Objective To explore a kind of biomedical signal pattern (BSP) with a new method called as state representation methodology (SRM ) .Methods Based on the heart sound signals ,ECG signals ,breathing ,as the important research problem for BSP description ,with some comparisons on several traditional methods ,in which support vector machines (SVM ) and response sur-face methodology (RSM ) etc .,using frequency slice wavelet transform (FSWT ) method to extract the BSP signal dynamic damping characteristics ,thus ,this paper proposes a new idea of SRM analysis .In the case of heart sound signal analysis ,the general steps of SRM evaluation method is given .Results In 40 cases of normal heart sounds SRM model is set up ,with 80 cases of abnormal heart sounds are compared ,the obvious differences of the SRM state distributions of the two groups are found .Conclusion The combi-nation of SRM with FSWT can provide a novel approach for BSP analysis ,and provide powerful development tool for the analysis of BSP .

Objective To compare the effect of target-controlled infusion (TCI) and manual controlled infusion (MCI) of propofol in out-patients undergoing gastroscopy with the sedative depth monitoring by bispectral index (BIS).Methods Forty-eight patients with physical status Ⅰ-Ⅱ scheduled for an elective gastroscopy under general anesthesia were enrolled in this study. All patients were randomly divided into two groups, group T (n=24) and group M (n=24). Before induction, all patients were received a single dose of fentanyl (1 ?g/kg) intravenously. With the monitoring of BIS, the gastroscope was inserted in by the time of BIS value less than 60. Patients in group T received a propofol infusion with the initial plasma concentration of 1 ?g/ml and then the dose was titrated upward by 0.5 ?g/ml each time till the BIS values was less than 60 and then propofol was maintained at a concentration of 2-3 ?g/ml. In the group M, propofol was infused at a rate of 4 g/h until the BIS was less than 60 and then propofol was administrated at a rate of 4-6 mg?h -1?kg -1. During the period of gastroscopy, the sedation depth was maintained by BIS value of 40 to 60. The infusion was stopped by the end of biopsy in both groups. The time from induction to put in the endoscopy, the examination maintenance and the duration of anesthesia, the induction and total amounts of propofol infused were recorded and the average infusion rate was calculated. Results The induction time was significantly shorter in group T than in group M. The duration of examination, time from the induction to opening the eyes and time from induction to the orientation were not significantly different between two groups. Propofol consumption for induction and maintenance was much higher in group M than in group T. The average infusion rate was not significantly different in both groups. The BIS values were almost same at the beginning of gastroscopy and at opening the eyes. The plasma concentration and effect-site concentration were (4.25 ?0.94) ?g/ml and (1.78?0.66)?g/ml at the time of beginning of gastroscopy; while being (1.34?0.39) ?g/ml, ( 1.77?0.40) ?g/ml at the time of opening the eyes. There were 3 cases in group T and 7 cases in group M had sidereactions during the gastroscopy, respectively, but all were mild. Conclusions BIS could be a good sedative depth monitor in total intravenous anesthesia in out-patients gastroscopy. Target-controlled infusion system can help us to get accurate depth of anesthesia quickly and stably, and decrease the consumption of propofol and side effects as well.

Objective The current study was to investigate the clinical and pathological features of macroscopic hematuria associated acute kideny injury (MH-AKI) in patients with IgA nephropathy (IgAN) and its associated prognostic factors.Methods We performed an analysis on the clinical and pathological features of biopsy-proven IgAN patients diagnosed during 2004 to August of 2007,who had experienced MH associated AKI.The patients enrolled in the study were followed up.The renal lesions were evaluated with Katafuchi pathological scores of IgAN.Results 5 patients with IgAN had experienced at least one episode of MH-AKI,accounting for 1.3% of IgAN diagnosed during the same period and 13.5% of IgAN patients with macroscopic hematuria.High proportion of tubules filled with red blood cell casts and tubular injury were demonstrated in all biopsy specimens.Renal function of 3 patients completely recovered within 14 days.One patient (patient 4) got quick recovery in the first month of the disease but completely recovered 418 days later.The other patients only had an incomplete recovery during the 20-month follow-up.The incompletely recovered one had relatively an older age,longer persistence of MH,more sclerotic glomeruli and a more severe tubule-interstitial damage.Conclusion AKI is commonly seen during episodes of MH in patients with IgAN.Not all patients with MH-AKI showed a complete recovery.Age,duration of MH,proportion of glomerular sclerosis and the severity of tubular necrosis might be the risk factors of an incomplete recovery of renal function.

Anti-Bacterial Agents ; adverse effects ; Child, Preschool ; Clindamycin ; adverse effects ; Humans ; Infant ; Male ; Paraplegia ; chemically induced

Objective To study the effect of lincomycin hydrochloride on the intestinal mucosal barrier of mice. Methods A total of 24 mice were equally and randomly divided into normal control group and model group. Mice in the model group were administered with 8 mg · kg-1 · d-1 of lincomycin hydrochloride through gastric lavage for 3 days to establish the model of intestinal mucosa injury and alteration of intestinal flora in mice. The intestinal flora was tested,bacterial translocation was analyzed,and mucosa permeability was determined by measuring diamine oxidase( DAO)in plasma. Results Lincomycin hydrochloride led to alteration of intestinal flora in mice after oral administration for three days in mice. The aerobes translocation rate was 16. 7% and 52. 3% in the normal and model groups,respectively(P〈0. 01). The anaerobes translocation rate was 8. 3% and 68. 2% in the normal and model groups,respectively(P〈0. 01). The plasma concentration of diamine oxidase was increased from(2. 08±0. 05)mg·mL-1 in the normal group to(7. 18±0. 10)mg·mL-1 in the model group(P〈0. 01). Conclusion Lincomycin hydrochloride damages intestinal mucosal barrier in mice.

Acute Disease ; Child ; Cytokines ; blood ; Humans ; Purpura, Thrombocytopenic, Idiopathic ; blood ; immunology

ObjectiveTo investigate the treatment effects of comprehensive nursing intervention on patients with chronic obstructive pulmonary disease(COPD) treated by non-invasive mechanical ventilation with BiPAP mode.Methods96 patients with diagnosed COPD and using non-invasive mechanical ven- tilation with BiPAP mode were randomly divided into the control group(46 cases) which was treated with routine measures and the comprehensive nursing intervention group (50 cases) which adopted comprehen- sive nursing intervention according to experimental design. The frightening degree, incidence rate of com- plications and clinical treatment effect by ventilator were compared between the two groups.ResultsPa- tients compliance with treatment and clinical treatment effect by ventilator in the comprehensive nursing in- tervention group was better than that of the control group. The frightening degree and incidence rate ofcomplications were lower than those of the control group (P < 0.01 ).ConclusionsComprehensive nurs-ing intervention with non-invasive mechanical ventilation with BiPAP mode can improve the treatmentcompliance of COPD patients,reduce complications followed by non-invasive mechanical ventilation andreach the prospective treatment effect.

Objective To compare the efficacy of rcmifentanil combined anesthesia and fentanyl or sufentanil combined anesthesia in patients undergoing cardiac surgery.Methods We searched the Coehrane library,PubMed,EMBASE,OVID and Chinese Biomedical Database for prospective randomized controlled trials involving the comparison of the efficacy of remifentanil combined anesthesia and fentanyl or sufentanil combined anesthesia in patients undergoing cardiac surgery.The quality of the studies was evaluated by the method recommended by Cochrane Collaboration.Evaluation indexes included the mechanical ventilation time after operation,duration of stay in hospital,and level of cardiac troponin,mortality,requirement for positive inotropic drugs and incidence of hyperalgesia and myocardial infarction during perioperative period.Meta-analysis was conducted using the RevMan 5.0 software.Results Sixteen prospective randomized controlled trials involving 1473 patients were included in our Meta-analysis.The patients were divided into 2 groups:fentanyl or sufentanil group ( n =644) and remifentanil group ( n =573).Compared with fentanyl or sufentanil group,the mechanical ventilation time after operation and duration of stay in hospital were significantly shortened,the level of cardiac troponin during the perioperative period was significantly decreased and the requirement for positive inotropic drugs during the perioperative period was significantly reduced ( P ＜ 0.05),and no significant change was found in the incidence of hyperalgesia or mortality of myocardial infarction during the perioperative period in remifentanil group ( P ＞ 0.05 ).Conclusion The efficacy of remifentanil combined anesthesia is better than that of fentanyl or sufentanil combined anesthesia in patients undergoing cardiac surgery.

Objective To identify the changes of outpatients/emergency visits at Nanjing Children′s Hospital since introduction of the general pricing reform at public hospitals.Methods Fluctuations of outpatients/emergency visits at Nanjing Children′s Hospital before and after the reform in 2015 were compared,and an empirical analysis was made in view of the overall structural changes,demand price elasticity and cross-price elasticity of various outpatients/emergency visits.Results The change of total outpatients/emergency visits was minimal,yet the composition registered significant changes.Monthly average of common outpatients totaled 7 072 visits,a growth of 12.6%;that of senior specialists totaled 3 035 visits,a growth of 48.4%.The price elasticity was<1,while the demand for various outpatients/emergency visits services and cross-price elasticity appeared inelastic.Conclusions The one year reform has witnessed the hospital in smooth operations as yet.Given the sizable rise of examination prices for both outpatients/emergency visits,patient volume remains stable instead of drastic decrease,evidencing the strong demand for children′s medical services.

BACKGROUND: Ultrasound-medium frequency electrotherapy has better pain-relieving effect,whether it involves enkephalin and the like neurotransmitter is still not very clear, it is necessary to carry out qualitative and quantitative analysis of the pain response in rats received ultrasound-medium frequency electrotherapy.OBJECTIVE: To investigate the pain-relieving effect of ultrasound-medium frequency electrotherapy and its influence on the enkephalin content in rats, aiming to probe its underlying mechanism and relationship with neurotransmitter enkephalin.DESIGN: Randomly controlled study taking experimental animals as subjects.SETTING: Department of Physiotherapy, First Hospital Affiliated to China Medical University, Institute of Basic Medicine, Peking Union Medical CollegeMATERIALS: This experiment was carried out at the Institute of Basic Medicine, Peking Union Medical College between June 2002 and March 2003. Forty healthy male Wistar rats were adopted and randomized into four groups,namely methionine enkephalin detection experimental group and control group,as well as leucine enkephalin detection experimental group and control group with 10 rats in each group ,amongst which methionine enkephalin experimental group and leucine enkephalin experimental group were generally designed as experimental group ,with the other two group as control group.METHODS: ①Rats ín the experímental group were subjected to ultrasound-medium frequency electrotherapy with frequency of 0.8 MHz in manner of geminal pulse,the modulatìng frequency was 100 Hz and ultrasound intensity of 0.9 W/cm2;the carrier frequency of medium frequency electricity was 4 kHz with modulating frequency of 100 Hz in manner of continuous wave,the electric current of medium frequency was 2 mA and acting time of 10 min. rats in control group received the same dealing,but the higher voltage of ultrasound-medium frequency electrotheprauetic instrument was not used, thereby no energy output was available. tail flick test(TFr) was used to test rat algesthesia,and stopwatch was used to record the time for tail flick(s) that was taken as the value of pain threshold. ②The threshold of pain was tested at 10 minutes instantly after ultrasoundmedium frequency electric stimulation,and then pituitary (removing the posterior pituitary lobe) and hypothalamus were obtained to detect the content of methionine enkephalin and leucine enkephalin by using radioimmuno assay.MAIN OUTCOME MEASURES: The changes of the pain threshold after treatment,the content of methionine enkephalin and leucine enkephalin.RESULTS: Totally 40 rats were enrolled in the experiment and entered in the results analysis. ① The changing rate of pain threshold in two experimental group were 265.79% and 272.90% respectively,the difference was of no statistical significance (P ＞ 0.05). ②After ultrasoundmedium frequency electrotherapy,the content of methionine enkephalin and leucine enkephalin in pituitary and hypothalamus were obviously higher than before treatment [ The changing rate of methionine enkephalin and leucine enkephalin in adenohypophysis was 300.48 ±36.21)% and(204.61±68.65)% , respectively, compared to (239.80±59.98)%and(205.53±51.62)% in hypothalamus, P ＜ 0.05]. ③Linear regression analysis revealed that the variance of the pain threshold was positively correlated with the content of methionine enkephalin in adenohypophysis(r=0.91 ,P ＜ 0.01), suggesting the increment of methionine enkephalin in adenohypophysis was closely connected with the increment of pain threshold,and the level of methionine enkephalin in adenohypophysis would be higher than that in control group by 117.02% when the value of pain threshold increased by100%.CONCLUSION: One of the important mechanisms for the pain-relieving effect of ultrasound-medium frequency electrotherapy might be the increase of methionine enkephalin in adenohypophysis.