we have designed a program-controlled high-fi amplifier for EMG.Its gain can be controlled by computer.The program-contralled circuit is implemented with numerical control resistor.The amplifier can be used in automatically measuring EMG signals over 100?v.The circuit is characterized by easy de- sign,simple programing and convenient control.

Colorectal Neoplasms ; surgery ; Humans

Objective To study the diagnosis and management of extra-adrenal pheochromocytoma.Methods A retrospective clinical study was done on 33 patients of extra-adrenal pheochromocytoma treated at our department.Results Extra-adrenal pheochromocytoma accounted for 16.2％ (33/204) of all pheochromocytoma patients admitted between Jan 2005 and Dec 2012.There were 13 males and 20 females.The mean age at diagnosis was 45 years,with a range from 17 to 81 years.14 patients were hospitalized for abdominal discomfort,8 patients suffered from typical hypertension symptoms including headache and dizziness and blurred vision,one of bladder pheochromocytoma was found paroxysmal hypertension and 10 patients had no obvious clinical symptoms.All the patients underwent CT scan,and 8 extra-adrenal pheochromocytoma were discovered.11 patients were given circulation expansion therapy.Most of the tumors were located at bladder(3 case),renal hilus (7 case) and para-aorta(23 case).There were two patients with multiple tumors.In 26 cases,blood pressure fluctuated when touching tumor during operation.All the patients were treated with surgical operation.Except for 1 biopsy,32 patients underwent total resection of tumor including a case combined resection with left kidney and a case with the spleen.There were no perioperative mortality.Postoperative follow up showed very good prognosis,with no death.Conclusions Compared with imaging examination,clinical manifestations and laboratory tests were less evaluable for the diagnosis of extra-adrenal pheochromocytoma.Proper preoperative preparation and precise operation is essential for the prognosis.

Objective To investigate the application of position vector in balance evaluation of stroke patients with hemiplegia.Methods The static balance of 30 healthy subjects and 30 stroke patients with hemiplegia was measured by the balance instrument when standing on a force plate with eyes' open.There were 10 patients tested before and after rehabilitation training.Results The position vectorgram of the healthy subjects showed anterior-posterior sway and the patients showed right-left or diagonal sway.The patients exhibited much longer value in position vector than healthy subjects(P<0.01).After rehabilitation training,10 patients showed the changes in position vector at six directions,and there was a significant difference compared with those before rehabilitation training(P<0.01).Conclusion The position vector is clinically valuable in balance evaluation and monitoring the effect of treatment.

This paper adopted a series of related analysis methods to comprehensively analyze post-marketing clinical safety data of Shenmai injection from 4,220 cases of SRS and 32,358 cases of multicenter, prospective, registered hospital centralized monitoring in large data background, calculated ADR incidence rate was 0.93 per 1,000, main symptoms of ADR includes chest pain, chills, skin itching, palpitations, fever, nausea, dizziness, vomiting, flushing, numbness, allergic reaction, cyanosis, rash, low back pain, and "breath", "anaphylactoid reaction" and "flush" were the safety warning signals of Shenmai injection. Primary disease for chronic pulmonary heart disease, thyroid disease, and combined with cerebral vascular disease, prior to the injection and continuous use of alprostadil, cyclic adenosine monophosphate, combined with quinolones, penicillins were suspicious influence factors of ADR of Shenmai injection, these promot the clinical safety.
Drug Combinations ; Drugs, Chinese Herbal ; adverse effects ; Humans ; Injections ; Product Surveillance, Postmarketing ; Prospective Studies

Objective To investigate the prenatal emotional disorder of the primipame and the related factors,and to analyze its influence on the delivery mode.Methods In the prospective cohort study,590 healthy primiparase were asked to complete a self-compiled questionnaires for their general social mental state,state-trait anxiety inventory(STAI)and self-rating depression scale(SDS).Results Questionnaires of 159 patients were selected and these patients were divided into the anxiety group(114 cases)and the control group(455 cases),the depression group(159 cases)and the control group(410 cases).The ratio of selective cesarean section in the anxiety group was significantly higher(45.61%,32.53%,X2=6.85,P＜0.01),while the successful trial of labor were less than that of the control group(19.35%,47.88%,X2=26.30,P＜0.01).The ratio of selective cesarean section in the depression group was significandy higher than that of the control group(46.54%,31.95%,X2=10.21,P＜0.01),while the successful trial of labor were less than that of the control group(31.76%.46.59%,X2=9.13,P＜0.01).Single-factor analysis showed that prenatal anxiety related to the following factors:fear of childbirth,worried about their children,knowledge for childbirth,high economic status,maternal age and their own economic situation.Conclusions Higher incidence and risk factors of anxiety or depression before delivery,such as advanced delivery age,bad economic condition,weak family support,worrying about the safety of babies and themselves,are found in our study.Prenatal emotional disorder would affect the quality of labor and delivery options,and lead the high risk of cesarean section.

Appendectomy involves several key concepts in the foundation course of operative surgery. So it is the best choice to test whether the students can be flexible in using and fully under-stand what they learned about the basic theories and skills of appendectomy. Changzheng Hospital applies Wechat-ald team-based learning and problem-based learning teaching in appendectomy-related courses by actively delivering messages with content of educational administration, basic knowledge, clinical images and videos to the micro-groups, achieving instantly efficient information dissemination and interactive communication. It breaks the shackles of traditional classroom in space and time, mo-bilizes students' enthusiasm for learning, enhances their communicational skills and sense of team-work and improves students' comprehensive analysis and practical ability, therefore achieving better teaching results.

Objective To summarize the diagnosis and treatment of localized malignant peritoneal mesothelioma(LMPM). Methods A total of 68 cases of LMPM were analyzed retrospectively,including 65 patients in the literature concerning LMPM published in Chinese medical journals be-fore October 2014 plus 3 cases of LMPM admitted in The First Hospital of China Medical University in the same period. Results Among the 68 cas-es,30 cases were male,38 cases were female,with a male to female ratio of 1:1.27. Mean age was 57.6 years. Major clinical manifestations includ-ed abdominal pain or discomfort(76.9%)and palpable abdominal masses(58.5%). Patients(41.7%)had the history of exposure to asbestos. Among the 48 cases(92.3%)that underwent CT examination,ascites was found in 16 cases,and hepatic metastasis was found in 11 cases. Most of the tumors were epithelial type(76.7%),with a mean diameter of 12.2 cm. The main therapeutic strategy was combination therapy of cytoreductive surgery with intraperitoneal hyperthemic chemotherapy. Conclusion LMPM is a rare malignant tumor that occurs predominantly in old people. Symptoms and imaging examinations are untypical. The diagnosis is dependent on pathological examination. Combining several laboratory tests could help the diagnosis. Combination therapy of cytoreductive surgery with intraperitoneal hyperthemic chemotherapy provides an adequate and efficient treatment for LMPM.

Objective To explore the clinical charateristics,diagnosis and treatment of solid pseudopapillary tumors of the pancreas (SPTP).Methods 40 SPTP cases admitted in the First Hospital of China Medical University from 2004 to 2014 were analyzed retrospectively.Results Among 40 cases,male to female ratio was 1 ∶ 7 with the average age of 33.8 years.Major clinical manifestations included abdominal pain or discomfort and palpable abdominal masses.CT and MRI accuracy for detecting the location of tumors was better than B Ultrasonic.Surgical procedure included spleen preserving distal pancreatectomy in 15 cases,distal pancreatectomy with splenectomy in 9 cases,tumor enucleation in 11 cases,pancreaticoduodenectomy in 3 cases,duodenum preserving pancreas head resection in 2 cases.30 postoperative cases were followed-up with the mean follow-up time of 58.4 months and were all doing well.Conclusions SPTP is a tumor with low-grade malignant potentiality.Cystic and solid tumors of the pancreas found among young women are highly suspected as SPTP.Surgery is the main method of treatment and the prognosis is good.

Background:As a new concept of treatment for gastroesophageal reflux disease(GERD),local electrical stimulation on lower esophageal sphincter(LES)is still in a preliminary stage. Aims:To explore the ideal local electrical stimulation parameters for LES contraction and the local neural reflex path that inhibits LES contraction. Methods: Anti-gastroesophageal reflux model with electrical stimulation in vivo was established. The changes of gastroesophageal reflux were observed to explore the ideal electrical stimulation parameters for LES contraction. Effects of different drugs on gastroesophageal reflux in condition with ideal electrical stimulation parameters were observed. Results:When frequency was 10 Hz and pulse was 0. 4 ms,gastroesophageal reflux in voltage 10 V or 15 V groups was significantly decreased(P <0. 001). When voltage was 10 V and pulse was 0. 4 ms,gastroesophageal reflux in frequency 10 Hz group was significantly decreased(P < 0. 001). When voltage was 10 V and frequency was 10 Hz,gastroesophageal reflux in pulse 0. 4 ms group was significantly decreased(P < 0. 001). Local infiltration of tubocurarine or capsaicin on LES could significantly increase gastroesophageal reflux(P < 0. 05). The administration of NK1 receptor blocker L-732,138 or NO synthase inhibitor L-NAME could significantly decrease gastroesophageal reflux(P < 0. 05). Conclusions:In view of the injury of electrical energy on tissue,the ideal electrical stimulation parameters are voltage of 10 V,frequency of 10 Hz and pulse of 0. 4 ms. Local neural reflex path consisted of primary TRPV-1-positive tachykininergic neurons and nitrergic neurons in the muscle layer of esophagus could inhibit LES contraction evoked by electrical stimulation.