Objective To evaluate the clinical effect of regulating expiratory airway pressure of noninvasive ventilation(NIV)to treat overlap syndrome(OS)with respiratory failure by pressure titration in monitor during sleep.Method Individuals who met the following criteria were selected for the study:(1)OS with respiratory failure confiemed by polysomnogram(PSC)and pulmonary function tests;(2)ability to tolerate PSG tests all night;(3)lucid consciousness and spontaneous breathing upon awaken and(4)ability to tolerate NIV.The criteria of exclusion were:(1)frequent expectoration of blood or hemoptysis;(2)spontaneous pneumothorax;(3)severe prosopo-trauma or facial ulcer and(4)large amount of secretion in the airway.From August 2005 to Decentber 2008,27 patients were selected with two patients excluded.The remaining 25 patients treated with noninvasive bi-level positive airway pressure(BiPAP)were randomly assigned to titration group or control group.During sleep,the patients of titration group were put under the optimal expiratory airway pressure[EPAP,(8.8 ± 0.5)cmH2O]which was got from titration by AutoCPAP ventilator and the EPAP decreased immediately to 5 cmH2O when the patients wake up next day.In the patients of control group,the EPAP was maintained at 5 cm H2O round the clock.The degree of apnoea and the hypopnea index(AHI),the results of arterial blood gas analysis(pH,PaO2,PaCO2)in the morning,the lowest pulse oxygen saturation(SPO2LOW)and the arterial blood gas level at 10 am before and after ventilation,duration of taking off ventilator at night,complications of NIV,incidence of air leakage and invasive ventilation after NIV were comparatively analyzed between the two groups.Results Compared with the control group,the titration group showed a notably increase in the value of SPO2LOW[(25.9± 11.3)%vs.(14.9±8.4)%;P＜0.05].The PaO2 level was significantly higher in the titration group(29.4±4.4)mmHg than that in the control group(22.6 ± 2.1)mmHg(P＜0.0001);however,the PaCO2 level in the titration group(16.8 ±7.3)mmHg was not significant different from that in the control group(20.0±6.3)mmHg(P＞0.05).The PaO2 level at 10am in the titration group(28.9 ± 6.7)mmHg was not significant different from that in the control group(31.3 ± 7.7)mmHg(P＞0.05);however,the PaCO2 level in the titration group(23.3 ±5.7)mmHg was higher than that in the control group(18.2 ±5.0)mmHg(P＜0.05).Conclusions Regulating EPAP of NIV to treat overlap syndrome with respiratory failure by pressure titration in monitor during sleep was more effective at improving hypoxemia and carbon dioxide retention than traditional methods without adjusting the EPAP to the optimal level.The optimal didn't increase carbon dioxide retention at night,confirming that the method was safe.

Objective PSGL-1 is specifically expressed in leucocytes.The aim of this study was to explore the changes of myeloid-derived suppressor cells (MDSCs) in the spleen and bone marrow in PSGL-1-deficient mice.Methods PSGL-1 -/-mice were used in the experiment.After identification of the offsprings, flow cytometry was used to test the expression of CD11b and Gr-1 in C57 and PSGL-1 -/-mice.Results Compared with the C57 mice, the expression of MDSCs was up-regulated in the PSGL-1-deficient mice ( P <0.001).Conclusion The expression of MDSCs is upregulated in PSGl-1-deficient mice.

Objective To evaluate the application of multi-slice computed tomographic coronary angiography in diagnosis of chronic total occlusion (CTO) of coronary artery.Methods Six hundred and thirty eight patients were diagnosed as CTO disease with coronary angiography (CAG) from June 2011 to December 2012 in Zhongshan Hospital;236 of them received multi-slice computed tomographic coronary angiography in 60 days before.Results In total 708 vessels of the 236 patients,244 vessels were proved totally occluded,128 (52.5％) of which were located in left anterior descending artery,31 (12.7％) were located in left circumflex coronary artery and 85 (34.8％) located in right coronary artery.Multi-slice computed tomographic coronary angiography was superior to CAG in judgment of stump anatomy (64.3％ vs.52.5％,F =7.09,P =0.010),plaque calcification (40.2％ vs.26.2％,F =10.68,P =0.001) and distal vessel interpretability (93.9％ vs.74.6％,F =34.06,P ＜ 0.001).There was no significant difference in judging side branch,tortuosity and lesion length between multi-slice computed tomographic coronary angiography and CAG (all P ＞ 0.05).Conclusion Multi-slice computed tomographic coronary angiography provides more detailed anatomy information of CTO lesions and is of value in diagnosis and treatment of CTO lesions.

Objective To improve the tri-primer allele gene amplification for realizing the single nucleotide polymorphisms (SNP) genotyping of the peripheral blood sample .Methods Aiming at the peripheral blood samples with the clinical usual antico-agulation processing by EDTA ,heparin and citrate ,with the locus rs1165205 as the target site ,the buffer solution(YW) suitable for whole blood was prepared and the PCR amplification system and the amplification condition were optimized for realizing the detec-tion of SNP genotyping .Results The genotyping results of locus rs1165205 by improved tri-primer allele gene amplification method were consistent with the results of the Sanger sequencing method ,and the peripheral blood samples treated by different anticoagu-lant were genotyped by the improved tri-primer ASA .Among 80 samples ,various genotypes of locus rs1165205 had no statistical differences in the distribution between the gout population and non-gout population(P= 0 .335) .Conclusion The improved tri-primer allele gene amplification method can be adopted to conduct the rapid genotyping research on gout SNP locus of the peripheral blood samples with the clinical usual anticoagulation processing .

ObjectiveTo compare X-ray,spiral CT and low does digital subtr,action angiongraphy technology of three dimensional reconstruction in 30 cases of the applications in the joint fractures,to study the application value of the digital subtraction angiography three- dimensional reconstruction in joint fracture.MethodsA retrospective analysis was made on 30 cases with joint fracture in Guangdong Provincial Guangzhou Development District Hospital,who were confirmed by the X-ray and spiral CT three-dimensional reconstruction and digital subtraction angiography three-dimensional reconstruction and the demonstrations three-dimensional reconstruction,spiral CT three-dimensional reconstruction and X-ray were compared.ResultsAll 30 cases fractures showed clear line,line of walk line,of the number of fracture,source and separation shift condition.Digital subtraction angiography could be clearly shows 30 cases in spiral CT could clearly show in 20 cases,10 cases not clearly show in,while X-ray clearly show in 10 cases,not show in 20 cases.Spiral CT showed clearly joint capsule and soft tissue.The SPSS 11.0 statistical soft package was used.Spearman correlation analysis,the single factor analysis of variance and the independent t test and the chi-square test were employed for data analysis,P ＜ 0.05 was considered statistical significance.Conclusions Digital subtraction angiography three-dimensional reconstruction can more clearly display fracture line,fracture pieces,walk line,source and separation shift condition compared with spiral CT and Xray essaminations,which is helpful for treatment options and prognosis estimation.

Objective To discuss the clinical value of bidirectional quantitative detection of MSCT in the diagnosis of diabetic lung injury.Methods From May 2016 to July 2017,120 patients with diabetes in Wenzhou Hospital of Traditional Chinese Medicine were selected as diabetic group,and 50 healthy people were selected as control group.The two groups received the pulmonary function test ( PFT) and the MSCT bidirectional quantitative detection,the test results of the two groups were analyzed.And the correlation of indicators of MSCT bidirectional detection and PFT detection indicators was analyzed.Results After examination,the maximum inspiratory lung volume (Vin),maximum expiratory volume (Vex),respiratory volume (EVvin,EVvex)-emphysema,EIvin (%),EIvex (%) in the diabetic group were (3 627.64 ±867.43)mL,(3 785.34 ±835.64)mL,(476.95 ±326.25)mL,(236.53 ±86.18)mL,(9.26 ±4.85)%,(4.11 ±2.58)%,respectively,which were significantly lower than those in the control group (t＝11.151,13.809,21.317,21.623,24.76,26.708,all P＜0.05).The Vin,Vex,EVvin,EVvex,EIvin(%),EIvex(%) in the patients with ≤5 years of diabetes were (3 627.64 ±867.43)mL,(3 785.34 ± 835.64)mL,(326.25 ±56.95) mL,(236.53 ±86.18) mL,(9.26 ±4.85)%,(4.11 ±2.58)%,respectively,which were significantly higher than those in the patients with ＞5-10 years of diabetes mellitus (t＝129.09,36.01,21.03,12.38,22.17,19.48,all P＜0.05).Conclusion MSCT bidirectional quantitative detection is of great signif-icance for patients with diabetes lung injury,and plays a significant role in clinical treatment.

In this paper,we have made a preliminary analysis on the necessity,main contents and difficulties in teaching medical undergraduates the principles and applications of optogenetics experimental technology.We focused on theory and practice teaching and emphasized on the most important technological principles,including how to achieve selective intervention of specific neural pathways;how to achieve twoway control of cell excitation or inhibition effect and the main process of the experiment.Finally,we have summarized our recent experience in the teaching process,to provide reference for basic medical experiments teaching in related medical colleges,so as to promote optogenetics experimental teaching for undergraduates in domestic medical colleges.

Objective: To examine the exposure to television advertising of unhealthy food among children and adolescents in Beijing, in order to provide a basis for the formulation of marketing management policies with unhealthy food. Methods: Four weekdays and four weekend days were randomly selected during October 19, 2020 to January 17, 2021, excluding holidays and school holidays. The top five popular channels of children and adolescents aged 3 to 18 years old were selected. A total of 720 hours was included for coding and analysis. World Health Organization Nutrient Profile Model for the Western Pacific Region was used to classify food and assess the health level. Results: A total of 13 864 advertisings (ads) was monitored, 38.8% (5 376) of which were food ads. Furthermore, 49.9% (2 680) of food ads were unhealthy food ads, with a frequency of 2.00 per hour per channel. The top five most frequent food ads were infant formula for 12-36 months (26.7%), cheese (16.7%), savory snacks (12.2%), milk drinks (10.5%) and chocolate and candy (6.0%). The most frequently used marketing strategies for unhealthy food ads were brand benefit claims (96.8%) and promotional characters (67.9%). Conclusion Children and adolescents in Beijing are highly exposed to TV marketing of unhealthy foods. Marketing strategies such as brand benefit claims and promotional characters are employed to boost the impact of unhealthy food ads. There is an urgent need to introduce relevant policies to regulate TV marketing of unhealthy foods.

Objective: To investigate the exposure to television advertising of sugar sweetened beverages and the use of persuasive marketing techniques among children and adolescents in Beijing, so as to provide evidence for reduing childrens intake of sugar sweetened beverages. Methods: From October 19, 2020 to November 16, 2021, 32 days were randomly selected. The top four popular channels of children and adolescents aged 3-18 years were defined. Each channel was monitored from 6:00:00 to 23:59:59 for each date. A total of 2 304 h was recorded. Advertisements involving sugar sweetened beverages broadcast before, during or after the program were included. The frequency and the use of persuasive marketing techniques were analyzed. Results: A total of 1 237 advertisements for sugar sweetened beverages were included, of which 50.93% were dairy beverages, 28.38% were teabased beverages, and 19.48% were vegetable protein beverages. The average frequency of sugar sweetened beverages advertisements on every channel was (0.62±1.29)piece/h. The frequency of sugar sweetened beverages advertisements on every local channel [(1.04±1.35)piece/h] and childrens channel [(1.11±1.61)piece/h] was separately higher than every national channel [(0.48±1.24)piece/h] and general channel [(0.12±0.48)piece/h] (t=-14.05, 31.64, P<0.01). There were seasonal differences in television advertising of sugar sweetened beverages, and were more frequent during lunch and dinner times. The most frequently used persuasive marketing techniques were "images of children" (74.54%), "nutritional message" (61.76%), "product composition details" (58.61%), "nutrition claim" (57.24%), and "nutrition function claim or other function claim" (53.11%). Conclusions Children and adolescents are often exposed to television advertisement of sugar sweetened beverages on childrens channels and during meal times. There is an urgent need to formulate relevant policies to regulate the marketing of sugar sweetened beverages advertisement and reduce children and adolescents intake.

The diagnosis of hypertrophic cardiomyopathy (HCM) is of great significance for the early risk classification of sudden cardiac death and the screening of family genetic diseases. This research proposed a HCM automatic detection method based on convolution neural network (CNN) model, using single-lead electrocardiogram (ECG) signal as the research object. Firstly, the R-wave peak locations of single-lead ECG signal were determined, followed by the ECG signal segmentation and resample in units of heart beats, then a CNN model was built to automatically extract the deep features in the ECG signal and perform automatic classification and HCM detection. The experimental data is derived from 108 ECG records extracted from three public databases provided by PhysioNet, the database established in this research consists of 14,459 heartbeats, and each heartbeat contains 128 sampling points. The results revealed that the optimized CNN model could effectively detect HCM, the accuracy, sensitivity and specificity were 95.98%, 98.03% and 95.79% respectively. In this research, the deep learning method was introduced for the analysis of single-lead ECG of HCM patients, which could not only overcome the technical limitations of conventional detection methods based on multi-lead ECG, but also has important application value for assisting doctor in fast and convenient large-scale HCM preliminary screening.
Algorithms ; Cardiomyopathy, Hypertrophic/diagnosis* ; Databases, Factual ; Electrocardiography ; Heart Rate ; Humans ; Neural Networks, Computer