Objective To explore the depression and its related factors of the patients with craniocerebral injury during rehabilitation.Methods 111 patients with craniocerebral injury were investigated with the questionnaire about general condition. They were assessed withHamilton Rating Scale for Depression (HAMD). The relationship between the general condition and the score of HAMD were analyzed. ResultsThere were 27 cases (24.32%) with score of HAMD≤7, 31 cases (27.93%) with the score from 8 to 17 and 53 cases (47.75%) with thescore≥18. The score of HAMD was significantly related to the patients' age, education, profession, economy status, economic compensationand the cause of injury (P<0.05). However, it was not related to the sexuality, marital status, registered residence, level of the injury, thecourse of disease and the coma time (P>0.05). Only economy state (x₁), education (x₂) and economic compensation (x₃) entered into the regressionequation by multiple regression analysis: y=22.782-6.879x₁+2.357x₂+3.54x₃ (F=75.609, P=0.000). Conclusion Patients with craniocerebralinjury generally depress during rehabilitation. The patients with a worse economy state, a higher education and no economic compensationappear more serious depression.

BACKGROUNDThree dimensional conformal radiotherapy is one of the important treatment methods for patients aged 65 and older with inoperable non-small cell lung cancer (NSCLC). The aim of this study is to evaluate the efficacy of three dimensional conformal radiotherapy in elderly patients with inoperable NSCLC.

METHODSThirty-one patients aged 65 and older with stage II and III NSCLC were treated by three dimensional conformal radiotherapy. Clinical effects, survival rates and pulmonary toxicity were analyzed.

RESULTSThe overall response rate (CR+PR) was 87.1% (27/31). The 1, 2 and 3-year survival rates were 83.9% (26/31), 51.6% (16/31), and 25.8% (8/31) respectively. The relation of treatment efficacy and tumor size was observed. Acute radiation pneumonitis occurred in 3.2% (1/31) of the patients. Radiation pulmonary fibrosis occurred in 19.4% (6/31) of the patients.

CONCLUSIONSThree dimensional conformal radiotherapy is a safe and effective treatment for elderly patients with inoperable NSCLC and has a high survival rate.

In this paper a filtering method for EECG (Exercise ECG) signal is proposed which is based on wavelet transform (WT) and Stein's unbiased risk estimate (SURE). This algorithm was used to decompose original EECG signals into detail signals on different frequency bands by using WT and get different thresholds with SURE. According to EECG signal features and by using the above thresholds, the method amended several detail signals so that the main interferences in EECG signal can be removed efficiently. The authors also put forward two indexes to estimate the validity of such algorithms. Our experimental results demonstrate that this is an efficient de-noising method for EECG.
Algorithms ; Echocardiography, Stress ; Electrocardiography ; methods ; Exercise Test ; methods ; Humans ; Signal Processing, Computer-Assisted

OBJECTIVETo investigate the correlation between arterial partial pressure of CO2 (PaCO2) and end expiratory tidal partial pressure of CO2 (Pet-CO2) in morbidly obese patients during anesthesia for laparoscopic gastric bypass surgery.

METHODSForty morbidly obese patients with a body mass index (BMI) between 35 and 50 kg/m(2) underwent laparoscopic gastric bypass surgery under general anesthesia. PaCO2 and Pet-CO2 were measured after intubation and before induction of pneumoperitoneum (T0), at 30 min (T1), 60 min (T2), and 120 min (T3) during pneumoperitoneum, and at 30 min (T4) and 60 min (T5) after deflation.

RESULTSAt each time point of measurement, Pet-CO2 was lower than PaCO2 in all the patients. PaCO2 and Pet-CO2 were positively correlated before, during, and after pneumoperitoneum (P<0.05). At a moderate pressure of CO2 pneumoperitoneum (16 mmHg), the level of correlation between PaCO2 and Pet-CO2 at T1, T2, and T3 differed from that before and after post-pneumoperitoneum.

CONCLUSIONSPaCO2 and Pet-CO2 are closely correlated during a moderate CO2 pneumoperitoneum in morbidly obese patients undergoing laparoscopic gastric bypass surgery.

Adult ; Anesthesia ; Arterial Pressure ; Blood Gas Analysis ; Carbon Dioxide ; blood ; Female ; Gastric Bypass ; Humans ; Laparoscopy ; Male ; Middle Aged ; Obesity, Morbid ; blood ; surgery ; Pneumoperitoneum, Artificial

Objective To establish a non-venous bypass orthotopic liver transplantation model in Bama miniature pigs with high repeatability and stability. Methods Twelve Bama miniature pigs were randomly divided into the donor group (n=6) and recipient group (n=6). Pigs underwent non-venous bypass orthotopic liver transplantation. The time of anhepatic phase during operation was shortened, blood pressure during anhepatic phase was stably maintained, and management of anesthesia and body fluid during operation were strengthened. The operation time, anhepatic phase and survival status of the recipients were observed and recorded. The intraoperative heart rate, mean arterial pressure (MAP) and changes in arterial blood gas analysis were monitored. The perioperative liver function was evaluated. Results Among 6 Bama miniature pigs, 1 died from transplantation failure intraoperatively. The operation time of the remaining 5 pigs was (247±27) min and the time of anhepatic phase was (46±4) min. Three animals survived for more than 2 weeks. Compared with the preanhepatic phase, the heart rate of the animals was significantly faster, MAP was considerably reduced to (46±6) mmHg, blood pH value, base excess (BE) and HCO₃^- level were all significantly decreased and serum level of K⁺ was significantly elevated during the anhepatic phase (all P < 0.05). In the neohepatic phase, MAP of Bama miniature pigs was significantly increased, heart rate was dramatically slower.Blood pH value, BE, HCO₃^- level were significantly increased and serum level of K⁺ was significantly declined (all P < 0.05). During abdominal closure, MAP, blood gas indexes and serum level of K⁺ were almost recovered to those in the preanhepatic phase. Compared with preoperative levels, the levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), lactate dehydrogenase(LDH)and alkaline phosphatase(ALP)were significantly increased after operation (all P < 0.05), the change in AST was the most obvious, and it gradually decreased at postoperative 2 d. The level of γ-gutamyl transferase(GGT) did not significantly elevated. The level of total bilirubin (TB) was evidently elevated at postoperative 5 d. Compared with the preoperative levels, the levels of total protein (TP) and albumin (ALB) were significantly decreased after operation (both P < 0.05), and began to gradually increase at postoperative 1 d. Conclusions The non-venous bypass orthotopic liver transplantation model of Bama miniature pig is convenient, with highly reproducible and survival rate, which can be utilized as a standardized liver transplantation model.

Objective To evaluate the effect of the different Child-Pugh classification on the recurrence and survival of hepatocellular carcinoma (HCC) recipients after liver transplantation. Methods Clinical data of 125 HCC recipients undergoing liver transplantation were retrospectively analyzed. The 3-year disease-free survival (DFS) and overall survival (OS) rates were calculated by Kaplan-Meier survival curve. The independent risk factors probably affecting the recurrence and survival of HCC recipients after liver transplantation were identified by using Cox's proportional hazards regression model. Results The median follow-up time was 25.6 months. The 3-year DFS and OS rates were 68.4% and 65.7% for all patients. The 3-year DFS and OS rates in 113 patients with Child-Pugh class A/B HCC were 68.6% and 66.2%, whereas 66.7% and 65.6% for 12 patients with Child-Pugh class C HCC with no statistical significance (all P>0.05). Cox's proportional hazards regression model demonstrated that vascular invasion (P=0.001)and the number of tumors>3 (P=0.025) were the independent risk factors for the postoperative recurrence of HCC in recipients undergoing liver transplantation. Alpha fetoprotein (AFP)>400μg/L (P=0.035), vascular invasion (P=0.031) and number of tumors>3 (P=0.008) were the independent risk factors affecting the survival of HCC patients. Conclusions The postoperative prognosis does not significantly differ between Child-Pugh class C and A/B HCC patients after liver transplantation. AFP, vascular invasion and number of tumors are the risk factors affecting the clinical prognosis of HCC patients after liver transplantation. Liver transplantation is an efficacious treatment for HCC patients with Child-Pugh class C.

BACKGROUND:Some studies have shown that the hounsfield units(HU)value based on lumbar CT can be used to screen osteoporosis.At present,the number of patients with pulmonary infection has increased;the number of patients with pulmonary infection and type 2 diabetes is also increasing,which increases the utilization rate of chest CT. OBJECTIVE:To investigate the role of lumbar 1 vertebral body HU value based on chest CT in the screening of type 2 diabetes mellitus osteoporosis. METHODS:The clinical data of 244 patients with type 2 diabetes mellitus treated in the First Affiliated Hospital of Chengdu Medical College from June 2020 to June 2022 were analyzed retrospectively.The bone mineral density was obtained by dual-energy X-ray absorptiometry.According to WHO's diagnostic criteria for osteoporosis,the subjects were divided into the non-osteoporosis group(n=120)and the osteoporosis group(n=124).The general condition,T value and HU value of lumbar 1 vertebra in chest CT were compared,and the relationship between the HU value and T value of each position was analyzed and the accuracy of type 2 diabetes mellitus osteoporosis was evaluated. RESULTS AND CONCLUSION:(1)There was no significant difference in sex,age,body mass index,glycosylated hemoglobin,mean blood glucose,calcium(Ca),phosphorus(P),time of type 2 diabetes mellitus,history of hypertension and history of hyperlipidemia between the two groups(P>0.05).(2)The HU value was positively correlated with the lowest T value of the hip(r=0.619,P<0.01);the HU value was positively correlated with the hip T value(r=0.584,P<0.01),and the HU value was positively correlated with the femoral neck T value(r=0.641,P<0.01).When the HU value was 98,the prediction of type 2 diabetes mellitus osteoporosis had good accuracy,and the sensitivity was 70.8%.(3)It is concluded that the HU value of the lumbar 1 vertebra based on chest CT examination is of good value for osteoporosis screening in patients with type 2 diabetes mellitus,and may be an opportunistic and cost-free supplementary screening method for type 2 diabetes mellitus osteoporosis.