It is difficult to distinguish the inferior alveolar nerve (IAN) from other tissues inside the IAN canal due to their similar CT values in the X image which are smaller than that of the bones. The direct reconstruction, therefore, is difficult to achieve the effects. The traditional clinical treatments mainly rely on doctors' manually drawing the X images so that some subjective results could not be avoided. This paper proposes the partition reconstruction of IAN canal based on shape features. According to the anatomical features of the IAN canal, we divided the image into three parts and treated the three parts differently. For the first, the directly part of the mandibular, we used Shape-driven Level-set Algorithm Restrained by Local Information (BSLARLI) segment IAN canal. For the second part, the mandibular body, we used Space B-spline curve fitting IAN canal's center, then along the center curve established the cross section. And for the third part, the mental foramen, we used an adaptive threshold Canny algorithm to extract IAN canal's edge to find center curve, and then along it established the cross section similarly. Finally we used the Visualization Toolkit (VTK) to reconstruct the CT data as mentioned above. The VTK reconstruction result by setting a different opacity and color values of tissues CT data can perspectively display the INA canal clearly. The reconstruction result by using this method is smoother than that using the segmentation results and the anatomical structure of mental foramen position is similar to the real tissues, so it provides an effective method for locating the spatial position of the IAN canal for implant surgeries.
Integrating visualization toolkit and the capability of interaction, bidirectional communication and graphics rendering which provided by HTML5, we explored and experimented on the feasibility of remote medical image reconstruction and interaction in pure Web. We prompted server-centric method which did not need to download the big medical data to local connections and avoided considering network transmission pressure and the three-dimensional (3D) rendering capability of client hardware. The method integrated remote medical image reconstruction and interaction into Web seamlessly, which was applicable to lower-end computers and mobile devices. Finally, we tested this method in the Internet and achieved real-time effects. This Web-based 3D reconstruction and interaction method, which crosses over internet terminals and performance limited devices, may be useful for remote medical assistant.
ObjectiveTo investigate the molecular pathogenesis of pulmonary fibrosis induced by bleomycin in a murine model,and provide novel insights for clinical diagnosis and treatment. MethodsFrom Gene Expression Omnibus,we downloaded microarray data extracted from experiments of bleomycin induced pulmonary fibrosis in wild-type mice. With BRB-Array Tools,differentially expressed genes at different time points during disease development were screened,selected and analyzed by DAVID software. ResultsBRB array analysis identified 45101 differentially expressed genes. After induction by bleomycin on 7th day,1164 genes and 735 genes were significantly up-regulated and down-regulated (P<0.05,fold change>2),respectively. On 14th day,731 genes and 390 genes were significantly up-regulated and down-regulated (P<0.05,fold change>2),respectively. DAVID analysis revealed that the up-regulated genes were significantly enriched in cell cycle,p53 signaling and chemokine signaling pathway,damaging reaction and collagen metabolism gene sets. While the down-regulated genes were enriched in the drug metabolism pathway gene set. ConclusionsBioinformatics methodologies are able to efficiently analyze microarray data and extract its underlying information,provide novel insights for major molecular events and shift of cell signaling pathway during pulmonary fibrosis progression,and furthermore,finding molecular markers for early diagnosis and therapeutic targets.
ObjectiveTo comprehensively collect quality assessment tools of systematic review/meta-analysis (SR/MA) of randomized controlled trials (RCTs), and compare the differences of numbers and contents of items, in order to provide references for optimizing and using these quality assessment tools. MethodsWe searched PubMed and EMbase databases up to December 31th, 2013 for quality assessment tools of SR/MA of RCTs. EndNote X3 software was used for screening literature and Excel 2010 software was used for data extraction. A descriptive analysis was performed. ResultsA total of 61 studies including 32 quality assessment tools were included. Among them, 30 tools were for methodological quality and 2 tools for reporting quality. These tools were developed by different medical universities or colleges, research institutes, national health institutes, and some famous epidemiologists and methodologists from 1984 to 2007. Among the 32 tools, 4 tools were scales, while 28 were checklists. The numbers of items of these tools ranged from 5 to 101, among them, 9 tools had more than 20 items. ConclusionThere are many quality assessment tools for SR/MA, but none of them is generally acknowledged. The quality, contents of items, and applicability of these tools are different, and some of them are too long to use. In practice and decision-making, most of the tools have the problems of low relevance and applicability. How to regularly use these tools to guide the research, practice and decision-making of SR/MA is still needed to be further researched.
ObjectiveTo provide references for scientific selection of different tools/guidelines by comprehensively collecting international and national tools/guidelines for assessing reporting quality and methodological quality of animal experiments, comparing them in development foundation, application scope, and aims. MethodsPubMed, EMbase, CNKI, VIP and WanFang Data were searched up to July 2014, to collect tools/guidelines for reporting quality and methodological quality of primary animal experiments. We extracted data from included guidelines/tools, including the number of items, development foundation, disease models, application scope, and assessment focus. Then descriptive analysis was conducted. ResultsA total of 32 studies were finally included, of which, 6 were for reporting quality and 26 for methodological quality. The item number of the included tools/guidelines ranged from 2 to 54. Seven tools/guidelines applied score system to assess methodological quality. Fifteen tools/guidelines were designed for specific disease models. Nineteen tools/guidelines were suitable for assessing preclinical drug studies, and 4 were designed to assess environmental toxicology research. ConclusionAlthough many tools for assessing methodological quality of animal experiments have been published so far, SYRCLE's risk of bias tool is the only one that is used to assess internal validity of animal experiments at present. Besides, although the ARRIVE guidelines and GSPC are not official mandatory reporting criteria at present, they are acknowledged by many researchers as efficient reference checklists and writing guidelines for writing and publishing animal experiments. We recommend the application of SYRCLE's risk of bias tool, ARRIVE guidelines and GSPC, in order to efficiently improve research design, implementation, reporting, differentiation, and evaluation of animal experiments, promote the development of animal experiments, and to promote full application and translation of scientific achievements.
ObjectiveTo preliminarily explore the effect of Osteoporosis Self-assessment Tool for Asians (OSTA) and Fracture Risk Assessment Tool (FRAX) on predicting osteoporosis and osteoporosis fracture in postmenopausal patients with maintenance hemodialysis (MHD).MethodsThirty-six postmenopausal patients undergoing MHD from August 2017 to October 2018 in Hemodialysis Center of Nephrology Department, West China Hospital of Sichuan University were selected. Relevant data such as age, height, and weight were collected. OSTA index and the 10-year probability of major osteoporotic fractures and 10-year probability of hip fractures of FRAX score were calculated. Bone mineral densities (BMD) of the hip and lumbar spine were measured by dual energy X-ray absorptiometry (DXA) at the same time. The value of OSTA index and FRAX scale in evaluating the risk of osteoporosis predicated on T value ≤−2.5 determined by DXA BMD and fracture in postmenopausal patients with MHD were analyzed.ResultsThe DXA BMD of the 36 patients showed that 50.0% (18/36) had a T value≤−2.5, and 30.6% (11/36) had a fracture history. BMD in postmenopausal patients with MHD was negatively correlated with FRAX score (model without BMD values), and positively correlated with OSTA index. The sensitivity and specificity of OSTA in the prediction of osteoporosis were 94.4% and 61.1%, respectively; and the sensitivity and specificity of FRAX (the model without BMD values) in the prediction of osteoporosis were 88.9% and 50.0%, respectively. The FRAX score with or without BMD had the same clinical value in predicting osteoporosis.ConclusionsPostmenopausal MHD patients have a higher risk of osteoporosis and fracture. Both OSTA index and FRAX scale can predict osteoporosis risk among postmenopausal MHD patients, and the FRAX scale with or without BMD has the same clinical value in predicting osteoporosis risk. In clinical work, for primary hospitals and dialysis centers lacking DXA, preliminary screening of osteoporosis in MHD patients can be performed with OSTA and FRAX scales.
ObjectiveTo explore the effect of goal directed analgesia on patients with noninvasive positive pressure ventilation (NPPV) in the intensive care unit (ICU).MethodsThis was a retrospective study. Two hundred sixty-four patients requiring non-invasive positive pressure ventilation were enrolled in the ICU of this hospital, including 118 patients in the empirical analgesia group and 146 in the goal directed analgesia group. The empirical analgesia group was treated with remifentanil to analgesia and propofol, midazolam or dexmedetomidine to sedation. The sedative depth maintained <1 measured by the score of the Richmond restless sedative scale (RASS). The same analgesic and sedative drug were first used in the goal directed analgesia group to maintain the Critical Care Pain Observation Tool score <2, and the RASS score <1 was maintained after the analgesia depth were achieved. Whether the patients occurred delirium was assessed by the Confusion Assessment Method for the ICU. The dosage of analgesic and sedative drugs, the dependability (based on the total ventilation time in the first 24 hours after ventilation), the incidence of delirium, the rate of invasive ventilation, the total time of NPPV and the length of stay of ICU were observed in the two groups.ResultsThere were no significant differences in age, sex, APACHEⅡ score, mean arterial pressure, heart rate, respiratory rate, SpO2, arterial blood gas and the reason of NPPV between the two groups. The dosage of analgesic and sedative drugs in the goal directed analgesia group were less than the empirical analgesia group, and the dependability was higher than that of the empirical analgesia group ［(12.6±5.8)h vs. (10.9±4.8)h, P<0.05), and the incidence of delirium and the rate of invasive ventilation were also lower than those of the empirical analgesia group (15.8% vs. 25.4%, P<0.05; 32.9% vs. 44.9%, P<0.05). The total time of NPPV in the goal directed analgesia group was shorter than that of the empirical analgesia group ［(28.6±8.8)h vs. (37.3±10.7)h, P<0.05), but there was no significant difference in the length of stay in ICU.ConclusionGoal directed analgesia can improve the dependability of NPPV patients, reduce the use of sedative drugs, and decrease the incidence of delirium and rate of invasive ventilation.
RoB2 (revised version 2019), an authoritative tool for assessing the risk of bias in randomized controlled trials, has been updated and improved based on the original version. This article elaborated and interpreted the background and main content of RoB2 (revised version 2019), as well as the operation process of the new software. Compared with the previous version of RoB2 (revised version 2018), RoB2 (revised version 2019) has the advantages of rich content, complete details, accurate questions, and simple operation, etc. Additionally, it is more user-friendly for researchers and beginners. The risk bias assessment of randomized controlled trials is more comprehensive and accurate, and it is an authoritative, trustworthy, and popular tool for evaluating the risk of bias in randomized controlled studies in medical practice.
ObjectiveTo analyze the perdictive value of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) for malnutrition or postoperative complications in children with critical congenital heart disease (CHD).MethodsA total of 875 children with critical CHD who were hospitalized in West China Hospital, Sichuan University form August 2019 to February 2021, including 442 males and 433 females with a median age of 30 (12, 48) months, were assessed by STAMP in Health Information System. Clinical data of postoperative complications were collected.Results(1) Based on World Health Organization Z-score as gold standard, 24.5% had malnutrition risk, and 34.3% were diagnosed with malnutrition. According to STAMP, the children were with medium malnutrition risk of 37.9% and high malnutrition risk of 62.1%. There was a statistical difference of incidence rate of malnutrition and detection rate of STAMP malnutrition risk in gender, age, ICU stay or length of mechanical ventilation (P<0.05); (2) with the optimal cut-off point of 5.5 in STAMP for malnutrition, the sensitivity, specificity, positive predictive value, negative predictive value and area under the curve (AUC) were 68.3%, 84.3%, 48.1%, 88.3% and 0.82, respectively; (3) 12.0% of the children were with postoperative complications; (4) with the optimal cut-off point of 5.5 in STAMP for postoperative complications, the sensitivity, specificity, positive predictive value, negative predictive value and AUC were 83.8%, 73.1%, 18.8%, 99.1% and 0.85, respectively.ConclusionChildren with critical CHD have a higher incidence of malnutrition risk and postoperative complications. STAMP has a good perdictive value for malnutrition or postoperative complications, however, the sensitivity and specificity of STAMP are affected by the gold standard or the cut-off point.
Objective To analyze the complaint characteristics of emergency department of women and children’s specialized hospital, and to provide a basis for improving medical service quality, enhancing hospital management, increasing satisfaction, and reducing complaint rates in specialized hospitals. Methods Using the Healthcare Complaint Analysis Tool classification framework, a retrospective analysis was conducted on complaints from the Emergency Department of West China Second University Hospital of Sichuan University. Results The total number of complaints from 2020 to 2022 was 525, and the number of complaints had been increasing year by year. There were 196 complaints against personnel and 329 complaints against regions. There were 320 complaints related to management issues (61.0%), 143 complaints related to doctor-patient relationship issues (27.2%), and 62 complaints related to clinical issues (11.8%). The complained areas were mainly fever clinics (193 cases), and the complained personnel were mainly nurses (82 cases). Conclusion The emergency department of women and children’s specialized hospitals is different from comprehensive hospitals, and active optimization should be carried out to address the main issues. While continuously improving the level of medical technology, it is also necessary to strengthen information technology construction, optimize medical procedures, improve environmental facilities, and provide psychological support for patients and their caregivers.