To study the quantitative detection method of T-wave alternans (TWA), we analyzed the relationship between the graphic mode of Poincare scatter and TWA, and proposed 'horizontal search algorithm' to complete graphic processing. Then, based on the shape of Poincare scatter, we took Axial_ratio as the final index. Through Matlab simulation, Axial_ratio was compared with the results of spectral method (SM) and appropriate threshold value was selected to recognize the TWA. The results showed that Axial_ratio could accurately detect the TWA.
Algorithms ; Arrhythmias, Cardiac ; diagnosis ; Electrocardiography ; Humans

The present paper is to analyze the trend of sinus heart rate RR interphase sequence after a single ventricular premature beat and to compare it with the two parameters, turbulence onset (TO) and turbulence slope (TS). Based on the acquisition of sinus rhythm concussion sample, we in this paper use a piecewise linearization method to extract its linear characteristics, following which we describe shock form with natural language through cloud model. In the process of acquisition, we use the exponential smoothing method to forecast the position where QRS wave may appear to assist QRS wave detection, and use template to judge whether current cardiac is sinus rhythm. And we choose some signals from MIT-BIH Arrhythmia Database to detect whether the algorithm is effective in Matlab. The results show that our method can correctly detect the changing trend of sinus heart rate. The proposed method can achieve real-time detection of sinus rhythm shocks, which is simple and easily implemented, so that it is effective as a supplementary method.
Algorithms ; Arrhythmias, Cardiac ; physiopathology ; Electrocardiography ; Heart Rate ; Humans ; Ventricular Premature Complexes ; physiopathology

Aim To investigate the molecular mecha-nism of Gab2 in the invasion and metastasis of breast cancer and provide a theoretical basis for clinical pre-vention of breast cancer invasion and metastasis. Methods The Gab2 , MMP-2 and MMP-9 expressions in 80 cases of breast cancer were detected by immuno-histochemistry . Western blot was used to detect the ex-pression of Gab2 protein in MDA-MB-231 cells and MCF-7 cells. The siRNA plasmid was used to transfect MDA-MB-231 cells. Western blot was used to detect the proteins expression of Gab2 , MMP-2 and MMP-9 . Transwell in vitro experiment was used to detect the in-vasion ability of each group transfected MDA-MB-231 cells, Western blot was used to analyze phosphorylation of Akt and ARK5 induced by epithelial growth factor ( EGF ) in transfected cells ( SiGab2/MDA-MB-231 and Scr/MDA-MB-231 ) . Results The expression of Gab2 protein in invasive ductal carcinoma was signifi-cantly higher than in normal breast tissue ( P<0. 01 ) . The expression of Gab2 was dramatically correlated with lymph node metastasis, ER expression, tumor his-tological grade, MMP-2 and MMP-9 (P<0. 05). The expression of Gab2 protein in MDA-MB-231 cells was higher than in MCF-7 cells. The expression of Gab2, MMP-2 and MMP-9 decreased in SiGab2/MDA-MB-231 cells and the invasion ability of SiGab2/MDA-MB-231 cells was significantly decreased ( P<0. 05 ) , and after 5 minutes’ stimulating by EGF, the phosphoryla-tion of Akt and ARK5 was significantly reduced. Con-clusion Gab2 can promote the invasion and metasta-sis of breast cancer by effecting the expression of MMP-2 and MMP-9 through PI3 K/ Akt /ARK5 signal path-way.

Objective To evaluate the role of extracellular signal-related kinase (ERK) 1/2 signal transduction pathway at the supraspinal level in maintenance of neuropathic pain in mice.Methods Sixty-four Kunming mice,aged 2 months,weighing 18-20 g,were randomly divided into 4 groups (n =16 each):sham operation group (group S),chronic constrictive injury (CCI) group; CCI + U0126 (MEK inhibitor) group; CCI + dimethyl sulfoxide (DMSO) group.Neuropathic pain was induced by CCI.The sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1mmintervals with 4-0 silk thread in CCI,CCI + U0126 and CCI +DMSO groups.On 5 days after CCI,5 μg U0126 (in 5 μl of 5％ DMSO) and 5％ DMSO 5 μl were injected into the lateral cerebral ventricle over 10 s in CCI + U0126 and CCI + DMSO groups,respectively,and the time of.needle retaining was 20 s.Paw withdrawal threshold to mechanical stimulation with yon Frey filament (MWT) and paw withdrawal latency to thermal stimulation (TWL) were measured before operation (baseline),before intracerebroventricular injection (T1),and at 30 min and 2,6,12 and 24h after intracerebroventricular injection (T2-6).Resuits Compared with group S,MWT was significantly decreased and TWL was shortened at T1-6 in CCI and CCI +DMSO groups,and at T1 in CCI + U0126 group (P ＜ 0.05),while no significant change in MWT and TWL was found at T2-6 in group CCI + U0126 (P ＞ 0.05).Compared with group CCI,MWT was significantly increased and TWL was prolonged at T2-6 in group CCI + U0126 (P ＜ 0.05),while no significant change in MWT and TWL was found in group CCI + DMSO (P ＞ 0.05).Conclusion ERK1/2 signaling transduction pathway at the supraspinal level is involved in maintenance of neuropathic pain in mice.

Objective To determine the prognostic significance of positive peritoneal cytology (PPC) among patients with endometrial cancer and to find out potential risk factors for PPC in endometrial cancer.Methods Data were extracted from Peking Union Medical College Hospital between Jan 1 2005 and Dec 31 2010.Only those patients who had undergone a staging procedure were included.A total of 486 patients were identified.Statistical analyses were performed using Fisher`s exact test, Kaplan-Meier log rank, and Cox proportional hazards models.ResultsRate of PPC was 4.8% in endometrial cancer.Non-endometrioid endometrial cancer(P=0.000), stage Ⅲ/Ⅳ(P=0.000), deep myometrial invasion(P=0.001), and cervical stromal involvement(P=0.018) appeared to be risk factors for PPC in endometrial cancer.Univariate analysis revealed statistically difference in 5-year PFS (70.9% vs 90.0%) and 5-year OS (72.2% vs 96.0%).Progression-free survival and overall survival showedstatistically difference(P=0.005,P=0.000)between PPC and NPC endometrial cancer.On multivariate analysis, PPC remained no statistically difference in progression-free survival or overall survival(RR=3.812,95% CI 0.897-16.200,P=0.070;RR=3.426,95% CI 0.800-14.673,P=0.097).Conclusions PPC is not an independent risk factor in patients with endometrial cancer.Aggressive histology, FIGO stage, deep myometrial invasion and cervical stromal involvement are presumed to be associated with PPC in endometrial cancer.

Objective To investigate the high-risk factors of retroperitoneal lymph nodes metastasis (LNM) and the effect of lymph nodes metastasis on prognosis in patients with endometrial carcinoma (EC).Methods Retrospec-tive research was carried out from January 2005 to December 2010 to identify 289 endometrial carcinoma patients treated with retroperitoneal lymphadenectomy at Peking Union Medical College Hospital.The high-risk factors of retroperitoneal LNM and prognostic factors of this disease were studied.Results 1) The median age at diagnosis was 55 years old.Patients of stage Ⅰ, Ⅱ, Ⅲ and Ⅳ were 224 (77.5%), 13 (4.5%), 45 (15.6%) and 7 (2.4%), respectively.Two hundred and eighty-nine patients received pelvic lymphadenectomy, of that 30 (10.4%) patients were found the pelvic LNM.Ninety-six patients received periaortic lymphadenectomy, of that 11 (11.5%) patients were found the periaortic LNM.Twenty-one (7.3%) patients developed recurrent disease and 11 (3.8 %) dead.The median follow-up was 37 months and the median disease-free survival (DFS) was 34 months.2) In univariate analysis, the incidence of LNM significantly increased in patients with CA125 ≥ 35 U/mL preoperatively, non-endometrioid adenocarcinoma, low grade, deep myometrium invasion, diameter of tumor ≥ 2 cm, cervical stroma involvement, positive peritoneal cytology and vagina or parametrial involvement (P<0.05).In multivariate analysis, CA125 ≥ 35 U/mL preoperatively, low grade, deep myometrium invasion were the independent high-risk factors of LNM (P<0.05).3)The Kaplan-Meier analysis showed a significant difference between positive peritoneal cytology, vagina or parametrial involvement, appendix involvement, LNM and DFS (P<0.05).We also found a significant difference in the impact of non-endometrioid adenocarcinoma, low grade, deep myometrium invasion, positive peritoneal cytology, appendix involvement and LNM on overall survival (OS) (P<0.05).Cox regression analysis revealed retroperitoneal LNM is the independent prognostic factor of 5-year DFS (patients without LNM 92.1% vs patients with LNM 65.3%, P=0.002, 95% CI 0.078-0.552).We also found the trend that the 5-year OS was higher in patients without LNM than them with LNM, even though there was no significant difference(patients without LNM 96.1% vs patients with LNM 70.0%, P=0.086, 95% CI 0.039-1.238).Conclusions 1) there is a predictive value of low grade and deep myometrium invasion for EC patients with LNM.2)Patients with LNM have poorer prognosis than them without LNM.Therefore, patients with LNM should receive adjuvant therapy to reduce the risk of recurrence.

Objective To investigate the correlation between admission hyperglycemia and clinical prognosis in elderly patients with community-acquired pneumonia.Methods Based on the electrical medical record (EMR),information of the patients with pneumonia was retrospectively collected and the necessary data were prepared and arranged.Based on clinical outcomes,demographic characteristics and clinical indicators were compared between groups in order to screen potential variables affecting clinical outcomes.Then,the random blood glucose level 8.6 mmol/L was considered to be the cutoff point for grouping patients,with clinical outcomes as outcome variables,random blood glucose levels as grouping variables,propensity score value analysis method was applied along with the ratio of 1:1 nearest neighbor matching method to generate paired samples in order to assess the impact of blood glucose level on mortality rate;With hospitalization time serving as time variable,survive analysis method was used to analyze COX proportional model.Results Five hundred and fifty-eight patients were enrolled in the analysis,197 patients of which were recorded dead during hospitalization (the dead group).After the correction of demographic characteristics,past medical history and blood test indexes,white blood cells,C reactive protein,random blood glucose at admission and triglyceride levels were regarded as potential factors for the deaths of patients (P<0.05).However,the propensity score analysis method suggested that there was no significant difference between the blood glucose levels and mortality.The survival analysis showed that the mortality in the high blood glucose group was higher than that in the normal blood glucose group (HR=1.68,95%CI(1.22,2.31)).Conclusion Admission hyperglycemia is an important indicator of adverse prognosis in elderly patients with pneumonia.It may be of significance for screening and identifying high-risk patients.

To clone and express the gene encoding chicken aminopeptidase N (chAPN), and analysis the biological function of chAPN expressed in Escherichia coli (E. coli). The chAPN gene was amplified by RT-PCR from the kidney cells of chicken embryo and then cloned into the prokaryotic expression vector pCOLD-TF. Recombinant expression plasmid of pCOLD-TF-chAPN was constructed and then transformed into the competent E. coli BL21(DE3) cells for expression under different conditions such as induction time and inductor concentrations. Purified soluble recombinant chAPN was obtained by Ni-NTA His Bind Resin affinity chromatography and identified by SDS-PAGE gel and Western blotting assay. Its biological function was detected by its reaction with Leu-PNA and Enzyme-Linked Immunosorbent Assay (ELISA). The results showed that the expression product of chAPN gene in E. coli was soluble. It was able to bind infectious bronchitis virus (IBV) dose-dependently. In conclusion, chAPN gene has been successfully cloned and expressed in E. coli, which will establish a basis for further research the enzymatic activity and antiviral function.
Animals ; CD13 Antigens ; biosynthesis ; genetics ; metabolism ; Chickens ; Cloning, Molecular ; Escherichia coli ; genetics ; metabolism ; Recombinant Proteins ; biosynthesis ; genetics ; metabolism

Hemophagocytic syndrome, also known as hemophagocytic lymphohistiocytosis (HLH), is a highly stimulated and defective inflammatory response caused by genetic inheritance or acquired immune regulation abnormalities.Malignancy-associated HLH can be secondary to lymphoma, leukemia, etc.HLH-directed or malignancy-directed combination chemotherapy is the main regimen and the prognosis is poor.Now the pathogenesis, clinical manifestations, diagnosis and treatment of malignancy-associated HLH will be reviewed in children, in order to increase understanding of the disease.

Objective To explore the application effects of quality control circle (QCC) on improving accuracy of pupil observation for nurses in the department of neurosurgery. Methods Quality control circle was established. The theme of the activity was determined according to urgency and circle capacity, and activity proposal was decided. Investigation on current situation was carried out, and objective was set according to the focus on improvement and circle capacity. Reasons were analyzed, and feasible strategies were proposed and implemented. Accuracy of pupil observation before and after the QCC activity was compared, and the effects after the implementation of QCC was confirmed. Results As for tangible results, the scores of examination on specialized theoretical knowledge for nursing practitioners was (83.11±4.55) before the QCC activity, and the scores were (90.59±3.57) after the activity, the specialized theoretical knowl-edge for nursing practitioners significantly improved, and the difference was statistically significant (P<0.05). Accuracy of pupil observation was 47.50% before the QCC activity, and the accuracy was 90.83% after the activity, the accuracy of pupil observation after the activity significantly improved compared to that before the activity, and the difference was statistically significant (P<0.05). As for intangible results, self scores from the circle members in 8 aspects including a-bility of solving problems, responsibility, ability of coordination and communication, team coherence, confidence, enthu-siasm, ability of applying quality control circle and happiness were all higher than those before the activity, and the differences were statistically significant (P<0.05). Conclusion The activity of QCC is able to improve the level of spe-cialized nursing knowledge for nurses in the department of neurosurgery, enhance the ability of scientific research, un-derstanding of QCC, application ability and execution for nursing practitioners, and improve the accuracy of pupil ob-servation.