In order to improve the control rate of risk factors of chronic disease, it is developed a status control method of risk factor and its mobile monitor. The monitor uses 32 bit RISC microprocessor of S3C2410X as a controller based on ARM920T core, and MC35i cellular engine GSM/GPRS supported by SIEMENS as the communication unit. The proving tests show that the physical activity, diet, smoking and alcohol of the controlled people can be controlled using the status control method, and the monitor plays a key role in the method. The conclusion is that status control method and mobile monitor can become an alternation method and technology for the risk factor control of chronic disease.
Chronic Disease ; prevention & control ; Equipment Design ; Humans ; Monitoring, Physiologic ; instrumentation ; methods ; Risk Factors

Objective To investigate the protective role of losartan,an angiotensin Ⅱ receptor(AT1 type)blocker,in the mechanical ventilation-induced lung injury(VILI).Methods Forty Sprague-Dawley rats weighing 300-350 g were randomly divided into the following four experimental groups(10 rats in each group):control group(group A),normal tidal volume venti-lation group(group B),large tidal volume mechanical ventilation group(group C),large tidal volume mechanical ventilation plus Losartan pretreatment group(group D).The pulmonary tissues were removed for pathological examination and detection of NF-κB activity,and the lung lavage fluid was collected for analysis of white blood cell count,total protein concentration and the level of MIP-2,after the rats were sacrificed.Results The pathology of lung tissues was normal in groups A and B.There was obvi-ous inflammatory damage in lung tissues in group C.The pathological inj uries of lung tissue were significantly reduced in group D compared with group C.The NF-κB activity and the level of p65 were significantly higher in group C than in groups A and B (P<0.01);they were significantly reduced in group D compared with group C(P<0.05).Total protein concentration,the MIP-2 level and the white blood cell count were significantly higher in group C than in groups A and B(P<0.01).They were significantly reduced in group D compared with group C(P<0.05 or 0.01).Conclusion Losartan,a selective inhibitor of sub-type AT1 receptors for angiotensin Ⅱ,can relieve VILI by inhibiting the activity of NF-κB.

Objective: To explore influence of exercise on cardiac autonomic nerve function in patients undergoing coronary artery bypass grafting (CABG) and its clinical significance. Methods: A total of 53 patients with coronary heart disease undergoing CABG were randomly divided into routine treatment group (n=25) and rehabilitation group (n=28, received exercise training based on routine treatment). Changes of autonomic nerve function before, second and eighth week after CABG were analyzed in two groups using time domain indexes of heart rate variability (HRV) by ambulatory electrocardiography, including standard deviation of normal to normal RR intervals calculated over the 24 h period (SDNN), standard deviation of normal to normal RR intervals in all 5 min segments of the entire recording (SDANN), root-mean square of differences between successive normal to normal intervals (rMSSD) and adjacent normal RR interval difference > 50ms stroke accounted for a percentage of 24h total RR interval (PNN50). Results: Compared with before CABG, there were significant decrease in SDNN, SDANN, RMSSD and PNN50 in both groups two weeks after CABG (P<0.05~0.01); eight weeks after CABG, above indexes recovered to levels before CABG in routine treatment group[SDNN （113.6±29.4）vs.（116.7±24.7）, SDANN（112.2±32.1）vs.（113.6±28.6）, rMSSD（21.9±8.2） vs.（23.2±7.1）, and PNN50 （7.5±4.2）vs.（8.2±3.7）] , P>0.05 all; Compared with before CABG, there were significant improvements in SDNN [(114.7±25.2) ms vs. (132.6±30.6) ms], SDANN [(111.6±23.5) ms vs. (129.2±30.8) ms], rMSSD [(24.2±8.7) ms vs. (29.9±7.5) ms] and PNN50 [(7.8±2.2) ms vs. (9.5±2.3) ms], and there were significant improvement than those of routine treatment group [SDNN （132.6±30.6）vs.（113.6±29.4）, SDANN（129.2±30.8）vs.（112.2±32.1）, rMSSD（29.9±7.5）vs.（21.9±8.2）and PNN50 （9.5±2.3）vs.（7.5±4.2）] eight weeks after CABG in rehabilitation group, P<0.05 all. Conclusion: All HRV indexes significantly decrease on two weeks after CABG in both groups, suggesting that CABG can damage cardiac autonomic nerve system. These indexes of rehabilitation group were more improvement than those of routine treatment group, suggesting exercise training can more significantly improve cardiac autonomic nerve function after CABG.

Objective:To explore the effect of spinal interleutkin-33 (IL-33) on radicular pain in rats modeling non-compressive lumbar disc herniation.Methods:A total of 80 male Sprague-Dawley rats were randomly divided into a sham operation group, a model group, a lentivirus negative control group, a low-dose IL-33 recombinant lentivirus group and a high-dose IL-33 group, each of 16. Non-compressive lumbar disc herniation was successfully induced in all except the rats in the sham operation group. Two days later, the model group was injected intrathecally with 10μl of enhanced infection solution. The lentivirus control group received 10μl of negative lentivirus, the low-dose IL-33 recombinant lentivirus group received 5μl of IL-33 recombinant lentivirus and the high-dose IL-33 recombinant lentivirus group received 10μl of IL-33 recombinant lentivirus. The 50% paw withdrawal threshold (50% PWT) was measured one day before the modeling and on the 1 st, 3 rd, 5 th, 7 th, 9 th, 11 th, 13 th, 15 th, 17 th, 19 th, and 21 st day afterward. On the 12 th day the expressions of IL-33 protein and mRNA were evaluated. Results:The average expression of IL-33 protein and mRNA in the model and the lentivirus negative control group increased significantly after the modelling compared with the sham group, while expression in the low- and high-dose IL-33 recombinant lentivirus groups was significantly lower than in the lentivirus negative control group. Compared with one day before the modelling, average 50% PWTs on the affected side decreased significantly in all of the modelling groups. From the 9 th to the 21 st day significantly increased 50% PWTs were observed on the affected side in the low-dose and high-dose IL-33 recombinant lentivirus groups compared with the other two modelling groups. Immunostaining showed significant increase in the expression of IL-33 in the dorsal horn of the spinal cord in the model group, compared with the sham operation group. Significant decrease in the average expression of IL-33 in the spinal dorsal horns was observed in the low-dose and high-dose IL-33 recombinant lentivirus groups. Conclusions:Intervertebral disk herniation may increase the expression of IL-33 in the spinal cord, and may cause radicular pain.

OBJECTIVETo evaluate the effect of erythritol on cell wall structure of Streptococcus mutans (S. mutans) and explore its potential mechanism.

METHODSEnzyme activities of lactate dehydrogenase (LDH) in bacterial solution were detected under respective condition of sucrose and erythritol. A scanning electron microscope (SEM) was used to investigate the change of S. mutans' cell wall under the condition of sucrose and erythritol.

RESULTSEnzyme activities of LDH in erythritol culture medium were different from that in sucrose, but the difference was slight. SEM observation showed the integrity of cell wall was not destroyed and no content leaked out.

CONCLUSIONIt's suggested that erythritol has an antibacterial effect on S. mutans through no affecting on the normal structure of the cell wall of S. mutans.

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 explore the importance of intraoperatlVe transesophageal echocardlography(TEE) in totally endoscopic atrial septal defect(ASD)repair.Methods Twenty four patients underwent repair of ASD by a totally endoscopic approach，utilizing the da Vinci S robotic system.After induction of general anesthesia and a left-sided double-lumen endotracheal tube was positioned，a TEE probe was inserted.①Before cardiopulmonary bypass(CPB)，TEE examination was conducted to document the types and size of ASD.The procedures were predetermined by the operator according to the TEE diagnosis.②CPB was achieved peripherally.With TEE guidance，a 19-or 21-Fr.femoral venous cannula was inserted into the right common femoral vein and passing it into the inferior vena cava(IVC)，with its tip just inferior to the IVC-right atrium junction；a 15-or 17-Fr.femoral arterial eannula was placed percutaneously into the right internal jugular vein and passed into the superior vena cava(SVC).The bypass circuit was completed by inserting a 14G arterial perfusion cannula into the ascending aorta(AAO)，with its distal tip passing over the center of the AAO，approximately 3 cm from the aortic valve.③ After weaning from CPB，TEE examination was performed again.Results①Surgical confirmation was obtained in all the patients and no operative procedures were changed.②All venous，arterial and arterial perfusion cannula were located in correct position.③In all patients，TEE after weaned from CPB confirmed successful repair.Conclusions Intraoperative TEE is essential for totally endoscopic ASD repair.

Objective To explore the utility of intraoperative transesophageal echocardiography (TEE) in robotic mitral valve repair (MVR) with the da Vinci system. Methods Intraoperative TEE was performed in 24 patients undergoing robotic MVR for severe degenerative mitral regurgitation (MR)between September 2007 and February 2010. Before cardiopulmonary bypass (CPB) ,TEE was performed to document the mechanism and location of degenerative MR. During establishment of peripheral CPB, TEE was used to guide placement of the cannulae in the inferior vena cava (IVC),superior vena cava (SVC),and ascending aorta (AAO). After weaning from CPB, TEE was performed to evaluate the effect of the procedure. Results Accuracy of TEE was 93.1% for the mechanism of degenerative MR, and 98.6% for the localization of the prolapsed leaflets. All the cannulae in the SVC,IVC and AAO were located in correct position. In all patients, TEE confirmed successful repair with no residual insufficiency and no procedurerelated complications. Conclusions In robotic MVR, TEE have important roles as follows: providing the reliable diagnostic information before CPB, guiding placement of the cannulae in the IVC, SVC, and AAO correctly during establishment of peripheral CPB determining the competency of MVR immediately after CPB. TEE is important for robotic MVR.

Objective To summarize the surgical experience gained from robotic mitral valve replacement (MVR), and demonstrate the long-term clinical follow-up results. Methods From Jan. 2007 to Jan. 2015, more than 700 patients underwent various types of robotic cardiac surgery in the Department the authors served in, and of them 43 patients underwent robotic MVR with da Vinci Surgical System (Intuitive Surgical, USA). Among the 43 patients, the average age was 47±11 years (ranged 19-65 years), and sex ratio (female to male) was 0.8:1. Six patients were with heart function of NYHA class Ⅰ, 30 patients were of NYHA class Ⅱ and 7 patients were of NYHA class Ⅲ. The left ventricular ejection fraction (LVEF) were 54%-78% (64.0%±7.1%), and 20 patients had atrial fibrillation on admission, and 35 patients were with rheumatic mitral stenosis (MS). Atrial septal defect (0.7cm in size) co-existed in 1 case and 1 patient had mild aortic regurgitation. Mechanical or bioprosthetic mitral valve was replaced via left atriotomy by using da Vinci robotic surgical system after cardiopulmonary bypass (CPB) set-up. Radiopaque titan clips was employed by Cor-Knot knot-tying device (LSI Solutions, Inc, Victor, NY) to anchor the prosthetic valve. Trans-esophageal echocardiography (TEE) was performed before and after surgery. The operative data were collected and patients were followed up at outpatient clinic regularly up to 6 years. Results All cases were performed successfully with the same surgery. No conversion to median sternotomy or operative mortality occurred. The average operation time was 292±62 minutes (ranged 140-450 minutes) with CPB time of 124±26 minutes and aortic occlusion time of 88±21 minutes. The postoperative mechanical ventilation support time was continued for 15±6 hours, and the average staying length in critical care unit was 4±1 days. No myocardial infarction, ventricular tachycardia or excessive bleeding was complicated. All patients were successfully followed up for a median of 3.5 years (ranged 1 month to 6 years). In the follow-up period, no incidence of death, stroke, re-operation due to prosthetic endocarditis or prosthetic failure was reported. However, 39.5% (n=17) patients still had atrial fibrillation after surgery. Conclusion Robotic MVR is a safe and effective procedure with excellent long term surgical outcome.

Objective Objective This study is to discuss a surgical approach for ideal and safe resection of atrial myxoma using da Vinci S surgical system. Methods Forty consecutive patients underwent resection of atrial myxoma with the da Vinci S Surgical System. Mean age of the patients was(48 ± 13) yeas. Mean tumor size was 2. 3 cm ×4. 6 cm ～4. 3 cm ×7. 4 cm. 36 tumors were in the left atrium, of which 31 tumors arose form the interatrial septum, 2 from the postercaudal wall, 2 from the root of the anterior leaflet of the mitral valve, and 1 from the left atrial roof. In 34 patients, exploration was conducted through a left atriotomy anterior to the pulmonary veins and excision was achieved by dissecting a plane through the atrial muscle at the point of attachment. In the first 2 patients, exploration and excision were conducted through an oblique right atriotomy.Four tumors were in the right atrium, all of which were resected from the beating heart. The da Vinci instrument arms were inserted through three 0. 8 cm trocar incision in the right side of the chest via 4 port incision and 2 cm working port, all the procedures were completed with 30 o angled endoscopic facing upward with da Vinci S robot. Results Resection were successful in all patients. There were no operative deaths, strokes or other complication. All the patients were discharged. No recurrences of tumor or septal learkag were found in the follow-up. Conclusion The excision of atrial myxomas with the da Vinci S Surgical System is feasible, efficacious, and safe. Surgical results are excellent.