Diaphragmatic electromyographic (EMGdi) signal is a weak biological signal, which contains some significant physiological information of our body respiration system and is susceptible to strong electrocardiography (ECG) signal interference. Based on wavelet transform and theory of information entropy, a new wavelet energy entropy threshold algorithm to remove ECG interference is proposed in this paper. On the base of analysis of wavelet coefficients of each scale, the method sees the information of each scale as a single signal source, equalizes it byzones, and then divides the energy entropy into two categories (i. e., high energy entropy and low energy entropy) through the distribution characteristics of energy entropy of each zone to conduct absolute mean value threshold. In addition, the denoised signal is reconstructed by wavelet coefficients processed. The experimental results showed that the method removed the ECG signal in EMGdi effectively and reserved the available characteristics of EMGdi better.
Algorithms ; Artifacts ; Diaphragm ; physiology ; Electrocardiography ; methods ; Electromyography ; methods ; Entropy ; Humans ; Signal Processing, Computer-Assisted ; Wavelet Analysis

OBJECTIVETo evaluate clinical effect and safety of floating needle therapy and duloxetine in treating patients with persistent somatoform pain disorder (PSPD).

METHODSTotally 108 PSPD patients were randomly assigned to the floating needle treatment group, the duloxetine treatment group, and the placebo treatment group, 36 in each group. Patients in the floating needle treatment group received floating needle therapy and placebo. Those in the duloxetine treatment group received duloxetine and simulated floating needle therapy. Those in the placebo treatment group received the placebo and simulated floating needle therapy. All treatment lasted for six weeks. Efficacy and adverse reactions were evaluated using Simple McGill pain scale (SF-MPQ) and Treatment Emergent Symptom Scale (TESS) before treatment and immediately after treatment, as well as at the end of 1st, 2nd, 4th, and 6th week of treatment, respectively. Hamilton Depression Scale (HAMD, 17 items), Hamilton Anxiety Scale (HAMA) were assessed before treatment and at the end of 1st, 2nd, 4th, and 6th week of treatment, respectively. Patients in the floating needle treatment group and the duloxetine treatment group with the total reducing score rate of SF-MPQ in Pain Rating index (PRI) ≥ 50% after 6 weeks' treatment were involved in the follow-up study.

RESULTS(1) Compared with the same group before treatment, SF-MPQ score, HAMD score and HAMA total scores all decreased in all the three groups at the end of 1st, 2nd, 4th, and 6th week of treatment (P < 0.05, P < 0.01). Besides , each item of SF-MPQ significantly decreased immediately after treatment in the floating needle treatment group (P < 0.01). Compared with the placebo treatment group, SF-MPQ, HAMD, and HAMA total score in the floating needle treatment group significantly decreased after 1, 2, 4, and 6 weeks of treatment (P < 0.05, P < 0.01). SF-MPQ score, HAMD score and HAMA total score in the duloxetine treatment group also significantly decreased after 2, 4, and 6 weeks of treatment (P < 0.05, P < 0.01). (2) There were 3 patients (8.3%) who had adverse reactions in the floating needle treatment group, 17 (50.0%) in the duloxetine treatment group, and 7 (21.2%) in the placebo treatment group. Compared with the placebo treatment group, the incidence of adverse reaction increased in the duloxetine treatment group (χ² = 6.04, P < 0.05). Besides, it was higher in the duloxetine treatment group than in the floating needle treatment group (χ² = 14.9, P < 0.05). (3) There were 19 patients in the floating needle treatment group and 17 patients in the duloxetine treatment group involved in the follow-up study. Compared with 6 weeks after treatment, no significant difference was observed at 3 and 6 months after treatment in the score of SF-MPQ, HAMD, and HAMA in the floating needle treatment group and the duloxetine treatment group. No significant difference was observed between the two groups (P > 0.05). There were 5 patients (29.4%) who had adverse reactions in the duloxetine treatment group, and no adverse reactions were observed in the floating needle treatment group. The adverse reaction rate was significantly different between the two groups (χ² = 4.26, P < 0.05).

CONCLUSIONSFloating needle therapy and duloxetine were effective in treatment of patients with PSPD. However, floating needle therapy could relieve pain more rapidly than duloxetine, with obviously less adverse reactions.

Acupuncture Therapy ; methods ; Analgesics ; therapeutic use ; Anxiety Disorders ; Duloxetine Hydrochloride ; therapeutic use ; Follow-Up Studies ; Humans ; Needles ; Pain ; Pain Management ; methods ; Pain Measurement ; Psychiatric Status Rating Scales ; Somatoform Disorders ; therapy ; Treatment Outcome

Objective To analyze retrospectively the clinico-pathological features that influencing the occurrence of anastomotie leakage after low anterior resection of rectal cancer, as well as its management and outcome of patients. Methods The data of 513 patients underwent anterior resection for low rectal cancer from june 1999 to June 2007 were reviewed. Results The incidence of anastomotic leakage was 4.5 %(23/ 513). 20 patients underwent conservative therapy,while 3 patients underwent reoperation, all patients were cured without ileostomy or colostomy.Conclusion The occurrence rate of anastomotie leakage is closely re- lated to the type of operation,the Dukes staging,Diabetes Mellitus and Diarrhea. Local irrigation via the drainage tube is the main strategic point to manage the leakage.

Objective To find out the iodine nutritional status of Longyan downtown residents,evaluate the effectiveness of control measures and provide a scientific basis for developing control strategies.Methods Infants aged 0 to 2 year-old,children aged 8 to 10,adults aged 18 to 45 and pregnant and lactating women were selected as survey subjects.Children goiter was detected with B ultrasound.Residents per capita daily salt intake was investigated by weighing method.Three urinary samples and a milk sample of lactating women were randomly collected.Urinary iodine and milk iodine content were determined by arsenic cerium catalytic spectrophotometric assay.Blood samples were collected and thyroid function (including serum TT3,FT3,TT4 and FT4) and thyroid stimulating hormone(TSH) were measured with direct chemiluminescence immunoassay,and thyroglobulin antibody(TgAb),thyromicrosome antibody(TMAb),and thyroglobulin (Tg) were measured with radioimmunoassay (RIA) in serum.ResultsThe goiter rate of children aged 8 to 10 was 1.8％ (2/110),and median thyroid volume was 2.75 ml.Household iodized salt coverage rate was 100.00％(318/318),and qualified iodized salt was 94.03％ (299/318).The daily per capita salt intake was (6.13 ± 3.56)g.The average medians of urinary iodine of the infants,children,adults,pregnant and lactating women were 181.8,315.2,196.6,158.7,136.4 μg/L,respectively.The median of milk iodine of lactating women was 155.6 μg/L.The proportions of serum TT3,FT3,TT4,FT4 and TSH which higher than normal were 3.6％ (11/308),0.6％ (2/309),23％ (7/309),1.0％ (3/313) and 1.3％ (4/312),respectively.While the proportions of serum TT3,FT3,TT4,FT4 and TSH that lower than normal were 2.3％ (7/308),11.7％(36/309),2.3％(7/309),12.8％(40/313),and 1.6％(5/312),respectively,of which 16 cases of both TgAb and TMAb were higher than normal.ConclusionsExisting salt iodine level is appropriate for 0 to 2 year-old infants and young children,18 to 45 year-old adults,pregnant and lactating women in downtown Longyan city.The iodine intake of children aged 8 to 10 is excessive.Thyroid function monitoring is recommended to be included in the routine monitoring.

OBJECTIVETo analyze the long- term results of radical resection for rectal cancer and the factors influencing the operative results.

METHODSFrom January 1990 to December 1999, clinical data of 689 patients who underwent radical resection for rectal cancer were analyzed retrospectively.

RESULTSThe overall operative mortality was 0.7%, the follow- up rate was 96.7%, the median survival rate was 67.4 months. The 1-, 3-, 5- and 10-year survival rate after operation was 89.9%, 77.3%, 69.6% and 63.3% respectively. Univariate analysis showed that the survival rate was related with the first onset symptom, tumor location, infiltrated circumference of intestine, T staging, Dukes staging, histological type, extent of lymph node metastasis and operative approaches. Multivariate analysis showed that tumor location, histological type, invasive depth and Dukes staging were independent prognostic factors.

CONCLUSIONSThe long-term efficacy after radical resection for rectal cancer is correlated with tumor location, histological type, invasive depth and Dukes staging.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Rectal Neoplasms ; mortality ; pathology ; surgery ; Rectum ; pathology ; Regression Analysis ; Retrospective Studies ; Survival Rate ; Treatment Outcome

OBJECTIVETo compare the effect of 5-fluorouracil (5-FU) portal vein infusion (PVI) for 7 days after radical resection, with intraluminal chemotherapy during operation for eliminating liver metastasis and elevating long-term prognosis in colorectal cancer.

METHODS162 colorectal cancer patients with radical resection were divided into portal vein chemotherapy group (group A, 82 cases) and intraluminal chemotherapy group (group B, 80 cases) randomly. In group A, 5-fluorouracil were infused with 1g per day constantly for 7 days after operation through portal vein catheters, which placed into greater omental vein and fixed on the abdominal wall. In group B, intraluminal chemotherapy was given and 5-fluorouracil 0.5 g was injected into the greater omental vein during operation.

RESULTSThe short-term complications and long-term effect in the two groups were compared by statistical software SPSS 8.0. Group A had more operative complications, and no statistical differences was found in hospital time and survival rate of the two groups. The 5-year survival rate is 76.7% (group A: 74.3%, group B: 79.2%), and the liver metastasis rate is 19.8%. There is no significant difference between the two group-survival curves. Multiple variable analysis suggested that Dukes' stage was the prognosis factor (P < 0.05).

CONCLUSIONSThe present study demonstrated that the two chemotherapy methods play an important role in preventing liver metastasis and improving the survival rate, and the intraluminal chemotherapy would be easier and simpler. The result should be further improved by using combined chemotherapy.

Adult ; Aged ; Antimetabolites, Antineoplastic ; administration & dosage ; Chemotherapy, Adjuvant ; Chemotherapy, Cancer, Regional Perfusion ; methods ; Colorectal Neoplasms ; drug therapy ; mortality ; therapy ; Combined Modality Therapy ; Female ; Fluorouracil ; administration & dosage ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Male ; Middle Aged ; Portal Vein ; Survival Rate ; Treatment Outcome

BACKGROUND AND OBJECTIVEAs a prospective vaccine carrier, nanoparticles can protect antigens from degradation and enhance immune response. This study prepared nanovaccines with MAGE-3-derived CD4+-CD8+T cell epitope peptides, and investigated its character and antitumor effects on transplanted gastric cancer in mice.

METHODSWe adopted the self-assembly method to prepare peptide/chitosan conjugated with deoxycholic acid (chitosan-deoxycholic acid) nanoparticles. We observed the appearance of the chitosan-deoxycholic acidnanoparticles through a transmission electron microscope (TEM) and analyzed the peptide content and its release pattern by fluorescence spectrophotometry. We observed tumor-suppression efficacy in vivo through animal experiments.

RESULTSWe successfully prepared nanoparticles with MAGE-3 peptide antigen, and its encapsulation efficiency and loading level were about 37% and 17.0%, respectively. These nanoparticles presented a delayed release pattern in phosphate buffered saline (PBS) at pH 7.4, and the full release time was about 48 h. In 2 mg/mL lysozyme, the nanoparticles showed a sudden release, and the full release time was about 24 h. ELISPOT and cytotoxic experiments showed that the MAGE-3 peptide loaded nanoparticles could stimulate immune response in vivo and could generate MAGE-3-targeted cytotoxic T lymphocytes (CTLs), and kill MAGE-3-specific tumor cells. Tumor suppression experiments showed that the regression ratio of the peptide-loaded nanoparticles group was 37.81%.

CONCLUSIONSMAGE-3 peptide/chitosan-deoxycholic acidvaccine-loaded nanoparticles can stimulate antitumor immune response in vivo and can regress the growth of mouse forestomach carcinoma cell line MFC.

Animals ; Antigens, Neoplasm ; chemistry ; immunology ; Cancer Vaccines ; administration & dosage ; Cell Line, Tumor ; Chitosan ; chemistry ; Dendritic Cells ; immunology ; Deoxycholic Acid ; chemistry ; Drug Carriers ; chemistry ; Epitopes, T-Lymphocyte ; immunology ; Male ; Mice ; Nanoparticles ; Neoplasm Proteins ; chemistry ; immunology ; Neoplasm Transplantation ; Stomach Neoplasms ; pathology ; therapy ; T-Lymphocytes, Cytotoxic ; immunology ; Tumor Burden

OBJECTIVETo investigate the therapeutic effects of closed reduction and external fixation (plaster or splint) for the treatment of displaced humeral supracondylar fractures in children.

METHODSFrom March 2007 to September 2009,33 children (15 female and 18 male) with humeral supracondylar fractures treated in our hospital, ranging from 3 to 12 years old with an average of 6.4 years old. All the fractures were extension-type injuries, the flexion injures were excluded in our study. The humeral supracondylar fractures were classified according to Gartland classification. There were 21 Type H and 12 type III. In the initial treatment, all the patients were treated with closed reduction and external immobilization. The blood supply of the damaged upper extremity was evaluated before and after treatment. Clinical assessment was obtained at final follow-up using Flynn criteria, and radiologic assessment was obtained using Baumann and lateral humerocapitellar angles.

RESULTSAll the children were treated successfully with closed reduction in the initial time; 24 children maintained limb alignment by external immobilization. Nine patients lost position due to the swelling around the elbow which affected unstable external fixation during the follow-up, 5 of which were treated with a repeated closed reduction and internal fixation with Kirschner wires, 4 of which were treated with traction. Thirty-one patients had a satisfactory outcome and 2 patients had an unsatisfactory outcome according to the Flynn criteria at the latest follows-up.

CONCLUSIONClosed reduction and external stabilization is an important method for the treatment of displaced humeral supracondylar fractures in children. Making regular follow-up visits after closed reduction and casting is important for patients to maintain acceptable alignment, avoid complications and diagnose any loss of reduction.

Casts, Surgical ; Child ; Child, Preschool ; External Fixators ; Female ; Fracture Fixation, Internal ; Humans ; Humeral Fractures ; surgery ; Male ; Splints

OBJECTIVETo study the effect of angiogenesis inhibitor YH-16 in combination with 5-FU on liver metastasis of colorectal cancer.

METHODSIn vitro, the inhibitory effects of YH-16 and 5-FU on the growth of vascular endothelial cells and colorectal cancer cells were examined by MTT assay. In vivo, colorectal cancer cells were transplanted into BALB/c mice, and the mice were divided into six groups randomly:control group, low-dose YH-16 group, middle-dose YH-16 group, high-dose YH-16 group, 5-FU group and combination group. The number of liver metastases, the size of primary tumor and the toxicity were examined after 2 weeks postoperatively. The expression of vascular endothelial growth factor (VEGF) in liver metastases was detected by immunohistochemistry, and tumor microvessel density (MVD) was measured by immunostaining with CD34 and factor VIII (monoclonal antibodies.

RESULTSIn vitro, YH-16 inhibited the growth of colon cancer cells and vascular endothelial cells, with the IC50 at (2.16+/-0.28) microg/ml and (0.64+/-0.10) microg/ml respectively. In vivo high-dose YH-16 and 5-FU had a remarkable inhibitory effect on liver metastasis, and the combination group showed significant enhancement on this effect (P< 0.05). The combination group and 5-FU group could inhibit the growth of primary tumor, but not found in YH-16 group. The toxicity of YH-16 was lower than that of 5-FU (P< 0.05), and the difference was not found in the toxicity between combination group and 5-FU group (P > 0.05). Expression of VEGF in liver metastases was clearly inhibited by YH-16 in combination with 5-FU or 5-FU alone compared to the control group, and MVD in middle-dose and high-dose YH-16 group, 5-FU group and combination group was lower than that in control group (P< 0.05).

CONCLUSIONSThe angiogenesis inhibitor YH-16 can inhibit liver metastasis of colorectal cancer through inhibiting the growth of vascular endothelial cells. YH-16 in combination with 5-FU has additive effect on inhibitory activity against liver metastasis.

Angiogenesis Inhibitors ; therapeutic use ; Animals ; Cell Line, Tumor ; Colorectal Neoplasms ; drug therapy ; pathology ; Drug Therapy, Combination ; Female ; Fluorouracil ; therapeutic use ; Liver Neoplasms ; prevention & control ; secondary ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVETo discuss the operation skills and evaluate the effects of open total extraperitoneal herniorrhaphy for inguinal hernia via a ventral midline incision.

METHODSFrom June 2008 to December 2009, 106 patients with inguinal hernia received open total extraperitoneal herniorrhaphy via a ventral midline incision, the clinical data were analyzed retrospectively.

RESULTSOf the patients, 86 cases were male, 20 were female, the mean age was 60.2 years (range, 21 - 86 years). The mean operation time was (32.6 ± 10.5) minutes. The postoperative hospital stay was (2.3 ± 0.7) days. Intra-operative peritoneal perforation occurred in 2 cases. Four cases experienced urine retention and seroma happened in 2 cases, 6 cases suffered early surgical-site pain, and all of the complications were cured with conservative treatment. Three cases developed scrotal hydrocele. No neuralgia or incisional infection occurred in this group. During a 3- to 22-months follow-up period (mean, 10.2 months), no patient complained of discomfort or foreign body sensation in the inguinal area. Two cases recurred 2 and 11 months after the surgery, respectively; the recurrence rate was 1.9%, the two patients healed after reoperation.

CONCLUSIONSOpen total extraperitoneal herniorrhaphy operation via a ventral midline incision is a safe, effective and convenient technique for inguinal hernia with few postoperative complications. This method is worth popularizing.

Abdomen ; surgery ; Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Hernia, Inguinal ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult