A realizaton project of electrical stimulator aimed at motor dysfunction of stroke is proposed in this paper. Based on neurophysiological biofeedback, this system, using an ARM9 S3C2440 as the core processor, integrates collection and display of surface electromyography (sEMG) signal, as well as neuromuscular electrical stimulation (NMES) into one system. By embedding Linux system, the project is able to use Qt/Embedded as a graphical interface design tool to accomplish the design of stroke rehabilitation apparatus. Experiments showed that this system worked well.
Biofeedback, Psychology ; Computers ; Electric Stimulation Therapy ; instrumentation ; Electromyography ; Equipment Design ; Humans ; Software ; Stroke Rehabilitation

Objective To analyze the prognostic value of baseline serum free light chain (sFLC) in light-chain (AL) cardiac amyloidosis.Methods Twenty-seven patients with AL cardiac amyloidosis were retrospectively reviewed from January 2014 to January 2015.sFLC was measured by immuoturbidimetric assay.Baseline characteristics,echocardiographic parameters and electrocardiogram data were analyzed.According to the median baseline dFLC (involved sFLC minus uninvolved sFLC),patients were categorized into either the low dFLC(≤307mg/L) or the high dFLC group (＞307mg/L).Results More subjects in the high dFLC group with early/late diastolic mitral velocity ratio (E/A ratio) over 2 (71.4％ vs 30.8％,P =0.035),and subjects in this group had a shorter median survival time than those in the low dFLC group (3 months vs 17 months,P =0.004).A similar phenomenon for median survival time was observed when the subjects were redivided either by a new cut-off value of 180mg/L for dFLC (low dFLC group:17 months;high dFLC group:4 months,P =0.014) or a κ/λ ratio,in which subjects with κ type sFLC-ratio ≤ 19.6 and λ type sFLC-ratio ＞0.065 were in the low sFLC-ratio group (17 months) and those with κ type sFLC-ratio ＞ 19.6 and λ type sFLC-ratio ≤0.065 were in the high sFLC-ratio group (4 months,P=0.023).In multivariate analysis,dFLC and New York Heart Association (NYHA) classification of cardiac function were two risk factors associated with all-cause mortality in patients,among which the hazard ratio for higher dFLC was 4.28 (95％ CI 1.55-11.8,P =0.005).Conclusion The level of sFLC could be a marker for the prognosis of AL cardiac amyloidosis.

Objective To investigate the clinical features of young female patients with acute myocardial infarction (AMI) who were referred to Peking Union Medical College Hospital. Methods A total of 24 consecutive AMI female patients (age≤44 years) who underwent coronary angiography were retrospectively retrieved from the database, and 70 AMI patients whose age ≥ 65 years and who also underwent coronary angiography were enrolled as a control (elderly) group. Clinical features were compared between the two groups. Results Of the 24 young female AMI patients, MI from non-atherosclerosis was identiifed in 9 patients (non-ATS group). Compared to the remaining 15 young female AMI patients (ATS-group), non-ATS group was younger (P<0.05), with lower BMI (P<0.05) and less traditional risk factors of coronary heart disease (P<0.05). Coronary angiography showed more normal artery (P<0.05) and lesions on left main (P<0.05). However, when compared to the elderly group, the young female ATS-group was associated with less hypertension (P<0.01), smoking (P<0.05), traditional risk factors (P<0.01) and lower level of blood pressure (P<0.05), fasting glucose (P<0.05), serum creatine (P<0.01), TC (P<0.05), and LDL-C (P<0.01) at admission. Coronary angiography showed single vessel disease was the most common lesion. Conclusions Acute myocardial infarction in young female might be caused by non-atherosclerosis. Those due to atherosclerosis differ in coronary risk factors and angiographic features from the elderly female AMI patients.

Objective To investigate the manifestations of cardiac involvement in the patients with mucopolysacharidosis Ⅰ (MPS Ⅰ).Methods The clinical data of 10 MPS Ⅰ patients were collected.Electrocardiography (ECG) and echocardiography (Echo) were performed in all patients and then analyzed.Results Among the ten patients,seven were men.The onset age of MPS was (0.5 ～ 8.0) years old and the age of diagnosis was (1.8 ～ 20.0) years old.Two patients had grade 2 precordial systolic murmur.ECG was abnormal in three patients with right ventricular hypertrophy in two and right axis deviation in another one.Echo showed valvular thickening and insufficiency in nine patients,enlarged left atrium and ventricle in one patient,hapulmonary hypertension and right ventricular hypertrophy in two patients and abnormal left ventricular configuration in five patients.Conclusions Cardiac involvement is common in MPS Ⅰ patients and may present as valvular thickening with regurgitation,abnormal left ventricular configuration and pulmonary hypertension.The cardiac involvement progresses with age.ECG and Echo should be done regularly during follow-up of MPS Ⅰ patients.

ObjectiveTo analyze the underlying causes of postoperative gastrointestinal (CI)bleeding after pancreaticoduodenectomy and to discuss the strategies in diagnosis,prevention and management.MethodsThe clinical data of 331 patients who were admitted to the Surgical Department of the First Hospital,Peking University from Jan. 1998 to Jan. 2010 was retrospectively analyzed.ResultsThe overall postoperative morbidity was 37.2 ％,with a bleeding complication rate of 6.7 ％,and a GI bleeding rate of 1.5％.For postoperative GI bleeding,the main bleeding sites were from the pancreaticointestinal anastomosis (40.0％) and the gastrointestinal anastomosis (20.0％). Embolotherapy using vascular intervention alone (20.0％),open abdominal operation following vascular interventional therapy (40.0 ％ ) and open abdominal operation alone (40.0 ％ ) were used to control GIbleeding.ConclusionsThe common bleeding sites in the GI tract were at the pancreaticointestinal anastomosis and the gastrointestinal anastomosis. The main procedures used to control bleeding were embolization using vascular interventional therapy,endoscopic therapy and open abdominal therapy.

Objective This study aims to evaluate the impact of early surgery on long-term outcome of patients with left-sided native valve infective endocarditis (IE).Methods Clinical data were retrospectively reviewed in 239 consecutive patients with left-sided native valve IE from 2002 to 2012 in Peking Union Medical College Hospital (PUMCH).Propensity score was used to match patients in the early operation and conventional treatment groups.Results Early surgery was performed in 70 (29.3％)patients and the conventional treatment strategy was applied in 169 (70.7％) patients.The median followup period was 2 years.IE-related mortality was lower in the early operation group than in the conventional treatment group (10.0％ vs 23.1％,P =0.02).For 58 propensity score-matched pairs,the cumulative survival free from IE related death was significantly higher in the early operation group than in the conventional treatment group (P =0.027).Regression analysis of the matched cohorts revealed that early surgery was independently associated with decreased IE-related mortality (HR 0.286 ; 95％ CI 0.092-0.893 ;P =0.031).While either cardiac function with NYHA Class Ⅲ-Ⅳ (HR 4.044; 95％ CI 1.318-12.407;P =0.015) or uncontrolled infection (HR 52.064; 95％ CI 10.996-247.194; P ＜ 0.001) was associated with poor prognosis of increased mortality.Conclusions Early surgery improved long-term outcome in patients with left-sided native valve IE compared with conventional therapy.Risk factors related to increased mortality included heart failure and uncontrollable infection.

Objective To investigate the surgical procedure selection for chronic pancreatitis.Methods The clinical data of 80 patients with chronic pancreatitis who were admitted to the Peking University First Hospital from January 2000 to August 2013 were retrospectively analyzed.Thirty-eight patients were with or without pancreatic duct stone,and the dilation of the pancreatic duct was above 7 mm,44 patients were with common bile duct dilation,32 patients were with inflammatory mass in the head of the pancreas,and 3 patients were with splenomegaly and esophagogastric varices.Surgical procedures were selected according to the symptoms and results of imaging examination.The remission or recurrence of pain was judged according to the visual analog scales.Patients were followed up via out-patient examination,mail or phone call till December 2013.Results Choledochojejunostomy was done on 27 patients,Partington-Rochelle pancreaticojejunostomy on 24 patients,PartingtonRochelle pancreaticojejunostomy + choledochojejunostomy on 6 patients,pancreaticoduodenectomy on 7 patients,resection of the body and tail of the pancreas on 4 patients,Beger's procedure on 3 patients,splenectomy on 3 patients,Frey's procedure + fenestration of bile duct in the head of the pancreas on 3 patients,Frey's procedure on 2 patients,common bile duct exploration + T tube drainage on 1 patient.The remission rate of abdominal pain was 95.2％ (60/63).One patient died of abdominal infection and multiple organ dysfunction syndrome perioperatively.Three patients were complicated with abdominal infection,2 with pancreatic fistula,1 with biliary fistula and 1 with abdominal bleeding.All the complications were cured by conservative treatment.Seventy-nine patients were followed up,and the mean time of follow-up was 58.6 months (range,4-156 months).Thirty patients had recurrence or new onset of abdominal pain,and the recurrence rate was 38.0％ (30/79).Of the 32 patients with inflammatory mass in the head of the pancreas,17 received choledochojejunostomy,and the recurrence rate of abdominal pain was 9/17 ; the other 15 patients received pancreatoduodenectomy,Beger' procedure or Frey's procedure,and the recurrence rate of abdominal pain was 1/15.Of the 41 patients without inflammatory mass,10 received choledochojejunostomy,and the recurrence rate of abdominal pain was 7/10; 30 received PartingtonRochelle pancreaticojejunostomy,and the recurrence rate of abdominal pain was 33.3％ (10/30).Conclusions Complete drainage could relieve the symptoms for patients with pancreatic duct dilation.Surgical resection or combined surgical procedure is effective for the treatment of patients with inflammatory mass in the head of the pancreas.

Objective To evaluate the examination of non-small-cell lung (NSCLC) vein formation and the dynamic characteristics of blood stream through enforced SCT scanning for the research on and clinical diagnosis of tumor.Methods Double period enhanced SCT scanning was done to 152 NSCLC cases identified pathologically.Makes the color coding the tumour blood stream irrigation chart,the analysis blood stream irrigation characteristic.Compare the enforced morphologic manifestation of cancer focus with histology and analyze their pertinence.Results The enforced CT peak value (PV) of the low differentiation is bigger than that of the medium differentiation,which is bigger than the high differentiation.63 cases are 45-70 HU,78 cases are 20-45 HU and 11 cases are 10-20 HU.67 case are of abnormal arteriola; 23 cases are of abnormal hemal sinus development; 35 cases are pistil-like.Conclusion Accurately examining and quantifying cancer focus vein formation according to SCT double period enforced scanning is of high guiding value in the enactment of the plan for treating NSCLC and the comprehensive treatment of tumors.

Objective:To investigate the correlation of serum hs-CRP,D-dimmer and Lp-PLA2 with vulnerable plaque of coronary artery atherosclerosis in patients with coronary heart disease.Methods:Selected 106 cases of patients in our hospital from January 2014 to December 2015,all taken coronary angiography and intravascular ultrasound.Divided into three groups according to the results of the examination,the levels of serum hs-CRP,D-dimmer and Lp-PLA2 were examined and compared,and the correlation with fiber cap thickness,plaque eccentricity index,and vascular remodeling index were tested by Pearson correlation analysis.Results:Serum levels of hs-CRP,D-dimmer and Lp-PLA2 of vulnerable plaque group and stable plaque group were significantly higher than that of the control group (P＜0.05),and the serum levels of hs-CRP,D-dimmer and Lp-PLA2 of vulnerable plaque group were significantly higher than that of stable plaque group (P＜0.05);hs-CRP was negative correlated with the thickness of fibrous cap (r=-0.712,P＜0.05),and positive correlated with eccentric plaque index and vascular remodeling index (r=0.813,0.756;D-,P＜0.05),D-dimmer was negative correlated with the thickness of fibrous cap (r=-0.654,P＜0.05),and positive correlated with eccentric plaque index and vascular remodeling index (r=0.912,0.853,P＜0.05);Lp-PLA2 was negative correlated with the thickness of fibrous cap (r=-0.796,P＜0.05),and positive correlated with eccentric plaque index and vascular remodeling index (r=0.836,0.729,P＜0.05).Conclusion:Hs-CRP,D-dimmer and Lp-PLA2 have high correlation with vulnerable plaque in coronary artery disease,can be used as reference indexes for assessing the instability of coronary atherosclerotic plaque.

Sphincter of Oddi dysfunction (SOD)is a functional gastrointestinal disorder manifesting with the main symptoms of abdominal pain,abnormal liver function and recurrent idiopathic acute pancreatitis,which involved the abnormal contraction of sphincter of Oddi. The incidence of SOD has been increasing in recent years. More attention should be paid on SOD for decreasing the misdiagnosis in clinical practice. This article reviewed the recent advances in diagnosis and treatment of SOD.