Accurate measurements of voltage and current from electrosurgery are the basis of development of electrosurgery with feedback function. We, therefore, developed a parameter measurement system based on PC, with high voltage and current from electrosurgery being sensed with transformers, amplified, filtered, transformed into single-ended signals, and then into RMS signals. The root mean square (RMS) signals were transformed into digital signals through DAQ card and the data was processed in PC with Labview. The process included sampling, displaying and storage. The experiment results indicated that the measurement system could measure the output parameters from electrosurgery steadily and correctly so that the development of the system has been successful. It can be the basis of development of embedded parameters measurement system and can provide accurate feedback information for intellectual electrosurgery.
Electrosurgery ; instrumentation ; Equipment Design

Objective To study the pattern of ultrasonic bone mineral density of calcaneus with age, height and body weight, and to establish a normal reference value of stiffness index (SI) of females in Southern China for providing scientific foundation for osteoporotic diagnosis and prevention. Methods SI for calcaneus in 2498 healthy people 10～87 years old was measured with Achilles Express ultrasound apparatus made in USA. They were divided into groups according to sex and age. One group for 10 years each and the records beyond 69 years were classified into one group, total 7 groups. Results The SI showed a characteristic mild rise-then-fall pattern with increasing age. And the peak value of SI presented in 20～29 age group. Pearson correlation analysis showed negative correlation between SI and age and a positive correlation between SI/ height and weight. The prevalence of osteoporosis gradually increase with age. Conclusion There are significant correlations in SI with age, height and weight; the values of SI will provide an important data reference to establish the normal values and diagnostic]standard of osteoporosis.

To develop a core-shell structure pDNA-CaPi-PLGA nanoparticles (CS-pDNA-CaPi-PLGA-NPs), calcium phosphate-pDNA nano complexes (CaPi-pDNA) were encapsulated inside of PLGA shells. The characteristics of the nanoparticles, including morphology, average particle size, zeta potential, entrapment efficiency, loading efficiency, stability in medium, pDNA protection ability from nuclease degradation, in vitro release, cytotoxicity and cell transfection were investigated and compared with the embedded structured CaPi modified PLGA nanoparticles (embedded-pDNA-CaPi-PLGA-NPs). The results showed that the obtained CS-pDNA-CaPi-PLGA-NPs were spherical in shape with an average particle size of (155 +/- 4.5) nm, zeta potentials of (-0.38 +/- 0.1) mV, entrapment efficiency of (80.56 +/- 2.5)% and loading efficiency of (1.16 +/- 0.04)%. The CS-pDNA-CaPi-PLGA-NPs were stable in the release media and could protect pDNA against nuclease degradation. And they also exhibited sustained release of pDNA in vitro. The highest gene transfection efficiency of the CS-pDNA-CaPi-PLGA-NPs in vitro reached (24.66 +/- 0.46)% (after 72 h transfection), which was significantly higher than that of free pDNA [(0.33 +/- 0.04)%, P < 0.01] and the pDNA-PLGA-NPs [(1.5 +/- 0.07)%, P < 0.01]. Besides, the transfection lasted for longer time than that of embedded-pDNA-CaPi-PLGA-NPs and the cytotoxicity of it was significantly lower than that of PEI (P < 0.01). These results indicate that CS-pDNA-CaPi-PLGA-NPs are a promising non-viral gene vector. Key words: gene delivery system; polylactic-co-glycolic acid; calcium phosphate; nanoparticle

Objective To discuss the relationship between TCM syndromes and peritoneal fluid cytokine IL-6, IL-8 and TNF-α of endometriosis infertility patients, and provide thoughts for clinical treatment. Methods Totally 105 patients of endometriosis infertility were differentiated to six syndrome groups, including kidney deficiency and blood stasis, qi stagnation and blood stasis, heat stagnation and blood stasis, cold congelation and blood stasis, qi deficiency and blood stasis, phlegm-dampness stagnation. Thirty patients of non-endometriosis infertility were selected as control group. Enzyme-linked immunosorbent assay was used to detect cytokine levels of IL-6, IL-8 and TNF-α. Results In 105 cases of EM infertility, 35 cases (33.33%) were syndrome of kidney deficiency and blood stasis, 22 cases (20.95%) were syndrome of cold congelation and blood stasis, 18 cases (17.14%) were syndrome of qi stagnation and blood stasis, 10 cases (9.52%) were syndrome of heat stagnation and blood stasis, 11 cases (10.48%) were syndrome of qi deficiency and blood stasis, 9 cases (8.57%) were phlegm-dampness stagnation syndrome. The levels of IL-6, IL-8 and TNF-αin each syndrome group of EM infertility were higher than control group (P<0.01). IL-6 level in kidney deficiency and blood stasis group were higher than other syndrome groups (P<0.05). The levels of IL-8 and TNF-α in kidney deficiency and blood stasis group, and heat stagnation and blood stasis group were higher than other syndrome groups (P<0.05). IL-8 in kidney deficiency and blood stasis group was higher than that in heat stagnation and blood stasis group (P<0.05). Conclusion TCM syndromes in patients with endometriosis infertility have some relevance with peritoneal fluid cytokine levels of IL-6, IL-8, TNF-α, which may guide clinical understanding and treatment of endometriosis infertility.

BACKGROUND:With the development of medical instruments, more and more traditional surgical operations are replaced by minimal y invasive surgeries. In minimal y invasive surgery, cutting and sealing tissue is a conventional procedure;however, due to the limitation of space and vision, the ordinary methods are not suitable for minimal y invasive surgery. OBJECTIVE:To develop high frequency electrosurgical generator that has a constant power output and ability for tissue cutting and closing. METHODS:In order to improve the efficiency of tissue cutting and sealing in surgical, a kind of high-frequency energy generator was developed for tissue cutting and sealing. The instrument consisted of switching power supply with adjustable amplitude, high-frequency power amplifier, impedance monitor and microcontrol er. The energy converter composed of switching power supply and high-frequency power amplifier converted the 220 V, 50 Hz utility powers to a kind of high-frequency energy with 450 kHz and applied on tissues. Impedance monitor would real-timely detect the electrical parameter impacting on tissue that was provide the amount of feedback to microcontrol er in order to complete constant power control and bioimpedance determination by the control er. RESULTS AND CONCLUSION:The experimental results indicated that the instrument could rapidly and stably provide high-frequency energy, and could detect the biological impedance in real-time, achieve constant power output through feedback control, and could cut and close the biological tissue efficiently.

Objective To explore the value of MR imaging-guided percutaneous lumbar discectomy and discolysis with oxygen-ozone mixture for treatment of posterolateral lumbar disc herniation via a new puncture approach of facet joint medial route. Methods All 114 lumbar intervertebral discs in 103 patients were diagnosed as posterolateral lumber disc herniation by CT or MRI, which were located at the levels of L3-4 in 5 cases, LA-5 in 87 cases and L5-S1 in 22 cases. The procedure was guided under 0. 23 T open magnetic resonance with iPath 200 optical tracking system. A 14 G MR-compatible needle was punctured into the disc center via a new puncture approach of facet joint medial route. The therapy steps were as follows: firstly, cut nucleus pulposus and inject 6 ml oxygen-ozone mixture of 60 μg/ml in the disc center;secondly, retreat the needle to the local prominence, cut prominent part and inject 6 ml oxygen-ozone mixture of 60 μg/ml. Thirdly, retreat the needle to the periradicular nerve root, inject 15 ml oxygen-ozone mixture of 40 μg/ml and 4 ml pain-block liquid. All patients were followed up at 3 days, 1 month, 3 months and 6 months after operation, evaluated for the effect of treatment with the modified Macnab criteria, and the results were compared with the χ2 test. Results All procedures were successfully performed. Intraoperative dural injury occurred in 5 cases. Postoperative infection of intervertebral space occurred in 2 cases. The clinical effective rate was 96. 1% (99/103), 84.5% (87/103), 94.2% (97/103), 95.1% (98/103)respectively at 3 days, 1 month, 3 months and 6 months after operation, and the differences were signifieant (χ2 = 12. 942, P = 0. 005 ) . Conclusion MR imaging-guided percutaneous lumbar discectomy and discolysis with oxygen-ozone mixture via facet joint medial route is a minimally invasive, safety and effective method for the treatment of posterolateral lumbar disc herniation.

Objective To evaluate the feasibility, accuracy and its clinical value of MRI-guided needle biopsy of lung lesions. Methods A total of 137 patients with pulmonary nodules or masses underwent lung biopsy in low-field open MRI equipped with iPath 200 optical tracking systems. Among them, 103 cases had solitary pulmonary lesion; the other 34 cases had multiple foci. The maximum diameter of the lesion was not smaller than 3.5 cm ( ≥ 3.5 cm) in 57 patients, between 1.5 cm and 3.4 cm( 1.5-3.4 cm) in 71 patients, not greater than 1.4 cm ( ≤ 1.4 cm) in 9 patients. Results The puncture success rate was 100.0% (57/57) for lesions ≥3.5 cm, 98.6% (70/71) for lesions 1.5-3.4 cm,77.8% (7/9) for lesions ≤1.4 cm and 97. 8% (134/137) for total cases, respectively. According to the pathological results, pulmonary lesions were malignant in 98 cases and benign in 39 cases. The sensitivity,specificity, accuracy, positive predictive value and negative predictive value of MRI-guided lung biopsy were 94.2%(98/104), 100.0% (33/33), 95.6% (131/137), 100.0% (98/98) and 84.6% (33/39),respectively. Conclusion MRI-guided needle biopsy of lung lesion can be performed precisely in a lowfield open MRI with a low risk of complications. As a supplement to US or CT-guided biopsy, it is worth further promotion and application.

Objective:Organizing pneumonia (OP) is a clinical syndrome manifested by granulation tissue plug in respiratory bronchioles, alveolar ducts and alveolar spaces pathologically.With advent of lung biopsy techniques, increasing pathological diagnosis of organizing pneumonia was made, most of which were confirmed secondary organizing pneumonia (SOP) either at time of diagnosis or on follow-up.The secondary etiology is related to the choice of treatment and prognosis.First of all, we need to rule out infection, find evidence of connective tissue disease, or previous medication, radiotherapy and even transplantation.The coexistence of multiple pathological features and simultaneous involvement of pulmonary vessels and pleura suggest possible secondary causes.The pathological diagnosis of organic pneumonia by empty core needle puncture or transbronchial lung biopsy needs to be combined with imaging to avoid omitting the tumor, granuloma and necrosis around organic pneumonia.In general, organizing pneumonia, no matter cryptogenic or secondary, is mostly responsive to corticosteroids compared with other interstitial lung diseases, although relapses are frequent.In summary, real cryptogenic organized pneumonia is actually relatively uncommon and should be diagnosed with caution.Long term follow up is not only crucial to assess the evolution of lung disease but also for looking into the underlying etiologies behind an organizing pneumonia.

Objective:To investigate the status of post-traumatic growth and its afffecting factors in middle-aged and young patients with type 2 diabetes, in order to carry out clinical intervention for reference.Methods:A general data questionnaire, Posttraumatic Growth Inventory, Perceived Social Support Scale, and Connor-Davidson Resilience Scale were used to survey 222 middle-aged and young patients with type 2 diabetes hospitalized from December 2020 to March 2021 in Shandong First Medical University Affiliated Center Hospital, Shandong Provincial Qianfoshan Hospital, Liaocheng People′s Hospital.Results:The total score of Posttraumatic Growth Inventory, Perceived Social Support Scale, and Connor-Davidson Resilience Scale was (45.20 ± 12.90), (42.73 ± 10.16),(51.41 ± 10.60) points in middle-aged and young patients with type 2 diabetes. Regression showed that treatment mode, medical payment mode, social support, and psychological resilience were the main influencing factors of post-traumatic growth levels in middle-aged and young patients with type 2 diabetes ( P<0.05), which could explain 42.3% of the variation. Conclusions:Middle-aged and young patients with type 2 diabetes have grown at low level. Medical staff should concentrate on the positive psychology of patients and improve their level of social support and resilience to promote the production of post-traumatic growth.

Objective To analyze the influence regularities of different sizes on thermal stress field of bipolar high-frequency electric knife. Methods Based on the ANSYS software, the electric-thermal coupling simulation analysis was performed for thermal stress field of bipolar high-frequency electric knife during working. The effects of 3 different insulation layer thicknesses (0-5, 1-0, 1-5 mm), electrode thicknesses (0-5, 1-0, 1-5 mm) and coating thicknesses (3, 6, 9 μm) on thermal stress field of bipolar high-frequency electric knife were studied. Results If thickness of the insulation layer was larger, deformation of the myocardial tissues would be smaller due to thermal stress, that is, the thickness of the insulation layer was inversely proportional to thermal deformation of the myocardial tissue during working process of the high-frequency electric knife. For the 3 electrode thicknesses, 1-0 mm was a better choice. And for the 3 coating thicknesses, 6 μm was a better choice. Conclusions The component sizes for the high-frequency electric knife have an important influence on thermal stress field, and the result can provide guidance for design of the high-frequency electric knife.