In this paper, a heart rate variability analysis system is presented for short-term (5 min) applications, which is composed of an electrocardiogram signal acquisition unit and a heart rate variability analysis unit. The electrocardiogram signal acquisition unit adopts various digital technologies, including the low-gain amplifier, the high-resolution analog-digital converter, the real-time digital filter and wireless transmission etc. Meanwhile, it has the advantages of strong anti-interference capacity, small size, light weight, and good portability. The heart rate variability analysis unit is used to complete the R-wave detection and the analyses of time domain, frequency domain and nonlinear indexes, based on the Matlab Toolbox. The preliminary experiments demonstrated that the system was reliable, and could be applied to the heart rate variability analysis at resting, motion states etc.
Electrocardiography ; Heart Rate ; Humans ; Signal Processing, Computer-Assisted

Objective To analyze the different spreading patterns and the prognostic factors of nasopharyngeal adenocarcinoma (NPAC).Methods The clinical and radiological data of 39 pathologically confirmed consecutive cases of NPAC were retrospectively reviewed.Results In the 1 1 patients with CT/MRI-detected cranial nerve (CN)involvement,there were ACC (n=7),CAC (n=2)and MEC (n=2)(P <0.05).Lymph node metastasis occurred in 40% of CAC,7.7% of ACC and 1 6.7% of MEC (P =0.035). Significant differences were observed in 5 year OS and DFS rates between patients with and without CT/MRI-detected CN involve-ment (P <0.001;P =0.001).In 1 9 patients with early stage disease (stageⅠ-Ⅱ),significant difference was observed in 5 year OS rate between the surgical treatment group and non-surgical treatment group (P =0.038),and the difference was not significant in DFS (P =0.056).Conclusion CT and MRI are valuable tools not only for discovering the different spreading patterns of NPAC, but also for its prognosis.

Objective To analyze computed tomography imaging features of primary adrenal schwannoma.Methods The clinical and radiological data of six cases of adrenal schwannoma confirmed by histopathology were analyzed in this study.Results All six cases of adrenal schwannoma were well-circumscribed,round-like or oval-like,solid and cystic tumors,in which two cases were with calcification,and three cases with septations.On the enhanced CT images,all six tumors displayed progressive enhancement.Conclusion Adrenal schwannoma usually presents a well-defined heterogeneous mass with cystic degeneration,sepations,calcification and characteristic progressive contrast enhancement.

Objective: To investigate the factors affecting social alienation among elderly stroke patients, so as to provide the reference for the prevention of social alienation among elderly patients with chronic disease. Methods: The stroke patients aged ≥60 years who visited Hangzhou Hospital of Traditional Chinese Medicine from January to June 2024 were selected as subjects. Demographic information and disease status were collected through questionnaire surveys. Social alienation, stigma and social support were assessed using the General Alienation Scale, Stroke-Specific Stigma Scale and Perceived Social Support Scale, respectively. Factors affecting social alienation among elderly stroke patients were analyzed by using a multiple linear regression model. Results: Totally 283 elderly stroke patients were surveyed, including 165 males (58.30%) and 118 females (41.70%). The mean age was (69.55±8.72) years. The mean scores for social alienation, stigma and social support was (41.72±6.10), (43.70±8.96) and (59.86±10.22) points, respectively. Multiple linear regression analysis identified educational level (high school/technical secondary school, β' =-0.157; college degree or above, β' =-0.322), household monthly income per capita (≥3 000 yuan, β' =-0.260), number of stroke occurrences (recurrent stroke, β' =0.181), number of comorbid chronic diseases (≥2, β' =0.165), self-care ability (partially self-care, β' =0.142; unable to self-care, β' =0.308), stigma (β' =0.277) and social support (β' =-0.253) as factors affecting social alienation among elderly stroke patients. Conclusion Social alienation among elderly stroke patients is associated with educational level, household monthly income per capita, number of stroke occurrences, number of comorbid chronic diseases, self-care ability, stigma and social support.

Objective: To study the application effect of information-based health education WeChat platform on the cognition, attitude and behavior of pelvic floor muscle training (pelvic floor muscle training, PFMT) of puerpera, in order to provide an effective intervention method and scientific basis to improve the compliance level of PFMT. Methods: Full-term birth 329 cases of vaginal delivery have been chosen from August to September in 2017 in Beijing Obstetrics and Gynecology Hospital, Capital Medical University. They were divided into 3 groups: control group, audio group, video group by computer random digital table method. The number of the cases of the corresponding groups were 108,113, 108 cases. Control group was given general postpartum health education, audio group and video group were given continuation of voice remind audio guide and continuation of voice remind video guide respectively from postpartum 1 week to 7 weeks. The compliance level of PFMT of the three groups would be evaluated before and after the intervention. Results: The KAP(Knowledge, Altitude and Practice, KAP) scores of PFMT of control group, audio group and video group were 9.0(7.0,10.0), 11.0(8.0,12.0), 12.0 (11.0,13.0) points, respectively. There were significant differences between the video group and the control group, between the video group and the audio group and between the audio group and the control group (Z =-4.302, -10.233, -6.429, P<0.01). Comparison of the PFMT scores before and after the three groups, there was a visibility significant statistical difference in KAP scores (Z =-5.596, -11.762. -15.061, P< 0.01). Conclusions The maternals' knowledge level and physical activity level of PFMT are relatively low. Health care workers should enhance their knowledge about PFMT and improve their understanding of PFMT. WeChat platform to continue voice remind audio guide and continue voice remind video guide way of health education, could improve the KAP level of maternal PFMT and adherence. The KAP level of video guide health education is superior to the audio guide way of health education, which has clinical significance, and is worth popularizing.

Objective: To evaluate the concordance of PD-L1 expression in various tissues using antibodies 28-8 and SP263 on their respective detection platforms. Methods: Three hundred seventy four specimens of surgical resection of pulmonary diseases in the First Affiliated Hospital of Nanjing Medical University from January 1, 2012 to January 31, 2017 were collected. Totally 374 cases were tested for PD-L1 expression using the two antibodies, 28-8 and SP263, by respective detection platforms (Dako and Ventana). Finally, 336 cases were used for further evaluation, and the results were statistically analyzed for concordance. Results: For non-small cell lung carcinoma (NSCLC), the positive rate of PD-L1 was 57.5% (177/308) using SP263, and 57.5% (177/308) using 28-8 antibody. The correlation coefficient was 0.97 (P<0.01). The positive rate of both benign lung diseases and paracancerous tissues was about 10.7% (3/28), and the positive concordance rate was 100.0%. The distribution of both antibodies was also relatively consistent. Conclusions The expression levels of 28-8 and SP263 antibodies in NSCLC and other tissues are relatively consistent, suggesting both antibodies may be complementary and substitute for each other, which may be useful in guiding clinical management.

Objective To observe over-time changes in rat blood flow in the skins of related meridian points during physiological status, the pathological state of ischemic myocardial injury and low or high frequency electroacupuncture intervention and explore the post effect of different frequency electroacupuncture on related meridian points after treating ischemic myocardial injury. Method Fifty male Wister rats were randomized into five groups: blank control, sham operation, model, low frequency electroacupuncture (meridian point A) and high frequency electroacupuncture (meridian point B), 10 rats each. Blood flow in the skins of bilateral points Neiguan (PC6), Ximen (PC4) and Tianquan (PC2), and non-meridian and non-acupoint control points was measured by laser speckle contrast imaging in every group immediately and at 30 and 60 min after the end of three treatments. Statistical analysis was made. Result Blood flow in the skins of bilateral points Neiguan, Ximen and Tianquan was significantly lower in the blank control group than in the model group (P<0.01,P<0.05). Blood flow in the skin of every acupoint increased in varing degrees after low or high frequency electroacupuncture treatment. Blood flow in bilateral points Neiguan, Ximen and Tianquan regions in meridian point group A was closer to that in the blank control group immediately after treatment. Blood flow in three left-side and three right-side acupoint regions in meridian point group B was closer to that in the blank control group at 30 and 60 min, respectively, after treatment. Conclusion The immediate effect of low frequency electroacupuncture on blood flow in acupoint regions is better than high frequency electroacupuncture during intervention in ischemic myocardial injury. The post effect of high frequency electroacupuncture on blood flow in acupoint regions is better than low frequency electroacupuncture during intervention in ischemic myocardial injury.

Objective To observe the effect of Shoutai Pills on endometrial decidualization of mice with recurrent spontaneous abortion(RSA);To explore its possible mechanism in the treatment of RSA based on histone modification.Methods Totally 40 female CBA/J mice were divided into normal group,model group,Shoutai Pills low-dosage group(7.5 g/kg),Shoutai Pills high-dosage group(15 g/kg)and dydrogesterone group(3 mg/kg).The normal group were co housed with BALB/C male mice,while the other groups were co housed with DBA/2 male mice to establish an RSA mouse model.After modeling,the administration groups were given corresponding medication solution by gavage,while the normal group and model group were given equal volume of pure water by gavage for 10 consecutive days.The embryo condition was observed and the embryo loss rate was calculated,ELISA was used to detect serum prolactin(PRL)content,HE staining was used to observe the morphological changes of decidual tissue,RT-PCR was used to detect PRL mRNA expression in decidual tissue,Western blot was used to detect the protein expressions of H4ac,H3K27ac,H3K27me3.Results Compared with the normal group,the model group mice showed a significant increase in embryo loss rate,a significant decrease in serum PRL content,disordered arrangement of decidual cells,and extensive bleeding and necrosis;the expression of PRL mRNA and protein in decidual tissue significantly decreased,the protein expressions of H4ac and H3K27ac significantly decreased,while the expression of H3K27me3 protein significantly increased,with statistical significance(P<0.05).Compared with the model group,the embryo loss rate of Shoutai Pills low-and high-dosage groups and the dexamethasone group significantly decreased,the serum PRL content significantly increased,tightly arranged decidual cells,reduced necrosis,and intact glands;the expression of PRL mRNA and protein in decidual tissue of mice in Shoutai Pills high-dosage group and the dexamethasone group significantly increased,the protein expressions of H4ac and H3K27ac significantly increased,the expression of H3K27me3 protein significantly decreased,with statistical significance(P<0.05).Conclusion Shoutai Pills can promote endometrial decidualization in RSA mice,which is related to the changes of histone modification in endometrial stromal cells.

OBJECTIVETo study the clinical and histopathologic features of metanephric adenoma (MA).

METHODSEight cases of recently diagnosed MA were retrieved from archival file. Immunohistochemical study was carried out. The clinical characteristics, pathologic parameters, differential diagnosis, treatment options and prognosis of MA were analyzed, with literature review.

RESULTSThe patients included 6 females and 2 males. The age of patients ranged from 12 to 70 years (mean=43.6 years). Eight cases were located in renal cortex and showed well-defined borders. Histologically, the tumor was composed of tubules lined by small basophilic cells and embedded in an edematous stroma. Papillary structures and psammoma bodies were focally seen. Immunohistochemical study showed that the tumor cells were positive for PAX2 and vimentin in all the 8 cases. WT-1 was positive in 2 cases, focal and weak in 5 cases, and negative in 1 case. CK-Pan was positive in 3 cases. CK7 staining was mostly negative, with focal and weak positivity only in 1 case. The proliferative index, as highlighted by Ki-67 staining, was less than 2% in 7 cases and focally around 5% in 1 case. The expressions of CK20, CD10, RCC, epithelial membrane antigen, CD56, synaptophysin and chromogranin A were negative. Follow-up information from 7 to 57 months was available in all patients; and none of them developed local recurrence or distant metastasis.

CONCLUSIONSThe diagnosis of MA relies primarily on thorough histologic examination and immunohistochemical study (vimentin and PAX2 positive, WT-1 focally and weakly positive in some cases, and low proliferative index). Correlation with clinical and radiologic findings would also be helpful.

Adenoma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Adolescent ; Adult ; Aged ; Biomarkers, Tumor ; metabolism ; Carcinoma, Renal Cell ; metabolism ; pathology ; Child ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Nephrectomy ; methods ; PAX2 Transcription Factor ; metabolism ; Tomography, X-Ray Computed ; Vimentin ; metabolism ; WT1 Proteins ; metabolism ; Wilms Tumor ; pathology ; Young Adult