Cardiovascular disease (CVD) has caused a huge burden of disease worldwide, and accurate diagnosis and assessment of CVD has a clear significance for improving the prognosis of patients. The development of artificial intelligence (AI) and its rapid application in the medical field have enabled new approaches for the analysis and fitting of various CVD data. At present, in addition to structured medical records, the CVD field also includes a large number of non-linear data brought by imaging and electrophysiological examinations. How to use AI to process such multi-source data has been explored by a large number of studies. Therefore, this review discusses the existing ways of processing various multi-source heterogeneous data with existing artificial intelligence technologies by summarizing various existing studies, and analyzes their possible advantages and disadvantages, in order to provide a basis for the future application of AI in CVD.
Cardiovascular disease has caused a huge burden of disease worldwide, and the rapid advancement of smart wearable devices has provided new means for early diagnosis, real-time monitoring, and event prevention of cardiovascular disease. Smart wearable devices can be classified into various categories based on detection signals and physical carrier types. Based on an overview of the composition of such devices, this article further introduces the current cutting-edge research and related market products related to smart blood pressure monitoring, electrocardiogram monitoring, and ultrasound monitoring. It also discusses the future development and challenges of such devices, aiming to provide evidence support for the research and development of smart wearable devices in the diagnosis and treatment of cardiovascular diseases in the future.
Objective To study the effect on liver hemodynamics of portal arterialization and complete shunt (PACS), splenorenal shut （SRS） and peripheral cardia divided vessel (PCDV). Methods The preparation of canine model was made. Group PCDV accepted a splenectomy and peripheral cardia divided vessel, while the group SRS accepted a spleen-renal vein shunt. Group PACS accepted a splenectomy, splenic artery and upper portal vein anastomosis, and complete portal-caval shunt. The blood pressure and flow of the portal system were observed. The hepatic function was also measured before and 2 weeks after the three kinds of operation. Results In the PCDV group, the postoperative PVF decreased in 17% while PVP decreased in 5%. In the SRS group, the postoperative PVF decreased in 51% while PVP decreased in 51%. In the PACS group, the postoperative hepatic inflow PVF increased to 180% of the former while PVP increased to 196%; the caval-inflow PVF increased to 130% of the former while PVP decreased to 46%. The results of PACS group had a magnificent statistic difference comparing with those two traditional operations （P＜0.05，P＜0.01）. ALT obviously increased after SRS （P＜0.05）, whereas slightly changed after the other two. Conclusion PACS can significantly increase the hepatic inflow and decreased the blood pressure of the portal system with a pleasant dog survival, and without obvious influence to the hepatic function. It may be a worthy attempt in the treatment of portal hypertension and need more research work going on.
目的 探讨康复新液联合奥美拉唑三联疗法治疗幽门螺杆菌（Hp）阳性的胃溃疡的临床疗效和内镜下溃疡愈合情况。 方法 将2010年1月－2012年1月对住院及门诊180例内镜诊断并检测证实Hp阳性的胃溃疡患者，按计算机产生的随机数字表随机分为两组，每组各90例。两组均给予口服奥美拉唑20 mg，2次/d，克拉霉素0.5 g，2次/d，甲硝唑0.4 g，2次/d，铝碳酸镁1.0 g，3次/d，治疗7 d。7 d后改为口服奥美拉唑20 mg，1次/d，铝碳酸镁1.0 g，3次/d，疗程4周，治疗组加服康复新液10 mL，3次/d；对照组不使用康复新液。治疗期间以上腹痛作为判断症状改善的主要指标，疗程结束后复查胃镜观察溃疡愈合情况，同时观察药物不良反应。 结果 治疗组在临床症状改善总有效率93.3%，对照组为总有效率82.2%；溃疡病灶愈合方面治疗组总有效率94.4%，对照组为总有效率83.3%，两组比较有统计学意义（P＜0.05），临床应用4周后无任何不良反应，Hp根除率两组间差异无统计学意义。 结论 康复新液联合奥美拉唑三联疗法可有效治疗胃溃疡，治疗期间患者未发生不良反应，为治疗胃溃疡的一种安全有效的药物。
Objective To validate the mechanism of effect of hepatic artery ischemia on biliary fibrosis after liver transplantation and the prevention method. Methods Eighteen male dogs were established into the concise auto orthotopic liver transplantation models and assigned into three groups randomly: hepatic artery ischemia (HAI) group, TBB group (transferred the blood by a bridge duct ) and control group, each group contained 6 dogs. After opening portal vein, the samples were cut from liver in each group at the time of 6 h, 3 d and 14 d. The pathological modifications of intrahepatic bile ducts were observed and expression of transforming growth factor-β1 (TGF-β1) were detected in the three times. Expressions of Smad3 and phosphate-Smad3 as well as mRNA of α-smooth muscle actin (α-SMA) in intrahepatic bile ducts were detected 14 d after opening portal vein.Results Compared with control group, the collagen deposition and lumens stenosis in biliary vessel wall were more obviously in HAI group. In TBB group, the pathological modifications were slighter compared with HAI group. The positive cell index of TGF-β1 reached peak on day 3 after opening portal vein, then decreased in TBB group, and which in HAI group kept increase and was significantly higher than that in TBB group （Plt;0.05）. The expression level of phosphate-Smad3 and transcriptional level of α-SMA mRNA were 1.04±0.13 and 1.12±0.55 in TBB group on day 14 after opening portal vein, which were significantly higher than those in control group (0.59±0.09 and 0.46±0.18) and lower than those in HAI group (1.82±0.18 and 1.86±0.73), the diversities among three groups were significant (Plt;0.05). There was not significant difference of expression of Smads among three groups (Pgt;0.05). Conclusions Hepatic artery ischemia could increase the deposition of collagen fibers and the transdifferentiation of myofibroblast in bile duct and result in the biliary fibrosis by activating the TGF-β1/Smads signaling pathway. The bridging bypass device could lessen the biliary fibrosis caused by hepatic artery ischemia by inhibiting the activation of TGF-β1/Smads signal transduction passageway.
Objective To evaluate hepatic functional reserve and investigate the clinical value through measuring hepatic functional blood flow by D-sorbitol clearance rate and liver volume changes with CT. Methods Ninety-two patients with portal hypertension due to posthepatic cirrhosis were investigated (cirrhosis group). Twenty healthy volunteers were used as control group. D-sorbitol was infused intravenously at a steady rate. Blood and urine were collected and recorded once before infusion and at 120, 150 and 180 min after infusion, and their concentrations of D-sorbitol were examined by enzyme spectrophotometry. From pharmacokinetic equations, hepatic clearance rate of D-sorbitol (CLH) was calculated. Total hepatic blood flow (QTOTAL) was measured by Doppler sonography, intrahepatic shunt rate (RINS) was obtained. The liver volume change rate was obtained in patients with cirrhosis through the abdominal CT scan. The relations among the indicators, Child classification and postoperative complications were studied. Results After D-sorbitol was infused intravenously for 120 min, the plasma concentration was at the steady state. The plasma concentration was (0.189±0.05) mmol/L in control group and (0.358±0.06) mmol/L in cirrhosis group (Plt;0.01). CLH was (1 248.3±210.5) ml/min in control group and (812.7±112.4) ml/min in cirrhosis group (Plt;0.01). Although QTOTAL in cirrhosis group was declined, compared with the control group 〔(1 280.6±131.4) ml/min vs. (1 362.4±126.9) ml/min〕, Pgt;0.05, while RINS increased markedly 〔(36.54±10.65)% vs. (8.37±3.32)%, Plt;0.01〕. In cirrhosis group, the mean liver volume of Child A, B and C patients were (1 057±249) cm3, (851±148) cm3 and (663±77) cm3 respectively. There were significant differences among the mean liver volume (Plt;0.05). The liver volume was significantly smaller in Child B and C patients than that in Child A (Plt;0.05, Plt;0.01). When CLH was less than 600 ml/min, and liver volume decreased by more than 40%, postoperative complications increased significantly. CLH and the liver volume change rate were not in absolutely good accordance with Child classification. Conclusion The hepatic clearance of D-sorbitol and the quantitative determination of the liver volume with CT can be an objective evaluation of the liver metabolism of the inherent capacity and the hepatic functional blood flow changes. It contributes to the correct understanding of the hepatic functional reserve and lay the foundation for determining a reasonable treatment plan, surgical methods and time.
Objective To summarize the effect of the splenectomy in patients with portal hypertension on the occurrence and recurrence of hepatocellular carcinoma. Methods The related literatures about the splenectomy in patients with hepatocirrhosis combined with portal hypertension or patients with hepatocellular carcinoma combined with portal hypertension in recent years were reviewed. Results At present, most academics considered that, for patients with hepatocirrhosis combined with portal hypertension, splenectomy could reduce the occurrence of hepatocellular carcinoma. For patients with hepatocellular carcinoma combined with portal hypertension, splenectomy+hepatectomy didn’t increase the perioperative mortality, and it could reduce the recurrence rate of hepatocellular carcinoma. Conclusion Splenectomy for patients with portal hypertension is safe, and it can inhibit the occurrence and progress of hepatocellular carcinoma, however, the specific mechanism remain needs further study.
In continuous renal replacement therapy (CRRT), the combination of medicine and engineering is propelling advancements in therapeutic technology. By enhancing the biocompatibility and specific adsorption capabilities of the blood adsorption materials, the therapeutic efficacy of CRRT is augmented, leading to a reduction in adverse reactions for patients. Moreover, the application of big data and artificial intelligence in CRRT is continually being developed. Utilizing intelligent devices, data analysis, and machine learning, the initiation, monitoring, and formulation of CRRT treatment plans are optimized, providing clinical patients with more efficient and secure therapeutic options, thereby further improving clinical outcomes.
【Abstract】Objective The injury induced by hepatic artery ischemia (HAI) in the liver transplantation procedure and the protective effects of using hepatic artery bridge-conduit (HABC) technique were studied. Methods Thirtytwo dogs were randomly divided into 4 groups: control, HAI 30 min, HAI 2 h and HABC groups. We observed the pathological changes of hepatocytes and biliary tract tissues and the microstructure of chondriosome, which were based on the model of auto-orthotopic liver transplantation in dogs. Biochemical and spectrophotometric methodswere used to evaluate the content of MDA and SOD, SDH activities in the graft liver tissue respectively. Results The pathologic and electrical microscopic changes of hepatocytes and epithelial cells of bile ducts were found in HAI 30 min and HAI 2 h groups,while the content of MDA increased to （1.652±0.222） nmol/mg prot and (2.379±0.526) nmol/mg prot, and SOD activity decreased to (11.15±3.9) U/mg prot and (9.47±3.4) U/mg prot. At the same time, SDH activity was also down-regulated to 0.362±0.019 and 0.281±0.029. Compared with control group, the differences were significant (Plt;0.05, Plt;0.01). But these changes of functional index caused by HAI injury were not significant in HABC group. Conclusion The HABC technique can not only avoid HAI injury during operation but also alleviate the occurrence of complication after transplantation, especially the biliary tract complication.
【Abstract】Objective To investigate the influence of hepatectomy combined with splenectomy on curative effect of primary hepatocellular carcinoma patients associated with hypersplenism.Methods Twenty three cases of primary hepatocellular carcinoma associated with hypersplenism were analyzed retrospectively and divided into hepatectomy combined with splenectomy group (n=10) and hepatectomy combined with ligation of splenic artery (n=13). Peripheral blood samples were collected 1 week before operation and 3 monthes after operation respectively. The levels of CD4, CD8, CD16, CD4/CD8, WBC and PLT in the blood were detected. Survival rate between the two groups was compared. Results There were not significant differences in the expressional levels of CD4, CD8, CD16, CD4/CD8,WBC and PLT before operation, bleeding quantity during the operation and rate of severe complications after operation in the two groups. The expressional levels of CD4, CD16, CD4/CD8, WBC and PLT of hepatectomy combined with splenectomy group were much higher in 3 months after operation than those in 1 week before operation and in hepatectomy combined with ligation of splenic artery group (P＜0.01) and the latter with no distinct changes of the above indexes. There was no difference of survival rate between the two groups. But in the hepatectomy combined with ligation of splenic artery group, 7 patients of 13 patients were compelled to terminate chemotherapy because of their low WBC while not a single patient was forced to do so in the hepatectomy combined with splenectomy group. Conclusion Hepatectomy combined with splenectomy is useful for patients with hepatocellular carcinoma associated with hypersplenism to restore the immunological function and the application of chemotherapy after operation.