The setting and adjustment of ventilator parameters need to rely on a large amount of clinical data and rich experience. This paper explored the problem of difficult decision-making of ventilator parameters due to the time-varying and sudden changes of clinical patient's state, and proposed an expert knowledge-based strategies for ventilator parameter setting and stepless adaptive adjustment based on fuzzy control rule and neural network. Based on the method and the real-time physiological state of clinical patients, we generated a mechanical ventilation decision-making solution set with continuity and smoothness, and automatically provided explicit parameter adjustment suggestions to medical personnel. This method can solve the problems of low control precision and poor dynamic quality of the ventilator's stepwise adjustment, handle multi-input control decision problems more rationally, and improve ventilation comfort for patients.
Humans ; Ventilators, Mechanical ; Respiration, Artificial ; Neural Networks, Computer

OBJECTIVE: To investigate the synergistic interaction between the deltoid muscle and the rotator cuff muscle group in patients with rotator cuff tears (RCT), as well as the impact of the critical shoulder angle (CSA) on deltoid muscle strength. METHODS: A retrospective analysis was conducted on clinical data from 42 RCT patients who met the selection criteria and were treated between March 2022 and March 2023. There were 13 males and 29 females, with an age range of 42-77 years (mean, 60.5 years). Preoperative visual analogue scale (VAS) score was 6.0±1.6. CSA measurements were obtained from standard anteroposterior X-ray films before operation, and patients were divided into two groups based on CSA measurements: CSA>35° group (group A) and CSA≤35° group (group B). Handheld dynamometry was used to measure the muscle strength of various muscle group in the shoulder (including the supraspinatus, infraspinatus, subscapularis, and anterior, middle, and posterior bundles of the deltoid). The muscle strength of the unaffected side was compared to the affected side, and muscle imbalance indices were calculated. Muscle imbalance indices between male and female patients, dominant and non-dominant sides, and groups A and B were compared. Pearson correlation analysis was used to examine the relationship between muscle imbalance indices and CSA as well as VAS scores. RESULTS: Muscle strength in all muscle groups on the affected side was significantly lower than on the unaffected side ( P<0.05). The muscle imbalance indices for the supraspinatus, subscapularis, infraspinatus, and anterior, middle, and posterior bundles of the deltoid were 14.8%±24.4%, 5.9%±9.7%, 7.2% (0, 9.1%), 17.2% (5.9%, 26.9%), 8.3%±21.3%, and 10.2% (2.8%, 15.4%), respectively. The muscle imbalance indices of the anterior bundle of the deltoid, supraspinatus, and infraspinatus were significantly lower in male patients compared to female patients ( P<0.05); however, there was no significant difference in muscle imbalance indices among other muscle groups between male and female patients or between the dominant and non-dominant sides ( P>0.05). There was a positive correlation between the muscle imbalance indices of infraspinatus and VAS score ( P<0.05), and a positive correlation between CSA and the muscle imbalance indices of middle bundle of deltoid ( P<0.05). There was no correlation between the muscle imbalance indices of other muscle groups and VAS score or CSA ( P>0.05). Preoperative CSA ranged from 17.6° to 39.4°, with a mean of 31.1°. There were 9 cases in group A and 33 cases in group B. The muscle imbalance indices of the anterior bundle of the deltoid was significantly lower in group A compared to group B ( P<0.05), while there was no significant difference in muscle imbalance indices among other muscle groups between group A and group B ( P>0.05). CONCLUSION Patients with RCT have a phenomenon of deltoid muscle strength reduction, which is more pronounced in the population with a larger CSA.
Male ; Female ; Humans ; Adult ; Middle Aged ; Aged ; Shoulder ; Rotator Cuff Injuries/surgery* ; Shoulder Joint/diagnostic imaging* ; Rotator Cuff/surgery* ; Muscle Strength ; Deltoid Muscle

Objective:To establish and evaluate a new diagnostic model for significant liver tissue damage in patients with chronic hepatitis B virus (HBV) infection in the immune tolerance phase.Methods:The clinical data of 275 chronic HBV infection patients in the immune tolerance phase who underwent liver biopsy from January 2015 to November 2020 in the Hwa Mei Hospital, University of Chinese Academy of Sciences were included. According to the liver pathological changes, patients were divided into

Objective:To investigate the relationship between autophagy and nuclear factor E2 related factor 2(Nrf2) signaling pathway during high glucose-induced damage to Schwann cells.Methods:RSC96 were cells cultured in vitro and seeded in 96-well plates (1×10 4 cells/ml, 200 μl/well) or in 6-well plates (1×10 6 cells/ml, 2 ml/well) for 48 h. The cells were divided into 3 groups ( n=25 each) using a random number table method: control group (group C), high glucose group (group H) and high glucose+ autophagy agonist rapamycin group ( group H+ RAP). The cells were cultured in the common culture medium in group C. In group H, 50 mmol/L of glucose was added to the culture medium.In group H+ RAP, 50 mmol/L of glucose and 5 μmol/L rapamycin were added to the culture medium.At 48 h of incubation, the growth of cells was observed with inverted phase contrast microscope, the cell viability was measured using MTT method, apoptosis rate was determined by flow cytometry, malondialdehyde (MDA) content was determined by thiobarbituric acid method, superoxide dismutase (SOD) activity was detected using xanthine oxidase method, and the expression of Nrf2, P62 and microtubule-associated protein 1 light chain 3 Ⅱ (LC3 Ⅱ) was determined by Western blot. Results:Compared with group C, the cell viability and SOD activity were significantly decreased, apoptotic rate and MDA content were increased, and expression of Nrf2, P62 and LC3Ⅱ was up-regulated in group H and group H+ RAP ( P<0.05). Compared with group H, the cell viability and SOD activity were significantly increased, apoptosis rate and MDA content were decreased, the expression of Nrf2 and LCII was up-regulated and P62 expression was down-regulated in group H+ RAP ( P<0.05). Conclusion:Enhanced autophagy can activate Nrf2 signaling pathway, which is the endogenous protective mechanism of Schwann cell injury induced by high glucose.

Objective To analyze the epidemiological characteristics of hepatitis B in Guangzhou from 2006 to 2018. Methods The data were retrieved from the National Infectious Disease Surveillance Information Report Management System. Descriptive methods were used to analyze and summarize the results. Chi-square test was used for statistical analysis of classification data, and Joinpoint software was used to analyze the annual change percentage and trend. Results A total of 292 674 cases of hepatitis B were reported in Guangzhou from 2006 to 2018, and the annual average reported incidence was 182.2 per 100,000. Chronic hepatitis B was the main type, accounting for 89.9%. The incidence rate of males (241.6 / 105) was higher than that of females (117.9 / 105), with a ratio of 2.0:1. During the period from 2006-2018, the reported incidence of hepatitis B in Guangzhou first increased, reached the highest in 2008, and then decreased year by year. There was no significant difference in the number of HBV cases among different months. The average onset age of hepatitis B reported in Guangzhou was 39.3 years old, and the average onset age increased year by year from 2006 to 2018. Conclusion The incidence rate of hepatitis B in Guangzhou has decreased since 2008, but it was still higher than the national average incidence rate. The hepatitis B infection in Guangzhou remains a big issue. It is suggested to further strengthen the prevention and control of hepatitis B in adults by maintaining a national immunization program for children, thereby reducing the epidemiological level of hepatitis B in Guangzhou.

Objective: To evaluate the recent efficacy and safety of gemcitabine combined with S-1 in the treatment of advanced biliary tract cancer. Methods: From August 2014 to May 2017, 27 patients with advanced biliary tract cancer confirmed by pathology in the First People's Hospital of Zhengzhou received gemcitabine(1 000mg/m², day 1 and 8) and S-1(80mg/m², day 1-14) every three weeks.The recent efficacy and toxicities were observed after two cycles of chemotherapy. Results: All of the 27 patients were evaluated, 1 patient(3.7%) achieved CR, 6 patients(22.2%) with PR, 12 patients(44.4%) with SD, 8 patients(29.6%) with PD.The total response rate was 25.9%(7/27), the disease control rate was 70.4%(19/27). The main toxicities were gastrointestinal reactions and myelosuppression, no chemotherapy-related death was observed. Conclusion Gemcitabine combined with S-1 in the treatment of advanced biliary tract cancer is safe and effect.

Objective:To assess the association between preoperative neutrophil–lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and red cell distribution width (RDW) and the tumor pathological features in gastric cancer (GC) patients. Methods: We re-viewed the records of 434 patients from 2012 to 2014 in Fujian Cancer Hospital. All patients were admitted to the hospital for the first time, and no patients received any cancer-specific pretreatment. For comparison, 309 age-and gender-matched healthy individuals who underwent annual physical examination at the hospital and 342 patients with chronic atrophic gastritis were enrolled. Results:GC patients had higher NLR, PLR, and RDW than the controls (P<0.000 1). Elevated NLR, PLR, and RDW were associated with the develop-ment of tumor stages as indicated by the Kruskal-Wallis analysis. However, no similar association was observed between the tumor dif-ferentiation grade and location and those three markers. Multivariate regression analysis further revealed that both NLR and PLR were independent predicting factors for either the tumor TNM or T stage (P<0.000 1). ROC curve analysis showed that NLR and PLR had a certain diagnostic effect on the preoperative T staging of GC. Conclusion:The preoperative NLR and PLR levels are closely correlated with the tumor TNM stages in GC patients. Both these parameters have potential values as markers to assist either in early diagnosis or preoperative tumor stage evaluation in GC.

Objective To study the mental status of dento-maxillofacial deformities patients for orthognathic-orthodontic treatment,assess the testing results,and provide reference for doctors and nurses to evaluate mental features of patients.Methods 79 patients from a three-level and first-class hospital in Shanghai were collected from February 2011 to January 2012,who were to undergo orthognathic-orthodontic treatment.All the subjects filled in MMPI questionnaire before the operation.Results Scores of F and Pa subscales in male were significantly lower than the national norm.Scores of K and Mf subscales in female were significantly higher than the national norm.Scores of L,F,Hs,D,Pd,Pa,Pt,Sc,Si subscales were significantly lower than the national norm.Scores of F,Pa,Sc,Ma subscales in male were significantly higher than female.Scores of Mf subscales in female were significantly higher than male.Conclusions The whole personality of dento-maxillofacial deformities patients are normal.However,individualized personality deviation and psychological problems exist,including personality characteristics among different genders.

Objective:To evaluate the association of glutathione S-transferase M1 (GSTM1 )polymorphism,smoking and alcohol drinking with oral cancer susceptibility in Asians by meta-analysis.Methods:A literature search of PubMed,Chinese BioMedical, Wanfang,VIP and CNKI databases from inception to July 30th,2013 was conducted.Crude odd ration (OR)with 95% confidence intervals (95%CI)was calculated.Results:27 case-control studies were assessed,and the results showed that the association be-tween GSTM1 null genotype and oral cancer susceptibility was significant in Asians (OR=1.31,95%CI:1.18-1.45,P<0.001), especially in South Asians (OR=1.35,95%CI:1.20 -1.52,P<0.001).Significant associations between oral cancer risk and smoking and alcohol drinking were found in East Asians (Smoking:OR=1.70,95%CI:1.36 -2.13,P<0.001;Alcohol drink-ing:OR=1.54,95%CI:1.24 -1.90,P<0.001).Conclusion:GSTM1 null genotype may be associated with increased oral cancer risk in Asians.Smoking and alcohol drinking confer significant susceptibility to oral cancer in East Asians.

Objective To study the effect of nitrobenzene(NB) on the activity of enzymes and the content of zinc in the testis tissue of mice. Methods 40 male mice were divided into 4 groups, 10 in each, 3 groups were treated with NB at the doses of 2, 20, 200 mg/kg by gavage, the control group was treated with vegetable oil in the same volume, once a day, for 21 consecutive days. The activity of G-6-PD, LDH and the content of Zn2+ in testis cells were determined. Results The index of epididymis and testis in the groups of 200 mg/kg were significantly lower compared with the control and 2 mg/kg group (P0.05). The activity of G-6-PD, LDH and the content of Zn2+ in all the treated groups were lower than those in the control group (P