The attention is often paid toknowledge processing procedure including knowledge acquisition,knowledge expression and knowledge utilization when expert system is studied and designed.The knowledge expression is the most basic topic among them.Knowledge expression system and its application tomedical diagnosis computer-aided system are discussed in this paper.

Objective To investigate the therapeutic effect of laparoscopic radical resection of rectal carcinoma via natural orificespecimen extraction(NOSE). Methods Laparoscopic resection of rec-tal carcinoma was performed using NOSE technique in 35 cases of rectal cancer from October 2013 to 2015 July. Analysis of clinical data,postoperative exhaust time,the number of resected lymph node,and anastomotic leakage rate was conducted. Results All 35 cases underwent laparoscopic radical resection of rectal cancer with successful anus preservation. There were no preventive transverse colostomy. Among them,the success rate of laparoscopic radical resection via NOSE for rectal cancer was 85. 71%(30 /35). The operation duration ranged from 105 to 186 min(mean 129. 50 min). Anal exhaust time was 22 to 80 h(average 38. 13 h). Postoperative hospital stay lasted for 9 ~ 21 days(mean 10. 27 d). Anas-tomotic leakage occurred in 1 case and puncture infection in 2 cases. Conclusion Laparoscopic radical resec-tion of rectal carcinoma in middle and low rectal cancer is safe and reliable,which is worthy of being spread.

950 mg/d) group was significantly higher than those in median or low calcium intake group,among girls with BB genotype. However,such significant effect was not detected among girls with b allele. Conclusion:The PTH BstBⅠ polymorphism has significant interaction effect with calcium intake on bone mass accretion in Chinese adolescent girls. High calcium intake would be beneficial to gain higher bone mass accretion for girls with BB genotype than those with b allele.

Objective To evaluate the clinical efficacy of transcatheter renal sympathetic denervation(RDN)in the treatment of resistant hypertension.Methods Clinical data of 10 patients with resistant hypertension treated by transcatheter renal sympa-thetic denervation were retrospectively analyzed.The blood pressure and complications were analyzed.Results In all of the 10 pa-tients,systolic and diastolic blood pressure decreased significantly after two weeks compared with preoperative,and further de-creased after 3 months (P <0.05 ).There were no statistical difference of systolic and diastolic blood pressure between 3 and 6 months(P >0.05).Before the RDN,the mean number of antihypertensive drugs was 5.3±0.9.After 6 months which was 3.2±0. 6,and which was decreased significantly compared with the preoperative (P <0.05).No adverse reactions were found.Conclusion The RDN can be quickly and sustained decrease the blood pressure in patients with resistant hypertension.

Objective To clone the full length staphylococcal protein A(SPA) gene from Staphylococcus aureus (ATCC6538), and subsequently study the gene structure and antibody binding ability.Methods The full length and the functional region of the SPA gene were cloned into pHisSUMO vector respectively, and expressed in E. coli. The full length and the functional fragment of the SPA protein were detected for antibody binding ability and stability. The functional fragment of the SPA protein fused with SUMO was coupled to the CNBr-activated agarose for antibody purification from rabbit serum. Results A variant of the full length SPA gene was cloned, which has been submitted to GenBank (the accession number is EU695225). Two fusion proteins had the same antibody binding ability as the untagged SPA protein. However, the formers was more stable than the latter at the tested conditions. SUMO-SPA conjugated-agarose kept high efficiency for antibody binding. Conclusion To our knowledge, the full length SPA gene of S.aureus(ATCC6538) is a novel variant. The SUMO tag can improve the stability of the functional region of the SPA protein without damaging the antibody binding ability. This fusion protein has been used for antibody purification successfully.

Insulin is the most common medicine used for diabetic patients, unfortunately, its effective time is short, even the long-acting insulin cannot obtain a satisfactory effect. Fibroblast growth factor (FGF)-21 is a recently discovered glucose mediator and expected to be a potential anti-diabetic drug that does not rely on insulin. In this study, db/db mice were used as the type 2 diabetic model to examine whether mFGF-21 has the long-term blood lowering effect on the animal model. The results showed that mFGF-21 could stably maintain the blood glucose at normal level for a long-term in a dose-dependent manner. Administration of mFGF-21 once a day with three doses (0.125, 0.25 and 0.5 mg x kg(-1)) could maintain blood glucose of the model animals at normal level for at least 24 h. Administration of mFGF-21 every two days with the same doses could maintain blood glucose of the model animals at normal level for at least 48 h, although it took longer time for blood glucose to reach to normal level depending on doses used (twenty injections for 0.125 mg x kg(-1) and 0.25 mg x kg(-1) doses, ten injections for 0.5 mg x kg(-1) dose). Surprisingly, the blood glucose of the treated model animals still maintained at normal level for 24 h after the experiment terminated. Glycosylated hemoglobin level of the animals treated with mFGF-21, which represented long-term glucose status, decreased significantly compared to the control group and the insulin group. The results suggest that FGF-21 has potential to become a long-acting and potent anti-diabetic drug.

Objective To assess the effects of septal anterior ventricular exclusion(SAVE)procedure on left ventricular(LV)shape,volume and function in patients with post-infarction LV anterior aneurysm by intraoperative transesophageal echocardiography(TEE).Methods Twenty patients with LV anterior aneurysm underwent surgical ventrieular restoration(SVR)with the SAVE procedure.Intraoperative TEE was performed before cardiopulmonary bypass(CPB)and after weaning from CPB.LV volume and ejection fraction(EF)was measured using the biplane Simpson's method.LV end-diastolic and end-systolic volumes,indexed by body surface area(EDVI and ESVI,respectively)were calculated.To estimate the shape of LV,end-diastolic sphericity index(SI)of LV was determined.Results Compared with pre- CPB,after SVR,LV shape became more elliptical:SI increased from 0.76±0.04 to 0.84±0.05,P＜0.001.LV size became more normal:EDVI decreased from(121.51±16.91)ml/m2 to(60.27±9.93)ml/m2,P＜0.001,and ESVI decreased from(85.81±15.02)ml/m2 to (32.44±5.36)ml/m2,P＜0.001,respectively.EF was increased significantly:(46.02±3.90)% vs(29.52±6.0)%,P＜0.001.Conclusions The SAVE technique is easy to reshape LV to ellipsoid fogln and normal size and the resultant improved configuration may contribute to improving EF for patients with post-infarction LV anterior aneurysm.

Objective:To investigate the effect of the possibility of sleep-disordered breathing (SDB) as assessed by the four-variable score on the platelet function and the risk of stroke recurrence in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke admitted to the Department of Neurology, Weihai Municipal Hospital from January 2020 to January 2021 were enrolled prospectively. Main inclusion criteria: admission within 24 h of onset; National Institutes of Health Stroke Scale score ≤3; Receiving aspirin + clopidogrel dual antiplatelet therapy. All patients were divided into a high possibility group and a low possibility group of SDB according to the four-variable score. 7±2 d after dual antiplatelet therapy, PL-12 multi-parameter platelet function analyzer was used to detect the maximum aggregation rate (MAR). The patients were followed up for 6 months after discharge and the recurrence of ischemic stroke was observed. The mediating effect model was established with the high possibility of SDB as the independent variable, MAR as the intermediary variable and stroke recurrence as the dependent variable. Firstly, MAR as the dependent variable and high probability of SDB as the independent variable were analyzed by linear regression; then, a binary logistic regression analysis was performed with ischemic stroke recurrence as the dependent variable and the high probability of SDB and MAR as independent variables. Results:A total of 213 patients were enrolled in the study. The average age of the patients was 62.70 ± 10.04 years old. There were 146 male (68.5%) and 121 patients (56.8%) were in the high possibility group (56.8%). During the follow-up period, 24 patients (11.3%) had stroke recurrence. Univariate analysis showed that arachidonic acid (AA) induced MAR (MAR-AA) and adenosine diphosphate (ADP) induced the MAR (MAR-ADP) in the high possibility group of SDB were significantly higher than those in the low possibility group (all P<0.05); MAR-AA and MAR-ADP in the recurrent group were significantly higher than those in the non-recurrent group (all P<0.05), and the proportion of high possibility of SDB in the recurrent group was significantly higher ( P=0.008). Binary logistic regression analysis showed that homocysteine (odds ratio 1.132, 95% confidence interval 1.048-1.223; P=0.002) and having high possibility of SDB (odds ratio 6.351, 95% confidence interval 1.134-35.566; P=0.035) were the independent risk factors for stroke recurrence in patients treated with dual antiplatelet therapy. Intermediary effect analysis showed that MAR had a significant intermediary effect on the risk of stroke recurrence in patients with high probability of SDB. Conclusion:The MAR and stroke recurrence rates in the high possibility group of SDB were significantly higher than those in the low possibility group, and its stroke risk was probably mediated by platelet hyperreactivity.

Objective To compare the dissolution of Chuangxiong powder in different medium and discuss the dissolution characteristics in vitro of Changxiong powder. Methods The paddle method was adopted, the UV spectrophotometric method was developed to determine the in vitro dissolution quantity of Changxiong powder in five medium (water, 0.1 mol/L hydrochloric acid, acetate buffer of pH 4.5, phosphate buffer of pH 6.8, phosphate buffer of pH 7.4) with ferulic acid as index, and evaluated by drawing the dissolution curve and using the similar factor method and Weibull model. Results The dissolution quantity of Changxiong oral powder in five medium was different. The dissolution quantity in water, 0.1 mol/L hydrochloric acid, acetate buffer of pH 4.5 and phosphate buffer of pH 6.8 was similar and fit Weibull model, but it mutated in phosphate buffer of pH 7.4 and reached the maximum amount at 30 min. Conclusion The dissolution quantity of Changxiong powder is gradually increasing and the time is shorted in the medium from acidic to neutral then to alkaline. Dissolution curve is similar in the acidic and neutral medium. Changxiong powder dissolves out fast and completely in the alkaline medium.