BACKGROUND: Flash visual evoked potential(fVEP) can reflect the integrity of visual pathway from retina to pulvinar cortex. The utilization of its characters can accurately evaluate the injury situation of visual conduction pathway.OBJECTIVE: To investigate the feasibility and effects of fVEP on non-traumatic monitoring of intracranial pressure.DESIGN: A repeated measurement design based on patients.PARTICIPANTS: Totally 197 patients with brain injury including 138males and 59 females with an average of(38 ±9) years old were selected from the First Affiliated Hospital of Chongqing Medical University and Xuanwu Hospital Affiliated to Capital University of Medical Sciences. The selected diseases were: epidural hematoma( n=20),subdural hematoma(n = 26),cerebral contusion( n = 4),subdural hematoma companied with cerebral contusion( n = 92),and cerebral contusion companied with intracerebral hematoma( n = 55).METHODS: The level of intracranial pressure of 197 patients with brain trauma was detected with fVEP and epidural manometry. Data of traumatic surveillance were collected after the completion of fVEP. Changes of blood pressure and heart rate in patients were recorded simultaneously.MAIN OUTCOME MEASURES: fVEP results,and levels of intracranial pressure.RESULTS: The average intracranial pressure of 197 patients with brain trauma was(2.75 ± 0.64) kPa,( 1.54 - 4. 02 kPa) . The dispersion of both traumatic and non-traumatic surveillance was relatively big in patients with confirmed visual pathway injury. No typical wave was induced by fVEP in2.79% of patients. Scatter diagram suggested that the consistence between fVEP and epidural manometry was relatively good. Linear regression analysis showed that heart rate was the most sensitive one to the fluctuation of intracranial pressure (β = -0. 369) followed by systolic pressure (β= 0. 316),while diastolic pressure was not so sensitive (β = 0. 147). There was negative correlation between heart rate and intracranial pressure,which could quite sensitively reflect the fluctuation of intracranial pressure,systolic pressure was the next,and diastolic pressure was not easily to be affected by the changes of intracranial pressure.CONCLUSION: Non-traumatic surveillance,fVEP,has favorable consistence with traumatic detection,which can quantitatively evaluate the changes of intracranial pressure non-traumatically.

Objective To study the inner diameter and hemodynamics of ophthalmic artery(OA)and central retinal artery(CRA)in hyperuricemia by Enhance-flow(eFlow)imaging and spectral Doppler.Methods One hundred and one patients with hyperuricemia and 30 volunteers were selected,the inner diameter in eFlow imaging and the peak systolic velocities(PSV),the end diastolic velocities(EDV),the resistive index(RI)were measured,and pulsatility index(PI)of OA and CRA were measured by spectral Doppler.The 101 patients were divided into two groups according to the time of diagnosing hyperuricemia,one group had a diagnosis of hyperuricemia for more than five years and the other had such a diagnosis for less than five years.The data were compared by t-test.Then,the patients were further divided into a group of hyperuricemia combined with hypertension and the other without hypertension.The differences between the experimental group and the group of volunteers were carried out by One-way ANOVA,the comparison between two groups were analyzed with SNK.Results The RI(0.68±0.09)and PI(1.3±0.4)of OA in patients who were diagnosed as hyperuricemia for more than 5 years was higher[RI:0.63±0.09,PI:1.1±0.3(t=3.504,P=0.001 ;t=3.164,P=0.002)],the EDV[(6±3)cm/s]of OA was lower than those patients with a diagnosis of hyperuricemia for less than 5 years[(8±5)cm/s,t=1.988,P=0.049].The PSV[(11.5±3.5)cm/s]and EDV[(3.7±1.1)cm/s]of CRA in hyperuricemia combination hypertension group was lower,and the RI (0.88±1.40)was higher than hyperuricemia without hypertension group[PSV:(13.5±4.0)cm/s,EDV:(4.1±1.2)cm/s,RI:0.67±0.08].Conclusion By eFlow and spectral Doppler,we have found that hyperu-ricemia could accelerate OA and CRA atherosclerosis.The eFlow and spectral Doppler are valuable methods to study the hemodynamics in ophthalmic artery of patients with hyperuricemia.

OBJECTIVE:To establish a method for determination of trace platinum in zolpidem tartrate. METHODS:Graphite furnace atomic absorption spectrometry(GFAAS)was adopted for direct determination after dissolving sample in 1% Hydrochloric acid solution. Horizontal platform graphite tube was performed with detection wavelength of 244.79 nm,slit width of 0.2 nm and current intensity of hollow cathode lamp of 6 mA. The mode of background correction was zeeman effect,the peak height was used as measurement pattern,and the injection volume was 20 μl. RESULTS:The linear range of platinum was 0-100 ng/ml(r=0.999 0);RSDs of precision and reproducibility tests were no more than 2.0%;recovery was 97.78%-103.07%(RSD=1.6%,n=9);the detection limit was 1.48 ng/ml. CONCLUSIONS:This method is simple and rapid with good precision and accuracy,and can be applied for the determination of trace platinum in zolpidem tartrate.

This study designed an audio signal acquisition system to achieve real-time detection of R peak for heart rate variability (HRV) analysis, substituting ECG-specific data acquisition board with sound card. It is proved that the R peak with low frequency can be gathered by sound card. The comparison with PowerLab signal acquisition system has shown that the acquisition system of R peak could accurately detect the R peak. The R peak detected by sound card and PowerLab signal acquisition system completely overlap each other, while RR intervals has no difference. The HRV analysis was accurate and reliable with the RR interval from sound card. This low cost, high performance, strong compatibility and easy upgraded acquisition system of R peak compared with the traditional data acquisition board has the value of practical uses and might have broad applications in the future.
Algorithms ; Electrocardiography ; methods ; Heart Rate ; physiology ; Humans ; Monitoring, Physiologic ; instrumentation ; Signal Processing, Computer-Assisted ; instrumentation ; Sound

The specification of decoction pieces and quality uniformity are the important factors to influence the efficacy of clinical medicine. Considering the deficiency of diversity, poor quality uniformity and confusion of decoction pieces specifications, we first propose a new idea of precision decoction pieces (PDP) based on clinical demands and fresh-processed technology. In order to explain the idea, a study case of aconite SUP is provided, including the optimized specification design, processing technology, extraction effects, quality uniformity, and toxic and efficacy variation and so on. The results showed that preparing 5 mm PDP by fresh-cutting is rather simple and practicable, with high efficiency and large yield; then, this technology could significantly decrease the ingredients loss and increase the efficacy components; moreover, it was helpful for achieving the quality uniformity and best extraction effects. This work revealed the quality superiority of PDP, and provided a good strategy and example for the standard of decoction pieces specification and modernization of processing technology.
Aconitum ; chemistry ; Chemistry, Pharmaceutical ; methods ; Chromatography, High Pressure Liquid ; Particle Size ; Plant Extracts ; chemistry ; pharmacology ; Quality Control

Objective To evaluate the role of spinal c?Jun N?terminal kinase ( JNK ) signaling pathway in incisional pain in rats. Methods Sixty?three adult male Sprague?Dawley rats, weighing 200-250 g, were randomly divided into 3 groups ( n=21 each) using a random number table: incisional pain group ( IP group) , dimethyl sulfoxide ( DMSO) group, and JNK inhibitor SP600125 group ( SP group) . A 1?cm longitudinal incision was made through skin, fascia and muscle of the plantar aspect of the hindpaw in anesthetized rats. In group DMSO, 10% DMSO 10 μl was injected intrathecally at 30 min before surgery. In group SP, SP600125 25 μg (in 10 μl of 10% DMSO) was injected intrathecally at 30 min before sur?gery. Six rats in each group were sacrificed, and the mechanical paw withdrawal threshold ( MWT) and thermal paw withdrawal latency ( TWL) were measured at 24 h before establishment of the model and 2, 6, 24, 48 and 72 h after establishment of the model. After measurement of the pain threshold at 24 h before establishment of the model and 6, 24, 48 and 72 h after establishment of the model, the lumbar segment of the spinal cord was removed for determination of the expression of phosphorylated JNK ( p?JNK) by im?munofluorescence. Results The MWT was significantly lower, the TWL was shorter, and the expression of p?JNK was lower at each time point after establishment of the model than at 24 h before establishment of the model in group IP (P<0?05). Compared with group IP, the MWT was significantly increased, the TWL was prolonged, and the expression of p?JNK was down?regulated at each time point after establishment of the model in group SP ( P<0?05) , and no significant change was found in the parameters mentioned a?bove in group DMSO ( P>0?05) . Conclusion Spinal JNK signaling pathway is involved in the develop?ment and maintenance of incisional pain in rats.

Objective:To compare the similarities and differences of doctor -patient trust building mechanism between doctors in urban and rural areas from the perspective of rural residents by the empirical study .Methods:Based on the field research and secondary in -depth interviews to the related personnel in H County of Beijing .Re-sults:There had obvious difference of doctor -patient trust building mechanism between doctors in urban and rural areas from the perspective of rural residents .Trust building mechanism between village doctors were mainly the trust of the similar social background , between the doctors in township health centers and city hospital were the trust based on reputation , institution-based trust , and relationship-based trust .Conclusion:The difference of re-gional and cultural between urban and rural areas ,the nature of medical institutions the relationship with doctors , reputation of medical institution and medical and health care system in urban and rural areas ,maybe the reasons that The difference of doctor -patient trust building mechanism between doctors in urban and rural areas .

Objective to investigate the feasibility and outcomes of different surgical treatments for adrenal metastasis after previous radical ne-phrectomy for patients with renal cell carcinoma. Methods A total of 18 adrenal solitary metastasis of renal cell carcinoma were identified from da-tabase of two institutions between 2003 and 2013. Clinical and pathologic data were collected and analyzed. Results Of 9 patients who had ipsilater-al metastasis of the renal tumor,the estimated blood loss were obviously fewer in the transperitoneal LA group. Of 9 cases who had contralateral me-tastasis of the renal tumor,the fasting time[(1.4±0.8)h vs(4.0±1.4)h,P = 0.036]and length of hospital stay[(4.5±1.2)d vs(7.0±4.5)d,P =0.041]were obviously fewer in the retroperitoneal LA group. the averages of the fasting time and length of hospital stay in the retroperitoneal LA group were obviously smaller than in the transperitoneal LA group. Conclusion LA for treatment of renal cell carcinoma metastasis is technically feasible in selected patients. transperitoneal and retroperitoneal LA can be respectively recommended as an appropriate approach for isolated adrenal metastases of ipsilateral and contralateral renal cell carcinoma after nephrectomy.

Objective To develop a blood gas,acid-base imbalance analysis computer software to diagnose systematically,rapidly,accurately and automatically determine acid-base imbalance type,and evaluate the clinical application. Methods Using VBA programming language,a computer aided diagnostic software for the judgment of acid-base balance was developed. The clinical data of 220 patients admitted to the Second Affiliated Hospital of Guangzhou Medical University were retrospectively analyzed. The arterial blood gas〔pH value,HCO3-,arterial partial pressure of carbon dioxide(PaCO2)〕and electrolytes included data(Na+and Cl-)were collected. Data were entered into the software for acid-base imbalances judgment. At the same time the data generation was calculated manually by H-H compensation formula for determining the type of acid-base imbalance. The consistency of judgment results from software and manual calculation was evaluated,and the judgment time of two methods was compared. Results The clinical diagnosis of the types of acid-base imbalance for the 220 patients:65 cases were normal,90 cases with simple type,mixed type in 41 cases,and triplex type in 24 cases. The accuracy of the judgment results of the normal and triplex types from computer software compared with which were calculated manually was 100%,the accuracy of the simple type judgment was 98.9% and 78.0% for the mixed type,and the total accuracy was 95.5%. The Kappa value of judgment result from software and manual judgment was 0.935,P=0.000. It was demonstrated that the consistency was very good. The time for software to determine acid-base imbalances was significantly shorter than the manual judgment(seconds:18.14±3.80 vs. 43.79±23.86,t=7.466,P=0.000),so the method of software was much faster than the manual method. Conclusion Software judgment can replace manual judgment with the characteristics of rapid,accurate and convenient,can improve work efficiency and quality of clinical doctors and has great clinical application promotion value.