area(VCA)in diagnosing severe tricuspid regrugitation(TR)under different etiologies and its accuracy and practicality in clinical application.Methods From Mar 2019 to May 2021,ninety-two patients with confirmed TR underwent two dimensional(2D)and 3D transthoracic echocardiography.The correlation and consistency between 3D VCA 3D calculated based on the proximal isokinetic surface area(PISA)effective regurgitant orifice area(EROA)was calculated.Comprehensive 2D multi-parameter method was used as a reference method to calculate the cut-off value of the diagnosis of severe TR.Results A total of 85 patients were ultimately included.3D VCA and 3D PISA EROA had similar and acceptable correlations in both primary TR and secondary TR(primary TR:r=0.831,P<0.01;secondary TR:r=0.806,P<0.01).Bland-Altman analysis showed that 3D VCA overestimated TR compared with 3D PISA EROA(62%overestimated in the total patient population,51%overestimated in primary TR,and 74%overestimated in secondary TR).In secondary TR,the cut-off value of 3D VCA for diagnosing severe TR was 0.45 cm2(sensitivity 89%,specificity 82%);combining clinical symptoms,positive 2D PISA EROA results and 3D VCA results for severe TR,the chi-square value was higher than those only included clinical symptoms or incorporated clinical symptoms and positive 2D PISA EROA results(42.168 vs.26.059 and 16.759,P<0.01).Conclusion 3D VCA would overestimate TR,and had high and incremental diagnostic value for evaluating severe TR in secondary TR.

Infrared spectroscopy technology has many advantages such as high efficiency and non-destructiveness,and has an important research and application value in the field of petroleum pollutant classification and detection.In this study,a petroleum pollutant classification method by combing the discrete wavelet transform(DWT)algorithm and a one-dimensional convolutional neural network based on the Inception module(Inception-1D-CNN)was proposed.Firstly,the DWT algorithm was used to denoise the original infrared spectral data to eliminate the interference information caused by experimental environment,instrument error and manual operation.Then,the inception-1D-CNN model was used to obtain multi-scale infrared spectroscopy feature information,and then classify the petroleum pollutants.Experimental results showed that compared with preprocessing methods such as standard normal variable(SNV),adaptive iteratively reweighted penalized least squares(AirPLS),and Savitzky-Golay smoothing(S-G),the prediction accuracy of the DWT algorithm combined with the 1D-CNN model with a convolutional kernel size of 3×1 was 86.6%,which was 6.6%,6.6%and 3.3%higher,respectively.The prediction accuracy of DWT algorithm combined with 1D-CNN model with a convolutional kernel size of 5×1 was 93.3%,which was 10.0%,7.0%and 3.3%higher,respectively.The prediction accuracy of the DWT algorithm combined with the 1D-CNN model with a convolutional kernel size of 7×1 was 90.0%,which was 6.7%,10.0%and 3.4%higher,respectively.The prediction accuracy of the DWT algorithm combined with the inception-1D-CNN model was 100.0%,which was 10.0%,10.0%and 3.4%higher,respectively.Therefore,the DWT algorithm combined with the inception-1D-CNN model could accurately classify and predict petroleum pollutants,and provided a certain basis for the subsequent treatment of oil spills on the sea surface.

Objective To investigate the dynamic changes of left ventricular longitudinal systolic function in patients with atrial septal defect(ASD)and pulmonary hypertension(PH)before and after interventional occlusion using echocardiography.Methods A total of 57 patients undergoing interventional occlusion in Zhongshan Hospital,Fudan University from September 2015 to January 2016 were enrolled.Patients were divided into PH group and non-PH group.Echocardiographic examinations were performed for all subjects one day before,one day after and 1-6 months after the interventional occlusion.Twenty healthy individuals were included as a control group.Global and regional longitudinal strain(LS)of the left ventricle were analyzed using TomTec software.Results There were 27 patients in the PH group and 30 patients in the non-PH group.At baseline,tricuspid annular plane systolic excursion(TAPSE)and tissue Doppler velocity of tricuspid annulus S'in both the PH and non-PH groups were higher than those in the control group(P＜0.05).Longitudinal systolic function of the right ventricle decreased significantly on the first day after occlusion(P＜0.05),and slightly increased 1-6 months after occlusion.Patients in the non-PH group showed a decreased LS in a small portion of the left ventricular segments 1 d and 1-6 months after occlusion(P＜0.05);patients in the PH group showed a decreased left ventricular global longitudinal strain(GLS)on the first day after occlusion(P＜0.05),primarily was in the basal and middle parts of the ventricle(P＜0.05),without significant change in the apical part,and the LS of the left ventricle tended to increase 1-6 months after occlusion.Conclusions With or without PH,longitudinal movement of the right ventricle in ASD patient is excessive before occlusion,and gradually improves after occlusion.Left ventricular GLS decreases in ASD patients with PH,with segmental differences 1 day after occlusion.

The teaching effect of "process management and evaluation" was assessed in resident standardization training plan in acupuncture-moxibustion department of hospital for postgraduates of non-acupuncture-moxibustion speciality. A total of 120 postgraduates of non-acupuncture-moxibustion speciality participating in resident standardization training were randomized into an observation group (60 cases) and a control group (60 cases, 1 case dropped off). In the control group, the conventional training mode was used. In the observation group, the "process management and evaluation" was adopted, in which, the syllabus was refined, various teaching modes were cooperated and the summary was conducted once a week. The training results were evaluated at the end of 1-month shift test and questionnaire was issued in all of the postgraduates of the two groups. In the observation group, the score for theory and the score of each of the items for technical ability, named differentiation and treatment, technical manipulation and physician-patient communication, as well as the total score were all higher than the control group successively (
Acupuncture ; Acupuncture Therapy ; Hospitals ; Humans ; Moxibustion ; Reference Standards

Objective:To compare the clinical efficacy of rehabilitation training at different stages on patients with anterior talofibular ligament injury after conservative treatment. Methods:From October 2017 to October 2018, 58 patients with anterior talofibular ligament injury were divided into six-week rehabilitation group (n = 29) and twelve-week rehabilitation group (n = 29), according to the time they began rehabilitation after injury. Visual Analogue Score (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot function scoring system were used to evaluate ankle function before rehabilitation, and two weeks, four weeks and eight weeks after rehabilitation, respectively. Results:Two weeks, four weeks and eight weeks after rehabilitation, the scores of VAS and AOFAS improved in both groups (|t| > 4.137, P < 0.001), the scores of VAS were lower (|t| > 3.110, P < 0.01), and the scores of AOFAS were higher (|t| > 3.016, P < 0.01) in the six-week rehabilitation group than in the twelve-week rehabilitation group. Conclusion:It is suggested to begin rehabilitation within six weeks for patients with anterior talofibular ligament injury after conservative treatment.

BACKGROUND: Three-dimensional finite element analysis has been used by many scholars from department of orthopedics, but the results of postoperative evaluation of hip preserving treatment for osteonecrosis of femoral head are different. OBJECTIVE: To study the biomechanical changes of the femoral head and the biomechanical changes of the proximal femur after greater trochanter bone flap for the treatment of femoral head necrosis using three-dimensional finite element method, and to verify the mechanical safety and effectiveness. METHODS: One case of unilateral femoral head necrosis in ARCOIII stage undergoing parallel vascularized greater trochanter bone flap transplantation was selected. Computed Tomography data of proximal femur were collected before and 6 months after the operation, and preserved in DICOM format. With the aid of computer technology, professional medical modeling software, MIMICS and HYPERMESH, were used to establish the three-dimensional geometric models of the proximal femur. These models were divided into normal group, necrosis group and repair group. Finite element analysis software ANSYS was utilized to simulate human body standing and movement in different situations. The model was divided by free mesh, and given material parameters to establish normal proximal femur, femoral head necrosis and bone defect. Greater trochanter bone flap was applied in repairing three-dimensional finite element model of bone defect. Loads were loaded on different finite element models. The maximum displacement of the femoral head and the stress distribution in the proximal femur of the three groups were observed under different loading models. RESULTS AND CONCLUSION: (1) Under the same load, the maximum displacement of the three sets of models was 0.61 mm in the normal group, 0.66 mm in the necrosis group, and 0.61 mm in the repair group, respectively. Maximum Von Mises stress was greater in necrosis model than in the normal molding. The maximum Von Mises stress gradually decreased in the repair model, and was close to normal value. (2) Three groups of models showed stress concentration above the rotor in femoral neck region. The maximum stress in the trochanteric position was higher in necrosis models than in normal models. The maximum stress in this region gradually increased after repair, but was still lower than the failure stress of bone. (3) The results confirm that the maximum stress and the maximum displacement are closer to the normal value after greater trochanter bone flap for treatment of osteonecrosis of the femoral head. The greater trochanter is safe and reliable for repairing bone defect of femoral head.

Phenolics, as the main bioactive compounds in tea, have been suggested to have potential in the prevention of various human diseases. However, little is known about phenolics and their bioactivity in Zhangping Narcissue tea cake which is considered the most special kind of oolong tea. To unveil its bioactivity, three phenolic-enriched extracts were obtained from Zhangping Narcissue tea cake using ethyl acetate, n-butanol, and water. Their main chemical compositions and in vitro bioactivity were analyzed by high-performance liquid chromatography (HPLC) and ultra-performance liquid chromatography-mass spectrometry (UPLC-MS). The ethyl acetate fraction (ZEF) consisted of higher content of phenolics, flavonoids, procyanidins, and catechin monomers (including epigallocatechin gallate (EGCG), epicatechin gallate (ECG), and gallocatechin gallate (GCG)) than n-butanol fraction (ZBF) and water fraction (ZWF). ZEF exhibited the strongest antioxidant capacity in vitro due to its abundant bioactive compounds. This was validated by Pearson correlation and hierarchical clustering analyses. ZEF also showed a remarkable inhibition on the growth, migration, and invasion of 4T1 murine breast cancer cells.
Animals ; Antineoplastic Agents, Phytogenic/pharmacology* ; Antioxidants/pharmacology* ; Camellia sinensis/chemistry* ; Cell Line, Tumor ; Cell Movement/drug effects* ; Cell Proliferation/drug effects* ; Female ; Mammary Neoplasms, Experimental/pathology* ; Mice ; Neoplasm Metastasis ; Phenols/pharmacology* ; Plant Extracts/pharmacology*

BACKGROUNDThe emergency department (ED) has a pivotal influence on the management of acute heart failure (AHF), but data concerning current ED management are scarce. This Beijing AHF Registry Study investigated the characteristics, ED management, and short- and long-term clinical outcomes of AHF.

METHODSThis prospective, multicenter, observational study consecutively enrolled 3335 AHF patients who visited 14 EDs in Beijing from January 1, 2011, to September 23, 2012. Baseline data on characteristics and management were collected in the EDs. Follow-up data on death and readmissions were collected until November 31, 2013, with a response rate of 92.80%. The data were reported as median (interquartile range) for the continuous variables, or as number (percentage) for the categorical variables.

RESULTSThe median age of the enrolled patients was 71 (58-79) years, and 46.84% were women. In patients with AHF, coronary heart disease (43.27%) was the most common etiology, and myocardium ischemia (30.22%) was the main precipitant. Most of the patients in the ED received intravenous treatments, including diuretics (79.28%) and vasodilators (74.90%). Fewer patients in the ED received neurohormonal antagonists, and 25.94%, 31.12%, and 33.73% of patients received angiotensin converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers, and spironolactone, respectively. The proportions of patients who were admitted, discharged, left against medical advice, and died were 55.53%, 33.58%, 7.08%, and 3.81%, respectively. All-cause mortalities at 30 days and 1 year were 15.30% and 32.27%, respectively.

CONCLUSIONSSubstantial details on characteristics and ED management of AHF were investigated. The clinical outcomes of AHF patients were dismal. Thus, further investigations of ED-based therapeutic approaches for AHF are needed.

OBJECTIVETo investigate the occupational exposure levels of dust in new suspension preheated dry process (NSP) cement production line and put forward rectification measures for dust-exposed posts, and to provide ideas for the modern cement production enterprises in dust control and occupational health management.

METHODSOccupational health field investigation combined with field test were used to measure the time-weighted average concentration (C(TWA)) of the dust in the workplace. Rectification measures were taken for the dust-exposed posts with unqualified dust concentration, and the protective effects of dustproof facilities in the rectified workplace were evaluated.

RESULTSThe field investigation revealed incompletely closed dustproof facilities, improperly set dust hoods, excess of dust leakage points, and other problems in the dust-exposed posts of an NSP cement production line before rectification, and the dustproof facilities could hardly exert dust removal effect. The field test showed that the vast majority of dust-exposed posts had the dust concentrations exceeding the occupational exposure limits (OELs), with a qualified rate as low as 31.8%. A series of rectification measures were taken for these posts. After the rectification, the dust-exposed posts demonstrated dramatically dropped C(TWA), and the qualified rate of dust concentration in the dust-exposed posts rose to 90.9%.

CONCLUSIONThe dust hazards in NSP cement production line cannot be ignored. Taking appropriate protective measures are critical for curbing dust hazards in modern cement production.

Air Pollutants, Occupational ; analysis ; Construction Materials ; Dust ; analysis ; Humans ; Occupational Exposure ; analysis ; prevention & control ; Workplace

OBJECTIVETo examine the age, sex, and hemispheric differences in volume of the striatum by MRI in healthy adults.

METHODSThe volumes of the bilateral caudate nucleus and putamen were measured on MR images in 100 healthy right-handed adults (18-70 y).

RESULTSThe volume of bilateral caudate nucleus and putamen in healthy adults was (8.42 +/-0.88) cm(3) and (8.90 +/-0.89) cm(3), which were decreased with aging (for caudate nucleus r=-0.727, P<0.001; for putamen r=-0.709, P<0.001). The average annual shrinkage rate was 0.52 % in the caudate nucleus and 0.50 % in the putamen. There were no gender differences in the volume of the striatum, however, the age-related shrinkage of the striatum was more evident in men than that in women. The volume of the left caudate nucleus (t=4.43, P<0.001) and the putamen (t=4.88, P<0.001) was greater than that of its right counterpart.

CONCLUSIONBilateral age-related shrinkage of the striatum is found in healthy adults, which is more evident in men than that in women. In both sexes, significant leftward asymmetry in volume of the caudate nucleus and the putamen is found.

Adolescent ; Adult ; Age Factors ; Aged ; China ; Corpus Striatum ; anatomy & histology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Reference Values ; Sex Factors ; Young Adult