A Preliminary Clinical Study of Three Dimensional Ultrasonography in Prenatal Diagnosis

To evaluate the clinical value of three dimensional ultrasonography (3DUS) in prenatal diagnosis, 134 pregnant women with high risk factors in second and third trimester were examined by 3DUS. The results showed that 3DUS could provide more diagnostic information, exclude the abnormalities and enhance the confidence level of physician in 102 normal pregnant women. 3DUS was helpful in the diagnosis in 17 (60.7 %) of 28 cases of fetal anomalies. However, 3DUS was not useful in evaluating intrauterine growth retardation in 4 cases. It is conclucded that 3DUS is helpful in prenatal diagnosis.

Improving Thyroid Disorder Diagnosis via Ensemble Stacking and Bidirectional Feature Selection

Thyroid disorders represent a significant global health challenge with hypothyroidism and hyperthyroidism as two common conditions arising from dysfunction in the thyroid gland.Accurate and timely diagnosis of these disorders is crucial for effective treatment and patient care.This research introduces a comprehensive approach to improve the accuracy of thyroid disorder diagnosis through the integration of ensemble stacking and advanced feature selection techniques.Sequential forward feature selection,sequential backward feature elimination,and bidirectional feature elimination are investigated in this study.In ensemble learning,random forest,adaptive boosting,and bagging classifiers are employed.The effectiveness of these techniques is evaluated using two different datasets obtained from the University of California Irvine-Machine Learning Repository,both of which undergo preprocessing steps,including outlier removal,addressing missing data,data cleansing,and feature reduction.Extensive experimentation demonstrates the remarkable success of proposed ensemble stacking and bidirectional feature elimination achieving 100%and 99.86%accuracy in identifying hyperthyroidism and hypothyroidism,respectively.Beyond enhancing detection accuracy,the ensemble stacking model also demonstrated a streamlined computational complexity which is pivotal for practical medical applications.It significantly outperformed existing studies with similar objectives underscoring the viability and effectiveness of the proposed scheme.This research offers an innovative perspective and sets the platform for improved thyroid disorder diagnosis with broader implications for healthcare and patient well-being.

Application of General Fractal Dimension to Coupling Fault Diagnosis

This paper presents the coucept of general and sensitive dimension, and also proposes the calculation formula of the general dimension least squares method. By calculating and analyzing the power spectrum and general dimension from the fault sample, the relationship is achieved between sample status and the general dimension from vibration signals of the equipment so as to provide reference to fault diagnosis. Furthermore, a correlation function of general dimension is proposed, and calculations are carried out for a monitor signal and samples signal. The diagnosis method based on fractal theory is effective through the concrete examples of the steam electric generating set fault diagnosis, and the correlation coefficient of general dimension between a monitor signal and samples signal can improve the accuracy for fault diagnosis.

HIGHER ORDER SPECTRA AND ITS APPLICATION IN MACHINERY FAULT DIAGNOSIS

The application of higher order spectra to machinery faults diagnosis is studied in this paper.A brief review of bispectra is presented,and more emphasis is placed on the ability of higher order spectra to extract diagnostic information from fault signals.Furthermore,by use of the algorithm of higher order spectra,two kinds of typical mechanical faults are analyzed.Results show that the high order spectra analysis is a more efficient method in machinery diagnosis compared with the FFT based spectral analysis.

Role of 2-dimensional Doppler echo-cardiography in screening portopulmonary hypertension in portal hypertension patients

BACKGROUND: Portopulmonary hypertension (PPH) is difficult to recognize in the early and middle stages because it is frequently asymptomatic. As right ventricular function is impaired in patients with moderate and severe PPH, any dramatic hemodynamic changes in liver transplantation or other procedures may result in death from pulmonary and cardiac events. In this study, we investigated the prevalence of PPH in patients with portal hypertension (PHT) mainly caused by hepatitis B virus, and evaluated the effect of 2-dimensional Doppler echocardiography (2D-ECHO) in screening for PPH. METHODS: One hundred and five PHT patients received transthoracic 2D-ECHO preoperatively, systolic pulmonary arterial pressure (SPAP, normal range <30 mmHg) and pulmonary acceleration time (PAT, normal range >= 120 msec) were measured to screen for PPH (positive result: SPAP >= 30 mmHg and/or PAT <100 msec). Subsequently, pulmonary hemodynamic parameters were measured by right heart catheterization (RHC) for definitive diagnosis of PPH. The results of the two methods were compared to assess the screening effect of 2D-ECHO. RESULTS: The prevalence of PPH in this study was 3.8% (4/105). About 90% (95/105) of patients had a detectable tricuspid regurgitation by 2D-ECHO and the mean SPAP was 27.7 +/- 5.9 mmHg. Twenty-two of these 95 patients had an SPAP >30 mmHg. The mean PAT of all patients was 140 23 msec and 5 were <100 msec. Twenty-two patients were screened out by 2D-ECHO and 4 were diagnosed by RHC. A positive significant correlation (r=0.55, P<0.01) was found between SPAP measured by 2D-ECHO and mean pulmonary artery pressure (MPAP) measured by RHC, and a weak but significant negative correlation (r=-0.27, P=0.005) existed between PAT and pulmonary vascular resistance (PVR). The sensitivity, specificity, agreement rate, positive predictive value and negative predictive value of the screening test were 100%, 82%, 83%, 18% and 100%, respectively. CONCLUSIONS: The prevalence of PPH in this study is lower than in Western countries. As a screening test, 2D-ECHO has very high sensitivity and negative predictive value. A negative test result can directly be used to exclude PPH, while a positive result should be confirmed by RHC.

Three-Dimensional Ultrasonography in Obstetrics:the Clinical Value

To investigate the clinical value of three dimensional ultrasonography (3DUS) in obstetrics, various 3DUS rendering methods including surface mode, transparent mode and multiplanar mode were employed to scan 30 fetuses in second and third trimester by using the transabdominal volume transducer. The results showed that surface mode could vividly demonstrate the surface morphologic features of the fetuses, as well as the stereo shape and the spatial relationship among the surface structures. The face, limbs, umbilical cord and outer genitalia of the fetus could be well displayed by surface mode. Transparent mode could reveal the bony structures under the surface, such as ribs, vertebrae, crania, etc. The result was not affected by the sophisticated curvature of these bony structures and the success rate was up to 100 %. When rendered by multiplanar mode, the region of interest (ROI) could be viewed from different directions. It should be concluded that 3DUS could serve as a supplement to two dimensional ultrasonography (2DUS). 3DUS might play an important role in prenatal diagnosis and enhance the diagnostic confidence level of the physicians.

Research on a Diagnosis Method Based on a Correlation Integral

For the first time, the diagnosis idea based on a correlation integral isproposed, which regard's the correlation integral as a feature set. The correlation dimension iscontained in the double-log curve of the correlation integral to scale, so extracting featuresdirectly from the correlation integral can avoid the bottleneck problem of determining the range ofnon-scale length. Several features extracted from the correlation integral are better than thesingle feature of the correlation dimension when describing the signal. It is obvious that thismethod utilizes more information of the signal than does the correlation dimension. The diagnosisexamples verify that this method is more accurate and more effective.

THE FAULT DIAGNOSIS TECHNOLOGY BASED ON FRACTAL GEOMETRY FOR LOGGING TRUCK ENGINE

The paper discusses the fundamental conceptions and properties of fractal geometry.The definitions of fractal dimension are described and the mathods of calculating fractal dimension are introduced. The paper researches the peculiarities of fault diagnosis for logging truck engine and puts forward the technical way of diagnosing the faults with the help of the fractal geometry.

The Application of Coupled Three Order Cumulants’ Differential Feature in Fault Diagnosis

Complex three-order cumulant has different definition forms. Different forms conclude different information. For studying the effection of frequency in the coupled signals to fault diagnosis, the differential method to the three order cumulants of coupled signals is adopted. By using the differential of complex three order cumulants before and after respectively, then their ?dimensional spectrum is calculated, and the results are used to fault diagnosis. The experimental results show that, the increase frequency item in three order cumulants after differentiated impacts on the results of fault diagnosis and the degree of effection is relative to the differential times. And the correct rate of fault diagnosis can be raised by changing the differential times of three order cumulants.

From 2-dimensional to 3-dimensional: Overcoming dilemmas in intestinal mucosal interpretation

The purpose of this review is to provide a definitive account of small intestinal mucosal structure and interpretation. The coeliac lesion has been well known, but not well described to date and this review aims to identify the interpretative difficulties which have arisen over time with the histological assessment of coeliac disease. In early coeliac interpretation, there were significant inaccuracies, particularly surrounding intraepithelial lymphocyte counts and the degree of villous flattening which occurred in the tissue. Many of these interpretive pitfalls are still encountered today, increasing the potential for diagnostic errors. These difficulties are mostly due to the fact that stained 2-dimensional sections can never truly represent the 3-dimensional framework of the intestinal tissue under investigation. Therefore, this review offers a critical account occasioned by these 2-dimensional interpretative errors and which, in our opinion, should in general be jettisoned. As a result, we leave a framework regarding the true 3-dimensional knowledge of mucosal structure accrued over the 70-year period of study, and one which is available for future reference.

The Application of Three Order Cumulants Coupling Features in Fault Diagnosis

Although mechanical vibration is extremely complicated, each fault signal produced by it has its own inherent features, The distinction may be most prominent between the certain components hidden in those features and the same components of normal signals. Three-order cumulant can reduce the Gaussian background noise automatically and its complex formal includes different coupling information of its signal. In the experiment, through these different coupling modes, the same coupling components are fetched from specific fault signal and normal signal, then these components are used to diagnose that certain fault. The results show that the method can fetch the most prominent distinction between normal signal and the specific fault signal, so the specific fault diagnosis by this method is satisfactory.

Fault Diagnosis of Overflow Valve Based on Trispectrum

The high-order spectrum can effectively remove Gaussian noise. The three-spectrum and its slices represent random signals from a higher probability structure. It can not only qualitatively describe the linearity and nonlinearity of vibration signals closely related to mechanical failures, Gaussian and non-Gaussian Performance, and can greatly improve the accuracy of mechanical fault diagnosis. The two-dimensional slices of trispectrum in normal and fault states show different peak characteristics. 2-D wavelet multi-level decomposition can effectively compress 2-D array information. Least squares support vector machine can obtain the global optimum under limited samples, thus avoiding the local optimum problem, and has the advantage of reducing computational complexity. In this paper, 2-D wavelet multi-level decomposition is used to extract features of trispectrum 2-D slices, and input LSSVM to diagnose the fault of the pressure reducing valve, which has achieved good results.

Prenatal Diagnosis of Proximal Femoral Focal Deficiency Combining Ultrasound and Computer Tomography

Four cases of proximal femoral focal deficiency (PFFD) in an otherwise healthy infant are described. Antenatal diagnosis was made at 27, 23, 23 and 18 weeks of gestation by routine ultrasound (US) examination. Computer Tomography (CT) was performed after 30 weeks of gestation and confirmed the images obtained by US. The diagnosis was confirmed after delivery. These cases illustrate the importance of combining US and CT to improve accuracy of prenatal diagnosis of skeletal disorders.

DIP医保支付方式改革下医院多维联动精益运营管理研究

按病种分值付费(Diagnosis-Intervention Packet,DIP)医保支付方式改革的实施与落地对医院运营管理模式造成深远影响,使得医院的运营方式和管理内涵急需适配与优化。深度剖析DIP医保支付方式对于医院运营管理造成的影响,分别从病种分值政策的实施、医保成本核算控制、医疗服务质量提升、医保事后分析、病种管理等多个维度,对全生命周期视角DIP医保支付方式改革下医院运营管理模式的构建策略进行有力探索,以期更好地促进医院健康持续发展。

经阴道二维超声对子宫内膜息肉及子宫内膜息肉病变诊断的应用价值

目的探讨经阴道二维超声对子宫内膜息肉及子宫内膜息肉病变诊断的应用价值。方法选取2019年1月至2022年1月在本院就诊的患者46例,据病理检查结果将其分为息肉组和病变组。记录两组患者临床资料、BMI、超声指标(子宫内膜厚度、病灶最大直径、病灶回声不均匀、血流丰富),并以病理检查为金标准,分析经阴道二维超声诊断价值。结果依据病理检查检查显示,息肉组30例,病变组16例。两组患者年龄、产次0次占比比较差异无统计学意义(P>0.05),两组患者BMI≥24kg/m^(2)、绝经后出血比较差异具有统计学意义(P<0.05);病变组子宫内膜厚度、病灶最大直径、病灶回声不均匀占比、血流丰富占比均显著高于息肉组,差异均具有统计学意义(P<0.05);以病理结果作为金标准,灵敏度为67.50%(27/40),特异度为16.67%(1/6),阳性预测值为84.38%(27/32),阴性预测值为7.14%(1/14),符合率为60.87%(28/46)。结论经阴道二维超声可作为辅助手段用于子宫内膜息肉及其病变的早期诊断和鉴别诊断。

超声三维容积成像联合剪切波弹性成像诊断子宫内膜病变的价值

目的探讨超声三维容积成像联合剪切波弹性成像(SWE)诊断子宫内膜病变的价值。方法选取郑州人民医院2019年8月至2022年7月接收的100例子宫内膜病变患者,所有患者均在入院后接收超声三维容积成像、SWE检查,以术后病理结果为金标准,比较超声三维容积成像、剪切波弹性成像及联合诊断子宫内膜病变的价值。结果经活检或术后病理检查结果证实,100例子宫内膜病变患者中共有75例良性病变,25例恶性病变。其中子宫良性病变中子宫内膜息肉33例、子宫内膜增生不伴不典型增生18例,子宫黏膜下平滑肌瘤12例、其他(子宫腺肌病、子宫腺肌瘤、子宫内膜炎等)12例。恶性病变均为子宫内膜样腺癌;联合诊断的灵敏度及准确度最高,其次为SWE、超声三维容积成像,3种方式诊断效能比较,差异有统计学意义(P<0.05);Kappa一致性检验,超声三维容积成像联合SWE诊断不同子宫内膜病变的与活检或术后病理检查结果的一致性较好(P<0.05)。结论超声三维容积成像联合SWE在子宫内膜病变诊断中具有较高的临床价值,可提高对不同类型子宫内膜病变的诊断价值。

MSCT三维骨重建技术在髋关节骨折诊断及治疗中的应用

目的探讨多排螺旋CT(MSCT)三维骨重建技术在髋关节骨折诊断及治疗中的应用。方法选择2020年1月~2022年8月我院收治98例髋关节骨折患者,均行常规X线检查和MSCT检查,并进行MSCT三维重建,观察X线片、二维MSCT图像和MSCT骨三维重建图像。结果手术显示,98例患者共发现101处髋中骨折,其中35处为股骨头骨折,24处为股骨颈骨折,21处为粗隆间骨折,21处为髋臼骨折。X线漏检12处骨折,二维CT漏检7处骨折,MSCT三维骨重建未见漏检,其对髋关节骨折检出率显著高于X线及二维CT(P<0.05)。MSCT三维重建对髋臼骨折分型正确检出率高于二维CT和X线,但比较差异未见统计学意义(P>0.05)。根据患者术前MSCT骨三维重建资料设计治疗方案,术中所见与资料吻合,患者手术时间(106.30±27.40)min,术中出血量(356.60±54.17)mL,术中透视时间(21.35±5.11)s,骨折愈合时间(80.46±12.29)d;术后随访显示治疗优良率为94.90%,且暂未发生并发症。结论MSCT三维骨重建可清晰显示髋关节骨折情况,有利于髋关节骨折及骨折分型诊断,对临床手术方案制定及术后关节功能恢复具有重要价值。

经阴道子宫输卵管实时三维超声造影与X线碘油造影术对女性不孕症的诊断价值

目的:探讨经阴道子宫输卵管实时三维超声造影(RT-3D-HyCoSy)与X线碘油造影术(HSG)对女性不孕症的诊断价值。方法:选取70例(140条输卵管)不孕症患者为研究对象,按照影像学检查方式不同分为对照组和观察组,每组各35例。对照组患者行HSG检查;观察组患者行RT-3D-HyCoS检查,并于检查后次月月经干净后3~7 d行腹腔镜输卵管通液术(CLP)。比较两种影像学检查方法与CLP检查结果的符合率;以CLP检查结果为“金标准”,分析HSG与3D-HyCoSy检查对不孕症的诊断价值。结果:HSG和RT-3D-HyCoSy检查与CLP结果相符合的输卵管条数分别为52条和65条,两种检查方式与CLP的符合率比较,差异有统计学意义(74.29%vs.92.86%,χ^(2)=8.792,P=0.003)。以CLP检查结果为“金标准”,RT-3D-HyCoSy检查的敏感性、阴性预测值及准确性高于HSG检查(P<0.05);两种检查的特异性、阳性预测值比较,差异无统计学意义(P>0.05)。结论:相较传统HSG,RT-3D-HyCoSy是诊断女性不孕症更有效的方法,值得临床推广。

彩色多普勒超声与四维超声对胎儿肢体畸形的诊断及漏诊分析

目的:探讨彩色多普勒超声(CDUS)与四维超声(4D-US)对胎儿肢体畸形的诊断及漏诊情况。方法:选取2021年1月至2022年12月在保定市第一中心医院产检的201例孕妇,以引产后病理结果或出生结果为“金标准”,其中确诊为胎儿肢体畸形52例,并在产前均予以CDUS和4D-US检查,采用四格表法计算阳性、阴性预测值,采用受试者工作特征(ROC)曲线模型分析CDUS、4D-US诊断胎儿肢体畸形的ROC曲线下面积(AUC)值、灵敏度及特异度。结果:201例行胎儿肢体畸形筛查的孕妇经CDUS检查后,阳性预测值为64.15%,阴性预测值为85.53%,与“金标准”相比一致性一般(Kappa=0.532,P<0.001)。经4D-US扫描后,阳性预测值为84.31%,阴性预测值为94.00%,与“金标准”相比一致性较好(Kappa=0.778,P<0.001)。CDUS与4D-US的准确率相比,差异具有统计学意义(x^(2)=8.557,P<0.05)。201例行胎儿肢体畸形筛查的孕妇经4D-US诊断检出的人鱼序列综合征、裂手畸形、多指畸形、桡骨缺失并伴有或不伴有钩状手、长骨短小、足内翻、手掌缺如、胎儿股骨短小、并指畸形以及缺指畸形的总检出率(82.69%)高于CDUS的总检出率(65.38%),差异具有统计学意义(x^(2)=4.514,P<0.05)。ROC曲线分析显示,CDUS、4D-US诊断胎儿肢体畸形的AUC值分别为0.767和0.892;灵敏度分别为66.70%和84.30%;特异度分别为86.70%和94.00%;CDUS与4D-US的AUC比较,差异有统计学意义(Z=2.367,P<0.016)。结论:CDUS与4D-US在胎儿肢体畸形筛查中具有一定价值,其中以4D-US诊断效能更高。

3种方法单独及联合诊断甲状腺微小结节的价值比较

目的 比较二维高频超声、声脉冲辐射力成像(ARFI)-声触诊组织定量(VTQ)技术及应变弹性成像3种方法单独及联合诊断甲状腺微小结节良恶性的价值。方法 回顾性分析2021年6月—2023年6月在陕西省宝鸡市人民医院就诊的99例(107个甲状腺微小实性结节)结节直径≤10.0 mm患者的临床资料,均采用二维高频超声、ARF-VTQ技术及应变弹性成像进行检查,获得超声资料评分及数据,以穿刺活检和手术病理结果为诊断“金标准”,比较3种超声检查方法单独及联合应用对甲状腺微小结节的诊断效能。结果 62例患者(共68个结节)选择FNAB,37例患者(共39个结节)选择手术。107个甲状腺微小结节中,诊断为恶性微小结节45个,良性微小结节62个。恶性微小结节与良性微小结节相比,结节内回声(等回声和高回声、极低回声和低回声)、边界、微钙化、纵横比>1及血供情况和供血动脉阻力指数(RI)比较,差异均有统计学意义(P<0.05)。二维高频超声诊断甲状腺微小结节C-TIRADS积分临界值≥2分(C-TIRADS 4b)时,诊断灵敏度为73.33%,特异度为79.03%,曲线下面积[AUC(95%CI)]为0.762(95%CI:0.670~0.839);ARFI-VTQ技术中,107个甲状腺微小结节SWV测值为0.52~7.55 m/s,平均(2.62±0.61)m/s,其中24个实性结节多次出现×.××m/s,最后测值以7.55 m/s记录。恶性微小结节SWV均值为(5.24±2.23) m/s,高于良性微小结节的(2.11±0.70) m/s,差异有统计学意义(t=10.258,P<0.05);当SWV临界值为3.19 m/s时,诊断灵敏度为77.78%,特异度为80.65%,AUC(95%CI)为0.792(95%CI:0.703~0.865);应变弹性成像检查中,当评分临界值≥3分时,诊断的灵敏度为75.56%,特异度为77.42%,AUC(95%CI)为0.765(95%CI:0.673~0.841)。三者联合应用诊断的阳性微小结节为44个,阴性微小结节63个,诊断灵敏度为93.33%,特异度为96.77%,AUC(95%CI)为0.951(95%CI:0.891~0.983)。三者联合诊断效能与二维高频超声检查、ARFI-VTQ、应变弹性成像单独检测比较,差异均有统计学意义(Z=4.861、4.393、4.842,P<0.05)。结论 二维高频超声联合ARFI-VTQ技术及应变弹性成像可提高甲状腺微小结节良恶性的诊断准确性。