In order to quickly and accurately identify the onset and offset of the QRS complex in electrocardiogram (ECG) signal with different forms, a triple local transform method was employed in the present study to detect the suspected onset and offset points of QRS. The accurate onset and offset points of QRS complexes were selected according to the rules drawn by the trial process based on the characteristics of angle and amplitude constituted within these suspected points. The method makes full advantage of the angle and amplitude characteristics of the QRS complex, by which the results can be acquired with some simple arithmetic quickly, accurately and adaptively. The method was investigated with data from the MIT-BIH arrhythmia database and satisfactory results were obtained.
Algorithms ; Arrhythmias, Cardiac ; diagnosis ; Databases, Factual ; Electrocardiography ; Humans ; Signal Processing, Computer-Assisted

Visitation in ICU patients increases the risk of nosocomial infection, but it can meet the psychological needs of patients and their families and help patients with physical rehabilitation. The use of video visitation system, can realize not to enter the ICU unit can remote video visitation purposes, which can meet the needs of patients in ICU visitation, and can effectively reduce nosocomial infection. Video visitation system can be implemented by different ways. Through the researching and analyzing of the various video visiting ways, this article summarizes the advantages of each and the conditions of construction, and then points out that the hospital should choose the appropriate way based on the construction conditions of ICU, during its construction.

Objective:To retrospectively analyze the clinical data of 73 children with non-Hodgkin′s lymphoma to determine its clinical features, pathological types and relationship with efficacy.Methods:In Shanghai Children′s Hospital from October 2014 to October 2018, 73 children with newly diagnosed non-Hodgkin′s lymphoma were enrolled for a retrospective study, with 52 males and 21 females, aged between 2 and 13 years old, so as to comprehensively assess cumulative organs, pathological diagnosis, stage of disease, surgery and efficacy.Results:Among the 73 children with non-Hodgkin′s lymphoma, 66 cases had a clear pathological diagnosis, including 38 cases of surgical pathology and 20 cases of biopsy pathology.All of them were confirmed by immunohistochemisty, and 8 cases were determined by flow cytometry.Meanwhile, 6 cases of the rest 7 cases obtained approximate pathological classification.Only 1 case was unknown.Among the 66 cases, Burkitt lymphoma was the most common in 31 cases, followed by 14 cases of T-lymphocyte type, 7 cases of enlarged lymphoma, 6 cases of B-lymphocyte type, 5 cases of diffuse large B lymphoma, 1 case of extranodal natural killer/T cell lymphoma-nasal type, 1 case of blastic plasmacytoid dendritic cell neoplasm, and 1 case of panniculitis-like T lymphoma.The initial site or cumulative organ involved multiple organs, with most common in neck(20 cases), abdominal cavity(15 cases), and mediastinum(6 cases). In view of outcomes and efficacy, the complete remission rates of stage Ⅱ, Ⅲ, and Ⅳ in clinical were 100.0%, 85.1%, and 72.2%, respectively.The event-free survival rates in stage Ⅲ and Ⅳ were lower than those in stage Ⅱ(80.9% vs. 66.7% vs. 100.0%). From the perspective of the main pathological types grouping, the results revealed that lymphoblastic lymphoma had a lower event-free survival rate than Burkitt′s lymphoma (73.7% vs.90.3%), while there was no statistical significance(all P>0.05). Conclusions:Non-Hodgkin′s lymphoma in children is more common in men, and less common in infants and young children.Pathological type is simpler than adults, Burkitt lymphoma is the most common type, and clinical stage and pathological type may be related to prognosis.

ObjectiveTo observe the changes of serum homocysteine acid ( Hcy),interleukin-6 (IL-6) and high sensitive C-reactive protein (hs-CRP)and elucidate the clinical significance in patients with acute stroke. MethodsA total of 126 acute stroke patients were enrolled in the investigation. Based on the MESS,patients were divided into different groups according the severity and prognosis, and 108 physically healthy subjects were selected as controls. The concentration of serum Hcy, IL-6, and hs-CRP were determined in all cases after being attacked at day 3,day 14 and day 28 respectively. Results①The levels of Hcy, IL-6, hs-CRP in patients with acute stroke were significantly higher than controls ( (58.24 ±9.86) μmol/L vs. ( 17.12 ±4.23) μ mol/L, (59.64 ±13.82) ng/L vs. (18.46 ±4.62) ng/L,(19.78 ±6.12) mg/L vs. (2.28 ±0.82) mg/L,all P＜0. 01 ). ②The levels of Hcy,IL-6, hs-CRP in patients with mild, moderate and severe acute stroke were significantly higher than controls (P ＜ 0.01 ) at 3 day after the onset; and the Hcy, IL-6, hs-CRP were also significantly lower in mild cases with acute stroke compared with moderate and severe cases (P ＜ 0. 01 ). At day 14 ,the moderate and severe patients had significantly higher levels of Hcy, IL-6, hs-CRP than mild cases and controls (P ＜ 0.01 ). At day 28 the severe patients had significantly higher levels of Hcy, IL-6, hs-CRP than mild and moderate cases and controls (P ＜ 0.01 ) ③At day 28, the levels of Hcy, IL-6, hs-CRP in basically recovered and remarkably improved cases were significantly lower than unrecovered cases [ ( 16.12 ± 4.74) μmol/L, ( 1 8.42 ± 5.02) μ mol/L vs. ( 48.69 ± 7.89)μmol/L; ( 19.52 ± 5.67 ) ng/L, ( 20. 74 ± 6. 13 ) ng/L vs. ( 51.26 ± 11.66 ) ng/L, ( 3.21 ± 1.36) mg/L,(3.24 ± 2.51 ) mg/L vs. ( 8.86 ± 1.32 ) mg/L respectively, all P ＜ 0. 01 ]. ConclusionsThe levels of serum Hcy, IL-6, hs-CRP are significant biomarkers to evaluate the severity and prognosis of acute stroke.

Humans ; Hyoid Bone ; pathology ; Male ; Middle Aged ; Syndrome

Objective To further understand factors that influence health-related quality of life (HRQOL) in patients with ulcerative colitis (UC),especially the role of perceived stress and coping modes in Chinese patients with UC.Methods This study was a cross-sectional study.Patients with UC were recruited from July 2013 to September 2014 in Peking Union Medical College Hospital.HRQOL was measured using the inflammatory bowel disease questionnaire (IBDQ).Perceived stress was measured by Perceived Stress Scale (PSS).Coping strategy was evaluated using Medical Coping Modes Questionnaire (MCMQ).Demographic data,course of the disease,clinical disease activity,and disease phenotype according to Montreal classification were also collected.Univariate analyses were conducted to determine which variables were associated with HRQOL,and those were statistically significant were entered into a multivariate regression model.Results We recruited 214 patients (response rate 92.2％),whose median age was 37.5 (29.0,49.3) years old and median course of UC was 4 (2,9) years.Through univariate analyses,better HRQOL was significantly associated with regular medical visits,lower number of previous relapses and hospitalizations,no steroid use,Montreal E1,lower Mayo scores,clinical remission,less perceived stress and less acceptance strategy use.However,multivariate analyses revealed that perceived stress (OR =1.112,95％ CI 1.058-1.169),acceptance (OR =0.310,95％ CI 0.141-0.685),number of hospitalizations (OR =2.924,95 ％ CI 1.328-6.437) and clinical activity (OR =5.058,95 ％ CI 2.312-11.066) were most strongly related to HRQOL.Conclusions HRQOL of UC patients are not only associated with clinical activity of the disease,but also associated with coping strategy and perceivedstress.Further research needs to focus on whether or not relieving stress and guiding patients to cope with ulcerative colitis would improve HRQOL.

Objective To compare the effects of labor epidural analgesia initiated in latent phase and active phase on parturients and neonates. Methods One hundred twenty nulliparous women at full term (single, head presentation, ASA Ⅰ or Ⅱ ) were randomly divided into 3 groups (n=40 each):control group(group C) ; PCEA initiated in latent phase group (cervical dilatation 0.5-3.0 cm) (group L) and PCEA initiated in active phase group (cervical dilatation＞3.0 cm) (group A). Epidural catheter was placed through L2,3 interspace. 0.1% ropivacaine with fentanyl 2 μg/ml was used for PCEA. A test dose of 5 ml was followed by a loading dose of 10 ml. PCEA device was programmed to allow a bolus of 6 ml with a 30 min lockout interval. The intensity of pain was measured with VAS (0=no pain, 10=worst pain) before analgesia, at 5, 10, 15 and 30 min after beginning of PCEA and cervical dilatation of 7-8 cm and 10 cm. Degree of motor block was assessed by lower extremity muscle strength (modified Bromage scale,0=no motor block, 3=inability to flex ankle joints).Plasma cortisol in maternal venous blood obtained before analgesia and at delivery of fetus and in umbilical cord blood and plasma ropivacaine concentrations in umbilical core blood were determined.The length of every stage, duration of analgesia,delivery mode, the amount of oxytocin used, maternal satisfaction, Apgar scores of the neonates and adverse effects were recorded. Results PCEA initiated in latent phase or active phase significantly reduced VAS score, the plasma cortisol level at delivery, the duration of 1st stage of labor, and the rate of cesarean section and increased the use of oxytocin in L and A groups as compared with group C, but there was no significant difference in the above variables between L and A groups. The duration of analgesia was shorter in group A than in group L. Conclusions Labor epidural analgesia initiated in latent phase or active phase can decrease the rate of cesarean section but does not prolong the duration of labor and is safe for the newborn.

Objective To evaluate the significance of detecting plasma methylated Septin9 (SEPT9) alone and combined with fecal immunochemical test (FIT) in screening colorectal cancer (CRC) and adenoma.Methods From October 2014 to April 2015,outpatients received CRC and adenoma screening were enrolled.Colonscopy examination and pathological diagnosis were taken as gold standard.The sensitivity and specificity of plasma methylated SEPT9 and FIT in CRC and adenoma were calculated.The diagnostic value of combined examination was evaluated.Receiver operating characteristic (ROC) curve of SEPT9 in CRC diagnosis was drawn.Results A total of 300 outpatients were enrolled.Among them,CRC was detected in 45 patients (15.0％) and adenoma was detected in 68(22.7％) patients,including 37(12.3％) cases of advanced adenomas.The sensitivity of SEPT9 and FIT for CRC diagnosis was 80.0％ and 88.9％,and the specificity was 95.3 ％ and 54.1％,respectively.The area under concentration curve (AUC) of methylated SEPT9 in CRC diagnosis was 0.923.The sensitivity of SEPT9 and FIT in advanced adenoma diagnosis were 10.8％ and 62.2％,and the specificity were 83.3％ and 49.0％,respectively.The sensitivity of combined examination in CRC diagnosis was 97.8％ and the specificity was 52.9％;the sensitivity in advanced adenoma diagnosis was 67.6％ and the specificity was 47.4％.Conclusions Plasma methylated SEPT9 is helpful in CRC screening,moreover,when combined with FIT,it can increase detection rate of colorectal adenoma.

Objective To study the effect of modified sensorimotor training (SMT) method on standing ba- lance of the stroke patients during their recovery stage. Methods Sixty stroke patients at recovery stage were ran- domly divided into an intervention group and a control group. The intervention group was trained by modified SMT method which combined Thera-band with partial body weight support (PBWS) system, while the control group was trained only with their standing balance in the parallel bars based on the neurodevelopment therapy (NDT) method. Both groups were given the same medications as well as physical therapy, acupuncture and OT. The patients in the two groups practiced standing balance in front of a mirror daily, 40 minutes every day and 6 days every week for 4 weeks. The balance abilities of patients were evaluated by Berg balance scale (BBS) , and their lower extremity func- tions were assessed by simplification Fugl-Meyer assessment (FMA). Results After training, both groups showed significant improvement in BBS and FMA ( P

Objective To investigate the clinical diagnosis and the results of arthroscopic treatment for acetabular labrale tears. Methods From November 2008 to December 2009, 21 patients with unilateral acetabular labrale tears underwent hip arthroscopy were entered in the study, including 9 males and 12 females with an average age of 37.1 years. Physical examination, X-ray examination and magnetic resonance arthrography (MRA) were carried out preoperatively to make the definite diagnosis. Of 21 cases, including labrale debridement in 14 cases, labrale debridement plus femoral osteoplasty in 5 cases and labrale repair plus osteoplasty in 2 cases. Patients were followed-up either by telephone inquiring or out-patient interview.The visual analogue scale (VAS) and Harris hip score were recorded before operation and 6 months after operation respectively. Results All 21 patients showed a positive Fadir impingement sign on the affected hips,meanwhile 15 cases showed a positive Fabir impingement sign, and positive McCarthy test was observed in 9cases. X-ray film showed 11 cases have cam type impingement, among which 6 combined with pincer type impingement. Two cases had acetabulum retroversion alone. On MRA images, signals of contrast agent infiltration in anterior superior quadrant which indicated labrale tear were observed among all cases. All labrale tears were confirmed under arthroscopy. All patients were followed up for average 11.6 months (range, 6-19).The symptoms were obviously released after operation. The VAS decreased from (5.3±1.3) preoperatively to (1.4±-0.9) 6 months postoperatively. The mean Harris hip score improved from (63±9) preoperatively to (84±10) 6 months postoperatively. All the differences had statistical significance. Conclusion Acetabular labrale injury has a close correlation with femoroacetabular impingement. Impingement test and MRA have a high sensitivity and accuracy on clinical diagnosis of labrale tears. Arthroscopic debridement, repair and osteoplasty for labrale tears give a good early outcomes.