BACKGROUND: Researches on the diagnosis and detection methods of diabetic autonomic neuropathy(DAN) is very weak at present.OBJECTIVE: To get the data about the degree of autonomic neuropathy by using the nonlinear heart rate variability(HRV) so as to provide clinical evidence for the early diagnosis of DAN.DESIGN: A single sample study.SETTINGS: Computer department in a university; Staff room of medical physics of department of biomedical engineering in a university.PARTICIPANTS: The experiment was completed in the Staff Room of Medical Physics, Department of Biomedical Engineering in the First Military Medical University of Chinese PLA from March to May 2002. Thirty-four diabetic patients, including 22 with DAN complications, were selected from the inpatients of Department of Endocrinology in the Affiliated Nanfang Hospital of the First Military Medical University of PLA, and other 40 normal subjects, who were from the faculty in the First Military Medical University of Chinese PLA and students in the Department of Physical Education, Chinese PLA Institute of Physical Education, were taken as the controls. The R wave to R wave intervals(RRI) time series is sampled and corrected to 512 points for analysis.INTERVENTIONS: Based on the virtual instrumental workbench-LabVIEW, 74 standard adjacent RRI signals were selected from 34 diabetic patients and 40 normal cases, and then analyzed with the method of nonlinear predictability.MAIN OUTCOME MEASURES: Collective and analytical results of the 74 standard adjacent RRI signals.RESULTS: There was no significant difference between the diabetic patients without DAN and the controls by the analysis with normalized mean square error(NMSE) NMSE ( P = 0. 075 ), but the significant difference between the DAN patients and the controls( P = 0. 001) . While significant analysis between the diabetic patients without DAN complications and the controls was significant by the analysis of mean absolute error(MAE) (P = 0. 007 and P = 0. 000), there was also significant difference between the diabetic patients with and without DAN ( P = 0. 001 ).CONCLUSION: Different impaired degree of autonomic nerve system in diabetic patients can result in nonlinear reduction in HRV analysis, but nonlinear predictability analysis can prove the nonlinear model of HRV,. and can also provide important state information of sympathetic and parasympathetic systems so that it can provide reliable evidence for the earlier diagnosis and the prognosis evaluation of DAN.

Objective To evaluate the influence of different combination of anesthetics on blood pressure (BP) and heart rate (HR) of aged patients with serious illness during operation. Methods Forty patients, aged 80～92, with physical status Ⅱ～Ⅲ as categorized according to American Society of Anesthesiologists (ASA) undergoing selective surgery, were randomly divided equally into two groups: in group A ancsthesia was induced with midazolam, fentanyl and maintained with isoflurane, and in group B anesthesia was induced and maintained with etomidate, sevoflurane and nitrous oxide. Mean arterial pressure (MAP), HR and bispectral index (BIS) were observed at the points of preinduction (T0), induction (T1), intubation (T2), incision (T3), 30 minutes after incision (T4) and extubation (T5). Results After induction, BIS decreased from 95?2 to 52?4, while MAP and HR decreased from 110?11mmHg and 73?8/min to 75?9mmHg and 59?4/min respectively, in group A. While in group B BIS decreased from 94?3 to 58?3, MAP and HR decreased from 103?8 mmHg and 76?6/min to 87?7 mmHg and 67?5/min, respectively. At the point of tracheal intubation, MAP and HR increased significantly in group A compared with group B (P

Objective To explore the effects of the application of targeted surveillance in the Deparment of Neurosurgery. Methods Someone was specially assignedd to work out both process and outcome goals by means of perspective investigation, clinical groups were formed and information feedback, evaluation of effects and correction of deviation were regularly conducted. Results The process goals were obtained: from July 1996 to June 1997, the rate of hospital infection in the Department of Neurosurgery droppoed from 26.07% to 21.32% (x2 = 4.3465,P ＜0.05). The outcome goals were also obtained: from July 1997 to June 1998, the rate of infection dropped from 21. 32% to 13.40% (x2 = 16.1193,P＜0.01). Conclusion Targeted surveillance is a really effective form of surveillance and information feedback and evaluation of effects are indispensable. Application of targeted surveillance in the Department of Neurosurgery has won initial success.

objectives To explore the clinical significance of the triple screening method and fetal sonographic markers in Down syndrome screening. Methods The retrospective study included maternal blood serum triple-marker screening per-formed in normal singleton pregnancies at 14+1 to 19+6 weeks and ultrasonography screening for fetal chromosomal trisomy at 18+1 to 23+6 weeks from 2010 to 2013. Results In 24 368 pregancies, Karyotype analysis reveal 35 Down syndromes, the incidence is 0.14%(35/24 368). 25/35 were pregnancies with an expected date of delivery lower than 35 years old and 10/35 were pregnan-cies with an expected date of delivery higher than 35 years old. In 1 215 pregnancies, second-trimester serum screening showed high risk (cutoff>1:380), 14 were confirmed as Down syndromes ( sensitivity 40%;specificity 95.06%). In 1 142 pregnant women showed ultrasonography abnormalities, of which 11 were found to have Down syndrome (sensitivity 60%;specificity 91.09%). In 112 pregnancies, second-trimester serum screening and ultrasonography showed high risk, 4 were conformed as Down syn-drome (sensitivity 11.43%;specificity 99.56). Conclusions The most effective method of screening for Down syndrome is by maternal serum biochemistry. Ultrasonography is important in screening fetal trisomy 21. combined screening methods can improve the detection rate of trisomy 21.

Objective To analyze the problems frequently found in medical equipment bidding at public hospitals and come up with countermeasures for building a scientific and standardized bidding procedure.Methods 168 cases of medical equipment bidding of the hospital in the recent five years served as objects of study,for a full-process longitudinal study.It covered the preparation of technical parameters,compilation of bidding documentation,bid opening/evaluation process,all the way to final acceptance and after-sales service,and complaints responses.Results In the 168 cases,imported equipments accounted for 86.90%;only 16.07% of the purchases involved consumables,yet their importance deserved high attention;59.52% of the equipments involved after-sales maintenance costs,calling for regular maintenance to ensure smooth operation of the equipments.Conclusions Quality of domestic equipments should be enhanced,for optimization of the ratio between domestic and imported equipments;equipment purchase,after-sales service and consumables purchase should be taken into account in general;scientific evaluation levels and standards should be established to enhance supervision,for the purpose of scientific and rational purchase of medical equipments.

Objective To study the anti-inflammatory mechanism of the Penyankangshuan (PYKS) in treating chronic pelvic inflammation. Methods After model rats with endometritis were established successflly, 6 groups were formed which were the high, the middle and the low dosage groups of the PYKS, the KFXYS (a kind of patent medicine has a similar effect) group, the model group, the normal group. The treated rats were continuously rectal administration 3 weeks, the expression of NF-?B, Caspase-3 and MMP-2 were observed in the high, the middle dosage groups of the PYKS, the KFXYS group, the model group and the normal group with immunohistochemistry. Results The PYKS obviously raised the expression of Caspase-3 and MMP-2, but decreased the expression of NF-?B. Conclusion The anti-inflammatory mechanism of the PYKS possibly raised the expression of Caspase-3 and MMP-2 of mice endometrial cells, decreased the expression of NF-?B, so as to reduce inflammation soakage in excess and formation of inflammatory medium, accelerate apoptosis and reduce local inflammation.

Objective To examine the role of c-Jun NH2-terminal kinase(JNK) 1 in cytolytic T lymphocyte (CTL) responses against virus infection.Methods Wild-type (WT) and JNK1-knockout (JNK1-/-) mice were infected with ectromelia virus(ECTV) through hind footpads.Survival and virus titers in the target organs (liver and spleen) were analyzed.Effector T cells in the spleen and popliteal lymph nodes were determined on day 3 and 7 post-infection.Proliferation and INF-γ production of CTL were also detected.Results JNK1 deficiency caused an increased susceptibility to ECTV infection in mice,indicated by higher case fatality and viral burden in target organs.The decrease in CTL response correlated with a defect in CTL proliferation and INF-γproduction.Conclusion The data suggest that JNK1 is involved in expansion of activated CTL during ECTV infection,and plays an important antiviral role in regulating the proliferation and effector function of CTL.

BACKGROUND:SIRT6/NF-κB is the important signal axis to cellsenescence, but the effect of SIRT6/NF-κB signal axis to hematopoietic stem and progenitor cell(HSC/HPC) senescence is unclear. OBJECTIVE:To induce (t-BHP) in vitro and to investigate the role of SIRT6/NF-κB signal axis in Sca-1+HSC/HPC senescence induced by tert-butylhydroperoxide in vitro. METHODS:Sca-1+HSC/HPC was isolated and purified by magnetic activated cellsorting. Sca-1+HSC/HPC senescence was induced by 100μmol/L tert-butylhydroperoxide in vitro. The senescence-associatedβ-Galactosidase staining, cellcycle analysis and culture of mixed hematopoietic progenitor cellwere used to investigate the biological effects of tert-butylhydroperoxide on Sca-1+HSC/HPC senescence. The expression of senescence associated SIRT6, NF-κB mRNA and protein was examined by real-time fluorescence quantitative PCR and western blot assay. RESULTS AND CONCLUSION:Compared with control group, the percentage of positive cells expressing SA-β-Gal and cells in G0/G1 phase increased and the number of forming colony of mixed hematopoietic progenitor decreased in the aging group. It showed lower expression of SIRT6 and higher expression of NF-κB in the aging group. The SIRT6/NF-κB signal axis may play a key role in the Sca-1+ HSC /HPC senescence inducted by tert-butylhydroperoxide.

This paper introduces the development and animal tests of a miniaturized electrical chest compression device. Based on pulse width modulation technology produced by micro control unit, the device can control the frequency and depth of the compression accurately, as well as perform real-time adjustment. Therefore, it can perform continuous and stable chest compression for long time, which may increase the successful rate of cardiopulmonary resuscitation (CPR). Besides, the device can also produce different types of compression waveforms, including trapezoidal and triangular waveforms. Then, the performance and efficacy of the device was assessed with a rat model of asphyxial cardiac arrest (CA).
Animals ; Cardiopulmonary Resuscitation ; instrumentation ; Disease Models, Animal ; Electricity ; Heart Arrest ; therapy ; Heart Rate ; Pressure ; Rats ; Thorax

BACKGROUND: It is indicated in latest research that in cerebral protective measures of cerebral vasospasm induced by subarachnoid hemorrhage due to various factors in acute stage, mild hypothermia has been drawn the attention specially and it has been recommended in clinical practice. But such therapy is generally limited in experimental research and aneurysm hemorrhage, the clinical research on subhypothermia probably provides important influence on cerebral vasospasm in severe craniocerebral injury.OBJECTIVE: Based on cerebral vascular hemodynamical indexes (CVDI),the cerebral protection of subhypothermia was observed on cerebral vasospasm in severe craniocerebral injury.DESIGN: Randomized controlled experiment.SETTING: Department of Neurological Surgery of No.16 Hospital of Chinese PLA and General Military Institute of Neurological Medical Science in Zhujiang Hospital Affiliated to First Military Medical University of Chinese PLA.PARTICIPANTS: Totally 36 cases of severe craniocerebral injury were selected in General Military Institute of Neurological Medical Science in Zhujiang Hospital Affiliated to First Military Medical University of Chinese PLA from July 1997 to August 1999, which were randomized into the control and treatment group, 18 cases in each one. At same period, 24 cases with normal CVDI were screened and taken as normal group. All of receptors participated in the experiment in volunteer.METHODS: In both the control and treatment group, the treatment was applied with anti-inflammation, stopping bleeding, fluid limitation, dehydration, supporting, hyperbaric oxygen, etc. In the control, the normal body temperature was maintained and in treatment group, anus temperature was dropped to about 33 ℃ in 4 hours to 8 hours, which was maintained for 3-test was given on the day of injury (0), on the 1st, 3rd, 7th, 14th and 21st days assay was done on the day of injury (0), on the 1st, 3rd, 7th, 14th and 21st days successively, in which, minimum blood velocity (Vmin) and minimum blood flow (Qmin) reflect blood supply of distal cerebral vessel and blood flow.Cerebral vessel resistance (CVR) reflects smooth degree of cerebral microcirculation. Dynamical resistance (DR) reflects auto-regulation of cerebral vessel. Criteria of evaluation: Recovery state of consciousness was justified according to Glasgow Coma Scale (GCS) in 1 week after injury. The outcomes were evaluated according to Glasgow outcome scale (GOS) in 3 months (5 score: good, 4 score: moderate handicapped, 3 score: severely handicapped, 2 score: vegetative state and 1 score: death). The case over 4 score indicated good outcome.ery of consciousness and outcomes in 1 week after injury in the control and treatment group.RESULTS: Totally 36 cases of severe craniocerebral injury entered result phases after injury in the control, named hypoperfusion phase (0 day), hyperperfusion phase (1-3 days), cerebral vasospasm phase (4-14 days) and improving phase (＞15 days). In treatment group, 3 phases were manifested,named hypoperfusion phase (0 day), improving phase (1-3 days) and recovery phase (＞ 4 days), without hyperperfusion phase. Eight cases and 2 cases of cerebral vasospasmodic changes in CVDI presented in the control in focus: The maximum volume (140.9±22.95) cm3 was on the 14th day after injury in the control and that (95.83-±14.97) cm3 was on the 3rd day in treatment group. On the 14th day after injury, the volume in treatment group in 1 week after injury: It was 22.2% (4/18) in the control and 55.6%(10/18) (P ＜ 0.05) in treatment group. Improving outcome rate: It was 38.9% (7/18) and 66.7% (12/18) in treatment group.CONCLUSION: Subhypothermia reduces incidence of cerebral vasospasm by stabilizing cerebral circulation after severe craniocerebral injury, especially by inhibiting acute hyperperfusion after the injury so that the volume of cerebral edema in focus is lessened remarkably and the prognosis is improved.