Objective:To propose a differential privacy fuzzy C-means clustering algorithm based on Gaussian kernel function(DPFCM_GF)to optimize the data privacy and security issues brought about by data analysis and mining of medical data in the context of big data,and to provide a theoretical basis for data privacy protection.Methods:In order to solve the problem of reducing the accuracy of the algorithm by randomly initializing the fuzzy C-mean membership matrix,the maximum distance method was used to determine the initial center point,the Gaussian value of the clustering center point was used to calculate the privacy budget allocation ratio,and the Laplace noise was added to complete the differential privacy protection and the DPFCM_GF was constructed.The effectiveness of DPFCM_GF was verified by collecting and collating the heart disease,breast cancer,thyroid disease and diabetes public data sets from the machine learning repository of the University of California,Irvine,and the gastric cancer and lung cancer datasets of The Second People's Hospital Huai'an were collected to verify the usability of the DPFCM_GF,and the analysis results were compared with the fuzzy C-means clustering algorithm(FCM)and the differentially private fuzzy C-means clustering algorithm(DPFCM).Results:For public datasets of heart disease,breast cancer,thyroid disease and diabetes,the optimal clustering effects of DPFCM_GF and DPFCM were equivalent to those of FCM;compared with DPFCM,the iteration time of DPFCM_GF was faster,the convergence speed was significant,the difference was statistically significant(t=4.01,4.71,4.01,12.38,P<0.05).For lung cancer and gastric cancer dataset,with the increase of privacy budget ε,the correct recognition rate of DPFCM_GF gradually converged to 91.9%and 93.9%,and the AUC values converged to 0.79 and 0.81,respectively,and when the privacy function ε was 0.1,0.5,1 and 2(ε<3),the DPFCM_GF clustering effect was significantly better than that of DPFCM,and the clustering effect was better and the difference was statistically significant(x2=12.25,87.12,68.58,7.76,P<0.05;x2=4.74,43.51,42.47,4.89,P<0.05).Conclusion:The DPFCM_GF is an effective method for protecting the privacy of medical data,and can also perform data analysis and mining tasks,which has certain research significance and prospects.

Objective:To observe the effect of electroacupuncture(EA)combined with oriented conductive bio-protein hydrogel(OCBH)on the recovery of nerve function in rats with complete spinal cord injury(SCI)and to explore its effect and mechanism on the formation and changes of glial scars.Methods:A total of 72 female Sprague-Dawley rats were randomly divided into groups according to the treatment received.A rat model of complete SCI was constructed using a spinal cord transection.Behavioral assessments,hematoxylin-eosin(H&E)staining,immunofluorescence staining,and Western blotting were performed at a fixed period after the operation.Results:The material group and the material+EA group obtained better results in the behavioral as-sessments(all P＜.05)and the H&E staining.In the immunofluorescence staining and Western blotting,the GFAP protein was expressed more and denser in the material group and the material+EA group than in the model group,and the density of the GFAP expression in the material+EA group was lower at week 12 than in the material group(all P＜.05).The expression of complement C3 in the model,material,and material+EA groups decreased in turn.Some inflammatory factors and the NF-kB signaling pathway showed similar results in the Western blotting(all P＜.05).The expression of the GDNF protein in the material+EA group was significantly higher than that in the model group and the material group(both P＜.01).Conclusion:EA combined with OCBH can promote the recovery of motor functions after SCI by facili-tating the formation of glial scars in the early stage,preventing the further spread of an inflammatory response that would affect the activation of A1/A2 astrocytes and change the morphology of glial scars at the spinal cord-material interface in its late stage.

Objective: To explore the molecular basis for an individual with ABO subtype. Methods: The ABO phenotype of the proband was determined by convention serological testing. Exons 6 and 7 of the ABO gene were subjected to PCR amplification and bi-directional Sanger sequencing. Haplotypes for exons 6 and 7 of the proband was determined using an ABO haplotype-specific amplification and sequencing technique. Results: Red blood cells of the proband showed a 4+ agglutination strength with anti-A or anti-H, no agglutination reaction with anti-A1, and a 3+ agglutination strength with anti-B. His serum had no reaction with standard A cells, O cells or self cells, but was weakly reactive with B cells at 4℃. The proband was assigned as an ABO subtype based on his serological features. Bi-directional sequencing of the ABO gene revealed heterozygosity of 261 G/del, 297AG, 526CG, 657CT, 703GA, 803GC and 930GA, and homozygosity of 796CC in the proband. Haplotype-specific amplification and sequencing showed that one of his alleles was ABO*O.01.01, and another contained a c. 796A>C variation compared with the ABO*B.01 allele, which led to replacement of methionine by leucine at position 266. Searching the ABO allele database of International Society of Blood Transfusion suggested the variation to be a novel one. Conclusion The c. 796A>C variation in the ABO*B.01 allele probably underlies the CisAB subtype. Accurate identification of the ABO subtype requires combined use of serological method and genetic testing.

Objective: To explore the effect of substrate mechanical microenvironment and cell-cell interaction on differentiation of bone marrow mesenchymal stem cells (BMSCs), intrahepatic cellular function and phenotype. Methods: Bone marrow mesenchymal stem cells (BMSCs)-hepatocytes (HCs) and BMSCs-hepatic stellate cells (HSCs) were co-cultured on polyvinyl alcohol (PVA) hydrogel substrates at different stiffness (4.50 ± 0.47 kPa, 19.00 ± 3.51 kPa and 37.00 ± 2.09 kPa) by non-contact co-culture method. Furthermore, the effect of substrate mechanical microenvironment on BMSCs, HCs and HSCs and the activation and proliferation of HCs under different co-cultured condition was studied. A Student's t-test was used to compare the two groups. Results: The expression ofα-smooth muscle actin (α-SMA) and collagenα1- I (Col1A1) in BMSCs and HSCs cultured on its own increased with increase of substrate stiffness. After 72 h, the expression of albumin (ALB) of HCs on three stiff substrates was significantly higher than that of 24 and 48 h. Moreover, the expression of ALB of HCs increased with the increase of substrate stiffness. During the co-culture of BMSCs and HSCs, BMSCs of all three stiffness substrates promoted the expression ofα-SMA, Col1A1 in HSCs, but reduced the expression of PPARγin HSCs cells, thererby promoted the activation of HSCs, with apparent stiffness at 37 kPa. HSCs promoted the expression of ABL in BMSCs at three stiff substrates, but inhibited the expression of alpha-SMA and Col1A1 in BMSCs at 37 kPa, suggesting that co-culture had inhibited the differentiation of BMSCs myofibroblasts, and promoted the differentiation of hepatocyte-like cells, especially at high stiff substrates. In the co-culture of BMSCs and hepatic parenchymal cells, BMSCs had promoted the proliferation of hepatic parenchymal cells at 4.5 kPa. Further, hepatic parenchymal cells had inhibited the expression ofα-SMA in BMSCs, and promoted the expression of Alb, with inhibition of BMSCs differentiation towards myofibroblasts. Conclusion The differentiation of BMSCs affects the substrate mechanical microenvironment, co-culture of HCs and HSCs. Simultaneously, affecting the function of hepatocytes in relation to the mechanical state of the substrates.

Objective? To explore the reliability and validity of critical-care pain observation tool (CPOT) in pain assessment in resting state among neurosurgery patients undergoing craniotomy. Methods? From May 2017 to May 2018, we selected 200 neurosurgery patients undergoing craniotomy at Beijing Tiantan Hospital with the method of prospective and observational study. The Chinese version of CPOT was used to pain assessment in resting state of patients and its scores were recorded. At the same time, the Changhai Pain Rating Scale was used to pain assessment by themselves as a gold standard. We drew the receiver operating characteristic (ROC), calculated the area under curve and confirmed the score of CPOT to determine the sensitivity and specificity of pain. The intraclass correlation coefficient (ICC) was used to evaluate the reliability among CPOT reviewers. Results? A total of 200 patients undergoing craniotomy back to intensive care unit (ICU) were included including 100 patients without and 100 patients with trachea cannula. The Chinese version of CPOT had good reliability in patients between two groups with 0.857 (95%CI: 0.787-0.904) for the ICC of patients without trachea cannula and with 0.851 (95%CI: 0.778-0.899) for the ICC of patients with trachea cannula. Among patients without trachea cannula, when the cut-off value of CPOT was equal or greater than 2, CPOT showed the highest Youden index in assessing pain with 58% for the sensitivity and 86% for the specificity. Among patients with trachea cannula, the cut-off value of CPOT being equal or greater than 3 showed the highest Youden index in assessing pain with 74% for the sensitivity and 91% for the specificity. There was no statistical difference in the area under curve of pain assessed by CPOT between patients with and without trachea cannula (0.866 vs. 0.777, P＞0.05). Conclusions? CPOT has the good reliability and validity in pain assessment in resting state among neurosurgery patients undergoing craniotomy.

PURPOSE: The treatment of triple-negative breast cancer (TNBC) remains challenging, due to the absence of estrogen, progesterone, and human epidermal growth factor receptors. This study was designed to evaluate the efficiency and safety of cytokine-induced killer (CIK) cell immunotherapy, following regular chemotherapy, for patients with TNBC. METHODS: A total of 340 patients with postmastectomy TNBC, from January 1, 2010 to June 30, 2014, were included in this retrospective study. Seventy-seven patients received CIK cell immunotherapy, following regular chemotherapy (arm 1), and 263 patients received regular chemotherapy alone (arm 2). The primary aim was overall survival (OS) and disease-free survival (DFS), and the treatment responses and adverse events were also evaluated. RESULTS: The 5-year DFS and OS rates in arm 1 were 77.9% and 94.3%, compared with 69.8% and 85.6% in arm 2, respectively (p=0.159 and p=0.035, respectively). This clearly shows that there was no statistical difference in the 5-year DFS between the two groups. Multivariate analyses of arm 1 indicated that a Karnofsky performance score (KPS) ≥90 and stage I/IIA disease were significantly associated with a prolonged DFS period (hazard ratio [HR], 0.25; 95% confidence interval [CI], 0.09–0.74; p=0.012; and HR 0.21; 95% CI, 0.06–0.82; p=0.024, respectively), but a KPS ≥90 and stage I/IIA disease were not independent prognostic factors for OS. Toxicity was mild in patients who received the CIK therapy. CONCLUSION: The data suggested that CIK cell immunotherapy improved the efficiency of regular chemotherapy in patients with TNBC, and the side effects of CIK cell immunotherapy were mild.
Arm ; Cytokine-Induced Killer Cells* ; Disease-Free Survival ; Drug Therapy* ; Estrogens ; Humans ; Immunotherapy ; Multivariate Analysis ; Progesterone ; Prognosis ; Receptor, Epidermal Growth Factor ; Retrospective Studies ; Triple Negative Breast Neoplasms*

OBJECTIVE:To provide reference for rational use of antibiotics to treat Pseudomonas aeruginosa (PA) infection in the clinic. METHODS:Resistant rate of PA in our hospital during 2011-2015 were analyzed retrospectively. Antibiotics use densi-ty(AUD)of 10 commonly used antibiotics were analyzed statistically,and the correlation of resistant rate with AUD was investi-gated by Spearman correlation analysis. RESULTS:One thousaud and eleven strains of PA were isolated in our hospital during 2011-2014,detection rate of PA always occupied the top 5 place. Top 3 antibiotics in the list of AUD were levofloxacin,ceftazi-dime,cefoperazone sodium and tazobactam sodium. AUD of piperacillin sodium and tazobactam sodium,levofloxacin,ciprofloxa-cin and meropenem were positively correlated with resistant rate of PA(r were 1.000,0.900,1.000,1.000,P<0.05). AUD of ce-foperazone sodium and tazobactam sodium were negatively correlated with resistant rate of PA(r=-0.900,P<0.05). AUD of imi-penem and cilastatin sodium,ceftazidime,gentamicin,aztreonam and amikacin had no correlation with resistant rate of PA(P>0.05). CONCLUSIONS:There is correlation between AUD of antibiotics and resistant rate of PA. It is of important significance to detect resistant rate of PA and the use of antibiotics regularly. Antibiotics should be selected cautiously in accordance with bacterial monitoring data,results of drug sensitivity tests,the amount and resistant rate of antibiotics,etc,in order to reduce resistant PA.

Objective To observe the effects of Yushen Heji on expressions of Heme Oxygenase (HO-1) and HO-2 in kidney of diabetic rats;To explore its mechanism in diabetic nephropathy. Methods SD rats were randomly divided into normal group, model group, control group and treatment group. Models were duplicated by subcutaneous injection STZ. Control group and treatment group were given gavage with related medicine, while normal group and model group were given gavage with the same amount of distilled water. Eight weeks later, the urine of rats was collected to detect the 24 h Upro and Ucr;the rats were sacrificed to detect the levels of CO, BUN and Scr;the kidneys were harvested for observing the expressions of HO-1 and HO-2 by immunohistochemistry.Results Compared with normal group, the contents of BUN, 24 h Upro and Scr all increased in model group;Ccr and plasma CO decreased;the expressions of HO-1 and HO-2 in kidney tissues were obviously reduced (P<0.01). Compared with model group, the contents of BUN, 24 h Upro and Scr all obviously decreased in treatment group and control group;Ccr and plasma CO increased;the expressions of HO-1 and HO-2 in kidney tissues obviously increased (P<0.05,P<0.01). Compared with control group, the contents of 24 h Upro decreased in treatment group;plasma CO increased;the expressions of HO-1 and HO-2 in kidney tissues obviously increased (P<0.05,P<0.01).Conclusion Yushen Heji has therapeutic effect on diabetic nephropathy rats, which may related with HO/CO system.

OBJECTIVE: To investigate the relationship between high-normal blood pressure and chronic kidney disease (CKD) in occupational physical examination population in Changsha. METHODS: With a convenient sampling method, a cross-sectional survey of representative sample of 11 274 white collar workers was conducted in Changsha between March 2011 and May 2011 in a large comprehensive hospital. All subjects were assigned into 4 groups: a normal blood pressure group, a high-normal blood pressure group, an undiagnosed hypertension group, and a diagnosed hypertension group. Anthropometry, blood pressure, blood sample and urine sample were measured with standard instruments and methodology for all the subjects. Multiple logistic regression analysis was used to identify risk factors for CKD. RESULTS: The prevalence of CKD in the normal blood pressure, high-normal blood pressure, undiagnosed hypertension, and diagnosed hypertension were 3.31%, 6.60%, 11.78%, and 17.35%, respectively. The prevalence of CKD in males was significantly higher than that in females (P<0.01). For males with high-normal blood pressure, the CKD risk was significantly greater (OR, 1.30; 95% CI:1.03 - 1.63) than those with optimal blood pressure. The logistic regression analysis showed that there was an additive effect of hyperuricemia on CKD risk in men with high-normal blood pressure compared with men with optimal blood pressure (OR, 2.25; 95% CI, 1.59 - 3.19; P<0.05). CONCLUSION The prevalence of CKD in people with the high-normal blood pressure is 6.60% in occupational physical examination population in Changsha. CKD is a high risk for men with highnormal blood pressure and hyperuricemia is an independent risk factor.
Blood Pressure ; China ; Cross-Sectional Studies ; Female ; Humans ; Hypertension ; epidemiology ; Hyperuricemia ; epidemiology ; Male ; Physical Examination ; Prevalence ; Renal Insufficiency, Chronic ; epidemiology ; Risk Factors

Objective To observe the effect of the joint treatment containing single sialic acid four hexose gangliosides,clopidogrel,atorvastatin in the treatment of cerebral infarction.Methods 88 acute cerebral infarction patients met the inclusion criteria were randomly divided into the observation group of 44 cases and the control group of 44 cases.The control group were given clopidogrel and atorvastatin,and the observation group were give single sialic acid four hexose gangliosides on the base of the control group,100mg/time,qd,4 week for a course.The symptoms before and after treatment were observed.The NIHSS and ADL score were calculated.Blood lipids,CRP,IMT was inspected.Results The total effective rate of the observation group was 90.91％,the control group was 77.27％,the observation group was significantly higher than the control group (x2 =11.967,P ＜ 0.05) ; the TC,TG,LDL-C,HDL-C,CRP,IMT,ADL,NIHSS of both group after treatment were significantly improved than before treatment,there were a statistically significant differences (all P ＜ 0.05).After treatment,the TC,TG,LDL-C,HDL-C,CRP,IMT,ADL NIHSS of observation group and the group were (4.06/ ± 0.98) mmol/L vs (4.18 t 1.02) mmol/L,(1.35 ±0.73)mmol/L vs (1.42 ±0.81)mmol/L,(1.68 ±0.82) mmol/L vs (1.74 ±0.85)mmol/L,(1.44 ±0.58) mmol/L vs (1.41 ±0.52)mmol/L,(40.55 ±3.12)mg/L vs (47.27 ±3.57)mg/L,(0.78 ±0.08)mm vs (0.87 ±0.09)mm,(28.9 ± 11.3) scores vs (22.3 ± 10.0) scores,(8.2 ± 5.3) scores vs (15.5 ± 6.2) scores.the CRP,IMT,ADL,NIHSS of observation group were improved more significantly than the control group,the differences were statistically significant(all P ＜ 0.05).Conclusion Jointing treatment containing single sialic acid four hexose gangliosides,clopidogrel,atorvastatin can improve significantly lipid levels,inhibit platelet aggregation,make a stability of carotid atherosclerotic plaque,improve activities of daily living and neurological deficit,but also can prevent secondary brain damage after traumatic brain injury,which is the ideal solution for the treatment of cerebral infarction.