OBJECTIVE: To extract weak fetal ECG signals from mixed ECG signals recorded from maternal abdominal wall for accurate analysis of fetal heart rate and fetal ECG patterns. METHODS: By exploiting the superior nonlinear mapping ability of deep convolutional network, we developed a nonlinear adaptive noise cancelling (nonlinear ANC) extraction framework based on a temporal convolutional encoder-decoder network for extracting fetal ECG signals. We first constructed a deep temporal convolutional network (TCED-Net) model for fetal ECG signal extraction, and with the maternal chest ECG signal as the reference signal, the maternal ECG component in the abdominal mixed signal was estimated using this model. The estimated maternal ECG component was subtracted from the mixed abdominal ECG signals to obtain the fetal ECG component. Experimental analyses were performed using synthetic ECG signals (FECGSYNDB) and clinical ECG signals (NIFECGDB, PCDB) to test the performance of the propose method. RESULTS: The results of experiments on the FECGSYNDB dataset showed that the proposed approach achieved good performance in F₁-score (98.89%), mean-square-error (MSE; 0.20) and quality signalto-noise ratio (qSNR; 7.84). The F₁- score reached 99.1% on the NIFECGDB dataset and 98.61% on the PCDB dataset. The R peak detection accuracy index of the proposed method was higher than the existing best-performing algorithms such as EKF (F₁=93.84%), ES-RNN (F₁=97.20%) and AECG-DecompNet (F₁=95.43%) by 5.05%, 1.9% and 3.18%, respectively. CONCLUSION The fetal ECG signals extracted using the proposed method are clearer than those by the existing algorithms, suggesting the potential value this method for effective fetal health monitoring during pregnancy.
Female ; Pregnancy ; Humans ; Electrocardiography ; Algorithms

Objective:Organizing pneumonia (OP) is a clinical syndrome manifested by granulation tissue plug in respiratory bronchioles, alveolar ducts and alveolar spaces pathologically.With advent of lung biopsy techniques, increasing pathological diagnosis of organizing pneumonia was made, most of which were confirmed secondary organizing pneumonia (SOP) either at time of diagnosis or on follow-up.The secondary etiology is related to the choice of treatment and prognosis.First of all, we need to rule out infection, find evidence of connective tissue disease, or previous medication, radiotherapy and even transplantation.The coexistence of multiple pathological features and simultaneous involvement of pulmonary vessels and pleura suggest possible secondary causes.The pathological diagnosis of organic pneumonia by empty core needle puncture or transbronchial lung biopsy needs to be combined with imaging to avoid omitting the tumor, granuloma and necrosis around organic pneumonia.In general, organizing pneumonia, no matter cryptogenic or secondary, is mostly responsive to corticosteroids compared with other interstitial lung diseases, although relapses are frequent.In summary, real cryptogenic organized pneumonia is actually relatively uncommon and should be diagnosed with caution.Long term follow up is not only crucial to assess the evolution of lung disease but also for looking into the underlying etiologies behind an organizing pneumonia.

To cultivate high-quality professionals of transfusion medicine and construct a new mode of undergraduate practice of transfusion medicine. Since 2013, orientation interns in blood transfusion medicine were recruited from the undergraduate program of laboratory medicine, and a new teaching mode of orientation practice of blood transfusion medicine was established from the aspects of teaching staff, rotation of posts, practice content and comprehensive quality. Through the new training mode of orientation practice, excellent transfusion medical professionals with solid basic knowledge, strong operational skills and high comprehensive quality were cultivated. The establishment of the oriented practice mode of blood transfusion medicine is beneficial to the cultivation and output of high-quality transfusion talents and plays a positive role in promoting the development of transfusion medicine education.

【Objective】 To analyze the root causes of adverse events to insufficient plasma transfusion, so as to explore improvement measures, optimize the transfusion strategy and avoid such adverse events. 【Methods】 The root causes of insufficient plasma transfusion were analyzed by health care failure mode and effect analysis, the targeted improvement measures were formulated and the effect was evaluated. 【Results】 After the improvement, the incidence of adverse events to insufficient plasma transfusion decreased significantly.The risk priority value affecting the safety of blood transfusion decreased from 70 to 8, and the proportion of coagulation function test after blood transfusion increased from 44.61%(1 309/2 934)in 2012 to 80.55% (2 187/2 715)in 2019, and plasma transfusion volume per capital increased from 300 mL to 528 mL. PT and APTT values after plasma transfusion in 2019 significantly increased compared with those in 2012. Meanwhile, the proportion of plasma transfusion in hospitalized patients decreased from 3.16% (2 934/92 838)to 2.12%(2 715/128 352). 【Conclusion】 Risk management of quality and safety of blood transfusion by combing healthcare failure mode, effect analysis and root cause analysis(RCA) can improve the risk awareness of clinical blood transfusion, optimize the proportion of plasma transfusion, and is essential to ensure the safety and effectiveness of blood transfusion and improve the prognosis of transfused patients.

Catheter Ablation ; Electrocardiography ; Heart Ventricles ; Humans ; Tachycardia, Ventricular ; therapy

OBJECTIVEEscape from the body's immune response is a basic characteristic of lung cancer, and indoleamine-2,3-dioxygenase (IDO) plays a key role in mediating immune escape of non-small-cell lung cancer, which leads to recurrence and metastasis. Feiji Recipe, a compound Chinese herbal medicine, has the effect of stabilizing lesions and prolonging survival in patients with lung cancer. The purpose of this study was to investigate the mechanisms underlying the anticancer properties of Feiji Recipe.

METHODSAn orthotopic transplant model of mouse Lewis lung cancer, with stable expression of IDO gene, was established in C57BL/6 mice. Optical imaging was used to observe the effects of Feiji Recipe in the treatment of lung cancer in vivo. The effects of Feiji Recipe on the proliferation of mouse Lewis lung cancer cell line 2LL, 2LL-enhanced green fluorescent protein (2LL-EGFP) and 2LL-EGFP-IDO were investigated, and the apoptosis of T-cells was examined by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide using flow cytometry. Chemical composition of Feiji Recipe was validated by high-performance liquid chromatography.

RESULTSCompared to the control group, the survival of animals treated with Feiji Recipe was significantly prolonged (P = 0.0074), and the IDO protein level decreased (P = 0.0072); moreover, the percentages of CD4CD25 T-cells and Foxp3 T-cells were significantly decreased (P < 0.05). The molecular mechanism of Feiji Recipe against lung cancer may relate to the regulation of immune cells, such as T-cells and regulatory T-cells.

CONCLUSIONThe molecular mechanism of Feiji Recipe in treatment of lung cancer is to restore the function of T-cells in the cancer microenvironment through interfering with the IDO pathway.

Animals ; Apoptosis ; drug effects ; Carcinoma, Lewis Lung ; drug therapy ; enzymology ; immunology ; physiopathology ; Cell Proliferation ; drug effects ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Growth Inhibitors ; administration & dosage ; Humans ; Indoleamine-Pyrrole 2,3,-Dioxygenase ; genetics ; immunology ; Lung Neoplasms ; drug therapy ; enzymology ; immunology ; physiopathology ; Male ; Mice ; Mice, Inbred C57BL ; T-Lymphocytes, Regulatory ; drug effects ; immunology

Aged ; Catheter Ablation ; methods ; Female ; Hematoma ; surgery ; Humans ; Thrombosis ; surgery

OBJECTIVETo explore whether MG-132 could enhance the anti-tumor activity of obatoclax against esophageal cancer cell line CaES-17.

METHODSMTT assay was used to determine the cytotoxicity of obatoclax and MG-132 in CaES-17 cells. The IC(50) of obatoclax and MG-132 were used to determine the molar ratio (1:2.4) of the two drugs for combined treatment of the cells. The concentrations of obatoclax and MG-132 ranged from 1/8 IC(50) to 4 IC(50) after serial dilution, and their combination index (CI) was calculated using CompuSyn software. The expression of ubiquitin and the cleavage of PARP, caspase-9, phospho-histone H3 and phospho-aurora A/B/C in the exposed cells were examined with Western blotting; the cell apoptosis was measured by flow cytometry with Annexin V staining, and the percentage of cells in each cell cycle phase was also determined by flow cytometry.

RESULTSThe CI of obatoclax and MG-132 was 0.296 for a 50% inhibition of Caes-17 cells and was 0.104 for a 95% inhibition. The cells treated with obatoclax or MG-132 alone showed increased expression of ubiquitin and cleavage of PARP and caspase-9. Compared with the cells treated with obatoclax or MG-132 alone, the cells with a combined treatment exhibited significantly increased expression of ubiquitin, cleavage of PARP and caspase-9, and expression of phospho-Histone H3 (P<0.05). The combined treatment of the cells also resulted in significantly increased expression of phospho-Aurora A/B/C compared with obatoclax treatment alone. The cells with the combined treatment showed significantly higher percentages of apoptotic cells and cells in sub-G(1) and G(2)/M phases compared with the cells treated with either of the drugs (P<0.05).

CONCLUSIONObatoclax combined with MG-132 shows a significant synergistic anti-tumor effect against esophageal cancer CaES-17 cells by inducing apoptosis and cell cycle arrest.

Apoptosis ; Caspase 9 ; metabolism ; Cell Cycle Checkpoints ; Cell Line, Tumor ; drug effects ; Esophageal Neoplasms ; pathology ; Histones ; metabolism ; Humans ; Leupeptins ; pharmacology ; Poly (ADP-Ribose) Polymerase-1 ; Poly(ADP-ribose) Polymerases ; metabolism ; Pyrroles ; pharmacology

Adolescent ; Catheterization, Central Venous ; adverse effects ; Humans ; Jugular Veins ; Male ; Mammary Arteries ; injuries ; Subclavian Artery ; surgery

OBJECTIVETo compare the difference in the clinical efficacy on cervical spondylosis between acupuncture at three lines of cervical Jiaji (EX-B 2) and oral administration of jingfukang granules.

METHODSThree hundred cases of cervical spondylosis were divided into an acupuncture group and a medication group, 150 cases in each one. In the acupuncture group, according to the different types of cervical spondylosis, acupuncture was applied at three lines of cervical Jiaji (EX-B 2), once a day. In the medication group, jingfukang granules were prescribed for oral administration, one bag each time, three times a day. The treatment of ten days made one session in the two groups and two sessions were required totally. Before and after two sessions of treatment, the clinical assessment scale for cervical spondylosis (CASCS) was adopted to evaluate the score of subjective symptoms, clinical physical signs and adaptability as well as the total score in the patients of the two groups and the efficacy was compared.

RESULTSThe patients' symptoms and physical signs were alleviated, the adaptability was improved and the score of each item and the total score were increased in the two groups after treatment (all P<0.01). The improvements in the acupuncture group were better than those in the medication group (all P<0.01). The curative and markedly effective rate was 90.7% (136/150) in the acupuncture group, better than 66.0% (99/150) in the medication group (P<0.01).

CONCLUSIONAcupuncture at three lines of cervical Jiaji (EX-B 2) achieves the significant clinical efficacy on cervical spondylosis. This therapy is superior to relieving symptoms and physical signs and recovering adaptability as compared with jingfukang granules.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Spondylosis ; therapy ; Treatment Outcome ; Young Adult