The bionic optic nerve can mimic human visual physiology and is a future treatment for visual disorders. Photosynaptic devices could respond to light stimuli and mimic normal optic nerve function. By modifying (Poly(3,4-ethylenedioxythio-phene):poly (styrenesulfonate)) active layers with all-inorganic perovskite quantum dots, with an aqueous solution as the dielectric layer in this paper, we developed a photosynaptic device based on an organic electrochemical transistor (OECT). The optical switching response time of OECT was 3.7 s. To improve the optical response of the device, a 365 nm, 300 mW·cm ^-2 UV light source was used. Basic synaptic behaviors such as postsynaptic currents (0.225 mA) at a light pulse duration of 4 s and double pulse facilitation at a light pulse duration of 1 s and pulse interval of 1 s were simulated. By changing the way light stimulates, for example, by adjusting the intensity of the light pulses from 180 to 540 mW·cm ^-2, the duration from 1 to 20 s, and the number of light pulses from 1 to 20, the postsynaptic currents were increased by 0.350 mA, 0.420 mA, and 0.466 mA, respectively. As such, we realized the effective shift from short-term synaptic plasticity (100 s recovery of initial value) to long-term synaptic plasticity (84.3% of 250 s decay maximum). This optical synapse has a high potential for simulating the human optic nerve.
Humans ; Quantum Dots ; Bionics ; Oxides ; Optic Nerve

Objective:To develop a risk prediction model for early cardiac arrest in emergency sepsis utilizing a machine learning algorithm to enhance the quality and efficiency of patient treatment.Methods:This study focused on patients with sepsis who received treatment at the emergency room of the First Medical Center of Chinese PLA General Hospital from January 1, 2020 to June 1, 2023. The basic clinical characteristics such as vital signs and laboratory results were collected. Patients who fulfilled the specified inclusion criteria were allocated randomly into a training group and a testing group with a ratio of 8:2. A CatBoost model was constructed using Python software, and the prediction efficiency of the model was assessed by calculating the area under the receiver operating characteristic curve (AUC). Furthermore, the performance of the model was compared to that of other widely employed clinical scores.Results:This study included a cohort of 2 131 patients diagnosed with sepsis, among whom 449 experienced cardiac arrest. The CatBoost model demonstrated an AUC of 0.760, surpassing other scores. Notably, the top 10 predictors in the model were identified as age, lactate, interleukin -6, oxygen saturation, albumin, N-terminal pro-B-type natriuretic peptide, potassium, sodium, creatinine, and platelets.Conclusions:The utilization of this machine learning algorithm-based prediction model offers a more precise basis for predicting cardiac arrest in emergency sepsis patients, thereby potentially improving the treatment efficacy for this disease.

Objective:To study the risk factors of necrotizing enterocolitis (NEC) after surgery for intestinal atresia.Method:From August 2013 to June 2020, children with intestinal atresia receiving surgery in our hospital were retrospectively reviewed. The patients were assigned into NEC group and non-NEC group according to the occurrence of postoperative NEC. Demographic data and clinical characteristics were summarized and the risk factors for postoperative NEC were analyzed using Logistic regression analysis method.Result:A total of 96 infants were enrolled and NEC occurred in 13 patients (13.5%) after surgery for intestinal atresia. Compared with the non-NEC group, the NEC group were diagnosed of intestinal atresia [4.0(1.5,6.0)d vs. 1.4(0,2.0)d, P<0.001] and received surgery [4.8(2.0,7.0)d vs. 3.1(1.0,4.0)d, P=0.034] at later ages. The incidences of complex intestinal atresia [76.9%(10/13) vs. 44.6%(37/83), P=0.030] and blood transfusion [46.2%(6/13) vs. 13.3%(11/83), P=0.007] in the NEC group were higher than the non-NEC group. Logistic regression analysis showed that the age of initial diagnosis of intestinal atresia ( OR=3.346, 95% CI 1.493~7.500, P=0.003), complex intestinal atresia ( OR=9.052, 95% CI 1.119~73.209, P=0.039) and blood transfusion ( OR=6.835, 95% CI 1.399~33.380, P=0.018) were independent risk factors for postoperative NEC. Conclusion:Patients with delayed diagnosis of intestinal atresia, complex intestinal atresia and blood transfusion within 48 hours after surgery should be monitored for the occurrence of postoperative NEC.

Objective To investigate the change in body weight over time in rectal cancer patients receiving radiotherapy and the correlation between setup errors and weight loss,and to establish the image-guided radiotherapy regimens in different periods of treatment.Methods A total of 24 postoperative patients with rectal cancer admitted to our hospital in 2016 were selected.Before each fraction of radiotherapy,the body weight was recorded,and the patients underwent cone-beam computed tomography (CBCT) with different frequencies in every week.The planning CT was matched with CBCT to obtain setup errors.The paired t test was used for difference analysis;the Pearson method was used to analyze the correlation between setup errors and weight loss.Results Body weight was measured 456 times in the 24 patients,and these patients underwent CBCT scans and image registration 456 times.Two patients were excluded because of treatment discontinuance.In the first and second weeks,there was no significant change in body weight.In the third week,the mean weight loss was 1.53 kg.In the fourth week,the mean weight loss was 2.48 kg.In the fifth week,the mean weight loss was 3.24 kg.The setup errors obtained by CBCT image registration in the superior-inferior (SI),anterior-posterior (AP),and left-right (LR) directions were 0.19 cm,0.20 cm,and 0.18 cm,respectively,in the first week,0.18 cm,0.17 cm,and 0.15 cm,respectively,in the second week,0.20 cm,0.22 cm,and 0.21 cm,respectively,in the third week,0.19 cm,0.25 cm,0.24 cm,respectively,in the fourth week,and 0.34 cm,0.33 cm,and 0.31 cm,respectively,in the fifth week.The Pearson correlation analysis showed that weight loss increased the setup errors,with P values of 0.140,0.046,and 0.044 in the SI,AP,and LR directions,respectively.Conclusions For rectal cancer patients receiving radiotherapy,the body weight decreases significantly in the late period (especially in the fifth week),which influences the setup errors.Therefore,in the fourth and fifth weeks of radiotherapy for rectal cancer,the weight loss should be closely monitored,and the number of CBCT scans can be increased before the treatment fraction to ensure the accuracy and optimization of treatment.

Objective To establish a HPLC method for simultaneously determining the content of dexamethasone ace-tate ,camphor and phenol in compound cream .Methods The separation was performed on a SHIADZU-GL Inertsil? ODS-3 RP C18 analytical column with the mobile phase consisting of methanol-water (60:40) .The flow rate was 1 .0 ml/min .The detection wave length was 285 nm and the column temperature was 40 ℃ .Results Dexamethasone acetate ,camphor and phe-nol showed good linearity (r> 0 .9995 , n= 7) within the concentration range of 4 .024-40 .24 ,101 .7-2033 and 10 .38-425 .2 μg/ml ,respectively . The average recovery of dexamethasone acetate ,camphor and phenol was 101 .2％ (RSD was 0.56％ ) ,99 .89％ (RSD was 0 .72％ ) ,100 .2％ (RSD was 0 .97％ ) ,respectively .Moreover ,the RSDs were less than 1 .5％ in the repeated tests .Conclusion The method was simple ,quick and accurate .It is suitable for the quality control of dexametha-sone acetate camphor and phenol cream .

Objective This study intends to explore the impacts of the establishment of chest pain center(CPC) on the door-to-balloon(D-to-B) time in patients with ST-elevation myocardial infarction (STEMI) by different transfer ways to hospital. Methods A regular CPC and a regional cooperative network were established based on the pre-hospital transmitted real-time 12-lead electrocardiogram system. The STEMI patients were divided into the following three groups by the different transfer ways to hospital before and after the establishment of chest pain center:self-referral groups (group A1, n=52, and group A2, n=65), EMS (emergency medical service ) groups (group B1, n=31, and group B2, n=92) and transfer PCI groups (group C1, n=23, and group C2, n=552). The mean D-to-B time and the rate of D-to-B below 90 minutes were compared between before and after the establishment of CPC and the reasons of reperfusion delay were analyzed. Results There were no statistical differences of the average D-to-B time [(123±78) min vs.(140±123)min, P > 0.05] and the rate of D-to-B time below 90 min (44.2%vs. 46.2%) between group A1 and group A2. The average D-to-B time was significantly shortened in group B2 [(89±66)min] while compared with that in group B1 [(155±115)min, P<0.05] and the rate of D-to-B time below 90 min was remarkably elevated in group B2 compared with that of group B1 (69.6%vs. 32.3%, P<0.05). The average D-to-B time was significant shorter in group C2 than in group C1 [(77±43)min vs. (337±662)min, P<0.05] and the rate of D-to-B time below 90 min was remarkable higher in group C2 than in group C1 (75.7%vs. 21.7%, P<0.05). The longer D-to-B time in self-referral groups was mainly due to the delay of getting informed consent before PCI when occupied catheterization laboratory was the major cause of reperfusion delay in EMS groups and transfer PCI groups. Conclusions The establishment of CPC may significantly shorten the D-to-B time and increase the rate of D-to-B time below 90 min for these patients admitted by EMS and transferred from non-PCI hospitals. However, the pathway for the self-referral patients should be further modified.

Objective To observe the effect of transnasal endoscopic choanal plasty for repairing congenital choanal atresia.Method A retrospective analysis of 15 patients with choanal atresia in Beijing Children's Hospital from January 2006 to September 2012 was made.All the 15 patients accepted electronic nasopharyngoscope examination and CT scanning of the paranasl sinus.The age was between 4 years old and 6 years old.Seven of them were male and 8 were female.Six cases were unilateral atresia,9 were bilateral atresia.Ten cases (16 sides) were membranous atresia,2 cases (4 sides) were mixed type atresia and 3 cases (4 sides) were bony atresia.All the patients accepted transnasal endoscopic choanal plasty.A tube was placed in order to support the enlarged nostrils.The nasal tube should be retained for 3 months and kept patency by routine care.Three months after operation,the tube could be removed.The patients were told to do physiological saline nasal irrigation and receive regular review by transnasal endoscopy.Result The patients were followed up for 1 year postoperatively by electronic nasopharyngoscope examination.There was no failure case in all the 15 patients.The total effective rate was 100％.Conclusion Transnasal endoscopic choanal plasty had better efficacy and safety in the treatment of congenital choanal atresia.

Objective To study the efficiency of tele-consultation on Internet with transmitting realtime 12-lead ECG carried out by the Chest Pain Center evaluated by the length of time required for the emergency percutaneous coronary intervention (PCI) in patients with ST segment elevation myocardial infarction (STEMI).Methods A total of 435 STEMI patients treated by emergency PCI were divided into the group A (n =98,admitted in 2010),group B (n =114,admitted in 2011) and group C (n =223,admitted in 2012).Data were collected before (2010) and after establishment of the Chest Pain Center (2011 to 2012) including the length of time elapsed from onset of symptoms to the first medical contact (FMC),the length of time required from FMC to the intra-aortic balloon inflated (FMC-2B) and the length of time required from entering the gate of hospital to the intra-aortic balloon inflated (D-2B).Measure data were described with non-normal median and interquartile intervals.Comparisons were made among groups with rank sum test.Results The median time of D2B of three groups were 107,78 and 59 mins in groups A,B and C,respectively.The differences in D2B among three groups were significant (P =0.000).The time of the D2B was shortened significantly because of the patients transferred to the hospital with a variety of ways (P =0.008).However,the length of D2B time was not significantly changed (P =0.846) when patients came to the hospital all on themselves.The median times from symptom onset to FMC in the group A,group B and group C were 112,62 and 78 mins.and the differences among three groups were not statistically significant (P =0.368).The median times of FMC2B in three groups were 287.0,313.5 and 421.8 mins,respectively,and there were no significant differences (P =0.135).Conclusions The establishment of the Chest Pain Center and Internet of things can effectively shorten the duration of D2B in STEMI patients.However,the reduction of time length from the symptom onset to reperfusion must rely on the coordination between communities and health care system.

Objective To evaluate the pre-hospital diagnostic reliability of real-time tele-transmission of 12-lead electrocardiogram of patients with ST-segment elevated acute myocardial infarction (STEMI).Methods The 12-lead electrocardiogram was simultaneously recorded with real-time tele-transmission system and a conventional electrocardiograph in 40 STEMI cases.The width and amplitude of each wave,the deviated amplitude of ST-segment in the same leads were compared by t-test and rank-sum test.Results There were no statistical differences in the width and amplitude of P wave,QRS wave and t wave as well as the deviated altitude of ST-segment between the two separate electrocardiographs (P ＞0.05).There was a significant positive correlation between the two ECG devices in respect of ST-segment elevated altitude (r =0.912,P =0.000).The differential ability of ST-segment elevation between two separate ECG devices kept highly consistent (Kappa value:0.976).Conclusions Real-time tele-transmission of 12-lead electrocardiogram is reliable for the pre-hospital diagnosis of STEMI.

Objective To observe the effects of cyclic tensile strain (CTS) on in vitro expression of glycosaminoglycans (GAG) in rabbit chondrocytes of different ages.Methods Nine male New Zealand rabbits were grouped into juvenile (2 months), adult (8 months), and senior (31 months) groups. The bilateral knee joints were harvested using sterile technique from each rabbits. In each age group, rabbit articular chondrocytes were cultivated in vitro after randomization into a control group and a CTS group, with 6 specimens in each. In the next 3 days, CTS was applied (sin10％, 0. 5 Hz, 6 h/d) in the CTS group for 6 hours per day while no CTS was applied in the control group. After the first CTS treatment, the supernatant of cell culture was collected every 12 hours from each specimen in both groups to assess the GAG levels by Alcian blue assay.Results Expressions of GAG showed significant increases in both control and CTS groups in each age group ( P ＜ 0. 05) . Different age groups showed significant differences in the GAG secretion over different time points. Compared with the younger cells, the older ones showed the most significant difference in growth between the control and CTS groups at 12 hours, though the older cells produced less GAG than the younger ones in both groups at the end of the experiment (72 hours).Conclusions CTS can stimulate rabbit chondrocytes of different ages to secrete more GAG, and younger cells tend to produce more GAG than the older ones.