Objective To observe the clinical effects of treating acute upper gastrointestinal bleeding(AUGIB) with freezing Zidi mixture lavage. Method 183 UGIB patients from the First Affiliated Hospital to Guanzhou University of TCM in August 2013 were randomly recruited into a control group with 91cases and a treatment group with 92 cases. The treatment group was treated with intragastric administration of freezing Zidi mixture, while the control group was treated with intragastric administration of cryohydrate and norepinephrine. The changes of clinical effects, blood pressure, hemoglobin, blood urea nitrogen, pulse and dark stool were observed and the bad emotions as anxiety, depression and fear were evaluated. Results ① On therapeutic effect, the total effective rate was 96.7% and 85.7% in the treatment group and the control group respectively, with statistical difference(χ2=2.943,P<0.05). ② On the time of symptom disappearance:the disappearing time of vomiting, dark stools and occult blood test in the treatment group was obviously shorter than the control group after the treatment(t=6.628、14.052、21.706,P<0.05 or 0.01). ③ On body symptom changes: after the treatment, the systolic pressure, heart rate, hemoglobin, and blood urea nitrogen [(114.3±12.1)mmHg,(78.6±11.4)/min,(98.1±10.5)g/L,(5.9±1.1)mmol/L] in the treatment group were all obviously improved than those [(106.3±11.2)mmHg, (88.7±12.1)/min,(88.2±11.7)g/L,(6.9±1.4)mmol/L] in the control group;body temperature returned to normal in both groups, and there was no statistical difference score was either in or between groups(P>0.05). ④ On changes of anxiety, depression and fear:the treatment group [the(42.5±9.4), (41.6±9.7), (26.3±5.4)for each]was obviously improved after the treatment than the control group[the score was(51.2±10.1),(50.4±11.5),(30.4±6.9)for each],P<0.05. Conclusion Freezing Zidi mixture lavage can obviously elevate systolic pressure, decrease heart rate, enhance hemoglobin, decrease blood urea nitrogen, relieve body stress reaction and other clinical symptoms. Its effects were better than intragastric administration of cryohydrate and norepinephrine in treating AUGIB.

Objective To build the method of computerized case classification,for the purpose of perfecting the diseases typing and classification,and supporting the management based on the quality and expenses of the disease.Methods 875 cases were defined into two types.Eight parameters were selected for non-surgery cases,namely the disease diagnosis,severity at admission,and age.For surgery cases,five parameters were defined,namely the disease diagnosis,operative quantity,and severity at admission.Then Fisher function was called into play to obtain the function descriminant equation,realizing computerized classification.Results The rate of matching was 86.2％ between computerized classification and manual classification.The high accuracy of function descriminant equation proves the satisfactory outcomes of the classification.Collusion The computerized classification is satisfactory in its outcomes,and therefore it can better quality of care and cost management of diseases in clinical practice.

Due to individual differences of the depth of anaesthesia (DOA) controlled objects, the drawbacks of monitoring index, the traditional PID controller of anesthesia depth could not meet the demands of nonlinear control. However, the adjustments of the rules of DOA fuzzy control often rely on personal experience and, therefore, it could not achieve the satisfactory control effects. The present research established a fuzzy closed-loop control system which takes the cerebral state index (CSI) value as a feedback controlled variable, and it also adopts the particle swarm optimization (PSO) to optimize the fuzzy control rule and membership functions between the change of CSI and propofol infusion rate. The system sets the CSI targets at 40 and 30 through the system simulation, and it also adds some Gaussian noise to imitate clinical disturbance. Experimental results indicated that this system could reach the set CSI point accurately, rapidly and stably, with no obvious perturbation in the presence of noise. The fuzzy controller based on CSI which has been optimized by PSO has better stability and robustness in the DOA closed loop control system.
Anesthesia ; methods ; Anesthesiology ; methods ; Anesthetics, Intravenous ; administration & dosage ; Feedback ; Fuzzy Logic ; Propofol ; administration & dosage

Objective: To study if the immune-enhancing effect of Arg was mediated via liver.Methods: The direct effect of Arg on T cell proliferation was measured by 3H-TdR incorporation. Rat hepatocytes were primarily cultured in serum-free DMEM/F12 medium, and then cultured in medium containing Arg(?mol/L:0,7.5,75,750,7 500), and the supernatant was collected at 0, 24, 48, 72 hours, and added to splenocytes culture, and T cell proliferation, NK cell activity and IL-2 activity,〔Ca 2+〕i were measured respectively.Results: Arg had no direct effect on splenocyte proliferation. The hepatocyte culture supernatant significantly increased the lymphocyte〔Ca 2+〕i ,IL-2 activity and T lymphocyte proliferation; 7 500 ?mol/L was most effective. Conclusion: Arg may enhance immune function via secretion of bioactive molecules by hepatocytes.

Objective To investigate the sleep status, quality of life, activities of daily living and the serum levels of interleukin-1β (IL-1β) and tumor necrosis factor alpha (TNF-α) in insomnia patients after meridian-collateral stroke treated by the new family rehabilitation program, a combined therapy including traditional family rehabilitalion, acupoint massage and ear point application. Methods A total of 80 cases of insomnia patients after meridian-collateral stroke were enrolled. Subjects were evenly divided into treatment group ( treated with new family rehabilitation program) and control group ( treated with traditional hospital health education and family rehabilitation). Clinical effects of the two groups were evaluated with the Pittsburgh Sleep Quality Index (PSQI), the brief version of WHO Quality of Life Assessment (WHOQOL-BREF) and activities of daily living ( ADL) . The serum levels of IL-1β and TNF-α were monitored before and after therapy and measured by enzyme-linked immunosorbent assay ( ELISA). Results ( 1) After treatment for 28 days, the scores of total PSQI, sleep time, sleep efficiency and sleep disorder incidence in the treatment group were significantly lower than those in the control group ( P<0.01) . ( 2) The scores of physiological, psychological, social relation, environmental dimensions of WHOQOL-BREF in the treatment group were significantly higher than those in the control group ( P<0.01) . ( 3) ADL scores were significantly higher in the treatment group than those in the control group (P<0.01) . (4) Serum levels of IL-1βand TNF-αwere increased in the treatment group as compared with those in the control group (P<0.01). Conclusion Compared with the traditional hospital health education, the new family rehabilitation program can effectively improve the quality of sleep, quality of life, as well as the activities of daily living. And the mechanism may be associated with the up-regulation of the serum levels of IL-1βand TNF-α, which are relevant to the sleep status.

Objective To measure the morphological parameters of the acromion with CT and to analyze their match with the hook plate. Methods From October 2009 to February 2010,spiral CT scanning (with Somatom Emotion16) and three-dimensional reconstruction of bilateral shoulders were conducted in 61 Chinese subjects.They were 24 men and 37 women,aged from 20 to 83 years (average,45.2 years).The thickness,length and width of the acromion were measured and the subacromial shape was observed with software of the CT system to analyze the match between the hook plate and the acromion.Results The mean thickness of the acromion was 0.85 ± 0.13 cm in all subjects,0.94 ± 0.12 cm in males and 0.79 ± 0.10 cm in fe males,with a significant difference between males and females ( t =2.382,P =0.202).The mean acromion length was 2.08 ± 0.20 cm in all subjects,2.09 ± 0.21 cm in males and 2.06 ± 0.18 cm in females,with no significant difference between males and females( t =1.541,P =0.129).The mean acromion width was 3.81 ± 0.52 cm in all subjects,4.34 ± 0.32 cm in males and 3.47 ± 0.25 cm in females,with a significant difference between males and females ( t =2.296, P =0.025 ). Conclusions The acromial morphology varies significantly between genders in Chinese population,particularly in the thickness and width.It is,therefore,necessary to modify the morphological parameters of the hook plate to match better the gender difference in Chinese population.It is optimal that the hook plate should allow individualized pre-moulding to enhance its therapeutic efficacy.

This paper proposed a rehabilitation training system with electromyography (sEMG) feedback for stroke patients based on ARM embedded system and LabVIEW. The system can achieve real-time acquisition, processing and dualview of multi-channel sEMGs and compute related sEMG parameters including iEMG, RMS, MPF and co-contraction ratio. The system was detected by clinical experiments and related inspection department. The result showed that the system is functional, interactive and in accordance with the relevant standards for medical devices so that it can fully satisfy the clinical demands. In addition, the system can help doctors to master the training state of the patient more effectively in a real-time and quantitative way that is direct to improve the training programs of stroke patients.
Electromyography ; Humans ; Neurofeedback ; Stroke Rehabilitation

Objective To analyze risk factors of northwest dryness syndrome (NDS) among the patients of metabolic syndrome in Xinjiang Uygur Autonomous Region.Methods Totally 321 cases of metabolic syndrome in Kashgar, Hami and Urumqi were collected to filter 15 variables to calculate OR value and 95% CI, and evaluated by single factor and multi-factor analysis by applying conditional Logistic regression analysis.Results Single factor conditional Logistic regression analysis showed that high fat diet, addiction to hot diet, salty diet, smoking history and hypertension were the risk factors of NDS. The OR values of them were 0.387, 0.071, 0.033, 2.614 and 0.440, respectively (P<0.05). Multi-factor conditional Logistic regression analysis showed that smoking history, alcohol drinking history, high fat diet and hypertension were all entered into regression model. The OR values of them were 3.945, 4.334, 0.370 and 2.142, respectively (P<0.01).Conclusion Patients of metabolic syndrome with a high fat, salty and hot diet are suggested to adjust their diet habit by adding sour food, giving up smoking and drinking, and controlling their blood pressure. It will be helpful for them to adapt local climate and living environment, and reduce the attack rate of NDS.

According to medicine high special educational reform’s mentality,we have extracted the knowledge points closely related to basic medical curriculum and the nursing spe-cialty,integrated the basic medical curriculum as "the basis of medical morphology"and"basic medical functions"and have it implemented in the nursing specialty in the three-year program.By doing so,we have gained some experience and provide practical basis for further integration of basic medical courses.

Objective:To explore the clinical characteristics and prognostic risk factors of accidental injuries in pediatric intensive care unit(PICU).Methods:The children with accidental injuries admitted to the PICU at Shanghai Children′s Hospital from January 2017 to December 2019 were analyzed retrospectively.The patients were divided into survival group and death group according to outcome.We collected the patients′ clinical data and laboratory indexes, and analyzed the differences between two groups.Multivariate Logistic regression was used to screen the risk factors of death and receiver-operating characteristic(ROC)curve was used to determine the threshold.Results:(1)A total of 253 children were included, accounting for 5.2% of PICU hospitalization during the same period.There were 137 males(54.2%)and 116 females(45.8%), with an average age of 45(19, 96)months.The top three causes of accidental injuries were fall injury in 82 cases(32.4%), traffic accident in 70 cases(27.7%)and foreign body in 39 cases(15.4%). There were 22 cases of deaths, with a fatality rate of 8.7%.(2)The mean arterial pressure at admission in the death group was lower than that in the survival group( P<0.05), and the total length of stay was longer( P<0.001). There were significant differences in Glasgow coma scale, Pediatric Risk of Mortality Scoring Ⅲ(PRISM Ⅲ)between the two groups( P<0.001). In the death group, and the blood lactic acid(LA) significantly increased( P<0.001), hemoglobin and fibrinogen were lower than those in the survival group, the activated partial thromboplastin time and prothrombin time(PT)were significantly prolonged( P<0.001). (3)Multivariate Logistic regression analysis showed that PRISM Ⅲ score, LA and PT were independent risk factors for the death of accidental injuries.The area under curve(AUC)of PRISM Ⅲ score was 0.987(95% CI 0.976-0.999, P<0.001)and the cut-off value was 11 with a sensitivity of 100% and a specificity of 95.7%.The AUC of LA was 0.886(95% CI 0.810-0.961, P<0.001)and the cut-off value was 3.1 mmol/L with a sensitivity of 85.7% and a specificity of 77.3%.The AUC of PT was 0.835(95% CI 0.730-0.941, P<0.001)and the cut-off value was 13.9 s with a sensitivity of 86.6% and a specificity of 72.7%. Conclusion:The main accidental injuries in PICU of our hospital in the past three years are falling injuries, traffic accidents and foreign body injuries.PRISM Ⅲ score, LA and PT at admission are independent risk factors for predicting death.