The ECG signal is susceptible to interference from the external environment during the acquisition process, affecting the analysis and processing of the ECG signal. After the traditional soft-hard threshold function is processed, there is a defect that the signal quality is not high and the continuity at the threshold is poor. An improved threshold function wavelet denoising is proposed, which has better regulation and continuity, and effectively solves the shortcomings of traditional soft and hard threshold functions. The Matlab simulation is carried out through a large amount of data, and various processing methods are compared. The results show that the improved threshold function can improve the denoising effect and is superior to the traditional soft and hard threshold denoising.
Algorithms ; Computer Simulation ; Electrocardiography ; Signal Processing, Computer-Assisted ; Wavelet Analysis

Objective To investigate the efficacy and safety of capecitabine in the treatment of colorectal cancer. Methods Totally 160 elderly patients with stageⅣcolorectal cancer were enrolled in this study. After first-line combined chemotherapy,80 patients were treated with capecitabine monotherapy(maintenance group)and another 80 cases were not(control group). The survival rate was analyzed by Kaplan-Meier curve and the efficiency and incidence of adverse events were compared. Results (1) The Kaplan-Meier curve suggested that the difference between two groups was statistically significant(P<0.05).(2)The response rate of maintenance group was significantly higher than that of control group (P < 0.05). (3)The incidence of adverse events during capecitabine monotherapy was lower than that during combined chemotherapy(P < 0.05).(4)The incidence of adverse reactions during capecitabine monotherapy was similar to that of control group(P > 0.05). Conclusion Capecitabine monotherapy in patients with stage Ⅳ colorectal cancer after combined chemotherapy has a longer median PFS than those without maintenance but similar adverse reactions ,which was worthy of clinical promotion.

Objective To evaluate the efficacy of the anterior approach to quadratus lumborum block in each abdominal and back region.Methods Twelve healthy volunteers of both sexes,aged 18-45 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with body mass index of 18-30 kg/m2,were enrolled in the study.Quadratus lumborum block was performed via the anterior approach under the guidance of ultrasound with 0.375％ ropivacaine 20 ml.The block was assessed by cold stimulation (ice cake) in each abdominal and back region (the right side of the body was divided into 15 regions using the anatomical landmarks on the body surface).The positive condition in each region was recorded at 30 min after administration.Results The region in which the positive rate ≤ 5％ was 0.The regions in which the positive rate ＞5％-20％ were 1 and 13 regions.The regions in which the positive rate ＞20％-50％ were 2,3 and 4 regions.The regions in which the positive rate ＞50％-70％ were 6,7 and 10 regions.The regions in which the positive rate ＞70％-＜95％ were 5,14 and 15 regions.The regions in which the positive rate ≥95％ were 8,9,11 and 12 regions.Conclusion The anterior approach to quadratus lumborum block is effective in the middle-lower region of the anterior abdominal wall on the blocked side.

Objective: To explore the relevant factors of acquired swallowing disorders in adult patients after cardiac surgery. Methods: A Jiatian water swallowing screening test was conducted for adult patients after cardiac surgery in our hospital from 2015-03 to 2015-09. There were 32 patients with acquired swallowing disorder deifned as Case group and meanwhile 420 patients without swallowing disorder at the same word deifned as Control group. Non-conditional Logistic regression analysis was applied to study the relevant factors for acquired swallowing disorders. Results: The overall incidence of acquired swallowing disorders was 7.08%. Multi Logistic regression analysis presented that duration of endotracheal intubation (OR=1.060,P<0.001), pre-operative arrhythmia (OR=2.780,P=0.019), NYHA grade (OR=1.789, P=0.033) and Euroscore (OR=1.216,P=0.040) were the relevant factors for the occurrence of acquired swallowing disorders in adult patients after cardiac surgery. Conclusion: Medical professionals should pay special attention to patients with above mentioned risk features at post-operative drinking to reduce the complications of acquired swallowing disorders.

BRCA2 Protein ; Humans ; Leukemia, Myeloid, Acute

Objective To investigate the risk factors of anastomotic leakage after laparoscopic anterior resection of rectal cancer.Methods Literatures on the risk factors of laparoscopic anterior resection of rectal cancer were retrieved from August 2003 to August 2013,and then a Meta analysis was carried out based on the data.Data were expressed by odds ratio (OR) and 95％ confidence interval (95％ CI).The heterogeneity of the data was analyzed using the chi-square test or I2 test.Data were pooled using the fixed or random model.Results Eight literatures including 3 289 patients with rectal cancer were retrieved.The incidence of anastomotic leakage was 6.050％ (199/3 289).The incidence of anastomotic leakage after laparoscopic anterior resection of rectal cancer in males was significantly higher than females (OR =2.17,95％ CI:1.54-3.06,P ＜0.05).Neo-adjuvant chemotherapy might increase the risk of postoperative anastomotic leakage (OR =1.53,95％ CI:1.00-2.32,P ＜ 0.05).Interoperative blood transfusion might increase the risk of postoperative anastomotic leakage (OR =4.80,95％CI:2.98-7.73,P ＜0.05).Patients with low rectal cancer had greater risk of anastomotic leakage than those with high rectal cancer (OR =1.60,95％ CI:1.14-2.23,P ＜ 0.05).Number of linear stapler firings greater than 3 increased the risk of postoperative anastomotic leakage (OR =0.46,95％ CI:0.27-0.78,P ＜ 0.05).The ASA classification of anethesia risk,depth of tumor infiltration,lymph node metastasis,preventive colostomy were not correlated with the incidence of postoperative anastomotic leakage (OR =0.66,0.91,1.25,0.78,95％CI:0.36-1.20,0.55-1.51,0.75-2.09,0.50-1.23,P＞0.05).Conclusion Male,neo-adjuvant chemotherapy,interoperative blood transfusion,low rectal cancer,number of linear stapler firings greater than 3 are the main risk factors for anastomotic leakage after laparoscopic anterior resection of rectal cancer.

Objective To understand the dynamic rules of schistosomiasis endemic situation before and after reaching the criteria of schistosomiasis transmission controlled or transmission interrupted,so as to provide the evidence for improving schis-tosomiasis control. Methods Wuling District,Xihu District and Linli County were selected and investigated retrospectively to collect the schistosomiasis epidemiological information 10 years before they reached the criteria of transmission controlled and the subsequent years until 2008. A database of retrospective investigation was established for analyzing the trends and rules of changes of the Oncomelania hupensis snail status and infection status of cattle and human. Results In Wuling District,the en-demic situation was declining,and no schistosome infection persons,animals and snails were found after 1974. There was no re-bound until 2008. In Xihu District,the endemic situation reached the criteria of transmission controlled in 1997,and the endem-ic situation was stable. The human infection rate was positively correlated with the area of infection snails(r=0.584,P<0.05). In Linli County,there were no snails,no infected persons and cattle twice,but 2 endemic rebounds,and there were positive corre-lations between the densities of living snails and the infection rates of human and animal during the endemic rebound period. Conclusion The snail status is an important indicator of schistosomiasis endemic rebound. Therefore,the snail control is one of the most important schistosomiasis control measures.

Objective To evaluate the diagnostic value of immunohistochemistry (IHC) for the identification and localization of Treponema pallidum (TP).Methods Rabbit anti-human TP polyclonal antibody labeled IHC was used to detect 20 paraffin-embedded biopsy samples from lesions of 14 patients with syphilis or suspected syphilis in Sir Run Run Shaw Hospital of Zhejiang University from January 2004 to May 2012.Results TP was detected in 80％ of all the 20 samples by IHC assay,including 83.3％ (5/6) in patients with primary syphilis,100.0％ (10/10) in patients with secondary syphilis,and 25.0％ (1/4) in patients with tertiary syphilis,with a positive diagnostic accuracy of 100.0％.TP was mainly present in lower part of epidermis or perivascular,characterized by an endotheliotropic and epitheliotropic patterns or in the tissue of granulomatous inflammation.Besides,the density of TP was associated with types of lesions.There were more TP in the lesions of syphilis chancre,syphilis proctitis and condyloma latum,and fewer TP in the lesions of squamous erythema,greyish-black plaque,ulcer of chest wall from tertiary syphilis,and least in syphilitic lymphadenitis.There were no correlations between the quantity of TP and the rapid plasma regain (RPR) test titer (P＞0.05).Conclusions IHC for TP is of both high sensitivity and specificity for the diagnosis of syphilis,suggesting that TP-IHC is helpful for the diagnosis of syphilis,especially for the diagnosis of early suspected syphilis with negative serological results,systemic damage of syphilis,or syphilis in untypical locations and unusual lesions.It can serve as an alternative method for the diagnosis of syphilis.

It is extremely necessary and important for colleges or universities to transform the education concepts that barricade students' initiative and creativity, especially the one that takes fi-nal examinations as sole standard to evaluate teaching and learning effects. In order to display and cultivate students' study ability more comprehensively, we manage to establish a set of formative eval-uation system for regional anatomy course , which involves tests and examinations and evaluations throughout the whole teaching and learning process. It solves the long-lasting problem that examina-tions are final purposes of teaching and learning, and thus, teaching values not only results but also learning process, which directs students' attention to conventional studies and helps develop good study habits, greatly reducing the randomness of final academic performances. The diverse assessment methods, along with accumulated assessment results, can improve students' learning effects through-out the whole semester. The fundamental purpose of this system is to inspire students' passion for study and creativity and monitor the teaching process.

Objective To investigate the expression of Toll-like receptors(TLRs) in condyloma acuminatum(CA) lesions and their possible roles in the pathogenesis of CA. Methods The expressions of TLR1-10 mRNA level in the lesions of CA and in the cervix scrape cells from the patients with human papillomavirus(HPV) negative chronic cervicitis were detected by real-time quantitative fluorescent PCR. HPV typing was detected by HPV GenoArray test kit. Results Low-risk HPV type 6 and type 11 were the most prevalent types in the forty CA cases with positive rate of 77.5% and 55% respectively. 55% CA patients were found infected with more than two types of HPV. 35% CA patients were concurrently infected with high-risk HPV. The expressions of TLR3, 7, 8 mRNA were higher than other TLRs and the expression of TLR9 mRNA was lower than others in the lesions of CA. No significant differences of the TLR1-10 mRNA levels were found between HPV6 and HPV11 positive CA lesions, so did it between low-risk and high-risk HPV concurrent infected CA lesions. The expressions of TLR1-3, TLR5-8, TLR10 mRNA, especially TLR2, TLR7 and TLR8 in the lesions of CA were significantly higher than that in cervix scrape cells of HPV negative chronic cervicitis. There were no significant differences of TLR4 and TLR9 mRNA levels between the two groups. Conclusion There were higher expressions of some TLRs (3, 7, 8) and lower expression of TLR9 in the lesions of CA. Compared with HPV negative chronic cervicitis, the expressions of TLR1-3, TLR5-8, TLR10 mRNA in the lesions of CA were up-regulated. The expression profile of TLRs in different type of HPV infected CA lesions had no significant differences. Our results suggested that the expression profile of TLRs in CA may be associated with the HPV infection. Whether it was associated with the immune escape mechanism and persistent infection of HPV need further demonstration.