In order to accurately capture the respiratory muscle movement and extract the synchronization signals corresponding to the breathing phases, a comprehensive signal sensing system for sensing the movement of the respiratory muscle was developed with applying the thin-film varistor FSR402 IMS-C07A in this paper. The system integrated a sensor, a signal processing circuit, and an application program to collect, amplify and denoise electronic signals. Based on the respiratory muscle movement sensor and a STM32F107 development board, an experimental platform was designed to conduct experiments. The respiratory muscle movement data and respiratory airflow data were collected from 3 healthy adults for comparative analysis. In this paper, the results demonstrated that the method for determining respiratory phase based on the sensing the respiratory muscle movement exhibited strong real-time performance. Compared to traditional airflow-based respiratory phase detection, the proposed method showed a lead times ranging from 33 to 210 ms [(88.3 ± 47.9) ms] for expiration switched into inspiration and 17 to 222 ms [(92.9 ± 63.8) ms] for inspiration switched into expiration, respectively. When this system is applied to trigger the output of the ventilator, it will effectively improve the patient-ventilator synchrony and facilitate the ventilation treatment for patients with respiratory diseases.
Humans ; Respiratory Muscles/physiology* ; Signal Processing, Computer-Assisted ; Movement/physiology* ; Respiration ; Monitoring, Physiologic/methods* ; Adult

Objective:To investigate the correlation between triglyceride-glucose (TyG) index and high on-treatment platelet reactivity (HTPR) during clopidogrel treatment in patients with ischemic stroke.Methods:Patients with ischemic stroke who received maintenance dose of clopidogrel (75 mg/d) in the Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine from January 2017 to March 2021 were retrospectively included. The highest quartile (Q4) of the TyG index was defined as insulin resistance. Platelet reactivity was assessed by thromboelastogram and clopidogrel HTPR was defined as the clot strength induced by adenosine diphosphate (MA ADP) >47 mm. Multivariate regression model was used to analyze the independent correlation between TyG index and platelet reactivity. Results:A total of 83 patients were included. The TyG index showed a linear correlation with MA ADP. The patients were divided into 4 groups according to the quartile of TyG index. The incidence of clopidogrel HTPR increased significantly with the increase of the quartile of the TyG index ( Ptrend=0.017). Multivariate analysis showed that there was a significant independent correlation between insulin resistance and clopidogrel HTPR (odds ratio 4.597, 95% confidence interval 1.285-16.446; P=0.019). Conclusions:In patients with ischemic stroke treated with clopidogrel, the incidence of clopidogrel HTPR gradually increases with the increase of the quartile of the TyG index. The insulin resistance assessed by the TyG index is independently associated with clopidogrel HTPR.

Stimulus-specific adaptation (SSA), defined as a decrease in responses to a common stimulus that only partially generalizes to other rare stimuli, is a widespread phenomenon in the brain that is believed to be related to novelty detection. Although cross-modal sensory processing is also a widespread phenomenon, the interaction between the two phenomena is not well understood. In this study, the thalamic reticular nucleus (TRN), which is regarded as a hub of the attentional system that contains multi-modal neurons, was investigated. The results showed that SSA existed in an interactive oddball stimulation, which mimics stimulation changes from one modality to another. In the bimodal integration, SSA to bimodal stimulation was stronger than to visual stimulation alone but similar to auditory stimulation alone, which indicated a limited integrative effect. Collectively, the present results provide evidence for independent cross-modal processing in bimodal TRN neurons.
Acoustic Stimulation ; Animals ; Auditory Perception/physiology* ; Geniculate Bodies ; Rats ; Rats, Wistar ; Thalamic Nuclei/physiology*

Lung transplantation is the only effective treatment of end-stage lung diseases. Nevertheless, shortage of donor lungs has become increasingly prominent worldwide. A large quantity of patients died while waiting for lung transplantation. Urgent lung transplantation is a prioritized allocation strategy for donor lung transplantation according to the urgency of diseases, aiming to shorten the waiting time for donor lungs and reduce the fatality of patients on the waiting list for lung transplantation. However, no consensus has been reached worldwide on the definition, criteria and application of the terminology of urgent lung transplantation. In addition, the survival and net benefits of lung transplant recipients based on this allocation system are still controversial. On the basis of previous clinical research on urgent lung transplantation, the definition criteria, risk factors, survival outcomes, limitations and optimization measures were explicitly elucidated in this article, aiming to provide theoretical reference for comprehensive evaluation of the feasibility of urgent lung transplantation and further optimizing the allocation system of donor lungs.

Essential palatal tremor is relatively rare in clinical practice, which manifests involuntary and rhythmic contraction of soft-palate along with auditory click. The cause is unknown and there is no specific treatment at present. This article reports a female patient with essential palatine tremor, who presented with involuntarily beating of soft palate, disappeared during sleep, had sensory tricks, and gradually developed mental and psychological problems such as anxiety disorders. After treatment with integrated traditional Chinese and Western medicine, the symptoms improved. The clinical features of the case were analyzed, relevant literature was reviewed, and the possible etiology and characteristics of the disease were explored, so as to provide reference for clinical diagnosis and treatment.

OBJECTIVETo investigate the role of miR-144-3p in regulating osteogenic differentiation of bone marrow mesenchymal stem cells and predict its target genes.

METHODSRat bone marrow mesenchymal stem cells (BMSCs) with induced osteogenic differentiation were examined for the expressions of Runx2, OCN and miR-144-3p. The effects of transfection with a miR-144-3p mimic or a miR-144-3p inhibitor were tested on the osteogenic differentiation of the BMSCs. The changes in the expressions of the predicted target of miR-144-3p in the BMSCs during induced osteogenic differentiation were examined using Western blotting and qRT-PCR.

RESULTSRat BMSCs with induced differentiation into osteoblasts exhibited a progressive increase in the expressions of Runx2 and OCN (two markers of osteogenic differentiation), while the expression of miR-144-3p gradually decreased during the differentiation till reaching the lowest level at 21 days of induction. In rat BMSCs, transfection with the miR-144-3p mimic significantly decreased ALP activity ( < 0.05) wile transfection with the miR-144-3p inhibitor significantly increased ALP activity ( < 0.05) in rat BMSCs. Analysis based on miRanda, microRNA.org database and TargetScan suggested that Smad4 was the most likely target gene of miR-144-3p. The results of qRT-PCR showed no significant differences in expression levels of Smad4 among the cells with different treatments ( > 0.05), while Western blotting revealed a significantly decreased expression of Smad4 in the cells transfected with miR-144-3p mimics and an increased Smad4 expression in the cells transfected with the miR-144-3p inhibitor as compared with the control cells ( < 0.05).

CONCLUSIONSmiR-144-3p participates in the regulation of osteogenic differentiation of rat BMSCs, and its inhibitory effect on osteogenic differentiation is achieved probably by decreasing the expression level of Smad4.

OBJECTIVETo explore the factors affecting the operative difficulty of triple-port laparoscopic surgery (TLS) in anterior resection.

METHODSA retrospective case-control study was carried out. Clinical and MRI imaging data of 106 colorectal cancer cases undergoing TLS anterior resection at Department of Colorectal Surgery of Ruijin Hospital between 2013 and 2016 were retrospectively analyzed.

INCLUSION CRITERIA(1) patients receiving TLS anterior resection (Dixon operation); (2) preoperative stageI( to III( malignant tumor;(3) distance of 5-15 cm from inferior margin of tumor to anal verge; and (4) available preoperative rectal MRI.

EXCLUSION CRITERIA(1) patients receiving preoperative adjuvant therapy; (2) patients with low rectal cancer or with local advanced disease; (3) T4b tumor. Rectal MRI was introduced to measure the structure of pelvis. In sagittal view, superior margin of the first sacral vertebrae, superior margin of the third sacral vertebrae, apex of coccyx, and the line of superior margin of pubic symphysis were used to form a pentagon. The 5 lines were marked as N, O, P, Q, R, and the 5 included angles were marked as angle 1, 2, 3, 4, 5. Organs (uterus and prostate) and tumor (transverse diameter, longitudinal diameter, section area, lesion length, distance to circumference cutting edge) were also measured on MRI. The operative time was applied to be the indicator of operative difficulty and patients were divided into 2 groups according to median operative time. Baseline information (age, gender, BMI, distance from inferior margin of tumor to anal verge, operative history, length of tumor), preoperative tumor staging, and MRI measurements (pelvis, tumor, uterus, prostate), etc were compared between two groups. Factors affecting operative difficulty of TLS were analyzed with logistic regression model.

RESULTSOf 106 enrolled patients, 73 were male and 33 female with mean age of (59.8±12.2) years and mean BMI of (22.8±3.3) kg/m; 25 patients had previous abdominal surgery; distance from inferior margin of tumor to anal verge was (7.4±2.0) cm and the tumor diameter was (3.7±1.4) cm; 24, 36 and 46 patients were in stage I(, II( and III( respectively. All operations were completed successfully. The median number of harvested lymph node was 13(11-16); the median length of distal resection margin was 2.5(2.0-3.1) cm; the median operative time was 2.0(1.5-2.6) hours; the median intraoperative blood loss was 50(0-100) ml; the median time to liquid diet was 4(3-5) days; the median hospital stay was 7(6-10) days. Ten cases (9.4%) developed complications within 30 days after surgery. Patients were divided into ≤2 h group and > 2 h group according to median operative time, and both groups had 53 patients. As compared to ≤2 h group, >2 h group had shorter distance from inferior margin of tumor to anal verge [(6.8 ± 1.5) cm vs. (8.0 ± 2.4) cm, t = 3.174, P = 0.004], lower ratio of (R+N)/(O+P)(1.61±0.27 vs. 1.73±0.19, t = 2.494, P = 0.014), larger transverse distance of tumor [(3.45±0.72) cm vs. (3.05±0.89) cm, t = 0.224, P = 0.027]. Multivariate logistic regression analysis showed the distance from inferior margin of tumor to anal verge was the independent factor affecting operative difficulty(OR=0.584, 95%CI:0.429-0.796, P = 0.001).

CONCLUSIONSSurgeons may have less difficulty in performing TLS anterior resection for patients with longer distance from inferior margin of tumor to anal verge. In preoperative assessment of operative difficulty of TLS, comprehensive evaluation should be performed. Distance from inferior margin of tumor to anal verge should be regarded as the main factor, and MRI (R+N)/(O+P) and transverse diameter of tumor should be used as important reference, leading to reasonable choice of cases for TLS and smooth pass of study curve.

Aged ; Anal Canal ; Case-Control Studies ; Female ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Rectal Neoplasms ; diagnostic imaging ; surgery ; Retrospective Studies ; Treatment Outcome

In view of the situation such as the serious shortage of anatomical teachers in medical colleges and universities,irrational personnel structure,anatomical teachers' single knowledge and weak scientific research ability,etc.,we analyzed the national policy,social impact,school leadership,personal career planning and other aspects of the problem and put forward some countermeasures to improve the treatment,improve the environment and train talents,which provided reference for the development of the discipline of anatomy,the construction of teaching staff and the reform of the basic medical education.

OBJECTIVETo explore the radicality, safety, feasibility and indication of right colectomy by laparoscopy-assisted surgery using three ports.

METHODSClinical data of 109 patients undergoing laparoscopy-assisted right colectomy in the Ruijin Hospital from 2013 to 2014 were retrospectively reviewed. Patients were divided into triple-port group(n=65, 3 ports) and traditional group(n=44, 4 or 5 ports). In the triple-port group, 21 cases were converted, including 14 cases added an additional port, 4 cases added 2 ports and 3 cases converted to laparotomy. The radicality, safety and feasibility were compared between the two groups. Difficulty of the triple-port procedure was summarized and the indication was concluded.

RESULTSNo significant differences were observed in specimen length, number of harvested lymph node, CME rate, time to resume fluids, postoperative hospital stay, morbidity of complication, reoperation rate, operation time, blood loss and incidental bowel damage between the two groups (all P>0.05). Among triple-port group, body mass index(BMI) and history of previous surgery were significantly different between those succeed and failed in the procedure [(22.4±2.9) kg/m(2) vs. (25.4±3.8) kg/m(2), P=0.001; 22.7%(10/44) vs. 47.6%(10/21), P=0.017], while other factors were not significantly different(all P>0.05).

CONCLUSIONSFor right-colectomy, triple-port and traditional laparoscopic procedures are comparable in terms of oncologic clearance, safety and feasibility. In selection of suitable patients for the triple-port procedure, BMI and history of previeus surgery should be considered.

Body Mass Index ; Colectomy ; methods ; Feasibility Studies ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Operative Time ; Reoperation ; Retrospective Studies

OBJECTIVETo investigate the effect of chloroquine in reversing multidrug resistance (MDR) of HNE1/DDP cell line and explore the mechanism.

METHODSMTT assay was used to detect the cell viability of HNE1 and HNE1/DDP after exposure to different concentrations of DDP (2, 4, 8, 16 and 32 µmol/L) and different concentrations of chloroquine (5, 10, 20, 40, and 80 µmol/L). q-PCR was used to assess the expression of MDR1 mRNA and Western blotting was employed to detect P-glycoprotein (P-gp) expression in HNE1 and HNE1/DDP cells exposed to 5 and 10 µmol/L chloroquine. The cell apoptosis rate of HNE1 and HNE1/DDP cells exposed to 10 and 20 µmol

RESULTSChloroquine exposure caused dose-dependent suppression of the proliferation in both HNE1 and HNE1

CONCLUSIONChloroquine can reverse multidrug resistance in HNE1
ATP-Binding Cassette, Sub-Family B, Member 1 ; metabolism ; Antineoplastic Agents ; pharmacology ; Apoptosis ; Cell Line, Tumor ; Chloroquine ; pharmacology ; Down-Regulation ; Drug Resistance, Multiple ; drug effects ; Drug Resistance, Neoplasm ; drug effects ; Humans