让学生对《道德与法治》课“动心”

必须向课堂短短四十分钟要质量,要效率,实现课堂教育教学效果的最大化。要让学生对思政老师“动心”。亲其师,才能信其道。要让学生对思政课堂“动心”。

Status of clinical applications of artificial intelligence in echocardiography

Artificial intelligence(AI)technology has been increasingly used in medical field with its rapid developments.Echocardiography is one of the best imaging methods for clinical diagnosis of heart diseases,and combining with AI could further improve its diagnostic efficiency.Though the applications of AI in echocardiography remained at a relatively early stage,a variety of automated quantitative and analytical techniques were rapidly emerging and initially entered clinical practice.The status of clinical applications of AI in echocardiography were reviewed in this article.

Deep learning models for automatic classification ofechocardiographic views

Objective To observe the value of deep learning (DL) models for automatic classification of echocardiographic views. Methods Totally 100 patients after heart transplantation were retrospectively enrolled and divided into training set, validation set and test set at a ratio of 7 ∶ 2 ∶ 1. ResNet18, ResNet34, Swin Transformer and Swin Transformer V2 models were established based on 2D apical two chamber view, 2D apical three chamber view, 2D apical four chamber view, 2D subcostal view, parasternal long-axis view of left ventricle, short-axis view of great arteries, short-axis view of apex of left ventricle, short-axis view of papillary muscle of left ventricle, short-axis view of mitral valve of left ventricle, also 3D and CDFI views of echocardiography. The accuracy, precision, recall, F1 score and confusion matrix were used to evaluate the performance of each model for automatically classifying echocardiographic views. The interactive interface was designed based on Qt Designer software and deployed on the desktop. Results The performance of models for automatically classifying echocardiographic views in test set were all good, with relatively poor performance for 2D short-axis view of left ventricle and superior performance for 3D and CDFI views. Swin Transformer V2 was the optimal model for automatically classifying echocardiographic views, with high accuracy, precision, recall and F1 score was 92.56%, 89.01%, 89.97% and 89.31%, respectively, which also had the highest diagonal value in confusion matrix and showed the best classification effect on various views in t-SNE figure. Conclusion DL model had good performance for automatically classifying echocardiographic views, especially Swin Transformer V2 model had the best performance. Using interactive classification interface could improve the interpretability of prediction results to some extent.

Deep learning models semi-automatic training system for quality control of transthoracic echocardiography

Objective To explore the value of deep learning(DL)models semi-automatic training system for automatic optimization of clinical image quality control of transthoracic echocardiography(TTE).Methods Totally 1250 TTE videos from 402 patients were retrospectively collected,including 490 apical four chamber(A4C),310 parasternal long axis view of left ventricle(PLAX)and 450 parasternal short axis view of great vessel(PSAX GV).The videos were divided into development set(245 A4C,155 PLAX,225 PSAX GV),semi-automated training set(98 A4C,62 PLAX,90 PSAX GV)and test set(147 A4C,93 PLAX,135 PSAX GV)at the ratio of 5∶2∶3.Based on development set and semi-automatic training set,DL model of quality control was semi-automatically iteratively optimized,and a semi-automatic training system was constructed,then the efficacy of DL models for recognizing TTE views and assessing imaging quality of TTE were verified in test set.Results After optimization,the overall accuracy,precision,recall,and F1 score of DL models for recognizing TTE views in test set improved from 97.33%,97.26%,97.26%and 97.26%to 99.73%,99.65%,99.77%and 99.71%,respectively,while the overall accuracy for assessing A4C,PLAX and PSAX GV TTE as standard views in test set improved from 89.12%,83.87%and 90.37%to 93.20%,90.32%and 93.33%,respectively.Conclusion The developed DL models semi-automatic training system could improve the efficiency of clinical imaging quality control of TTE and increase iteration speed.

Deep learning echocardiographic intelligent model for evaluation on left ventricular regional wall motion abnormality

Objective To observe the value of deep learning echocardiographic intelligent model for evaluation on left ventricular(LV)regional wall motion abnormalities(RWMA).Methods Apical two-chamber,three-chamber and four-chamber views two-dimensional echocardiograms were obtained prospectively in 205 patients with coronary heart disease.The model for evaluating LV regional contractile function was constructed using a five-fold cross-validation method to automatically identify the presence of RWMA or not,and the performance of this model was assessed taken manual interpretation of RWMA as standards.Results Among 205 patients,RWMA was detected in totally 650 segments in 83 cases.LV myocardial segmentation model demonstrated good efficacy for delineation of LV myocardium.The average Dice similarity coefficient for LV myocardial segmentation results in the apical two-chamber,three-chamber and four-chamber views was 0.85,0.82 and 0.88,respectively.LV myocardial segmentation model accurately segmented LV myocardium in apical two-chamber,three-chamber and four-chamber views.The mean area under the curve(AUC)of RWMA identification model was 0.843±0.071,with sensitivity of(64.19±14.85)%,specificity of(89.44±7.31)%and accuracy of(85.22±4.37)%.Conclusion Deep learning echocardiographic intelligent model could be used to automatically evaluate LV regional contractile function,hence rapidly and accurately identifying RWMA.

Flow equation and similarity criterion during centrifugal casting in micro-channel

Liquid metal filling flow process in the microscale during the centrifugal casting process was studied by means of similar physical simulation. The research was focused on derived similarity criterion. Based on the traditional flow equations, the flow equation and the Bernoulli＇s equation for liquid metal flows in micro-scale space were derived, which provides a mathematical model for numerical simulation of micro-scale flow. In the meanwhile, according to the micro-flow equation and the similarity theory, the similarity criterion for the physical simulation of the mold filling behaviors was presented under centrifugal force field, so as to achieve the visual observation and quantitative analysis of micro-flow process.

HEAT TRANSFER CHARACTERISTICS OF NEW COOLING TECHNIQUE BASED ON THERMAL DRIVING

A new cooling technique based on thermal driving in high centrifugal field （TDHCF） is developed for gas turbine rotational components, such as turbine blades. The key point of TDHCF is to enhance heat transfer by the fluid thermal driving in closed loop small channels placed in the high centrifugal field. Heat transfer characteristics of the new cooling technique are analyzed. In experiments, two different fluids （liquid water and Freon R12） are used as thermal driving media （fluid inside the loop channel）. And the channel width d is 1 mm and the height h is 30 mm. The temperature is measured by thermocouples and an average heat transfer coefficient KH is defined to indicate heat transfer capacity of TDHCF. Experimental results show that KH is enhanced when heat flux and the rotating speed increase. And thermal properties of thermal driving media are also influenced by KH. Larger KH can be achieved by using Freon R12 as thermal driving medium compared with using liquid water. It can increase to 2 300 W/（m^2 · K） and it is much higher than that of the normal air cooling method （usually at the level of 600-1200 W/（m^2·K））. All fundamental studies of TDHCF show that there actually exists thermal driving in the closed loop small channel in the centrifugal field to improve heat transfer characteristics.

Three-dimensional Imaging of Multi-slice Spiral CT in Bronchial Artery Correlative Study on Blood Supply of Central Lung Cancer and Its Clinical Significance

Objective: To evaluate three-dimensional bronchial artery imaging charactersin central lung cancer and applied values with multi-slice spiral CT (MSCT) to provide theoreticalevidence on blood supply and intervention therapy. Methods: Eighteen patients with central lungcancer underwent MSCT with real time helical thin-slice CT scanning. Three-dimensional bronchialartery reconstruction was done at the console work-station. The space anatomical characters ofbronchial artery were observed through different rotations. Results: For 6 cases, thethree-dimensional images of bronchial artery (33.33%) could exactly show the origins, the routes(lung inner segment and mediatism segment) and the diameters of bronchial arteries. Vision rate ofbronchial arteries was the highest in pulmonary artery stricture and truncation groups, and thevessels' diameter became larger apparently. These characters demonstrated blood supply of this kindof central lung cancer come from bronchial artery. Volume rendering images were the best ones amongthree-dimensional images. Conclusion: Three-dimensional imaging with MSCT in bronchial artery canreveal the anatomical characters of bronchial artery and provide theoretical evidence on bloodsupply and intervention therapy of central lung cancer.

The Role of Transesophageal Echocardiography for Transcatheter Closure of Atrial Septal Defects with the Amplatzer Septal Occluder

Objective: To evaluate of the role of transesophageal echocardiography (TEE)in percutaneous closure of atrial septal defects (ASD) with the Amplatzer septal occluder. Methods:Sixty- two patients (10 to 55 years of age) were selected for percutaneous closure of ASD bytrans-esophageal echocardiography, which was also used to monitor the procedure, to select theappropriate size of the Amplatzer device, to verify its position, and to access the immediateresults of the procedure. During the follow-up, transthoracic echocardiography (TTE) or TEE was usedto evaluate the presence and magnitude of residual shunt (RS), device position, and right cardiacchamber diameters. Results: The mean ASD diameter by TTE ([19. 1 +- 5. 8] mm) was significantlysmaller (P< 0. 001) than the stretched diameter of the ASD (25. 1 +- 6. 4) mm. There are nosignificant differences between the TEE -measured value (23. 5+_6. 2) mm and the stretched diameterof the ASD (P > 0. 05). Due to proper patient selection all procedures were successful. There wasimmediate and complete closure in 61/62 patients, only one patients had trivial residual shunt.Follow- up was performed using TTE or TEE right after operation, 1 d, 1 month, 3 months, 6 monthsand yearly thereafter. Ail, patients remain asymptomatic without any clinical or technical problems.Conclusion: With the aid of TEE, percutaneous closure of ASD can be performed successfully, safely,and effectively.

Similar physical simulation of microflow in micro-channel by centrifugal casting process

By means of similar physical simulation, liquid metal filling flow pattern in the microscale during the centrifugal casting process was studied. It was found that, in microscale, the flow channel with the maximum cross-sectional area was filled first, and the micro flow channels with 0.1 mm in diameter were filled when the rotational speed was increased to 964 r/min. The total fluid energy remained constant during the mould filling, and the changes of cross-sectional area only occurred in the microflow channels with 0.3 mm in diameter. Filling velocity increased with processing time, and a peak value was achieved rapidly, followed by a gentle increase as the process proceeded further. The time required to achieve the peak filling rate decreased dramatically with increase of rotational speed.

Population pharmacokinetics of paeoniflorin in guanxin Ⅱ prescription

To evaluate the effect of components in Guanxin Ⅱ prescription on the pharmacokinetic profiles of paeoniflorin. Plasma concentration of Paeoniflorin in rats after intravenous injection of Paronia Pall Extract （PPE） and oral administration of PPE and three types of decoctions in Guanxin Ⅱ prescription, respectively, were determined by HPLC analyses. NONMEM （nonlinear mixed-effect modeling） method was used to analyze full set of pharmacokinetic data directly. A two-compartment model with first-order degradation in absorption compartment was employed for the data analysis. The mean of population parameters, CL1, V1, CL2, V2, Ka0, and Kal, were measured to be 0.509 L/h, 0.104 L, 0.113 L/h, 0.123 L, 0.135/h, and 0.0135/h, respectively. Inter-individual variabilities were estimated and dose formulation （DF） was identified as a significant covariate of Ka 1, Ka0, and V1. It is concluded that the pharmacokinetic behaviors of paeoniflorin in rats can alter with different dose formulations.

Modeling Dynamical Noises Corrupted Chaotic System for Heart Rate Variability Analysis

It is difficult to establish the process of chaos in time series from cardiac dynamics. The output from such a system is probably the result of both its internal dynamics, and the input to the system from its surroundings. We present an optimization algorithm to find a time series that is as close as possible to the heart rate series subject to the constraint that it is deterministic with respect to some dynamics. The algorithm is tested by some famous forced dynamical systems, and applied to heart rate data. We find that the deterministic components of heart rate variability are chaotic.

Mechanical stirring for highly efficient gas injection refining

In gas injection refining processes,wide dispersion of small bubbles in the bath is indispensable for high refining efficiency.Eccentric mechanical stirring with unidirectional impeller rotation was tested using a water model for pursuing better bubble disintegration and dispersion.Effects of various factors on bubble disintegration and dispersion were investigated.These factors were stirring mode,eccentricity and rotation speed,nozzle structure,nozzle immersion depth,and gas flow rate.Gas injection from a nozzle at the end of the impeller shaft and from an immersed lance was studied.Under eccentric stirring,a vortex was formed away from the shaft.Small bubbles were produced in the strong turbulence or high shear stress field near the rotating impeller and moved in the direction to the vortex keeping up with the macroscopic flow induced by the mechanical stirring.Thus small bubbles could disperse widely in the bath under eccentric stirring with unidirectional rotation.

Surgical Significance of the Aortic Root and its Neighbouring Structure Relationships

Objective: To measure the calibration of different levels in aortic root andevaluate the relationships between the aortic sinuses and its neighbouring structure. Methods:Thirty heart specimens from cadaver of normal adult were studied. The dimensions of four levels inaortic root were measured and the relationships between the aortic sinues and its neighbouringstructure were observed. Results: The dimensions of four levels in aortic root obtained as follows;Sinus > STJ1 > STJ0 > Base (P < 0.05) . The dimensions of the aortic valve leaflets were measured.The right coronary leaflet was larger than those of the left coronary and noncor-onary leaflets .But there was no statistical signiftcane (P > 0.05) . The relationships between the middle axis ofthe anterior valve of the bicuspid valve and the aortic sinuses were examined. The middle axis ofthe anterior valve in 26 specimens (86.6%) located between the left coronary sinus and thenoncoronary sinus . The relationship between the aortic prominence of the right atrium and theaortic sinuses was examined. The aortic prominence was formed from noncoronary sinus in 22 specimens(73.3%) . The relationship between the middle point of the right and left pulmonary valves and theaortic sinuses was examined. The middle point of the right and left pulmonary valves in 24 specimens(80%) was faced to the point between the right and left aortic sinuses . Conclusion: The dimensionof the four levels in aortic root is as follows, sinus > STJ1 > STJ0 > Base (P < 0.05) . There wasno statistical significance in the size of the three aortic valve leaflets (P > 0.05).

Transcatheter to Close the Patent Duetus Arteriosus and Atrial Septal Defects in Children

Objective: To evaluate the therapeutic effect, safety and complications oftranscathetering Amplatzer device in the closure of patent ductus arteriosus (PDA) and atrial septaldefects (ASD) in children. Methods: Patients with PDA (n = 25) and ASD ( n = 16), confirmed byechocardiography, were treated by transcatheterization. Amplatzer occluder device was placed by thetranscatheterization with the image support of X-ray and transthoracic echocardiography ( TTE) . TheTTE, ECG and X-ray examination were engaged to evaluate the therapeutic results on the time pointsof 24 h , 1, 3 , 6, 12 months after the operation, and all these cases were engaged to the follow-upexamination. Results: The cardioangiographic diameter was 13.0-28.0 mm ([19.3+-4.9] mm) in ASD and2.0-7.7 mm ([3.9+-1.5] mm) in PDA . The diameter of the Amplatzer occluder selected were 13.0-30.0mm ( [20.6+-5.1] mm) in ASD and 4.0-12.0 mm ([6.6+-1.9] mm) in PDA , respectively. All the Amplatzeroccluders were placed successfully. There were no complications during and after the operation.Very small residual shunt was still found soon after the operation in 10 cases , and there were noresidual or recanalization after three months of the operation. The pulmonary artery pressure andheart size were significantly decreased in follow-up examination . Conclusion: Transcatheteringclosure with Amplatzer device is an effective, simple and safe technique in the treatment of ASD andPDA in children.

The psychological teaching approach to basic foreign language teaching

Basic foreign language teaching for language majors plays a significant role in the process of foreign language teaching and is also a crucial stage in the training of foreign language talents. During the stage teachers should learn about students＇ learning motives and the beginners＇ psychological state to rouse students＇ interest and mobilize their initiatives so that students can change from passive learning to active learning. The teaching effects will thereby be substantially enhanced.

Effects of IQ_23 on the Repolarization and Both Components of the Delayed Rectifier Potassium Current in Guinea Pig Ventricular Myocytcs

Using patch clamp whole cell recording techiques, we examined the effects ofIQ_23, a benzyl-isoquinoline derivative with antiarrhythmic activities, on the action potential (AP) andpotassium currents in single guinea pig ventricular myocytes. The results showed that IQ_23 at 10, 30and 100 μmol ·L_-1 slowed the repolarization in AP dose-dependently. The APD_90 were prolonged by15%, 28% and 31% respectively. This effect did not depend on the extracellular Ca^2+. In voltageclamp mode, IQ_23 effectively blocked both the components of the delayed rectifier potassium current(I_k), i.e., I_ks and I_kr. At concentrations of 30 and 100 μmol· L^-1, IQ_23 suppressed I_ks by 21% and 26%and suppressed I_kr by 67% and 86% respectively. But even at 100 μmol·L^-1, IQ_23 had little effect onthe inward rectifier potassium current (I_k1). It is concluded: 1. IQ_23 can dose-dependently prolongAPD in the ventriculas myocytes of guinea pig, the effect does not depend on the extracellular Ca^2+; 2.IQ_23 blocks both I_ks and Ikr in the ventricular myocytes without obvious specificities between them.

Cardiac evaluation of liver transplant candidates

Physicians previously thought that heart disease was rare in patients with end stage liver disease. However, recent evidence shows that the prevalence of ischemic heart disease and cardiomyopathy is increased in transplant candidates compared to most other surgical candidates. Investigators estimate that up to 26% of all liver transplant candidates have at least one critical coronary artery stenosis and that at least half of these patients will die perioperatively of cardiac complications. Cardiomyopathy also occurs in greater frequency. While all patients with advanced cardiac disease have defects in cardiac performance, a larger than expected number of patients have classical findings of dilated, restrictive and hypertropic cardiomyopathy. This may explain why up to 56% of patients suffer from hypoxemia due to pulmonary edema following transplant surgery. There is considerable controversy on how to screen transplant candidates for the presence of heart disease. Questions focus upon, which patients should be screened and what tests should be used. This review examines screening strategies for transplant candidates and details the prognostic value of common tests used to identify ischemic heart disease. We also review the physiological consequences of cardiomyopathy in transplant candidates and explore the specific syndrome of "cirrhotic cardiomyopathy".

Idiopathic ventricular fibrillation with fragmented QRS complex and J wave in resting electrocardiogram

Objective To describe the clinical characteristics of idiopathic ventricular fibrillation （IVF） with fragmented QRS complex （f-QRS） and J wave in resting electrocardiogram. Methods We reviewed data from 21 case subjects in our hospital who were resuscitated after cardiac arrest due to IVF and assessed the prevalence of f-QRS and J wave in resting electrocardiogram （ECG）. All the case subjects were classified among three groups based on the electrocardiographic morphology： group I, both f-QRS and J wave were observed （n = 6）, group II, only J wave was observed （n = 9）, group III, neither f-QRS nor J wave was observed （n = 6）. Population characteristics, history of syncope or sudden cardiac arrest, incidence of ventricular fibrillation （VF）, and circumstance of VF were evaluated among the three groups. Results The incidence of index events （syncope, survived cardiac arrest and VF episodes recorded in implantable cardioverter defibrillator （ICD） or pacemakers） was 13.4 ~ 5.6 per-year in group I, 10.8 ~ 3.9 per-year in group II, and 9.8 -4- 4.2 per-year in group HI. There were significant differences in incidences among the three groups, the most frequent index events were observed in group I. The hazard ratio for incidence was 3.2 （95%CI, 1.1-7.9; P = 0.01）. The history and circumstance of the index events were different among the groups. In group I, all the index events occurred during sleep in early morning. In group II, four subjects suffered VF during strenuous physical activities or agitation state, two during sleep in early morning, three in usual activity. In group III, one subject suffered VF during sleep in early morning, one in agitation state, four in usual activity. Conclusions This study suggests that the IVF patients with the combined appearance of f-QRS and J wave in the resting ECG suffer an increased risk of VF, this subgroup of IVF patients has a unique clinical feature.

Atrial fibrillation： the current epidemic

Atrial fibrillation （AF） is the most common arrhythmia diagnosed in clinical practice. The consequences of AF have been clearly estab- lished in multiple large observational cohort studies and include increased stroke and systemic embolism rates if no oral anticoagulation is prescribed, with increased morbidity and mortality. With the worldwide aging of the population characterized by a large influx of ＂baby boomers＂ with or without risk factors for developing AF, an epidemic is forecasted within the next 10 to 20 years. Although not all studies support this evidence, it is clear that AF is on the rise and a significant amount of health resources are invested in detecting and managing AF This review focuses on the worldwide burden of AF and reviews global health strategies focused on improving detection, prevention and risk stratification of AF, recently recommended by the World Heart Federation.