Medical image classification technology, preferably which is based on the deep learning, is not only a key auxiliary diagnosis and treatment method in clinical medicine but also an important direction of scientific research. With the intensification of social aging, the incidence of viral elderly pneumonia has been on the rise and needs dedication from the research community. Doctors rely on personal theories and experience to use traditional methods to check the computed tomography (CT) images of the lungs of elderly patients one by one, which is likely to cause diagnosis errors. The accuracy of the traditional method certainly meets the clinical needs, but it has higher requirements on the theory and experience of medical staff, and the classification efficiency is low. Constructing an accurate and fast auxiliary system can effectively save medical resources. In response to the above problems, we have proposed a viral pneumonia diagnosis method for lung CT images, which is based on the convolutional neural networks. The main research work is carried out around the following aspects: First, in the lung CT image classification task, the traditional methods are inefficient and effective for doctors. The basic quality requirements of the model are high, or, in the model training, the effective training data are small, and so forth, causing problems such as model overfitting. A lung CT classification model based on the improved Inception-ResNet is proposed. In this model, first the overall architecture of the network model is designed, and then the Contrast-Limited Adaptive Histogram Equalization (CLAHE) algorithm is used to perform the same image enhancement processing on the dataset and data needed in this article, and then the pictures pass through three different network models. A binary classification study was carried out on viral pneumonia and normal lung images, and finally the accuracy, sensitivity, and specificity of the three models were compared. The experimental results show that the accuracy of the three models for the judgment of viral pneumonia is more than 95%. Among these, the model proposed in this article has better classification effect and fit, the highest accuracy rate, and less parameters and can be used for rapid screening of viral senile pneumonia. Objective. To complete the classification of lung CT images of the elderly with viral pneumonia based on the improved Inception-ResNet network architecture. Methods. (1) Find and study domestic and foreign medical literature, understand the diagnosis and treatment methods of viral pneumonia, and study lung CT imaging; compare the pattern classifications of deep learning in lung imaging at home and abroad, and further study the application of convolutional neural networks in the medical field application. (2) Study various models and technologies of convolutional neural networks, summarize them separately, and have in-depth understanding of convolutional neural networks, including architecture, methods, and related system frameworks, experimental environments, and so forth. Results. This paper proposes an optimized Inception-ResNet network architecture for image classification. The control experimental model uses two network models, GoogLeNet and ResNet, and selects the viral pneumonia dataset for training and testing. The experimental results are as follows: the sensitivity and specificity are superior to those in the other two models, which can be used for actual medical screening and diagnosis. Conclusion. The improved Inception-ResNet network model method in this paper performs better in terms of accuracy, sensitivity, and specificity. Every metric is higher than those in the ResNet model and the GoogLeNet model, improving the classification effect. In addition, it can be seen from the experimental results that the model used in this paper has a very good classification effect in the classification of new coronary pneumonia CT image data.

Background Gender differences in bone metabolism of people with chronic obstructive pulmonary disease (COPD) remain unclear. We aim to explore the characteristics of bone metabolism and its clinical significance for patients with COPD. Methods A total of 564 cases (282 COPD cases and 282 controls) were preselected. Clinical and analytical characteristics of these cases were assessed. After excluding patients with other conditions known to disturb calcium metabolism, 333 patients (152 COPD cases and 181 controls) were identified. The medical records, indexes of bone turnover markers, serum calcium and phosphorus of the 333 patients were collected and their correlation was analyzed. Results The 152 cases with COPD were 82.61 ± 7.745 years, 78.3% males, and the 181 age- and sex-matched control cases were 79.73 ± 11.742 years, 72.4% males. Levels of total procollagen type I amino-terminal propeptide (tPINP), osteocalcin (OC), serum calcium and phosphate were significantly lower (P < 0.001) while the level of parathormone (PTH) was significantly higher (P = 0.004) in COPD than in controls. The 25-hydroxycholecalciferol (25(OH)D3) was below the lower limit of normal value (LLN) in both groups, which was significantly lower in COPD males than in control males (P = 0.026). In COPD group, PTH level was significantly higher in females (P = 0.006), and serum P was lower in males (P = 0.006). The adjusted linear regression analysis showed that the levels of tPINP, OC and serum Ca were decreasing greatly in COPD group [β (95%CI) − 8.958 (− 15.255 to − 2.662), P = 0.005; − 4.584 (− 6.627 to − 2.542), P < 0.001; − 0.065 (− 0.100 to − 0.031), P < 0.001]. Besides, smoke exposure, gender (male) were also related to hypocalcemia [β (95%CI) − 0.025 (− 0.045 to − 0.005), P = 0.017; − 0.041 (− 0.083 to − 0.001), P = 0.047], and 25(OH)D3 was correlated with serum calcium, phosphorus, and PTH [β (95%CI) 15.392(7.032–23.753), P < 0.001; − 7.287 (− 13.450 to − 1.124), P = 0.021; − 0.103(− 0.145 to − 0.061), P < 0.001], and female was more likely to have secondary hyperparathyroidism [β (95%CI) 12.141 (4.047–20.235), P = 0.002]. Conclusion COPD patients have remarkably low bone turnover (indicated by OC) and impaired bone formation (low tPINP), and they are also more prone to low calcium. Smoking and male may play roles in the formation of hypocalcemia, and the secondary hyperparathyroidism is more significant in COPD women. There may be gender differences in bone metabolism abnormalities and their mechanisms of COPD. The conclusion above still need further research and demonstration.

Objective: To determine the rate and risk factors of allogeneic red blood cell transfusions (ABT) in elderly patients with femoral neck fracture (FNF) after hemiarthroplasty (HA). Methods: We conducted a study on elderly patients (≥65 years old) who were admitted to the geriatric trauma orthopedics ward of Beijing Jishuitan Hospital for HA treatment from March 2018 to February 2019 due to FNF. The perioperative data were collected retrospectively, and univariate and multivariate stepwise logistic regression analysis were performed to determine the postoperative ABT rate and its risk factors. Results: 445 patients were included in the study, of which 177 (39.8%) received ABT after surgery. Multivariate stepwise logistic regression analysis showed that preoperative low hemoglobin (Hb), high intraoperative blood loss (IBL), advanced age, and low body mass index (BMI) are independent risk factors of ABT after HA in elderly FNF patients. Conclusion: ABT after HA is a common phenomenon in elderly patients with FNF. Their postoperative ABT needs are related to preoperative low Hb, high IBL, advanced age, and low BMI. Therefore, ABT can be reduced from the above aspects.

Objective: To determine the rate and risk factors of allogeneic red blood cell transfusions (ABT) in elderly patients with femoral neck fracture (FNF) after hemiarthroplasty (HA). Methods: We conducted a study on elderly patients (≥65 years old) who were admitted to the geriatric trauma orthopedics ward of Beijing Jishuitan Hospital for HA treatment from March 2018 to February 2019 due to FNF. The perioperative data were collected retrospectively, and univariate and multivariate stepwise logistic regression analysis were performed to determine the postoperative ABT rate and its risk factors. Results: 343 patients were included in the study, of which 151 (44.0%) received ABT after surgery. Multivariate stepwise logistic regression analysis showed that preoperative low hemoglobin (Hb), high intraoperative blood loss (IBL), advanced age, and low body mass index (BMI) are independent risk factors of ABT after HA in elderly FNF patients. Conclusion: ABT after HA is a common phenomenon in elderly patients with FNF. Their postoperative ABT needs are related to preoperative low Hb, high IBL, advanced age, and low BMI. Therefore, ABT can be reduced from the above aspects.