Electrocardiogram (ECG) is a noninvasive, inexpensive, and convenient test for diagnosing cardiovascular diseases and assessing the risk of cardiovascular events. Although there are clear standardized operations and procedures for ECG examination, the interpretation of ECG by even trained physicians can be biased due to differences in diagnostic experience. In recent years, artificial intelligence has become a powerful tool to automatically analyze medical data by building deep neural network models, and has been widely used in the field of medical image diagnosis such as CT, MRI, ultrasound and ECG. This article mainly introduces the application progress of deep neural network models in ECG diagnosis and prediction of cardiovascular diseases, and discusses its limitations and application prospects.
Objective To explore the application effect of 3D printed heart models in the training of young cardiac surgeons, and evaluate their application value in surgical simulation and skill improvement. MethodsEight young cardiac surgeons were selected form West China Hospital as the trainees. Before training, the Hands-On Surgical Training-Congenital Heart Surgery (HOST-CHS) operation scores of the 8 cardiac surgeons were obtained after operating on 2 pig heart models of ventricular septal defect (VSD). Subsequently, simulation training was conducted on a 3D printed peri-membrane VSD heart model for 6 weeks, once a week. After the training, all trainees completed 2 pig heart VSD repair surgeries. The improvement of doctors’ skills was evaluated through survey questionnaires, HOST-CHS scores, and operation time after training. ResultsBefore the training, the average HOST-CHS score of the 8 trainees was 52.2±6.3 points, and the average time for VSD repair was 54.7±7.1 min. During the 6-week simulation training using 3D printed models, the total score of HOST-CHS for the 8 trainees gradually increased (P<0.001), and the time required to complete VSD repair was shortened (P<0.001). The trainees had the most significant improvement in scores of surgical cognition and protective awareness. The survey results showed that trainees were generally very satisfied with the effectiveness of 3D model simulation training. Conclusion The 3D printed VSD model demonstrates significant application advantages in the training of young cardiac surgeons. By providing highly realistic anatomical structures, 3D models can effectively enhance surgeons’ surgical skills. It is suggested to further promote the application of 3D printing technology in medical education, providing strong support for cultivating high-quality cardiac surgeons.
ObjectiveTo systematically review mortality risk prediction models for acute type A aortic dissection (AAAD). MethodsPubMed, EMbase, Web of Science, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect studies of mortality risk prediction models for AAAD from inception to July 31th, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Systematic review was then performed. ResultsA total of 19 studies were included, of which 15 developed prediction models. The performance of prediction models varied substantially (AUC were 0.56 to 0.92). Only 6 studies reported calibration statistics, and all models had high risk of bias. ConclusionsCurrent prediction models for mortality and prognosis of AAAD patients are suboptimal, and the performance of the models varies significantly. It is still essential to establish novel prediction models based on more comprehensive and accurate statistical methods, and to conduct internal and a large number of external validations.
Objective To detect expression of NF-κB in the inner retina and in vestigate the inhibitoryeffect of pyrrolidine dithiocarbamate on retinal neovascularization in rats. Methods The rat models with retinopathy were set up un der the hypoxia condition, and fluorescein fundus angiography (FFA) was used to observe the retinal neovascularization. The expressions of NF-κB in the inner retina in rats with and without neovascularization were detected by immunohisto chemical method. PDTC was intraperitoneally injected in rats with neovascularization to observe the expression of NF-κB in the inner retina and the effect on retinal neovascularization. Results Hypoxia induced NF-κB activation in the retinal glial cells and endothelial cells. But immuno-staining intensity for NF-κB and adhesion molecules were reduced by PDTC intraperitoneal injection. Retin al angiogenesis in rats were suppressed effectively (P＜0.05). Conclusions NF-κB activation correlates with retinal neovascularization closely. PDTC may inhibit the NF-κB activation and prove beneficial in the treatment of ischemic neovascularization. (Chin J Ocul Fundus Dis，2003，19：201-268)
Objective To explore independent risk factors for 30-day mortality in critical patients with pulmonary infection and sepsis, and build a prediction model. Methods Patients diagnosed with pulmonary infection and sepsis in the MIMIC-Ⅲ database were analyzed. The CareVue database was the training cohort (n=934), and the Metavision database was the external validation cohort (n=687). A COX proportional hazards regression model was established to screen independent risk factors and draw a nomogram. We conducted internal cross-validation and external validation of the model. Using the receiver operator characteristic (ROC) curve, Calibration chart, and decision curve analysis, we detected the discrimination, calibration, and benefit of the model respectively, comparing with the SOFA scoring model. Results Age, SOFA score, white blood cell count≤4×109/L, neutrophilic granulocyte percentage (NEU%)>85%, platelet count (PLT)≤100×109/L, PLT>300×109/L, red cell distribution width >15%, blood urea nitrogen, and lactate dehydrogenase were independent risk factors. The areas under the ROC curve of the model were 0.747 (training cohort) and 0.708 (external validation cohort), respectively, which was superior to the SOFA scoring model in terms of discrimination, calibration, and benefit. Conclusion The model established in this study can accurately and effectively predict the risk of the disease mortality, and provide a visual assessment method for early identification of high-risk patients.
Objective To scoping review the risk prediction models for sarcopenia in China was conducted, and provide reference for scientific prevention and treatment of the disease and related research. Methods We systematically searched PubMed, Web of Science, Cochrane Library, Embase, China Knowledge Network, China Biomedical Literature Database, Wanfang Database, and Weipu Database for literature related to myasthenia gravis prediction models in China, with a time frame from the construction of the database to April 30, 2024 for the search. The risk of bias and applicability of the included literature were assessed, and information on the construction of myasthenia gravis risk prediction models, model predictors, model presentation form and performance were extracted. Results A total of 25 literatures were included, the prevalence of sarcopenia ranged from 12.16% to 54.17%, and the study population mainly included the elderly, the model construction methods were categorized into two types: logistic regression model and machine learning, and age, body mass index, and nutritional status were the three predictors that appeared most frequently. Conclusion Clinical caregivers should pay attention to the high-risk factors for the occurrence of sarcopenia, construct models with accurate predictive performance and high clinical utility with the help of visual model presentation, and design prospective, multicenter internal and external validation methods to continuously improve and optimize the models to achieve the best predictive effect.
Objective To investigate the interference effect of nerve growth factor (NGF) on apoptosis of retinal cells in experimental retinal detac hment (RD). Methods Twenty seven Sprague-Dawely rats were selected, and the left and right eyes were in the experimental control group and NGF group, respectively. After the RD model was set up by subretinal injection with sodium hyaluronate, 5mu;l NGF（1mu;g/mu;l）was injected into the vitreous body of the right eyes which were in the NGF group; 5mu;l PBS was injected into vitreous body of left eyes which were in the experimental control group. The injection was performed once every 4 days till the end of the observation period. The eye balls of the 27 rats were extrafted 1.5, 3, 6, 12 hours, 1 day, 2, 4, 8 , 16, and 32 days after the RD model was established. Another 2 rats were selected as the normal control, which underwent none of the injections but eyeball extraction at the end of the observation period. TUNEL and transmission electron microscopy were used to detect the apoptosis of the retinal cells. Cell counts and statis tical analysis were used to assess results. Results Typical apoptosis cells were observed in the early time of RD. Apoptosis was found in each retinal layers, especially in inner and outer nuclear layers. The number of apoptosis cells increased as the time of RD was prolonged（Plt;0.01）. It was also found that apoptosis cells in NGF group were less than that in the experimenta l control group（Plt;0.01）. Conclusion Intravitreous injection exogenous NGF may inhibit the apoptosis of retinal cells in experimental RD. (Chin J Ocul Fundus Dis, 2006, 22: 333-335)