The Effectiveness or Efficacy of Modified Nursing Interventions Classification (NIC) in Reducing the Severity of Depression among Patients with Myocardial Infarction

Background: Post myocardial infarction depression is common and puts a negative effect on recovery. Modified Nursing interventions effectively reduce the frequency and severity of depression in such patients. Objective: The study aimed to determine the effectiveness of Modified Nursing Interventions Classification (NIC) in reducing the severity of depression among patients with Myocardial Infarction. Methods: Sixty-eight stable patients with myocardial infarction (>1 month history) having mild to moderate depression in accordance to Patient Health Questionnaire-9 (PHQ-9) [with a score of 5 to 14] were enrolled. Patients were assorted into interventional and control group. Modified Nursing Intervention was offered in Interventional Group. The frequency and effectiveness of Modified Nursing Intervention among the groups were determined and compared. Results: Both moderate and mild level depression was decreased in Intervention Group as compare to Control Group. Baseline mean depression PHQ-9 score was 2.35 point statistically significantly higher in the Control Group than Interventional Group (Conclusion: Modified Nursing intervention is effective in reducing the frequency and severity of depression compared to routine care in patients with Myocardial infarction.

Assessment of Incidentally Detected Simple Renal Cyst in Pediatric Patient Based on the Modified Bosniak Classification —Incidentally Detected Simple Renal Cyst in Pediatric

Renal cysts in pediatric patients are uncommon lesion. A modified Bosniak classification system for renal cysts based on US has been developed to evaluate pediatric renal cysts to identify the simple cyst or cystic tumour. Nevertheless, it is not widely used. In this retrospective study, all incidentally detected renal cysts by ultrasound performed in children and the reproducibility of modified Bosniak classification to guide the radiological and clinical follow up.

Clavien-Dindo classification and risk factors of complications after pancreaticoduodenectomy

Objective: To analyze Clavien-Dindo classification and risk factors of complications after pancreaticoduodenectomy and inves-tigate the relationship between the major risk factors and Clavien-Dindo classification of complications. Methods: The retrospective case-control study was adopted. The clinical data of 200 patients who underwent pancreatico-duodenectomy at the Third Affiliated Hospital of Inner Mongolia Medical University from January 2010 to June 2015 were collected. The patients underwent Whipple procedure or pylorus-preserving pancreaticoduodenectomy according to the tumor site. Observation indicators included: (1) postoperative complications using Clavien-Dindo classification;(2) univariate and multivariate analyses: patients' basic information, surgery-related factors, pancreas-related factors;(3) relationship between independent risk factors and Clavien-Dindo classification of complications after pancreaticoduodenectomy. The chi-square test was applied to univariate analysis and categorical data. The comparison between groups was done by using independent samples nonparametric test (Kolmogorov-Smirnov Z), and multivariate analysis was done by using Logistic regression model. Results: (1) Postoperative complications: Of 200 patients, 122 underwent Whipple procedure and 78 underwent pylorus-preserving pancreaticoduodenectomy, including 6 cases combined with vascular reconstructions and 1 case with RFA of liver tumors. Ninety-eight patients had postoperative complications, including 41 patients with no less than 2 types of complications. After surgery, pancreatic fistula was detected in 80 patients, including 42 cases with grade A, 28 cases with grade B and 10 cases with grade C;incisional infection in 29 patients;gastric retention in 24 patients;intra-abdominal infection in 16 patients;intra-abdominal hemorrhage in 10 patients, including 8 patients receiving interventional treatment;biliary leakage in 7 patients and unplanned reoperation in 2 patients. Three patients were dead during hospitalization. The incidences of complications in grade Ⅰ, Ⅱ, Ⅲ (Ⅲ a and Ⅲ b), Ⅳ and Ⅴ of Clavien-Dindo classification were 28.00% (56/200), 13.00% (26/200), 5.00% (10/200), 1.50% (3/200) and 1.50% (3/200). (2) Univariate and multivariate analyses: The results of univariate analysis showed that body mass index (BMI) and pancreas texture were risk factors affecting complications after pancreaticoduodenectomy (χ2 = 6.483, Z = -3.189, p < .05). The results of multivariate analysis showed that BMI > 23.9 kg/m2 and soft pancreas were independent risk factors affecting complications after pancreaticoduodenectomy (OR = 2.044, 1.649, 95% confidence interval: 1.212-3.447, 1.194-2.275). (3) The relationship between independent risk factors and Clavien-Dindo classification of complications after pancreaticoduodenectomy was analyzed. There were statistically significant differences between BMI or pancreas texture and Clavien-Dindo classification of complications after pancreaticoduodenectomy (χ2 = 13.897, 27.077, p < .05). Conclusions: Clavien-Dindo classification of complications after pancreaticoduodenectomy contributes to comprehensive com-parison and evaluation, and this type of classification in this study mainly refers to grade I and II. Reducing BMI and good management of pancreatic stump may improve Clavien-Dindo classification of complications after pancreaticoduodenectomy.

Modified MUSIC estimation for correlated signals with compressive sampling arrays

This paper addresses the issue of the direction of arrival （DOA） estimation under the compressive sampling （CS） framework. A novel approach, modified multiple signal classification （MMUSIC） based on the CS array （CSA-MMUSIC）, is proposed to resolve the DOA estimation of correlated signals and two closely adjacent signals. By using two random CS matrices, a large size array is compressed into a small size array, which effectively reduces the number of the front end circuit. The theoretical analysis demonstrates that the proposed approach has the advantages of low computational complexity and hardware structure compared to other MMUSIC approaches. Simulation results show that CSAMMUSIC can possess similar angular resolution as MMUSIC.

Extending self-organizing maps for supervised classification of remotely sensed data

An extended self-organizing map for supervised classification is proposed in this paper. Unlike other traditional SOMs, the model has an input layer, a Kohonen layer, and an output layer. The number of neurons in the input layer depends on the dimensionality of input patterns. The number of neurons in the output layer equals the number of the desired classes. The number of neurons in the Kohonen layer may be a few to several thousands, which depends on the complexity of classification problems and the classification precision. Each training sample is expressed by a pair of vectors ： an input vector and a class codebook vector. When a training sample is input into the model, Kohonen＇s competitive learning rule is applied to selecting the winning neuron from the Kohouen layer and the weight coefficients connecting all the neurons in the input layer with both the winning neuron and its neighbors in the Kohonen layer are modified to be closer to the input vector, and those connecting all the neurons around the winning neuron within a certain diameter in the Kohonen layer with all the neurons in the output layer are adjusted to be closer to the class codebook vector. If the number of training sam- ples is sufficiently large and the learning epochs iterate enough times, the model will be able to serve as a supervised classifier. The model has been tentatively applied to the supervised classification of multispectral remotely sensed data. The author compared the performances of the extended SOM and BPN in remotely sensed data classification. The investigation manifests that the extended SOM is feasible for supervised classification.

Advanced Hierarchical Fuzzy Classification Model Adopting Symbiosis Based DNA-ABC Optimization Algorithm

This paper offers a symbiosis based hybrid modified DNA-ABC optimization algorithm which combines modified DNA concepts and artificial bee colony (ABC) algorithm to aid hierarchical fuzzy classification. According to literature, the ABC algorithm is traditionally applied to constrained and unconstrained problems, but is combined with modified DNA concepts and implemented for fuzzy classification in this present research. Moreover, from the best of our knowledge, previous research on the ABC algorithm has not combined it with DNA computing for hierarchical fuzzy classification to explore the merits of cooperative coevolution. Therefore, this paper is the first to apply the mechanism of symbiosis to create a hybrid modified DNA-ABC algorithm for hierarchical fuzzy classification applications. In this study, the partition number and the shape of the membership function are extracted by the symbiosis based hybrid modified DNA-ABC optimization algorithm, which provides both sufficient global exploration and also adequate local exploitation for hierarchical fuzzy classification. The proposed optimization algorithm is applied on five benchmark University of Irvine (UCI) data sets, and the results prove the efficiency of the algorithm.

CONTROLLING OVERGRINDING OF VALUABLE MATERIALS USING MODIFIED AIRSPARGED HYDROCYCLONE

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血管内弹簧圈栓塞术后不同MRRC分级颅内动脉瘤患者近期及远期疗效的比较

目的比较血管内弹簧圈栓塞术后不同改良的Raymond-Roy分级(MRRC)颅内动脉瘤患者近期及远期疗效。方法纳入接受血管内弹簧圈栓塞术的颅内动脉瘤患者248例,按术后MRRC分级分为Ⅰ级、Ⅱ级、Ⅲa级和Ⅲb级,比较各组近期及远期疗效。结果各组瘤体直径、瘤颈长度、动脉瘤位置、术前Hunt-Hess分级、手术方法和手术时长比较,差异均无显著性(P>0.05)。随MRRC分级提高,各组患者近期疗效改善率逐渐提高,恶化率逐渐降低(P<0.05)。248例患者中有53例出现复发,复发率为21.37%,MRRC分级Ⅰ、Ⅱ级患者远期复发率明显低于Ⅲa级和Ⅲb级患者(P<0.05)。结论随MRRC分级提高,颅内动脉瘤患者近期疗效逐渐提高,远期复发率逐渐提高。

白光内镜下不同评分直接判断幽门螺杆菌现症感染的诊断效能

目的 评估内镜医师运用京都胃炎评分及改良京都胃炎评分在白光内镜下直接判断幽门螺杆菌(Hp)感染与^(13)C-尿素呼气试验的一致性,明确改良京都胃炎评分的临床应用价值。方法 对重庆市某医院消化内镜医师进行京都胃炎分类专项培训,筛选1周内同时进行上消化道内镜检查及^(13)C-尿素呼气试验的患者,同时应用京都胃炎评分及改良京都胃炎评分对目标人群进行内镜下胃黏膜特征评分,计算出总分并与^(13)C-尿素呼气试验结果进行对比。结果纳入研究患者共1 342例,京都胃炎评分和改良京都胃炎评分在白光内镜下诊断Hp现症感染的灵敏度分别为74.03%、90.70%,特异度分别为95.85%、95.39%,阳性预测值分别为80.93%、82.39%,阴性预测值分别为93.94%、97.73%。改良京都胃炎评分与京都胃炎评分在白光内镜下诊断Hp现症感染比较,灵敏度、阴性预测值差异均有统计学意义(P均<0.01)。结论 经京都胃炎专项培训的内镜医师,运用改良京都胃炎评分在白光内镜下直接判断Hp现症感染,具有较高的诊断效能。

小孔径多波束声呐测深算法改进

多波束测深声呐采用多重信号分类算法能够在较小阵列尺寸的情况下保证较高的角度分辨率。然而,由于水底回波的边缘波束信噪比较低,多重信号分类算法伪谱中较强的伪峰干扰会导致后续测深算法的深度估计结果出现错误。针对该问题,提出一种基于最大信噪比的修正峰值搜索算法。该算法假定相邻波束的水底地形具有缓变性,选取回波信噪比最大的时刻,利用多重信号分类算法进行波达方向估计以获取信号角度、时间参考值。然后,分别向左右两侧利用时间期望值对回波信号进行加权与峰值搜索,实现更精确的测深。最后,通过实测数据验证了该文提出算法的有效性,该算法在特定条件下能够将边缘波束的最大测深误差减小25.85%,平均测深误差减小8.02%。

改良衰弱指数联合麻醉分级对老年腹腔镜手术患者麻醉相关不良事件的预测价值

目的评估改良衰弱指数(Modified frailty index,mFI)和美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级对老年腹腔镜手术患者麻醉相关不良事件的预测价值。方法收集皖南医学院第一附属医院2019年12月至2023年10月行老年腹腔镜手术的102例患者,根据患者术后是否发生麻醉相关不良事件分为发生组(n=23)、未发生组(n=79),比较两组临床资料、mFI、ASA分级,Spearman相关性分析mFI与ASA分级关系,采用受试者工作特征(Receiver operating characteristic,ROC)曲线分析mFI、ASA分级对麻醉相关不良事件的预测价值。结果与未发生组比较,发生组年龄、体质指数(Body mass index,BMI)、合并糖尿病、慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)比例升高,mFI和ASA分级升高,差异有统计学意义(P<0.05)。mFI与ASA分级呈正相关(r=0.627,P<0.001);衰弱患者发生麻醉相关不良事件的风险是非衰弱患者的4.580倍,ASA分级Ⅲ级患者发生麻醉相关不良事件的风险是Ⅰ~Ⅱ级患者的5.152倍(P<0.05);mFI、ASA分级联合预测麻醉相关不良事件的预测价值优于mFI、ASA分级单独预测(P<0.05)。结论mFI、ASA分级联合能有效预测老年腹腔镜手术患者麻醉相关不良事件发生情况,为临床预测麻醉相关不良事件提供理论依据。

改良版急诊危重患儿院内转运分级核查清单在儿科急危重症患儿院内转运中的应用

目的探讨改良版急诊危重患儿院内转运分级核查清单在儿科急危重症患儿院内转运中的应用。方法选取2021年1月至2022年12月苏州大学附属儿童医院儿科急诊收治的2500例急危重症患儿,根据不同的急诊危重患儿院内转运分级核查清单分为对照组和观察组,每组各1250例。对照组采用传统急诊危重患儿院内转运分级核查清单,观察组采用改良版急诊危重患儿院内转运分级核查清单。比较两组院内安全转运总合格率、转运时间、到达时间及不良事件总发生率。结果观察组院内安全转运总合格率高于对照组(P<0.05)。观察组转运时间及到达时间均短于对照组(P<0.05)。观察组不良事件总发生率低于对照组(P<0.05)。结论改良版急诊危重患儿院内转运分级核查清单在儿科急危重症患儿院内转运中的应用,可有效提高院内安全转运总合格率,缩短转运时间及到达时间,减少不良事件的发生。

SBS改性沥青热储存稳定性探讨及其等级划分

针对SBS改性沥青储存稳定性问题日益突出的现状,该文对改性沥青离析现象的本质进行了探讨,提出了离析指标等级划分建议,并对改性沥青储存稳定性快速检测新方法进行了总结。综合分析表明,改性沥青储存稳定性的优劣与体系的相容性有关,而改性沥青的离析现象是由热力学与动力学因素共同决定的;为实现对SBS改性沥青储存稳定性的精准评价,建议将离析指标划分为Ⅰ~Ⅴ五个等级;随着分析手段的不断进步,快速化、精准化、标准化已成为改性沥青储存稳定性快速检测技术的发展方向。

改良跟骨接骨板系统联合缝线锚钉治疗Liu-GangⅣ型肱骨大结节劈裂骨折

背景:既往有许多学者研究单独的肱骨大结节骨折及其手术方式。但是,对于肱骨大结节劈裂骨折(Liu-GangⅣ型)合并肩袖损伤,几乎没有学者进行深入的细化研究。目的:比较切开复位改良的跟骨接骨板系统联合缝线锚钉和PHILOS锁定内固定系统联合强生2#号线治疗肱骨大结节劈裂骨折合并肩袖损伤(Liu-GangⅣ型)的临床疗效。方法:回顾性分析2012年5月至2022年5月30例肱骨大结节劈裂骨折合并肩袖损伤患者(Liu-GangⅣ型)的病历资料,分为改良的跟骨接骨板系统联合缝线锚钉组(A组)和PHILOS锁定内固定系统联合强生2#号线组(B组),每组15例。记录所有患者术中出血量、手术时间和切口长度,术后末次随访(>1年),评估其疼痛目测类比评分、Constant-Murley评分以及肩关节外展、前屈、外旋和背伸活动。结果与结论:①A组手术切口长度、手术时间和出血量均小于B组(P<0.05);②两组目测类比评分和Constant-Murley评分相比差异无显著性意义(P>0.05);③术后末次随访A组患者前屈功能优于B组(P<0.05);A组外展功能、外旋、背伸与B组相比差异无显著性意义(P>0.05);④并发症方面,A组1例肩关节疼痛不适(7%);B组2例肩峰下撞击综合征,2例大结节上移,2例肩关节疼痛(40%),两组并发症发生率相比差异有显著性意义(P=0.031);⑤提示采用改良的跟骨接骨板系统联合缝线锚钉治疗肱骨大结节劈裂骨折(Liu-GangⅣ型),不仅可以更好地恢复肩关节前屈功能,而且手术切口较小、出血量较少、手术时间较短,且并发症较少。

Modified center-based feature line classification approach

A novel classification approach called modified center-based feature line(MCFL)is proposed to reduce the computational cost of the nearest feature line(NFL)and maintain the advantages of NFL.Unlike NFL,MCFL defines a different type of feature line and utilizes both the query point’s local information and corresponding class-global information in training set.In experiments provided,the comparisons with the nearest neighbor(NN),NFL,and other NFL-refined approaches show that the computation time of MCFL can be shortened dramatically with less accuracy decreases.MCFL proposed is probably a better choice for the classification application tasks of large-scale dataset.

炙甘草汤加减治疗心律失常的系统评价再评价

目的:对炙甘草汤加减治疗心律失常的系统评价/Meta分析进行方法学质量和证据等级再评价。方法:计算机检索中英文数据库,搜集炙甘草汤加减治疗心律失常的系统评价/Meta分析,检索时限为建库至2021年12月31日。由2名研究员独立筛选和提取资料,基于PRISMA声明、AMSTAR2量表和GRADE分级方法对纳入研究的报告质量、方法学质量及证据质量进行评价。结果:共纳入7篇系统评价/Meta分析。PRIMSA声明评价显示,纳入研究得分为13.5~21.0分,5篇文献质量中等,2篇文献质量低。报告质量缺陷主要表现在方案与注册、研究选择、证据总结强度方面;AMSTAR2量表显示,7篇文章质量等级均为极低级,存在问题最多的有4个条目;GRADE证据显示,22个证据包括14个极低级证据,7个低级证据,仅有1个中等证据。导致降级的主要因素为局限性和发表偏倚。结论:炙甘草汤加减治疗心律的失常系统评价/Meta分析提供的方法学质量和证据等级总体偏低,建议进一步开展高质量临床试验,规范系统评价报告程序。

神经保护技术联合改良手术通道在甲状腺乳头状癌TOET中的应用

目的探究神经保护技术联合改良手术通道在甲状腺乳头状癌(PTC)经口腔甲状腺切除术(TOET)中的应用效果。方法选取2019年6月—2022年1月收治的PTC 180例,随机分为对照组和联合组各90例。对照组采用常规TOET,联合组在TOET中采用神经保护技术联合改良手术通道。比较2组手术一般情况、手术前后甲状旁腺功能和术后1、3周颏神经功能及并发症发生情况,记录复发及转移情况。结果2组均无中转开放手术者。联合组住院时间短于对照组(P<0.05)。术后24、72 h,2组血钙、甲状旁腺激素水平低于术前,但联合组高于对照组(P<0.05)。2组术后24、72 h血磷水平高于术前(P<0.05)。联合组术后1、3周改良英国医学研究理事会感觉分级优于对照组,并发症总发生率低于对照组(P<0.05,P<0.01)。2组均未发生复发及转移。结论TOET中采用神经保护技术联合改良手术通道能降低PTC患者神经损伤风险,改善甲状旁腺功能,有助于术后恢复,减少并发症。

关节镜下前交叉韧带残端评估及保残重建的临床效果

目的探讨关节镜下前交叉韧带(ACL)残端评估及保残重建的临床效果。方法选取于我院行关节镜下人工韧带加强系统(LARS)移植重建ACL的患者111例,按照手术方式的不同分为Crain组(59例)及对照组(52例)。Crain组在改良Crain分型理论指导下保留残端并在鞘内重建ACL,对照组在ACL重建时清除残端。比较2组患者术前及术后24 h、72 h疼痛视觉模拟量表(VAS)评分。分别于术前及术后3个月、6个月、9个月和12个月采用Lysholm评分评估患者的膝关节功能。采用Lachman试验、轴移试验评估手术前后膝关节的稳定性。记录2组患者随访期间并发症发生情况。结果Crain组患者术后24 h、72 h VAS评分均低于对照组(P<0.05)。2组患者术前及术后9个月、12个月Lysholm评分比较差异无统计学意义(P>0.05),Crain组患者术后3个月、6个月Lysholm评分高于对照组(P<0.05)。2组患者手术前后Lachman试验及轴移试验阴性结果比较差异具有统计学意义(P<0.05),2组患者术后Lachman试验及轴移试验阴性结果比较差异无统计学意义(P>0.05)。对照组患者术后出现1例膝关节明显肿胀、疼痛,2组患者均未发生神经血管损伤及关节内感染等严重并发症。结论根据改良Crain分型理论进行关节镜下残端评估并保留残端的ACL重建可减轻膝关节疼痛,快速恢复膝关节功能和稳定性,严重并发症较少,临床效果满意。

基于阵列传感器的金属分类及成像

通过使用一种基于实测矩阵最值的灵敏度矩阵的修正方法,利用实测矩阵的最值对仿真所得的灵敏度进行修正,并将这3种矩阵分别进行电磁层析成像。其中,对2个磁导率不同的物体成像时,使用修正灵敏度矩阵所成的图像对于2种样品所处位置的中心点的灰度值不同,可以从图中明显看出2个样品的差异。在此基础上,通过对5种不同金属样品所成图像的最值进行分析,可以有效地分辨出不同金属样品。实验最终验证了修正灵敏度矩阵所成图像更加接近于实际电磁参数的分布,对于磁导率不同的物体更加有辨识性,可以有效对部分金属进行分类。

聚合物改性砂浆综述

介绍了聚合物改性砂浆在国内外的使用现状和应用前景、分类和性质、国内外研究现状以及研究趋势等,同时也探讨了聚合物改性砂浆的作用机理,并详细介绍了目前本领域所存在的几个问题,展望了聚合物改性砂浆未来的应用。