Correlation between key indicators of continuous glucose monitoring and the risk of diabetic foot

BACKGROUND Continuous glucose monitoring(CGM)metrics,such as time in range(TIR)and glycemic risk index(GRI),have been linked to various diabetes-related complications,including diabetic foot(DF).AIM To investigate the association between CGM-derived indicators and the risk of DF in individuals with type 2 diabetes mellitus(T2DM).METHODS A total of 591 individuals with T2DM(297 with DF and 294 without DF)were enrolled.Relevant clinical data,complications,comorbidities,hematological parameters,and 72-hour CGM data were collected.Logistic regression analysis was employed to examine the relationship between these measurements and the risk of DF.RESULTS Individuals with DF exhibited higher mean blood glucose(MBG)levels and increased proportions of time above range(TAR),TAR level 1,and TAR level 2,but lower TIR(all P<0.001).Patients with DF had significantly lower rates of achieving target ranges for TIR,TAR,and TAR level 2 than those without DF(all P<0.05).Logistic regression analysis revealed that GRI,MBG,and TAR level 1 were positively associated with DF risk,while TIR was inversely correlated(all P<0.05).Achieving TIR and TAR was inversely correlated with white blood cell count and glycated hemoglobin A1c levels(P<0.05).Additionally,achieving TAR was influenced by fasting plasma glucose,body mass index,diabetes duration,and antidiabetic medication use.CONCLUSION CGM metrics,particularly TIR and GRI,are significantly associated with the risk of DF in T2DM,emphasizing the importance of improved glucose control.

Reliability-Based Load and Resistance Factors Design for Offshore Jacket Platforms in the Bohai Bay:Calibration on Target Reliability Index

The target reliability index has been effectively used as the best solution to deal with the relationship between the structural safety and the optimal economy in any structural design. However, the target reliability index for offshore jacket platforms based on different sea areas in China has never been calibrated. This paper presents an approach for its calibration, and suggests many kinds of associated load cases. The uncertainties of loads and structural resistance are mainly in- vestigated. The target reliability index for structural components, tubular joints and piles of offshore jacket plaffortns are discussed respectively in detail. Finally, through the calibrated results from the offshore jacket platforms of QK18-1, JZ20-2, SZ36-1 and BZ28-1 in the Bohai Bay, it is proposed to adopt 2.8 as the target reliability index of offshore jacket platforms in the Bohai Bay for a 25-year design period. The results provide significant reference for the design of offshore jacket platforms.

Dosimetric Comparison of Volumetric Modulated Arc Therapy (VMAT), 5F Intensity Modulated Radiotherapy (IMRT) and 3D Conformal Radiotherapy (3DCRT) in Rectal Carcinoma Receiving Neoadjuvant Chemoradiotherapy

Objective: To investigate better dosimetric distribution of volumetric modulated arc therapy (VMAT) vs. 5F intensity modulated radiotherapy (IMRT) and 3D conformal radiotherapy (3DCRT) in patients with locally advanced rectal cancer (LARC) when treated with neoadjuvant chemoradiotherapy. Methods: 3D-CRT, 5F-IMRT and VMAT plans for preoperative radiotherapy were 66011designed in 12 patients with locally advanced rectal cancer. The conformity index (CI) and homogeneity index (HI) in target volume, and the dose and volume of the organs at risk (OAR) irradiated including small bowel, bladder and bilatera1 femoral heads were compared among the three plans. Results: The CI for planning target volume (PTV) 2 and HI for PTV1 of VMRT and 5F-IMRT were superior to 3D-CRT. The CI of VMAT, 5F-IMRT and 3D-CRT plans were 0.71, 0.69 and 0.62 (p = 0.011 and p = 0.019, respectively). The HI of the VMAT and 5F-IMRT plans were both 1.04 and 3D-CRT planning was 1.06 (p = 0.022 and p = 0.006, respectively). The V35 - V45 of small bowel in VMAT were significantly less than in 5F-IMRT and 3D-CRT. V35 was 47.0, 56.4, and 72.8 cm3 for VMAT, 5F-IMRT, and 3D-CRT (p = 0.021 and p = 0.034, respectively), while V40 was 30.5, 35.5, 45.1 cm3 (p = 0.024 and p = 0.032, respectively) and V45 was 15.1, 18.1, 30.0 cm3 (p = 0.033 and p = 0.032, respectively). The D5, V30 and V50 of bladder in 3D-CRT were less than in VMAT and 5F-IMRT planning (p = 0.034, 0.004, 0.002 and p = 0.027, 0.003, 0.002, respectively). The Dmean of left femoral head in VMAT and 5F-IMRT were less than in 3D-CRT planning (p = 0.028 and p = 0.022, respectively) and the Dmean, V30 of right femoral head in VMAT and 5F-IMRT were better than in 3D-CRT planning (p = 0.044, 0.036 and p = 0.023, 0.028, respectively). Conclusions: Dosimetric analyses demonstrated that IMRT is superior to 3D-CRT in the conformity and homogeneity of dose distribution to the target volume, and provide a better protection to OARs sparing in patients with locally advanced rectal cancer for preoperative radiotherapy. With similar target coverage, VMRT is superior to 5F-IMRT in normal tissue sparing.

A Comparison between Three-Dimensional Conformal Radiotherapy, Intensity-Modulated Radiotherapy, and Volumetric-Modulated Arc Therapy Techniques for Stereotactic Body Radiotherapy of Lung Tumors

Introduction: The aim of this study is to dosimetrically compare 3D CRT, IMRT, and VMAT techniques that employ coplanar and non-coplanar beams for the SBRT of lung tumors. Methods and Materials: Nine (n = 9) consecutive SBRT lung patients with ten tumor sites who were previously treated at our institution were selected for this study. Six (n = 6) treatment plans were created for each PTV: 1 coplanar and 1 non-coplanar 3D CRT, IMRT, and VMAT such that 98% of PTV received 100% of prescription dose, Rx of 50 Gy in 5 fractions. The data collected from each plan included the conformity index, R50%, and homogeneity index of the target as well as the volume of normal tissue irradiated by 5 Gy, 25 Gy isodose lines, V5 and V20 of total lung, and maximum dose to organs at risk. Beam angles and arc lengths were chosen in order to achieve the lowest total lung V5, V20 and R50% values. Results: According to the observed data, the mean total lung V5 and V20 values were lowest for the non-coplanar VMAT plans, but were not statistically different from the other planning techniques. Conformity values were similar for the IMRT and VMAT plans, and significantly lower than the 3D CRT plans. R50% values were lowest for the VMAT plans and significantly lower than both IMRT and 3D CRT plans in both coplanar and non-coplanar beam arrangements. However, dose homogeneity in the PTV is significantly higher in the IMRT coplanar plans than the corresponding 3D CRT and SmartArc (SA) coplanar plans. Coplanar VMAT plans were able to produce a significant 35.5% reduction in the maximum cord dose than coplanar 3D CRT plans

A Note on the Validity of the Shannon Formulation for Fitts’ Index of Difficulty

The three most common variations of Fitts’ index of difficulty are the Fitts formulation, the Welford formulation, and the Shannon formulation. A recent paper by Hoffmann [1] critiqued the three and concluded that the Fitts and Welford formulations are valid and that the Shannon formulation is invalid. In this paper, we challenge Hoffmann’s position regarding the Shannon formulation. It is argued that the issue of validity vs. invalidity is ill-conceived, given that Fitts’ law is a “model by analogy” with no basis in human motor control. The relevant questions are of utility: Does a model work? How well? Is it useful? Where alternative formulations exist, they may be critiqued and compared for strengths and weaknesses, but validity is an irrelevant construct. In a reanalysis of data from Fitts’ law experiments, models built using the Shannon formulation are (re)affirmed to be as good as, and generally better than, those built using the Fitts or Welford formulation.

A Study on the Multi-Compartment Linear Circulation Pharmacokinetic Model for the Targeting Drug Delivery System

By analyzing the observed phenomena and the data collected in the study, a multi-compartment linear circulation model for targeting drug delivery system was developed and the function formulas of the drug concentration-time in blood and target organ by computing were figured out. The drug concentration-time curve for target organ can be plotted with reference to the data of drug concentration in blood according to the model. The pharmacokinetic parameters of the drug in target organ could also be obtained. The practicability of the model was further checked by the curves of drug concentration-time in blood and target organ(liver) of liver-targeting nanoparticles in animal tests. Based on the liver drug concentration-time curves calculated by the function formula of the drug in target organ, the pharmacokinetic behavior of the drug in target organ(liver) was analyzed by statistical moment, and its pharmacokinetic parameters in liver were obtained. It is suggested that the (relative targeting index( can be used for quantitative evaluation of the targeting drug delivery systems.

Target reliability index for serviceability limit state of single piles

The objective is to develop an approach for the determination of the target reliability index for serviceability limit state(SLS) of single piles. This contributes to conducting the SLS reliability-based design(RBD) of piles. Based on a two-parameter,hyperbolic curve-fitting equation describing the load-settlement relation of piles, the SLS model factor is defined. Then, taking into account the uncertainties of load-settlement model, load and bearing capacity of piles, the formula for computing the SLS reliability index(βsls) is obtained using the mean value first order second moment(MVFOSM) method. Meanwhile, the limit state function for conducting the SLS reliability analysis by the Monte Carlo simulation(MCS) method is established. These two methods are finally applied to determine the SLS target reliability index. Herein, the limiting tolerable settlement(slt) is treated as a random variable. For illustration, four load test databases from South Africa are compiled again to conduct reliability analysis and present the recommended target reliability indices. The results indicate that the MVFOSM method overestimates βsls compared to that computed by the MCS method. Besides, both factor of safety(FS) and slt are key factors influencing βsls, so the combination of FS and βsls is welcome to be used for the SLS reliability analysis of piles when slt is determined. For smaller slt, pile types and soils conditions have significant influence on the SLS target reliability indices; for larger slt, slt is the major factor having influence on the SLS target reliability indices. This proves that slt is the most key parameter for the determination of the SLS target reliability index.

Comparative Study of Fast Superposition, Superposition Algorithm in Intensity Modulated Radiotherapy Techniques for Prostate Cancer

This study aims to compare the dosimetric coverage of the Planning Target Volume (PTV) and the dose to main organs at risk (OARs) between two different algorithms fast superposition (FSUP), superposition (SUP) using intensity-modulated radiotherapy (IMRT) techniques for prostate cancer. Ten patients with prostate cancer were selected for this study. For each patient, IMRT plans were created with 6 MV photon beam quality using CMS XiO treatment planning system. The delivery of IMRT was carried out using the step and shoot techniques. The dose coverage for each patient was designated to an ICRU report 62 reference point in the PTV, medium coverage of the planned target volume to be 95% of the prescribed dose while the maximum dose in the target volume to be not greater than 107% of the prescribed dose. A hypofractionated prescription dose of 70 Gy/28# at 2.5 Gy per fraction was used. Besides we compared the number of MUs and OARs dose to D15%, D25%, D35%, D50% on both algorithm planning sets. For target, this evaluation was made with comparing the conformity index (CI) and homogeneity index (HI). In our study, the results show the OARs got less dose from the SUP algorithm compared to FSUP algorithms. Statistically not significant difference was observed in V107% of PTV, MU/CC, conformity Index (p = 0.057, p = 0.215, p = 0.370) and 95% PTV Volume received prescription dose from both Plans. But Homogeneity Index for both algorithms was statistically significant (p = 0.000, p = 0.001). For prostate cancer, the superposition algorithm showed better results in the IMRT plan compared to the fast superposition algorithm.

The Effect of Absorbed Dose to Organs at Risk Following Craniospinal Irradiation Using Different Radiotherapy Techniques

Introduction: In medulloblastoma patients craniospinal irradiation is an important element the treatment. Our study aimed to evaluate the effect of absorbed dose to organs at risk using the hybrid intensity-modulated radiation therapy (IMRT) versus three-dimensional conformal radiotherapy (3DCRT) for craniospinal irradiation (CSI) in average risk medulloblastoma patients. Materials and Methods: In this study, thirteen medulloblastoma patients were included. The prescribed total dose to the planning target volume (PTV) was 23, 40 Gy in 13 fractions. Two radiotherapy techniques, three dimensional conformal radiotherapy (3DCRT) and hybrid intensity modulated radiotherapy (IMRT) were used to treat these patients. The coverage of the Target was evaluated using the D mean, D95%, D2%, D98% and V95%. Other parameters were also compared such as Integral dose (ID), Homogeneity index (HI) and doses to the organs at risk (OARs). Results: There was no significant difference in the mean dose received by the PTV-Brain or the dose received by 95% and 98% of PTV volume using the two techniques. For PTV-Spine, the percentage volume receiving 95% of the total dose increased significantly in the hybrid IMRT technique compared to the conformal technique. So, hybrid IMRT plan achieved the best coverage for PTV spine. Lower dose for OAR was delivered by 3DCRT, except the heart and thyroid, hybrid IMRT achieved better sparing. All plans resulted in the same dose homogeneity index (DHI) for PTV-Brain. For PTV-Spine, hybrid IMRT technique achieved better dose homogeneity compared to 3DCRT technique (1.09 vs. 1.12;p > 0.05). Conclusions: hybrid IMRT technique can be realized on conformal technique because it achieved better dose coverage for the (PTV) and organ at risk (OAR). 3DCRT reduced mean dose to most OARS, except the heart and thyroid. Therefore, the hybrid IMRT technique may be a CSI treatment alternative to 3DCRT.

The Journey of SRS: An Initial Experience of Starting Sterotactic Radiosurgery Facility at Purbanchal Cancer Hospital—First in Nepal

Introduction: Radiotherapy (RT) is a vital cancer treatment modality for both curative and palliative purposes. Nepal is a developing country with a population of around 30 million people. Cancer affects 100 - 120 people out of every 100,000, and the figure is increasing. The number of radiation facility machines in the country is still countable in fingers. Purbanchal Cancer Hospital, Nepal is the first comprehensive cancer facility capable of performing stereotactic radiosurgery (SRS). Our facility has cutting-edge Varian Truebeam Linear Accelerators with millennium MLC, which makes SRS and SRT’S for intracranial lesions such as small benign and malignant tumors much easier. In addition to SRS, we are the pioneers of SBRT for lung using 4DCT, interstitial & intraluminal brachytherapy, RPM Gated & DIBH modalities in Nepal. Methods & Materials: The purpose of this study is to share our experience in establishing an SRS facility in the country, which includes training the RT team on the importance of process accuracy, patient selection, patient assessment, mould preparation, and describing image data acquisition, target, and organ at risk delineation on CT and MRI images, treatment planning process, and quality assurance. Results & Discussion: The plans for all SRS and SRT cases are based on target coverage, OAR sparing, hotspot inside the target, conformity index, heterogeneity index, and dose fall off. To select the final plan, we used strict passing criteria such as a conformity index Paddick (CIPaddick) more than 0.85, a falloff between 100% and 50% of less than 5.5 mm (maximum 6 mm in irregular targets), and a hotspot inside the target between 115 to 140 percent, as per clinical standards. In addition, we determined the CILomax and CIRTOG for each case. Passing criteria for verification plans are set as minimum of 95% for a 2% percentage dose difference (% DD) and a 2-mm distance to an agreement (DTA). We also gathered demographic data from patients treated in the first year, such as diagnosis, lesion size, dose fraction, heterogeneity index (HI), conformity index (CI) and gamma index. SRS/SRT treatment was successfully implemented, and over 40 patients were treated with positive clinical outcomes. Conclusion: SRS now has a wider range of alternatives, thanks to technology advancements in recent years. SRS’s dosimetric advantages have steadily been extended to extracranial locations. Purbanchal Cancer Hospital, Birtamode, Nepal established a comprehensive cancer facility with qualified workforce with the goal of providing high-quality treatment to the people of Nepal.

Evaluation of 3D-CRT and VMAT Radiotherapy Plans for Left Breast Cancer with Regional Lymph Nodes Irradiation

Introduction: Radiation therapy after breast surgery is an integral part of the treatment of early breast cancer. The goal of radiation therapy is to achieve the best possible coverage of the planning target volume (PTV), while reducing the dose to organs at risk (OARs) which are normal tissues whose sensitivity to irradiation could cause damage that can lead to modification of the treatment plan. In the last decade, radiation oncologist started to use the Intensity Modulated Radiotherapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) for irradiating the breast, in order to achieve better dose distribution and target dose to the PTV and OAR. The aim of this study is to compare 2 external radiotherapy techniques (VMAT vs 3D) for patients with node-positive left breast cancer. Patients and Methods: We randomly selected 10 cases of postoperative radiotherapy for breast cancer in our hospital. The patients are all female, the average age was 45.4 years old, and the primary lesions are left breast. The ANOVA test was used to compare the mean difference between subgroups, and the p value Results: Dose volume histogram (DVH) was used to analyze each evaluation dose of clinical target volume (CTV) and organs at risk (OARs). Compared to 3DCRT plans, VMAT provided more uniform coverage to the breast and regional lymph nodes. The max point dose for tVMAT was lower on average (106.4% for VMAT versus 109% for 3DCRT). OAR sparing was improved with tVMAT, with a lower average V17Gy for the left lung (27.91% for VMAT versus 30.04% for 3DCRT, p and lower for V28Gy (13.75% for VMAT versus 22.34% for 3DCRT, p = 0.01). We also found a lower V35Gy for the heart on VMAT plan (p = 0.02). On the contrary, dose of contralateral breast was lower in 3DCRT than VMAT (0.59 Gy vs 3.65 Gy, p = 0.00). Conclusion: The both types of plans can meet the clinical dosimetry demands of postoperative radiotherapy for left breast cancer. The VMAT plan has a better conformity, but 3CDRT can provide a lower dose to the contralateral organs (breast and lung) to avoid the risk of secondary cancers.

MOTION QUALITY EVALUATION OF TARGET-REACHING MOVEMENT OF INDEX FINGER

ms paper proposes a set of objective and quantitative human motion evaluation indices, among Which the index of difficulty and index of performance are introduced as the general indices for the quality measure of 2-D target-to-talget movement. As an example, the target-reaching movement of index finger, which is a basic functional action of index finger in the daily life of hUman beings, were experimentally investigated. In the experiment five healthy male subjects were asked to perform three target-reaching movement tasks Which have different indices of difficulty. All movements were recorded by a 3-D motion analysis system. Later, their motion qualities were measured with these evaluation metrics. The results showed that these indices are reasonable and have potential applications to biomedical engineering.

Correlation between shock index and inflammation, oxidative stress as well as target organ damage in patients with sepsis

Objective:To study the correlation between shock index and inflammation, oxidative stress as well as target organ damage in patients with sepsis.Methods: A total of 70 patients with sepsis treated in our hospital between March 2013 and May 2016 were collected and divided into no shock group (SI<0.5) (n=11), general shock group (0.5 SI 2) (n=42) and severe shock group (SI>2.0) (n=17) according to the shock index (SI). Immediately after admission, serum levels of inflammatory factors, oxidative stress indexes and liver function indexes were detected.Results:Serum interleukin-1β (IL-1β), interleukin-8 (IL-8), tumor necrosis factor (TNF-α), advanced oxidation protein products (AOPPs), total bilirubin (TB),γ-glutamyl transpeptidase (GGT) and alanine aminotransferase (ALT) levels of severe shock group and general shock group were higher than those of no shock group while anti-inflammatory factors interleukin-10 (IL-10), interleukin-13 (IL-13), soluble tumor necrosis factor receptorⅠ(sTNF-RI), glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) and catalase (CAT) levels were lower than those of no shock group;serum IL-1β, IL-8, TNF-α, AOPPs, TB, GGT and ALT levels of severe shock group were higher than those of general shock group while IL-10, IL-13, sTNF-RI, CAT, GSH-Px and SOD levels were lower than those of general shock group.Conclusion:The higher the shock index in patients with sepsis, the more severe the inflammation, oxidative stress and target organ damage, and the two are positively correlated.

Identification of target behavior in process of intervention for children with feeding difficulty and relevant factors in randomized controlled trial

Objective To identify the target behavior in the process of behavioral intervention for children with feeding difficulty and relevant factors that may contribute to more effective intervention.Methods Children aged from 1 to 6 years with feeding difficulty randomly received interactive behavioral intervention(245 cases)or routine primary care(217 cases).By the end of the 1,3,6,and 9 months,the rating score of feeding difficulty and the body mass index(BMI)were assessed.The target behavior was determined based on the selecting criteria that simultaneously satisfied two conditions:①it was relevant to improving children's nutritional status;②it changed fast during intervention.Moreover,the relevant factors of target behavior were analyzed by multivariate analysis(Multi-Way ANOVA).Results Among nine behaviors of feeding difficulty,"eating slowly"was identified as a target behavior because it was closely relevant to the BMI z-score increment and had the biggest score reduction at early stage during intervention.Various factors were relevant to improving the target behavior,including parents acting as caregivers,caregiver's education level equal to and above junior college,and caregiver's concern about their children's feeding difficulty.Conclusion"Eating slowly"should be selected as the target behavior for early intervention for children with feeding difficulty and some social factors should be considered for optimizing the intervention.

“Extreme utilization”development of deep shale gas in southern Sichuan Basin,SW China

To efficiently develop deep shale gas in southern Sichuan Basin,under the guidance of“extreme utilization”theory,a basic idea and solutions for deep shale gas development are put forward and applied in practice.In view of multiple influencing factors of shale gas development,low single-well production and marginal profit of wells in this region,the basic idea is to establish“transparent geological body”of the block in concern,evaluate the factors affecting shale gas development through integrated geological-engineering research and optimize the shale gas development of wells in their whole life cycle to balance the relationship between production objectives and development costs.The solutions are as follows:(1)calculate the gold target index and pinpoint the location of horizontal well drilling target,and shale reservoirs are depicted accurately by geophysical and other means to build underground transparent geological body;(2)optimize the drilling and completion process,improve the adaptability of key tools by cooling,reducing density and optimizing the performance of drilling fluid,the“man-made gas reservoir”is built by comprehensively considering the characteristics of in-situ stress and fractures after the development well is drilled;(3)through efficient management,establishment of learning curve and optimization of drainage and production regime,the development quality and efficiency of the well are improved across its whole life cycle,to fulfil“extreme utilization”development of shale gas.The practice shows that the estimated ultimate recovery of single wells in southern Sichuan Basin increase by 10%-20%than last year.

容积旋转调强放疗与三维适形放疗在食管癌患者中的应用效果比较

目的:比较容积旋转调强放疗与三维适形放疗在食管癌患者中的应用效果。方法:回顾性分析2017—2022年该院收治的80例食管癌患者的临床资料,按照放疗方法不同将其分为观察组和对照组各40例。两组均予以卡培他滨片同步化疗,在此基础上,对照组采用三维适形放疗,观察组采用容积旋转调强放疗。比较两组临床疗效、靶区剂量学参数[计划靶区(PTV)总剂量、适形度指数(CI)、均匀度指数(HI)]、危及器官剂量和不良反应发生率。结果:观察组客观缓解率(ORR)为65.00%(26/40),高于对照组的42.50%(17/40),差异有统计学意义(P<0.05);观察组PTV总剂量、HI低于对照组,CI高于对照组,差异均有统计学意义(P<0.05);观察组双肺平均剂量、心脏平均剂量、脊髓最大剂量均低于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率为65.00%(26/40),低于对照组的95.00%(38/40),差异有统计学意义(P<0.05)。结论:容积旋转调强放疗应用于食管癌患者可提高ORR,改善靶区剂量学参数,减小危及器官剂量,降低不良反应发生率,效果优于三维适形放疗。

全膝关节置换术后阶段性目标康复锻炼方案的建立及应用

目的探讨全膝关节置换术(TKA)术后阶段性目标康复锻炼方案的应用效果。方法选取2020年2月至2023年10月郑州大学第一附属医院收治的82例行TKA治疗的患者作为研究对象,按随机数表法分为对照组和研究组各41例。对照组患者采用常规干预,研究组患者在对照组护理的基础上联合阶段性目标康复锻炼方案。两组患者均护理干预至出院,出院随访12周后回院复查。比较两组患者干预前及随访12周后的康复锻炼依从性、恐动症Tampa评分(TSK)、美国特种外科医院评分(HSS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分以及关节活动度。结果干预前,两组患者的康复锻炼依从性、TSK评分比较差异均无统计学意义(P>0.05);随访12周后,两组患者康复锻炼依从性均升高,TSK评分均下降,且研究组患者康复锻炼依从性评分为(55.03±6.91)分,明显高于对照组的(48.06±5.14)分,TSK评分为(35.88±4.81)分,明显低于对照组的(42.31±4.06)分,差异均有统计学意义(P<0.05);随访12周后,两组患者HSS评分均升高,WOMAC评分均下降,且研究组患者HSS评分为(78.29±6.19)分,明显高于对照组的(69.53±5.11)分,WOMAC评分为(40.09±7.62)分,明显低于对照组的(48.15±5.83)分,差异均有统计学意义(P<0.05);随访12周后,两组患者的关节主动活动度、关节被动活动度均升高,且研究组患者关节主动活动度、关节被动活动度分别为(89.95±10.34)°、(115.37±14.02)°,明显高于对照组的(83.63±8.53)°、(107.52±11.25)°,差异均有统计学意义(P<0.05)。结论阶段性目标康复锻炼方案能够提高TKA患者术后康复锻炼依从性,降低术后运动恐惧感,改善膝关节功能。

Switching variability index based multiple strategy CFAR detector

A switching variability index （SVl） constant false alarm rate （CFAR） detector is proposed for improving the detection performance of VI-CFAR detectors in multiple targets backgrounds. When the presence of non-homogeneity in CFAR reference windows is indicated by a VI-CFAR detector, a switching- CFAR detector is introduced to optimize the performance of the VI-CFAR detector in homogeneous, multiple targets and clutter edge backgrounds. The structure and parameters selection method of the SVI-CFAR detector is presented. Comparisons with classic CFAR detectors and recently proposed detectors are also given. Theoretical analysis and simulation results show that SVICFAR detector maintains the good performance of the VI-CFAR detector in homogeneous and clutter edge backgrounds, while greatly improving the capacity of anti-multi targets.

Diagnostic value of different color ultrasound diagnostic method in endometrial lesions

BACKGROUND Endometrial lesions include endometrial cancer and inferior fibroids.Among them,endometrial cancer as a malignant tumor seriously endangers the life and health of patients.Ultrasonography is an important means of diagnosing female reproductive system diseases,and it is of critical value for the early diagnosis of endometrial cancer.However,different ultrasound inspection programs have achieved different results.It is of great significance to choose a suitable inspection program.AIM To explore the diagnostic efficacy of different ultrasonic examination methods in clinical endometrial lesions.METHODS The 140 patients with endometrial lesions who were treated in our hospital from April 2018 to October 2019 were used as the research subjects.All patients underwent transvaginal color ultrasound and transabdominal color ultrasound.We compared the diagnostic coincidence and image display effects of the two different examination methods,and the endometrial thickness,blood flow,uterine effusion and resistance index of different diseases were observed by transvaginal color ultrasound.RESULTS The diagnostic coincidence rate of all types of diseases of transvaginal color ultrasound was significantly higher than that of transabdominal color ultrasound(P=0.001,0.005,0.001 and 0.001).In addition,the excellent and good rate of image display of transvaginal color ultrasound was higher than that of transabdominal color ultrasound(P=0.001).There were significant differences in endometrial thickness in patients with different types of endometrial lesions through the transvaginal color examination(P=0.001).The incidence rate of uterine effusion in patients with endometrial carcinoma was significantly higher than that in patients with other types of endometrial lesions(P=0.001),and the rate of the blood flow was the highest(P=0.001).The comparison of blood flow resistance index indicated that the blood flow resistance index in endometrial cancer patients was the lowest,which shows that the difference was statistically significant(P=0.001).CONCLUSION The overall diagnostic efficacy of transvaginal color ultrasound in the clinical diagnosis of endometrial lesions is better than that of transabdominal color ultrasound,which held higher diagnostic coincidence rate and image display effect.There were significant differences in the thickness of the endometrium and the blood flow in different types of lesions.

Evaluation of entropy for monitoring the depth of anesthesia ：ompared with bispectral index： a multicenter clinical trial

Background As a new electroencephalogram （EEG） signal processing technique for monitoring the depth of anesthesia, entropy consists of two indices： reaction entropy （RE） and state entropy （SE）. Our study compared entropy with classical bispectral index （BIS） in reduction of myoelectrical interference and noxious stimuli with EEG signals. Methods Two hundred and eighty patients （ASA I-II, 18-60 years old） undergoing scheduled surgeries from seven medical centers were enrolled. Anesthesia induction was managed with propofol via the target-controlled infusion （TCI） system. The results of BIS, RE, SE, mean arterial pressure （MAP） and heart rate （HR） were recorded before anesthesia induction, at the moment of unconsciousness, before and 2 minutes after administration of muscle relaxant, and before and one and three minutes after the tracheal intubation. Results The values of half maximum effective concentrations （EC50）, 5% effective concentrations （EC05） and 95% effective concentrations （EC95） of propofol effect-site concentration at the onset of unconsciousness were 1.2 （1.1-1.3 μg/ml）, 2.5 （2.4-2.5 μg/ml） and 3.7 （3.7-3.8 μg/ml）, while those of the predicted plasma propofol concentration were 2.8 （2.7-2.9 μg/ml）, 3.9 （3.8-3.9 μg/ml） and 4.9 （4.8-5.0μg/ml）, respectively. The values of BIS, SE and RE were 62, 59 and 63 when 50% of patients lost consciousness, and 79, 80, 85 and 42, 37, 44, respectively, when 5% and 95% of patients were unconscious. The values of BIS, RE and SE dropped two minutes after the injection of muscle relaxant, but there were no significant differences between RE and SE. MAP and HR increased visibly, which indicated a reaction to tracheal intubation; the values of BIS, RE and SE, however, did not display any significant changes. Conclusions This large-sample multicentric study confirmed the values of RE and SE as approximating BIS value, at the onset of unconsciousness during propofol TCI anesthesia. After elimination of myoelectrical activation, all values of RE, SE and BIS decreased significantly and the three indices were less sensitive to noxious stimuli than cardiovascular responses.