Search

Type-2 fuzzy logic system (FLS) cascaded with neural network, type-2 fuzzy neural network (T2FNN), is presented in this paper to handle uncertainty with dynamical optimal learning. A T2FNN consists of a type-2 fuzzy linguistic process as the antecedent part, and the two-layer interval neural network as the consequent part. A general T2FNN is computational-intensive due to the complexity of type 2 to type 1 reduction. Therefore, the interval T2FNN is adopted in this paper to simplify the computational process. The dynamical optimal training algorithm for the two-layer consequent part of interval T2FNN is first developed. The stable and optimal left and right learning rates for the interval neural network, in the sense of maximum error reduction, can be derived for each iteration in the training process (back propagation). It can also be shown both learning rates cannot be both negative. Further, due to variation of the initial MF parameters, i.e., the spread level of uncertain means or deviations of interval Gaussian MFs, the performance of back propagation training process may be affected. To achieve better total performance, a genetic algorithm (GA) is designed to search optimal spread rate for uncertain means and optimal learning for the antecedent part. Several examples are fully illustrated. Excellent results are obtained for the truck backing-up control and the identification of nonlinear system, which yield more improved performance than those using type-1 FNN. Index Terms--Back propagation, dynamic optimal learning rate, genetic algorithm, interval type-2 FNN.

Routine use of magnet-controlled capsule endoscopy of the stomach has been limited by the inadequate views of specific stomach regions. In the present study, radiology and upper gastrointestinal endoscopy (UGIE) were used to determine optimal subject body positioning and suitable external control magnet placement for capsule endoscopy. Healthy adult volunteers were subjected to upper gastrointestinal X-ray radiography (n=5), spiral computed tomography with volume reconstruction (n=4) or UGIE (n=1). Stomach fundus-to-body (FB) and body-to-antrum (BA) angles were compared when subjects were supine, prone, lying on their left side and on their right side, and when they were standing upright. Vertical distances from the surface of the body to the distal points of the fundus and antrum were also compared in this range of subject positions. Obtuse angles were considered the most beneficial for capsule movement and short vertical distances were considered desirable for optimizing magnetic force. The FB angle was sharply acute in the supine position, relatively open where subjects were on their side, and almost 180° in the standing position. The BA angle was obtuse in the standing position but acute in all other positions. With the subject in any position, the left lower lateral chest had the shortest distance to the fundus, while the ventral wall was closest to the antrum. The present modeling analysis indicates that standing is superior to all decubitus positions for magnetic-capsule endoscopy, including the commonly used supine position. Both the abdominal anterior wall and left lateral lower chest appeared to be advantageous locations for external control magnet placement. [ABSTRACT FROM AUTHOR]

Aging induces a series of alterations, specifically a decline in the stature and number of villi and crypts in the small intestine, thus compromising the absorbent capability of the villi. This investigation employed a senolytic combination of dasatinib and quercetin (D+Q) to examine its impact on the intestinal tract of elderly mice. Our findings demonstrate that D+Q treatment leads to a decrease in the expression of p21, p16, and Ki67, while concurrently triggering removal of apoptotic cells within the villi. Additionally, D+Q treatment exhibits the ability to promote growth in both the height and quantity of villi and crypts, along with stimulating nitric oxide (NO) production in aged mice. The study presented a model to assess strategies to alleviate age-related senescence in the intestinal tract of elderly mice. Importantly, D+Q showcases promising potential in enhancing intestinal functionality within the aging.

Competing Interests: The authors declare that they have no conflict of interest.

With the development and generalization of endoscopic technology and screening, clinical application of magnetically controlled capsule gastroscopy (MCCG) has been increasing. In recent years, various types of MCCG are used globally. Therefore, establishing relevant guidelines on MCCG is of great significance. The current guidelines containing 23 statements were established based on clinical evidence and expert opinions, mainly focus on aspects including definition and diagnostic accuracy, application population, technical optimization, inspection process, and quality control of MCCG. The level of evidence and strength of recommendations were evaluated. The guidelines are expected to guide the standardized application and scientific innovation of MCCG for the reference of clinicians., (© 2023 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.)

Objective: To explore the effect and the mechanism of Danhong Injection (DI), Ligustrazine Injection (LI), and adsorbable biomembranes in preventing the adhesion of tendons and tissues., Methods: Totally 120 patients all suffering from simple flexor digitorum tendon rupture on the hand zone two damaged by sharp weapons were randomly assigned to Group A (Dikang adsorbable biomembrane), Group B (Tianxinfu adsorbable biomembrane), Group C (Tianxinfu adsorbable biomembrane + Ligustrazine group), and Group D (Tianxinfu adsorbable biomembrane + DI group) in accordance with random digit table, 30 cases in each group. Indicators such as total active movement (TAM) of the hand tendon, Minnesota manual dexterity test (MMDT), and finger flex strength test (FFST) were observed., Results: The TAM and the favorable rate were higher in Group C and D than in Group A and B at post-operative 4 and 8 week (P < 0.05, P < 0.01). There was no statistical difference between Group C and D (P > 0.05). Each index of MMDT was lower in Group C and D than in Group A and B (P < 0.05). There was no statistical difference in FFST among all the 4 groups (P > 0.05)., Conclusions: Combined application of LI or DI with Tianxinfu adsorbable biomembranes could effectively prevent the adhesion of tendons. DI showed equivalent effect as LI did. Besides, the combined application was superior in preventing adhesion to using Xintianfu adsorbable biomembrane or Dikan adsorbable biomembrane alone.

Objective: To introduce treatment method of replantation of severed thumb trauma with proximal arterial, and to evaluate its efficacy., Methods: From February 2007 to March 2009,13 patients with severed thumb in serious injury of proximal arterial were treated with vein graft of volar forearm,bridging between dorsal carpal branch of radial artery on nasopharyngeal fossa and distal stump of ulnar proper digital artery. Among them, there were 11 males and 2 females with an average age of 34.5 years ranging from 16 to 50 years. Seven cases were in the left thumb,6 in the right thumb. Eight cases were complete separation, incomplete separation in 5 cases. Ten cases recieved emergency reimplantation, 3 cases with the arterial crisis after conventional replantation were explorated and repaired., Results: Thumb of 13 cases all survived. All patients were followed-up for 8 to 17 months (averaged, 11 months). Replantation thumb obtained satisfactory appearance. According to Chinese Medical Association Society of Hand Surgery Trial criteria, the results were excellent in 9 fingers, good in 3 fingers, 1 poor finger. Two point discrimination of finger pulp was 5 to 8 mm (averaged 6.5 mm)., Conclusion: By repairing artery of thumb with vein graft of volar forearm, bridging between dorsal carpal branch of radial artery on nasopharyngeal fossa and distal stump of ulnar proper digital artery,complex severed thumb replants on surgery position comfortable,without affecting the blood supply of the hand, expanding the indications for replantation and improving the success rate of replantation.

Objective: To introduce the method of the transverse carpal ligament (TCL) transection through palmar mini-incision for carpal tunnel syndrome (CTS) and evaluate its efficacy and safety., Methods: From January 2006 to September 2007, 15 patients (18 hands) with CTS were treated with palmar longitudinal mini-incision decompression. There were 2 males and 13 females, with an average age of 48 years (ranged 34 to 69) and an average course of 18 months (ranged 8 to 26). The main clinical symptom including the radial numbness or pain of the 3 and a half fingers, wrist pain and radiation to the forearm, the night awake history of numbness, thenar muscle atrophy, positive Tinel sign and Phalen sign. Median nerve electrophysiology showed that sensory nerve conduction velocity (SCV) slowed down and sensory nerve action potential (SNAP) decreased or missed, short abductor muscle of thumb had spontaneous potential in severe cases. Clinical effect were evaluated according to the Global symptom score (GSS) scoring in aspect of pain, numbness, paraesthesia, weakness and nocturnal awakening., Results: Postoperative wound smoothly healed in all patients and no complications occurred. All patients were followed up from 20 to 28 months with an average of 24 months. Symptoms of 1 patient had not incomplete relief, other patient's symptoms disappeared and muscle force of abductor pollicis brevis reinforced. Postoperative GSS scoring obviously improved than preoperative (P < 0.05)., Conclusion: Treatment of carpal tunnel syndrome through palmar mini-incision decompression has advantages such as higher safe, shorter operative time, less invasive, smaller scar, which can cut off carpi transversum ligament and thoroughly decompress median nerve under direct sight, it is a safe and effective operative approach.

Objective: To observe the clinical efficacy of Safflower Injection (Al) in treating and preventing the vascular crisis after free flap transplantation., Methods: Sixty patients undergoing free flap transplantation were randomly assigned to the treatment group and control group according to the visiting sequence, thirty in each. Free flap transplantation was performed on all patients, and medication was given 0. 5 h before flap vascular anastomosis, 1-7 days after surgery. Twenty mL Al was intravenously dripped to patients in the treatment group after adding in 250 mL 5% glucose injection, while Dextran-40 was intravenously dripped to patients in the control group. The medication was conducted once per day. The hemorheology and four indices of blood coagulation [prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), fibrinogen (FIB)] were compared between the two groups before operation (TO), during operation (T1), 24 h after operation (T2), three days after operation (T3), and seven days after operation (T4). Meanwhile, flaps were observed and adverse reaction recorded. The clinical efficacy and safety were compared., Results: Better result was obtained in the treatment group when compared their clinical efficacy (86. 67% vs 60. 00%, P<0.05). The whole blood high and low viscosity, plasma viscosity, red blood cell (RBC) volume, RBC aggregation index all decreased, and RBC deformed index increased in the two groups at T4, showing statistical difference when compared with those at T3 (P<0.05, P<0.01). There was no statistical significance in the four indices of blood coagulation when compared with any time point in the same group (P>0.05). There was no statistical significance in hemorheology and the four indices of blood coagulation between the two groups at the same time point (P>0.05). The adverse reaction rate in the treatment group was lower than that in the control group, showing statistical difference (13.33% vs 30.00%, P<0.05)., Conclusions: AI could effectively prevent and treat the vascular crisis after free flap transplantation. It had less adverse reaction and good safety. It was better than Dextran-40. It was a safe and effective drug to prevent the vascular crisis.

Objective: To study the impacts of tetramethylpyrazine (TMP) intervention on hemorheology and blood coagulation before and after free skin flap transplantation, in order to provide new clues of applying Chinese drugs for activating blood circulation and removing stasis in microsurgery., Methods: Sixty patients undergoing free skin flap transplantation were randomly and equally assigned to two groups, the treatment group administered with tetramethylpyrazine, the control group with low molecular dextran, both were treated for 7 days. The survival rate of transplanted flap, hemorrheologic parameters and four blood coagulation associated indices (prothrombin time, thrombin time, activated prothrombin time and fibrinogen) were detected before and after treatment., Results: Comparisons of clinical efficacy and hemorrheologic indices showed no significant difference between the two groups (P > 0.05), but TMP showed less impacts on the four blood coagulation associated indices at the 24, 48 and 72 h after operation (P < 0.05)., Conclusion: TMP could prevent blood vessel crisis after free skin flap transplantation, so it is valuable in microsurgical clinical application.