BACKGROUND:The human body pulse signal can be regarded as the convolution of the heart excitation resource signal and the pulse transfer system. The backward signal was studied more before, but the research to the forward signal is not enough.OBJECTIVE: To extract the heart excitation source signals in human pulse wave.DESIGN: A randomized controlled design.SETTING: Second Affiliated Hospital of China Medical University;Biomedical Engineering institute of Shandong University.PARTICIPANTS: Health physical-examined persons in the Second Affiliated Hospital of China Medical University on March 11,2004 were recurited. RM6240 physiological signals collection system was adopted.METHODS: The collection of pulse wave in healthy persons was input into system-analysis mode and based on the principle of blind deconvolution and feasible arithmetic, heart source signals were obtained.MAIN OUTCOME MEASURES: ①Normal human pulse wave ②The heart excitation source signals.RESULTS: In the back-half segment of cepstrum (n＞ n0), periodic impulse was in accordance with the basic human pulse frequency. There was an excitation source in the pulse wave. If high-pass filter was defined to the signal (when n0 equals to 30 in the experimentation the result will be best.), we could get the heart excitation source signal after it was filtered, F transformation, index and inverse transformation.CONCLUSION: This method is practical and feasible and will provide a basis to further analyze pulse wave.

Objective To evaluate the efficacy and toxicity of hyperthermia combined with chemoradiotherapy for local advanced cervical cancer. Methods Sixty-eight patients with local advanced cervical cancer were treated. Each patient was given cisplatin at the dose of 20 mg ivgtt dl -2 and 5 -fluorouracil 0.75 ivgtt dl -2, repeating every week, total 3 weeks. Thirty -eight patients received chemoradiotherapy alone. Thirty patients received hyperthermia with deeply focus technology, the temperature was increased and maintained 42.5 ℃ for 30 min at least, within 2 hours following irridiation. Hyperthermia was given twice per week with 7 or 12 sessions, as the same chemoradiation methods as the reference group.After 40 Gy therapy to estimate by cervical examination and ultrasonography, the patients with down stage were for operation, and the others continued to irridiation and additional brachytherapy with californium 252until radical dose. Results All patients were tolerated, fifteen patients of hyperthermia combined group were operated and ten patients of the reference group were operated, the difference was significance (50.0 % vs.26.3 %, P <0.05). The response rate of the combined group was 90.0 %, and the reference group was 84.2 %.The incidence of radiotherapy toxicity of the combined group was not higher than the reference group.Conclusion Hyperthermia combined with chemoradiotherapy can elevate the resection rate and the local control rate, not increase the radiotherapy toxicity and increase quality of life for cervical cancer patients.

Objective To investigate the expression of nuclear factor kappa B (NF-κB),tumor necrosis factor α (TNF-α) and interleukin6 (IL-6) in human colorectal carcinoma tissues,and to explore their clinical significances in the genesis and development of colorectal cancer.Methods Sixty cases of colorectal cancer tissues and 36 cases of colorectal adenoma tissues were collected,60 cases of paracancerous normal colorectal tissues were the controls.Immunohistochemistry SABC method was used to detect the expression of NF-κB,TNF-α and IL-6 in each group respectively.The correlation of NF-κB,TNF-α and IL-6 with clinical pathologic features of colorectal cancer was analyzed.Results In colorectal carcinoma,adjacent normal colorectal tissues and colorectal adenoma tissues the positive expression rates of NF-κB were 76.7 ％ (46/60),46.7 ％ (28/60),83.3 ％ (30/36),the positive rates of TNF-α were 70.0 ％ (42/60),36.7 ％ (22/60),66.7 ％(24/36),the positive rates of IL-6 were 80.0 ％ (48/60),43.3 ％ (26/60),61.1％ (22/36).The differences were significant in each group (all P ＜ 0.05).The expression of NF-κB was closely associated with the expression of TNF-α and IL-6 respectively.In addition,the expression of NF-κB and TNF-α were correlated with vascular invaded,lymphnode metastasis and different stages.The expression of IL-6 was correlated with lymphnode metastasis and different stages.Conclusion The over expression of NF-κB and the downriver inflammation factors have close relationship with biological behaviors of colorectal cancer.It may be considered that the pathway of NF-κB play an important role in the genesis and development of colorectal cancer.

Objective To study the preventive effect of biliary duct injury(BDI)of three-dimensional spiral CT cholangiography(SCTC)before laparoscopic cholecystectomy(LC).Methods A retrospective analysis was carried out for 30 patients suffering from cholelithiasts concurrent with choledocholithiasis from July 2007 to June 2009.EAndoscopic sphincterotomy(EST),then three-dimensional SCTC was carried out through endoscop-ic nasobiliary drainage(ENBD)before IX,and the preventive effect of BDI was evaluated.Results The visibility of intra-hepatic bile duct,the hepatic bile duct and the common bile duct were 100% the visibility of chol-ecyst bile duct was 73% ,and three-dimensional SCTC can tell the position of cholecyst duct,BDI was not happened in all these patients.Conclusion Three-dimensional SCTC before LC can decrease the possibility of BDI.

Objective To evaluate of three-dimensional spiral CT cholangiography to bile duct configuration before laparoscopic cholecystectomy.Methods A retrospective analysis was performed for 60 patients with cholelithiasts concurrent with choledocholithiasis from May 2009 to April 2012,which were treated with endoscopic retrograde cholangiopancreatography (ERCP),endoscopic sphincterotomy (EST),and endoscopic nasobiliary drainage (ENBD),then three-dimensional spiral CT cholangiography(SCTC) was performed through endoscopic nasobiliary drainage (ENBD) tube,and the bile duct tree image of SCTC was evaluated,then laparoscopic cholecystectomy (LC) was carried out.Results Sixty cases were performed three-dimensional SCTC.The left and right hepatic bile ducts,the hepatic bile duct and the common bile duct were visible in 100％ patients,and cholecyst bile duct was visible in 75％patients,and three-dimensional SCTC can tell the position of cholecyst duct and the place where the cholecyst bile duct enteres into the common bile duct.Conclusion Three-dimensional SCTC can show the shape of bile duct tree,especially the cholecyst duct,and has some guidance values to judge the structure of the bile duct tree and the configuration of cholecyst bile duct during operation,which can decrease the possibility of bile duct injure.

ObjectiveTo study the preoperative evaluation of three-dimensional spiral CTcholangiography(SCTC) in patients with bile duct obstruction.MethodsA retrospective analysis was performed for 60patients with bile duct obstruction from May 2008 to April 2011,who were treated with endoscopic retrograde cholangiopancreatography( ERCP),then SCTC was performed through endoscopic nasobiliary drainage( EN-BD) tube,and the bile duct tree image of SCTC of bile duct obstruction was evaluated.ResultsIn 60 cases of bile duct obstruction who performed three-dimensional SCTC,the left and right hepatic bile ducts,the hepatic bile duct and the common bile duct were visible in 100％ patients,cholecyst bile duct was visible in 80％ patients,and three-dimensional SCTC can tell the position of cholecyst duct and the place where the cholecyst bile duct enters into the common bile duct.ConclusionThree-dimensional SCTC can show the shape of bile duct tree,especially the cholecyst duct,and has some guidance values in judging the structure of the bile duct tree and the shape of cholecyst bile duct during operation.

Objective To evaluate the accuracy of high-aensitivity C-reactive protein (hs-CRP) in the prediction of perioperative cardiovascular accidents (CVAS) in patients with diabetes mellitus. Methods Ninetyone type 2 diabetic patients undergoing elective non-cardiac surgery were divided into 3 groups according to their blood concentrations of hs-CRP: low-concentration group ＜ 1.0 mg/L ( group Ⅰ , n = 9); median-concentration group 1.0-2.9 mg/L (group Ⅱ ,n= 16) and high-concentration group 3.0-10.0 mg/L (group Ⅲ ,n =66). Risk factors for perioperative CVA were analyzed using Spearman rank correlation analysis. Various risk factors including sex, age, ASA physical status, BMI, NYHA claasification, smoking history ,preoperative ECG changes, duration,treatment and complications of diabetes mellitus, hypertension and blood lipids were correlated with perioperative CVA. The risk factors of which P values were less than 0.05 would enter the binary logistic regression analysis to stratify CVA-related risk factors. Area under the ROC curve was used to analyze the accuracy of the risk factors in prediction of perioperative CVA. Results The incidences of perioperative CVAs were 0, 31% and 35 % in Ⅰ ,Ⅱ and Ⅲ groups respectively. It was determined by Spearman rank correlation analysis that preoperative ECG,NYHA classification, age, preoperative cardiovascular color doppler ultrasound, blood hs-CRP concentration and ASA classification of physical status were important risk factors ( P ＜ 0.05 or 0.01 ). Binary logistic regression .malysis indicated that preoperative ECG, NYHA classification and age were highly related to perioperative CVA (P ＜0.05 or 0.01).The area under ROC curve of preoperative ECG, NYHA classification, age and blood hsCRP concentration was 0.855, 0.755, 0.702 and 0.605 respectively. Conclusion The accuracy of blood concentration of hs-CRP in prediction of perioperative CVA in patients with diabetes mellitus is lower than that of the preoperative ECG, NYHA classification or age.

The purpose of the study was to investigate the impact of rat cytomegalovirus(RCMV) infection on the development of the nervous system in rat embryos,and to evaluate the involvement of Wnt signaling pathway key molecules and the downstream gene neurogenin 1(Ngn1) In RCMV infected neural stem cells(NSCs).Infection and control groups were established,each containing 20 pregnant Wistar rats.Rats in the infection group were inoculated with RCMV by intraperitoneal injection on the first day of pregnancy.Rat E20 embryos were taken to evaluate the teratogenic rate.NSCs were isolated from E13 embryos,and maintained in vitro.We found:1) Poor fetal development was found in the infection group with low survival and high malformation rates.2) The proliferation and differentiation of NSCs were affected.In the infection group,NSCs proliferated more slowly and had a lower neurosphere formation rate than the control.The differentiation ratio from NSCs to neurons and glial cells was significantly different from that of the control,showed by immunofluorescence staining.3) Ngn1 mRNA expression and the nuclear β-catenin protein level were significantly lower than the control on day 2 when NSCs differentiated.4) The Morris water maze test was performed on 4-week pups,and the infected rats were found worse in learning and memory ability.In a summary,RCMV infection caused abnormalities in the rat embryonic nervous system,significantly inhibited NSC proliferation and differentiation,and inhibited the expression of key molecules in the Wnt/β-catenin signaling pathway so as to affect NSCs differentiation.This may be an important mechanism by which RCMV causes embryonic nervous system abnormalities.

Objective:To establish a prediction model of postoperative 1-year mortality risk in elderly patients undergoing hip fracture surgery and verify its efficacy.Methods:Patients of both sexes, aged ≥65 yr, of American Society of Anesthesiologists physical status Ⅰ-Ⅳ, who underwent an operation for traumatic hip fracture in the Second Affiliated Hospital of Wenzhou Medical University from January 2017 to December 2018, were enrolled and randomly assigned to model group and verification group in a ratio of 3∶1.The demographic characteristics, clinical data and results such as laboratory examinations were collected.In model group, the logistic regression analysis was used to recognize the independent risk factors for 1-year mortality after procedure, and the prediction model was established.In verification group, the prediction efficacy was analyzed using the receiver operating characteristic curve, and the degree of fitting was evaluated by Hosmer-Lemeshow goodness-of-fit test.Results:Multivariate logistic analysis indicated that age ≥84 yr, Charlson comorbidity index ≥2 points, Braden score on admission to hospital ≤16 points, preoperative urea nitrogen ≥8.8 mmol/L and postoperative albumin ≤ 29.6 g/L were the independent risk factors for 1-year mortality after hip fracture surgery in elderly patients ( P<0.05). The prediction model was established based on the risk factors mentioned above.The area under receiver operating characteristic curve was 0.870, and the sensitivity and specificity were 82.8% and 80.0%, respectively.The prediction model showed good fitting ( χ2=4.672, P=0.700). Conclusion:Age ≥84 yr, Charlson comorbidity index ≥2 points, Braden score on admission to hospital≤16 points, preoperative urea nitrogen ≥8.8 mmol/L and postoperative albumin ≤ 29.6 g/L are the independent risk factors for 1-year mortality after hip fracture surgery in elderly patients, and the prediction model established based on the above indicators has good efficacy.

Objective To investigate the association of copy number variations (CNVs) in the FCGR3A and FCGR3B genes with different outcomes and disease progression after hepatitis B virus (HBV) infection. Methods Peripheral blood samples were collected from 841 patients with chronic HBV infection and 296 patients with self-limited HBV infection, an according to the degree of disease progression, the patients with chronic HBV infection were further divided into chronic hepatitis B (CHB) group, liver cirrhosis (LC) group, and hepatocellular carcinoma (HCC) group. The AccuCopy technique was used for the quantitative analysis of CNVs in the FCGR3A and FCGR3B genes in peripheral blood. The independent samples t -test was used for comparison of continuous data between two groups, and a one-way analysis of variance and the Kruskal-Wallis H test were used for comparison between multiple groups; the chi-square test was used for comparison of categorical data between groups. The chi-square test was also used to investigate the difference in the distribution of CNVs in the FCGR3 gene between different groups. The age-and sex-adjusted logistic regression model was used to investigate the influence of CNVs on the chronicity of HBV infection. Results There was a significant difference in the frequency distribution of CNVs in the FCGR3A and FCGR3B genes between the chronic HBV infection group and the self-limited HBV infection group ( χ 2 =11.406 and 19.143, both P < 0.05). As for disease progression after chronic HBV infection, there were no significant differences in CNVs of the FCGR3A and FCGR3B genes between the CHB group, the LC group, and the HCC group (FCGR3A: χ 2 =3.125, P =0.537; FCGR3B: χ 2 =5.274, P =0.260). There were also no significant differences in CNVs of the FCGR3A and FCGR3B genes between the HBeAg-positive group and the HBeAg-negative group (FCGR3A: χ 2 =1.025, P =0.599; FCGR3B: χ 2 =0.712, P =0.701). Reduction or deletion of the copy number of the FCGR3A and FCGR3B genes was a risk factor for the chronicity of HBV infection (FCGR3A: odds ratio [ OR ]=0.621, 95% confidence interval [ CI ]: 0.513-0.752; FCGR3B: OR =0.594, 95% CI : 0.491-0.719). Conclusion Reduction or deletion of the copy number of the FCGR3A and FCGR3B genes may be a genetic susceptibility factor for the chronicity of HBV infection, but it is not associated with disease progression.