“胸痛优先”分诊方法对胸痛患者诊治及预后的影响

目的:探讨"胸痛优先"分诊方法对胸痛患者诊治及预后的影响。方法:设计胸痛患者分诊记录单,实时录入2015年1月1日—2017年12月31日急诊科接诊的胸痛患者临床资料,根据"胸痛中心(CPC)"成立时间,分成对照组和观察组,对照组沿用常规方法进行分诊,观察组采用"胸痛优先"分诊方法进行分诊,比较两组患者的分诊准确率、患者满意度、急诊诊疗时间、1周内死亡率及3个月内死亡率的差异。结果:观察组406例,对照组384例;观察组分诊准确率及患者满意度均明显高于对照组(P <0. 05);观察组急诊诊疗时间、1周内死亡率及3个月内死亡率均显著低于对照组(P <0. 05)。结论:"胸痛优先"分诊方法可明显提高胸痛患者的分诊准确率,缩短急诊诊疗时间,改善患者近期预后,提高患者对医护工作的满意度。

眼科门诊分诊眼部疾病患者的方法讨论

目的:研究眼科门诊分诊眼部疾病的方法。方法:我院多年前便在眼科门诊使用电子分诊呼叫系统,由护士和导医配合分诊,于2018年2月至2019年2月随机选取100例患者为对照组,于2019年2月至2020年2月随机选取100例为观察组,对比两组患者满意度、候诊时间、治疗全程时间。结果:经本文研究,对照组候诊时间(39.18±10.26)min,治疗全程时间(135.94±23.67)min,满意度69例(69.0%)。观察组候诊时间(24.70±8.56)min,治疗全程时间(104.52±20.13)min,满意度91例(91.0%)。对照组分诊错误9例(9%),护理纠纷例13(13%),延误治疗6例6(%)。观察组分诊错误1例(1%),护理纠纷2例(2%),延误治疗1例(1%)。与对照组对比,差异显著(P<0.05)。结论:在眼科门诊采用分诊呼叫系统,并提供人性化护理,显著缩短患者就诊时间,保障了门诊候诊和治疗的秩序,简化就诊程序,减少了患者混乱现象,让患者得到及时治疗,减轻患者经济上的负担,最大程度上提高患者满意度。

急诊昏迷患者的迅速分诊与急救方法

目的对急诊中出现昏迷患者采取的分诊以及急救方法进行探讨。方法对我院急诊过程中出现的昏迷患者依据病情进行分类,对患者的临床症状、患者身体状况进行分析,使用先进的仪器进行检查,对患者实施迅速的分诊和急救。结果昏迷患者中,经过抢救获得成功的有106例,脱离生命危险的患者有63例,13例患者出现死亡,治疗有效率为92.85%。结论对患者出现昏迷后的临床症状、身体状况进行分析,配合仪器的检测,能够迅速对患者实施分诊和急救,避免患者出现死亡。

急腹症的分诊及急诊护理

吉林省人民医院是吉林省卫生厅直属的三甲医院,是吉林省医疗救治中心,每天的患者量非常大.尤其是急诊科每天接触无数急重症病人,我作为急诊科的护士也是经常协助医生救治病人,努力做好医生的助手,为患者服务,经常遇到各种各样的急诊急救病人.如急腹症的病人,非常常见.多年来在急诊科体会颇深.急腹症是急性腹痛疾病的总称,它包括内科、外科和妇产科急腹症.急腹症是急诊科常见疾病之一,它以发病急、变化快、病情重为其特征.分诊是否正确是关系到抢救能否成功的因素之一,判断症状不典型的急腹症易被主诉掩盖致命性疾病.因此急诊科护士必须掌握正确分诊方法,才能配合各科医生进行抢救工作,做好病情观察.急诊急救意味着来的都是急救病人或是危重病人,处理得当将挽救病人的生命,处理不及时有可能危及生命甚至死亡.现将我科从2010年1月至2014年1月1628例急腹症患者的分诊及急诊护理总结如下.

Fault Diagnosis in Chemical Process Based on Self-organizing Map Integrated with Fisher Discriminant Analysis

Fault diagnosis and monitoring are very important for complex chemical process. There are numerous methods that have been studied in this field, in which the effective visualization method is still challenging. In order to get a better visualization effect, a novel fault diagnosis method which combines self-organizing map (SOM) with Fisher discriminant analysis (FDA) is proposed. FDA can reduce the dimension of the data in terms of maximizing the separability of the classes. After feature extraction by FDA, SOM can distinguish the different states on the output map clearly and it can also be employed to monitor abnormal states. Tennessee Eastman (TE) process is employed to illustrate the fault diagnosis and monitoring performance of the proposed method. The result shows that the SOM integrated with FDA method is efficient and capable for real-time monitoring and fault diagnosis in complex chemical process.

Contrast-enhanced ultrasonographic imaging diagnosis on assessment of vascularity in liver metastatic lesions

AIM: To investigate the vasculature of rabbit liver metastatic lesions by color Doppler imaging and power Doppler imaging (PDI) techniques.METHODS: Eight New Zealand rabbits with implanted VX2 liver tumors were used. All ultrasound examinations were performed with a HP 5500 color Doppler ultrasound scanner. Before and after the injection of contrast agent, the changes of gray scale and the periphery and intralesional blood flow of the liver metastatic lesion were carefully observed by B mode ultrasound, color Doppler flow imaging (CDFI)and PDI.RESULTS: Twelve lesions were found in the eight rabbits with implanted VX2 liver tumors, whose diameter rangedfrom 1.6 to 4.8 cm. Echoes of these lesions were not characterized and has lack of specificity. After the injectionof contrast agent, the numbers of dot or strip-like flow messages increased both at the periphery and inside of these lesions under the mode of CDFI and PDI, and were more pronounced under PDI. Morphology of intralesional vessels extended, even branched and some signals were clearly found encircling the lesion. And some vessels were found penetrating into the center of the lesion.CONCLUSION: PDI after injection of self-made echo contrast agent can show a pronounced sensitivity than that of B mode ultrasound and CDFI in diagnosis of vascularity of a metastatic lesion.

Classification Methods Based on Pattern Discrimination Models for Web-Based Diagnosis of Rice Diseases

Two classification and identification methods based on pattern discrimination models and the majority-vote technique were investigated for implementing a World Wide Web-based system for the identification of rice diseases. The experiment was carried out using color and shape patterns in 425 images of three rice diseases, which were classified into four classes： two classes of leaf blast, and one class each of sheath blight and brown spot. A method consisting of two discrimination steps involving application of multiple discrimination models of a support vector machine gave the best result because of its capacity to evaluate the similarity of disease types. This accuracy of the method was 88% for leaf blast （A-type）, 94% for sheath blight, and 80% for leaf blast （B-type） and brown spot; on average, the accuracy of this method was 5% greater than that of the other method when three classes were used in the model. Although the accuracy of both methods was inadequate, the results of this study show that it is possible to estimate the least number of possible or similar diseases from a large number of diseases. Therefore, we conclude that there is merit in grouping classes into subgroups rather than attempting to discriminate between all classes simultaneously and that these methods are effective in identifying diseases for web-based diagnosis.

Particle swarm optimization based RVM classifier for non-linear circuit fault diagnosis

A relevance vector machine (RVM) based fault diagnosis method was presented for non-linear circuits. In order to simplify RVM classifier, parameters selection based on particle swarm optimization (PSO) and preprocessing technique based on the kurtosis and entropy of signals were used. Firstly, sinusoidal inputs with different frequencies were applied to the circuit under test (CUT). Then, the resulting frequency responses were sampled to generate features. The frequency response was sampled to compute its kurtosis and entropy, which can show the information capacity of signal. By analyzing the output signals, the proposed method can detect and identify faulty components in circuits. The results indicate that the fault classes can be classified correctly for at least 99% of the test data in example circuit. And the proposed method can diagnose hard and soft faults.

Independent component analysis approach for fault diagnosis of condenser system in thermal power plant

A statistical signal processing technique was proposed and verified as independent component analysis(ICA) for fault detection and diagnosis of industrial systems without exact and detailed model.Actually,the aim is to utilize system as a black box.The system studied is condenser system of one of MAPNA's power plants.At first,principal component analysis(PCA) approach was applied to reduce the dimensionality of the real acquired data set and to identify the essential and useful ones.Then,the fault sources were diagnosed by ICA technique.The results show that ICA approach is valid and effective for faults detection and diagnosis even in noisy states,and it can distinguish main factors of abnormality among many diverse parts of a power plant's condenser system.This selectivity problem is left unsolved in many plants,because the main factors often become unnoticed by fault expansion through other parts of the plants.

Treatment regimen design in clinical radiotherapy for hepatoma

Recently, the paper by Wang et at published in World Journal of Gastroenterology has given rise to great interest of many researchers. It is well known that hepatoma is one of the lethal diseases with a high incidence in the world, especially in Asia. Radiotherapy is the main treatment modality of hepatoma in clinical practice. Unfortunately, intrinsic radiosensitivity of cancer cells is not fully understood, though a large number of papers on it are now available. Yang and colleagues 21 have developed the premature chromosome condensation technique for clinical radiotherapy of hepatoma. A precise and quick measurement of cell radiosensitivity can detect the highrisk results after exposure to a large dose.

A diagnostic approach to abdominal tuberculosis

TO THE EDITORWe read with interest the article by Uzunkoy et al[1]. about diagnosis of abdominal tuberculosis. In this article authors concluded that PCR for mycobacterium tuberculosis complex is a noninvasive method which can provide the diagnosis in most cases. If this tests negative or not feasible, laparotomy should be performed.

The diagnosis and differential diagnosis of granulocytic sarcoma

Objective： To discuss the diagnosis and differential diagnosis of granulocytic sarcoma （GS）. Methods： Six cases were reported in this paper. They were assessed by pathologists. Immunohistochemistry （IHC） stain and routine hematoxylin and eosin （H＆E） stain were applied. Results： All patients involved in different anatomic sites respectively including skin, lymph node, soft tissue, breast, cervix and penis. All cases were previously error diagnoses. Three of them were initially diagnosed as non-Hodgkin lymphoma （NHL）. One case of cervical lymph node lesion was first considered as metastasized carcinoma by clinician. One biopsied skin sample was initially reported as Karposi＇s sarcoma. And one breast case was suspicious of the Iobular carcinoma with the frozen samples without antecedent clinical history information. GS was accompanied with acute myeloid leukemia （AML） in one case and with acute lymphocytic leukemia （ALL） in one case. Histopathologically, blastic, immature and differentiated variants were found in four, one and one, respectively. Immunohistochemistry （IHC） showed that myeloperoxidase （MPO） and lysozyme were both found to be positive in all cases, CD43 was found in 5 of 6 cases. Three of six cases were CD68, CD15 and LCA positive. CD34 and CDl17 were positive in 1/5 and 1/6 cases, respectively. However, CD20 and CD3 were negative in all cases. Conclusion： GS was uncommon and it may be misdiagnosed easily in routine practice. Each area had its own character, but they had the common features too. It can be correctly diagnosed by combination of H＆E stain, IHC stain, peripheral blood and bone marrow. MPO and Lysozyme were necessary for the nature of granulocytes. In addition, CD43, CD68 and CD15 were very helpful.

A data-mining approach to biomarker identification from protein profiles using discrete stationary wavelet transform

Objective: To develop a new bioinformatic tool based on a data-mining approach for extraction of the most infor- mative proteins that could be used to find the potential biomarkers for the detection of cancer. Methods: Two independent datasets from serum samples of 253 ovarian cancer and 167 breast cancer patients were used. The samples were examined by surface- enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS). The datasets were used to extract the informative proteins using a data-mining method in the discrete stationary wavelet transform domain. As a dimensionality re- duction procedure, the hard thresholding method was applied to reduce the number of wavelet coefficients. Also, a distance measure was used to select the most discriminative coefficients. To find the potential biomarkers using the selected wavelet coefficients, we applied the inverse discrete stationary wavelet transform combined with a two-sided t-test. Results: From the ovarian cancer dataset, a set of five proteins were detected as potential biomarkers that could be used to identify the cancer patients from the healthy cases with accuracy, sensitivity, and specificity of 100%. Also, from the breast cancer dataset, a set of eight proteins were found as the potential biomarkers that could separate the healthy cases from the cancer patients with accuracy of 98.26%, sensitivity of 100%, and specificity of 95.6%. Conclusion: The results have shown that the new bioinformatic tool can be used in combination with the high-throughput proteomic data such as SELDI-TOF MS to find the potential biomarkers with high discriminative power.

Correlation Analysis between TCM Syndromes and Physicochemical Parameters

Traditionally, differentiation of syndromes of Traditional Chinese Medicine (TCM) mainly depends on the information obtained from four diagnosis methods. Now many physicochemical parameters are available in clinic. There exists great correlation between TCM syndromes and physicochemical parameters. The objective of the paper is to analyze the correlation between TCM syndromes and physicochemical parameters quantitatively. Correlation analysis has been widely studied and many analysis methods have been developed. Mutual information based on entropy can measure arbitrary dependence between variables. It has been applied to many kinds of fields, especially to pattern recognition. But most works are restricted to discrete variables and little work has been done to study the relation between discrete and continuous variables. A novel algorithm is proposed to calculate the mutual information between discrete and continuous variables. It is used to analyze the correlation between TCM syndromes and physicochemical parameters.

A local and global statistics pattern analysis method and its application to process fault identification

Traditional principal component analysis （PCA） is a second-order method and lacks the ability to provide higherorder representations for data variables. Recently, a statistics pattern analysis （SPA） framework has been incorporated into PCA model to make full use of various statistics of data variables effectively. However, these methods omit the local information, which is also important for process monitoring and fault diagnosis. In this paper, a local and global statistics pattern analysis （LGSPA） method, which integrates SPA framework and locality pre- serving projections within the PCK is proposed to utilize various statistics and preserve both local and global in- formation in the observed data. For the purpose of fault detection, two monitoring indices are constructed based on the LGSPA model. In order to identify fault variables, an improved reconstruction based contribution （IRBC） plot based on LGSPA model is proposed to locate fault variables. The RBC of various statistics of original process variables to the monitoring indices is calculated with the proposed RBC method. Based on the calculated RBC of process variables＇ statistics, a new contribution of process variables is built to locate fault variables. The simula- tion results on a simple six-variable system and a continuous stirred tank reactor system demonstrate that the proposed fault diagnosis method can effectively detect fault and distinguish the fault variables from normal variables.

Diagnosis of Valve-Slap of Diesel Engine with EEMD-EMD-AGST Approach

A hybrid of ensemble empirical mode decomposition and empirical mode decomposition (EEMD-EMD) is introduced to diagnose the valve-slap vibration signal,which is relative to the dominant combustion knock vibration signal given out by a diesel engine around the top dead center (TDC).The time-frequency representations of intrinsic mode functions (IMFs) decomposed by EEMD-EMD are obtained by adaptive generalized S transform (AGST).A type 493 diesel engine was used for the experiment,and the result indicates that the valve-slap of the diesel engine is serious,and the vibration frequencies are higher than the combustion knock.With EEMD-EMD-AGST approach,the valve-slap can be identified by the vibration analysis of the diesel engine.

Development and evaluation of a novel multiplex probe array for rapid differential identification of Mycobacterium in clinical specimens

Rapid differential identification of Mycobacterium species is essential for effective diagnosis and management of mycobacteriosis. The aim of this study was to develop a novel multiplex probe array based on the 16S-23S rRNA gene internal transcribed spacer sequence for the genotyping of mycobacteria to the species level. A pair of primers and a set of genus- and species-specific probes were designed from the conserved and polymorphic regions of the 16S rRNA gene, internal transcribed spacer, and 23S rRNA gene sequences of mycobacteria. We used a novel multiplex probe array for identification of 266 clinical specimens obtained from patients with mycobaterial infection. The results showed that the overall specificity and sensitivity of our novel probe array were both 100% for the genus-specific probe and Mycobacterium tuberculosis complex- specific probe. There were 79.3 % （23/29） of nontuberculous mycobacteria which could be identified to the species level directly in the specimens from China. Some intraspecies heterogeneity in M. avium, M. intracellulare, M. chelonae and M. abscessus was observed. With the increase of sequences of internal transcribed spacer and numbers of whole microbial genomes, and further optimization of probes, the multiplex probe army will become a promising tool for the rapid and accurate identification of mycobacteria in ordinary clinical laboratories.

The combined time-frequency analysis of the acoustic signals backscattered from ultrasonic contrast agents in the evaluation of the blood perfusion

Objective: To analyze the non-periodic, unstable and even chaotic echoes scattered from microbubbles which are extremely sensitive and may easily collapse, fragment or shrink when ultrasound contrast agents are exposed to ultrasound (US) irradiation. Methods: The combined time-frequency analysis was applied to the original signals instead of the traditional Fourier spectral analysis technique. Results: The results obtained from simulation as well as experiment showed that the subharmonic, 2nd harmonic and ultra harmonic of the microbubbles occurred during the oscillation and varied with time. The dependence on the incident ultrasonic amplitude and microbubble parameters were established. Conclusion: The transient echoes backscattered from the ultrasound agent in the evaluation of the blood perfusion can be analyzed thoroughly by the technique of combined-frequency analysis and the time detail of the frequency contents can be revealed.

Application of injury severity score to multiple injuries headed by spinal cord injury

Objective： To evaluate the application of injury severity score （ISS） to multiple injuries headed by spinal cord injury. Methods： The data of 55 cases （40 males and 15 females, aged 17-69 years, mean = 41 years） of multiple injuries headed by spinal cord injury treated in our hospital from January 2000 to December 2004 were reviewed and analyzed with ISS （Version of AIS-2005 ） to explore their relationship. Results ： The ISS values increased with the number of injured regions, so did the complications. The recovery rate was negatively related to ISS values. During the period of immunity observation, the patients with ISS 〉 25 could undergo planned operations safely. Conclusions： Treatment for multiple injuries headed by spinal cord injury closely depends on the general and local conditions of the patients. ISS may provide useful data for the choice of treatment methods.

Therapeutic effect in patients with coronary heart disease based on information analysis from Traditional Chinese Medicine four diagnostic methods

OBJECTIVE:To study information gained by Traditional Chinese Medicine(TCM)four diagnostic methods and characteristics of syndrome development before and after treatment in patients with coronary heart disease,and to probe into assessment indexes of therapeutic effects with distinctive TCM features.METHODS:Information from the four diagnostic methods before and after treatment in 100 patients with coronary heart disease was collected using the TCM interrogation scale,a pulse condition instrument,a tongue-face diagnosis instrument,anda voice diagnosis information collection system.Changes in the four diagnostic method results from before and after treatment were analyzed with frequency analysis and t-test methods.RESULTS:Before treatment,deficiency syndrome complicated with hyperactivity of pathogenic factors was most common.After treatment,deficiency syndrome was most common.This change from complex syndromes to single syndromes indicates disease and syndrome alleviation.Frequencies of symptoms gained by interrogation after treatment for syndrome of deficiency of heart-Qi,syndrome of deficiency of heart-Yin,and turbid phlegm syndrome were all less severe than those before treatment.Parameters of face color,color on all sub-regions of tongue,color of tongue fur,septic and greasy fur,and lip color after treatment all had significant changes.After treatment,part of the voice diagnosis parameters in the deficiency of heart-Yin and turbid phlegm syndromes had significant changes,but no significant changes were found in the deficiency of heart-Qi syndrome.CONCLUSION:Use of the TCM four diagnostic methods can provide an effective basis forTCM syndrome diagnosis,observation of development of state of illness,and evaluation of clinical therapeutic effects.