Auto interpretable depth learning model to analyze the hemodynamic changes and pulmonary complications in laparoscopic gynecologic tumor surgery with nalmefene hydrochloride combined with general anesthesia

OBJECTIVE

In this work, based on intelligent computing, the biological signals of patients were analyzed to investigate the hemodynamic changes and pulmonary complications of Nalmefene Hcl combined with general anesthesia (GA) in laparoscopic gynecological tumor surgery (GTS).

PATIENTS AND METHODS

Eighty computer-aided GTS patients were randomly divided into a control group (n = 40) and an observation group (n = 40). Biomedical electrocardiogram (ECG) signals were detected by wavelet neural network in all patients undergoing laparoscopic gynecological tumor surgery and were computerized according to the android interface definition language model (AIDL). GA was used during surgery. The observation group was injected intravenously with 0.2 μg/kg naproxenacin hydrochloride after operation. The control group was given 1 mL 0.9% sodium chloride solution after operation. Mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), pulse oxygen saturation (SPO), coma score, and adverse reactions (AR) were compared between the two groups at 10, 20, and 30 minutes after wakefulness. The hemodynamic parameters between the two groups were compared. Serum urocholine (URO) and creatinine (Cre) levels were analyzed in patients without complications.

RESULTS

ECG waveform based on wavelet neural network has a high recognition rate and strong generalization ability. 37 patients in the observation group recovered within 10 minutes after surgery, and the recovery rate at 30 minutes was 95%. 30 patients in the control group awoke 10 minutes after the operation, and the recovery rate at 30 minutes m-AR was 75%. The average abstract windows toolkit (AWT) of the observation group and control group was 11.87 ± 5.78 min and 16.46 ± 5.32 min, respectively, and the difference was significant (p < 0.05). There were significant differences in HR, systolic blood pressure (SBP), and diastolic blood pressure (DBP) between the observation group and the control group during the extubation (p < 0.05). Blood gas indexes PaO2, PvO2, PaCO2, and PvCO2 in the observation group were significantly different from those in the control group half an hour after the operation and half an hour after pneumoperitoneum (p > 0.05).

CONCLUSIONS

Intelligent computational biological signal detection was beneficial to the development of surgery. Nalmefene Hcl combined with GA on the basis of the AIDL model has a significant effect on the awakening of GTS patients and can shorten sleep time. Patients with underlying cardiac disease were more likely to develop postoperative lung complications.

[Preliminary observation on the differential expression of metformin in preventing noise-induced hearing loss in inner ear protein group of rats]

Objective: To study the protective effects of metformin on noise-induced hearing loss (NIHL) and its differential protein omics expression profile. Methods: In January 2021, 39 male Wistar rats were randomly divided into control group, noise exposure group and metformin+noise exposure group, with 13 rats in each group. Rats in the noise exposure group and metformin+noise exposure group were continuously exposed to octave noise with sound pressure level of 120 dB (A) and center frequency of 8 kHz for 4 h. Rats in the metformin+noise exposure group were treated with 200 mg/kg/d metformin 3 d before noise exposure for a total of 7 d. Auditory brainstem response (ABR) was used to test the changes of hearing thresholds before noise exposure and 1, 4, 7 d after noise exposure in the right ear of rats in each group. Tandem mass tag (TMT) quantitative proteomics was used to identify and analyze the differentially expressed protein in the inner ear of rats in each group, and it was verified by immunofluorescence staining with frozen sections. Results: The click-ABR thresholds of right ear in the noise exposure group and metformin+noise exposure group were significantly higher than those in the control group 1, 4, 7 d after noise exposure (P<0.05) . The click-ABR threshold of right ear in the metformin+noise exposure group were significantly lower than that in the noise exposure group (P<0.05) . Compared with the noise exposure group, 1035 up-regulated proteins and 1145 down-regulated proteins were differentially expressed in the metformin+noise exposure group. GO enrichment analysis showed that the significantly differentially expressed proteins were mainly involved in binding, molecular function regulation, signal transduction, and other functions. Enrichment analysis of KEGG pathway revealed that the pathways for significant enrichment of differentially expressed proteins included phosphatidylinositol 3-kinase-protein kinase B (PI3K-Akt) signaling pathway, focal adhesion, diabetic cardiomyopathy, mitogen, and mitogen-activated protein kinase (MAPK) signaling pathway. Immunofluorescence experiments showed that compared with the noise exposure group, the fluorescence intensity of insulin-like growth factor 1 receptor (IGF1R) in the metformin+noise exposure group was increased, and the fluorescence intensity of eukaryotic translation initiation factor 4E binding protein 1 (eIF4EBP1) was decreased. Conclusion: Noise exposure can lead to an increase in rat hearing threshold, and metformin can improve noise-induced hearing threshold abnormalities through multiple pathways and biological processes.

Effects of feeding solid-state fermented wheat bran on growth performance and nutrient digestibility in broiler chickens

Solid-state fermentation has been used to improve the nutritive value of feed ingredients. In the present study, we investigated the effects of solid-state fermented wheat bran (FWB) on growth performance and apparent digestibility in broiler chickens. We measured the growth performance (ADFI, ADG, feed conversion, livability, and European performance efficiency factor) over 38 d in chicks fed a corn-soybean meal control diet (CON) or CON plus wet FWB (25 g/kg [T₁]; 50 g/kg [T₂]); or T₁ plus 3 g/kg (T₃); or T₂ plus 6 g/kg (T₄) soybean oil). The same diets were used to determine nutrient availability in chicks aged 20 d. Regression equations for AME and AME_n were obtained using 20-day-old chicks fed either the corn-soybean meal basal diet only or basal diet partially substituted with 50, 150, or 300 g/kg DM FWB. Diets containing 25 or 50 g/kg wet FBW did not affect the growth performance of broiler chickens, nor the apparent DM, energy, and nitrogen digestibility of the feeds, compared with the control diets (all P > 0.05). Further supplementation with oil did not improve the growth performance of broiler chickens compared with controls or chickens fed FBW. However, chickens fed diets containing soybean oil (T₃ or T₄) had lower (P = 0.005 and P = 0.040, respectively) apparent DM and energy digestibility than the control and FWB groups. The regression equations for AME and AME_n with the substitution of FWB produced values of 1,854.3 and 1,743.9 kcal/kg DM, respectively, and the equations were Y = 1854.3X + 52.7 (R² = 0.971, n = 24, P < 0.001), and Y = 1743.9X + 44.6 (R² = 0.978, n = 24, P < 0.001), respectively. Supplementation with wet FWB did not affect the growth performance of broiler chickens. Therefore, FWB is a suitable feed component for broilers.

[Risk factors and clinical prognosis analysis of carbapenem-resistant Enterobacterales bacteria nosocomial infection]

Objective: To explore the risk factors for carbapenem-resistant Enterobacterales (CRE) infection and death. Methods: A case-control analysis of 482 inpatients in 18 secondary or tertiary hospitals in Beijing in 2018 was conducted. Patients infected by CRE were selected as the case group (n=247), and infected by carbapenem susceptible Enterobacterales (CSE) as the control group (n=235). The risk factors and clinical prognosis of CRE infection were analyzed by single factor analysis and multivariate logistic regression analysis. Results: CRE were resistant to most antimicrobials, but were highly sensitive to colistin and tigecycline, with sensitivity of 94.0% and 99.5%, respectively. Multivariate analysis showed that prior 30-day tracheal intubation (OR=2.607, 95%CI: 1.655-4.108, P<0.001), empirical treatment using third or fourth generation cephalosporins (OR=2.339, 95%CI: 1.438-3.803, P=0.001), carbapenems (OR=2.468, 95%CI: 1.610-3.782, P<0.001) and quinolones (OR=2.042, 95%CI: 1.268-3.289, P=0.003) were independent risk factors for CRE infection. Mechanical ventilation (OR=3.390, 95%CI: 1.454-7.904, P=0.005), heart failure (OR=4.679, 95%CI: 1.975-11.083, P<0.001), moderate or severe liver disease (OR=3.057, 95%CI: 1.061-8.806, P=0.038), prior 30-day quinolones exposure (OR=2.882, 95%CI: 1.241-6.691, P=0.014) and septic shock (OR=7.772, 95%CI: 3.505-17.233, P<0.001) were independent risk factors for death after CRE infection. Conclusions: Reducing the use of antimicrobials and invasive procedures such as prior 30-day tracheal intubation may reduce the probability of CRE infection. Grading the severity of the underlying disease in patients with CRE infection, as well as predicting and preventing the occurrence of septic shock will help reduce the risk of death.

[A multi-center clinical observation on safety and efficacy of a plasma derived coagulator factor Ⅷ for treatment of patients with hemophilia A]

OBJECTIVE

To evaluate the efficacy and safety of homemade plasma derived coagulation factor Ⅷ in patients with hemophilia A.

METHODS

Patients with congenital hemophilia A who met the inclusive and exclusive criteria were enrolled in the study after informed consent. The doses of factor Ⅷ were calculated according to the weight, disease severity etc. FⅧ activity and infusion efficacy value at 10 min and 60 min after infusion were recorded, as well as adverse events and validity rating according to the improvement of clinical syndromes. Viral infections including HBV, HCV, HIV and FⅧ inhibitor were determined after 3 and 6 months.

RESULTS

A total of 65 patients were enrolled in this study, all of whom were evaluable for drug safety. Treatment efficacy was evaluated in 60 patients and 57 cases completed the trial finally. In this 57 cases, most (52/57) subjects were of middle and severe hemophilia A mainly characterized by joint bleeding. Overall response rate of acute bleeding events was classified as "excellent" (70.00%) or "better" (30.00%). The non-responder was 0. FⅧ activity and infusion efficiency value of first administration after 10 min and 60 min improved significantly [10 min: (123.66±47.54)%; 60 min: (108.05±43.24)%]. The incidence of adverse events was 1.54%. Neither allergic reaction nor reactivation of HBV, HCV, HIV was detected after treatment of 3 and 6 months. No FⅧ inhibitor negative patients converted to positive during follow-up.

CONCLUSION

This homemade plasma derived coagulation factor Ⅷ is safe and effective for the treatment of acute bleeding in patients with hemophilia A.

In vitro and in vivo digestibility of corn starch for weaned pigs: Effects of amylose:amylopectin ratio, extrusion, storage duration, and enzyme supplementation

The objective of this study was to investigate the effects of amylose (AM):amylopectin (AP) ratio, extrusion, storage duration, and enzyme supplementation on starch digestibility of corn. Three corn varieties with high (0.60; HA), medium (0.44; MA), and low (0.39; LA) AM:AP ratios, respectively, were selected from 74 corn samples to evaluate the in vitro and in vivo digestibility of starch. In Exp. 1, during wk 4 after extrusion, resistant starch (RS) content of the 3 selected corn varieties (LA, MA, and HA) increased (P < 0.05) each week and starch digestibility in vitro decreased as storage time increased (P < 0.05). The AM:AP ratio affected the formation of RS (P < 0.01). The RS content of the 3 corn varieties was ranked as LA < MA < HA in each week (P < 0.05). Correlation analysis showed that AM:AP ratio and storage duration were both positively correlated with RS content (P < 0.01). Furthermore, a significant quadratic relation was found between storage duration and RS content in each corn variety as well as storage duration and digestibility. Starch digestibility was negatively correlated with RS content (P < 0.001). In Exp. 2, digestion trials were performed on cannulated pigs with BW of 13.20 ± 0.94 kg. Extrusion increased ileal digestibility of GE and starch of either HA or LA compared with the enzyme-supplemented diets (P < 0.001). Enzyme supplementation did not improve ileal energy and starch digestibility. The ileal digestibility of starch and GE of LA varieties was greater than HA samples (P < 0.05). The results implied that AM:AP ratio and storage duration after extrusion may be important determinants of RS formation and digestibility of starch for corn. In addition, RS content could be an important indicator of digestibility of starch in extruded corn. Using a lower AM:AP ratio corn or reducing the storage duration of extruded corn would help to reduce the formation of RS and improve the starch bioavailability of corn for piglets.

[Effect of acupuncturing houxi and shenmen in treating cerebral traumatic dementia]

Sixty-two cerebral traumatic dementia patients were randomly divided into two groups: acupuncture group (32 cases) and physiotherapy group (30 cases). The changes of mini-mental status examination (MMSE) scores and auditory evoked potential P300 were observed before and after treatment.

RESULTS

marked effective rate and effective rate of acupuncture group were 46.9% and 81.3% respectively, significantly higher than 10.0% and 30.0% of physiotherapy group (P < 0.01). It was found that after treatment the above-mentioned indexes in acupuncture group changed significantly (P < 0.05 - 0.001), while in physiotherapy group were not (P > 0.05). The therapeutic effect in acupuncture group was better than that in physiotherapy group (P < 0.001). The results confirmed that the cognitive function of cerebral traumatic dementia patients was enhanced effectively with acupuncturing at Houxi and Shemen.