Objective:To observe the effects of real-time and retrospective analyze of cardiac remote monitoring based on differential threshold method.Methods: Xin An Bao XAB - M3AG ECG remote monitoring system which based on the differential threshold method of improvement being used to determine the parameters of electro cardio signal was installed in 8957 patients.Results: We had collected all 46967 ECG real-time data, including 9564 manual transmission, 25830 timing transmitting and 11573 automatically transmission. 5728 of automatically transmission was with arrhythmia (49.5%) and the others of automatically transmission was attribute to inference.Conclusion: The results showed that algorithm complexity based on the improved differential threshold method is low, the precision is high and it has a good real-time performance. It realized the real-time monitoring of ECG.

Objective To investigate the change of P300 of the attention - deficit/hyperactivity disorder children before and after they took litalin, according to this objective subject to guide the clinical treatment of ADHD children. Methods Using the looking se-ducible electricity stimulates 22 ADHD children, and check the change of latency and the rate of the wave before and after they took litalin. Results After ADHD children took litalin, their latency of P300 has decreased clearly, and the amplitude had no change. Conclusion The changes of P300 latency in ADHD children after they took litalin can be adopted as the guidelines of clinical treatment for the ADHD children.

0.10), but more significant after the causes of DIC were corrected( P

Objective To compare the biomechanical properties between the two-level fixation by im- plantation of pedicle-screws into the adjacent upper and lower vertebrae of the fractured vertebra and the three-level fixation by implantation of pedicle screws into the fractured vertebra and its adjacent upper and lower vertebrae in the treatment of thoracolumbar burst fractures.Methods Eight fresh frozen calf spines were used in this study.Each specimen was tested in four models:intact model as the control,L1 burst fracture model,two-level fixation model, and three-level fixation model.The L1 burst fracture model was created on a biaxial material testing machine (MTS858 Bionix test system,America).During the experiment,the flexion,extension,bilateral bending and axial rotation loadings were applied to the specimens and the range of motion(ROM)was measured with a three-dimensional laser analysis apparatus and the stiffness was calculated subsequently.One-way statistical analysis was used.Results The ROMs under six different loadings in the fracture model became larger obviously(P＜0.05)and the stiffness decreased(P＜0.05).The ROMs in both fixation models were smaller than those in the other models(P＜0.01)and the stiffness increased distinctly(P＜0.05).There were no significant differences in ROMs and stiffness between the two-level fixation and three-level fixation models(P＞0.05).Conclusion Two-level fixation provides similar biomechanical stability as three-level fixation does in the reconstruction of unstable thoracolumbar fractures.

Objective To explore the impact of combined laparoscopic and choledochoscopic treatment on bile leak in hepatic hydatid disease at a high attitude region.Methods The clinical data of 50 patients who underwent combined laparoscopic and choledochoscopic treatment were compared with 50 patients who underwent laparoscopic surgery alone for hepatic hydatid internal capsule excision surgery.Results In the combined laparoscopic and choledochoscopic group,the incidence of biliary fistula after surgery was 15％,the incision infection rate was 13％,the length of hospitalization was (11.6 ± 3.8) days and the postoperative time to take off drain was (14.3 ± 7.9) days.These were significantly better than those in the laparoscopic alone group.The operation time in the former group was (108.2 ± 28.4)min,which was slightly longer than the laparoscopy group.Conclusion The combined laparoscopic and choledochoscopic treatment is a safer therapeutic option in treating hepatic hydatid disease with less trauma,faster recovery and shorter hospital stay than laparoscopic surgery alone in a high attitude region.

Objective To investigate laparoscopic-guided selective portal vein ligation in the two-stage hepatectomy for patients with primary hepatocellular carcinoma (HCC).Methods Twenty-three patients with HCC who were not suitable for one-stage hepatectomy were admitted to the Sichuan Provincial People's Hospital from March 2009 to February 2012.Their clinical data were retrospectively analyzed.Laparoscopic-guided selective portal vein ligation was firstly performed,dynamic changes of hepatic volume and predicted volume of liver to be resected were detected by computed tomography.Two-stage open hepatectomy was performed after assessment of resectability of HCC.All data were analyzed using the analysis of variance or q test.Results Laparoscopic-guided selective portal vein ligation was successfully performed on 22 patients (2 patients received concomitant cholecystectomy because the right branch of portal vein was difficult to expose),1 patient was converted to open surgery because of hemorrhage during portal vein separation.Three patients with multiple lesions received transcatheter arterial chemoembolization at 1 week after selective portal vein ligation.Dull pain in the hepatic region,low fever,nausea and vomiting were observed in the 23 patients,while no severe complications including peritoneal hemorrhage,bile leakage,hepatapostema was observed.The levels of aspartate aminotransferase,alanine aminotransferase and total bilirubin were back to normal at 1 week after the surgery.The right liver volume at postoperative week 3 was (590 ± 154)cm3,which was significantly smaller than (698 ± 135)cm3 before surgery.Compared with right liver volume at postoperative week 1,2,3,the right liver volume before operation was significantly smaller (F=15.62,P ＜0.05).The left hepatic volume at postoperative week 3 was (408 ± 149)cm3,which was significantly bigger than (331 ± 68)cm3 before operation.The left liver volume before operation was significantly different from those at postoperative week 1,2,3 (F =17.48,P ＜ 0.05).The predicted ratio of liver to be resected was 60％ ± 18％ at postoperative week 3,which was significantly smaller than 67％ ± 15％ before operation (F =12.35,P ＜ 0.05).Two patients with insufficient hyperplasia of offside liver,2 patients with intrahepatic metastasis at postoperative week 3,2 patients were lost to follow up and 3 patients gave up hepatectomy,14 patients received hepatectomy at 2-4 weeks after laparoscopic-guided selective portal vein ligation.The resection rate was 60.9％ (14/23).There were 2 patients received extended right hepatectomy,8 received right hepatectomy,4 received non-anatomical hepatectomy.All the 14 patients recovered well,and no hepatic failure,severe peritoneal effusion and infection was observed.Conclusion Laparoscopic-guided selective portal vein ligation is easy to perform,and it extends the indication of hepatectomy,increases the safety of two-stage hepatectomy.

Objective To investigate the effects of early rehabilitation therapy in mechanically ventilated ICU in patients.Methods A randomized controlled trial was carried out.Sixty mechanically ventilated patients,with tracheal intubation or tracheostomy more than 48 h and less than 72 h,were admitted to the intensive care unit (ICU) of the Affiliated Hospital of Medical College Qingdao University from May 2010 to May 2012.These patients were randomly (random number) divided into two groups,the rehabilitation group and the control group,30 patients in each group.In rehabilitation group,rehabilitation therapy was taken twice daily,and the training time and intensity was adjusted according to the condition of the patients.Early rehabilitation therapy included head up actively,transfer from the supine to sit,out of bed,transfer to a chair,standing bedside bed and walking bedside bed.The patient' s body mass index,days to first out of bed,duration of mechanical ventilation,ICU stay,APACHE Ⅱ score,highest FiO2,lowest PaO2/FiO2 and hospital mortality of patients were compared between rehabilitation group and control group.The differences between the groups were compared using t test.Results There was no significant difference in body mass index,APACHE Ⅱ score,highest FiO2,lowest PaO2/FiO2 and hospital mortality between rehabilitation group and control group (P ＞ 0.05).Patients in the rehabilitation group had shorter first out of bed time [(3.8 ± 1.2) d vs.(14.9 ±4.7) d; P =0.00],duration of mechanical ventilation [(5.6±2.1) dvs.(12.7±4.1) d; P=0.005] andICUstay [(7.3±2.8) dvs.(15.2±4.5) d;P =0.01] compared with control group.Conclusions Early rehabilitation therapy was safe and effective in improving the outcomes of mechanical ventilation patient.

BACKGROUND: Ultrasound-medium frequency electrotherapy has better pain-relieving effect,whether it involves enkephalin and the like neurotransmitter is still not very clear, it is necessary to carry out qualitative and quantitative analysis of the pain response in rats received ultrasound-medium frequency electrotherapy.OBJECTIVE: To investigate the pain-relieving effect of ultrasound-medium frequency electrotherapy and its influence on the enkephalin content in rats, aiming to probe its underlying mechanism and relationship with neurotransmitter enkephalin.DESIGN: Randomly controlled study taking experimental animals as subjects.SETTING: Department of Physiotherapy, First Hospital Affiliated to China Medical University, Institute of Basic Medicine, Peking Union Medical CollegeMATERIALS: This experiment was carried out at the Institute of Basic Medicine, Peking Union Medical College between June 2002 and March 2003. Forty healthy male Wistar rats were adopted and randomized into four groups,namely methionine enkephalin detection experimental group and control group,as well as leucine enkephalin detection experimental group and control group with 10 rats in each group ,amongst which methionine enkephalin experimental group and leucine enkephalin experimental group were generally designed as experimental group ,with the other two group as control group.METHODS: ①Rats ín the experímental group were subjected to ultrasound-medium frequency electrotherapy with frequency of 0.8 MHz in manner of geminal pulse,the modulatìng frequency was 100 Hz and ultrasound intensity of 0.9 W/cm2;the carrier frequency of medium frequency electricity was 4 kHz with modulating frequency of 100 Hz in manner of continuous wave,the electric current of medium frequency was 2 mA and acting time of 10 min. rats in control group received the same dealing,but the higher voltage of ultrasound-medium frequency electrotheprauetic instrument was not used, thereby no energy output was available. tail flick test(TFr) was used to test rat algesthesia,and stopwatch was used to record the time for tail flick(s) that was taken as the value of pain threshold. ②The threshold of pain was tested at 10 minutes instantly after ultrasoundmedium frequency electric stimulation,and then pituitary (removing the posterior pituitary lobe) and hypothalamus were obtained to detect the content of methionine enkephalin and leucine enkephalin by using radioimmuno assay.MAIN OUTCOME MEASURES: The changes of the pain threshold after treatment,the content of methionine enkephalin and leucine enkephalin.RESULTS: Totally 40 rats were enrolled in the experiment and entered in the results analysis. ① The changing rate of pain threshold in two experimental group were 265.79% and 272.90% respectively,the difference was of no statistical significance (P ＞ 0.05). ②After ultrasoundmedium frequency electrotherapy,the content of methionine enkephalin and leucine enkephalin in pituitary and hypothalamus were obviously higher than before treatment [ The changing rate of methionine enkephalin and leucine enkephalin in adenohypophysis was 300.48 ±36.21)% and(204.61±68.65)% , respectively, compared to (239.80±59.98)%and(205.53±51.62)% in hypothalamus, P ＜ 0.05]. ③Linear regression analysis revealed that the variance of the pain threshold was positively correlated with the content of methionine enkephalin in adenohypophysis(r=0.91 ,P ＜ 0.01), suggesting the increment of methionine enkephalin in adenohypophysis was closely connected with the increment of pain threshold,and the level of methionine enkephalin in adenohypophysis would be higher than that in control group by 117.02% when the value of pain threshold increased by100%.CONCLUSION: One of the important mechanisms for the pain-relieving effect of ultrasound-medium frequency electrotherapy might be the increase of methionine enkephalin in adenohypophysis.

BACKGROUND: It is proposed that elevated serum homocysteine is an important independent risk factor for ischemic stroke (IS), and 5, 10-methylenetetrahydrofolate reductase (MTHFR) is the key enzyme for homocysteine metabolism. The relationship between genetic mutation of MTHFR and IS remains controversial.OBJECTIVE: To examine the association of hyperhomocysteinemia and two MTHFR gene polymorphisms with IS in Northwest Chinese population.DESIGN: Case-control study.SETTING: Department of Neurology, First Hospital Affiliated to Jilin University, and Department of Neurology, Xijing Hospital, Fourth Military Medical University of Chinese PLA.PARTICIPANTS: Ninety-seven consecutive patients with ischemic stroke (71 males and 26 females) treated between November 2001 and May 2002were recruited, who were diagnosed by CT scan or MRI in the Department of Neurology, Xijing Hospital, Fourth Military Medical University of Chinese PLA. The control group consisted of 94 subjects (58 males and 36 females) without history of ischemic stroke. All the subjects were free of intracranial hemorrhage, cancer, renal dysfunction, and none used multivitamins or estrogen.METHODS: Serum homocysteine was measured by fluorescence polarization immunoassay. Polymerase chain reaction-restriction length polymorphism (PCR-RFLP) method was employed to detect the genotype at the two sites of C677T and A1298C in MTHFR gene.MAIN OUTCOME MEASURES: Serum homocysteine levels and the genotypic frequency frequencies of the two mutations of MTHFR.RESULTS: The 677T allele frequency was 59.3% in IS patients and 44.7% in the controls, showing significant differences (P=0.006), but no difference in 1298C allele frequency was detected between the two groups (22.7% vs 19.7%, P ＞ 0.05). Homozygous 677TT genotype was closely associated with hyperhomocysteinemie (P ＜ 0.01). In multivariate logistic regression analysis,677T gene mutation and hyperhomocysteinemie were all associated with the IS, with an OR of 1.870 and 1.031 (P＜ 0.05), respectively.CONCLUSION: Hyperhomocysteinemie is a risk factor of IS, and C677T mutation significantly increases homocysteine levels, and serves also as an independent genetic risk factor of IS.

Objective To analyze the correlation between the expression of phosphoinositide-3 kinase,catalytic subunit beta (PIK3CB) and the clinicopathologic characteristics in gastric adenocarcinoma tissues.Methods Immunohistochemistry was used to determine PIK3CB expression in human gastric adenocarcinoma tissues and matched adjacent tissues.The correlation between PIK3CB expression and the patients' clinicopathological characteristics and prognosis was statistically analyzed.Results PIK3CB is highly expressed in gastric adenocarcinoma tissues (positive rate 63.8％) compared with matched adjacent tissues (positive rate 45.7％) (x2 =9.139,P =0.003).PIK3CB expression is significantly correlated with tumor size (x2 =8.677,P =0.003),infiltration (x2 =9.306,P =0.025),and clinical stage (x2 =8.242,P =0.041) ; Level of PIK3CB expression has a significant impact on prognosis (x2 =25.644,P =0.000).Multivariate analyses showed that high PIK3CB expression is an independent poor prognostic factor for overall survival (HR =15.785,95％ CI:1.943-7.805,P =0.000).Conclusions Upregulated PIK3CB is correlated with poor postoperative prognosis of gastric carcinoma.