Objective To evaluate the relationship between plasma substance P (SP) and calcitonin gene-related peptide (CGRP) concentrations and intraoperative cardiovascular events in diabetic patients.Methods Twenty-two patients of either sex with type 2 diabetes mellitus and 22 non-diabetic patients of either sex,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 50-77 yr,undergoing elective knee arthroplasty under neuraxial anesthesia,served as diabetes mellitus group (group DM) and non-diabetes mellitus group (group NDM),respectively.The patients of either group were further divided into 2 subgroups (n =11 each) according to whether or not the patients had cardiovascular diseases before operation:no cardiovascular disease subgroups (NDM-NCVD subgroup and DM-NCVD subgroup) and cardiovascular disease subgroups (NDM-CVD subgroup and DM-CVD subgroup).The plasma SP and CGRP concentrations were dertermined by enzyme-linked immunosorbent assay at 30 min before operation and at the end of operation.The plasma cardiac troponin Ⅰ (cTnI) concentrations were measrued by enzyme-linked immunosorbent assay at 30 min before operation and 24 h after operation.The development of intraoperative cardiovascular events was recorded.Results Compared with group NDM,the incidence of intraoperative cardiovascular events and plasma cTnI concentrations at each time point were significantly increased,and the plasma concentrations of SP and CGRP were decreased in group DM (P＜0.05).Compared with group DM-NCVD,the incidence of intraoperative cardiovascular events and plasma cTnI concen trations at each time point were significantly increased,and the plasma concentrations of SP and CGRP were decreased in group DM-CVD (P＜0.05).Conclusion The development of intraoperative cardiovascular events is related to the decrease in plasma concentrations of SP and CGRP in diabetic patients.

Objective To investigate the value of the imaging division and features of CT and MRI in the differential diagnosis of benign and malignant space-occupying lesions.Methods A retrospective analysis of the clinical and imaging data of 201 patients with orbital space-occupying lesions confirmed by pathology was conducted.Four sector method was used to analyze the distribution of the lesions.The shape,border and relationship with surrounding tissues,MRI signal,CT density,and calcification of the orbital wall were also analyzed.Results There was statistical difference in the distribution of lesions in each of the 4-sector between orbital benign lesions and malignant tumors(χ2总=48.93,P=0.000).Lesions located in separate orbital zone including extra-periosteum compartment (18 cases),optic nerve compartment (4 cases),intraconal compartment(39 cases) were benign.Benign lesions (64%, 66/103) were more than malignant lesions (36%,37/103) in 103 lesions located in extraconal compartment.Additionally,there was significance in the distribution in separate and mixed zones between benign and malignant lesions(χ2=25.559,P=0.000).Benign lesions (77%,127/164) were more than malicious lesions(23%,37/164) in 164 cases in separate zone.Malignant lesions (65%,24/37) were more than benignant lesions (35%,13/37) in the 37 lesions located in mixed zone.Signs of CT and MRI:the benign and malignant lesions were 140 and 61,respectively.The features of those lesions are as follows(ratio=benign lesions/ malignant lesions):regular morphology(ratio=93/10),clear boundary(ratio=108/24),eyeball-surrounded (ratio=24/39),bone destruction (ratio=4/11).Features of lesions including shape,border,eyeball-surrounded, bone destruction had significant difference between benign and malignant lesions,whereas no differences was observed in calcification,signal on T1WI or T2WI,displacement of the eyeball and the occurrence of single or bilateral lesions.Conclusion The characteristic distribution of orbital space-occupying lesions based on the 4-sector and the features of CT and MRI has a great value in the diagnosis.

Objective To construct a eukaryotic expression plasmid of pcDNA 3.1-Ag85A-CD226, and to use it as DNA vaccine then further evaluate its immunogenicity through oral administration in a mouse model.Methods The CD226-PCR2.1-ToPo plasmid was used as the template to clone CD 226 gene by PCR.The CD226 gene was then inserted into pcDNA 3.1-Ag85A plasmid to construct the recombinant plas-mid of pcDNA3.1-Ag85A-CD226.After identified by restriction enzyme analysis and sequencing , the re-combinant plasmid was transfected into HEK 293 cells by using lipofection .The expression of Ag85A-CD226 gene in HEK293 cells was detected by RT-PCR, Western blot and indirect immunofluorescence assay .The purified recombinant plasmid was used to prepare the Ag 85A-CD226 DNA vaccine by liposomal encapsula-tion.The vaccine was administered intragastrically to mice .The activities of NK cells , the cytokine levels in the supernatants of spleen cell cultures and the mRNA level of cytokines in the intestines were evaluated to analyze the immunogenicity of Ag85A-CD226 DNA vaccine.Results The Ag85A-CD226 DNA vaccine was prepared successfully .The expression of Ag85A-CD226 fusion protein was detected in HEK293 cells.The activities of NK cells from mice vaccinated with Ag 85A-CD226 DNA vaccine were higher than those from other control groups (P<0.01).The level of TNF-α, IFN-γand IL-2 in the supernatants of spleen cell cul-tures and in the intestines were significantly up-regulated in comparison with other control groups ( P <0.01).The level of IL-4 in the supernatants of spleen cell cultures was down-regulated in the experimental group (P<0.01), but the level of IL-4 in intestines showed no significant difference among the five groups (P>0.05).Conclusion The Ag85A-CD226 DNA vaccine could significantly enhance Th1 type immune responses systemically and in the intestine as in comparison with those vaccinated with single dose of Ag 85A DNA vaccine or CD226 DNA vaccine.

Purpose To investigate the application value of 18F-FDG PET/CT in the diagnosis and staging of tongue cancer,in order to improve the accuracy of preoperative staging.Materials and Methods The 18F-FDG PET/CT findings of 52 patients with pathologically confirmed tongue cancer were retrospectively analyzed.The tumor location,size,FDG metabolic characteristics and tumor staging were observed,and compared with postoperative pathology.Results PET/CT showed that most patients were at middle or late stage when initially diagnosed (28/52).The lesions were mostly located on middle or middle-back region of tongues,and the average SUVmax was 6.81 ± 3.81.The sensitivity of PET/CT diagnosing tongue cancer was 94.2％.There was no significant difference in SUVmax between high,medium-high and medium differentiated tongue cancer primary lesions (P＞0.05).The SUVmax of tongue cancer at stage Ⅲ and Ⅳ was obviously higher than that at stage Ⅰ and Ⅱ,and the difference was statistically significant (P＜0.008).The diagnose and staging of tongue cancer using preoperative PET/CT and postoperative pathology were in excellent consistence (Kappa=0.859,P＜0.01).The staging accuracy reached 90.4％ (47/52).Conclusion Higher SUVmax value indicates worse tongue cancer staging,but it is of little significance in predicting differentiation.PET/CT can provide an objective imaging basis for preoperative diagnosis and accurate staging of tongue cancer.

目的探讨康复患者使用经外周置入中心静脉导管(PICC)的可行性。方法对康复组16例住院患者行PICC,并与非康复组行PICC的12例患者进行对照观察,分别观察留管时间、局部症状、全身症状等。结果康复组与非康复组的留管时间、局部症状、全身症状无显著性差异。结论康复治疗活动对PICC的留管时间等无影响,PICC对康复治疗也无影响,进行康复治疗的患者可行PICC。

To evaluate the value of prenatal ultrasound in the diagnosis of single umbilical artery( SUA ) and fetal malformation . Methods T he characteristics of the prenatal ultrasound findings of 143 fetuses with SU A in different gestational weeks were retrospectively analyzed ,and the missing side of SU A were checked . Different types of SUA combined with fetal malformation were analyzed as well as chromosomal abnormalities and so on . Results For 143 fetuses with SU A ,there were 83 cases ( 58 .0% ) with absent left umbilical artery and 60 cases ( 42 .0% ) with absent right umbilical artery ,there was no statistical difference between the two groups ( P ＞0 .05 ) . Six cases ( 4 .2% ,6/143 ) were detected at and before 20 weeks of gestation ,and the rest 137 cases were detected after 20 weeks( 95 .8% ,137/143) . T here were 121 cases ( 84 .6% ) of isolated SUA ,22 cases ( 15 .4% ) were complicated with other malformations , including 10 cases ( 45 .5% ) with absent left umbilical artery and 12 cases ( 54 .5% ) with absent right umbilical artery . T here was no statistical difference between left and right umbilical artery deletion combined with fetal malformation( χ2 ＝1 .692 ,ν＝1 , P ＞0 .05) . T here were 11 cases( 7 .7% ,11/143) with cardiovascular malformation and nine cases ( 6 .3% , 9/143 ) with digestive system malformation . Chromosome examination was performed in 23 cases . One case of trisomy 18‐trisomy and 1 case of trisomy 13‐trisomy were found to be with missing right umbilical artery and all of them were complicated with multiple deformities . Conclusions The absence of left and right umbilical artery can be combined with abnormal fetal malformation . Prenatal ultrasonography can accurately diagnose SU A and fetal malformation .

Objective:To evaluate the optical performance of two aspheric intraocular lenses (IOL) AcrySof IQ SN60WF and Proming A1-UV with identical negative spherical aberration values, using the optical bench OptiSpheric IOL R&D through an in vitro study. Methods:The optical performance of + 20.0 D blue-light filtering SN60WF and monofocal high-order aspheric non blue-light filtering A1-UV IOL was evaluated through cornea models with the spherical aberration of 0 μm (ISO-1) and + 0.28 μm (ISO-2) under apertures of 3.0 mm and 4.5 mm via the optical bench OptiSpheric IOL R&D.The modulation transfer function (MTF) and USAF 1951 resolution test chart were employed to measure the IOL with centering, decentration of 0.3, 0.5, 0.7, 0.9 and 1.1 mm, as well as tilt of 3°, 5°, 7°, 9° and 11°.The spectral transmittance of IOL was measured with the UV-3300 UV-VIS spectrophotometer.Results:Compared with the A1-UV IOL, the spectral transmittance of SN60WF for blue light with wavelengths of 400-500 nm was significantly reduced, which effectively reduced the passage of blue light.At an aperture of 3.0 mm, the MTF values at 100 lp/mm spatial frequency for the centered SN60WF and A1-UV were 0.576 and 0.598 under ISO-1 corneal measurement conditions, 0.564 and 0.563 under ISO-2 conditions.At an aperture of 4.5 mm, the MTF values were 0.238 and 0.404 under ISO-1 corneal measurement conditions, and 0.438 and 0.339 under ISO-2 conditions.The MTF values of A1-UV and SN60WF at 3.0 mm aperture and 100 lp/mm spatial frequency under ISO-1 corneal measurement conditions were larger than those under ISO-2 corneal measurement conditions.Under ISO-1 corneal measurement conditions with a 3.0 mm aperture, A1-UV had a better optical quality compared to SN60WF, whereas under ISO-2 corneal measurement conditions, the optical quality of both IOLs was similar.Under the 3.0 mm aperture, the MTF values of SN60WF and A1-UV at a decentration of 0.3 mm and 100 lp/mm spatial frequency were 0.414 and 0.571 under ISO-1 corneal measurement conditions, 0.438 and 0.512 under ISO-2 corneal measurement conditions, respectively.The MTF values of SN60WF and A1-UV at a tilt of 3° were 0.522 and 0.597 under ISO-1 corneal measurement conditions, and 0.532 and 0.531 under ISO-2 corneal measurement conditions.The MTF values and USAF resolution test chart of A1-UV had no significant change between the two corneal measurement conditions.When subjected to equal degrees of decentration or tilting, except for the ISO-1 corneal measurement conditions at a 4.5 mm aperture, the MTF values of A1-UV showed a gradual decline across various spatial frequencies compared to SN60WF.With the increase in aperture size, the impact of IOL decentration or tilting on MTF values and USAF 1951 resolution test chart became more notable for A1-UV relative to SN60WF.Conclusions:The SN60WF IOL effectively filters blue light within the wavelength range of 400-500 nm.However, when both IOL experience decentration greater than 0.3 mm or tilting beyond 3°, the optical quality of the IOL will decline.A1-UV has a distinct advantage over SN60WF in terms of resistance to both decentration and tilting-induced optical performance degradation in vitro.

Wearable monitoring, which has the advantages of continuous monitoring for a long time with low physiological and psychological load, represents a future development direction of monitoring technology. Based on wearable physiological monitoring technology, combined with Internet of Things (IoT) and artificial intelligence technology, this paper has developed an intelligent monitoring system, including wearable hardware, ward Internet of Things platform, continuous physiological data analysis algorithm and software. We explored the clinical value of continuous physiological data using this system through a lot of clinical practices. And four value points were given, namely, real-time monitoring, disease assessment, prediction and early warning, and rehabilitation training. Depending on the real clinical environment, we explored the mode of applying wearable technology in general ward monitoring, cardiopulmonary rehabilitation, and integrated monitoring inside and outside the hospital. The research results show that this monitoring system can be effectively used for monitoring of patients in hospital, evaluation and training of patients' cardiopulmonary function, and management of patients outside hospital.
Humans ; Artificial Intelligence ; Internet of Things ; Wearable Electronic Devices ; Monitoring, Physiologic/methods* ; Electrocardiography ; Internet