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简介：AbstractBackground:The association between heart rate and 1-year clinical outcomes in heart failure (HF) patients with atrial fibrillation (AF), and whether this association depends on left ventricular ejection fraction (LVEF), are unclear. We investigated the relationship between discharge heart rate and 1-year clinical outcomes after discharge among hospitalized HF patients with AF, and further explored this association that differ by LVEF level.Methods:In this analysis, we enrolled 1760 hospitalized HF patients with AF from the China Patient-centered Evaluative Assessment of Cardiac Events Prospective Heart Failure study from August 2016 to May 2018. Patients were categorized into three groups with low (<65 beats per minute [bpm]), moderate (65-85 bpm), and high (≥86 bpm) heart rate measured at discharge. Cox proportional hazard models were employed to explore the association between heart rate and 1-year primary outcome, which was defined as a composite outcome of all-cause death and HF rehospitalization.Results:Among 1760 patients, 723 (41.1%) were women, the median age was 69 (interquartile range [IQR]: 60-77) years, median discharge heart rate was 75 (IQR: 69-84) bpm, and 934 (53.1%) had an LVEF <50%. During 1-year follow-up, a total of 792 (45.0%) individuals died or had at least one HF hospitalization. After adjusting for demographic characteristics, smoking status, medical history, anthropometric characteristics, and medications used at discharge, the groups with low (hazard ratio [HR]: 1.32, 95% confidence interval [CI]: 1.05-1.68, P = 0.020) and high (HR: 1.34, 95% CI: 1.07-1.67, P = 0.009) heart rate were associated with a higher risk of 1-year primary outcome compared with the moderate group. A significant interaction between discharge heart rate and LVEF for the primary outcome was observed (P for interaction was 0.045). Among the patients with LVEF ≥50%, only those with high heart rate were associated with a higher risk of primary outcome compared with the group with moderate heart rate (HR: 1.38, 95% CI: 1.01-1.89, P = 0.046), whereas there was no difference between the groups with low and moderate heart rate. Among the patients with LVEF <50%, only those with low heart rate were associated with a higher risk of primary outcome compared with the group with moderate heart rate (HR: 1.46, 95% CI: 1.09-1.96, P = 0.012), whereas there was no difference between the groups with high and moderate heart rate.Conclusions:Among the overall HF patients with AF, both low (<65 bpm) and high (≥86 bpm) heart rates were associated with poorer outcomes as compared with moderate (65-85 bpm) heart rate. Among patients with LVEF ≥50%, only a high heart rate was associated with higher risk; while among those with LVEF <50%, only a low heart rate was associated with higher risk as compared with the group with moderate heart rate.Trail Registration:Clinicaltrials.gov; NCT02878811.

简介：Heartratevariaty(HRV)of85caseswithAMIwasobservedintheearlyphaseafteronsetandrehabilitationphaseatfirstmonthandsixthmonth,andwascontrastedwithsixtimethresholdindicesof111caseswithcoronaryheartdiseaseandthatof35normalcontrol.WefoundtheHRVofAMIwasapperantlylowerintheacutephasethanthatofcoronaryheartdiseaseandnormalcontrols.HRVrecoveredgraduallywithincliningtobestableafterhalfayear,butitwasstilllowerthanthatofcontrols.LowHRVinearlyphaseofAMIsuggestedthepoorprognosis.

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简介：AbstractObjective:To investigate the safety and efficacy of internal electronic fetal heart rate (FHR) monitoring during labor.Methods:This was a retrospective case-control study, which was an analysis of monitoring FHR with a fetal scalp electrode or a Doppler probe (94 pregnant women per group). In the internal monitoring group, when the opening of the uterine orifice was ≥3 cm, the fetal scalp electrode was placed after natural or artificial rupture of the membrane. FHR was simultaneously monitored using a Doppler probe. In the external monitoring group, continuous FHR monitoring was performed using an ultrasound Doppler transducer fixed on the maternal abdomen. The toco transducer was used to record uterine contractions. Pathological examination of the placenta was performed prospectively in 49 and 48 cases in the internal electronic FHR monitoring group and control group, respectively. Maternal-infant outcomes (e.g. fever, puerperal infection, puerperal morbidity, delivery mode, Apgar score, and scalp injury) were recorded. Umbilical artery blood was extracted for blood gas analysis. Differences between the two groups were compared using the paired t-test, χ2 test, Yates corrected χ2 test or Fisher exact test.Results:Non-statistically significant differences between the internal and external monitoring groups were observed in the incidence of neonatal acidosis (1/94 (1.06%) vs. 3/94 (3.19%), respectively; χ2= 0.255, P= 0.613), cesarean section/operative vaginal delivery (8/94 (8.51%) vs. 15/94 (15.96%), respectively; χ2 = 2.427, P= 0.181), fever during labor (18/94 (19.15%) vs. 15/94 (15.96%), respectively; χ2=0.331, P= 0.565), puerperal morbidity (2/94 (2.13%) vs. 3/94 (3.19%), respectively; χ2= 0.000, P= 1.000), chorioamnionitis (9/49 (18.37%) vs. 7/48(14.58%), respectively; χ2= 0.252, P= 0.616), and neonatal asphyxia (0/94 (0.00%) vs. 1/94 (1.06%), respectively; χ2= 0.000, P= 1.000). There were no puerperal infections, neonatal scalp injuries, or scalp abscesses found in either group. Using the internal monitoring value as reference, the incidence of FHR false deceleration in external FHR monitoring was 20.21% (19/94 women).Conclusion:Internal FHR monitoring during labor does not increase the incidence of adverse perinatal outcomes. External monitoring was associated with FHR false decelerations.

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简介：Detrendedfluctuationanalysis(DFA)isfitforstudiesonthelong-rangeexponentialcorrelationofnon-stationarytimeserial.Inthispaper,inordertofindahypoxiaadaptabilityevaluationcriterion,theheartrateandSaO2signalsareanalyzedbythismethod.Thedemarcateexponentaboutfit-good-groupandfit-bad-groupinhypoxiaandnormalairarecalculatedandcompared.Theresultshowsαisdifferentindifferentsituation,theαinhypoxiaismuchhigherthanαofbreathinnormalair.Andαoffit-good-groupishigherthanfit-bad-group.ItshowsthatDFAcouldbeagoodcriteriontoanalyzehypoxiaadaptability,whichisusefulintheanalysisofhypoxiaphysiologysignal.

简介：AbstractObjective:This study investigates the efficacy of analyzing fetal heart rate (FHR) signals based on Artificial Intelligence to obtain a baseline calculation and identify accelerations/decelerations in the FHR through electronic fetal monitoring during labor.Methods:A total of 43,888 cardiotocograph(CTG) records of female patients in labor from January 2012 to December 2020 were collected from the NanFang Hospital of Southern Medical University. After filtering the data, 2341 FHR records were used for the study. The ObVue fetal monitoring system, manufactured by Lian-Med Technology Co. Ltd., was used to monitor the FHR signals for these pregnant women from the beginning of the first stage of labor to the end of delivery. Two obstetric experts together annotated the FHR signals in the system to determine the baseline as well as accelerations/decelerations of the FHR. Our cardiotocograph network (CTGNet) as well as traditional methods were then used to automatically analyze the baseline and acceleration/deceleration of the FHR signals. The results of calculations were compared with the annotations provided by the obstetric experts, and ten-fold cross-validation was applied to evaluate them. The root-mean-square difference (RMSD) between the baselines, acceleration F-measure (Acc.F-measure), deceleration F-measure (Dec.F-measure), coefficient of synthetic inconsistency (SI) and the morphological analysis discordance index (MADI) were used as evaluation metrics. The data were analyzed by using a paired t-test.Results:The proposed CTGNet was superior to the best traditional method, proposed by Mantel, in terms of the RMSD.BL (1.7935 ± 0.8099 vs. 2.0293 ± 0.9267, t=-3.55 , P=0.004), Acc.F-measure (86.8562 ± 10.9422 vs. 72.2367 ± 14.2096, t= 12.43, P <0.001), Dec.F-measure (72.1038 ± 33.2592 vs. 58.5040 ± 38.0276, t= 4.10, P <0.001), SI (34.8277±20.9595 vs. 54.8049 ± 25.0265, t=-9.39, P <0.001), and MADI (3.1741 ± 1.9901 vs. 3.7289 ± 2.7253, t= -2.74, P= 0.012). The proposed CTGNet thus had significant advantages over the best traditional method on all evaluation metrics.Conclusion:The proposed Artificial Intelligence-based method CTGNet delivers good performance in terms of the automatic analysis of FHR based on cardiotocograph data. It promises to be a key component of smart obstetrics systems of the future.

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简介：Atotalof30studentsscoringbetween12and20ontheTestAnxietyScalewhohadbeenexhibitingananxiousstate>24hours,and30normalcontrolstudentswererecruited.IndicesofheartratevariabilitywererecordedusinganActiheartelectrocardiogramrecorderat10minutesbeforeauricularpressing,inthefirsthalfofstimulationandinthesecondhalfofstimulation.Theresultsrevealedthatthestandarddeviationofallnormaltonormalintervalsandtherootmeansquareofstandarddeviationofnormaltonormalintervalsweresignificantlyincreasedafterstimulation.Theheartratevariabilitytriangularindex,very-low-frequencypower,low-frequencypower,andtheratiooflow-frequencytohigh-frequencypowerwereincreasedtodifferentdegreesafterstimulation.Comparedwithnormalcontrols,therootmeansquareofstandarddeviationofnormaltonormalintervalswassignificantlyincreasedinanxiousstudentsfollowingauricularpressing.Theseresultsindicatedthatauricularpressingcanelevateheartratevariability,especiallytherootmeansquareofstandarddeviationofnormaltonormalintervalsinstudentswithpre-examanxiety.

简介：AbstractObjective:To investigate the efficacy of in-phase and quadrature (IQ) demodulation in electronic fetal heart rate monitoring (EFM) to reduce false reports of fetal heart rate (FHR) doubling or halving.Methods:This is a prospective cohort study. A total of 263 full-term pregnant women who delivered at Peking University Shenzhen Hospital between August 2019 and July 2020 were prospectively enrolled in the study. FHR monitoring began when the cervix was dilated to 2-3 cm and continued until delivery. Raw fetal Doppler audio signals and internal and external cardiotocography curves from internal electrode monitoring, EFM with conventional demodulation (external), and EFM with IQ demodulation (external) were acquired to compare FHR doubling and halving time. In cohort 1, FHR was compared between IQ demodulation and conventional demodulation. In cohort 2, FHR was compared between IQ demodulation, conventional demodulation, and internal FHR monitoring. Count data were statistically analyzed using the Chi-squared test, and measurement data were statistically analyzed using t-test for correlation coefficients, and Bland-Altman analysis for concordance ranges.Results:To compare IQ demodulation and conventional demodulation, 225 pregnant women were monitored for a total of 835,870 seconds. The beat-to-beat interval of FHRs in raw fetal Doppler audio signals was used as the reference. The results showed a doubling time of 3401 seconds (0.407%, 3401/835,870) and a halving time of 2918 seconds (0.349%, 2918/835,870) with conventional demodulation, compared to 241 seconds (0.029%, 241/835,870) and 589 seconds (0.070%, 589/835,870), respectively, with IQ demodulation. IQ demodulation reduced FHR doubling by approximately 93% (3160/3401) and FHR halving by approximately 80% (2329/2918) compared to conventional demodulation (P < 0.01).To compare IQ demodulation, conventional demodulation, and internal FHR monitoring, 38 pregnant women were monitored for a total of 98,561 seconds. FHR from internal electrode monitoring was used as the reference. The results showed a doubling time of 238 seconds (0.241%, 238/98,561) and a halving time of 235 seconds 0.238%, 235/98,561) with conventional demodulation, compared with 30 seconds (0.030%, 30/98,561) and 81 seconds (0.082%, 81/98,561), respectively, with IQ demodulation (P < 0.05). No significant difference was observed in doubling or halving time between IQ demodulation and internal FHR monitoring (P > 0.05). IQ demodulation was more closely correlated with internal FHR monitoring than conventional demodulation (0.986 vs. 0.947). The Bland-Altman analysis showed that the concordance range of IQ demodulation vs. internal FHR monitoring was significantly narrower than that of conventional demodulation vs. internal FHR monitoring ((-5.32,6.01) vs. (-10.87,11.46)).Conclusion:EFM with IQ demodulation significantly reduces false FHR doubling and halving, with an efficacy similar to that of internal FHR monitoring.

简介：背景:心率变异分析(HRV)是测量高水平运动员周期训练负荷安排和减量训练过程中心脏自主神经系统波动的一种简单、无创的测量方法。本研究包括3个案例分析,目的是检测残奥会游泳冠军日常心脏自主神经波动的变化。方法:在残奥会之前的17周每天监测3名残奥会游泳冠军的静息HRV。在特定的时间和频率区域测试,并伴HRV非线性指标计算进行分析。所有HRV数据用每日值进行单独分析,用周平均值进行分析以及静息时相和训练时相均值进行分析。结果:在整个监测阶段,3名运动员(截肢运动员)所有的HRV参数均存在显著性差异。结论:在运动员监测过程中,尽管长期改变非常微小,游泳分类和残疾类型都能明显影响HRV。关于影响残疾运动员对训练、旅行和其他外界因素的个体反应进一步理解,可能会提高对增强运动表现运动负荷的管理和监控。

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简介：AbstractObjective:To evaluate the clinical utility of noninvasive prenatal screening (NIPS) for fetuses with congenital heart disease (CHD) and impact of NIPS results on pregnancy outcome.Methods:This was a retrospective study of pregnant women with fetuses diagnosed with CHDs by sonographic examination, who willing to underwent NIPS as a side-test for fetal aneuploidies. From August 2016 to October 2017, in the sonographic examination center of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region. NIPS was offered to 117 women, 19-32 years old, who carried fetuses with CHD diagnosed by fetal ultrasound (mean gestational age= 24 weeks). The pregnancy outcomes were followed-up.Results:NIPS positive rate in our pregnancies with CHD fetuses’ cohort was 11.1% (13/117), and the positive predictive value for aneuploidies is 85.7% (6/7). In the NIPS positive group (n = 13), all pregnancies terminated, 76.9% (10/13) of those decisions were made on ultrasound finding alone. In the NIPS negative group (n= 104), 2 lost follow-up, 79 pregnancies terminated, among which 77.2% (61/79) of the decision was made by ultrasound results alone. Twenty-three pregnancies continued and 78.3% of those fetuses carried single type CHD. In terminated pregnancies that did not considered NIPS results (71/115), 73.2% (52/71) of those carried fetuses with two or more types of CHDs.Conclusion:NIPS can detect common aneuploidy associated with CHD with high positive predictive value and screening yield. The NIPS result played certain meaningful roles in determining pregnancy outcomes, particularly for fetus with simplex CHD; yet the parents’ decision of pregnancy was mainly made based on ultrasound findings.

简介：（本句意思：最好使用红色或粉色卡纸，但如果你喜欢．你也可以使用白色卡纸进行涂色。）

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简介：Theheartisamidline,valvular,muscularpumpthatisconetshapedandthesizeofafist.Itweighs300ginadultsandliesinthemiddlemediastinumofthethorax.