Objective To analyze the risk factors for postoperative pulmonary complications (PPCs) in elderly patients with esophageal cancer aged 70 years and over. Methods 185 elderly patients aged 70 years and over after esophagectomy were retrospectively analyzed. Univariate and multivariate logistic regression analysis were used to examine the risk factors for PPCs and related mortality. Results In 185 elderly patients from 70 to 86 years of age with a median age of 72 years, PPCs occurred in 36 patients(19.5%) including pneumonia in 23(63.8%) cases, atelectasis in 3 (8.3%) cases, adult respiratory distress syndrome (ARDS) in 2(5.5%) cases, pulmonary embolism in 1(2.7%) case and respiratory failure in 7(19.4%) cases. The related mortality was 5.9% (11cases) and the causes of death were pneumonia (4 cases), ARDS (1 case), pulmonary embolism (1case) and respiratory failure (5 cases). There were 43 (23.2%) cases with the forced expiratory volume in one second (FEV1%)< 65% before operation. The bleeding volume during operation ranged from 200ml～2000 ml, with a mean volume of about 350ml, and was above 800ml in 8(4.3%) cases. Injury of recurrent laryngeal nerve during operation occurred in 13(7.0%) cases. Univariate and multivariate logistic regression analysis indicated that smoking, obesity, poor preoperative pulmonary function (FEV1 % < 65%), bleeding volume over 800ml during operation and injury of recurrent laryngeal nerve were the independent risk factors for PPCs in elderly patients with esophageal cancer aged 70 years and over. Poor preoperative pulmonary function (FEV1% < 65%)(OR=29.49, P=0.023), bleeding volume over 800ml during operation(OR=32.93, P=0.011) and injury of recurrent laryngeal nerve(OR= 10.14, P= 0.034) were also the independent risk factors for related mortality of PPCs. Conclusions The high risks of PPCs and related mortality in elderly patients with esophageal cancer are not only due to the physiological and pathological characteristics of elderly people, but also due to the operative manipulation.

Objective To contrast the efficacy of mechanical stapler and hand suture for cervical esophagogastrostomy in the treatment of esophayeal cancer.Methods From January 2001 to August 2007,217 cases of cervical esophagogastrostomy were done in esophageal carcinoma.Among them.136 cases were treated by mechanical stapler and 81 cases by hand.Results The incidence of anastomotic fistula was 2.2%(3/136)in mechanical stapler group and 11.1%(9/81)in the group by hand.There was significant difference between the two groups(P＜0.95).The incidence of cervical incision infection was 2.9%(4/136)in mechanical stapler group and 14.8%(12/81)in the group by hand.There was significant difference between these two groups(P＜0.05).There was no significant difference between these two groups about pulmonary infection,arrhythmia,chylothorax and laryngeal nerve injury.Conclusion The incidence of anastomotic fistula and cervical incision infection was reduced by mechanical stapler which was displayed to advantage in esophagogastrostomy.

ObjectiveTo evaluate the technical feasibility of animal model of avascular necrosis of femoral head (ANFH)with transcatheter arterial embolization (TAE).MethodsTwenty experimental pigs were randomly divided into experimental group and control group (each n= 10).Experimental group:A 5F Cobra catheter was inserted into left femoral artery,and the feeding arteries of femoral head were superselectively inserted.The feeding arteries were embolismed through transcatheter arterial injecting the segments of silk measuring about 500μm.Control group:The arterial embolization was not performed,and the other treatment was identical to experimental group.The articulation of hip in all pigs underwent plain X-ray examination,CT and MR scanning 2 weeks and 4 weeks after treatment,respectively.Histological examination was made in 4 weeks to evaluate volume of bone trabecula (TBV) and percentage of bone lacuna (PBL) at unit area under microscope.The data were compared between the two groups.Results In experimental group,CT and MRI showed swolling in hip soft tissue and high T1 in hip joint cavity,while no obvious abnormalities were found in plain X-ray film 2 weeks after feeding arteries were embolized.Four weeks after feeding arteries embolization,plain X-ray film,CT and MR showed typical necrosis of femoral head in the experimental group,while no obvious abnormalities were found in control group.The histology examination revealed there were obvious karyopyknosis and anachromasis in the bone cells.The quantity of bone cells decreased obviously or disappeared.PBL increased and TBV decreased significantly compared with those of control group (P＜0.05).ConclusionThe animal model of ANFH in pigs can be induced by TAE.It can preferably mimic the pathological situation of ANFH.

Objective To retrospectively analyze the effect of interventional embolization for hepatocelluar carcinoma (HCC) associated with arteriovenous shunting (AVS), and to discuss the factors influencing the therapeutic results. Methods The clinical data of 62 cases with HCC associated with AVS , who were treated with interventional chemoembolization , were retrospectively analyzed. Based on the type and extent of AVS identified by angiographic manifestations, appropriate obstruction of the shunt and Lipiodol chemoembolization of HCC were conducted. The curative effect of the shunt embolization was assessed by DSA at one or two months after the treatment. The relevant factors influencing the prognosis of embolization were analyzed by using univariate and multivariate Cox regression analysis methods. Results Of the 62 patients, arterioportal shunting (APS) was detected in 44, hepatic arterio-venous shunting (HAVS) in 11, APS together with HAVS in 4, and hepatic artery-pulmonary artery shunting (HAPAS) in 3. Re-examination with DSA was carried out in 53 patients at 1 - 2 months after the treatment , which showed that the shunting disappeared in 18 cases, obvious reduction of the shunt flow was seen in 19 cases, the lesion remained stable in 9 cases and the disease became worse in 7 cases. Univariate analysis indicated that the kind of embolic material and the presence of tumor thrombus could affect the obstructive result of the shunt , while multivariate Cox regression analysis showed that portal tumoral thrombus was an independent risk factor. The embolization effect of polyvinyl alcohol (PVA) particles and Lipiodol-ethanol mixture, used as the embolic agents, was better than that of gelatin sponge particles. Conclusion To ensure a successful interventional chemoembolization for HCC combined with AVS the procedure should be individualized according to the type and extent of the arteriovenous shunting. The type of embolic materials used for embolization can affect the results to a certain degree.

Objective To observe changes of hippocampal levels of pro-inflammatory cytokines in rats with neuropathic pain-induced depression, and to explore the relationship between hippocampal levels of pro-inflammatory cytokines and severity of depression.Methods Twenty-eight adult male rats were randomly divided into two groups: group sham (n=14) and spared nerve injury (group SNI) (n=14).Mechanical withdrawal thresholds (MWT) were measured 1 day before and 7, 14 and 21 days after operation.Sucrose preference test and forced swim test were tested 1-3 days before and 21-23 days after operation.After test, hippocampus was collected.The hippocampal levels of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α (TNF-α) were measured by ELISA.Correlational relationships between hippocampal levels of pro-inflammatory cytokines and sucrose preference were evaluated.Results Compared with group sham, MWT was decreased 7, 14, 21 days after operation (P<0.001).Group SNI displayed decreased sucrose preference 21 days after operation (P<0.01) and increased immobility time in FST 23 days after operation (P<0.05).The levels of IL-6 and TNF-α were increased in hippocampus (P<0.05 or P<0.01).No significant difference was observed in IL-1β.The hippocampal levels of IL-1β (r2=0.60,P<0.01), IL-6 (r2=0.55,P<0.01) and TNF-α(r2=0.60,P<0.01) were negatively correlated with sucrose preference.Conclusion The hippocampal levels of pro-inflammatory cytokines IL-6 and TNF-α are increased in rats with depression induced by neuropathic pain, and the levels of hippocampal pro-inflammatory cytokines are negatively correlated with the severity of depression.

OBJECTIVEExtraction of cepstral coefficients combined with Gaussian Mixture Model (GMM) is used to propose a biometric method based on heart sound signal.

METHODSFirstly, the original heart sounds signal was preprocessed by wavelet denoising. Then, Linear Prediction Cepstral Coefficients (LPCC) and Mel Frequency Cepstral Coefficients (MFCC) are compared to extract representative features and develops hidden Markov model (HMM) for signal classification. At last, the experiment collects 100 heart sounds from 50 people to test the proposed algorithm.

RESULTSThe comparative experiments prove that LPCC is more suitable than MFCC for heart sound biometric, and by wavelet denoising in each piece of heart sound signal, the system achieves higher recognition rate than traditional GMM.

CONCLUSIONThose results show that this method can effectively improve the recognition performance of the system and achieve a satisfactory effect.

Algorithms ; Biometry ; Heart ; physiology ; Humans ; Markov Chains ; Models, Biological ; Phonocardiography ; methods ; Wavelet Analysis

As an important human body sound signal, heart sound is of great value in the researches on diagnostics of heart diseases. This study sought to explore the methods of transmitting heart sound through the telephone correspondence system for simultaneous telemetering cardiac contractility and heart rate. Heart sounds were transmitted from a phone to another phone with 4 modes, the wirelessly transmitted distance between the two phones being 5 m, 10 km, and 1000 km, respectively. The results of experiments show that telemetering cardiac contractility and heart rate can be realized by the telephone correspondence system. Such methods have the advantages of being noninvasive, inexpensive, rapid and convenient; moreover, they can be used repeatedly and be available for in-home use.
Heart Sounds ; physiology ; Humans ; Phonocardiography ; instrumentation ; methods ; Signal Processing, Computer-Assisted ; instrumentation ; Telemedicine ; methods ; Telemetry ; methods

Objective To explore the feasibility and validity of Satir model on compulsory drug rehabilitation for female drug users in closed settings. Methods Satir Model-based group psychotherapy was adopted in the treatment on 33 female drug users. Results The findings are that the pre-treatment SCL-90 scores were all higher than norm,indicating very high significant differences(P＜0.01) ; while the post-treatment SCL-90 scores,except the score of somatization, were approximate to norm, showing no statistical differences(P ＞0. 05). Conclusion Satir model played a positive role in the process of female drug users mental health recovery.

Long non-coding RNA regulates gene expression at multiple levels (epigenetics,transcriptional level,post-transcriptional level) and plays an important role in the development and progression of individual development and tumors.With the deep research,it is found that LncRNA CRNDE is an important cancer-related long non-coding RNA,and it is necessary to understand the specific role of LncRNA CRNDE in regulating tumor cell life activities.In recent years,the role of LncRNA CRNDE in tumorigenesis and development has been increasing.It has been found that LncRNA CRNDE is up-regulated in various tumors and is closely related to tumor proliferation,invasion,metastasis and patients' prognosis,becoming a new hot spot in cancer research.The author combines the latest literatures at home and abroad to review the role and mechanism of LncRNA CRNDE in the development of digestive system tumors,hoping to prevent and treat tumors in the future.

Objective: To analyze the incidence rate of occupational noise-induced hearing loss in noise-exposed workers in an iron and steel plant from 2006 to 2015. Methods: Using a cohort study method, workers exposed to occupational noise from Jan 1, 2006 to Dec 12, 2015 were followed up and the pure tone hearing test was conducted. In total, 6 297 subjects completed two or more physical checks and the pure tone hearing test and were included in the analysis. The noise exposure level at the workplace and the equivalent continuous A-weighted sound pressure level for workers was monitored and the cumulative noise exposure dose was evaluated. The subjects were divided into low, middle and high exposure groups according to the noise exposure level, and the equivalent continuous A-weighted sound pressure level for 8 hours for each group was 80.6-85.0, 85.1-90.0 and 90.1-103.4 dB (A), respectively. While the RR and 95% CI were derived from unconditional logistic regression models. In logistic regression analysis, confounding factors such as age, gender, smoking habit, drinking habit, high temperature exposure and chemical hazards exposure level were controlled. Results: During the follow-up period, 392 cases of occupational noise-induced hearing loss were diagnosed among the 6 297 subjects, with an incidence rate of 6.23%; 318 cases of high-frequency hearing loss were diagnosed, with an incidence rate of 5.05%; and 74 cases of occupational noise-induced deafness were diagnosed, with an incidence rate of 1.18% . The incidence rates of hearing loss among the high, medium and low exposure groups were 9.22% (158/1 737), 6.49% (204/3 142) and 2.08% (30/1 442), respectively; the rates of high-frequency hearing loss were 7.41% (127/1 737), 5.25% (165/3 142) and 1.80% (26/1 442), respectively; and the rates of occupational noise-induced deafness were 1.81% (31/1 737), 1.24% (39/3 142) and 0.28% (4/1 442), respectively. For the groups corresponding to cumulative noise exposure doses of ≤84.99, 85.00- 87.99, 88.00- 90.99, 91.00- 93.99, 94.00- 96.99, 97.00- 100.99, 101.00- 102.99 and ≥103.00 dB (A) · year, the incidence rates of hearing loss were 0 (0/185), 1.22% (2/164), 2.52% (17/674), 3.83% (35/913), 5.80% (106/1 827), 6.02% (67/1 113), 9.20% (95/1 003) and 18.04% (70/388), respectively. Compared with the low exposure group, the RR of hearing loss, high-frequency hearing loss and occupational noise-induced deafness for the high exposure group were 4.78 (95% CI: 3.22- 7.11), 4.36 (95% CI: 2.84- 6.69) and 6.63 (95% CI: 2.33- 18.82), respectively; and for the medium exposure group were 3.27 (95% CI: 2.22-4.82), 3.02 (95% CI: 1.99-4.59) and 4.52 (95% CI: 1.61-12.67), respectively. Conclusion The incidence rate of hearing loss for workers exposed to noise in an iron and steel plant was related to the cumulative noise exposure dose, gender, age, educational level, smoking habits, drinking habits and exposure to high temperature.