BACKGROUND:In some clinical applications or special work conditions,extremely intonse 50 Hz AC intefference exists.As the amplifier's output reaches or is close to saturation,it cannot be suppressed by general anti-interference circuits or software algorithms.Themfore,the hardware circuit must be impreved to suppress this interference,thus obtajning the desired signals.OBJECTIVE:To introduce a biopotential amplifier,which can effectively suppress the impact of 50 Hz AC interference on the weak biomedical signals.DESIGN:Create a circuit model based on the advanced theoretical analysis,then make software emulation and finally design the actual circuit implementation.SETTINGS:the 305 Hospital of Chinese PLA:Institute of Aviation Medicine,Air Force of CIIinese PLA.MATERIALS:The experimentaIinstruments and analytical software were provided by the Institute of Aviation Medicine,Air Force of Chinese PLA:the high-voltage electrical field environment was provided by the 305 Hospital of Chinese PLA.METHODS:The first step was theoretical analysis at the Institute of Aviation Medicine,Air Force of Chinese PLA in 2005,then the 50 Hz anti-reference model was created.After that,the following three anti-reference measures were put forward:①Enhancing the common-mode input impedance of the overall circuit to remove the interference caused by the imbalance electrode impedance;②reducing the equivalent common mode input impedance of the instrument amplifier in the circuit by using a current source controlled by the comlnou mode voltage;③using the driven-right-leg circuit to reduce the common mode voltage.Moreover,emulation analysis was made for the above circuit model by using the circuit emulation software TINA PRO.Through ceaseless improvement of the circuit model,the correct emulation results were obtained.In 2006,the Circuit model helped us realize the electrocardiogram(ECG)amplifier that could suppress the 50 Hz AC intefference effectively in intense interference environments.And that amplifier was put into practical use in the high-voltage electrical field environment produced by the high-voltage electrical field treatment equipment in the 305 Hospital of PLA.The result was satisfying:the 50 Hz AC interference was suppressed effectively and the high-quality ECG signals were obtained.MlAIN OUTCOME MEASURES:Common-Mode Rejection Ratio(CMRR)and the frequency spectrum of signals obtained in intense intefference environment,which are used to assess the ability against the 50 Hz AC interference.RESULTS:A 100 ù resistor or a 200 kù resistor were connected in series in the input loop so as to produce the imbalance electrode impedance status.When the imbalalice electrode impedance was 100 ù,the amplifier output was 1.69 Mv,and CMRR was 125.8 Db.When the imbalance electrode impedance was 200 k ù,the amplifier output was 1.78 Mv,and CMRR was 125.3 Db.Two voltage sources(20 Hz,amplitude of peak to peak value 50 ì V,opposite phases)were used to produce differential mode signals.The amplification gain was 1000 times.In the input loop of the circtilt mentioned above,a 200 kù resistor was connected in series to create the inabalance electrode impedance status.The amplifter output the peak-to-peak value 50 Mv.The fast Fourier transform(FFT)frequency spectrum of the output wave contained no 50 Hz spectrum line.CONCLUSION:Through the emulation experiment and the real application.we can all find that the amplifier has good signal amplification performance and anti-interference capabillty in intensive 50 Hz AC interference environments and severe imbalance electrode impedance Status.

Arteriovenous Malformations ; therapy ; Child ; Female ; Humans ; Pulmonary Artery ; abnormalities ; Pulmonary Veins ; abnormalities ; Septal Occluder Device

Objective To explore the microRNA expression changes and related characteristics and analyze the corresponding miRNA target genes and their bioinformatics in colorectal cancer with liver metastasis.Methods The fresh specimens of primary CRC were collected in 10 patients during operation,with liver metastasis or without.The miRNA expression levels were compared by miRNA microarray between two groups.Then,target genes were identified using target prediction algorithms.The liver metastasis related miRNA-target networks and gene ontology (GO) bioinformatics analysis were further performed.Results A total of six dysregulated miRNAs were identified in colorectal cancer liver metastasis comparing with no metastasis,including 3 up-regulated miRNAs (miR-224,miR-1236,miR-622) and 3 downregulated miRNAs (miR-155,miR-342-5p,miR-363).miR-224 with most significantly up-regulation played regulation role not only with corresponding target-genes but also downstream genes.Conclusions As a core of the regulation networks,miR-224 can regulate the related gene functional groups simultaneously and asynchronously.It further implements the post-transcriptional regulation and plays a vital role in liver metastasis of colorectal cancer.

Objective:To study the clinical efficacy of vitrectomy combined with cataract surgery enin the treatmt of proliferative diabetic retinopathy.Methods:90 patients of proliferative diabetic retinopathy who were treated from January 2013 to June 2016 in our hospital were selected.According to random number table,those patients were divided into the observation group (n=45) and the control group (n=45).The control group was treated with vitrectomy+lentectomy,while the observation group was treated with vitrectomy+ phacoemulsification.Then the best corrected visual acuity,tear interleukin (IL)-2,fluorescein (FL),breakup time of tear film (BUT) and Schirmer test(SIt) and incidence of complications were compared.Results:After operation,the best corrected visual acuity of observation group was better than that of the control group(P＜0.05);the tear IL-2 level in the observation group was significantly higher than that of the control group (P＜0.05);the FL in the observation group was significantly lower than that of the control group,the BUT and SIt were significantly higher than those of the control group (P ＜ 0.05);the incidence rate of capsular opacity,iris neovascularization,corneal edema,xerophthalmia in the observation group was significantly lower than that of the control group (P ＜0.05).Conclusion:Vitrectomy combined with phacoemulsification was effective for proliferative diabetic retinopathy,which could promote the recovery of visual acuity after surgery,improvement of tear secretio and decrease the complications.

Objective To investigate whether the inhibition of caveolin-1 (Cav-1) phosphorylation will regulate effectively nuclear factor-erythroid 2-related factor (Nrf2) signal pathway and downstream effector molecules and protest against ventilation induced lung injury (VILI) in an animal model in vivo. Methods Ninety male Sprague-Dawley (SD) rats were randomly divided into nine groups (each n = 10): sham group in which rats did not receive ventilation but received tracheotomy; lung protective ventilation (PV) for 1 hour or 2 hours group; mechanical ventilation (MV) at high volume tidal (VT, 40 mL/kg) for 1 hour or 2 hours group; protein tyrosine kinase inhibitor PP2 or rosiglitazone (Rsg) pretreatment + high VT ventilation for 1 hour or 2 hours groups. The two pretreatment groups were given intraperitoneal injection PP2 15 mg/kg or intragastric administration of Rsg 5 mg/kg 1 hour before ventilation respectively. The rats were sacrificed after model reproduction, and bronchoalveolar lavage fluid (BALF) was collected. Pulmonary vascular permeability was measured by Evans blue (EB). The levels of tumor necrosis factor-α (TNF-α), activator protein-1 (AP-1), nuclear factor-κB (NF-κB), and interleukin-8 (IL-8) in BALF were determined by enzyme linked immunosorbent assay (ELISA). Then the lung tissues were collected, the lung wet/dry ratio (W/D) was calculated, the changes in pathology was observed with light microscope, and myeloperoxidase (MPO) activity was determined by colorimetric analysis. Nrf2 mRNA was determined by reverse transcription-polymerase chain reaction (RT-PCR). The expressions of Cav-1 tyrosine residues 14 phosphorylation (pCav-1-Y14), Cav-1, peroxisome proliferators-activated receptor γ (PPARγ) and claudin-5 as well as Nrf2 in cytoplasm and nucleus were determined by Western Blot. The positive expressions of PPARγ and claudin-5 in lung tissues were assayed with immunohistochemistry staining. Results There were no obvious pathological changes in the lung tissue in sham group and PV groups, and there were no significant differences in all the parameters between the two groups either. However, the injury in lung tissue was severe in the high VT groups in which W/D ratio, EB contents, MPO activity, and TNF-α, AP-1, IL-8, NF-κB levels in BALF as well as the protein expressions of Cav-1 and pCav-1-Y14 were significantly higher than those of sham group and PV groups, and the protein expressions of PPARγ and claudin-5 were significant lower than those of sham group and PV groups with a dose-dependent manner; but Nrf2 expressions in cytoplasm and nucleus did not show a statistical increase. After pretreatment of PP2 or Rsg, W/D ratio, MPO activity, EB contents, TNF-α, AP-1, IL-8, and NF-κB in BALF were significantly decreased as compared with those of high VT group, and RT-PCR showed significant up-regulation of Nrf2 mRNA in lung tissues too. Moreover, there was a statistically significant increase in expressed Nrf2 proteins in nucleus in PP2 or Rsg groups as compared with those of high VT groups [Nrf2 in nucleus (gray value): 0.61±0.06, 0.56±0.06 vs. 0.31±0.02 at 1 hour, 0.38±0.06, 0.43±0.07 vs. 0.22±0.03 at 2 hours; all P < 0.05], but no significant difference was found in the expression of Nrf2 protein in the cytoplasm among all groups. The protein expressions of pCav-1-Y14 in PP2 pretreatment groups were significantly lower than those of high VT groups (gray value: 0.89±0.04 vs. 1.48±0.02 at 1 hour, 0.86±0.02 vs. 1.31±0.01 at 2 hours; both P < 0.05); but expressed PPARγ proteins and expressed claudin-5 proteins in PP2 or Rsg pretreatment groups were significantly higher than those of high VT groups [PPARγ (gray value): 0.34±0.07, 0.42±0.13 vs. 0.17±0.07 at 1 hour, 0.38±0.09, 0.33±0.07 vs. 0.16±0.03 at 2 hours; claudin-5 (gray value): 0.33±0.05, 0.38±0.07 vs. 0.14±0.03 at 1 hour; 0.30±0.06, 0.31±0.04 vs. 0.17±0.04 at 2 hours; all P < 0.05]. Conclusions The inhibition of Cav-1-Y14 phosphorylation can increase the expression of Nrf2 in the nucleus, then result in an increase in the protein expressions of PPARγ and claudin-5 of its effector molecules. This effect can reduce the inflammation and capillary permeability of lung tissue in the model of VILI.

Objective To investigate the relationship between the apolipoprotein B (ApoB) gene Xba Ⅰ and EcoR Ⅰ polymorphisms and cholelithiasis in Han and Mongolian population in the Midwest Area of Inner Mongolia.Methods The clinical data of 100 patients with cholelithiasis and 115 healthy individuals at the First Affiliated Hospital of Medical College of Baotou from April to October in 2010 were collected.A case-control study which detected ApoB alleles of patients with cholelithiasis (cholelithiasis group) and healthy individuals (control group) in Han nationality and Mongolian nationality in the Midwest Area of Inner Mongolia was conducted by polymerase chain reaction-restriction fragment length polymorphism,which included Xba Ⅰ (X + X +,X + X-,X-X-,X +,X-) and EcoR Ⅰ (E + E +,E-E-,E + E-,E +,E-).The serum lipid (including triglyceride,total cholesterol,high density lipoprotein and low density lipoprotein) levels in different groups were detected.The count data and the measurement data were analyzed using the chi-square test and t test,respectively.Results Genotype X + X + was not found in the Han and Mongolian population,and Xba Ⅰ (X +) or EcoR Ⅰ (E-) alleles was not found in the Mongolian population.The levels of low density lipoprotein were (2.8 ± 0.9)mmol/L in the cholelithiasis group,which was significantly higher than (1.9 ± 0.8) mmol/L of the control group in the Han population (t =2.800,P ＜ 0.05).The levels of high density lipoprotein and low density lipoprotein were (1.7 ± 0.3) mmol/L and (3.5 ± 0.8) mmol/L of the cholelithiasis group,which were significantly higher than (1.2 ± 0.3) mmol/L and (2.8 ± 0.9) mmol/L of the control group in the Mongolian population (t =7.596,2.549,P ＜ 0.05).The levels of triglyceride,total cholesterol,high density lipoprotein and low density lipoprotein of the cholelithiasis group in the Mongolian population were (3.1 ± 1.6) mmol/L,(5.6 ± 1.0) mmol/L,(1.7 ± 0.3) mmol/L and (3.5 ± 0.8) mmol/L,which were significantly higher than (1.2 ± 0.6) mmol/L,(4.4 ± 1.2) mmol/L,(1.3 ± 0.3) mmol/L and (2.8 ± 0.9) mmol/L of the cholelithiasis group in the Han population (t =5.501,3.667,4.448,3.430,P ＜ 0.05).The levels of triglyceride,total cholesterol,low density lipoprotein were (2.6 ± 1.7) mmol/L,(5.1 ± 1.1) mmol/L and (2.8 ± 0.9) mmol/L of the control group in the Mongolian population,which were significantly higher than (1.3 ±0.7)mmol/L,(3.9 ±0.9) mmol/L and (1.9 ±0.8) mmol/L of the control group in the Han population (t =4.298,4.772,3.888,P ＜ 0.05),while the level of high density lipoprotein was significantly higher of the control group in the Han nationality than the control group in the Mongolian population (t =1.997,P ＜ 0.05).The levels of low density lipoprotein in patients with genotypes X + X-,X-X-of the cholelithiasis group in the Han population were (2.7 ± 0.1) mmol/L and (2.6 ± 1.0) mmol/L,and the levels of low density lipoprotein in patients with genoeypes E + E ±,E + E-/E-E-were (2.6 ± 1.0) mmol/L and (2.5±0.4)mmol/L,with no significant difference (t=0.225,0.124,P＞0.05).Conclusion In the Midwest area of Inner Mongolia,the Mongolian population might be more susceptible to cholelithiasis than the Han population.No relationship between the rare alleles X +,E-and the increase of blood lipids,which indicates that X + and E-of ApoB may not be a risk factor of cholelithiasis.

Objective To design a system for monitoring pulse wave transit time (PWTT) in working condition non-intrusively and continuously. Method The system was composed of wireless ECG sensor and wireless pulse wave sensor which measure pulse wave signal from the temporal artery and ECG signal from body synchronously and calculates PWTT continuously. Result Both the wireless ECG sensor and the wireless pulse wave sensor were small sized and powered by button battery. And the accuracy of time synchronization about sensors was less than 1 ms. The calculated PWTT changed slowly with deep breathing. Conclusion The system works smoothly for continuous monitoring of PWTT in working condition.

Objective To investigate the value of procalcitonin (PCT) on predicting the severity and prognosis in patients with early acute respiratory distress syndrome (ARDS).Methods A prospective observation study was conducted. A total of 113 patients with ARDS undergoing mechanical ventilation admitted to intensive care unit (ICU) of Affiliated People's Hospital ofJiangsu University from October 2012 to April 2016 were enrolled. Based on oxygenation index (PaO2/FiO2), the patients were classified into mild, moderate, and severe groups according to Berlin Definition. Twenty-five healthy volunteers were served as controls. Demographics, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, and Murray lung injury score were recorded. Within 24 hours after diagnosis of ARDS, the serum levels of PCT and C-reactive protein (CRP) were determined by enzyme-linked fluorescence analysis (ELFA) and immune turbidimetric method, respectively. The patients were also divided into survival and non-survival groups according to clinical outcome within 28-day follow-up, and the clinical data were compared between the two groups. Spearman rank correlationwas applied to determine the correlation between variables. The predictive value of the parameters on 28-day mortality was evaluated with receiver operating characteristic curve (ROC). Kaplan-Meier survival curve analysis was used to compare different PCT levels of patients with 28-day cumulative survival rate. Results After excluding patients who did not meet the inclusion criteria and loss to follow-up, the final 89 patients were enrolled in the analysis. Among 89 ARDS patients analyzed, 27 of them were mild, 34 moderate, and 28 severe ARDS. No significant differences were found in age and gender between ARDS and healthy control groups. Infection and trauma were the most common etiology of ARDS (55.1% and 34.8%, respectively). Compared with healthy control group, both CRP and PCT in serum of ARDS group were higher [CRP (mg/L): 146.32 (111.31, 168.49) vs. 6.08 (4.47, 7.89), PCT (μg/L): 3.46 (1.98, 5.56) vs. 0.02 (0.01, 0.04), bothP < 0.01], and the two showed sustained upward trends with the ARDS course of disease. Compared with mild group, severe group had significantly higher APACHE Ⅱ and Murray scores. Spearman rank correlation analysis showed that both serum PCT and CRP in patients with ARDS was correlated well with APACHE Ⅱ score (r values were 0.669 and 0.601, respectively, bothP < 0.001), while PCT was weakly but positively correlated with Murray score (r = 0.294,P = 0.005), but not the case of CRP (r = 0.203,P = 0.052). APACHE Ⅱ score and serum PCT in non-survival group (n = 38) were significantly higher than those of the survival group [n = 51; APACHE Ⅱ score: 26.00 (23.00, 28.50) vs. 21.00 (17.00, 25.00), PCT (μg/L): 6.38 (2.82, 9.49) vs. 3.09 (1.08, 3.57), both P < 0.01], but Murray score and CRP level were similar between survivors and non-survivors. The areas under ROC curve (AUC) of APACHE Ⅱ score and PCT for predicting 28-day mortality were 0.781 and 0.793, respectively, which were better than those of AUC of Murray score and CRP (0.606 and 0.561, respectively, allP < 0.05). The AUC of APACHE Ⅱ score combined with PCT was significantly higher than that of PCT (0.859 vs. 0.793,P = 0.048) or APACHE Ⅱ score alone (0.859 vs. 0.781,P = 0.038). Using a PCT cut-off value of > 4.35μg/L for predicting 28-day mortality, the sensitivity and specificity was 92.2% and 63.2%, respectively, and the positive and negative likelihood ratios were 2.50 and 0.12 respectively. Kaplan-Meier survival curve analysis indicated that the patients whose PCT more than 4.35μg/L, had lower 28-day cummulative survival rate as compared with those with PCT ≤ 4.35μg/L (log-rank test: χ2 = 5.013,P = 0.025).Conclusion The elevated serum PCT level in patients with ARDS seems to be correlated well with the severity of lung injury, and appears to be a useful prognostic marker of outcome in the early phases of ARDS.

ObjectiveTo determine whether the inhibition of caveolin-1 tyrosine residues 14 (Cav-1-Y14) phosphorylation with protein tyrosine kinase inhibitors (PP2) will upregulate heme oxygenase-1 (HO-1) activity to protect against ventilation induced lung injury in vivo of an animal model.Methods Fifty-four male Sprague-Dawley (SD) rats were randomly divided into nine groups (eachn = 6). Group A served as normal control group, in which rats did not receive ventilation but tracheotomy. Groups B1 and B2 received lung protective ventilation respectively for 1 hour or 2 hours. Groups C1 and C2 received high tidal volume (40 mL/kg) ventilation for 1 hour or 2 hours, respectively. The group D1 or D2 also received high tidal volume ventilation for 1 hour or 2 hour respectively, but they were given PP2 1 hour before high tidal volume ventilation. The groups E1 and E2 also received high tidal volume ventilation respectively for 1 hour or 2 hours, but tyrosine kinase inhibitor PP2 and HO-1 inhibitor zinc protoporphyrinⅨ(ZnPPⅨ) were given to animals 18 hours before high tidal volume ventilation. All the animals were sacrificed after ventilation, and the specimens of lung tissues and bronchoalveolar lavage fluid (BALF) were harvested. Then the changes in pathology of lung tissue was observed, and diffuse alveolar damage scores (DAD) were calculated, myeloperoxidase (MPO) activity was measured by colorimetric analysis, lung wet/dry ratio (W/D) was estimated. The expressions of phosphorylated caveolin-1 (P-Cav-1-Y14), caveolin-1 (Cav-1) and HO-1 were determined by Western Blot. The expressions of high mobility group B1 (HMGB1) and advanced glycation end product receptor (RAGE) in lung tissues were assayed with immunohistochemistry staining. The levels of tumor necrosis factor-α(TNF-α) in BALF were measured by enzyme linked immunosorbent assay (ELISA).Results There was no significant difference in all the parameters between group A and groups B. Compared with group B1, DAD score, W/D ratio, the activity of MPO and the concentration of TNF-α in BALF in group C1 were significantly increased [DAD score:7.97±0.59 vs. 0.55±0.13, W/D ratio: 5.70±1.61 vs. 5.04±0.63, MPO (U/g): 1.82±0.14 vs. 0.77±0.26, TNF-α(ng/L): 370.10±29.61 vs. 54.38±8.18, allP< 0.05], and the injury in ventilation 2 hours group was more serious than that in ventilation 1 hour group. Compared with groups C, all the parameters in groups D were significantly decreased. The parameters in groups E were significantly higher than those in groups A, B, and D, but no significant difference was found as compared with groups C. Compared with groups B, the protein expressions of Cav-1 and P-Cav-1-Y14 (gray value) in groups C were significantly increased (1 hour: 1.49±0.02 vs. 1.26±0.13, 1.34±0.02 vs. 0.87±0.04;2 hours: 1.58±0.02 vs. 1.27±0.27, 1.31±0.01 vs. 0.95±0.02, allP< 0.05), and the expression of HO-1 protein (gray value) was significantly decreased (1 hour: 0.59±0.02 vs. 1.10±0.01, 2 hours: 0.49±0.01 vs. 1.20±0.02, both P< 0.05). No significant difference in Cav-1 protein expression between groups D as well as groups E and groups C. The protein expression of P-Cav-1-Y14 in groups D and E was significantly lower than that in groups C. The protein expression of HO-1 in groups D was significantly higher than that in groups C, but the phenomenon was not found in groups E as compared with groups C. Compared with group A, the positive expression of HMGB1 and RAGE in lung tissue in groups C and E was significantly increased, but no significant difference was found between groups B as well as groups D and group A.Conclusion Cav-1-Y14 phosphorylation is the key factor for ventilator induced lung injury, which can not only lead to a decrease in vascular barrier function, but also inhibit the activity of HO-1 enzyme, thus further aggravates inflammatory injury of the lung as induced by mechanical ventilation.