we have designed a program-controlled high-fi amplifier for EMG.Its gain can be controlled by computer.The program-contralled circuit is implemented with numerical control resistor.The amplifier can be used in automatically measuring EMG signals over 100?v.The circuit is characterized by easy de- sign,simple programing and convenient control.

Colorectal Neoplasms ; surgery ; Humans

Objective To study the diagnosis and management of extra-adrenal pheochromocytoma.Methods A retrospective clinical study was done on 33 patients of extra-adrenal pheochromocytoma treated at our department.Results Extra-adrenal pheochromocytoma accounted for 16.2％ (33/204) of all pheochromocytoma patients admitted between Jan 2005 and Dec 2012.There were 13 males and 20 females.The mean age at diagnosis was 45 years,with a range from 17 to 81 years.14 patients were hospitalized for abdominal discomfort,8 patients suffered from typical hypertension symptoms including headache and dizziness and blurred vision,one of bladder pheochromocytoma was found paroxysmal hypertension and 10 patients had no obvious clinical symptoms.All the patients underwent CT scan,and 8 extra-adrenal pheochromocytoma were discovered.11 patients were given circulation expansion therapy.Most of the tumors were located at bladder(3 case),renal hilus (7 case) and para-aorta(23 case).There were two patients with multiple tumors.In 26 cases,blood pressure fluctuated when touching tumor during operation.All the patients were treated with surgical operation.Except for 1 biopsy,32 patients underwent total resection of tumor including a case combined resection with left kidney and a case with the spleen.There were no perioperative mortality.Postoperative follow up showed very good prognosis,with no death.Conclusions Compared with imaging examination,clinical manifestations and laboratory tests were less evaluable for the diagnosis of extra-adrenal pheochromocytoma.Proper preoperative preparation and precise operation is essential for the prognosis.

Objective To investigate the application of position vector in balance evaluation of stroke patients with hemiplegia.Methods The static balance of 30 healthy subjects and 30 stroke patients with hemiplegia was measured by the balance instrument when standing on a force plate with eyes' open.There were 10 patients tested before and after rehabilitation training.Results The position vectorgram of the healthy subjects showed anterior-posterior sway and the patients showed right-left or diagonal sway.The patients exhibited much longer value in position vector than healthy subjects(P<0.01).After rehabilitation training,10 patients showed the changes in position vector at six directions,and there was a significant difference compared with those before rehabilitation training(P<0.01).Conclusion The position vector is clinically valuable in balance evaluation and monitoring the effect of treatment.

This paper adopted a series of related analysis methods to comprehensively analyze post-marketing clinical safety data of Shenmai injection from 4,220 cases of SRS and 32,358 cases of multicenter, prospective, registered hospital centralized monitoring in large data background, calculated ADR incidence rate was 0.93 per 1,000, main symptoms of ADR includes chest pain, chills, skin itching, palpitations, fever, nausea, dizziness, vomiting, flushing, numbness, allergic reaction, cyanosis, rash, low back pain, and "breath", "anaphylactoid reaction" and "flush" were the safety warning signals of Shenmai injection. Primary disease for chronic pulmonary heart disease, thyroid disease, and combined with cerebral vascular disease, prior to the injection and continuous use of alprostadil, cyclic adenosine monophosphate, combined with quinolones, penicillins were suspicious influence factors of ADR of Shenmai injection, these promot the clinical safety.
Drug Combinations ; Drugs, Chinese Herbal ; adverse effects ; Humans ; Injections ; Product Surveillance, Postmarketing ; Prospective Studies

Background Doxycycline is a broad spectrum antibiotic,and it is frequently used in the treatment of ocular surface diseases.Objective The purpose of the present study was to investigate the effect of doxycycline on the inhibition of cell proliferation in bovine corneal myofibroblasts in vitro and assess its contribution to ocular surface repairing mechanism.Methods Six fresh bovine corneas were collected.The corneal stromal layer was isolated by two-step method of 1.0 g/L and 2.0 g/L collegenase-1.Isolated cells were plated at mantaryay culture flask in 10％ FBS of RPMI-1640.Vimentin and alpha-smooth muscle actin (α-SMA) organization were evaluated by immunocytochemistry,and the cells with influoresccence staining for vimentin and α-SMA were identified as the corneal myofibroblasts.Doxycycline at the concentrations of 10,20,40,60,80 mg/L was added to the medium,respectively,in different concentrations of doxycycline groups.Dexamethasone (120 mg/L)was used in the same way in the positive control group,and no drug was used in the negative control group.Cell proliferation was evaluated by MTT and the cell cycle was analyzed by BD FACScan flow cytometer assay 24 hours and 48 hours after addition of any drug.Results The cells grew well and showed the positive response for vimentin and α-SMA.MTT assay showed that the A570values of bovine corneal myofibroblasts were gradually declined with the increase of the concentration of doxycycline and lapse of active time,showing statistically significant difference (Fconcentration =1233.778,P＜0.001 ; Ftime =227.564,P ＜ 0.001).And the difference between the two factors was also statistically significant (Ftime*concentration =51.656,P＜0.001).Flow cytometry cell cycle analysis showed that 24 hours after 10,20,40,60,80 mg/L doxycycline treated,the perentage of of corneal myofibroblast cell in G0-G1 phase was 82.85％,84.36％,85.18％,87.12 ％ and 89.31％,showing significant increase in comparison with 63.89％ of the negative control group (all P＜0.05),and that of 40 mg/L doxycycline group was near the positive control group.Forty-eight hours after 10,20,40,60,80 mg/L doxycycline treated,the perentage of of corneal myofibroblast cell in G0-G1 phase was 82.78％,86.15％,88.23％,89.57％,93.00％,with significant increase in comparison with 70.17％ of the negative control group (all P ＜ 0.01),and that of 40 mg/L doxycycline group was near the positive control group.Conclusions The growth of the bovine corneal myofibroblasts is inhibited by doxycycline in time-and dosedependent manner in the range from 10 mg/L to 80 mg/L,and 40 mg/L of doxycycline has an obviously inhibitory action as 120 mg/L dexamethasone.

Objective To explore the clinical charateristics,diagnosis and treatment of solid pseudopapillary tumors of the pancreas (SPTP).Methods 40 SPTP cases admitted in the First Hospital of China Medical University from 2004 to 2014 were analyzed retrospectively.Results Among 40 cases,male to female ratio was 1 ∶ 7 with the average age of 33.8 years.Major clinical manifestations included abdominal pain or discomfort and palpable abdominal masses.CT and MRI accuracy for detecting the location of tumors was better than B Ultrasonic.Surgical procedure included spleen preserving distal pancreatectomy in 15 cases,distal pancreatectomy with splenectomy in 9 cases,tumor enucleation in 11 cases,pancreaticoduodenectomy in 3 cases,duodenum preserving pancreas head resection in 2 cases.30 postoperative cases were followed-up with the mean follow-up time of 58.4 months and were all doing well.Conclusions SPTP is a tumor with low-grade malignant potentiality.Cystic and solid tumors of the pancreas found among young women are highly suspected as SPTP.Surgery is the main method of treatment and the prognosis is good.

Objective To summarize the diagnosis and treatment of localized malignant peritoneal mesothelioma(LMPM). Methods A total of 68 cases of LMPM were analyzed retrospectively,including 65 patients in the literature concerning LMPM published in Chinese medical journals be-fore October 2014 plus 3 cases of LMPM admitted in The First Hospital of China Medical University in the same period. Results Among the 68 cas-es,30 cases were male,38 cases were female,with a male to female ratio of 1:1.27. Mean age was 57.6 years. Major clinical manifestations includ-ed abdominal pain or discomfort(76.9%)and palpable abdominal masses(58.5%). Patients(41.7%)had the history of exposure to asbestos. Among the 48 cases(92.3%)that underwent CT examination,ascites was found in 16 cases,and hepatic metastasis was found in 11 cases. Most of the tumors were epithelial type(76.7%),with a mean diameter of 12.2 cm. The main therapeutic strategy was combination therapy of cytoreductive surgery with intraperitoneal hyperthemic chemotherapy. Conclusion LMPM is a rare malignant tumor that occurs predominantly in old people. Symptoms and imaging examinations are untypical. The diagnosis is dependent on pathological examination. Combining several laboratory tests could help the diagnosis. Combination therapy of cytoreductive surgery with intraperitoneal hyperthemic chemotherapy provides an adequate and efficient treatment for LMPM.

Appendectomy involves several key concepts in the foundation course of operative surgery. So it is the best choice to test whether the students can be flexible in using and fully under-stand what they learned about the basic theories and skills of appendectomy. Changzheng Hospital applies Wechat-ald team-based learning and problem-based learning teaching in appendectomy-related courses by actively delivering messages with content of educational administration, basic knowledge, clinical images and videos to the micro-groups, achieving instantly efficient information dissemination and interactive communication. It breaks the shackles of traditional classroom in space and time, mo-bilizes students' enthusiasm for learning, enhances their communicational skills and sense of team-work and improves students' comprehensive analysis and practical ability, therefore achieving better teaching results.

Objective To investigate the effect of moderate pain on attentional bias towards emotional pictures among healthy subjects.Methods Thirty-two healthy college students aged from 17 to 26 (21.8±2.2;16 males and 16 females) participated in this study.A tourniquet was tied to each subject's left upper arm 1 to 2cm above the cubits horizontal grain.Pain was inflicted by inflating the tourniquet,and the pressure was maintained at 26.66kPa.While tourniquet was inflated (with pain) or not (no pain),each subject was asked to finish a pictorial dot-probe task with three kinds of pictures-emotionally positive,negative and neutral.In experiment 1,subjects performed the dot-probe tasks with the contralateral hand while the tourniquet was tied on the left upper arm without inflation.In experiment 2 the tourniquet was inflated until the subject completed the dot-probe task (for about 10min).The reaction times (RTs) and the error rates (Ers) in the recognition task were recorded,and the intensity of the subject's pain and discomfort were measured using a verbal rating scale.Results The subjects reported moderate to severe pain with the tourniquet inflated.The RT and ER data were analyzed using two-way analysis of variance (ANOVA) which showed a significant difference between the average RTs of the males (482±73ms without pain and 466±82ms with pain) and those of the females (536±90ms without pain and 519±100 ms with pain).The average ER was significantly different between the pain (2.38±1.49)％ and no pain (1.09±0.82)％ conditions in both groups.Holn-Sidak multiple comparison testing showed significant differences in both groups' average ER between the negative picture (3.81±1.73)％ and the positive picture (1.66±0.97)％,and between the negative and neutral pictures (1.68±0.8) ％ in the pain condition.Mild attentional avoidance was observed with the positive [pain condition (-5.1±4.8) ms and no pain (-4.6±4)ms] and negative pictures [pain condition (-3.43±6) ms and no pain (-0.79±4.1)ms],but no significant difference was found between the pain and no pain conditions.Conclusion The error rate in a pictorial dot-probe task is influenced by pain,especially with negative pictures.