ASPECTS评分及多模态CT定量分析在AIS预后预测中的应用

目的探讨ASPECTS评分及多模态CT中各参数在急性缺血性脑卒中(AIS)预后预测的应用价值。方法收集2019年1月-2023年4月诊断为AIS并在蚌埠医学院第一附属医院就诊的患者,在治疗前均行多模态CT(包括NCCT、CTA、CTP)检查的患者93例,3个月后随访并根据改良Rankin量表评分(mRs)将患者分为预后良好组(mRs≤2)和预后不良组(mRs>2),收集两组患者的临床资料及多模态CT定量参数比较其在预测AIS中预后中有无意义。结果一般资料分析可见预后不良组患者入院基线NIHSS评分、远端侧支循环及ASPECTS评分均与预后良好组之间有一定的统计学差异(P<0.05);CT灌注定量参数分析可见预后不良组CBF较低,而MTT、Tmax、TTP较预后良好组延长,且具有统计学意义(P<0.05)。其中NIHSS、远端侧支循环及Tmax为影响AIS预后的独立危险因素。结论NIHSS、远端侧支循环、ASPECTS及多模态CT可以对AIS的预后进行评测。均具有较好的预测效能,其中Tmax及NIHSS预测效能最好。

颈动脉斑块MRI特征与同侧急性脑梗死患者DWIGASPECTS的相关性研究

目的:探讨颈动脉斑块MRI特征与同侧急性脑梗死患者DWI-ASPECTS的相关性。方法:回顾性搜集我院85例颈动脉斑块患者的临床及影像资料,所有患者均于出现脑血管症状2周内行颈动脉高分辨率MRI和常规颅脑MRI平扫。将患者分为DWI-ASPECTS≤7分组和DWI-ASPECTS>7分组,比较两组间临床、实验室资料和颈动脉斑块定量、定性指标的差异。通过Logistic回归筛选DWI-ASPECTS评分的预测因子。结果:25例(29.4%)DWI-ASPECTS≤7分,60例(70.6%)DWI-ASPECTS>7分。DWI-ASPECTS≤7分组患者纤维帽变薄/破裂(分别为80.0%和35.0%,P<0.001)、斑块内出血(分别为72.0%和21.7%,P<0.001)、钙化(分别为76.0%和45.0%,P=0.009)和富脂质坏死核心(分别为72.0%和45.0%,P=0.023)的发生率均高于DWI-ASPECTS>7分组;此外,DWI-ASPECTS≤7分组患者显示出更高的斑块负荷,DWI-ASPECTS≤7分组与DWI-ASPECTS>7分组的最大管壁厚度[分别为(4.38±1.68)和(3.47±1.78)mm,P=0.033]、平均管腔面积[分别为(15.33±11.57)和(22.88±13.95)mm 2,P=0.019]、最小管腔面积[分别为(11.52±11.23)和(18.98±13.52)mm 2,P=0.017]、平均管壁面积[分别为(62.81±14.32)、(55.66±14.93)mm 2,P=0.045]、最大管壁面积[分别为(66.70±14.57)、(59.56±15.19)mm 2,P=0.049]、平均标准化管壁面指数[分别为(81±14)%、(71±16)%,P=0.011]、最大标准化管壁指数[分别为(86±14)%、(76±16)%,P=0.012)]差异均有统计学意义。DWI-ASPECTS≤7分组中NIHSS评分>4分的患者比例更高(分别为48%和23.3%,P=0.025),高密度脂蛋白浓度更低[分别为(1.24±0.28)、(1.10±0.28)mmol/L,P=0.043]。Logistic回归分析结果显示,纤维帽变薄/破裂(OR=4.133,95%CI:1.151~14.836,P=0.030)和斑块内出血(OR=6.409,95%CI:1.737~23.646,P=0.005)与较低的DWI-ASPECTS评分显著相关。结论:颈动脉斑块中存在纤维帽变薄/破裂和斑块内出血的急性脑卒中患者DWI-ASPECTS评分更低,有助于评估患者的病情严重程度。

Management of Significant Environmental Aspects and Impacts in Accordance with the ISO 14001:2015 Standard during the Operation and Maintenance Phase of Senegal River Basin Development Authority Hydroelectric Works and Facilities: The Case of Manantali Dam

This study aims to determine the environmental aspects and impacts of the phase relating to the operation of Manantali’s hydroelectric structures and facilities according to the requirements of the ISO 14001 version 2015 standard. To do this, the mapping of the different work areas made it possible to identify all the activities within the framework of the farm. Based on the mapping, environmental measurements made including noise level, brightness, electric and magnetic fields, total particles, PM10, PM2.5, PM1 showed the work areas with the exposure limit values exceeded. The inventories of the waste produced show eighteen (18) types of waste, 67% of which are special industrial waste (SIW), 28% are ordinary industrial waste (OIW) and 5% are inert industrial waste (IIW). The identification and assessment of environmental aspects and impacts made it possible to determine sixteen (16) positive and negative significant environmental aspects (ESAs). The positive AES must be maintained, and for the negative ones, mitigation and mitigation measures must be put in place in order to manage them effectively. This will ultimately improve environmental management in the operation of hydroelectric structures and facilities.

Psychosocial Aspects of Male Infertility at the Service of Urology-Andrology of the Hospital of the Sino-Guinean Friendship

Objective: Describe the psychosocial aspects of male infertility at the hospital of the Sino-Guinean Friendship. Patients and method: It is a prospective study of a descriptive type covering a period of 6 months. The study covered 17 patients, all received for a desire to conceive after at least one year of regular sexual intercourse without contraception. The data were collected from patient interviews using a pre-established questionnaire. Results: The average age of the patients was 32.07 years with extremes of 23 years and 42 years. During this study, 64.70% of patients were no longer participating in community ceremonies. The patients’ relationships with their spouse and family deteriorated in 52.94% and 47.06%, respectively. Conversely, relations with the family of origin remained unchanged in 70.59 percent of cases. The reduction in economic activity was by 13 patients (76.48%). Conclusion: Male infertility causes a real psychic earthquake in men with its corollaries of negative feelings. The rather complex moral repercussions of male infertility affect not only the individual, his/her partner, and family, but also economic activity.

人工智能在急性缺血性脑卒中早期ASPECTS评估中的研究进展

急性缺血性脑卒中(AIS)的早期诊断和及时干预对于降低脑卒中的致死致残率具有重要意义。目前,临床上采用阿尔伯塔卒中项目早期计算机断层扫描评分(ASPECTS)来评估AIS的严重程度,但人为评估方法主观性过强且耗时耗力,极易导致漏诊、误诊。因此,近年来涌现了许多基于人工智能算法对AIS进行ASPECTS自动评分的方法研究。本文对此进行综述,以期为进一步研究探索提供参考。首先,简述ASPECTS评分的可靠性;其次,重点介绍目前基于人工智能的脑区提取及脑区评分的方法,证实计算机辅助ASPECTS评分能够有效提高对病情判断的可靠性;最后,总结现有ASPECTS自动评分方法存在的不足,并对其未来的发展趋势进行展望。

FibroScan-aspartate transaminase:A superior non-invasive model for diagnosing high-risk metabolic dysfunction-associated steatohepatitis

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)with hepatic histological NAFLD activity score≥4 and fibrosis stage F≥2 is regarded as“at risk”non-alcoholic steatohepatitis(NASH).Based on an international consensus,NAFLD and NASH were renamed as metabolic dysfunction-associated steatotic liver disease(MASLD)and metabolic dysfunction-associated steatohepatitis(MASH),respectively;hence,we introduced the term“high-risk MASH”.Diagnostic values of seven non-invasive models,including FibroScan-aspartate transaminase(FAST),fibrosis-4(FIB-4),aspartate transaminase to platelet ratio index(APRI),etc.for high-risk MASH have rarely been studied and compared in MASLD.AIM To assess the clinical value of seven non-invasive models as alternatives to liver biopsy for diagnosing high-risk MASH.METHODS A retrospective analysis was conducted on 309 patients diagnosed with NAFLD via liver biopsy at Beijing Ditan Hospital,between January 2012 and December 2020.After screening for MASLD and the exclusion criteria,279 patients wereincluded and categorized into high-risk and non-high-risk MASH groups.Utilizing threshold values of each model,sensitivity,specificity,positive predictive value(PPV),and negative predictive values(NPV),were calculated.Receiver operating characteristic curves were constructed to evaluate their diagnostic efficacy based on the area under the curve(AUROC).RESULTS MASLD diagnostic criteria were met by 99.4%patients with NAFLD.The MASLD population was analyzed in two cohorts:Overall population(279 patients)and the subgroup(117 patients)who underwent liver transient elastography(FibroScan).In the overall population,FIB-4 showed better diagnostic efficacy and higher PPV,with sensitivity,specificity,PPV,NPV,and AUROC of 26.9%,95.2%,73.5%,72.2%,and 0.75.APRI,Forns index,and aspartate transaminase to alanine transaminase ratio(ARR)showed moderate diagnostic efficacy,whereas S index and gamma-glutamyl transpeptidase to platelet ratio(GPR)were relatively weaker.In the subgroup,FAST had the highest diagnostic efficacy,its sensitivity,specificity,PPV,NPV,and AUROC were 44.2%,92.3%,82.1%,67.4%,and 0.82.The FIB-4 AUROC was 0.76.S index and GPR exhibited almost no diagnostic value for high-risk MASH.CONCLUSION FAST and FIB-4 could replace liver biopsy as more effectively diagnostic methods for high-risk MASH compared to APRI,Forns index,ARR,S index,and GPR;FAST is superior to FIB-4.

Influence of quarantine during the coronavirus disease 2019(COVID-19)pandemic on physical and psychosocial aspects:perceptions of 214 Brazilian athletes

Background:Social distancing may affect athletes,training,causing negative effects on mental and physical health.Objective:This study therefore aimed to characterize the perception of Brazilian athletes about their physical and psychosocial aspects,sleep quality and coping strategies during the quarantine of the coronavirus disease 2019(COVID-19)pandemic.Methods:This was a cross-sectional study with online survey,performed with Brazilian athletes(amateur and professional)over 18 years.The main outcomes measures assessed were physical and psychosocial aspects,sleep quality and coping strategies.Results:A total of 214 athletes were included.The average weekly hours of training during the quarantine was 4.71±3.71 h,of which 64.5%athletes(138/214)were oriented by medical staff during training.For 52.8%(113/214)of athletes,training intensity during the quarantine was different/very different from the intensity before the quarantine.79.4%athletes(170/214)reported moderate to extreme difficulties in keeping the same level of training during the quarantine.77.1%athletes(165/214)had moderate to extreme anxiety and each of the athletes had concern about his or her athletic career future,including return to the sport.72.9%athletes(156/214)reported change in sleep schedule during the quarantine period.Conclusion:The quarantine period during COVID-19 pandemic negatively affected the athlete^perception about training routine,since athletes reported reduction in training hours and training intensity.Overall,the athletes reported that they were moderately to extremely anxious.They also had concerns about their career in the future,as well as concerns regarding return to sport.

Efficacy of mycophenolate mofetil combined with topical 0.05%tacrolimus in high-risk keratoplasty:1-year cohort study

AIM:To investigate the efficacy of systemic mycophenolate mofetil(MMF)as an adjunct in combination with topical tacrolimus(FK506)and corticosteroid eyedrops for preventing corneal graft rejection after high-risk keratoplasty(HRK).METHODS:In this cohort study,55 consecutive patients(55 eyes)from an eye center who met the criteria of HRK were included.The definition for HRK includes large grafts of no less than 9 mm diameter,vascularized cornea of two or more quadrants,regrafting,or eccentric grafts.After penetrating keratoplasty,25 patients treated with systemic MMF in combination with 0.05%FK506 and tapering corticosteroid eyedrops were enrolled in Group 1 from October 2019.Thirty patients receiving postoperative treatment with 0.05%FK506 and tapering corticosteroid eyedrops alone were enrolled in Group 2 from January 2018 to September 2019.All participants were closely monitored after surgery,and episodes of graft rejection and relevant clinical data were collected and assessed over a one-year follow-up period.RESULTS:After a follow-up of 9.6±3.2mo,graft rejection episodes occurred in 4 cases(16%)in Group 1 and 18 cases(60%)in Group 2.One reversible and 3 irreversible graft rejections occurred in Group 1,while 3 reversible and 15 irreversible rejections occurred in Group 2.Kaplan-Meier analysis revealed that 82.5%of grafts in Group 1 and 37.1%in Group 2 did not experience corneal graft rejection(P<0.01,log-rank test).The clear graft survival rate was 83.6%in Group 1 and 36.7%in Group 2(P<0.01,log-rank test)within one year of follow-up.No severe systemic side effects were observed in either group during the follow-up period.CONCLUSION:The triple treatment regimen consisting of MMF,topical FK506,and corticosteroid eyedrops represents a promising strategy for effectively preventing graft rejection and improving graft survival in patients with HRK.

Intravitreal conbercept injection with panretinal photocoagulation for high-risk proliferative diabetic retinopathy with vitreous hemorrhage

AIM:To assess the clinical efficacy and safety of combining panretinal photocoagulation(PRP)with intravitreal conbercept(IVC)injections for patients with high-risk proliferative diabetic retinopathy(HR-PDR)complicated by mild or moderate vitreous hemorrhage(VH),with or without diabetic macular edema(DME).METHODS:Patients diagnosed with VH with/without DME secondary to HR-PDR and received PRP combined with IVC injections were recruited in this retrospective study.Upon establishing the patient’s diagnosis,an initial IVC was performed,followed by prompt administration of PRP.In cases who significant bleeding persisted and impeded the laser operation,IVC was sustained before supplementing with PRP.Following the completion of PRP,patients were meticulously monitored for a minimum of six months.Laser therapy and IVC injections were judiciously adjusted based on fundus fluorescein angiography(FFA)results.Therapeutic effect and the incidence of adverse events were observed.RESULTS:Out of 42 patients(74 eyes),29 were male and 13 were female,with a mean age of 59.17±12.74y(33-84y).The diabetic history was between 1wk and 26y,and the interval between the onset of visual symptoms and diagnosis of HR-PDR was 1wk-1y.The affected eye received 2.59±1.87(1-10)IVC injections and underwent 5.5±1.02(4-8)sessions of PRP.Of these,68 eyes received PRP following 1 IVC injection,5 eyes after 2 IVC injections,and 1 eye after 3 IVC injections.Complete absorption of VH was observed in all 74 eyes 5-50wk after initial treatment,with resolution of DME in 51 eyes 3-48wk after initial treatment.A newly developed epiretinal membrane was noted in one eye.Visual acuity significantly improved in 25 eyes.No complications such as glaucoma,retinal detachment,or endophthalmitis were reported.CONCLUSION:The study suggests that the combination of PRP with IVC injections is an effective and safe modality for treating diabetic VH in patients with HR-PDR.

Elliptical vibration chiseling:a novel process for texturing ultra-high-aspect-ratio microstructures on the metallic surface

High-aspect-ratio metallic surface microstructures are increasingly demanded in breakthrough applications,such as high-performance heat transfer enhancement and surface plasmon devices.However,the fast and cost-effective fabrication of high-aspect-ratio microstructures on metallic surfaces remains challenging for existing techniques.This study proposes a novel cutting-based process,namely elliptical vibration chiseling(EV-chiseling),for the high-efficiency texturing of surface microstructures with an ultrahigh aspect ratio.Unlike conventional cutting,EV-chiseling superimposes a microscale EV on a backward-moving tool.The tool chisels into the material in each vibration cycle to generate an upright chip with a high aspect ratio through material deformation.Thanks to the tool’s backward movement,the chip is left on the material surface to form a microstructure rather than falling off.Since one microstructure is generated in one vibration cycle,the process can be highly efficient using ultrafast(>1 kHz)tool vibration.A finite element analysis model is established to explore the process mechanics of EV-chiseling.Next,a mechanistic model of the microstructured surface generation is developed to describe the microstructures’aspect ratio dependency on the process parameters.Then,surface texturing tests are performed on copper to verify the efficacy of EV-chiseling.Uniformed micro ribs with a spacing of 1–10μm and an aspect ratio of 2–5 have been successfully textured on copper.Compared with the conventional EV-cutting that uses a forward-moving tool,EV-chiseling can improve the aspect ratio of textured microstructure by up to 40 times.The experimental results also verify the accuracy of the developed surface generation model of microstructures.Finally,the effects of elliptical trajectory,depth of cut,tool shape,and tool edge radius on the surface generation of micro ribs have been discussed.

Prevalence of Precancerous Lesions Based on Digital Cervicography with VIA/VILI among Women Positive for High-Risk Human Papillomavirus Serotypes: A Screening Center-Based Study in Cameroon

Background: Since 2021, high-risk Human Papilloma Virus (HR-HPV) testing has been the recommended screening test for cervical cancer for all settings;either used alone in a “test and treat” strategy, or with a triage test, with or without biopsy, before treatment. Cameroon has rolled out immunization against HPV 16 and 18, but studies show a higher prevalence of non-16/18 HR-HPV types. Objectives: Determine the prevalence of precancerous lesions, in women with HR-HPV infection and evaluate association of digital cervicography (DC) VIA/VILI positivity with HPV serotype, as a measure of their contribution to precancer and cancer incidence. Methodology: The study was cross-sectional, descriptive, and analytic. It took place at the Etoug-Ebe and Ekoudoum Baptist Hospitals in Yaoundé, during the period April-September 2022. We reviewed the records of women screened for cervical cancer between February 2020 and December 2021 and evaluated the prevalence of lesions on digital cervicography (DC) with VIA/VILI for women positive for HR-HPV serotypes. The data were analyzed using SPSS version 20.0 for Windows. P values Results: We identified 315 cases with a positive HR-HPV deoxyribonucleic acid (DNA) test, 224 (71.1%) had a DC VIA/VILI triage test done. Of these, 30 (13.4%) women had a positive DC VIA/VILI, with five women (2.2%) having lesions suggestive of cancer. Out of 11 cases positive for HPV 16 alone, 05 (45.5%) had a positive DC VIA/VILI test. Of the 14 cases positive for HPV 18 alone, 03 (21.4%) had a positive VIA/VILI, meanwhile only 19 (10.7%) of the 177 cases positive for non-16/18 HPV had a positive VIA/VILI test. Conclusion: A high proportion of women (13.4%) with HR HPV had a positive DC VIA/VILI, with a significant proportion (2.2%) having lesions suggestive of invasive cervical cancer HR-HPV serotype was associated with DC VIA/VILI positivity;HPV 16 had the strongest association (45.5%), followed by HPV 18 (21.4%), and non-16/18 HR-HPV (10.7%), suggesting a decreasing order of oncogenicity.

Study on the Influence of Aspect Ratio on the Seismic Response and Overturning Resistance of a New Staggered Story Isolated Structure

The aspect ratio of the structure has a significant impact on the overall stability of the ultra high-rise building. A large aspect ratio of the structure increases the risk of overturning and reduces the lateral stiffness of the structure, leading to significant tensile and compressive stresses in the isolated bearings. To study the effect of aspect ratio on the seismic response and overturning resistance of a new staggered story isolated structure, three models with different aspect ratios were established. Nonlinear time-history analysis of the three models was conducted using ETABS finite element software. The results indicate that the overturning moment and overturning resistance moment of the superstructure in the new staggered story isolated structure increase with an increasing aspect ratio. However, the increase in the overturning moment of the superstructure is much greater than the increase in the overturning resistance moment, resulting in a decrease in the overturning resistance ratio of the superstructure with an increasing aspect ratio. The overturning moment and overturning resistance moment of the substructure in the new staggered story isolated structure decrease with an increasing aspect ratio. However, the decrease in the overturning moment of the substructure is greater than the decrease in the overturning resistance moment, leading to an increase in the overturning resistance ratio of the substructure with an increasing aspect ratio. The decrease in the overturning resistance ratio of the superstructure in the new staggered story isolated structure is much greater than the increase in the overturning resistance ratio of the substructure. Therefore, as the aspect ratio of the overall structure increases, the overturning resistance ratio of the superstructure and the entire structure decreases.

Effects of Health Education with Problem-Based Learning Approaches on the Knowledge, Attitude, Practice and Coping Skills of Women with High-Risk Pregnancies in Plateau Areas

Objective: Given the unique cultural background, way of life, and physical environment of the Tibetan Plateau, this study aims to investigate the effects of health education using problem-based learning (PBL) approaches on the knowledge, attitude, practice, and coping skills of women with high-risk pregnancies in this region. Methods: 76 high-risk pregnancy cases were enrolled at Tibet’s Linzhi People’s Hospital between September 2023 and April 2024. 30 patients admitted between September 2023 and December 2023 were selected as the control group and were performed with regular patient education. 46 patients admitted between January 2024 and April 2024 were selected as the observation group and were performed regular patient education with problem-based learning approaches. Two groups’ performance on their health knowledge, attitude, practice and coping skills before and after interventions were evaluated, and patient satisfaction were measured at the end of the study. Results: There was no statistical significance (P P P Conclusions: Health education with problem-based learning approaches is worth promoting as it can help high-risk pregnant women in plateau areas develop better health knowledge, attitude and practice and healthier coping skills. Also, it can improve patient sanctification.

Experimental models of high-risk bowel anastomosis in rats:A systematic review

BACKGROUND Anastomotic leaks remain one of the most dreaded complications in gastrointestinal surgery causing significant morbidity,that negatively affect the patients’quality of life.Experimental studies play an important role in understanding the pathophysiological background of anastomotic healing and there are still many fields that require further investigation.Knowledge drawn from these studies can lead to interventions or techniques that can reduce the risk of anastomotic leak in patients with high-risk features.Despite the advances in experimental protocols and techniques,designing a high-quality study is still challenging for the investigators as there is a plethora of different models used.AIM To review current state of the art for experimental protocols in high-risk anastomosis in rats.METHODS This systematic review was performed according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.To identify eligible studies,a comprehensive literature search was performed in the electronic databases PubMed(MEDLINE)and Scopus,covering the period from conception until 18 October 2023.RESULTS From our search strategy 102 studies were included and were categorized based on the mechanism used to create a high-risk anastomosis.Methods of assessing anastomotic healing were extracted and were individually appraised.CONCLUSION Anastomotic healing studies have evolved over the last decades,but the findings are yet to be translated into human studies.There is a need for high-quality,well-designed studies that will help to the better understanding of the pathophysiology of anastomotic healing and the effects of various interventions.

Application Value of NLR,PLR,LMR,HEART score,and POCT in Early Warning and Accurate Graded Diagnosis of High-Risk Chest Pain in Emergency Medicine

Objective: To evaluate the application value of neutrophils/lymphocytes (NLR), platelets/lymphocytes (PLR), lymphocytes/monocytes (LMR), HEART (history, electrocardiogram, age, risk factors, and troponin) score, and point-of- care testing (POCT) in the early warning and precise diagnosis of high-risk chest pain in emergency medicine. Methods: A total of 157 patients with acute chest pain who were admitted to the emergency department and chest pain treatment unit of our hospital between August 2022 and September 2023 were selected. Rapid testing of bedside myocardial markers (ultrasensitive troponin (hs-cTnI), myoglobin (MYO), creatine kinase isoenzyme (CK-MB), D-dimer (D-Dimer), and N-terminal B-type natriuretic peptide precursor (NT-proBNP)) was performed on the patients using a POCT device (ThermoKing BioMQ60proB). A HEART score was used to classify the patients into low (n = 53), intermediate (n = 59), and high-risk (n = 45) groups, and the NLR, PLR, and LMR were calculated. The NLR, PLR, and LMR values were compared among the three groups of patients, and the optimal cutoff values as well as sensitivity and specificity were determined based on receiver operating characteristic (ROC) analysis. Results: The HEART scores of patients in the low-risk, intermediate-risk, and high-risk groups were (2.72 ± 0.24), (4.75 ± 0.56), and (5.32 ± 0.73) respectively, and the differences were statistically significant (P < 0.05). Compared with the low-risk group, the intermediate-risk group and high-risk group had a significantly higher NLR and PLR, and a significantly lower LMR;the high-risk group had higher NLR and PLR and lower values of LMR as compared to the other two groups, and the difference was statistically significant (P < 0.05). The ROC curves suggested that the area under the curve, sensitivity, and specificity of the combined diagnosis of NLR, PLR, LMR, HEART score, and POCT were greater than those of LR, PLR, and LMR with HEART score and POCT alone. Conclusion: The combined application of NLR, PLR, LMR, HEART score, and POCT has significant application value in the early warning and precise diagnosis of emergency high-risk chest pain. It provides a more simple, easy-to-access, and efficient assessment index for the clinical prediction and treatment of emergency high- risk chest pain.

一种基于预训练模型掩码Aspect术语的数据增强方法

数据增强是解决低资源场景下数据稀缺问题的有效方案。然而,当应用于诸如方面术语提取(ATE)之类的词级别任务时,数据增强方法通常会遭受词标签不对齐的问题,从而导致效果不理想。对此提出了掩码方面语言建模(MALM)作为ATE的新型数据增强框架。为了缓解标记、标签错位问题,将ATE标签显式注入到句子上下文中,由此经过微调的MALM能够显式地调整标签信息来预测掩码的方面标记。因此,MALM可帮助生成具有新方面的高质量增强数据,提供丰富的层面方面知识。此外,提出了一个两阶段的训练策略来整合这些合成数据。通过实验,证明了MALM在两个ATE数据集上的有效性,相比基线方法,所提出的MALM有显著的性能改进。

Aspect-Level Sentiment Analysis Incorporating Semantic and Syntactic Information

Aiming at the problem that existing models in aspect-level sentiment analysis cannot fully and effectively utilize sentence semantic and syntactic structure information, this paper proposes a graph neural network-based aspect-level sentiment classification model. Self-attention, aspectual word multi-head attention and dependent syntactic relations are fused and the node representations are enhanced with graph convolutional networks to enable the model to fully learn the global semantic and syntactic structural information of sentences. Experimental results show that the model performs well on three public benchmark datasets Rest14, Lap14, and Twitter, improving the accuracy of sentiment classification.

CT灌注成像ASPECTS在急性缺血性脑卒中溶栓再通中的应用

目的研究CT灌注成像(CTP)、Albertu脑卒中项目早期CT评分(ASPECTS)在检测可逆性脑组织缺血方面的作用。方法回顾62例患者临床和影像学资料,这些患者均因急性缺血性脑卒中(持续时间<3 h)接受了静脉溶栓治疗,脑卒中患者最初影像学评估包括非对比增强CT(NCCT),CT血管造影(CTA)和CTP。结果共25例患者存在CTP ASPECTS不匹配。CTP ASPECTS不匹配亚组最终脑梗死体积分别与NCCT 0 h-ASPECTS,平均间隔时间(MTT)-ASPECTS,脑血容量(CBV)-ASPECTS,NCCT 24 h-ASPECTS均呈负相关,ΔmRS分别与NCCT 0 h-ASPECTS,MTT-ASPECTS,CBV-ASPECTS,NCCT 24 h-ASPECTS间均呈负相关。与所有患者组或所有前循环事件的患者亚组相比,在CTP ASPECTS不匹配亚组,ASPECTS和临床结果之间的相关性较高。MTT-ASPECTS和CBV-ASPECTS分数与临床结果之间的相关性比NCCT 0 h-ASPECTS(即入院时NCCT-ASPECTS)与临床结果的相关性要强。二分ΔmRS,采用ΔmRS≤1表示良好的临床效果,MTT-NCCT 24 h ASPECTS不匹配的统计学显著性最低的阈值为2(P=0.04),该值预测良好的临床结果。在MTT-NCCT 24 h ASPECTS不匹配≥2的患者亚组(n=12),此参数和CTP-ASPECTS不匹配间有较强的相关性(r=0.79,P<0.001),并具有较强的线性相关性(R2=0.671)。结论 CTP ASPECTS不匹配可充分预测潜在的可挽救缺血脑组织的量。

CTP-ASPECTS评分在前循环梗死患者急性期预后判断中的应用

目的探讨前循环梗死患者入院时CT灌注成像(CTP)-ASPECTS评分与急性期预后的关系。方法回顾分析起病时间在4.5～8.0 h的34例急性前循环梗死患者头颅CT平扫、CTP及头颅血管造影(CTA)检查结果,根据患者缺血性中风1周内的预后(有无意识改变或死亡)分为预后较好组及预后较差组,多模CT检查获得脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)、达峰时间等参数图,并对各参数图进行ASPECTS评分,同时获得动态CT血管成像(CTA)。比较两组患者CTP参数ASPECTS评分的差异。结果 34例患者中预后较差组12例,预后较差组CBV-ASPECTS评分较低,与预后较好组比较差异有统计学意义(P<0.01),两组病变侧CBF-ASPECTS与MTT-ASPECTS比较差异无统计学意义(P>0.05)。结论 CBV-ASPECTS评分可以作为前循环梗死患者急性期预后的预测因子。

NIHSS/DWI-ASPECTS不匹配预测大脑中动脉供血区脑梗死早期神经功能恶化

目的 探究NIHSS/DWI-ASPECTS不匹配对大脑中动脉供血区脑梗死早期神经功能恶化的预测价值。方法 回顾性收集2017年3月~2018年5月因大脑中动脉供血区脑梗死在安徽医科大学第二附属医院神经内科住院的患者。收集其临床资料,根据入院时和住院72 h NIHSS评分,评估早期神经功能恶化(early neurological deterioration,END),将患者分为END组和非END组。所有患者在入院48 h内完成头部MRI检查,并行DWI-Alberta 卒中项目早期CT评分(DWI-ASPECTS),NIHSS/DWI-ASPECTS不匹配(NIHSS/DWI-ASPECTS Mismatch,NDM)定义为 NIHSS评分≥8且DWI-ASPECTS≥8,应用多变量Logistic回归分析NDM与大脑中动脉供血区脑梗死END的相关性。结果 共收集94例大脑中动脉供血区脑梗死患者,男性52例(55.3%),年龄(65.4±11.0)岁。符合END患者31例(33%)。NIHSS/DWI-ASPECTS不匹配(NDM)病例18例(19.1%),其中END组14例(45%),非END组4例(6.5%)。END组年龄大、NIHSS高、DWI-ASPECTS低、NDM患者比例显著高于非END组( P ≤0.05或 P ≤0.01)。多变量Logistic回归分析显示,在校正混杂因素后,DWI-ASPECTS(优势比0.637,95%置信区间0.409~0.994, P =0.047)和NDM(优势比13.175,95%置信区间1.539~112.824, P =0.019)是大脑中动脉供血区脑梗死END的预测因素。结论 NIHSS/DWI-ASPECTS不匹配对大脑中动脉供血区脑梗死早期神经功能恶化具有一定的预测价值。