目的本研究旨在基于全球疾病负担(Global Burden of Disease,GBD)2021数据库,评估全球及中国20~54岁女性群体的异位妊娠负担,包括发病率、死亡率和寿命损失年(years of life lost,YLLs),并通过年龄-时期-队列(age-period-cohort model,A...目的本研究旨在基于全球疾病负担(Global Burden of Disease,GBD)2021数据库,评估全球及中国20~54岁女性群体的异位妊娠负担,包括发病率、死亡率和寿命损失年(years of life lost,YLLs),并通过年龄-时期-队列(age-period-cohort model,APC)模型分析年龄、时期和出生队列的独立效应,进一步预测2050年异位妊娠负担的变化趋势。方法本研究使用GBD 2021数据库提供的全球和中国数据,计算并分析了1990—2021年间20~54岁女性的异位妊娠发病率、死亡率和YLLs。通过APC模型,评估了不同年龄组、时期和出生队列对异位妊娠负担的独立影响。采用贝叶斯统计框架预测模型(Bayesian age-period-cohort model,BAPC)对2050年全球异位妊娠的负担进行了预测分析。结果2021年全球20~54岁女性的异位妊娠发病率为431.07/100000,死亡率为0.304/100000,YLLs率为17.866/100000。中国相较于全球,异位妊娠的死亡率和YLLs率较低。1990—2021年间,全球和中国的异位妊娠负担均呈现下降趋势,尤其是在发病率和死亡率方面。年龄-时期-队列分析显示,年轻女性群体(20~29岁)异位妊娠的发生率在2007年后显著下降。2050年预测显示,全球20~54岁女性的异位妊娠年龄标准化发病率为163.149/100000,年龄标准化死亡率为0.505/100000,年龄标准化YLLs率为29.421/100000。结论尽管全球在医疗干预和健康管理方面取得了显著进展,异位妊娠依然是全球范围内的重要公共卫生问题。特别是在低收入和中等收入国家,异位妊娠负担仍较重。未来的公共卫生政策应加强对年轻女性群体的健康教育、提高早期诊断水平,并确保医疗资源的公平分配,以减少异位妊娠的发生率和相关健康负担。展开更多
针对Faster R-CNN算法对多目标、小目标检测精度不高的问题,本文提出一种基于Faster R-CNN的多任务增强裂缝图像检测(Multitask Enhanced Dam Crack Image Detection Based on Faster R-CNN,ME-Faster RCNN)方法。同时提出一种基于K-me...针对Faster R-CNN算法对多目标、小目标检测精度不高的问题,本文提出一种基于Faster R-CNN的多任务增强裂缝图像检测(Multitask Enhanced Dam Crack Image Detection Based on Faster R-CNN,ME-Faster RCNN)方法。同时提出一种基于K-means的多源自适应平衡TrAdaBoost的迁移学习方法(multi-source adaptive balance TrAdaBoost based on K-means,K-MABtrA)辅助网络训练,解决样本不足问题。ME-Faster R-CNN将图片输入ResNet-50网络提取特征;然后将所得特征图输入多任务增强RPN模型,同时改善RPN模型的锚盒尺寸和大小以提高检测识别精度,生成候选区域;最后将特征图和候选区域发送到检测处理网络。K-MABtrA方法利用K-means聚类删除与目标源差别较大的图像,再在多元自适应平衡TrAdaBoost迁移学习方法下训练模型。实验结果表明:将ME-Faster R-CNN在K-MABtrA迁移学习的条件下应用于小数据集大坝裂缝图像集的平均IoU为82.52%,平均精度mAP值为80.02%,与相同参数设置下的Faster R-CNN检测算法相比,平均IoU和mAP值分别提高了1.06%和1.56%。展开更多
Dear Editor,The most serious heat related injury is exertional heat stroke(EHS).EHS occurs when healthy individuals perform physical activity in a hot and humid environment[1].A disrupted balance between heat producti...Dear Editor,The most serious heat related injury is exertional heat stroke(EHS).EHS occurs when healthy individuals perform physical activity in a hot and humid environment[1].A disrupted balance between heat production and dissipation in the human body results in excessive body heat storage in cases.It occurs frequently in the military population because of work characteristics such as the requirements to perform essential duties under prolonged heat stress,the need to achieve mission objectives during deployment operations,or the opportunities for training and selection for elite units[2].The pathophysiology of EHS is complex,which often results in thermoregulation failure,hemodynamic disturbance,and endotoxin release,and further causes multiple organ failure,probably increasing myocardial enzymes and N-terminal pro-brain natriuretic peptide(NT-proBNP)levels.Rhabdomyolysis caused by EHS often results from mechanical and metabolic injury to the striated muscle fibers accompanied with the release of muscle contents into the circulation[3].Liu et al.展开更多
This study sought to investigate late-onset hypogonadism （LOH） in old and middle-aged males in Shanghai communities, using symptom score evaluation systems and measurements of sex hormone levels. One thousand cases ...This study sought to investigate late-onset hypogonadism （LOH） in old and middle-aged males in Shanghai communities, using symptom score evaluation systems and measurements of sex hormone levels. One thousand cases of males aged 40-70 years were investigated. The aging male symptoms （AMS） scale and androgen deficiency in aging males （ADAM） questionnaire were used at the beginning of the investigation, followed by measurement of the sex hormone-related factors （total testosterone （TT）, free testosterone （fT）, sex hormone-binding globulin （SHBG） and bioavailability of testosterone （Bio-T））. There were 977 valid questionnaires. The LOH-positive rates shown by AMS and ADAM were 59.88% and 84.65%, respectively; values increased with the age of the patients. There were 946 results related to sex hormone measurements, which showed the following results： TT was not related to aging （P〉O.05）; levels of SHBG increased with age; and fT and Bio-T decreased with age. There was a significant difference in fT between LOH-positive and LOH-negative patients, as shown by the ADAM. In summary, TT levels were not related to aging, even though SHBG did increase while fT and Bio-T decreased with aging. Clinically, the diagnosis of LOH cannot be based on serum TT level.展开更多
Sperm banking can preserve male fertility effectively, but the current conditions of sperm cryopreservation in China have not been investigated. This retrospective investigation was based on data collected at multiple...Sperm banking can preserve male fertility effectively, but the current conditions of sperm cryopreservation in China have not been investigated. This retrospective investigation was based on data collected at multiple centres in China from January 2003 to December 2008. The collected data included urogenital history, indication for cryopreservation, semen parameters, use rate, type of assisted reproductive technique （ART） treatment and pregnancy outcome. The study population included 1 548 males who had banked their semen during the study period at one of the clinics indicated above. Approximately 1.9% （30/1 548） of the cryopreserved semen samples were collected from cancer patients; about 88.8% （1 374/1 548） of the patients had banked their semen for ART and 8.6% （134/1 548） had a male infertility disease （such as anejaculation, severe oligozoospermia and obstructive azoospermia）. The total use rate of cryopreserved semen was 22.7% （352/1 548）, with 119 live births. The cancer group use rate was 6.7% （2/30）, with one live birth by intracytoplasmic single sperm injection （ICSI）. The ART group use rate was 23.2% （319/1 374）, with 106 live births. The reproductive disease group use rate was 23.1% （31/134）, with 12 live births. The semen parameters in each category varied; the cancer patient and infertility disease groups had poor semen quality. In vitro fertilization （IVF） and ICSI were the most common ART treatments for cryopreserved sperm. Semen cryopreservation as a salvage method is effective, but in many conditions it is underutilized, especially in cancer patients. Lack of awareness, urgency of cancer treatment and financial constraints are the main causes of the low access rate. The concept of fertility preservation should be popularized to make better use of this medical service in China.展开更多
文摘目的本研究旨在基于全球疾病负担(Global Burden of Disease,GBD)2021数据库,评估全球及中国20~54岁女性群体的异位妊娠负担,包括发病率、死亡率和寿命损失年(years of life lost,YLLs),并通过年龄-时期-队列(age-period-cohort model,APC)模型分析年龄、时期和出生队列的独立效应,进一步预测2050年异位妊娠负担的变化趋势。方法本研究使用GBD 2021数据库提供的全球和中国数据,计算并分析了1990—2021年间20~54岁女性的异位妊娠发病率、死亡率和YLLs。通过APC模型,评估了不同年龄组、时期和出生队列对异位妊娠负担的独立影响。采用贝叶斯统计框架预测模型(Bayesian age-period-cohort model,BAPC)对2050年全球异位妊娠的负担进行了预测分析。结果2021年全球20~54岁女性的异位妊娠发病率为431.07/100000,死亡率为0.304/100000,YLLs率为17.866/100000。中国相较于全球,异位妊娠的死亡率和YLLs率较低。1990—2021年间,全球和中国的异位妊娠负担均呈现下降趋势,尤其是在发病率和死亡率方面。年龄-时期-队列分析显示,年轻女性群体(20~29岁)异位妊娠的发生率在2007年后显著下降。2050年预测显示,全球20~54岁女性的异位妊娠年龄标准化发病率为163.149/100000,年龄标准化死亡率为0.505/100000,年龄标准化YLLs率为29.421/100000。结论尽管全球在医疗干预和健康管理方面取得了显著进展,异位妊娠依然是全球范围内的重要公共卫生问题。特别是在低收入和中等收入国家,异位妊娠负担仍较重。未来的公共卫生政策应加强对年轻女性群体的健康教育、提高早期诊断水平,并确保医疗资源的公平分配,以减少异位妊娠的发生率和相关健康负担。
文摘针对Faster R-CNN算法对多目标、小目标检测精度不高的问题,本文提出一种基于Faster R-CNN的多任务增强裂缝图像检测(Multitask Enhanced Dam Crack Image Detection Based on Faster R-CNN,ME-Faster RCNN)方法。同时提出一种基于K-means的多源自适应平衡TrAdaBoost的迁移学习方法(multi-source adaptive balance TrAdaBoost based on K-means,K-MABtrA)辅助网络训练,解决样本不足问题。ME-Faster R-CNN将图片输入ResNet-50网络提取特征;然后将所得特征图输入多任务增强RPN模型,同时改善RPN模型的锚盒尺寸和大小以提高检测识别精度,生成候选区域;最后将特征图和候选区域发送到检测处理网络。K-MABtrA方法利用K-means聚类删除与目标源差别较大的图像,再在多元自适应平衡TrAdaBoost迁移学习方法下训练模型。实验结果表明:将ME-Faster R-CNN在K-MABtrA迁移学习的条件下应用于小数据集大坝裂缝图像集的平均IoU为82.52%,平均精度mAP值为80.02%,与相同参数设置下的Faster R-CNN检测算法相比,平均IoU和mAP值分别提高了1.06%和1.56%。
基金supported by the Natural Science Foundation of Hainan Province(821QN389,821MS112,822MS198,820MS126,820QN383)the Military Medical Science and Technology Youth Incubation Program(20QNPY110,19QNP060)+6 种基金the Excellent Youth Incubation Program of Chinese PLA General Hospital(2020-YQPY-007)the Heatstroke Treatment and Research Center of Chinese PLA(413EGZ1D10)the Simulation Training for Treatment of Heatstroke,the Major Science and Technology Programme of Hainan Province(ZDKJ2019012)the National Key Research and Development Program of China(2018YFC2000400)the National S&T Resource Sharing Service Platform Project of China(YCZYPT[2018]07)the Specific Research Fund of Innovation Platform for Academicians of Hainan Province(YSPTZX202216)the Medical Big Data Research and Development Project of Chinese PLA General Hospital(MBD2018030).
文摘Dear Editor,The most serious heat related injury is exertional heat stroke(EHS).EHS occurs when healthy individuals perform physical activity in a hot and humid environment[1].A disrupted balance between heat production and dissipation in the human body results in excessive body heat storage in cases.It occurs frequently in the military population because of work characteristics such as the requirements to perform essential duties under prolonged heat stress,the need to achieve mission objectives during deployment operations,or the opportunities for training and selection for elite units[2].The pathophysiology of EHS is complex,which often results in thermoregulation failure,hemodynamic disturbance,and endotoxin release,and further causes multiple organ failure,probably increasing myocardial enzymes and N-terminal pro-brain natriuretic peptide(NT-proBNP)levels.Rhabdomyolysis caused by EHS often results from mechanical and metabolic injury to the striated muscle fibers accompanied with the release of muscle contents into the circulation[3].Liu et al.
文摘This study sought to investigate late-onset hypogonadism （LOH） in old and middle-aged males in Shanghai communities, using symptom score evaluation systems and measurements of sex hormone levels. One thousand cases of males aged 40-70 years were investigated. The aging male symptoms （AMS） scale and androgen deficiency in aging males （ADAM） questionnaire were used at the beginning of the investigation, followed by measurement of the sex hormone-related factors （total testosterone （TT）, free testosterone （fT）, sex hormone-binding globulin （SHBG） and bioavailability of testosterone （Bio-T））. There were 977 valid questionnaires. The LOH-positive rates shown by AMS and ADAM were 59.88% and 84.65%, respectively; values increased with the age of the patients. There were 946 results related to sex hormone measurements, which showed the following results： TT was not related to aging （P〉O.05）; levels of SHBG increased with age; and fT and Bio-T decreased with age. There was a significant difference in fT between LOH-positive and LOH-negative patients, as shown by the ADAM. In summary, TT levels were not related to aging, even though SHBG did increase while fT and Bio-T decreased with aging. Clinically, the diagnosis of LOH cannot be based on serum TT level.
文摘Sperm banking can preserve male fertility effectively, but the current conditions of sperm cryopreservation in China have not been investigated. This retrospective investigation was based on data collected at multiple centres in China from January 2003 to December 2008. The collected data included urogenital history, indication for cryopreservation, semen parameters, use rate, type of assisted reproductive technique （ART） treatment and pregnancy outcome. The study population included 1 548 males who had banked their semen during the study period at one of the clinics indicated above. Approximately 1.9% （30/1 548） of the cryopreserved semen samples were collected from cancer patients; about 88.8% （1 374/1 548） of the patients had banked their semen for ART and 8.6% （134/1 548） had a male infertility disease （such as anejaculation, severe oligozoospermia and obstructive azoospermia）. The total use rate of cryopreserved semen was 22.7% （352/1 548）, with 119 live births. The cancer group use rate was 6.7% （2/30）, with one live birth by intracytoplasmic single sperm injection （ICSI）. The ART group use rate was 23.2% （319/1 374）, with 106 live births. The reproductive disease group use rate was 23.1% （31/134）, with 12 live births. The semen parameters in each category varied; the cancer patient and infertility disease groups had poor semen quality. In vitro fertilization （IVF） and ICSI were the most common ART treatments for cryopreserved sperm. Semen cryopreservation as a salvage method is effective, but in many conditions it is underutilized, especially in cancer patients. Lack of awareness, urgency of cancer treatment and financial constraints are the main causes of the low access rate. The concept of fertility preservation should be popularized to make better use of this medical service in China.
