Objective To compare the prediction probability (Pk) of loss of consciousness (LOC) for the four EEG nonlinear indexes-correlation dimension ( D2), approximate entropy (ApEn) complexity (Cx) and bispectral index (BIS) and their relative accuracy. Methods Twenty ASA Ⅰ-Ⅱ patients aged 22-71 undergoing elective operation on lower limb under epidural anesthesia were studied. The patients were unpremedicated. Epidural catheter was placed at L2,3 or L3,4 interspace. The block height was 95% . Sedation was produced by target-controlled infusion (TCI) of propofol. The target plasma concentration of propofol (Cp) was initially set at 0.5 ?g?ml-1. Cp was gradually increased in increments of 0.3-0.5 ?g?ml-1 every 3 min until LOC. Depth of sedation was assessed using OAA/S scale (5 = alert, 1 = LOC) . LOC was maintained for 12 min. Cp was equal to effect-site concentration (Ce) by the end of 12 minutes. Cp was then gradually decreased in increments of 0.3-0.5 ?g?ml-1 until the patients regained consciousness. The same procedure was repeated 4 times in every patient. BIS, D2 , ApEn and Cx were recorded simultaneously every 3 min. The prediction probability of LOC for D2, ApEn, Cx and BIS was calculated and compared.Results The BIS value was 80.2?6.2 when the patients regained consciousness (T1) and 67.3?7.9 at LOC (T2); D2 was 3.45?0.18 (T1) and3.01?0.16 (T2); ApEn was 0.84?0.05 (T1) and 0.71?0.06 (T2); Cx was 0.55?0.05 (T1) and 0.44?0.05. There was no significant difference in Pk of LOC among the 4 indexes. Conclusion Our results show that all the 4 indexes can be used to monitor the level of sedation produced by propofol.

Objective To realize the tactile and slip sensory functions for electromyogram controlled prosthetic hand. Methods The piezoelectric membrane polyvinylidence floride (PVDF) was used to construct a transducer for the tactile and slip sensory feedback. The fea-ture and piezoelectric response of PVDF and its mechanism of signal production were studied. The feedback control system was designed and a prototype for testing the tactile and slip sensor function was constructed and tested. Results and Conclusion The signal response of PVDF sensor is obviously, and the PVDF sensor can be used in practice.

Objective To analyze the bispectral index (BIS) and the EEG nonlinear index (including Correlation dimension, D2; Approximate entropy, ApEn; Complexity, Cx.) during alternating periods of consciousness and unconsciousness produced by target-controlled infusions (TCI) of propofol. Methods We studied twenty patients (ASA Ⅰ～Ⅱ grades) undergoing the elected leg operations under epidural anesthesia. With TCI consciousness of the patient was controlled by an increase or decrease of concentration of propofol in a range of 0.3～0.5?g/ml for four times. Every target plasma concentration of propofol lasted 12 minutes. BIS, D2, ApEn and Cx were recorded simultaneously during the periods of consciousness and unconsciousness every 3 minutes. Results During consciousness and unconsciousness, the respective mean values for the four measurements were: BIS, 80.2?6.2 and 67.3?7.9; D2, 3.45?0.18 and 3.01?0.16; ApEn, 0.84?0.05 and 0.71?0.06; Cx, 0.55?0.05 and 0.44?0.05. Determined threshold values with 100% specificity during the state of unconsciousness were: BIS, 51 (sensitivity3.8%); D2, 2.90 (sensitivity 30.3%); ApEn, 0.69 (sensitivity42.3%); Cx, 0.41 (sensitivity 25.5%). Conclusion BIS, D2, ApEn and Cx can all reflect the change in consciousness and unconsciousness produced by TCI of propofol. Our findings suggest that of the four EEG variables, ApEn was best in identifying the transition from unconsciousness to consciousness.

Objective To investigate the clinical characteristics and therapeutic strategy of acute subdural hematoma. Methods A restrospective study was carried out with a total of 94 consecutive ASDH patients who were confirmed through computed tomographic scan and obtained the clinical characteristics by experienced neurosurgeons.15 cases werepure acute subdural hematoma and the other 79 cases were acute compound subdural hematoma according to CT scan. Results In accordance with the GOS,36 cases had good recovery,19 cases had moderate disability,17 cases had severe disability and 22 cases dead. Conclusion The most important treatment for pure acute subdural hematom was to diagnose the source of bleeding, and acute compound subdural hematoma had poor prognosis than pure acute subdural hematoma since the traumatic severity. Early decraniuim by large bone flap to treat acute compound subdural hematoma could improve survival rate,reduce the fatality rate and decrease postoperative complications.

Objective To investigate the clinical value of continuously detecting serum and pelvic drainage fluid C-reactive protein (CRP) and drainage fluid matrix metalloproteinase-9 (MMP-9) in the early diagnosis of anastomotic leakage after anterior resection of low rectal cancer.Methods The levels of CRP and MMP-9 in serum and pelvic drainage fluid were measured on postoperative 1,3,5,7 d in 158 patients with low rectal cancer anterior resection.The patients were divided into the anastomotic group (n=9) and non-anastomotic leakage group (n=149).The differences in the detection values between the two groups were compared and analyzed statistically.Results Among 158 cases,anastomotic leakage occurred in 9 cases.The correlation analysis of serum and drainage fluid CRP detection value and postoperative days (POD) in the two groups showed the POD 3,POD 5 and POD 7 difference was statistically significant (P＜0.05).The ROC curve analysis showed that the accuracy of the serum and drainage fluid CRP continuous detection for diagnosing the anastomotic leakage on postoperative 3 d was middle,which on postoperative 5,7 d was higher.The patients with CRP detection value ＞ 128.23 mg/L and drainage fluid CRP ＞89.93 mg/L on postoperative 5 d and those with CRP detection value＞113.71 mg/L and drainage fluid CRP＞81.75 mg/L on postoperative 7 d developed the anastomotic leakage.The drainage fluid MMP-9 detection value had no statistical difference between the anastomotic leakage group and the non-anastomotic leakage group (P＞0.05).Conclusion Continuous detection of serum and drainage fluid CRP level can be used for early diagnosing postoperative anastomotic leakage in low rectal cancer anterior resection.The drainage fluid MMP-9 continuous detection has no relation with early diagnosis of anastomotic leakage after low rectal cancer anterior resection.

Objective To study the effects of resilience training on work fatigue,psychological stress and mental health in warship soldiers.Methods100 warship soldiers were selected and divided randomly into training-group (n=45) and control group (n=55),and the training group was divided into two groups by casting lots ( n t =22,n 2 =23 ).The shedding rate of the training group was 13％ (6 out of 45 ),while the control group was 10％ (5 out of 50).All of them were tested by the Resilience Scale for Adults ( RSA),Newly Developed Questionnaire for Work Related Fatigue Feelings (WRFFQ),Psychological Stress Self-evaluation Test (PSET) and Symptom Checklist (SCL-90) before and after training.According to resilience theory and its elements to design the group-training,10 times resilience training was arranged 2 hours once per week for the training group.The aim was to train members' self-awareness,emotion management,interpersonal communication,problem solving and social support and other capabilities.Before training there were no significant differences between the training-group and control-group in age,military service,job and education level and total average score of RSA,WRFFQ score,PSET standard scores and the SCL-90 total average score (P＞ 0.05 ).Results ①Compared with the pre-test resuits,the RSA ( 2.90 + 0.47) scores of training-group ( n =39) significantly increased after training,but the scores of WRFFQ(33.62 ± 11.24),PSET(47.80 ±9.09) and 5CL-90( 1.14 ±0.09) significantly reduced (P＜0.05) ;For control group ( n =50),no significant differences were found in scores of RSA (2.56 + 0.57 ),WRFFQ (42.38± 17.76),PSET( 53.70 ± 13.25) and SCL-90( 1.43 ± 0.45 ) (P＞0.05 ) ; ②Compared to the control group,posttest scores of RSA significantly increased,but the scores of WRFFQ,PSET and SCL-90 significantly decreased for the training-group(P ＜ 0.05).Conclusion Resilience training can effectively improve warship soldiers' resilience,increase their anti-stress ability and mental health level and reduce fatigue symptoms.

OBJECTIVETo investigate the effects of transforming growth factor beta(1) (TGF-beta(1)) and bone morphogenetic protein 2 (BMP2) combined with heparin on odontoblast differentiation.

METHODSTrypsin-isolated dental papillae from day 17 mandibular first molar were cultured in semisolid-agar medium for 6d. Recombinant human TGF-beta(1) and BMP2 combined with heparin were added to the medium.

RESULTSTGF-beta(1) and BMP2 combined with heparin induced differentiation of odontoblasts and promoted matrix secretion. Odontoblast differentiation never occurred when TGF-beta(1) or BMP2 were added alone to the medium, whereas an increase in extracellular matrix production was observed.

CONCLUSIONThese results demonstrate that both TGF-beta(1) and BMP2 stimulate the cytological and functional differentiation of preodontoblasts, and that heparin might play important role as a substrate.

Animals ; Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; pharmacology ; Cell Differentiation ; drug effects ; Heparin ; pharmacology ; Mice ; Odontoblasts ; cytology ; drug effects ; Transforming Growth Factor beta ; pharmacology ; Transforming Growth Factor beta1

Objective To explore the related risk factors of anastomotic leakage after low rectal cancer anterior resection op-eration .Methods The clinical data of 158 patients with low rectal cancer anterior resection operation in this hospital from January 2011 to June 2016 were retrospectively analyzed .The clinical features and treatment factors were performed the univariate and mult-ivariate correlation analysis .Results The total incidence rate of anastomotic leakage was 5 .7% (9/158) .The univariate analysis showed that the age ,sex ,body mass index(BMI) ,preoperative concurrent disease ,tumor stage ,location ,pathological type ,preopera-tive intestinal obstruction and surgical mode (laparoscopy and laparotomy) had no significant correlation with postoperative anasto-motic leakage (P>0 .05) .Preventive ileostomy did not affect the incidence rate of anastomotic leakage (P=0 .694) .Postoperative placement of anorectal decompression tube could reduce the incidence rate of anastomotic leakage (P=0 .047) .The univariate and multivariate analysis showed that postoperative diarrhea was an independent risk factor for anastomotic leakage occurrence (OR=10 .522 ,P=0 .001) .Conclusion Postoperative early diarrhea is an independent risk factor for anastomotic leakage occurrence after rectal cancer anterior resection operation .Postoperative placement of anorectal decompression tube can reduce the incidence rate of anastomotic leakage .

Objective To study protective and therapeutic measures to improve perioperative safety in extremely elderly patients with biliary diseases.Methods A retrospective case-control study was conducted.The clinical data of elderly patients with biliary diseases treated at the Department of General Surgery,Beijing Electric Power Hospital,from July 2013 to December 2018,were collected.According to age,the patients were divided into the high age (HA) group (≥80.0 years) and the middle-low age (MLA) group (60.0～79.0 years).The related indexes of perioperative safety such as preoperative coexisting diseases,functions of liver,kidney,heart and lung,surgical procedures,intraoperative blood loss,operation time,postoperative hospital stay and postoperative hospital stay were analyzed and compared between the two groups.Results Of the 372 included patients,there were 168 males and 204 females,aged 60.0 to 96.0 (72.0 ± 8.6) years.There were 69 elderly patients (37 males and 32 females) aged 80.0 to 96.0 (84.4 ±3.8) years in the HA group.There were 303 patients in the middle and lower age group (131 men and 172 women),aged 60.0 to 79.0(68.4 ±5.8) years (MLA group).(1) Preoperative coexisting diseases were significantly increased in the HA compared with the MLA group (all P ＜ 0.05),including the proportion of coexisting coronary heart disease [34.8％ (24/69) vs.18.5％ (56/303)],hypertension [68.1％ (47/69)vs.46.9％ (142/303)],chronic bronchitis with emphysema [17.4％ (12/69) vs.3.6％ (11/303)],hypoproteinemia [39.1％ (27/69) vs.26.7％ (81/303)],and anemia [42.0％ (29/69) vs.11.9％ (36/303)].(2) Laboratory examinations:the functions of liver,kidney,heart,lung and blood coagulation were significantly worse in the HA compared with the MLA group (P ＜ 0.05).(3) Surgical procedures:the proportion of open cholecystectomy with transcystic common bile duct exploration (OC + OTCBDE) was higher [17.4％ (12/69) vs.6.9％ (21/303)],while laparoscopic cholecystectomy (LC) was lower [43.5％ (30/69) vs.62.7％ (190/303)],in the HA compared with the MLA group (P ＜0.05,totally).(4) Operative effects:the intraoperative blood loss [30.0 (20.0,75.0) ml vs.20.0 (10.0,30.0) ml],operation time [90.0(72.5,137.5) min vs.77.0(55.0,115.0) min],postoperative hospital stay [10.0(6.0,18.0) d vs.7.0(4.0,11.0) d],and length of hospitalization [17.0(11.5,23.0) d vs.13.0(9.0,19.0) d] were significantly increased or prolonged in the HA compared with the MLA group (all P ＜0.05).(5) Postoperative complications:the incidence of postoperative complications was significantly higher [30.4％ (21/69) vs.12.2％ (37/303)] in the HA compared with the MLA group (P ＜ 0.05).(6) Therapeutic outcomes:there was a cure rate of 95.7％ (66/69) in the HA group,and 97.7％ (296/303)in the MLA group.No significant difference in the therapeutic effects was found between the two groups (P ＞ 0.05).Conclusions Operation in extremely elderly patients with biliary diseases is safe and feasible.The key is to take measures such as actively treating preoperative coexisting diseases,strictly mastering operative indications,reasonably selecting surgical procedures,accurately carrying out precise operation,strictly monitoring and dealing with intraoperative emergency,timely preventing and treating postoperative complications,and especially focusing on maintaining cardiopulmonary function during the perioperative period.

Objective:To observe the natural course of patients with simple traumatic intraparenchymal contusions and hematomas (TIPHs), and analyze the risk factors for TIPHs progression.Methods:Using a prospective observational study, 69 patients with TIPHs in Affiliated Xiaolan Hospital, Southern Medical University from July 2018 to January 2020 were selected. The gender, age, cause of injury, compound injury status, combined injury and Glasgow coma score (GCS) were recorded. The plasma levels of prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fbg), international normalized ratio (INR), D-dimer, platelet, hemoglobin at admission were detected. The occurrence of hypoxemia and high intracranial pressure were observed. The time of the first CT examination, volume of the first CT hematoma, time of the control CT examination, volume of the control CT hematoma, and lesion morphology, multifocality, subarachnoid hemorrhage (SAH), edema zone and cortical distance showed in the first CT examination were recorded. The risk factors of progression in patients with TIPHs were analyzed.Results:Among 69 patients with TIPHs, TIPHs progression was in 28 cases (progression group), and the progression rate was 40.58%; TIPHs progression was not in 41 cases (non-progression group). There were no statistical differences in gender composition, age, PT, APTT, INR, hemoglobin, cause of injury, compound injury, incidence of hypoxemia, incidence of high intracranial pressure, incidence of SAH, incidence of edema zone, incidence of irregular lesions, time of the first CT examination, time of the control CT examination and volume of the first CT hematoma between 2 groups ( P>0.05). The GCS, cortical distance and Fbg in progression group were significantly lower than those in non-progression group, the TT, platelet, multifocality rate and volume of the control CT hematoma were significantly higher than those in non-progression group, and there were statistical differences ( P<0.01 or <0.05). Multivariate Logistic regression analysis result showed that cortical distance <1 cm, Fbg<2 g/L and multifocality were independent risk factors affecting the progression in patients with TIPHs ( OR = 6.723, 5.515 and 4.827; P<0.05). The model had a sensitivity of 71.43% (20/28), a specificity of 92.68% (38/41), and an accuracy of 84.06% (58/69) in judging the progression of TIPHs. Conclusions:Based on the risk factors for the progression of TIPHs, predicting these patients in advance can provide necessary intervention measures for high-risk patients, which will help to reduce the rate of progression and improve the prognosis of patients.