Objective To review the clinical operation methods of abdominal incisional hernia. Methods Classification, operation method and fellow-up of 78 patients with abdominal incisional hernia were retrospectively analyzed. Results The average time of fellow-up was 26 months. Nineteen cases were repaired with simple suture with 3 cases (15.8%) recurrence, 57 cases were repaired with man-made material with 2 case （3.4%） recurrence. Conclusions Individual operation method should be chosen according to body condition, classification of the size of abdominal loss and abdominal hypertension. It is an effective method to repair the hernia of abdominal incision with man-made material.
ObjectiveTo identify primary osteoporosis patients’ function and environment status based on International Classification of Functioning, Disability and Health (ICF) and provide evidence to clinical treatment, rehabilitation therapy and rehabilitation nursing.MethodsA questionnaire survey was conducted among osteoporosis patients hospitalized in the Center of rehabilitation Medicine of West China Hospital of SiChuan University, from May 2017 to December 2019. The research design was based on a cross-sectional survey. ICF was applied to simplify the core classification set, and a convenient sampling method was adopted.ResultsA total of 240 patients were investigated. All of the patients’ function showed limitation but different level. Meanwhile, including Walking (D450), Sensation of pain(B280), Structure of trunk (S760), Lifting and carrying objects (D430), Mobility of joint function (B710), the proportion of injuries were more than 90%, most of which the limitation level were light and moderate injuries indicating 5%-49% injuries; more than 50% pointed the three parts of environment factors were facilitative factors including Products or substances for personal consumption (E110), Health professionals (E355), Health services, systems and policies (E580), of which the proportion of Health services, systems and policies (E580) were highest.ConclusionOsteoporosis has a significant effect on patients’ function, we should develop clinical treatment, rehabilitation therapy, rehabilitation nursing based on the current evaluation of function.
ObjectiveTo investigate the classification and clinical value of unilateral cervical lateral mass fracture (C3-7).MethodsFrom January 2008 to December 2017, 68 patients with unilateral cervical lateral mass fracture who had received treatment in Affiliated Hospital of Southwest Medical University, were included. According to the position of fracture, the fractures were classified into three types: articular process fractures (type A), isthmus fracture (type B), and comminution (type C). Two subtypes of articular process fractures were type A1 and type A2. Type A1 refered to articular process fracture with no or slight displacement. Type A2 refered to articular process fractures result in foraminal stenosis and nerve root compression. Single-level anterior cervical disectomy and fusion (ACDF) or anterior cervical corpectomy and fusion (ACCF) or conservative treatment was used in type A1. Posterior decompression, fixation and fusion or the method of posterior decompression associated with ACDF were suited to A2. Single-level ACDF was used in type B as well. Type C underwent two-level ACDF or ACCF or posterior procedure.ResultsThere were 35 cases of Type A1, of which 31 patients underwent single-level ACDF, 2 patients underwent ACCF, and 2 patients received conservative treatment, but one of the two underwent ACDF due to delayed cervical instability. Among the 7 cases of type A2, 4 underwent posterior foraminal decompression and posterior fusion with pedicure screw fixation, 2 underwent single-level ACDF and posterior decompression, and 1 underwent single section ACDF and posterior decompression combined with pedical screw fixation. Type C accounted for 21 cases of all targets. Fourteen performed two-level ACDF, 6 performed ACCF, and 1 performed posterior fixation with pedicure screw and expansive open-door laminoplasty. Six patients showed postoperative complications, including C5 root palsy in one case, incision hematoma in two and pulmonary infection in three. There were no case with incision infection or aggravating nervous injury. Sixty-two patients (91.2%) were followed up with a mean duration of 14 months. All the patients obtained bony fusion and no internal fixation failure or kyphosis was found.ConclusionsAccording to fracture position and CT, the unilateral cervical lateral mass fracture can be classified as type A1, type A2, type B, and type C. A satisfied clinical result can be obtained when choosing an appropriate treatment in accordance with different fracture types.
Feature extraction methods and classifier selection are two critical steps in heart sound classification. To capture the pathological features of heart sound signals, this paper introduces a feature extraction method that combines mel-frequency cepstral coefficients (MFCC) and power spectral density (PSD). Unlike conventional classifiers, the adaptive neuro-fuzzy inference system (ANFIS) was chosen as the classifier for this study. In terms of experimental design, we compared different PSDs across various time intervals and frequency ranges, selecting the characteristics with the most effective classification outcomes. We compared four statistical properties, including mean PSD, standard deviation PSD, variance PSD, and median PSD. Through experimental comparisons, we found that combining the features of median PSD and MFCC with heart sound systolic period of 100–300 Hz yielded the best results. The accuracy, precision, sensitivity, specificity, and F1 score were determined to be 96.50%, 99.27%, 93.35%, 99.60%, and 96.35%, respectively. These results demonstrate the algorithm’s significant potential for aiding in the diagnosis of congenital heart disease.
Objective To discuss the concept of ulnar tunnel at thewrist, the types, causes, traits of compression, diagnosis, and clinical significance of ulnar tunnel syndrome(UTS). Methods Thirty-nine cases diagnosed as having UTS from 1986 were retrospectively reviewed combined with previous relevant literature. Results Ulnar tunnel included Guyon’s canal, pisohamate tunnel and hypothenar segment. There were 8 types andmany causes of UTS. Some patients had compression in more than one zones and might be associated with carpal tunnel syndrome or cubital tunnel syndrome. UTS could be diagnosed through clinical manifestations and electrophysiological examination. Conclusion Defining the concept of ulnar tunnel and the knowledge of the complexity and rarity of UTS can effectively guide diagnosis and treatment.
Objective To review the latest progress in classification system of thoracolumbar fractures and its surgical treatment with posterior approaches. Methods Recent l iterature about classification system of thoracolumbar fractures and its surgical treatment was reviewed. Results For the treatment of thoracolumbar fracture, the surgeon first should decide whether the surgical treatment was necessary. Recently, a new classification system had been developed to help the surgeon make the right decision. The surgical methods included short segment internal fixation and long segment internalfixation with or without fusion, and minimally invasive internal fixation. Conclusion The progress in the surgical treatmentof thoracolumbar fracture will help spinal surgeon decide the necessary surgery beneficial for the patients. The most appropriate and effective surgical method with the minimum damage should be used to treat the fracture. The advantages of non-fusion surgical treatment still need a further study.
Objective To summary the pathological classification， clinical manifestations， diagnosis， and treatments of gastrointestinal neuroendocrine tumors （GE-NETs）. Methods Domestic and international literatures were collected to summary the status of clinical researches and treatments of GE-NETs. Results GE-NETs derived from enterochromaffin cells throughout the gut which had the function of amine precursor uptake decarboxylase （APUD）. These tumors secreted discrete bioactive substances and produced characteristic immunohistochemical patterns， making patients to manifest endocrine syndrome. But there were no unified standards on the diagnosis， grade， TNM classification， and prognosis of GE-NETs. Early diagnosis rate of GE-NETs was low， and most of tumors were asymptomatic and detected at late stage， with a tendency to metastasize to the liver. Imaging examation was important in early diagnosis of GE-NETs. Surgery was the traditional first-line therapy and the only possible curative approach. Somatostatin analogues， such as long-term-release （LAR） octreotide， could relieve the hormonal symptoms， slow down the tumor growth， and had shown synergistic antiproliferative activity in combination with biological agent everolimus. Conclusions The lack of standardized classification and an incomplete understanding of this disease are some of the impediments to the progress of treatment. Individualized comprehensive therapy is the aim of the future treatment.
ObjectiveTo evaluate the differences of visual evoked potentials (amplitudes and latency) between cerebral palsy (CP) children and normal children. MethodsThis study involved fourteen children aged from 4 to 7 years with CP (monoplegia) between 2009 and 2013. Another 14 normal children aged from 5 to 9 years treated in the Department of Ophthalmology in West China Hospital during the same period were regarded as the control group. Both eyes of all the participants were examined by multifocal visual evoked potential (mfVEP). The mfVEP examination results were recorded, and amplitude and latency were analyzed. First, we analyzed the differences of amplitudes and latency time between monoplegia children and children in the control group. Second, gross motor function classification system (GMFCS) was used to classify the fourteen monoplegia children among whom there were five GMFCS Ⅰ patients and nine GMFCS Ⅱ patients. The differences of mfVEP were analyzed between the two GMFCS groups. ResultsThe amplitude and latency of mfVEP in children with CP showed gradual changes similar to those in the normal children. The amplitudes were decreasing and the latencies were delaying from the first eccentricity to the sixth eccentricity. The amplitudes in children with CP were lower than those in the control group in the first to the third eccentricities for both eyes (P＜0.05), and latency of left eye was delayed in the first eccentricity in children with CP (P=0.045). No difference was found between the two GMFCS groups (P>0.05) except the amplitude of the first eccentricity (P=0.043). ConclusionsThe results of mfVEP show significant differences of amplitude and latency between CP and normal children, suggesting the existence of visual pathway impairments in cerebral palsy children. The results of mfVEP can provide an objective basis of visual impairments for cerebral palsy children.
Objective To recognize the different phases of Korotkoff sounds through deep learning technology, so as to improve the accuracy of blood pressure measurement in different populations. Methods A classification model of the Korotkoff sounds phases was designed, which fused attention mechanism (Attention), residual network (ResNet) and bidirectional long short-term memory (BiLSTM). First, a single Korotkoff sound signal was extracted from the whole Korotkoff sounds signals beat by beat, and each Korotkoff sound signal was converted into a Mel spectrogram. Then, the local feature extraction of Mel spectrogram was processed by using the Attention mechanism and ResNet network, and BiLSTM network was used to deal with the temporal relations between features, and full-connection layer network was applied in reducing the dimension of features. Finally, the classification was completed by SoftMax function. The dataset used in this study was collected from 44 volunteers (24 females, 20 males with an average age of 36 years), and the model performance was verified using 10-fold cross-validation. Results The classification accuracy of the established model for the 5 types of Korotkoff sounds phases was 93.4%, which was higher than that of other models. Conclusion This study proves that the deep learning method can accurately classify Korotkoff sounds phases, which lays a strong technical foundation for the subsequent design of automatic blood pressure measurement methods based on the classification of the Korotkoff sounds phases.
ObjectivesTo explore classification management method of evidence-based evidence for medical consumables based on cost multiplication and to conduct empirical test.MethodsFour quadrants was used to explore the classification management of consumables evidence.Results95.22% of the “recommended” items in the consumables department were “recommended” by the group. 100% of group “recommended” items passed the committee resolution. Advice of consumables department and group was highly relevant with decision of commission.ConclusionsOne-dimensional recommendations allow the decision-making of group and committee to be more convenient. Cost calculation is based on all consumables required for medical treatment, which is similar to reality. The classification threshold requires further optimization, and the classification basis requires continual adjustment under different conditions of hospital. The evidence-based evidence evaluation method for medical consumables based on incremental cost ratio is a simple and rapid hospital health technology assessment method suitable for China’s national conditions.