Heart disease is the major disease that threaten human health. ECG is an important tool for the diagnosis of cardiac disease. As traditional ECG measurement devices have many disadvantages, a non-contact ECG measurement system was designed. With the non-contact electrode based on capacitive coupling, the signals were collected and then they were amplified and filtered. The conditioned analog signal was converted to digital data which was sent to the mobile terminal through bluetooth. Finally, the ECG data was analyzed to extract the key ECG parameters. The results showed that the precise ECG signals can be got with the non-contact electrode and the key ECG parameters can be acquired accurately.
Electrocardiography, Ambulatory ; instrumentation ; Electrodes ; Equipment Design ; Signal Processing, Computer-Assisted

Objective:To investigate the training needs of nursing students during their practice in the emergency department, and to provide evidence for further improvement and development of the training.Methods:A total of 279 nursing students from 24 hospitals in Guangdong Province and 4 undergraduate universities running nursing specialty were investigated by convenience sampling. The contents of the questionnaire included general information and emergency training needs, including teaching contents and teaching methods.Results:Among the surveyed nursing students, 97.13% (271 students) believed it was very necessary to learn first aid knowledge and skills, and 85.66% (239 students) were very interested in learning first aid knowledge and skills. The score of "acute and critical skills" in the emergency training needs was the highest (88.91 points), and the score of "department rules and regulations" was the lowest (76.08 points). Univariate analysis showed that there were significant differences in gender, willingness to engage in nursing work in the future, interest in learning first aid knowledge and willingness to learn first aid knowledge independently by network ( P < 0.05). The three teaching methods ranked the highest in the survey of emergency teaching methods were situational teaching, problem-based learning and action teaching method. Conclusion:Nursing students have a strong demand for training during the emergency internship. Clinical nursing administrators and educators should combine the internship demand of nursing students and the teaching outline of medical colleges to carry out the training arrangement during the emergency practice, so as to meet the learning needs of nursing students during the emergency practice.

Objective To explore the long-term prognosis of the patientswithpulmonary arterial hypertension ( PAH) after cardiac repair operations through follow up .Methods We filtered the CHD patients with PAH after cardiac repair operation , admitted to the department of pediatric cardiology in Beijing Anzhen Hospital from June 2004 to December 2014, and collected their preoperative and postoperative data to analysis the long-term prognosis.Results 92 patients were included, median age was 20.78 years(2.44-60.26 years),median operation age was 13.54 years(1.33-53.99 years), World Health Organiza-tion functional classⅠ-Ⅱ was 80(86.96%), Ⅲ -Ⅳ was 12(13.04%), mean 6 min walk test distance was(481.74 ± 80.74) meters, mean Borg score was 1.53 ±1.14, and mean percutaneous oxygen saturation was 0.95 ±0.05.Among them, 64 patients completed preoperative right heart catheterization.Their average pulmonary artery pressure was(72.23 ±12.83) mmHg, aortic pressure on average was(85.57 ±11.91) mmHg, and average pulmonary vascular resistancewas(10.79 ±5. 04) Wood· U.The range of follow-up was between 6 months and 28.32 years(median 13.67years).During the follow-up, there were arrhythmia in 2 cases(2.17%), syncope in 7 cases(7.61%), hemoptysis in 4 cases(4.35%),heart failure in 8 cases(8.70%) and death in 1 case(1.09%).Compared with preoperative data, WHO cardiac function was found decreased in 22 patients(23.91%), stabled in 61 patients(66.30%) and significantly improved in 9 patients (9.78%).63 patients (68.48%) received targeted drug therapy, only 5 patients were treated with combined therapy,29 cases were not.Conclusion Compared with idiopathic pulmonary hypertension , PAH after defect correction has a lower incidence of arrhythmia , hemop-tysis and heart failure, and a higher long-term survival rate, and heart function is stable.To patients with PAH after defect cor-rection, targeted therapy is not only in perioperative period, but also more important in the long-term after surgery.In the targe-ted drug therapy, the combination treatment rate is low.

Objective:To explore the application effect of dynamic case scenario simulation combined with video playback in the teaching of trauma emergency for nursing interns.Methods:A total of 80 nursing interns who had internship in the Department of Emergency, The First Affiliated Hospital of Guangzhou Medical University from December 2017 to November 2018 were recruited in the study, and they were randomly divided into experimental group and control group (40 nurses per group). The dynamic case scenario simulation combined with video playback method was applied in the experimental group, and the traditional teaching method was used in the control group. Both groups had the same teaching hours (8 class hours) and trauma practice outline. Trauma theoretical knowledge and operational skills of the two groups were assessed, and the scores of nursing students in the two groups, teaching satisfaction and teaching evaluation in the experimental group were analyzed. SPSS 19.0 was used for t test. Results:The trauma theoretical knowledge assessment results and clinical operation skills assessment scores of control group were (73.40±7.11) points and (78.69±8.71) points, respectively, and those of experimental group were (78.09±6.84) points and (85.34±6.43) points respectively, with a statistical difference between the two groups ( P<0.05). The overall satisfaction of nursing students in the experimental group was higher than that in the control group [(98.34±2.19) vs. (94.94±2.58), P<0.01]. Most of nursing students (97.5%, 39/40) in the experimental group hoped to apply dynamic case scenario simulation combined with video playback method in the future. Conclusion:The dynamic case scenario simulation combined video playback method could enhance the trauma emergency ability of the nursing interns and improve the teaching satisfaction and teaching effect.

Objective To investigate the influence of long-term exposure to oil and gas toxicants on the peripheral blood T lym-phocyte subsets in Karamay Uygur and Han refining workers and the underlying mechanism.Methods 175 cases of Uighur and Han refinery workers who had long-term close contact with poison of oil and gas(112 cases of Han people and 63 cases of Uygur people)and 110 healthy people(70 cases of Han people,40 cases of Uighur)were selected as research subject.The peripheral blood T lymphocyte subsets of all cases were detected for comparative analysis.Results Compared with healthy control group,the median of CD4+in the uighur refinery workers was significantly reduced(P<0.05);the CD8+in Han ethnic refinery workers was signifi-cantly lower,while the ratio of CD4+/CD8+increased significantly(P<0.05).Compared with Han ethnic,the median of CD3+, CD8+in uighur significantly increased,while the ratio of CD4+/CD8+decreased significantly(P<0.05).Conclusion Long-term close contact(more than 5 years)of oil and gas poison will significantly reduce the function of peripheral blood T lymphocyte sub-sets of refinery workers,and the effect on Han ethnic oil refinery workers was significantly higher than that on Uighur,,so corre-sponding measures on effective occupational protection are necessary to carry out.

Objective: To analyze the prognosis and associated risk factors of pediatric idiopathic pulmonary arterial hypertension. Methods: A total of 119 patients under 18 years of age diagnosed as idiopathic pulmonary arterial hypertension in the Pulmonary Arterial Hypertension Center in Beijing Anzhen Hospital between June 2007 and May 2017 were enrolled in this retrospective study. The clinical informations and follow-up data were collected. The endpoints of follow-up were defined as death or undergoing lung transplantation. Kaplan-Meier survival curve was used to assess the survival,and the COX risk regression model was used to analyze the prognostic risk factors. Results: The mean age at diagnosis was (5.9±4.2) years. For 92 (77.5%) patients, the main reason for visit was decreased activity with shortness of breath after exercise. Seventy patients (58.8%) were in baseline NYHA functional class Ⅲ-Ⅳ and 49 patients (41.2%) were in NYHA functional class Ⅰ-Ⅱ. The mean systolic pulmonary arterial pressure estimated by echocardiography was (90±23) mmHg (1 mmHg=0.133 kPa) . Right heart catheterization was performed in 50 patients. Hemodynamic parameters revealed that the mean pulmonary artery pressure was (66±19) mmHg. Mean right atrium pressure was (8.5±3.4) mmHg. Mean pulmonary vascular resistance index was (17±9) wood·m² and the mean cardiac index was (3.4±1.3)L/m²; 100 patients (84.0%) received targeted therapy in which 55 patients (46.2%) were on monotherapy,40 patients (33.6%) were on dual therapy and 5 patients (4.2%) were on triple therapy. The mean time of follow-up was 22.0 months (0-108 months). During follow-up, 43 patients (36.1%) died and 1 patient received double-lung transplantation. Main causes of death including right heart failure, pulmonary hypertension crisis, asphyxia and massive hemoptysis. The mean survival time from diagnosis was 37.0 months,1-,2-,3-and 5-year survival rates were 86.3%, 72.2%, 51.4%and 37.8% respectively. Survival analysis showed that patients in baseline NYHA functional class Ⅰ-Ⅱ had better prognosis. COX regression analysis showed that NYHA function class, edema, increased total bilirubin and troponin concentration and the pulmonary artery and aorta diameter ratio measured by echocardiogram are risk factors of pediatric IPAH (HR=2.310, 2.723, 1.066, 1.696, 3.719, P=0.028, 0.005, 0.001, 0.024, 0.030) . While the existence of aterial septal defect or patent foramen ovale, using bosentan and phosphodiesterase inhibitors_, dual or triple therapy were protective factors (HR=0.563, 0.559, 0.603, 0.682, 0.044, P=0.169, 0.076, 0.115, 0.258, 0.220) . In multivariate analysis only edema associated with decreased survival (HR=2.398, P=0.025) . Conclusion Childhood idiopathic pulmonary arterial hypertension patients are seriously ill at visit. Worse cardiac function classification at visit associate with high mortality. Target therapy including using bosentan, dual or triple therapy can improve survival.

Objective To summarize the common causes and types of circuit failure after vagus nerve stimulator (VNS) implantation,and analyze the available methods of resolving these problems.Methods Three patients with postoperative circuit fault in the 97 patients performed VNS implantation for drug refractory epilepsy in our hospital from October 2011 to January 2014,and three patients with postoperative circuit fault performed surgery in other hospitals at the same period were chosen in this study.The causes of circuit failure of these 6 patients were identified by performing system diagnostics and X-ray evaluation.A revision surgery may be necessary if a broken or damaged lead was suspected.Results In these 6 patients of device failure,two patients were due to the disconnection of the lead from the pulse generator;the lead impedance became normal after re-inserting the existing lead connector pins into the pulse generator following proper lead insertion techniques.Four patients performed lead revision surgery to replace or remove the existing lead;in 3 of them,the helices and associated scar tissues were removed from the vagus nerve under the microscope,and a new set of electrodes was placed;in one of them,the lead was transected as much as possible and the distal portion of the lead was severed at the neck following the removal of pulse generator.There were no complications such as hoarse voice,dyspnea,slow rhythm,subcutaneous hematoma or infection after the revision surgery.Five patients were followed up,indicating the devices work normally.Four patients had obvious improvement,and one patient had no significant improvement after the revision surgery.Conclusions The high lead impedance is the main manifestation of circuit failure after vagus nerve stimulator implantation.Surgical exploration is an effective method to identify and resolve these problems.

Objective To explore the insula sensory features and analyze its electrophysiological characteristics based on stereo-electroencephalograph (SEEG).Methods The clinical data of 16 drug-refractory epilepsy patients,admitted to our hospital from December 2013 to June 2016,were retrospectively analyzed.All patients were implanted with SEEG electrodes;totally,34 electrodes (257 contacts) located in insular lobe.Micro current stimulation was performed every adjacent two contacts to get the sensory mapping and the stimulus threshold of the insula.Results Of all the 257 contacts,160 presented clinical symptoms (positive contacts);there were 149 contacts with sensory manifestations,of which 72 were on the left side and 77 on the right.Sensory symptoms of insula mainly included both somatic sensation and visceral sensation.The threshold of somatosensory was (4.9±2.9) mA,and the threshold of visceral sensation was (6.0±2.9) mA,without significant difference (P＞0.05).No significant difference was noted between the left insula sensory ([6.2±3.1] mA) and the right insula sensory ([5.7±2.8] mA,P＞0.05).It showed sensation abnormal of larynx,lingua,face and limb when the middle and posterior short gyrus,as well as anterior and posterior long gurus,respectively,were stimulated;insula sensory showed anatomy distribution,with different stimulated sensitivities.The sensory function showed parallel distribution with the insular gyrus from the middle short gyrus to posterior long gurus,as laryngeal-lingual-facial (nasal and lips)-limb sensation,and the thresholds of the five insular gurus were (6.0±3.1) mA,(4.7±1.5) mA,(8.0±2.9) mA,(5.1±2.4) mA and (4.5±2.6) mA,respectively,with statistically significant differences (P＜0.05).Conclusions The sensitivity of somatic sensation and visceral sensation of the insula monitored by SEEG is similar,as well as the left and right side.The sensory threshold and sensory fan-shaped distribution play important roles in conforming insular symptoms and location for clinician.

Objective To investigate the extents of corpus callosotomy (CC) resulting in optimal seizure control and compare the efficacies and complications of two CC approaches. Methods Clinical data of 25 patients underwent CC in our hospital from January 2013 to December 2018 were retrospectively analyzed. All 25 patients were diagnosed as having medically refractory epilepsy, and 27 CC procedures were performed. The patients underwent either anterior two thirds CC (n=13) or single-stage complete CC (n=12). Two patients had a second-stage posterior CC in 61 and 36 months after anterior CC, respectively. The efficacies were studied by using two evaluation indexes, the effective rate (worthwhile improvements) and the markedly effective rate (favorable outcomes).Results The average postoperative follow-up time was 2.6 years. In comparison, the markedly effective rate (>75％ reduction in seizure frequency or severity) was 71.4％ after complete CC and 15.4％ after anterior two thirds CC with a statistical significant difference between the two groups (P<0.05). The effective rate (>50％ reduction in seizure frequency or severity) of complete CC (78.6％) was higher than that of anterior two thirds CC (53.8％), but without significant difference (P>0.05). Overall, 66.7％ of patients benefited from anterior or complete CC. There were no such complications as intracranial hemorrhage, hydrocephalus, cerebrospinal fluid leakage or postoperative infection.Conclusion Complete CC is more effective for seizure control than anterior two thirds CC; no permanent neurological deficits are observed postoperatively.

Objective To establish the GIOP model and extract BMSCs from the rat model.We aim to in-vesitigatethe effect ofrhPTH(1-34)for inhibiting β-catenin ubiquitination when combining with Micro-CT and bio-logical technology.We also investigate the influence of rhPTH(1-34)on the GIOP.Methods Female SPF emale rats wererandomly divided into normal control group,methylprednisolone group(model group),methylpredniso-lone+saline group(blankcontrol group)and methylprednisolone+rhPTH(1-34)group(test group). The proximal femoral cancellous bone was examined by Micro-CTand histopathological Staining. The expression of Wnt10b and β-catenin protein were detected. By comparing with inducedBMP-2,BMSCs were treated withrhPTH(1-34)and stained with ALP and alizarin red.Results(1)In Micro-CT,BV/TV,Tb.Th and Tb/N decreased,whereas Tb/sp increased in the test group comparedwith model group(P<0.05).ROI three-dimensional reconstruction of trabecu-lar bone in test group showed local bone repair;(2)Wnt10b and β-cateninexpression increased in the test group compared with the model model(P<0.05),indicating that rhPTH(1-34)can enhance the transcriptional activity of β-catenin(P<0.05)and promote the expression of Wnt10b andβ-catenin(P<0.05).Conclusion The inter-vention with rhPTH(1-34)can prevent GIOP by regulating the Wnt/β-catenin signaling pathway and inhibiting GIOP progress,which can improve the microstructure of bone.