Objective To observe the effects of instant hyperbaric oxygen (HBO) therapy on brain edema and aquaporin-4 (AQP4) expression after cerebral ischemia in rats. Methods 18 healthy adult male Sprague-Dawley rats were randomly divided into sham group (n=6),control group (n=6) and HBO group (n=6). Middle cerebral artery occlusion model was established with modified Longa method in the control group and HBO group. HBO was administered after cerebral ischemia immediately in HBO group for 60 min. They were observed with the neurological function score, brain tissue water content and AQP4 experssion 6 h after operation. Results Compared with the control group, the neurological score in HBO group improved significantly (P<0.05), while the brain tissue water content and brain AQP4 expression decreased (P<0.05). Conclusion HBO may improve the neurological function and brain edema after cerebral ischemia, which may relate with inhibiting the expression of AQP4.

Pulse signal contains a wealth of biological and pathological information. However, it is susceptible to the influence of various factors which results in poor signal quality, and causes the device to generate false alarms. First the pulse signals are processing into discrete symbols, and then compare the test signal with the pulse template by using Dynamic Time Warping (DTW) to get the threshold for which can be used to find the interference segment of the test signal. By analyzing the DTW distance of the pulse signal, we can get the interference degree of the signal, then the quality level of the plus signal can be defined by the relationship between the interference degree and quality of the signal. The 1 055 group pulse signals provided by MIMIC II physiological database are used to train and test the signal quality assessment algorithms, and compared with other existing algorithms. The results show that the algorithms can accurately detect interference segments in pulse signal and reflect the quality of it.
Algorithms ; Heart Rate ; Humans ; Pulse ; Signal Processing, Computer-Assisted

Based oncompetence-basedphilosophy of education, core competences of Master of Nursing Specialist (MNS) postgraduates serve as a benchmark for the education quality. Furthermore, the evaluation of core competences is a key link. Our research mainly summarizes the evaluation methods of core competences of MNS at home and abroad, thus providing suggestions to the improvement of domestic core competences evaluation methods of MNS.

Given that there has been a series of problems in the teaching of diagnostics,appropriated approaches should be made and feasible actions carried out.First of all,the notion of clinical teaching should be transformed and the level of qualified teaching staffs should be further elevated.In addition,the humanity connotation should be integrated into the course of diagnostics,and quality supervision and control should be executed to ameliorate the teaching of diagnostics.

Objective To investigate the effect of endoscopic management of upper tract urothelial carcinoma (UTUC),and evaluate the indication and clinical value of postoperative prophylactic pelviureteric instillation chemotherapy.Methods Patients who met the inclusion criteria included elderly patients,patients who could not tolerate radical surgery,patients with renal insufficiency or needed dialysis after removal of the kidney,patients with bilateral UTUC,patients with tumor≥3 cm in diameter but could be completely resectted under ureteroscopy who required to preserve renal function.Surgical procedure was successful.The ureteral stents were placed,and prophylactic ureteral infusion chemotherapy via the retrograde transvesical ureteric catheterisation was conducted 1-2 times one week at 2 days after surgery.40 milligram of pirarubicin hydrochloride or epirubicin hydrochloride was dissolved in 40 milliliter sterile water for the prophylactic infusion chemotherapy.These instillations were completed within 40 minutes.Results Totally,9 patients (3 males and 6 females) aged 60-86 years,mean age of (69.7±6.4) years,were enrolled in this study.The carcinoma of the renal pelvis was found in 2 cases and ureteral tumors in 7 cases.In pathological results,ureteral polyps was found in 1 case,papillary ureteral neoplasm with low malignant potential in 2 cases,urinary tract epithelial carcinoma in 4 cases (1 case with poorlydifferentiation,1 case with well-differentiation,2 cases with urinary tract epithelial cancer),and 2 cases were lack of pathological reports because of too few pathologic specimens.4 patients received adjuvant chemotherapy by instillation successfully,and lumbago,fever or other complications were not found.Patients were followed up for a mean period of 15 moths (4-31 months).Only 1 patient had recurrence of bilateral ureteral tumor 15 months after surgery,and no tumor recurrence was found in other patients.Conclusions Endoscopic management is a safe and effective in treating UTUC,which can preserve renal function by avoiding nephrorectomy in some patients.The instillation chemotherapy after endoscopic management is safe,which has a satisfactory effect,but further validation in a large clinical sample is needed.Patients with tumor resection under ureteroscopy who cannot obtain the pathology results need to be closely followed up.

Objective To investigate the pathological change in articular cartilages after firearm injury.Methods Four rabbits from 28 New Zealand healthy rabbits were chosen as control group and subjected to joint capsule incision only. Another 24 rabbits were equally divided into 6 experimental groups( groups B to G) and subjected to medial femoral condyle cartilage surface damage by the nail gun.After the operation, their specimens were collected after 6 h,3 d,7 d,14 d,28 d and 56 d, respectively.Tissue sections were observed and stained by HE staining and toluidine blue staining.The histolopathological changes in articular cartilage after firearm injury were detected.Results The color of articular cartilages in experimental groups became lighter, the cell number increased but then decreased, the articular cartilage layer disappeared, the cell shape became uneven, cells began to cluster and the Mankin score increased, and the statistical differences between experimental groups and control group were significant.Conclusion The histological pathological changes in articular cartilages after fiream injury seem to follow some pattern.The degeneration seems obvious after 7 days and then becomes heavier.

ObjectiveTo study the effect of comprehensive rehabilitation on the patients with craniocerebral trauma. Methods85 cases with craniocerebral trauma were subjected to the rehabilitation training supplemented with hyperbaric oxygen and acupuncture and ultrasound therapy in addition to routine neurosurgical operation. Before and after treatment,Glasgow coma scale (GCS), Fugl-Meyer assessment (FMA) and Barthel index were assessed and compared. ResultsAfter comprehensive rehabilitation therapy, the degree of coma, limbs motion and activities of daily living were improved significantly (P<0.01).ConclusionComprehensive rehabilitation is effective on the patients with craniocerbral trauma.

Objective:To investigate the clinical security and feasibility of neoadjuvant chemotherapy with imatinib following lap-aroscopy-guided intersphincteric resection for patients with gastrointestinal stromal tumor of the low rectum (GSTLR). Methods:Clini-cal data of nine patients with GSTLR who were admitted to the Shengjing Hospital between January 2007 and January 2011 were re-viewed. These patients were treated with neoadjuvant imatinib chemotherapy after laparoscopic intersphincteric resection. Results:Pri-or to neoadjuvant chemotherapy, the tumor diameter ranged between from 5 cm to 9 cm (median=7.0 cm). After imatinib chemothera-py, the tumor diameter decreased to 2-4.5 cm (median=3.5 cm, P<0.001). Laparoscopic surgery through intersphincteric resection was performed after imatinib treatment for 3-24 months (median=7 months). All patients received a protective stoma, which was closed 3 months after the surgery. The Wexner scale scores ranged from 1 and 4 (median=2) prior to neoadjuvant imatinib chemotherapy and changed to 1-5 (median=2) after the chemotherapy (P=0.397). After stomal closure operation, the scores significantly increased to 4-9 (median=7, P<0.001) but were not statistically significantly different from those before the therapy. One year after laparoscopic surgery, the Wexner scale scores ranged from 1 to 5 (median=2, P=0.842). Six patients were treated with imatinib for 24 and 30 months after lap-aroscopic surgery. Recurrence in pelvis occurred in only one patient, who ceased imatinib administration at the 30th month after the sur-gery. Conclusions: Laparoscopic surgery through intersphincteric resection was secure and feasible and thus could be used for treat-ment of GSTLR.

ObjectiveTo study the different clinical effects of using 5 kinds of hemostatic surgeries to manage the intractable postpartum hemorrhage and analyse the risk factors of failed hemostasis.Methods From Jan.2007 to Jul.2011,96 patients with intractable postpartum hemorrhage were studied retrospectively and grouped by the first step surgical treatment.The hemostatic surgeries included uterine tamponade (tamponadegroup ), pelvicbloodvessels ligation(ligationgroup), pelvical arterial embolization (embolization group), uterine compression sutures (sutures group)and uterine compression sutures combining tamponade (combined group).The intraoperative and postoperation datum were compared among groups,so dose the treatment outcomes.Multivariate analysis were used for failed hemostasis.Results( 1 ) The blood loss of 96 patients ranged from 1200 to 9100 ml,and 71 patients had a succeed hemoatasis after employing these surgeries and 25 failed.(2) The blood loss before hemostasis surgeries in tamponade group and embolization group was statisically greater than in sutures group ( P ＜ 0.05 ).Blood loss during the hemostasis surgeries in ligation group was statistically greater than in embolization and sutures groups ( P ＜0.05).The operating time of embolization group was statistically shorter than ligation group,sutures group and the combined group (P ＜ 0.05 ).(3) Fine of 96 patients had uterine atony and 43 had a successful hemostasis with the success rate about 78％.Forty-six had placenta previa and 39 success with success rate 85％.Thirty-three had placenta accrete and 13 of which succeed in hemostasis with success rate about 39％.In patients with uterine atony and placenta previa,the difference of hemostasis rate in groups had no statistically significant ( P ＞ 0.05 ).In patients with placenta accrete,the hemostasis rate in embolization group was higher than in others groups (P ＜ 0.01 ). (4) The multivariate analysis found that scar uterus,placenta accrete and coagulation defects were the risk factors of failed hemotasis.The OR value respectively was 2.9 (95 ％ CI:1.1 - 7.6 ),17.9 ( 95 ％ CI:5.6 - 56.3 ) and 16.2 ( 95 ％ CI:3.2 - 83.5 ).Embolization had some extent of protective effection ( OR =0.9,95 ％ CI:0.8 - 0.9 ).Conclusions ( 1 ) Five kinds of hemostatic surgeries were all effective.Though the success rate among groups did show statistical difference,pelvical arterial embolization has the comparative advantage of shorter operating time,less operating blood loss and higher success rate in placenta accrete.(2) Since scar uterus,placenta accrete and coagulation defects were the risk factors of failed hemostasis,sufficient preparation should be made for patients with these risk factors and the hemostatic surgeries should be choosed individually.

Objective To explore the association between glycated hemoglobin (HbA1c) level at admission and coronary plaque characteristics under intravenous ultrasound (IVUS) study in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). Methods 118 patients with NSTE-ACS were divided into the low(HbA1c ≤ 5.6％), medium(HbA1c 5.7％-6.4％)and high(HbA1c ≥ 6.5％)level groups based on admission HbA1c. IVUS was performed in all target lesions. Results As compared with the other two groups, patients with high level HbA1c had higher mean body weight index, higher co-morbidities of diabetes mellitus, dyslipidemia and non-ST-elevation acute myocardial infarction.The high HbA1c level group had more diffuse coronary atherosclerosis ,increased plaque burden and higher rates of positive remodeling, soft plaque and plaque rupture. Conculsions The HbAlc level of admission is associated with plaque vulnerability in NSTE-ACS patients.