This study designed an audio signal acquisition system to achieve real-time detection of R peak for heart rate variability (HRV) analysis, substituting ECG-specific data acquisition board with sound card. It is proved that the R peak with low frequency can be gathered by sound card. The comparison with PowerLab signal acquisition system has shown that the acquisition system of R peak could accurately detect the R peak. The R peak detected by sound card and PowerLab signal acquisition system completely overlap each other, while RR intervals has no difference. The HRV analysis was accurate and reliable with the RR interval from sound card. This low cost, high performance, strong compatibility and easy upgraded acquisition system of R peak compared with the traditional data acquisition board has the value of practical uses and might have broad applications in the future.
Algorithms ; Electrocardiography ; methods ; Heart Rate ; physiology ; Humans ; Monitoring, Physiologic ; instrumentation ; Signal Processing, Computer-Assisted ; instrumentation ; Sound

This study designed one index of HRV from Poincaré plot named 5SSD1 by the present authors, which can describe the characteristics of the heart rate dynamics with 5-second data. We also investigated the feasibility of its clinical application in real-time monitoring of the activity of autonomic nervous system. We studied 20 patients scheduled for oral maxillofacial surgery. ECG recording was obtained when kept awake and anesthetic states, respectively. We calculated the correlation coefficients between the 5SSD1 and the other quantitative indicators, such as 5-minute HRV in the time domain, the frequency domain, and the Poincaré plot families. The correlation between 5SSD1 and indicators, such as rMSSD, HF and SD1 of 5-minute HRV was significantly high, with r=0.995, 0.895, 0.996, respectively, at P<0.01 for all. However, the correlation between 5SSD1 and the other indicators of 5-minute HRV was relatively poor. It was proved that 5SSD1 could be used to assess the activities of the autonomic nervous system in real-time, and the stable and reliable results might play more roles in the clinical applications.
Adolescent ; Adult ; Algorithms ; Autonomic Nervous System ; physiology ; Electrocardiography ; methods ; Female ; Heart Rate ; physiology ; Humans ; Male ; Middle Aged ; Signal Processing, Computer-Assisted ; Young Adult

Objective To investigate the value of PET-CT in TNM staging and three-conformal radiotherapy (3DCRT) in esophageal carcinoma. Methods From September 2007 to November 2008, 20 patients with pathologically confirmed esophageal carcinoma were enrolled, including 2 treated with surgery and 18 with 3DCRT. All the patients received PET-CT simulation before the treatment. The length and maximum transverse diameter of Grit based on esophagoscope, esophagography, CT, PET-CT_(SUV2.5) and PET-CT_(40%SUVmax) were compared. The TNM stages were compared based on CT and PET-CT images. Three treatment plans were produced and analyzed based on images of CT, PET-CT_(SUV2.5) and PET-CT_(40%SUVmax),respectively. Results The length of lesion on esophagoscope, esophagography, CT, PET-CT_(SUV2.5) and PET-CT_(40%SUVmax) was 4. 93 cm, 5.06 cm, 6. 67 cm, 5. 89 cm and 4. 84 cm, respectively. The corresponding maximum transverse diameter on the last 3 images was 4. 05 cm, 3.38 cm and 2. 95 cm, respectively. In all, 31, 21 and 14 positive lymph nodes were identified according to CT images, PET-CT images and the both. Five patients with CT diagnosed stage M_0 were found to have distant metastasis by PET-CT images, and 1 patient with CT diagnosed stage M_1 was excluded by PET-CT. The volumes of GTV_(CT) were similar with GTV_(SUV2.5) in 2 patients, smaller in 5 patients, and larger for the remaining 13 patients. For these 13 patients, the radiation dose of normal tissues based on GTV_(SUV2.5) was relatively lower. Conclusions The length of lesion based on PET -CT_(SUV2.5) matches the pathological length best , followed by esophagography. With PET-CT_(40%SUVmax) the actual lesion length may be underestimated. TNM stage might be changed by PET-CT, and then the target volumes and radiation doses of normal tissues might be reduced.

Nonalcoholic fatty liver disease (NAFLD) is a chronic disease with complex lesions, and it is difficult to determine the clinical stage. Liver biopsy is still the gold standard for the diagnosis of NAFLD; however, its clinical application is limited by various factors. Therefore, noninvasive methods for the accurate diagnosis of NAFLD are research hotspots at present. Imaging examinations help to achieve qualitative and quantitative evaluations of hepatic steatosis and fibrosis and thus has a promising future in clinical practice. This article summarizes the research advances in the imaging diagnosis of nonalcoholic fatty liver disease in recent years.

Objective:To study the effects of tetramethylpyrazine on the expressions of ferroptosis related molecules after spinal cord injury; To explore the mechanism of tetramethylpyrazine promoting the repair of spinal cord injury (SCI).Methods:Totally 36 SD rats were divided into sham-operation group, model group and tetramethylpyrazine group according to random number table method, with 12 rats in each group. The rats in the sham-operation group underwent laminectomy without injury to the spinal cord. The SCI model was prepared in the other two groups. The rats in the tetramethylpyrazine group were intraperitoneally injected with tetramethylpyrazine of 80 mg/kg, and the rats in the sham-operation group and model group were intraperitoneally injected with the same volume of normal saline, once a day, continuous intervention for 28 days. One day before operation and 1, 3, 5, 7, 14, 21, 28 days after operation, BBB limb motor function score was used to evaluate the limb motor function of rats. Nissl staining was used to observe the morphology of neurons. Prussian staining was used to observe iron deposition. Assay kit was used to detect the contents of MDA and ROS in spinal cord tissue. Western blot was used to detect the protein expressions of xCT, GPX4 and ACSL4, and qPCR was used to detect the mRNA expressions of mRNA of xCT, GPX4 and ACSL4.Results:On the 14th, 21st and 28th days after operation, compared with the model group, the BBB score of tetramethylpyrazine group increased ( P<0.01); tetramethylpyrazine could significantly improve the morphology and structure of neurons and reduce the iron content in spinal cord tissue; compared with the model group, the contents of MDA and ROS in the spinal cord tissue of tetramethylpyrazine group decreased ( P<0.01); the levels of xCT and GPX4 mRNA and protein increased ( P<0.01), while the expression of ACSL4 mRNA and protein decreased ( P<0.01). Conclusion:Tetramethylpyrazine can regulate lipid peroxidation by regulating the expressions of ferroptosis related molecules, which is conducive to the recovery of limb motor function in rats with spinal cord injury.

Objective: To explore the diagnostic values of FibroTouch and FibroScan for liver fibrosis in patients with chronic hepatitis B(CHB). Methods: This study enrolled patients with CHB who was accepted liver biopsy at Beijing Friendship Hospital, Capital Medical University between March 2014 to December 2017. FibroTouch and FibroScan were performed among these patients at same time. Liver stiffness measurement(LSM), optimal cut-off value, receiver operating characteristic(ROC) were compared. Results: In our 103 patients, there were no significantly different between FibroTouch and FibroScan in LSM. The threshold of the optimal cut-off value for FibroTouch and FibroScan were 5.45 versus 5.55 kPa (≥S1), 7.10 versus 6.65 kPa (≥S2), 11.05 versus 9.20 kPa (≥S3), 15.50 versus 15.45 kPa (S4), respectively. The area under the ROC curve for the prediction of the stage1, stage2, stage2, stage 4 of liver fibrosis in these patients were 0.858 versus 0.765 (P=0.54), 0.812 versus 0.801 (P=0.68), 0.863 versus 0.878 (P=0.45), and 1.0 versus 0.99 (P=0.38) respectively. Conclusions FibroTouch and FibmScan have a good consistency in the evaluation of the degree of liver fibrosis in patients with CHB.

OBJECTIVETo perform a comparative assessment of the performance of FibroTouch and FibroScan in patients with hepatitis B.

METHODSA total of 211 patients with hepatitis B, including cases of chronic hepatitis B (CHB) and of compensated cirrhosis, were enrolled for study between June and November of 2013. The patients underwent FibroScan testing (group 1) and FibroTouch testing (group 3), after which the operator examined a time motion ultrasound image from the FibroScan test and located a specific liver portion for focused FibroTouch testing (group 2). The consistency between the two tests' results was investigated by Pearson's correlation analysis, and the difference of liver stiffness between CHB patients and compensated cirrhosis patients was investigated by the two independent samples t-test or Mann-Whitney U test.

RESULTSThe values of liver stiffness were 5.30 (4.30,8.65) in group 1,6.10 (4.70,8.90) in group 2, and 5.70 (4.50, 8.00) in group 3 (all P < 0.05); the Pearson correlation coefficients were all more than 0.8 (P < 0.05) and there was no statistically significant difference found between the results from FibroScan and FibroTouch.The values of liver stiffness were significantly different between the CHB patients and the compensated cirrhosis patients (P < 0.05). The rates of successful detection were 100% for FibroTouch and 97% for FibroScan.

CONCLUSIONFibroTouch and FibroScan have good consistency in the evaluation of the degree of liver fibrosis. FibroTouch has a higher rate of successful detection than FibroScan.

Objective:To analyze the differences in gut microbiota between patients with hyperuricemia (HUA) and healthy population for better understanding the correlation between gut microflora and high uric acid.Methods:This study recruited 63 adult volunteers, including 25 HUA patients (HUA group) and 38 healthy people (control group), who underwent physical examination in the PLA Strategic Support Force Characteristic Medical Center in 2021. Their fecal samples were collected and analyzed by 16S rRNA high-throughput full-length gene sequencing to analyze the composition of gut microbiota.Results:The overall composition of gut microbiota was different between HUA group and control group. The α diversity index decreased significantly in HUA group and β diversity analysis showed that there were significant differences between the two groups. HUA group showed increased Bacteroidetes and decreased Firmicutes. LEfSe analysis indicated a unique microbiota structure in HUA group, characterized by significantly decreased short-chain fatty acid (SCFA)-producing bacteria represented by Faecalibacterium prausnitzii and significantly increased Streptococcus salivarius, Bacteroides fragilis, Fusobacterium hwasookii, Flavonifractor plautii, Mycobacterium mucogenicum B and Blautia sp003287895. In addition, functional prediction through PICRUSt2 showed that the metabolism related to gut microbiota SCFA pathway in HUA group was decreased, which was consistent to the unique microbiota structure. Conclusions:Compared with healthy population, patients with hyperuricemia had different composition of gut microbiota and metabolic feature.

Objective:To investigate the correlation between gut microbiota and serum diamine oxidase (DAO) level and to analyze the differences in gut microbiota between high DAO (DAO-H) and normal DAO populations.Methods:This study recruited 62 adult volunteers (31 in DAO-H group and 31 in normal control group) taking health examination in the Strategic Support Forces Special Medical Center in 2021. Their stool samples were collected to analyze the composition of gut microbiota in the two populations by full-length 16S rRNA gene sequencing.Results:No significant difference in the alpha diversity of gut microbiota was found between the DAO-H group and the normal control group, but the structure and function of gut microbiota varied. In the DAO-H group, commensal bacteria decreased, such as Phocaeicola and Bacteroidetes, while potential pathogenic bacteria increased, such as Klebsiella pneumoniae. There were changes in the metabolism of gut microbiota in the DAO-H group, including inhibited sphingolipid metabolism and enhanced biosynthesis of vancomycin group antibiotics, one carbon pool by folate pathway, terpenoid backbone biosynthesis, cell cycle-Caulobacter, protein export, base excision repair and nitrogen metabolism.Conclusions:Compared with the people with normal DAO, the population with high DAO had unique characteristics in gut microbiota composition and metabolism.

Background/Aims: Existing hepatocellular carcinoma (HCC) prediction models are derived mainly from pretreatment or early on-treatment parameters. We reassessed the dynamic changes in the performance of 17 HCC models in patients with chronic hepatitis B (CHB) during long-term antiviral therapy (AVT). Methods: Among 987 CHB patients administered long-term entecavir therapy, 660 patients had 8 years of follow-up data. Model scores were calculated using on-treatment values at 2.5, 3, 3.5, 4, 4.5, and 5 years of AVT to predict threeyear HCC occurrence. Model performance was assessed with the area under the receiver operating curve (AUROC). The original model cutoffs to distinguish different levels of HCC risk were evaluated by the log-rank test. Results: The AUROCs of the 17 HCC models varied from 0.51 to 0.78 when using on-treatment scores from years 2.5 to 5. Models with a cirrhosis variable showed numerically higher AUROCs (pooled at 0.65–0.73 for treated, untreated, or mixed treatment models) than models without (treated or mixed models: 0.61–0.68; untreated models: 0.51–0.59). Stratification into low, intermediate, and high-risk levels using the original cutoff values could no longer reflect the true HCC incidence using scores after 3.5 years of AVT for models without cirrhosis and after 4 years of AVT for models with cirrhosis. Conclusions The performance of existing HCC prediction models, especially models without the cirrhosis variable, decreased in CHB patients on long-term AVT. The optimization of existing models or the development of novel models for better HCC prediction during long-term AVT is warranted.