Atrial fibrillation (AF) is a common arrhythmia, which can lead to thrombosis and increase the risk of a stroke or even death. In order to meet the need for a low false-negative rate (FNR) of the screening test in clinical application, a convolutional neural network with a low false-negative rate (LFNR-CNN) was proposed. Regularization coefficients were added to the cross-entropy loss function which could make the cost of positive and negative samples different, and the penalty for false negatives could be increased during network training. The inter-patient clinical database of 21 077 patients (CD-21077) collected from the large general hospital was used to verify the effectiveness of the proposed method. For the convolutional neural network (CNN) with the same structure, the improved loss function could reduce the FNR from 2.22% to 0.97% compared with the traditional cross-entropy loss function. The selected regularization coefficient could increase the sensitivity (SE) from 97.78% to 98.35%, and the accuracy (ACC) was 96.62%, which was an increase from 96.49%. The proposed algorithm can reduce the FNR without losing ACC, and reduce the possibility of missed diagnosis to avoid missing the best treatment period. Meanwhile, it provides a universal loss function for the clinical auxiliary diagnosis of other diseases.
目的 觀察鹽酸氨基葡萄糖對Pilon骨折的輔助治療作用。 方法 2007年6月－2010年9月，將43例接受手術治療的Pilon骨折患者隨機分成兩組，A組術后口服鹽酸氨基葡萄糖，B組作為對照組（僅服用安慰劑）。A組21例患者，平均年齡（35.7± 8.0）歲，B組22例患者，平均年齡（36.7 ± 7.1）歲。兩組患者年齡、性別、骨折分型及手術時機相比較，無統計學差異（P＞0.05）。定期隨診（術后6、12、18個月），根據美國足與踝關節協會踝與后足功能評分（AOFAS）評分系統對患者進行功能評分，進行前瞻、對照、雙盲研究。 結果 術后6、12、18個月，A組患者的AOFAS評分均明顯高于B組，差異有統計學意義（t=2.530，2.856，2.881；P=0.015，0.007，0.006）；術后18個月，A組臨床療效優良率為95.2%，B組優良率為72.3%，差異有統計學意義（χ2=3.995，P=0.046）。A組2例患者分別發生輕度頭暈及惡心，無嚴重不良反應發生。 結論 鹽酸氨基葡萄糖輔助治療Pilon骨折可改善踝關節功能，減少創傷性骨關節炎的發生。
【摘要】 目的 探討胸膜活檢在結核性胸膜炎中的診斷價值。 方法 將2009年1-11月收治的52例結核性胸膜炎患者隨機分為常規組（40例）和胸膜活檢組（12例）。常規組采用常規方法診斷結核性胸膜炎，胸膜活檢組采用胸膜活檢進行診斷，比較兩組診斷結果。 結果 常規組均未獲得細菌學、病理學依據，病原病理學診斷率為0.0%；胸膜活檢組有5例獲得細菌學病理學依據，病原病理學診斷率為41.7%；兩組比較，差異有統計學意義（Plt;0.05）。常規組平均診斷時間為60 d，胸膜活檢組平均診斷時間為5 d；兩組比較，差異有統計學意義（Plt;0.05）。胸膜活檢組無并發癥發生。 結論 胸膜活檢在結核性胸膜炎診斷中具有重要價值。【Abstract】 Objective To explore the value of pleural biopsy in the diagnosis of tuberculous pleurisy. Methods From January to November 2009, Fifty-two patients with tuberculous pleurisy were randomly divided into conventional group (40 patients) and pleural biopsy group (12 patients), in order to compare the results of conventional diagnostic methods and tuberculous biopsy methods in the diagnosis of tuberculous pleurisy. Results Conventional group was unable to obtain the final bacteriological, pathological basis which obstained the diagnostic rate of 0, but in the pleural biopsy group, five patients got diagnosis basing on bacteriological and pathology tests, and the diagnostic rate was 41.7%;there was significant difference when compared the results of the two groups (Plt;0.05). The average diagnosis time were 60 days in the conventional group, and five days in the pleural biopsy group, there was significant difference when compared the results of the two groups (Plt;0.05). Pleural biopsy group had no complications occurred. Conclusion Pleural biopsy methods in the diagnosis of tuberculous pleurisy are of great value.