摘要:目的: 研究尿微量白蛋白与冠心病的相关性。 方法 : 按冠状动脉造影诊断标准将116例患者分为冠心病组(82人) 与非冠心病组(34人),测定晨尿白蛋白/ 肌酐浓度值(ACR),比较两组患者尿ACR 并分析ACR与冠脉病变程度的相关性。 结果 : 冠心病组ACR显著高于非冠心病组的; ACR与冠脉计分呈显著的直线正相关。 结论 :冠心病患者ACR水平升高,微量白蛋白尿与冠状动脉病变范围和程度密切相关, 且对冠状动脉狭窄程度具有独立预测价值。Abstract: Objective: To investigate the relationship between microalbuminuria and coronary artery disease(CAD). Methods : According to the diagnostic standard of coronary artery angiography,116 patients were divided into CAD group (82 patients) and nonCAD group (34 patients). The albumin and creatinine concentrationratio ratio(ACR) in morning urine samples from patients of both groups was estimated and compared. The correlation of ACR to the extent of coronary lesions was analyzed. Results : ACR in the CAD group was significantly higher than that in nonCAD group. A distinctly linear positive correlation existed between ACR and the score of the coronary lesions. Conclusion : ACR increase in patients with CHD.Micoalbuminuria was associated with the severity of coronary lesions in patients with CHD and is an independent predictor of CAD.
Objective To explore the correlation between the inserting angle of vertebral screws and the extent of post-operative lateral angulation instantly in sugery via anterior approach for thoracolumbar fractures. Methods The cl inical data were from 172 patients consecutively treated with surgery via anterior approach in thoracic and lumbar fractures betweenMay 2004 and January 2008. These cases included 124 males and 48 females at the age of 15-70 years old (mean 39 years old). One fracture were located at T11, 37 at T12, 88 at L1, 30 at L2, 15 at L3, 3 at L4. One segment was involved in 170 cases and two segments in 2 cases. According to Frankel assessment for neurological status, there were 19 cases of grade A, 24 cases of grade B, 45 cases of grade C, 53 cases of grade D, and 31 cases of grade E. The time from injury to operation was 2-30 days (median 8 days). According to the coronal Cobb angle instantly after surgery, the patients were divided into three groups: 0-5° group, 5-10° group and over 10°group. Every group was further divided into four subgroups according to the type of the internal fixation instruments: Z-plate subgroup, Antares subgroup, Profile subgroup and single screw rod (SSR) subgroup. Radiograph images were used to evaluate the coronal Cobb angle and inserting angle between the screws and end-plates. The screws were named as A, B, C and D in vertebral bodies from the cephal ic to the caudal portion. The angles between the superior endplate and the screws A, B were named as angles A, B, and the angles between the inferior endplate and the screws C, D were named as angles C, D. The differences were compared between the screw’s inserting angle A+D (or/and B+C) and the post-operative coronal Cobb angle instantly, and l inear regression analysis was done. The satisfaction survey was acommpl ished. Results Surfacialinfection occurred in 1 patient at 7 days and incision healed well after debridement; other incisions healed by first intention. A total of 172 cases were followed up for 6-49 months (mean 39 months). The degree of satisfaction was 3-10 points, median 8.5 points. Various degrees of neurological function recovered in final follow-up except patients for Frankel A grade. The mean coronal Cobb angles were (0.75 ± 3.91)° for pre-operatively, (3.17 ± 4.07)° for instantly post-operatively and (3.46 ± 4.21)° at last follow-up; showing statistically differences between pre-operatively and instantly post-operatively, between pre-operatively and at last follow-up (P lt; 0.05). Comparing the screw’s inserting angle A+D (or/and B+C) and the coronal Cobb angle, there was statistically significant difference between Z-Plate subgroup and other subgroups in 0-5° group (P lt; 0.05), and there were no statistically significant differences between other subgroups in each group (P gt; 0.05). Except the screw’s inserting angle A+D (Z-Plate and SSR subgroups) and angle B+C (Antares subgroup) in 0-5° group, the post-operative coronal Cobb angle correlated closely with the screw’s inserting angle A+D (or/and B+C) in other subgroups of 3 groups. Conclusion Nonparallel ism between the vertebral screws and the correlative end plate is one of the main causes of post-operative spinal lateral angulation.
ObjectiveTo study the effects of visceral adipose tissue area (VTA) and subcutaneous adipose tissue area (STA) on pulmonary ventilation function (PVF), and then to evaluate the impact of abdominal fat distribution on PVF.Methods Patients who underwent both PVF examination and abdominal CT between January 1st and December 31st, 2017 were selected from the electronic medical record system of West China Hospital of Sichuan University. The demographic data and PVF indexes [vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and 1 s rate (FEV1/FVC)] were collected. VTA and STA were obtained by abdominal CT measurement. The correlations between PVF indexes and VTA or STA were compared. Results A total of 224 patients were included. According to the VTA/STA ratio, there were 92 cases (41.07%) in group VTA/STA<1 and 132 cases (58.93%) in group VTA/STA≥1. VTA was not correlated with FVC (rs=−0.078, P=0.244), but negatively correlated with VC (rs=−0.138, P=0.040), FEV1 (rs=−0.141, P=0.034) and FEV1/FVC (rs=−0.137, P=0.041); STA had no correlation with VC, FVC, FEV1 or FEV1/FVC (P>0.05). VTA/STA was negatively correlated with VC (rs=−0.220, P=0.001), FEV1 (rs=−0.273, P<0.001) and FEV1/FVC (rs=−0.380, P<0.001), but it had no correlation with FVC (rs=−0.083, P=0.214). In group VTA/STA<1, VTA/STA was negatively correlated with FEV1 (rs =−0.205, P=0.050) and FEV1/FVC (rs=−0.317, P=0.002), but it had no correlation with VC or FVC (P>0.05). In group VTA/STA≥1, VTA/STA was negatively correlated with VC, FVC, FEV1 and FEV1/FVC (P<0.05). Conclusions VTA and STA are negatively correlated with PVF. The ratio of VTA/STA can be used as an index to evaluate the effect of abdominal fat distribution on lung function.
ObjectivesTo analyze the balance of medical human resource allocation in Chengdu and to discuss the impact of human resource allocation structure on the hospital’s medical service capabilities, so as to provide a theoretical basis for the hospital to optimize the talent team structure.MethodsThe Moran’s index and Gini coefficient were used to evaluate the spatial aggregation and grade distribution difference of human resources allocation, respectively. The case mix index (CMI), the length of hospital stay, and the difficulty of surgery were used as outcome variables, and a multiple regression analysis model was established to explore the impact of human resource indicators on the hospital’s medical service capabilities.ResultsThe distribution of doctors showed an obvious spatial aggregation in Chengdu, and there was a positive spatial correlation (Moran’s Idoctor=0.290); the distribution of nurses had no obvious spatial aggregation (Moran’s Inurse=0.102). Under different medical service capacity segments, the Gini coefficient of doctors was 0.518, and the Gini coefficient of nurses was 0.576, both exceeding 0.5, indicating that the distribution of medical human resources in different levels of hospitals was considerably different. The regression results showed that the expansion of the quantity of senior title doctors and the proportion of medical care both could improve the hospital’s CMI. The increase in the quantity of doctors with senior titles also had a certain impact on improving the hospital’s surgical capabilities. The expansion of the proportion of medical care could lead to a slight increase in the length of patients' hospital stay.ConclusionsOptimizing the allocation structure of medical human resources in different regions and hospitals with different levels is an important task in the construction of a hierarchical diagnosis and treatment system. It is necessary to further integrate medical human resources throughout the whole city and strengthen personnel training and team building in primary health institutions. Hospitals at different levels should implement their own development positioning and further optimize their human resource allocation structure according to development needs. Tertiary hospitals should pay more attention to the cultivation of senior professional doctors, optimize the proportion of medical care, and improve the hospital’s medical service capabilities. The primary health institutions should pay attention to the comprehensive construction of medical personnel, and strengthen the development of the team of general practitioners, so as to achieve a comprehensive improvement of the city’s medical service capabilities.
We proposed a multi-resolution-wavelet-transform based method to extract brainstem auditory evoked potential (BAEP) from the background noise and then to identify its characteristics correctly. Firstly we discussed the mother wavelet and wavelet transform algorithm and proved that bi-orthogonal wavelet bior5.5 and stationary discrete wavelet transform (SWT) were more suitable for BAEP signals. The correlation analysis of D6 scale wavelet coefficients between single trails and the ensemble average of all trails showed that the trails with good correlation (> 0.4) had higher signal-to-noise ratio, so that we could get a clear BAEP from a few trails by an average and wavelet filter method. Finally, we used this method to select desirable trails, extracted BAEP from every 10 trails and calculated theⅠ-Ⅴinter-waves' latency. The results showed that this strategy of trail selection was efficient. This method can not only achieve better de-noising effect, but also greatly reduce the stimulation time needed as well.
ObjectiveTo observe and analyze the rate of visual acuity progression and binocular symmetry in patients with choroideremia (CHM). MethodsA single-center retrospective longitudinal cohort study. From April 2009 to August 2022, 38 eyes of 19 patients diagnosed with CHM through clinical and genetic testing at the Department of Ophthalmology, Peking Union Medical College Hospital, were included in this study. All patients underwent at least 2 follow-up visits with a minimum interval of 1 year between visits, and binocular best-corrected visual acuity (BCVA) results were recorded at each follow-up visit. Decimal visual acuity was converted into logarithm of the minimum angle of resolution (logMAR) for analysis. The patient group consisted of 19 males from 16 unrelated families. The age at initial visit was (39.52±13.24) years, with a (2.63±1.61) follow-up visits over a duration of (4.95±2.68) years. A total of 50 binocular BCVA data were included. Annual progression rate of visual acuity was calculated based on longitudinal and cross-sectional data. Spearman correlation coefficient and Bland-Altman method were used to evaluate the binocular symmetry. ResultsThe rate of visual acuity progression was (0.095±0.148) logMAR units/year based on longitudinal data and (0.018±0.009) logMAR units/year based on cross-sectional data. The binocular symmetry for BCVA of the baseline values was strong; however, the binocular symmetry of progression rates for BCVA was moderate. Spearman correlation analysis showed that binocular symmetry in baseline BCVA was high (r=0.881, P＜0.001). The symmetry of binocular vision progression rates based on longitudinal data was moderately symmetric (r=0.528, P=0.020). Bland-Altman analysis showed that 94.7% of binocular baseline BCVA differences were within 95% confidence interval (CI) of 95% limit difference (LOA), indicating good symmetry of binocular baseline BCVA. The number of binocular BCVA progression rate differences within 95%CI of 95%LOA was 89.5%, suggesting moderate symmetry in binocular BCVA progression rate. The results of Spearman correlation coefficient and Bland-Altman analysis of binocular symmetry were basically consistent. ConclusionsThe rate of visual acuity progression of patients with CHM based on longitudinal and cross-sectional data is (0.095±0.148) and (0.018±0.009) logMAR units/year, respectively. Cross-sectional data from patients of different ages should not be used to infer the progression rate of the natural history. Binocular eyes with highly symmetrical baseline visual acuity may differ in the rate of visual acuity progression.
ObjectiveThe time relationship between seizure semiology and epileptic discharges during focal epileptic seizures is a crucial predictor for the localization of epileptogenic zone. Low voltage fast activities (LVFA), especially gamma band oscillations, are confirmed to play a central role in ictogenesis and semiology production. In the present study, we focus on the “electro-clinical correlation” between LVFA in agranulo-dysgranular insulo-cingulate cortices and the sign of “Chapeau de gendarme (CDG)” via detailed analysis of ictal video-stereoencephalography (video-SEEG) of focal epileptic seizures. MethodsWe retrospectively analyzed the ictal video-SEEG of the 7 cases in which CDG signs were presented in habitual seizures and intracerebral electrodes were co-implanted in agranulo-dysgranular insular and cingulate cortices. We calculate the latency of LVFA in each of cortical regions of interest, agranulo-dygranular insular cortex, agranulo-dysgranular cingulate cortex, and the latency of CDG signs via visual and spectral analysis of the ictal SEEG. Moreover, Pearson correlation analysis and linear regression were used to test the time relationship between gamma band oscillations in agranulo-dysgranular insulo-cingulate cortices and generation of CDG signs. ResultsThe co-activation of LVFA occurred in agranulo-dysgranular insulo-cingulate cortices always preceded the appearance of CDG sign in all of the 69 seizures. The LVFA were confirmed as gamma band oscillations via spectral analysis of SEEG. A linear relationship between the latencies of CDG signs and the latencies of co-activation of agranulo-dysgranular insulo-cingulate cortices in gamma band was furth confirmed by Pearson correlation analysis and linear regression. ConclusionsThere is a causal relationship between the involvement of agranulo-dysgranular insulo-cingulate cortices and the generation of CDG sign, and thus the CDG sign could be view as semiological marker of activation of emotional insulo-cingulate cortex in focal epilepsy.
Objective To investigate the differences between six parts of China in prediction models of lung function.Methods The predicted values of 360 healthy volunteers underwent pulmonary functiontest in east China were compared with that of north China, northeast China, northwest China, southwest China, south China and Asian American. Results In the male group, the prediction values of east China were as follows: VC ( 4. 19 ±0. 33) L, coefficient correlation( r) to the other five regions were 0. 803-0. 983,the differences to the other five regions were 1. 90% -4. 30% ; FVC ( 4. 06 ±0. 35) L, r to the others were 0. 912-0. 981, the differences to the other four regions were 0-2. 46% except for south China of 8. 10% , to Asian American ×0. 88 and Asian American ×0. 94 were 1. 97% and 4. 68% ; FEV1 ( 3. 34 ±0. 40) L, r to the others were 0. 963-0. 992, the differences to north China and east China were 0. 9% and 3. 59% , to southwest China and south China were gt;5% , to Asian American ×0. 88 and Asian American×0. 94 were 6. 89% and 0. 6% ; FEV1 /FVC ( 80. 87 ±3. 84) % , r to the others were 0. 989-0. 999, the differences to north China, northeast China and south China were 0. 42% -3. 04% , to the others were gt;5% . In the female group, the prediction values of east China were as follows: VC ( 3. 00 ±0. 33) L, r to the other five regions were 0. 899-0. 993, the differences to the other five regions were 0. 33% -3. 67% ; FVC( 2. 92 ±0. 34) L, r to the other five regions were 0. 929-0. 990, the differences to the other five regions were 1. 02% -2. 40%, to Asian American ×0. 88 and Asian American ×0. 94 were 4. 79% and 6. 16% ; FEV1 ( 2. 38 ±0. 39) L, r to the other five regions were 0. 958-0. 994, the differences to northeast China, southwest China, south China were 0. 84% -3. 36% , to north china was 7. 19% , to Asian American ×0. 88 and Asian American ×0. 94 were 2. 10% and 4. 62% ; FEV1 /FVC ( 82. 04 ±3. 94) % , r to the others were 0. 991-1. 000, the differences to the other four regions were 1. 34% -4. 55% except for southwest China was 7. 59% . Conclusions VC and FVC predicted values are coincident between six parts of China. FEV1 /FVC predicted values are coincident in the four parts of China except for westnorth and westsouth China. FEV1 predicted values are different. The oversea predicted values should be used with appropriate conversion factors.
Objective To summarize the current research progress on the concept, clinical presentation, diagnosis, biomechanical changes, and pathological mechanisms of the medial meniscus posterior root tear (MMPRT), and its clinical correlations with tibial rotation. MethodsThe research literature on MMPRT and its relationship with tibial rotation at home and abroad in recent years was extensively consulted and summarized. Results MMPRT is a specific and common type of medial meniscus injury of the knee joint. The occurrence of posterior medial pumping pain events following low-energy trauma in patients provides important clues for the diagnosis of this injury, with MRI being the preferred imaging modality. The biomechanical effects generated by MMPRT are similar to those caused by total removal of the medial meniscus. And this injury is usually associated with tibial rotation. MMPRT induces pathological external rotation of the tibia, which can be restored by timely medial meniscus posterior root repair. Furthermore, changes in tibial rotation are related to the healing status after medial meniscus posterior root repair. ConclusionMMPRT is closely related to tibial rotation. Understanding the biomechanics, pathological mechanisms, and clinical correlations between the two is of great significance for improving the diagnosis and treatment strategies.
In order to improve the accuracy of classification with small amount of motor imagery training data on the development of brain-computer interface (BCI) systems, we proposed an analyzing method to automatically select the characteristic parameters based on correlation coefficient analysis. Throughout the five sample data of dataset Ⅳa from 2005 BCI Competition, we utilized short-time Fourier transform (STFT) and correlation coefficient calculation to reduce the number of primitive electroencephalogram dimension, then introduced feature extraction based on common spatial pattern (CSP) and classified by linear discriminant analysis (LDA). Simulation results showed that the average rate of classification accuracy could be improved by using correlation coefficient feature selection method than those without using this algorithm. Comparing with support vector machine (SVM) optimization features algorithm, the correlation coefficient analysis can lead better selection parameters to improve the accuracy of classification.