Objective To explore the clinical significance of two new indexes including approximate entropy of oxygen saturation (SpO2ApEn) and saturation impairment time index (SITi) in assessing the severity of hypoxemia in obstructive sleep apnea hypopnea syndrome (OSAHS) patients.In addition,to investigate the correlation betewwn new indexes and other parameters.Methods The six hour polysomnography (PSG) of 500 patients with OSAHS and snorers in our hospital was retrospectively analyzed.According to the level of apnea hypopnea index (AHI),subjects were divided into four subgroups,namely 113 healthy controls,121 mild OSAHS,118 moderate OSAHS,and 148 severe OSAHA patients.SpO2 ApEn and SITi values among the four groups were compared.the correlations between SpO2 ApEn,SITi and other parameters were analyzed,including AHI,oxygen desaturation index (ODI),the lowest oxygen saturation(LSpO2) and the duration of oxygen saturation lower than 90％ (T ＜ 90％).Next,taking AHI as the gold standard,the significance of SpO2ApEn and SITi in assessing the severity of hypoxemia in OSAHS patients was explored by ROC curve analysis.Results SpO2ApEn and SITi between two each groups were significantly different (P ＜ 0.001) and increased synchronously with AHI.Spearman correlation analysis showed that SpO2ApEn and SITi had a good correlation with AHI (correlation coefficient r =0.765,r =0.678,P ＜ 0.O1).SpO2ApEn and SITi also had a good correlation with ODI,LSpO2and T ＜ 90％.According to the ROC analysis,the Boundary values of SpO2ApEn for mild,moderate and severe OSAHS patients were 16.70,17.81,and 20.03,respectively,and the corresponding SITi values were 3.685,4.055,and 4.445.Conclusion In this study,SpO2ApEn and SITi increased synchronously with AHI,SpO2ApEn and SITi had good correlations with AHI,ODI,LSpO2and T ＜90％.SpO2ApEn and SITi have important clinical significance for assessment of hypoxia severity in OSAHS patients.

Tuina is a physical therapy for treatment and prevention of diseases.The predecessors had summed up the systematic tuina manipulations through experiences.In order to study the scientificity and usability of the technology,the researchers established a mathematical model of tuina manipulations,and used video technology to capture the trajectory of the manipulations.Using the mechanical sensor to sense the real manipulations,researchers developed a tuina manipulation instrument and obtained a lot of basic mechanics data about the manipulation technology.Through the summary of the research results of the predecessors,accurate,true and comprehensive mechanical parameters of technology of tuina manipulations were obtained to guide the research and development of instruments of tuina manipulations,and promote the development of the discipline of tuina science.

Five hundred elderly patients with ischemic stroke admitted from January 2008 to December 2010 were enrolled in the study,including 352 recurrent cases and 148 primary cases.There was a positive correlation of stroke recurrence with age,blood pressure,blood glucose and lipid levels,smoking and alcohol consumption of patients(P ＜0.05 ); while the stroke recurrence was negatively correlated with physical exercise(P ＜ 0.05).Stepwise multiple regression analysis indicated that the blood pressure,blood glucose and lipid levels were risk factors for the recurrence of ischemic stroke in elderly patients.

OBJECTIVETo evaluate the clinical effects of arthroscopic reconstruction of anterior cruciate ligament (ACL) and minimally invasive reconstruction of posteromedial corner (PMC).

METHODSThere were 22 cases of ACL and PMC tear were performed with reconstruction from March 2012 to February 2014. The patients were 29.4 years old on average, including 8 males and 14 females. ACL reconstruction was performed under arthroscopy and PMC reconstruction was performed minimally invasively through the ACL incision. The stability of knee was assessed by anterior drawer test,Lachman test,vulgus stress test and Slocum test. The function of knee was assessed by Lysholm score and Tegner activity rating. MRI of knee was checked 12 months after operation.

RESULTSThe stability tests of all patients were negative at 2 and 6 months after operation, and there was one positive case in anterior drawer test and another positive case in vulgus stress test at 12 months after operation. Lysholm score of all patients 12 months after operation was 96.8 +/- 6.8, which was significantly better than 32.0 +/- 11.2 before operation. Tegner activity rating of all patients at 12 months postoperatively was 6.1 +/- 0.9, which was significantly better than 0.9 +/- 0.5 before operation. It showed the grafts were very well in the MRI 12 months postoperatively.

CONCLUSIONArthroscopic ACL reconstruction and minimally invasive PMC reconstruction can restore the stability of knee.

Adult ; Anterior Cruciate Ligament ; physiopathology ; surgery ; Anterior Cruciate Ligament Injuries ; Anterior Cruciate Ligament Reconstruction ; Female ; Humans ; Knee Injuries ; physiopathology ; surgery ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Treatment Outcome ; Young Adult

Purpose: To study the expression of VEGF, VEGF-C, fit-4 in breast cancer and its relationship with lymph node metastasis and explore the significance of lymphangiogenesis on metastasis via lymphtics. Methods: Paraffin-embedded specimens from 82 patients with primary breast cancer who had undergone radical mastectomy with lymph node dissection were studied. VEGF, VEGF-C, flt-4 expression were investigated by immunohistochemical staining. Results: Positive staining for VEGF, VEGF-C, flt-4 were observed in some breast cancer cells. Furthermore, the expression of VEGF-C, flt-4 were significantly higher in lymph node-positive group than in node-negative group. Correlation was found within the expression of VEGF-C, flt4 also. Conclusions: Clinical significance was found between VEGF-C, flt-4 expression and lymph-node metastasis in breast cancer, and may be involved in the metastatic process.

ObjectiveTo investigate the influence of the midazolam sedation based on remifentanil analgesia on the occurrence of delirium in critically ill patients in intensive care unit (ICU).Methods A single-center prospective randomized controlled trial was conducted. 140 consecutive critically ill patients admitted to ICU of Peking University People's Hospital, undergoing mechanical ventilation longer than 24 hours, with the need of sedation, from February 2014 to January 2015 were enrolled. They were randomly divided into two groups by computer generated random numbers table, eachn = 70. The patients in observation group received midazolam 1μg·kg-1·min-1 for sedation, and 1 mg/mL remifentanil for analgesia with 0.05 mg/kg intravenous bolus, then continuous infusion of 0.02-0.10 mg·kg-1·h-1. The patients in control group received midazolam for sedation only. The data were recorded as follows: the main indices for observation included the occurrence of delirium and its duration; the second item for observation was consumption of drug for sedation, followed by the mean arterial pressure (MAP) before and after sedation, the time of wake-up, duration of mechanical ventilation, the length of ICU stay, and 28-day fatality rate. The 28-day survival was analyzed by Kaplan-Meier survival curve.Results The dosage of remifentanil used in observation group was (98.6±24.9) mg/d, the dosage of midazolam was significantly lower than that of the control group (mg/d: 160.6±33.3 vs. 178.9±43.4, t = 2.829,P = 0.005), the incidence of delirium was obviously lower than that of the control group [22.9% (16/70) vs. 57.1% (40/70),χ2 = 15.700,P< 0.001], and the time of delirium was slightly shorter than that of the control group (hours: 162.9±78.0 vs. 194.8±117.3,t = 0.947,P = 0.348). Among the patients with delirium, the dosage of dexmedetomidine used in observation group was significantly less than that of the control group (mg/d: 0.54±0.11 vs. 0.64±0.14,t = 2.112,P = 0.041). The MAP before sedation was similar as the MAP after sedation in both groups, and there was no significant difference between observation group and control group [mmHg (1 mmHg = 0.133 kPa), before treatment: 84.7±16.2 vs. 89.5±37.7, after treatment: 82.3±10.7 vs. 80.8±13.9, bothP> 0.05]. There was no significant difference in the time of waking-up between observation group and control group (hours: 2.3±0.9 vs. 2.4±0.8,t = 0.487,P = 0.627). The duration of mechanical ventilation (hours: 143.4±138.3 vs. 163.9±158.9, t = 0.812,P = 0.418), the length of ICU stay (days: 8.8±7.7 vs. 10.0±7.8,t = 0.917,P = 0.361) and 28-day fatality rate [11.4% (8/70) vs. 20.0% (14/70),χ2 = 1.941,P = 0.245] in observation group were slightly lower than those of the control group without significant difference. Kaplan-Meier survival curve showed that the cumulative 28-day survival rate in observation group was slightly higher than that of control group (χ2 = 1.647,P = 0.199). ConclusionAnalgesia based on sedation may reduce the occurrence of delirium and its severity, furthermore, even if delirium occurs, it may be less severe.

· AlM:To compare the therapeutic effects of different surgical methods in treating pterygium patients and to observe tear film stability.
· METHODS: A total of 120 pterygium patients ( 120 eyes) were divided into three groups, each 40 cases (40 eyes).Data including SchirmerⅠtest (SⅠt), tear break-up time ( BUT) , corneal fluorescein staining ( CFS) were recorded preoperatively and postoperatively to evaluate the clinical efficacy of surgery and the effects of tear function changes.
·RESULTS:There were no significant differences in BUT in group A before the operation and one month after operation.Groups B and C showed significant difference before and after operation, but differences were not statistically significant ( all P<0.05 ); One month after operation, there was significant difference in CFS among group A, B and C (P<0.05), but the difference was not satistically significant between groups B and C; After 3mo, BUT in group A was not significant difference compared with the preoperative; but there was significant difference in groups B and C (P<0.05).When
compared it between groups B and C, there showed no significant difference; Group A showed no significant difference in SⅠt compared with preoperative, SⅠt of groups B and C were significant differences compared with preoperative (P<0.05), but no significant difference between the two groups;After 3mo, CFS of preoperative group A and group B and group C had no significant difference. After 10mo follow - up, there was axsignificant difference ( P<0.05 ) in recurrence rate in group A comparing with groups B and C, there were differences between groups B and C, but no statistically significant.Surgery is more likely to relapse in summer than in winter.
·CONCLUSlON: Pterygium excision combined with self-corneal limbal stem cell transplantation and Tenon capsule closed is an ideal surgical to reduce the recurrence and improve tear film function to some extent.

Gout ; diagnostic imaging ; surgery ; Humans ; Radiography ; Tartrates ; analysis ; Young Adult

Objective To design and manufacture a hypobaric cabin simulator for experimental animals.Methods The simulator was composed of a fully transparent working chamber,an electrical chamber,a pressure control component and a program control component,which had its body made of polymethyl methacrylate plastics,the hatch made of metal plate and support by reinforced metal bar.The air inside chamber was exhausted by the diaphragm vacuum pump,the air inflow was controlled by proportional valve,and the inner pressure and the speed of rise and decline were exactly controlled by the balance of inflow and exhaust.Results The new type of hypobaric cabin simulator had the characteristics of accurate pressure control,low fluctuation range and controllable up and down time,low noise as well as adaptable air exchange rate.Conclusion The new type of hypobaric cabin simulator matches the national standard for experimental animals,and can be used in making the animal model of high altitude diseases.

Minichromosome maintenance protein 7 (MCM7) is an important regulator of DNA replication,and plays an important role in replication initiation and elongation steps.Recent studies show that MCM7 is closely related with the formation and growth of digestive tumors.The detection of MCM7 protein can provide new ideas for the early diagnosis,treatment and prognosis of the digestive tumors.