At present the parkinsonian rigidity assessment depends on subjective judgment of neurologists according to their experience. This study presents a parkinsonian rigidity quantification system based on the electromechanical driving device and mechanical impedance measurement method. The quantification system applies the electromechanical driving device to perform the rigidity clinical assessment tasks (flexion-extension movements) in Parkinson’s disease (PD) patients, which captures their motion and biomechanical information synchronously. Qualified rigidity features were obtained through statistical analysis method such as least-squares parameter estimation. By comparing the judgments from both the parkinsonian rigidity quantification system and neurologists, correlation analysis was performed to find the optimal quantitative feature. Clinical experiments showed that the mechanical impedance has the best correlation (Pearson correlation coefficient r = 0.872, P < 0.001) with the clinical unified Parkinson’s disease rating scale (UPDRS) rigidity score. Results confirmed that this measurement system is capable of quantifying parkinsonian rigidity with advantages of simple operation and effective assessment. In addition, the mechanical impedance can be adopted to help doctors to diagnose and monitor parkinsonian rigidity objectively and accurately.
The electroencephalogram (EEG) signal is a general reflection of the neurophysiological activity of the brain, which has the advantages of being safe, efficient, real-time and dynamic. With the development and advancement of machine learning research, automatic diagnosis of Alzheimer’s diseases based on deep learning is becoming a research hotspot. Started from feedforward neural networks, this paper compared and analysed the structural properties of neural network models such as recurrent neural networks, convolutional neural networks and deep belief networks and their performance in the diagnosis of Alzheimer’s disease. It also discussed the possible challenges and research trends of this research in the future, expecting to provide a valuable reference for the clinical application of neural networks in the EEG diagnosis of Alzheimer’s disease.
Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic at the end of December 2019, more than 85% of the population in China has been infected. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mainly affects the respiratory system, especially the lungs. The mortality rate of patients with severe infection is high. A percentage of 6% to 10% of patients will eventually develop into COVID-related acute respiratory distress syndrome (CARDS), which requires mechanical ventilation and extracorporeal membrane oxygenation (ECMO) support. Some patients who survive acute lung injury will subsequently develop post COVID-19 pulmonary fibrosis (PCPF). Both fully treated CARDS and severe PCPF are suitable candidates for lung transplantation. Due to the special course, evaluation strategies are different from those used in patients with common end-stage lung disease. After lung transplantation in COVID-19 patients, special treatment is required, including standardized nucleic acid testing for the novel coronavirus, adjustment strategy of immunosuppressive drugs, and rational use of antiviral drugs, which is a big challenge for the postoperative management of lung transplantation. This consensus was evidence-based written and was reached by experts after multiple rounds of discussions, providing reference for assessment and postoperative management of patients with interstitial pneumonia after COVID-19 infection.
In order to solve the problems of difficult test, high cost and long cycle in the development of large-scale airborne negative pressure isolation system, the simulation analysis of negative pressure response characteristics is carried out around various aviation conditions such as aircraft ascending, leveling and descending, especially rapid decompression, based on the computational fluid dynamics (CFD) method. The results showed that the isolation cabin could achieve –50 Pa pressure difference environment and form a certain pressure gradient. The exhaust air volume reached the maximum value in the early stage of the aircraft’s ascent, and gradually decreased with the increase of altitude until it was level flying. In the process of aircraft descent, the exhaust fan could theoretically maintain a pressure difference far below –50 Pa without working; Under the special condition of rapid pressure loss, it was difficult to deal with the rapid change of low pressure only by the exhaust fan, so it was necessary to design safety valve and other anti-leakage measures in the isolation cabin structure. Therefore, the initial stage of aircraft ascent is the key stage for the adjustment and control of the negative pressure isolation system. By controlling the exhaust air volume and adjusting parameters, it can adapt to the change of low pressure under normal flight conditions, form a relatively stable negative pressure environment, and meet the needs of biological control, isolation and transport.
The scientific research on prevention and control of coronavirus disease 2019 (COVID-19) has been a major and urgent task, of which clinical trials occupy a pivotal position in the entire prevention and control system. 204 relative clinical trials of traditional Chinese medicine (TCM) have been registered on Chinese Clinical Trial Registry. Through the analysis of all online public protocols of registered trials, it is found that the clinical studies of TCM in China showed lack of research foundation, tight time and heavy tasks, difficult clinical implementation, and disturbance by changes of the epidemic status. Based on these characteristics, this paper put forward several thoughts and suggestions on the quality management and design improvement for clinical trials of TCM preventing and treating COVID-19, in order to improve the quality of clinical trials in China, provide effective supports for the public health decision-making on the epidemic, and also give a reference for the prevention and control of epidemics in the future.
ObjectivesTo systematically review the efficacy and safety of butylphthalide soft capsule with routine treatment for Alzheimer’s disease (AD).MethodsDatabases including CNKI, WanFang Data, VIP, CBM, PubMed, EMbase, and The Cochrane Library were electronically searched from September 2002 to July 2018 to collect randomized controlled trials of butylphthalide soft capsule with routine treatment for Alzheimer’s disease. The trial was screened based on inclusion and exclusion criteria, and the methodological quality of the included trial was assessed. Meta-analysis was then performed by Revman 5.3 software.ResultsA total of 8 studies involving 576 patients were included. The butylphthalide soft capsule group included 283 patients and the control group included 293 patients. The result of meta-analysis showed that butylphthalide soft capsule with routine treatment (Donepezil hydrochloride or Memantine or EGb761) significantly improved the score of mini-mental state examination (MMSE) (MD=3.19, 95% CI 2.69 to 3.69, P<0.001) and clinical efficacy (RR=1.36, 95%CI 1.21 to 1.53, P<0.001). There was no significant difference in number of adverse events between the butylphthalide group and the control group (RR=1.13, 95%CI 0.77 to 1.67, P=0.52).ConclusionsBased on the routine treatment, combining with butylphthalide soft capsule can further facilitate cognitive function of AD and improve clinical efficacy. At the same time, no increase in adverse reactions has been found. However, due to the low quality of the included studies, more high quality randomized controlled trials are required to verify the results.
Most patients with coronavirus disease 2019 (COVID-19) have a good prognosis, but a certain proportion of the elderly and people with underlying diseases are still prone to develop into severe and critical COVID-19. Kidney is one of the common target organs of COVID-19. Acute kidney injury (AKI) is a common complication of severe COVID-19 patients, especially critical COVID-19 patients admitted to intensive care units. AKI associated with COVID-19 is also an independent risk factor for poor prognosis in patients. This article mainly focuses on the epidemiological data, possible pathogenesis, diagnostic criteria, and prevention and treatment based on the 5R principle of AKI associated with COVID-19. It summarizes the existing evidence to explore standardized management strategies for AKI associated with COVID-19.
ObjectiveTo investigate the clinical characteristics and risk factors of patients with coronavirus disease 2019 (COVID-19), to provide a basis for clinical classification, diagnosis, and treatment.MethodsThe clinical data of COVID-19 patients comfirmed between January 17th and February 13th, 2020 were collected, single-factor test and multivariate logistic regression were used to compare the relevant indicators between the mild or common cases and the severe or critically severe cases.ResultsA total of 202 patients with COVID-19 were included, with an average age of 45.2 years and a male-to-female ratio of 1∶1.02. There were 146 patients (72.3%) without underlying diseases. The average time from onset to diagnosis was 5.4 d, and 31 were clustering epidemic cases. There were 13 (6.4%) mild cases, 151 (74.8%) common cases, 32 (15.8%) severe cases, and 6 (3.0%) critically severe cases. The main clinical symptoms were fever, cough, gasp, and diarrhea. Of the 202 patients, 135 (66.8%) had normal white blood cell count, 22 (10.9%) had lymphocyte ratio >40%, 18 (8.9%) had elevated aspartate aminotransferase (AST), 11 (5.4%) had elevated creatine kinase MB isoenzyme (CKMB), and 143 (70.8%) had elevated C-reactive protein (CRP). Single factor analyses showed that there were statistically significant differences between the mild or common cases and the severe or critically severe cases in the days of diagnosis, age, underlying disease, percentage of neutrophil, percentage of lymphocyte, arterial oxygen partial pressure, CRP, procalcitonin, lactate dehydrogenase, creatine kinase, CKMB, and AST (all P<0.05); multiple logistic regression analysis showed that CRP [odds ratio (OR)=1.035, 95% confidence interval (CI) (1.015, 1.055), P=0.001], CKMB [OR=1.078, 95%CI (1.023, 1.135), P=0.005], and AST [OR=1.042, 95%CI (1.016, 1.069), P=0.002] were correlated with clinical classification.ConclusionsCOVID-19 patients are mild or common cases mostly. CRP, CKMB, and AST are elevated in some cases, which may be related to early inflammation and certain myocardial damages and are independent risk factors for predicting classification.
Objective To generate eukaryotic expression vector of pcDNA3.1-β-site amyloid precursor protein cleaving enzyme (BACE) and obtain its transient expression in COS-7 cells. Methods A 1.5 kb cDNA fragment was amplified from the total RNA of the human neuroblastoma cells by the RT-PCR method and was cloned into the plasmid pcDNA3.1. The vector was identified by the double digestion with restriction enzymes BamHI and XhoI and was sequenced by the Sanger-dideoxy-mediated chain termination. The expression of the BACE gene was detected by immunocytochemistry. Results The results showed that the cDNA fragment included 1.5 kb total coding region. The recombinant eukaryotic cell expression vector of pcDNA3.1-BACE was constructed successfully, and the sequence of insert was identical to the published sequence. The COS-7 cells transfected with the pcDNA3.1BACE plasmid expressed a high level of the BACE protein in the cytoplasm. Conclusion The recombinant plasmid pcDNA3.1-BACE can provide a very useful tool for the research on the cause of Alzheimer’s disease and lay an important foundation for preventing Alzheimer’s disease.
Objective To study the cl inical characteristics of sacrum echinococcosis disease so as to provide a basis for its diagnosis and treatment. Methods Between July 1999 and August 2010, 14 cases of sacrum echinococcosis disease were treated and the cl inical data were analysed retrospectively. There were 6 males and 8 females with an average age of 28.7 years (range, 16-58 years). The median disease duration was 5.7 years (range, 6 months to 11 years). Twelve cases came from cattle area or had a history of close contact with dogs and sheep; 12 patients had a history of lung or l iver hydatid disease. The main clinical symptoms were lumbosacral and lower extremity pain, one or both lower extremities and perineal hypoesthesia, the gradual dysfunction of both lower extremities and neurogenic bladder and bowel, and decreased force of urination. The imaging examination showed multicystic bone erosion. The Casoni test was performed in 10 cases and the results were positive in 8 cases. The eight immunoserology markers of hydatidosis were detected in 4 cases, and the results were all positive. After entire debridement of the focus, defects were repaired with autogenous bone, allogeneic bone, artificial bone, or bone cement, and then albendazole was used as a routine treatment for 3 months. Results Incisions healed by first intention, and no compl ication occurred. All patients were followed up 6 months to 11 years with a median time of 5.7 years. The preoperative cl inical symptoms were rel ieved. Eight cases recurred at 6 months to 3 years after operation; after debridement (3 times in 5 and 5 times in 1) and the lesions marginal resection with a high-speed burr (2 cases), the symptoms were relieved in different degrees without recurrence. No hydatid disease occurred and spreaded. Conclusion The cl inical manifestation of sacrum is not typical, which is easy to be misdiagnosed. MRI is helpful to diagnosis sacrum echinococcosis disease; serological examination is the major method of identification diagnosis, and surgery is the main treatment method.