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BACKGROUND:In some clinical applications or special work conditions,extremely intonse 50 Hz AC intefference exists.As the amplifier's output reaches or is close to saturation,it cannot be suppressed by general anti-interference circuits or software algorithms.Themfore,the hardware circuit must be impreved to suppress this interference,thus obtajning the desired signals.OBJECTIVE:To introduce a biopotential amplifier,which can effectively suppress the impact of 50 Hz AC interference on the weak biomedical signals.DESIGN:Create a circuit model based on the advanced theoretical analysis,then make software emulation and finally design the actual circuit implementation.SETTINGS:the 305 Hospital of Chinese PLA:Institute of Aviation Medicine,Air Force of CIIinese PLA.MATERIALS:The experimentaIinstruments and analytical software were provided by the Institute of Aviation Medicine,Air Force of Chinese PLA:the high-voltage electrical field environment was provided by the 305 Hospital of Chinese PLA.METHODS:The first step was theoretical analysis at the Institute of Aviation Medicine,Air Force of Chinese PLA in 2005,then the 50 Hz anti-reference model was created.After that,the following three anti-reference measures were put forward:①Enhancing the common-mode input impedance of the overall circuit to remove the interference caused by the imbalance electrode impedance;②reducing the equivalent common mode input impedance of the instrument amplifier in the circuit by using a current source controlled by the comlnou mode voltage;③using the driven-right-leg circuit to reduce the common mode voltage.Moreover,emulation analysis was made for the above circuit model by using the circuit emulation software TINA PRO.Through ceaseless improvement of the circuit model,the correct emulation results were obtained.In 2006,the Circuit model helped us realize the electrocardiogram(ECG)amplifier that could suppress the 50 Hz AC intefference effectively in intense interference environments.And that amplifier was put into practical use in the high-voltage electrical field environment produced by the high-voltage electrical field treatment equipment in the 305 Hospital of PLA.The result was satisfying:the 50 Hz AC interference was suppressed effectively and the high-quality ECG signals were obtained.MlAIN OUTCOME MEASURES:Common-Mode Rejection Ratio(CMRR)and the frequency spectrum of signals obtained in intense intefference environment,which are used to assess the ability against the 50 Hz AC interference.RESULTS:A 100 ù resistor or a 200 kù resistor were connected in series in the input loop so as to produce the imbalance electrode impedance status.When the imbalalice electrode impedance was 100 ù,the amplifier output was 1.69 Mv,and CMRR was 125.8 Db.When the imbalance electrode impedance was 200 k ù,the amplifier output was 1.78 Mv,and CMRR was 125.3 Db.Two voltage sources(20 Hz,amplitude of peak to peak value 50 ì V,opposite phases)were used to produce differential mode signals.The amplification gain was 1000 times.In the input loop of the circtilt mentioned above,a 200 kù resistor was connected in series to create the inabalance electrode impedance status.The amplifter output the peak-to-peak value 50 Mv.The fast Fourier transform(FFT)frequency spectrum of the output wave contained no 50 Hz spectrum line.CONCLUSION:Through the emulation experiment and the real application.we can all find that the amplifier has good signal amplification performance and anti-interference capabillty in intensive 50 Hz AC interference environments and severe imbalance electrode impedance Status.

The receptor for advanced glycation end product (RAGE) is a member of the immunoglobulin superfamily of cell surface molecules.As a pattern recognition receptor,it can bind with a variety of ligands.The adult lung is unique in which it expresses high amounts of RAGE under normal conditions while other tissues express low amounts normally and up-regulate RAGE during pathologic processes.The lung exhibits high basal level expression of RAGE localised mainly in alveolar type I cells,suggesting a potentially important role for the receptor in epithelial cell proliferation and differentiation and maintaining lung homeostasis.Indeed,disruption of RAGE levels has been implicated in the pathogenesis of a variety of pulmonary disorders such as acute and chronic lung injury.Furthermore,its soluble form sRAGE,as a decoy receptor,has been shown as an important marker of alveolar epithelial type I cell injury.Studies have suggested that RAGE plays an important role in the biology of the lung and may become a therapeutic target for lung injury.

Objective To investigate the clinical value of low molecular weight heparin (LMWH) as prophylaxis against venous thromboembolism after rectal cancer surgery.Methods The clinical data of 120 patients who received rectal cancer surgery at the Tianjin People's Hospital from October 2008 to October 2010 were retrospectively analyzed.All patients were divided into the test group (50 patients) and the control group (70 patients).Patients in the test group received subcutaneous injection of 0.4 ml of LMWH (4100 U) at 8-12 hours after operation,and then once a day thereafter until mobilization.LMWH was not given to patients in the control group.Patients in the 2 groups who experienced venous thromboembolism (VTE) and postoperative bleeding were recorded and compared.The clinical data of patients with VTE were proceeded with risk factors analysis.All data were analyzed using the t test,chi-square test or by calculating Fisher exact probability.All factors influencing VTE formation were analyzed using Logistic regression analysis.Results The incidences of VTE in the test group and the control group were 2.0％ (1/50) and 14.3％ (10/70),respectively,with a significant difference between the 2 groups (x2=3.915,P ＜ 0.05).The incidences of postoperative blood loss in the test group and the control group were 6.0％ (3/50) and 2.9％ (2/70),respectively,with no significant difference between the 2 groups (x2=0.149,P ＞ 0.05).Varicose veins of lower limbs,previous cardiopulmonary diseases,obesity and age ＞ 65 years were the independent risk factors of VTE (OR =2.3,2.5,1.4,2.1,P ＜0.05).The number of patients with VTE increased as the increase of the risk factors.Conclusion Early injection of LMWH after rectal cancer surgery is safe and effective in preventing VTE.

Objective:To provide reference for clinical pharmacists' participation in treatment of drug-induced autoimmune hypo-glycemia. Methods:Clinical pharmacists participated in drug treatment of a case of insulin aspart-induced autoimmune hypoglycemia, analyzed treatment and provided suggestion and pharmaceutical care. Results:Clinical pharmacists' suggestion was accepted and the patient was cured and discharged from the hospital. Conclusion: Clinical pharmacists' participation could help doctors to make safe and effective medication, provide good pharmaceutical care and medication education for patients.

Objective To investigate the effieacy and safety of intravenous itraconazole for the treatment of invasive fungal infection(IFI)in patients with hematological disease or undergoing allogeneic hematopoietic stem cell transplantation(HSCT).MethodsSix hundred and sixty-six patients with above mentioned conditions and diagnosed as IFI from January.2007 to July,2007 were enrolled.Intravenous itraconazole was administered at a dose of200 nag every 12 hours for 2 days and followed by 200 mg every 24 hours.Patients were then switched to oral itraconazole according to the clinical situation Responses were determined on the basis of clinical and microbiological criteria.Results The probability of defervescence Was 69.8%and the total response rates among related to itraconazole were the proven.probable and possible IFI patients were 73.7%.68.1%and 68.2%(P=0.380).Adverse effects were found in 58 patients (8.7%).which were mainly mild to medium reversible dysfunction of liver and gastrointestinal tract, Conclusion Itraconazole is an effective and safe antifungal agent for patients with hematological disease or undergoing HSCT and is suitable for empirical antifungal therapy.

A pepsin modified poly (glycidyl methacrylate-ethyleneglycol dimethacrylate)(poly (GMA-EDMA)) capillary monolith (32 cm ×75 μm,22cm effective lenth)was applied in exploring the interaction between nefo-pam enantiomers and bovine serum albumin (BSA),mode of frontal analysis was selected to measure the binding constant,number of binding sites and the location of binding sites of BSA to both nefopam enantiomers.The opti-mal CEC conditions obtained were a running buffer consisted of 15 mmol /L ammonium acetate at pH 5.5,separa-tion voltage 5.0 kV,detection wavelength 215 nm,injection 10 kV ×6 s,solvent of samples consisted of 50 mmol/L ammonium acetate at pH 7.4.The results indicated that the monolith could provide a satisfactory resolution between the two enantiomers plateaus,BSA in the binding system didn′t disturb the separation or determination of nefopam enantiomers in electrochromatography.The frontal analysis demonstrated that BSA has only one binding site with both enantiomers,the binding constants (K)were 443 L/mol and 527 L/mol,respectively,and the dis-placement experiments indicated that binding site of both isomers to BSA molecule was the Sudlow siteⅡ.

Objective To improve the traditional treatment of retrograde pulpitis, using Periocline adjuvant therapy, to evaluate its clinical effect.Methods From January 2015 to 2017 in January, our hospital 70 patients treated with retrograde pulpitis.The patients were randomly divided into two groups.The observation group of 35 cases, adopt the traditional treatment methods (periodontal treatment and dental pulp treatment), 35 cases in the control group based on conventional therapy, the adjuvant treatment of periocline.The related indexes and treatment effects were observed.Results After treatment, the indexes of the two groups of patients were significantly decreased compared with the control group[(1.57±0.50),(3.37±1.88),(4.89±1.60),(5.31±1.39)],the observation group decreased much more[(0.79±0.24),(2.01±1.14),(4.01±1.38),(4.11±0.62)], the difference was significant (P<0.05).At the same time, the effective rate of the observation group was 94.29% (33 cases), and the effective rate of the control group was 74.29% (26 cases), the difference was significant (P<0.05).Conclusion Based on conventional therapy, using Periocline adjuvant therapy, can improve the therapeutic effect of retrograde pulpitis, has significant value of application and promotion.

Objective To investigate the effects of minocycline hydrochloride ointment on collagenase in gingival crevicular fluid.Methods 60 patients with chronic periodontitis treated in our hospital from January 2015 to December 2016 were selected as the research object, the patients were divided into two groups according to their intervention methods, 30 cases in each group.The control group was treated with ultrasound clean governance and iodine glycerol, the observation group was treated with ultrasound clean governance and minocycline hydrochloride ointment The experimental data of the two groups were compared.Results The index change of gingival crevicular fluid volume plaque index,,depth of exploration and clinical attachment loss in the observation group were better than those in the control group, the difference between the two groups was statistically significant (P<0.05);The clinical therapeutic effect of the observation group(93.3%)was better than that of the control group(73.3%), and the difference between the two groups was statistically significant (P<0.05).The incidence of adverse reactions in the observed group(10.0%)was lower than that in the control group(26.7%), and the difference between the two groups was statistically significant (P<0.05).Conclusion Minocycline hydrochloride ointment can affect the level of collagenase in gingival crevicular fluid, and the clinical effect of the treatment of chronic periodontal disease is significant.

Objective To study the effect of minocycline hydrochloride ointment and ibuprofen on serum concentration of chronic periodontitis . Methods 86 patients with chronic periodontitis treated in our hospital from June 2014 to June 2016 were selected and randomly divided into two groups:observation group 43 cases, using minocycline hydrochloride ointment combined with ibuprofen treatment , the control group 43 cases, only the use of minocycline hydrochloride ointment for treatment.After treatment, the clinical efficacy of the two groups were observed, the level of plaque, the level of attachment, the level of gingival sulcus bleeding and the probing depth of periodontal pocket were recorded, the levels of IL-10, TNF-α, hs-CRP and IL-8 in serum and the incidence of adverse reactions were measured.Results The total effective rate was 90.7% in the observation group and 74.4%in the control group, which was significantly higher than that in the control group, the difference was statistically significant (P<0.05).The probing depth of the periodontal pocket, gingival sulcus bleeding index, attachment level and plaque index decreased to varying degrees in the two groups before and after treatment, the difference was statistically significant (P<0.05), patients in the observation group were significantly lower than those in the control group, the difference was statistically significant (P<0.05).After treatment, the levels of IL-8, hs-CRP and TNF-αin serum of the two groups decreased, IL-10 levels increased in different degrees, the difference was statistically significant (P<0.05).The observation group was better than the control group, the difference was statistically significant ( P<0.05 ) .Conclusion Minocycline hydrochloride ointment combined with ibuprofen has a good effect on patients with chronic periodontitis.It can effectively relieve the patient's condition and improve the serum concentration of patients.