Stroke is a kind of cerebrovascular disease with high incidence and disability rate. Motor dysfunction and cognitive dysfunction are common dysfunctions of stroke. Rehabilitation treatment can effectively reduce the disability rate of stroke and improve the quality of life. The short-term hospitalization and ambulatory rehabilitation treatment cannot meet the rehabilitation needs of stroke patients. Cloud rehabilitation is one of the ways to solve this problem. This article introduces the definition and application of cloud rehabilitation and artificial intelligence (including assisted rehabilitation assessment and assisted rehabilitation treatment), and summarizes the current problems in the development of stroke cloud rehabilitation in China, so as to promote the construction of remote rehabilitation based on artificial intelligence in China and provide some references for the selection of rehabilitation programs for patients with stroke.
Objective To explore the consistency between the iKcare® grading system and Brunnstrom staging in evaluating upper and lower limb motor function in stroke patients. Methods From May 2018 to May 2020, stroke patients who met the standards in 34 medical institutions in China were recruited. The iKcare® grading system and Brunnstrom staging were used to evaluate the motor function of the upper and lower limbs of the subjects, respectively. The Kappa consistency test was used to evaluate the consistency between the two evaluation methods. Results A total of 340 eligible subjects were included, including 230 males and 110 females, with an average age of (61.44±12.77) years old, and an average course of disease of (62.96±42.53) days. The results showed that the Kappa evaluated for upper limb staging was 0.597 (P<0.001), and the Kappa evaluated for lower limb staging was 0.514 (P<0.001). Conclusions The evaluation results of iKcare® grading and Brunnstrom staging have moderate consistency. The iKcare® grading system can be used as an assessment tool for remote rehabilitation of motor function in stroke patients, but there is still room for improvement.
Objectives To systematically review the efficacy and safety of carbetocinversusoxytocin on the prevention of postpartum hemorrhage (PPH) for women undergoing vaginal delivery. Methods PubMed, The Cochrane Library, Web of Science, CBM, WanFang Data, CNKI and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on carbetocinversusoxytocin on the prevention of PPH for women undergoing vaginal delivery from inception to January 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 and Stata 12.0 software. Results A total of 16 RCTs including 2 537 patients were included. The results of meta-analysis showed that: compared to oxytocin, carbetocin could reduce the amount of blood loss within 24h (MD=–107.68, 95%CI–130.21 to –85.15, P<0.000 01) and 2h (MD=–85.98, 95%CI–93.37 to –78.59,P<0.000 01), hemoglobin (Hb) within 24h after delivery (MD=–5.63, 95%CI–6.82 to –4.43,P<0.000 01), the occurrence of PPH (RR=0.46, 95%CI 0.32 to 0.66,P<0.000 01) and the requirement for additional uterotonic agents (RR=0.63, 95%CI 0.48 to 0.84,P=0.002). There was no significant difference in the risk of adverse effects between two groups. Conclusions Current evidence shows that carbetocin is superior to oxytocin in the prevention of PPH for women undergoing vaginal delivery, without increasing the adverse effects. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above the conclusion.
ObjectivesTo investigate the epidemiological and clinical characteristics of first diagnosed human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients in a general hospital, so as to improve early recognition and diagnosis of HIV/AIDS.MethodsWe retrospectively analyzed the data of HIV/AIDS patients who were diagnosed for the first time and had medical records in West China Hospital of Sichuan University from January 2015 to December 2016. Epidemiological information, clinical characteristics and opportunistic infection of these patients were analyzed.ResultsThe 1 036 HIV/AIDS patients were mainly from other regions of Sichuan Province except Chengdu. The overall ratio of male to female was 3.26∶1, and the ages of the patients were mainly between 15 and 59 years old (83.20%). In the occupational distribution, household or unemployed accounted for the largest proportion (36.39%). In terms of education level, junior high school accounted for the largest proportion (27.70%). Among marital status, married accounted for the largest proportion (52.41%). Among ethnic groups, the Han nationality accounted for the largest proportion (87.64%). The main infection route was sexual transmission (82.05%), of which heterosexual transmission accounted for 65.64% and homosexual transmission accounted for 16.41%. The clinical departments of confirmed patients had a wide range of sources, the top five of which were General Outpatient Clinic, Infection Center, Department of Emergency, Department of Dermatology & Venerology and Department of Neurology. Of the patients, 66.99% reported asymptomatic, and 33.01% had one or more symptoms. The most common symptoms were systemic symptoms such as fever, fatigue and lymphadenopathy, as well as clinical manifestations of respiratory system, nervous system and gastrointestinal system. The clinical stage of HIV/AIDS patients were mainly asymptomatic phase and AIDS phase, accounting for 98.65%. Among the HIV/AIDS patients, there were obviously more medical patients than surgical patients. The most common symptoms of the medical patients were fever, cough and expectoration, headache, fatigue and abdominal pain. The main symptoms of the surgical patients were headache, abdominal pain and lymphadenopathy. Compared with the surgical HIV/AIDS patients, the medical patients were younger (Z=−2.647, P=0.008), and the platelet counts (t=−2.110, P=0.036) and CD4+ T lymphocyte counts (Z=−4.639, P<0.001) were lower, the differences were statistically significant. Compared with the homosexually transmitted HIV/AIDS patients, the heterosexually transmitted patients were older (t=25.477, P<0.001), and had lower CD4+ T lymphocyte counts (Z=−2.779, P=0.005). And in males, the red blood cell count and hemoglobin content were lower. There were 214 patients (20.66%) with opportunistic infections, and 50 patients (4.83%) with tumors.ConclusionsHIV/AIDS patients in this general hospital come from different clinic departments, and were mainly Han nationality and married men. Sexual transmission is the main transmission route. Common clinical presentations of HIV/AIDS include fever, fatigue, cough and expectoration, headache, abdominal pain and lymphadenopathy. The diagnosis and treatment of HIV/AIDS patients combined with opportunistic infections and tumors need more attention.
Stroke is a common and frequently-occurring disease, which seriously endangers human health. Rehabilitation treatment can effectively reduce the disability rate of stroke and improve the quality of life. The tertiary rehabilitation treatment system for stroke can effectively improve the motor function of stroke patients and improve the quality of life. This paper focuses on the choices and methods of physical therapy and occupational therapy at all levels of the hospitals and in different periods of the disease. It also aims to summarize the tertiary rehabilitation strategy for motor dysfunction in stroke patients, to provide references for all levels of hospitals and communities, achieve standardization and unification of rehabilitation treatment, as well as the rehabilitation efficacy of homogeneity.
Objective To evaluate the performance of i3000 direct chemiluminescence detection of human immunodeficiency virus (HIV) antigen and antibody (Ag/Ab) screening assay (Maccura), compared with E170 electrochemiluminescence method (Roche, Elecsys® HIV Combi PT assay) and IS1200 indirect chemiluminescence method (Maccura). Methods Ten HIV seroconversion panels and 11 p24 antigen positive samples from West China Hospital of Sichuan University from April to December 2017 were used to evaluate the sensitivity of those three assays. A total of 351 samples were collected for consistency evaluation, including 350 HIV Ag/Ab test samples (200 HIV-1 positive plasma samples and 150 HIV 1+2 negative plasma samples) from West China Hospital of Sichuan University from April to December 2017, and one commercial HIV-2 sera. A total of 98 interfere samples for HIV testing were collected from West China Hospital of Sichuan University from April to December 2017. Results In the sensitivity evaluation, there were 63 samples from the 10 seroconversion panels, in which Roche E170 detected 25 samples, Maccura i3000 detected 23 samples, and Maccura IS1200 detected 22 samples; Maccura i3000 and Roche E170 assays detected all the p24 antigen positive samples (11, 100%), while Maccura IS1200 only detected 10 samples. In the consistency evaluation, Maccura i3000 had nice consistency with both Roche E170 and Maccura IS1200 (kappa>0.9, P<0.001). In the interference evaluation, there were two false positives in Maccura i3000 detection, one case of rheumatoid arthritis and one case of syphilis. Conclusion In addition to high throughput and good consistency, Maccura i3000 direct chemiluminescence reagent has high sensitivity and a short window period, which can meet clinical needs.
Objective To explore whether the effect of cloud rehabilitation system on motor dysfunction and activities of daily living (ADL) of stroke patients is not inferior to hemiplegia manual treatment. Methods This study adopted a multicenter randomized controlled trial design. A total of 118 stroke patients were enrolled from 5 hospitals in China between April 2018 and April 2019, and they were randomly divided into a trial group and a control group, with 59 patients in each group. The trial group adopted hemiplegia manual treatment (≥30 min per time, once a day) and cloud rehabilitation training (30 min per time, once a day), and the control group adopted hemiplegia manual treatment alone (≥30 min per time, twice a day). All patients received continuous treatment for 2 weeks, and followed up for 2 weeks after that. The Brunnstrom stage (BRS), IK exercise stage, and Modified Barthel Index (MBI) were used to evaluate the motor function and ADL before and 4 weeks after treatment. Results There was no significant difference in gender, age, course, hemiplegia side, source (inpatient/outpatient) or hospital grade between the two groups (P>0.05), which were comparable. Compared with those before treatment, there were significant improvements in the BRS (upper and lower extremities), IK exercise stages (upper and lower extremities), and MBI scores in both groups 4 weeks after treatment (P<0.05). The four-week improvements in motor function indicators (BRS and IK) of the trial group were not inferior to those of the control group (P<0.05), and there was no significant difference in MBI score between the two groups 4 weeks after treatment (F=1.498, P>0.05). Conclusion The cloud rehabilitation system is not inferior to hemiplegia manual treatment in improving the limb motor function or ADL of patients .
Medical engineering interdisciplinary aims to integrate medicine, engineering science and other disciplines and to carry out scientific research and application in a collaborative manner. At present, the demand for medical engineering interdisciplinary in the field of medical laboratory technology is increasing, which also puts forward new requirements for the “Clinical Microbiology Laboratory Technology”. This article elaborates on the necessity and existing problems of the medical engineering interdisciplinary, reports on the overall ideas of the curriculum reform of “Clinical Microbiology Laboratory Technology” at West China School of Medicine of Sichuan University based on the medical engineering interdisciplinary, and specifically elaborates on the reform practices in three aspects: teaching philosophy, teaching content and methods, and teacher optimization, as well as the preliminary achievements obtained, so as to provide new ideas for the curriculum reform of the “Clinical Microbiology Laboratory Technology”.
The existing mazes are mainly used to study the learning and memory of animals. However, there is still a lack of corresponding maze and method in the aspect of the observation and test of aquatic animal robots. For this purpose, the authors have developed a three-dimensional water maze combined with bilayer multi-channel which equips with stratified lines and tick marks. This device is a rectangular structure composed of one square bottom and four rectangular side walls, and the channels of every side wall are composed of one upper channel and two lower channels. The center of the upper channels is in the vertical center line of every side wall, and the two uper channels of adjacent side walls are at 90° degrees with each other, and the two lower channels of adjacent side walls are at 45° degrees with each other. There are stratified lines and tick marks on the side wall to test the spatial location and movement trajectories of aquatic animals. The carp robot was put into the water maze for the underwater experimental detection. The success rates of left and right steering at 135, 90 and 45 degrees as well as forward motion of the carp robots (n = 10) were over 60%. This study showed that the device could be used to observe and test the motion of the carp robot.
In order to solve the problems that the injury, hemorrhage, infection and edema of the brain tissue caused by brain electrodes implantation for aquatic animal robots, a light stimulation device and an optical control experiment method for carp robots are proposed in this paper. According to the shape of the carp skull, the device is a structure of Chinese character " 王” cut by a printed circuit board which can provide three groups of A, B and C bridge platforms for the light stimulation source. The two ends of a bridge in every group are welded with a jumper board, and the light emitting diodes (LED) are inserted into the jumper boards as the light stimulation source, and all negative poles of the jumper boards are connected to the console by the wire. A LED light can be replaced by another LED light according to the need of the wavelength of the LED light, and various combinations of the light stimulation modes can be also selected. This device was mounted on the carp robot’s head, the carp robot was placed in a water maze, and the optical control experiment method was observed to control the forward movement and steering movement of the carp robots (n = 10) under the dark light condition. The results showed that the success rates of the three groups of red light control experiments were 53%–87%, and the success rates of the three groups of blue light control experiments were 50%–80%. This study shows that the apparatus and the method are feasible.