This paper describes a detailed procedure for updating of GP TM210 treadmill system without changing the application software.By changing the hardware of computer and updating the operation system,the performance is improved greatly.

Objective To develop a portable and automatic quick screener for noise-induced hearing loss(NIHL),which is suitable for airman and ground crew.Methods Through using audio decoder chip VS1003 to achieve quick screener for noise-induced hearing loss and pre-exposing for special background noise.LPC2148 of ARM7-TDMI configuration was adopted as main controlling chip,and its software design was completed by multitask scheduler based on UCOS-Ⅱ,while the FAT system controlled the read-write to the files in SD card.The signal emergence,change in hearing class,frequency selection as well as records of subject reaction were automatically achieved.Results The system can produce stable signal of exact frequency according to GBZ49-2002 Diagnostic Criteria of Occupational Noise-induced Hearing Loss to output stability of the frequency and intensity of the audio signal,and the specific context of the noise pre-exposure function with screening of hearing impairment was achieved automatically.Conclusion Based on the great power of embedded system and VS1003,the portable and automatic quick screener for noise-induced hearing loss(NIHL) can be developed to carry out many functions,which has several features,such as simple structure,high integration,good stability and use of flexible etc.

Objective To summarize the experiences got from perioperative management for intravital liver transplantation. Methods Of 30 cases of intravital liver transplantation, executed from June 2006 to December 2007 in the General Hospital of PLA, the data of perioperative management were retrospectively analyzed. Among the recipients, 26 received right hepatic lobe including middle hepatic vein (MHV), 2 received right hepatic lobe without MHV, 1 received complementary liver transplantation with MHV in left half liver, and the remained one received right hepatic lobe plus left external lobe including MHV. The primary diseases in the recipients included serious chronic hepatitis (8 cases), primary hepatocarcinoma (9 cases), fulminant hepatic failure (5 cases), final-stage cirrhosis (5 cases), and one each of liver purpura, liver angiosarcoma and Kinnier-Wilson syndrome. On Child-Pugh status, 5 cases in grade A, 9 in grade B and 16 in grade C. The score on the model for end-stage of liver disease (MEHD) was 27.7 (6.8-45.6). The total and right half liver volumes of donors were evaluated by conventional 3-D CT, and well-provided preoperative evaluation was done to both donors and recipients. Results For donors the average length of stay was 11 days (9-15) and average blood loss was 341 ml (160-1200ml), only one donor suffered from intra-operative blood loss of 1200 ml and then received 600 ml of concentrated erythrocytes. No severe complications were found in donors, and all of them recovered finally. The complications occurred in 5 recipients (16.7%), including bile leakage (2 cases), pulmonary infection (2 cases) and one case of diffusive Aspergillus infection. The survival rate of recipients was 90% (27/30), 2 recipients died from severe pulmonary infection and 1 from diffusive Aspergillus infection. Conclusion Sufficient pre-operative assessment for both donors and recipients and exquisite technology are the keys for a successful liver transplantation, and well-provided perioperative managements are also requirements.

Objective To observe the relationship between vitamin D3 and the severity as well as prognosis in patients with sepsis, and to explore whether exogenous vitamin D3 can improve the prognosis in patients with sepsis.Methods A prospective randomized double-blind placebo study was conducted. Fifty-seven patients with sepsis admitted to intensive care unit (ICU) of Shengjing Hospital Affiliated to China Medical University from March to November in 2015 were enrolled. Twenty patients with systemic inflammatory response syndrome (SIRS) and 20 healthy volunteers with normal physical examination as control were enrolled during the same time. Patients with sepsis were divided into general sepsis group and severe sepsis group (including septic shock) according to the criteria for the diagnosis of severe sepsis and septic shock in 2012. According to the diagnostic criteria established by the American Endocrine Society, and on the basis of 25-hydroxy vitamin D3 [25(OH)D3], the sepsis patients with deficiency [25(OH)D320-30μg/L] or insufficiency [25(OH)D3 < 20μg/L] of vitamin D were divided into D3 treatment group (supplemented 300 kU vitamin D3) and placebo group (injected 1 mL physiological saline). 28th day was set as the end point, and the patients with sepsis were divided into survival group and death group. The levels of serum 25(OH)D3 in each group were measured by electrochemical luminescence method, and the difference in 25(OH)D3 levels among patients with different severity, gender, and age were recorded. Procalcitonin (PCT), C-reactive protein (CRP), blood routine, liver and kidney function, electrolytes and arterial blood gas analysis, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) and sequential organ failure score (SOFA), duration of mechanical ventilation, and length of ICU stay of patients with sepsis were observed. Multivariate Cox proportional hazard regression analysis was used to analyze the risk factors of prognosis in patients with sepsis.Results ① In 57 patients with sepsis, there were 15 patients in general sepsis group, and 42 in severe sepsis group; 29 in D3 treatment group, and 28 in the placebo group; 8 patients died within 28 days with mortality rate of 14.04%. ② The levels of serum 25(OH)D3 in sepsis group and SIRS group were significantly lower than those in healthy control group [μg/L: 3.92 (< 3.00, 11.22), 6.99 (3.51, 9.77) vs. 17.25 (13.48, 22.50), both P < 0.01], but there was no significant difference in the serum 25(OH)D3 level between sepsis group and SIRS group as well as patients with different degrees of sepsis. The serum 25(OH)D3 level in female patients with sepsis (n = 24) was significantly lower than that in male (n = 33), and the difference was statistically significant [μg/L: <3.00 (<3.00, 3.87) vs. 11.96 (5.14, 17.29),Z = -4.020,P = 0.000]. There was no significant difference in serum 25(OH)D3 level between the young (age <60 years old,n = 30) and the old (age ≥ 60 years old,n = 27) patients with sepsis [μg/L: 4.54 (<3.00, 9.88) vs. 3.00 (<3.00, 15.08),Z = -0.601,P = 0.548]. ③ In patients with sepsis, there was no significant difference in the duration of mechanical ventilation [hours: 41.00 (7.50, 82.50) vs. 67.00 (4.75, 127.75)], length of ICU stay (days: 5.48±4.08 vs. 6.68±4.87) and 28-day mortality (10.34% vs. 17.86%) between D3 treatment group and placebo group (allP > 0.05). It was shown by Kaplan-Meier survival curve analysis that there was no significance in 28-day accumulated survived rate between the two groups [log-rank test: χ2 = 0.222,P = 0.638]. It was shown by multivariate Cox regression analysis that APACHE Ⅱ score [relative risk (RR) = 8.487, 95% confidence interval (95%CI) = 1.506-47.835, P = 0.015] and 25(OH)D3 < 20μg/L (RR = 0.088, 95%CI = 0.013-0.592,P = 0.012) were the risk factors of prognosis in patients with sepsis.Conclusions The serum 25(OH)D3 level in ICU patients with sepsis was lower than that in healthy people, but there was no significant difference between patients with sepsis and SIRS. The serum 25(OH)D3 level in sepsis patients was related with gender, and the level of the female was lower than that of the male, but was not related with age. Exogenous vitamin D3 supplementation cannot improve the prognosis of ICU patients with sepsis. APACHE Ⅱ score and 25(OH)D3 < 20μg/L were risk factors for the prognosis in ICU patients with sepsis.

The principle and characteristics of I2C BUS are introduced as well as its application in multi physiological parameters measurement system.The hardware and software design of I2C BUS of multi physiological parameters measurement system are discussed.The system achieves the purpose of the design and the technology of I2C BUS meets the requirement in multi physiological parameters measurement system,including the acquisition of low frequency physiological parameters.I2C BUS predigests the design of hardware and software,thus reducing the cost of system.[Chinese Medical Equipment Journal,2008,29(2):91-93]

Objective To summarize the initial experience in adult-to-adult living donor liver transplantation(ALDLT),so as to improve the efficacy of ALDLT.Methods The clinical data of 31 adult patients who undelwent ALDLT from June 2006 to February 2008 were retrospectively analyzed.Results Of all the patients,8 was with decompensated cirrhosis,7 with acute liver failure,12 with hepatocellular carcinoma,2 with purpura of liver,1 with hilar cholangiocarcinoma,and 1 with Wilson disease.The liver grafts included 25 right lobes with middle hepatic vein(MHV),3 right lobes without MHV,1 right lobe with MHV+left lateral lobe,1 right lobe with MHV+left lobe.The remaining 1 patient underwent auxiliary partial orthotopic liver transplantation with left lobe graft.Six post-transplantation complications occurred in 5 donors. Eleven post-transplantation complications occurred in 9 recipients,including 4 biliary complications,3 vascular complications,3 infection complications and 1 delayed healing of the incision.After ALDLT,2 recipients died of pulmonary infection and 1 of multiple aspergillus infection. Conclusions ALDLT has become an effective method to expand the source of liver grafts.Rational donor and recipient assessment,surgical procedure and postoperative management are key to ALDLT.

ObjectiveTo study the potential of using temporal clustering analysis(TCA)technique in localizing an epileptogenic zone.MethodsTwelve patients with epilepsy were examined using resting functional MRI(fMRI). The patients had detectable focal lesions on cranial MRI.TCA was performed to analyze resting fMRI data in order to identify the timing of interictal epileptiform discharges (IEDs).Standard event-related fMRI analysis in SPM99 was used to generate maps of the activation induced by epileptic brain activities.Comparisons were made between TCA Resultsand SPM motion trochoid.ResultsEight of the twelve subiects showed activations in the brain regions that were consistent with those lesions determined on anatomic MRI.The remaining four subiects showed no clear activation in the areas of detectable lesions. In addition, correlation was found between TCA Resultsand motion trochoids.ConclusionsTemporal cluster analysis,an exploratory data-driven technique,may provide the timing information about interictal epileptiforill discharges.However,the Resultsfrom this novel fMRI analytical technique need to be interpreted with caution as it is vulnerable to motion artifact.

Objective To assess the feasibility,safety and advantages of robotic-assisted precise hepatectomy.Methods Between April and July 2009,13 consecutive patients underwent robotic-assisted hepatectomy for hepatic diseases.The clinical data were analyzed retrospectively.Results All 13 Da Vinci surgical systemassisted precise hepatectomies were successfully performed without conversion to laparotomy.Major hepatectomies were performed in 9 patients,left lateral segmentectomies in 4 patients.All the Da Vinci surgical system-assisted hepatectomies were performed anatomically with hilum dissection.Prior to the parenchymal transaction,vascular control of the portal vessels was carried out whenever possible.The mean operative time was 338 minutes(range,150-720 minutes).The mean blood loss was 208 ml(range,50-800 ml).No patient required blood transfusion,and no mortality,transient bile leakage was observed in patients with hilar cholangiocarcinoma.The mean postoperative stay was 7 days(range,2-13 days).Conclusions These preliminary results show that Da Vinci surgical system-assisted precise hepatectomy is safe and feasible with potential benefits of a minimally invasive approach.Da Vinci surgical system may broaden the indications for laparoscopic hepatactomy,and it enables surgeons to perform precise laparoscopic hepatectomy which required hilum dissection,hepatocaval dissection,endoscopic suturing and microanastamosis.

Objective To evaluate the effect of Da Vinci surgical system for the treatment of hepatopancreatobiliary diseases.Methods The clinical data of 29 patients with hepatopancreatobiliary diseases who had undergone operations with Da Vinci surgical system from March to November 2009 at the General Hospital of PLA were retrospectively analyzed.Results The operations were successfully done on 28 patients,except 1 patient was converted to open pancreaticoenterostomy.The total operation time was(339±149)minutes,and the time for operations done with Da Vinci surgical system was(285±117)minutes.The postoperative bowl movement recovery time was(33±21)hours,and the length of postoperative hospital stay was(8±6)days.No blood transfusion was needed.Three patients had postoperative complications and were cured by conservative treatment.Conclusion Laparoscopic operations for hepatopancreatobiliary diseases can be applied with the help of the threedimensional imaging system and flexible surgical instruments of the Da Vinci surgical system,and its superiority is more obvious when applied for intractable hepatopancreatobiliary diseases.

Objective To investigate the clinical value of computer-assisted operation planning system for precise hepatectomy.Methods The clinical data of 45 patients who had undergone precise hepatectomy at General Hospital of PLA from November 2006 to November 2009 were retrospectively analyzed.The 3-dimensional imaging of liver was constructed by computer-assisted operation planning system,and the anatomic relationship between hepatic vasculature and tumor Was analyzed.Volume of hepatic segments,total liver volume,tumor volume,predicted resection volume and the remnant liver volume were calculated before operation.Virtual liver resection was performed in order to select the best operative procedure.The predicted resection volume Was compared with the hepatic segment resected.All data were analyzed by t test,Pearson rank correlation analysis and chi-square test.Results The predicted resection volume calculated based on the 2-dimensional imaging was similar to that calculated based on the 3-dimensional imaging(t=2.125,P>0.05).The three-grade branches of the hepatic artery,portal vein and hepatic vein were clearly shown in the computer-assisted operation planning system.The anatomic relationship between tumor and adjacent vessels was quantitatively analyzed.There was a positive correlation between the predicted resection volume and the resected liver volume(r=0.999,P<0.05),and the error rate Was 5.1%.All patients received anatomical hepatectomy,and the incidence of postoperative complications was 20%(9/45).No liver failure or perioperative mortality was observed.Conclusion Computer-assisted operation planning system may facilitate and promote precise hepatectomy.