Objective To study the relationship between eye movement,HRV indexes and mental fatigue,find feasible objective indexes and build the comprehensive method to evaluate mental fatigue.Methods When twenty subjects executed the simulated monitoring task for 60 min,pupil diameter and ECG data were recorded by eye tracker system and Holter.The subjects were divided into 2 groups(fatigued group/scarcely fatigued group) according CFF(critical flicker frequency) and reaction time(RT).Based on comparison of various indexes between pre-and post-monitoring task,potent indexes were extracted to evaluate mental fatigue.Results After monitoring task,the change of fatigue feeling,Perclos,r-MSSD,PNN50,HF,LF and TP were significantly different in two groups.Conclusion It's suggested that psychology,Perclos and HRV indexes can be used to build the multilevel comprehensive method which can detect mental fatigue quantitatively and qualitatively.

Objective To investigate the efficacy of preoperative transcatheter artery chemoembolization (TACE) correlates with outcome after orthotopic liver transplantation (OLT) in patients with hepatocellular carcinoma (HCC). Methods Sixty-seven patients with HCC underwent TACE before OLT. In all the patients, there were 52 males and 15 females with age ranging from 34 to 67 years old (average 48). Sixty-one patients met the Milan' standard, and 6 patients exceeded Milan' standard. Classic OLT was done in 62 patients and pigyback liver transplantation was done in 5 patients. Immunosuppression regimen after operation included Tacrolimus (or Ciclosporin,Sirolimus), mycophynolate, steroid hormone. The efficacy of TACE was assessed according to histological findings after OLT. Tumor recurrence rate of 1-and 2-year tumor recurrence rate, and 1-and 2-year survival rate in different groups with different responses to preoperative TACE were compared. Results Tumor necrosis rate was greater than 50% in 50 patients and new tumor nodi occurred in 2 patients. Tumor necrosis rate after TACE was 73. 77%. Tumor necrosis rate was less than 50% in 17 patients and new tumor nodi occurred in 7 patients. Forty-eight patients had satisfactory efficacy after TACE and no new tumor nodi occurred, 1-and 2-year tumor recurrence rate was 2. 08/ (1/48) and 6. 25% (3/48) respectively, and 1- and 2-year survival rate was 97. 92% (47/48) and 95. 83% (46/48) respectively. Nineteen patients had worse efficacy after TACE and new nodi occurred, 1- and 2-year tumor recurrence rate was 36. 84% (7/19) and 57. 89% (11/19), and 1-and 2-year survival rate was 73.68% (14/19) and 47. 37% (9/19) respectively. There were statistically significant difference between the two groups (P＜0.05). Conclusion TACE provides good local control in preoperatively diagnosed HCC, but its impact is limited in lesions not detected preoperatively. Patients with satisfactory efficacy after TACE before OLT had a good prognosis. The response to preoperative TACE may predict long-term outcome after LT.

ObjectiveTo explore the surgical approach and therapeutic efficacy of injury of liver and vascular approaching to liver.MethodsThe clinical data from January 1997 to May 2010 of 35 patients with injury of liver and vascular approaching to liver were retrospectively analyzed.Results Among 35 cases,32cases were cured by surgery ( cure rate 91.43％ ) and 3 cases died ( mortality rate 8.57％ ).Postoperative complications occurred in 5 patients ( complication rate 14.29％ ).There were 2 cases of pulmonary infection,1case of biliary fistula,1 case of multiple organ failure and 1 case of incision infection.Conclusion Urgent surgery need to be performed for injury of liver and vascular approaching to liver and effective recovery was important.In the operation,careful handling,complete dissociation and sufficient exposure were the key to successful repair.

Objective To investigate the regulation of fluctuation of beat to beat cardiac cycle.Methods A cardio-electric cycle consists of cardio-electric activity called P-T interval and cardio-electric resting TP segment,P-R interval and Q-T interval constitute P-T interval.The cardiac cycles fluctuate along with the time span fluctuation of sub waves and segments.This paper firstly extracted sub waves and segments based on signal processing methods,then discussed the contribution ratio of all waves and segments toward cardiac cycle fluctuation according to statistics.Results Experimental results indicated that the cardiac cycle fluctuation was mainly consistent with the change of TP segment.The P-T interval varied consistently with P-R interval foremost.Conclusion It is revealed that rule of cardiac cycle fluctuation is very useful for further research to figure out the cardiac function and mechanism.

Objective To compare the consistency of thrombelastography (TEG) and light transmittance aggregometry (LTA) in monitoring the antiplatelet therapy of the patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI),and observe the changes of mean platelet volume (MPV) of the patients treated with aspirin and clopidogrel after PCI.Methods A total of 177 patients undergoing PCI and the treatment of aspirin and clopidogrel in Peking University First Hospital during March 2014 and May 2015 were enrolled in the study.Their adenosine diphosphate (ADP) or arachidonic acid (AA) induced platelet inhibition rates determined by TEG,MPV before and after antiplatelet therapy,and the maximum platelet aggregation rates measured by LTA from 99 patients were retrospectively analyzed.Results There was no any correlation between the maximum aggregation rates measured by LTA and the platelet inhibition rates determined by TEG regardless of using ADP or AA as agonist (all P ＞ 0.05).The detection rates of clopidogrel hyporesponsiveness determined by LTA and TEG were 30.3％ and 45.5％,respectively,while those of aspirin hyporesponsiveness were 19.2％ and 31.3％,respectively.The detection rate of hyporesponsiveness determined by LTA was significant lower than that by TEG (P ＜ 0.05).The MPVs after antiplatelet therapy were significant lower than that before treatment (all P ＜ 0.01) regardless of clopidogrel hyporesponsive or sensitive and aspirin hyporesponsive or sensitive.The MPVs in clopidogrel hyporesponsive group before and after treatment were significantly lower than that in clopidogrel sensitive group (all P ＜ 0.05).The PLT counts in clopidogrel or aspirin hyporesponsive groups after treatment were significantly higher than that before treatment (all P ＜ 0.05).Conclusion There is poor correlation between LTA and TEG.It should be noted that the incidence rate of antiplatelet drug hyporesponsiveness is high in clinical practice.The MPVs of the patients significantly decrease after antiplatelet therapy.The patients with a significant increase of PLT after antiplatelet therapy are more likely to become drug hyporesponsiveness,while the patients with lower MPV are more likely to have clopidogrel hyporesponsiveness.

Objective To evaluate extended criteria donor liver in adult cadaveric liver transplant.Methods 126 liver transplantations were performed from January 2003 to June 2009,of them,74 patients received standard criteria donor livers,52 patients received extended criteria donor livers.These 52 donor livers could be divided into two groups:E1 group (a graft with 1 to 2 risk factors) and E2 group(a graft with 3 to 4 risk factors).Results There was no significant difference in half a year and 1 year survival rates between patients received E1 group extended criteria donor livers and those received standard criteria donor livers(respectively x2 =2.55,3.64,all P ＞0.05).But 2 year survival rate of patients received E1 group extended criteria donor livers was lower than those receiving standard criteria donor livers (x2 =4.9,P ＜0.05).Half a year,1 year and 2 year survival rates in patients receiving E2 group extended criteria donor livers were less than those receiving standard criteria donor livers (respectively x2 =3.91,8.67,11.34,all P ＜ 0.05).The half a year,1 year,and 2 year survival rates of patients received extended criteria donor livers with MELD score more than 20 was less than those with MELD score ＜ 20 (respectively x2 =0.16,0.16,0.07,all P ＜ 0.05).Conclusions Extended criteria donor livers can be used safely if the risk factor of donor liver was less than 3,or when recipient's MELD score was ＜20.

Objective To approach the efficacy of urgent liver transplantation for acute liver failure.Methods The clinical data of 22 patients with acute liver failure undergoing urgent liver transplantation in our hospital from January 2003 to January 2009 were retrospectively analyzed.The prognosis,survival rate and complication were summarized.Results Among 22 patients,there were 14 cases of hepatitis B-induced acute liver failure,and 8 cases of drug-induced acute liver failure.The mean waiting time was 2.3 days.Three patients died perioperatively.Retransplantation was done in 1 patient.Complications after urgent liver transplantation included:abdominal cavity hemorrhage (2 cases),biliary complications (2 cases).There were no vascular complications.Renal dysfunction of different degrees occurred in all patients.Psychiatric symptom occurred in 17 cases,epilepsy in 1 patient,pulmonary infection in 11 patients,and acute cell rejection in 3 patients.The 1-,2-and 3-year recipient survival rate was 81.8 ％,81.8 ％,81.8 ％,respectively,and the 1-,2- and 3-year graft survival rate was 81.8 ％, 77.3 ％, 77.3 ％, respectively.ConclusionUrgent liver transplantation has a good efficacy for acute liver failure.Reasonable preoperative evaluation,length of waiting for graft,and effective treatment of various kinds of complications are the key point to improve the prognosis of patients with acute liver failure undergoing urgent liver transplantation.

Objective To study the mechanism of some vegetables inhibiting human platelet aggregation function.Methods Some vegetable juice was mixed(tomato juice as positive control)with platelet-rich plasma(PRP),and maximum ratio of platelet aggregation was measured after induction by agonists on the aggregometer.The expression levels of platelet activation marker were detected,including fibrinogen receptor(Fib-R),P-selectin(CD62P),and the combination amount of fibrinogen on the surface of platelet by flow cytometry to validate the inhibitory effect of platelet aggregation by animal tests.Ordinary white rabbits were randomly divided into five groups,each group was fed with saline,cooked tomato juice,blanched garlic leaves juice,Chinese cabbage juice or spinach juice,respectively.And the maximum ratio of rabbit platelet aggregation in different time were observed.Results Cooked vegetable juice couldn't inhibit human platelet aggregation induced by AA,but blanched garlic leaves juice,Chinese cabbage juice and spinach juice could inhibit human platelet aggregation obviously induced by ADP.collagen or epinephrine.The inhibition intensity of platelet aggregation increased markedly along with the increase of the concentration of the cooked vegetables juice.Cooked juice of blanched garlic leaves,Chinese cabbage,spinach could not inhibit the expression of Fib-R and CD62P,Whereas they were able to significantly decrease the amount of Fib-R and fibrinogen binding. ADP-induced rabbit platelet aggregation ratios in the group fed with cooked juice of blanched garlic leaves,Chinese cabbage or spinach were significantly lower than control group after 3,5,8 weeks,respectively.The inhibition ratios of the platelet aggregation in cooked Chinese cabbage juice group were 45.7%,53.6%,48.5% after 3,5,8 weeks,respectively.Cooked juice of blanched garlic leaves group were 10.7%,66.7%,46.3%,respectively. Cooked spinach juice group were 8.7%,21.0%,42.6%,respectively.The collagen-induced rabbit platelet aggregation ratios in the groups fed with cooked juice of blanched garlic leaves or Chinese cabbage were significantly lower than control group after 5 and 8 weeks respectively. The inhibition ratios of the platelet aggregation in cooked Chinese cabbage juice group were 54.9%,56.3%after 5 and 8 weeks,respectively. Cooked juice of blanched garlic leaves group were 28.4%and 86.7%,respectively. Cooked tomato juice could not inhibit rabbit platelet aggregation in 8 weeks. Conclusions After induced by ADP or collagen,cooked juice of blanched garlic leaves,Chinese cabbage and spinach could significantly decrease the amount of Fib-R and fibrinogen binding,and inhibit platelet aggregation function significantly.It may have potential application of therapy or prlevention of thrombotic diseases.

Objective To investigate the correlation of prognosis with the immunophenotype in acute myeloid leukemia(AML)patients.Methods Immunophenotyping was performed in 131 patients with AML by mtdtieolor flow cytometry.Correlation of immunophenotype with other laboratory parameters such as initial white blood cell count(WBC),platelet count(PLT),hemoglobin(Hb),and the complete remission(CR)ratio was analyzed.Results In these AML patients,myeloid antigens CDl3,CD33 and myeloperoxidase(MPO)were more highly expressed than other antigens.Expression of CD34 and HLA-DR were lower in acute promyelocytic leukemia(M3)subtype.The expression of lymphocyte antigen CD19 and CD7 were the highest.CD7 expression was associated with age(t=-2.27,P＜0.05).CD14 was associated with initial WBC(Z=-2.284,P＜0.05).The overall CR ratio was 56.5%among all patients.CD34positive patients had a significantly lower CR rato(45.1%),compared with the CD34 negative patients whose CR ratio was 75.6%(x2=11.524,P=0.001).The CR ratio was significantly lower in cases expressing both CD34 and HLA-DR(74 patients with CR rate 41.9%)than in cases expressing only CD34 or HLA-DR(38 patients with CR rate 78.9%)and both negative(19 patients with CR rate 68.4%)(Z=-3.492,P＜0.01).However,other antigens,including CD7,CD19,CD13,CD33,CD38,CD15,CD64,CD14 and MPO had no significant association with CR ratio.Logistic regression analysis showed that age(60 years or older),initial WBC(more than 50 x 109/L),PLT(more than 30 x 109/L),Hb(less than 60g/L)and CD34 were independent adverse factors for achieving CR.Conclusions In AML patients,age,initial WBC,PLT,Hb and CD34 are associated with CR ratio.Detection of immunophenotype may help to estimate prognosis of patients with AML and guide the treatment of AML.

Objective To establish a new flow cytometric immuno-bead array assay (FCIBA)to detect several platelet-specific autoantibodies simultaneously in a single serum sample.Methods A series of beads of different red fluorescent intensity were used for coating with different anti-platelet membrane protein monoclonal antibodies(anti-GP Ⅱb/a,anti-GP Ⅰ a/Ⅱ a,anti-GP Ⅳ,anti-GP Ⅰ b/Ⅸ and anti-HLAABC)to detect five platelet-specific autoantibodies in serum. The beads captured platelet antigenautoantiboay complex.Subsequently,different platelet-specific autoantibodies in a patient serum can be detected simultaneously by the flow cytometry.In addition,we evaluated the new FCIBA,and compared its results with modified antigen capture ELISA method(MACE).The new FCIBA was used to detect five platelet-specific autoantibodies in serums of autoimmune thrombocytopenic purpura(AITP)and nonautoimmune thromboeytopenic purpura patients.Results The new FCIBA can be used to detect five plateletspecific autoantibodies simultaneously(Anti-GP Ⅱ b/Ⅲ a,Anti-GP Ⅰ a/Ⅱ a,Anti-GP Ⅳ,Anti-GP Ⅰ b/Ⅸand Anti-HLA-ABC).The coefficient of variation(CV)of intra-repetition are 4.82%,6.09%,5.04%,5.73%and 5.30%,respectively.The dilution test results are in good logarithm linearity which are 0.997 2,0.996 6,0.998 8,0.996 5 and 0.998 2,respectively. The resuhs of the new FCIBA are highly correlated with those with MACE method,and the coefficient correlation were 0.928 9,0.922 4,0.889 4,0.910 0 and 0.913 4,respectively(P＜0.01).51.69%samples of AITP patients show positive for platelet-specific autoantibodies as detected by the new FCIBA.Among the AITP patients,the positivity of specific autoantibodies for anti-GPⅡb/ Ⅲ a,anti-GP Ⅰ a/Ⅱ a,anti-GP Ⅳ,anti-GP Ⅰb/Ⅸ and anti-HLA-ABC were 40.82%,24.45%,19.39%,32.65%and 17.35%.Among the 40 non-autoimmune thrombocytopenic purpura patients,none of platelet-specific autoantibodies in serum samples can be detected.Conclusion A new FCIBA is established successfully to detect five platelet-specific autoantibodies coefficient correlation.