A new method of acquiring electromyographic is presented.An EMG signal acquisition system is developed based on virtual instrument,which adopts traditional electromyographic instrument,high performance data acquisition card and Labview software.The real-time acquisition,digitalization and display of electromyographic signal are realized through the new system.Adapted to various physiological signals with the expanded functions,the system can be considered as the future physiological instrument's direction.

OBJECTIVE: To analyze the current status and existing problems of pharmacoeconomic evaluation studies in China, and to put forward suggestions for its future development. METHODS: The pertinent literature was analyzed from aspects of author affiliation, research method, research perspective, research object, research duration, clinical trial, cost, outcome, cost-output analysis, sensitivity analysis, ADR(adverse drug reaction) measurement, and research conclusion. RESULTS: There were still many problems in Chinese pharmacoeconomic evaluation studies. CONCLUSION: Chinese pharmacoeconomic evaluation studies are still in an infant stage, which remain to be further improved.

Objective To investigate the effect of multidisciplinary intervenient on survival of patients with malignant tumor. Methods Six hundred and thirty-nine malignant tumor patients were randomly assigned to the intervenient and the control group. A total of 584 completed the follow-up study. The intervenient group received comprehensive treatment for 2 years,while the control group was in a process of self-rehabilitation. The 2-year survival rate was compared between the groups by using Cox proportional hazard model. Results The 2-year survival rate was 94. 74% (108/114) or 80. 67% (121/150) in II stage patients of the intervenient or control group, respectively ( P < 0. 01 ) . The 2-year survival rate was 88. 03% (163/177) or 82. 8% (184/222) in early and medium stage patients of the intervenient or control group,respectively(P <0. 01). Conclusion The multidisciplinary intervenient may help to improve the 2 year survival of early or moderate stage malignant tumors.

Objective To investigate the methods of prevention and treatment of presacral venous plexus bleeding in pelvic operation.Methods The clinical data of 8 cases of presacral venous plexus bleeding in pelvic operation from 1998 to 2013 were analyzed.Results All 8 cases succeeded in controlling bleeding,The amount of bleeding was 1 000-4 000 mL,the average amount is 2 600 mL.Conclusions The key to prevention of presacral venous plexus bleeding was thorough familiar with pelvic anatomy and a dexterous technique of careful dissection.Massive hemorrhage occurred direct electric coagulation hemostasis was available,the method was simple.

Discussed in this paper is how to provide the personal , differential and intelligent information service for the users of library by putting the people-oriented purpose into its different information services .

Objective To explore the perinatal outcome of vaginal birth after cesarean (VBAC) in women with advanced age.Methods Totally 2 587 women delivered after one or two prior cesarean sections (gestational age≥28 weeks) in the First Affiliated Hospital of Kunming Medical University from July 2013 to February 2017.909 trial of labor after cesarean(TOLAC) cases of singleton pregnancy with one prior cesarean section were studied retrospectively.According to the age,of the 909 TOLAC cases,237 were the advanced age group,and 672 cases were the low age group.The maternal and neonatal outcomes between the two groups were compared.Results The percentage of TOLAC in women with advanced age was 32.4％ (237/731),and VBAC rate was 88.2％ (209/237).The percentage of TOLAC in younger women was 36.2％ (672/1 856),and VBAC rate was 82.4％ (554/672).The difference of the TOLAC rate between the two groups was not significant (P＞0.05),and the VBAC rate of the advanced age group was higher than the low age group (P＜0.05).In the comparison of the two groups,the proportion of bachelor degree or above(55.7％,132/ 237),the prepregnancy BMI (22.4±3.0) kg/m2,pregnant interval time (68.5±38.3) months,the proportion of gestational hypertension (8.4％,20/237),the proportion of gestational diabetes(34.6％,82/237) and the rate of the neonatal ICU admission (18.1％,43/237) in the advanced age group were higher than those of the low age group (P＜0.05),respectively.And there were no significant differences in the rate of postpartum hemorrhage,the rate of postpartum hemorrhage≥1 500 ml,the rate of postpartum transfusion,puerperal morbidity,neonatal birth weight,neonatal 5 min Apgar score＜7 score,umbilical artery blood pH＜7.0,neonatal tracheal intubation and respiratory distress syndrome (all P＞0.05).In all TOLAC cases,the rate of uterine rupture was 0.11％(1/909) and there was no maternal and neonatal death.Conclusion VBAC is a safe and feasible way of delivery for singleton pregnancy after one prior cesarean section in women with advanced age.

Objective To develop whole breast irradiation with volumetric-modulated arc therapy (VMAT)-based hybrid intensity-modulated radiotherapy (IMRT) after breast conserving surgery for breast cancer,and to evaluate its value in clinical application.Methods Ten patients with breast cancer undergoing breast conserving surgery were enrolled.Two radiotherapy plans were designed based on hybrid fixed-beam IMRT/IMRT technique and hybrid VMAT/IMRT technique,respectively.One group received whole breast irradiation with a prescribed dose of 50 Gy in 25 fractions.The other group received whole breast irradiation with a prescribed dose of 50 Gy in 25 fractions,as well as simultaneous integrated boost to the tumor bed with 60 Gy in 25 fractions.The dosimetric parameters and delivery efficiency were compared between the two plans using paired t test.Results For patients treated with whole breast irradiation alone,there were no significant differences in conformity index and homogeneity index of target volume between the two plans (P=0.866,0.056);however,compared with the hybrid fixed-beam IMRT/IMRT technique,the hybrid VMAT/IMRT technique significantly increased the doses to organs at risk (OARs) and the number of monitor units (MUs) in the intensity-modulated field (P=0.000-0.050,P=0.002).For patients treated with whole breast irradiation with a simultaneous integrated boost to the tumor bed;however,the hybrid VMAT/IMRT technique significantly reduced the doses to the lung and spinal cord,number of MUs in intensity-modulated field,and delivery time compared with the hybrid fixed-beam IMRT/IMRT technique (P=0.004,0.001,0.000,0.000).Conclusions For patients treated with whole breast irradiation with a simultaneous integrated boost to the tumor bed,the hybrid VMAT/IMRT technique is highly promising for clinical application due to better OAR sparing and higher delivery efficiency.

AIM:To observe the effects of Egr-1 gene transfection on the expression of tumor necrosis factor-α( TNF-α) and intercellular adhesion molecule-1 ( ICAM-1) , and to investigate the role of Egr-1 in the pathogenesis of dia-betic nephropathy .METHODS:The diabetic mouse model was established .Ten mice were randomly selected as the dia-betic group .The remaining 40 mice were injected with empty plasmid , Egr-1 expression plasmid or Egr-1 siRNA plasmid via the tail vein once a week.The normal control group was also set up .The animals were sacrificed at the end of the 4th week.The renal tissues were harvested .The expressions of Egr-1, TNF-αand ICAM-1 were detected by immunohisto-chemistry and Western blot .The pathological changes were observed under electron microscope .RESULTS: In diabetic mouse kidney, the expression of Egr-1, TNF-αand ICAM-1 was increased, and irregular thickening of glomerular basement membrane , mesangial expansion and fusion of foot were observed .The change trend was more significant in Egr-1 gene transfection group , and these changes in siRNA plasmid transfection group were obviously reduced compared with diabetes group.CONCLUSION:Egr-1 up-regulates the expression of TNF-αand ICAM-1, and induces mesangial cell proliferation and mesangial extracellular matrix accumulation , which is probably one of the mechanisms of accelerating glomerulosclerosis .

Objective To investigate the changes of traditional Chinese medical constitution types with menstrual cycle of sub-health state women, thus to explore the affectability of diseases during menstrual cycle. Methods Sub-health State Questionnaire and Menstruation State Questionnaire established in our previous study were used for the epidemiological survey of 330 women outpatients aged 20-45 years admitted by the disease-preventive department of Tianhe District Hospital of Traditional Chinese Medicine. Results In 330 cases, the cases of sub-health state accounted for 64.5%, in which 21.5%had pure sub-health state without any chronic diseases, and 43.0% had sub-health state together with some diseases. The diseases of hyperplasia of mammary glands, vaginitis, cervical spondylosis, hyperlipemia, chronic appendagitis, and uterus myoma had higher morbidity rate in order. At premenstrual phase, constitution types of Qi stagnation, damp heat, and blood stasis had the higher incidences; at menstruation phase, Qi stagnation, blood stasis, and damp heat had the higher incidences; at postmenstrual phase, yang deficiency, Qi deficiency, and damp heat had the higher incidences. Most of the sub-health state women had the complex constitution types, accounting for 93%. Conclusion Traditional Chinese medical constitution types are correlated with menstral cycle of sub-health state women, and show some effects on the affectability and progress of diseases. The investigation results of dynamic changes and the distribution of traditional Chinese medical constitution types during menstrual cycle will supply some evidence for the prevention and treatment of irregular menstruation and sub-health state of the women with Chinese medine.

Objective To evaluate the results of surgical treatment for patients with heterotaxy syndrome and cardiac anomaly.Methods From September 2008 to October 2013,34 patients with heterotaxy syndrome underwent 46 cardiac operations at Guangzhou Women and Children Medical Center.22 were male,and 12 female.Mean age at operation was 22 months (4 months to 14 year).There were right atrial isomerism 24 cases,left atrial isomerism 10 cases.Only one had a single VSD,and others were all with complex cardiac anomaly,including complete atrioventricular canal defect 26 cases,tricuspid atresia 4 cases,mitral atresia 1 case,anomalous pulmonary venous connection 18 cases,pulmonary venous stenosis 4 cases,double superior vena cava 17 cases,and interrupted hepatic portion of the inferior vena cava 5 cases.Fontan procedure was performed in 5 patients,bidirectional Glenn in 13,Kawashima in 3,central shunt in 1,atrioventricular valve replacement in 5,and pulmonary artery banding in 5.Results There were 4 died during hospitalization.The follow-up duration was 1 month to 5 years.There were 2 died.The early to middle term mortality was 17.6％ (6/34).In the same period the mortality for 103 patients without heterotaxy syndrome underwent univentricular repair was 4.8％ (5/103).There was significant statistical difference (P ＜ 0.05).Conclusion Right heart bypass operation remains the preferred palliative procedure for patients with heterotaxy syndrome,and the eraly and middle term results were satisfied.