Objective: To explore the change of activities of the cardiac autonomic nervous system in the EMG biofeedback with the quantified index of heart rate variability(HRV). Methods: Various physiological signals such as ECG、EEG、EMG were recorded by Synchronous Multi-Signal Recording Biofeedback System, and HRV analysis was applied to the extracted ECG signals. Thirty healthy young men received the tests. Results:Compared with the resting state, when the subjects entered biofeedback state, the values of low frequency power, indicator of the sympathetic activity decreased while the values of high frequency power (indicator of the vagal activity) increased, and the values of low frequency power/high frequency power ratio, the marker of the sympatho-vagal balance decreased too. During the later treatment sessions (after 7-10 times treatments) the change exhibited statistical difference and achieved one stable level (low frequency power, baseline 3.98?0.21, 3.82?0.15, 3.93?0.16, 3.91?0.23, test state 3.55?0.32, 3.51?0.29, 3.93?0.16, 3.39?0.26, t=-6.85～-3.68,P

Objective To investigate the relationship between mean amplitude of glycemic excursions (MAGE) and cognitive impairment in elderly patients with type 2 diabetes.Methods Totally 80 patients (aged ＞ 60 years) with type 2 diabetic were selected.According to the Montreal Cognitive Assessment (MoCA) score,the patients were divided into two groups:cognitive impairment group (31cases) and non-cognitive impairment group (49 cases).Then all subjects were observed by continuous glucose monitoring for 3 days including the mean blood glucose (MBG) and its standard deviation (SD),MAGE and numbers of glycemic excursion (NGE).Results Compared with noncognitive impairment group,diabetic course,fasting blood glucose,2 h postprandial glycemia,glycosylated hemoglobin (HbA1c) and body mass index (BMI) were significantly different with the cognitive impairment group (P＜0.05).Furthermore,MAGE,MBG and SD were obviously higher than those in the non-cognitive impairment group [(5.89 ± 2.17) mmol/L vs.(3.15 ± 0.60) mmol/L,t＝8.37,P＝0.00; (11.85±3.45) mmol/L vs.(8.23±1.73)mmol/L,t＝6.23,P＝0.00; (3.16±1.29)mmol/L vs.(1.26±0.42)mmol/L,t＝9.57,P＝0.00].MoCA scores of patients with type 2 diabetes were negatively correlated with MAGE (r ＝-0.891,P ＜ 0.01).After multiple linear regression analysis,diabetic course,2 h postprandial glycemia,MAGE and SD remained independently associated with cognitive impairment in type 2 diabetic patients (R2 ＝0.835,P＜0.05)Conclusions MAGE during a daily period is associated with cognitive impairment independent of fasting blood glucose,postprandial glycemia and HbA1c.

AIM: Utilizing mRNA fluorescent differential display RT-PCR in our previous study,we found that the mRNA expression level of an intermediate protein(IF)-desmuslin was dramatically down-regulated in the abnormal veins of patients with primary vein incompetence.In this study,we testified the alteration of desmuslin expressing style at gene transcription and translation levels.METHODS: Specific PCR primers were designed according to the sequence of desmuslin mRNA.The cDNA fragments of desmuslin obtained from differential display were labeled by DIG as specific probes.Then semi-quantitative RT-PCR and Northern blotting techniques were applied to investigate the expression level of desmuslin mRNA in normal and abnormal veins.Simultaneously,the specific single-cloned antibody bestowed by Yuji Mizuno was used to evaluate the amount of DMN protein in the two groups by Western blotting and immunohistochemical techniques.RESULTS: In the abnormal veins isolated from the patients with primary vein incompetence,the expression of desmuslin mRNA was significantly down-regulated,compared with that in control group(semi-quantitative RT-PCR: 0.19?0.05 vs 0.83?0.08,P

In view of risk characteristics of surgical site infection,the risk factors of the infection were graded and classified while the risk indicators system and risk assessment matrix for surgical site infection were built,based on literature analysis,integrated use of documents analysis,Delphi method and risk quantification matrix.The study indicated that surgical skills of the surgeon and surgical time length are the most important risk factors,followed by insufficient maintenance of the operating room environment and poor baseline assessment of the patient.Risk control of surgical site infection needs to focus on these key factors,optimize utilization of resources and improve the prevention and control ability of surgical site infection.

Objective To compare the value of contrast-enhanced ultrasound (CEUS) and conventional ultrasound (CUS) in the localization and definition of different types of uterine myomas.Methods With real-time CEUS technique, 56 patients with uterine myomas proved by pathology were observed. The accuracy between CEUS and CUS in the localization and definition of different types of uterine myomas was retrospectively analyzed. Results The accordance rates of CEUS and CUS in the diagnosis of total uterine myomas, intramural myomas, submueous and subserous myomas were 94.6% (53/56) vs 73.2%(41/56),99.3%(31/32) vs 78.1%(25/32) and 91.6%(22/24) vs 66.7%(16/24),respectively,and in the definition of number and margin of myomas were 92.8 % (104/112) vs 80.30% (90/112) and 91.9 (103/112) vs 78.6 % (88/112). The accordance rates of CEUS and CUS in the diagnosis of typical uterine myomas were 95.8% (23/24) and 87.5% (21/24),and in the diagnosis of atypical uterine myomas were 93.8%(30/32) and 62.5% (20/32),which were different in statistics (P<0.05). Conclusions CEUS is better than CUS in revealing the number and margin of different types of uterine myomas. The accordance rates of CEUS were higher than those of CUS in the diagnosis of different types of uterine myomas and atypical uterine myomas. CEUS may be a new technique in the localization and definition of uterine myomas.

Objective To investigate the clinical effects of subemergency treatment of femoral intertrochanteric fractures in elderly patients.Methods From June 2013 through February 2014,47 patients older than 65 years were treated for femoral intertrochanteric fracture at our department and completed full follow-ups.Of them,20 received subemergency operation.They were 9 men and 11 women,with an average age of 72.2 ± 4.8 years.By the Evans-Jensen classification,there were 2 cases of type Ⅰ,5 of type Ⅱ,5 of type Ⅲ,5 of type Ⅳ,and 3 of type Ⅴ.The time from injury to surgery ranged from 0.5 to 1.7 days (average,0.8 days).The other 27 patients underwent selective operation.They were 11 men and 16 women,with an average age of 74.9 ± 5.7 years.By the Evans-Jensen classification,there were 3 cases of type Ⅰ,6 of type Ⅱ,6 of type Ⅲ,7 of type Ⅳ,and 5 of type Ⅴ.The time from injury to surgery ranged from 2 to 5 days (average,3.4 days).We compared the 2 groups in terms of in-hospital complications,fracture healing time,length of hospital stay,and hip scores at the last follow-up.Results All the patients were followed up for 12 to 15 months (mean,13.4 months).The rate of in-hospital complications in the subemergency operation group (35.0％,7/20) was significantly lower than that in the selective operation group (51.9％,14/27),and the length of hospital stay in the former (12.1 ± 1.6 days) was significantly shorter than in the latter (16.1 ± 1.8 days) (P ＜ 0.05).There was no significant difference between the 2 groups in fracture healing time (13.1 ± 1.8 weeks versus 13.6 ± 1.2 weeks) (P ＞ 0.05).According to the hip scores at the last follow-up,the subemergency operation group had 16 excellent,2 good,one fair and one poor cases (with an excellent to good rate of 90.0％) while the selective operation group had 21 excellent,2 good,2 fair and 2 poor cases (with an excellent to good rate of 85.2％),showing no significant difference between groups (P ＞ 0.05).Conclusion Subemergency operation can reduce not only in-hospital complications but also length of hospital stay for old patients with femoral intertrochanteric fracture.

Objective To investigate the positive rate of microembolic signal (MES) and the related factors,as well as the correlation between MES and outcomes in patients with cardiogenic cerebral embolism.Methods Patients with cardiogenic cerebral embolism were enrolled.The baseline data of the patients were collected and the MES monitor was conducted.The baseline data of the MES positive group and MES negative group were compared.Multivariatelogistic regression analysis was used to identify the related factors of the positive MES.The patients were followed up regularly.The outcomes of stroke at 6 months and recurrent stroke within 2 years in the MES positive group and MES negative group were compared.Results A total of 165 patients with cardiogenic cerebral embolism were enrolled,including positive MES in 68 patients (41.2％).There were significant difference in the levels of brain natriuretic peptide (BNP),cardiac troponin-I (cTn-I),and D-dimer between the MES positive group and negative group.Multivariate logistic regression analysis showed that the increased levels of baseline BNP (odds ratio [OR] 1.001,95％ confidence interval CI 1.001-1.002;P＜0.001),cTn-I (OR 36.975,95％ CI 1.516-902.0;P=0.027),and D-dimer (OR 1.001,95％ CI 1.000-1.001;P=0.017) were independently associated with the positive MES in cerebral embolism within 48 h after onset.There was no significant difference in the proportion of patients in good outcome (modified Rankin scale score 0-2) and poor outcome (modified Rankin scale score ＞2) after 6 months between the MES positive group and MES negative group.When the average follow-up time was 20.8 months (range,7-24 months),there were 23 patients (33.8％) and 19 (19.6％) had recurrence in the MES positive group and MES negative group,respectively.Kaplan-Meier analysis showed that the recurrence rate of stroke in the MES positive group was significantly higher than that in the MES negative group (log-rank test:P=0.031).COX regression analysis showed that the positive MES was still an independent risk factor for stroke recurrence after adjusting for other confounding factors (OR 0.328,95％ CI 0.142-0.761;P=0.009).Conclusions The positive MES was associated with the increased BNP,cTn-I,and D-dimer levds.The positive MES was not associated with clinical outcomes at 6 month after the onset,but it was associated with the recurrence of stroke within 2 years.

Objective To evaluated the impact of obesity on surgical site infection (SSI)following colorectal cancer surgery.Methods A total of 215 patients undergoing radical surgery for colorectal cancer in a hospital be-tween January 2008 and December 2013 were investigated retrospectively,100 patients were with body mass index (BMI)≥25 kg/m2 (obesity group)and 115 patients with BMI<25 kg/m2 (normal weight group),the intra-opera-tive and postoperative indicators and surgical complications were compared between two groups.Results In obesity group,72(72.00%)patients had intra-operative blood loss of >60 mL,58(58.00%)patients’duration of surgery was >220 min ,20 (20.00%)of whom developed postoperative SSI;in normal weight group,30(26.09%)patients had intra-operative blood loss of >60 mL,20(17.39%)patients’duration of surgery was >220 min,8(6.96%)of whom developed postoperative SSI.Intra-operative blood loss and incidence of SSI in obesity group were both signif-icantly higher than normal weight group,duration of surgery and postoperative length of hospital stay were both longer than normal weight group(both P <0.05).Conclusion Incidence of SSI in colorectal cancer patients is high. Obesity,long duration of surgery,and more bleeding are high risk factors for SSI in colorectal cancer patients.

Objective To explore the value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of subserous myoma (SM) and ovarian fibroma.Methods CEUS was performed on 58 patients with SM and 26 patients with ovarian fibroma.The enhancement pattern was observed.The diagnostic performance was evaluated by using diagnostic test.Results SM exhibited homogeneous isoenhancement synchronously with the myometrium in early phase.In the late phase,the pseudocapsule remained hyper-enhancement with obvious membraniform sign.Some myomas showed the feeding artery from uterus.Ovarian fibroma demonstrated hyper-enhancement at the periphery portion and hypoenhancement inside.Conclusions The SM and ovarian myomas showed different enhancement patterns,which may provide us some exact information in the differential diagnosis between the two diseases.

Objective To evaluate the feasibility and accuracy of the transvaginal real-time three-dimensional hysterosalpingo-contrast sonography(RT 3D-HyCoSy) with SonoVue in the assessment of tubal patency.Methods Tubal patency was investigated by RT 3D-HyCoSy in 96 unselected infertile patients (a total of 191 tubes).The image quality of RT 3D-HyCoSy was evaluated.Laparoscopy was performed in 35 cases (a total of 70 tubes) of them.The efficacy of the procedure was compared with laparoscopy.Results The mean score of image quality of RT 3D-HyCoSy in ninety-six cases was 2.94 ± 0.26.The accordance between RT 3D-HyCoSy and laparoscopy was good,with the Kappa value was 0.802.Sensitivity,specificity,positive predictive value,negative predictive value and accuracy in diagnosing tubal patency by using RT 3D-HyCoSywas 87.5％ (14/16),94.4％ (51/54),82.3％ (14/17),96.2％ (51/53),92.9％ (65/70),respectively.Conclusions Transvaginal RT 3D-HyCoSy is a good imaging technique which can display the morphological character of fallopian tube and assess the patency.