Objective To develop a motor rehabilitation system based on Kinect somatosensory interaction technology to be used in families.Methods The Kinect skeleton real-time tracking technique was applied to develop three motor rehabilitation protocols to instruct patients in how to perform rehabilitation training and to evaluate their performance.Results Five subjects participated in the experiment.They achieved average scores of 79.15 ±4.89 and 98.89±0.67 for 3D movement and arm lifting respectively.In the pose recognition experiment,their average recognition rate was 90.37 ± 5.21％.Conclusion The proposed rehabilitation system can instruct patients in performing training exercises and evaluate their performance at home.

Objective To explore and evaluate the application value of damage control theory in bilateral craniotomy operation of severe craniocerebral trauma.Methods Seventy patients with Glasgow coma scale score ≤ 5 scores were divided into 2 groups by random digits table method with 35 cases each:standard trauma craniotomy group (normal group),non-standard craniotomy and small dural window exposure strategy group (improved group).The clinical data were compared.Results There was no significant difference in postoperative cerebral tissue bone window embedded meal,large area cerebral infarction incidence rate between two groups (P ＞ 0.05).There was significant difference in the duration of surgery,blood transfusion amount within 24 hours,traumatic epileptic seizure within 1 month,the acute intraoperative encephalocele between normal group and improved group [(2.80 ± 0.63) h vs.(4.21 ± 1.04) h,(3.90 ± 1.02) U vs.(5.55 ± 1.32)U,14.3％(5/35) vs.48.6％(17/35),5.7％(2/35) vs.25.7％(9/35)] (P ＜0.05).Followed up for 6 months,good prognosis,moderate disability,severe disability,vegetative state,death was 4,4,8,6,13 cases in normal group and 8,9,5,4,9 cases in improved group,and there was significant difference (x2 =5.040,P =0.025).Conclusion Severe craniocerebral trauma bilateral craniotomy damage is bigger,damage control theory to guide the improved operation method,can improve the rescue efficiency.

Objective To observe the accuracy of the five-level adult emergency triage system (FLAETS) in determining the severity of critically ill patients,and to analyze the factors that influenced the accuracy of the triage.Methods The triage information of patients admitted to Huashan North Hospital Affiliated to Fudan University between 1 year before and 1 year (started in July 2014) after the implementation of the FLAETS were retrospective analyzed.The patients who triaged by FLAETS (from September 2014 to August 2015) were served as observational group,and those manual triaged by modified early warning score (MEWS,from July 2013 to June 2014) were set as control group.The patients with triage of Ⅰ,Ⅱ,and Ⅲ levels were enrolled (fatal,critical,urgent),and the triage results of emergency physicians-in-chief on duty were set as gold standard.The gender,age,triage level,the proportion of over-triage,the proportion of under-triage,and mortality were compared between two groups.The reasons for the overtriage and under-triage were analyzed.The accuracy of FLAETS in determining severity of critically ill patients was calculated.Results 18449 patients were enrolled in observational group,and 720,1641 and 16088 patients were triaged as level Ⅰ,level ⅡⅡ,level Ⅲ respectively;17 378 patients were triaged as critically ill patients according to gold standard,and level Ⅰ,level Ⅱ,level Ⅲ were 637,1476 and 15 265 patients respectively.6 352 patients were enrolled in control group,and level Ⅰ,level Ⅱ,level Ⅲ were 204,771 and 5 377 patients respectively;6002 patients were triaged as critically ill patients according to gold standard,and level Ⅰ,level Ⅱ,level Ⅲ were 308,836 and 4 858 patients respectively.There were no statistically significant differences in gender and age between two groups (both P ＞ 0.05).Compared with the control group,the proportion of over-triage of level Ⅲ was significantly lowered [8.3％ (1 329/16088) vs.12.5％ (674/5 377),P ＜ 0.01],the proportion of under-triage of level Ⅱ and level Ⅲ was significantly lowered [level Ⅱ:0.6％ (9/1 641) vs.7.0％ (54/771),level Ⅲ:0.4％ (63/16088) vs.4.7％ (254/5 377),both P ＜ 0.01].The success rate of resuscitation in observation group was significantly higher than that of control group [80.70％ (619/767) vs.75.23％ (410/545),P =0.020],and the mortality was significantly lowered [1.11％ (193/17 378) vs.2.35％ (141/6002),P =0.037].Over-triages were mainly found in patients with chronic obstructive pulmonary disease (COPD),hypertension and the main complaint of chest tightness,shortness of breath,and under-triages were mainly found in patients with the multiple organ dysfunction in the elder,atypical heart disease and pneumothorax.The accuracy rates of level Ⅰ,level Ⅱ and level Ⅲ in observation group (99.37％,97.42％ and 89.58％) were significantly higher than those of the control group (97.51％,92.54％,and 80.16％,all P ＜ 0.01).Conclusion The FLAETS in determining severity of critically ill patients were objective and reliable,which enable the nurse to better handle the relationship of the emergency and the ordinary,the severe and the mild,the priority and the non-priority,which made the patients received timely and effective treatment.

Objective To study the role of esophagogastric junction contractile index (EGJ-CI) in evaluating the function of anti-reflux barrier,and in differentiating patients with gastroesophageal reflux disease (GERD) from those with functional heartburn (FH).Methods A total of 115 patients presenting heartburn were enrolled in the study from January 2012 to June 2015.All subjects had completed Gerd-Q questionnaire and undergone gastroscopy,24-hour pH-impedance monitoring and esophageal high-resolution manometry.GERD patients were divided into as reflux esophagitis,acid-nonerosive reflux disease (NERD) and weakly acid-NERD groups.Patients with normal esophageal mucosa,normal acid exposure and negative proton pump inhibitor test were enrolled in FH group.EGJ-CI (mmHg · cm) as well as EGJ rest pressure and 4s integrated relaxation pressure (IRP 4s) were measured.Results Among the 115 patients,18 were reflux esophagitis [(49.0 ± 18.9) years,M ∶ F =10 ∶ 8],25 were acid-NERD [(48.7 ± 14.4) years,M∶F=13∶ 12],37 were weakly acid-NERD [(52.0 ±14.8) years,M∶F=15∶22] and 35 were FH [(53.6 ± 14.8),M∶ F =8∶27].No differences of Gerd-Q scores were noticed between the four groups.(1) Negative correlations were demonstrated between EGJ-CI and esophageal acid exposure time (r =-0.283,P =0.002),EGJ-CI and acid reflux events (r =-0.233,P =0.012),EGJ-CI and weakly acid reflux events (r =-0.213,P =0.022),EGJ-CI and non-acid reflux events (r =-0.200,P =0.032).(2)The value of EGJ-CI was significantly higher in FH patients than in the three subgroups of GERD(all P ＜ 0.01).EGJ rest pressure of FH group was higher than that of acid-NERD (P ＜ 0.01).IRP 4s in acid-NERD group was lower than that of FH and weakly acid-NERD (P ＜ 0.05).(3) The area under curve (AUC) of EGJ-CI was higher than that of EGJ-CIT,EGJ rest pressure or IRP 4s (0.686 vs 0.678,0.641 and 0.578).The cut-off value of EGJ-CI to differentiate GERD from FH was 9.74 mmHg · cm with sensitivity 82.86％ and specificity 51.52％.Conclusions The EGJ-CI values are negatively correlated with esophageal acid exposure time,weakly acid reflux events and non-acid reflux events.Thus it might be used as a metric to reflect the anti-reflux function of EGJ.According to the cut-off value of EGJ-CI 9.74 mmHg · cm,patients with GERD can be sensitively differentiated from patients with FH.

BACKGROUND:Artificial knee joint replacement in older patients often combines with basic diseases, such as hypertension and diabetes. Perioperative blood loss is an important factor affecting the safety of replacement. OBJECTIVE: To explore the effect of the early closure of drainage tube on blood loss after primary total knee arthroplasty. METHODS: We randomly selected 90 patients with osteoarthritis of the knee who underwent primary total knee arthroplasty in the Affiliated Hospital of Qingdao University from January 2014 to July 2015. The patients were randomly divided into three groups (n=30). In the 4-hour occlusion group, the drainage tube was closed for 4 hours in early stage of replacement. In the 2-hour occlusion group, the drainage tube was closed for 2 hours in early stage of replacement. In the control group, the drainage tube was not closed. Because of the use of tourniquet during surgery, the amount of intraoperative blood loss was considered as 0 mL. Drainage blood loss after surgery was recorded. Total blood loss was calculated according to Gross formula through patient height, weight and preoperative and postoperative hematocrit. Hidden blood loss was gotten by subtracting the visible blood loss from total loss. Under the observation of postoperative joint sweling and subcutaneous ecchymosis, knee Hospital for Special Surgery score was recorded at 6 weeks after replacement, and compared among groups. RESULTS AND CONCLUSION:Statistical analysis indicated that significant differences in total blood loss and dominant blood loss were detected among the three groups (P < 0.05), indicating that both occlusion for 2 hours and 4 hours could reduce total blood loss and dominant blood loss, but the range of reduction was greater in occlusion for 4 hours. At 6 months after replacement, no significant difference in knee Hospital for Special Surgery score and hidden blood loss was detectable among three groups (P > 0.05). The incidence of joint sweling and subcutaneous ecchymosis was increased in the 4-hour occlusion group (P < 0.05). Above results confirmed that drainage tube occlusion can decrease total blood loss and dominant blood loss after total knee arthroplasty, but cannot reduce hidden blood loss. 2-hour occlusion after total knee arthroplasty is an ideal choice, but the amount of hidden blood loss should be carefuly considered.

Objective:Our aim was to study the levels of atrial natriuretic peptide (ANP) and pulmonary perfusion imaging in determining of pulmonary artery hypertension (PAH). Methods: We measured ANP levels by using radioimmunoassay after making various types of PAH in rabbits. Catheterization and pulmonary perfusion tomographic imaging were used in the control group. Results: When the pulmonary artery pressure increased slightly, the ANP levels were lower in PAH group than that of control group, but the difference was not significant (t=1, P>0.05). At the same time, pressure measured by catheterization did not change as the control group, but the ratio of back/abdomen radiopharmaceuticals distribution which was measured with pulmonary perfusion tomographic imaging was significantly higher in PAH group than that of the control (t=2.5, P<0.05). The difference between the ANP levels when the pulmonary artery pressure increased medially and seriously was significant (t＝4.0 and 6.5, P＜0.05). The other two methods got the same result (P＜0.05). Results of three examining methods were positively related. Conclusion:The ANP levels can determine the degree of PAH, and it was simple. But it was not as sensitive as that of pulmonary perfusion tomographic imaging.

Objective To investigate the discrepancy of anorectal function in patients of Parkinson's disease (PD) with constipation and functional constipation (FC).Methods Fifteen consecutive male PD patients with constipation and 45 male FC patients were recruited for the study.All subjects underwent colonoscopy or barium enema in order to exclude organic colon diseases.Every patient underwent anorectal manometry and was categorized into subgroups of either dyssynergic defecation (F3a) or inadequate defecatory propulsion (F3b).Results The ages of PD with constipation and FC patients were (70 ± 11) and (68 ± 11) years old respectively.The rectal resting pressure in PD with constipation was higher than that in FC group without statistical significance [9.0 (4.0,15.0) mm Hg vs 6.0 (3.0,9.5) mm Hg,P=0.082,1 mm Hg =0.133 kPa].The anal resting pressure in PD group was not different from FC group [(51.2±17.2) mm Hg vs (59.7 ± 20.4) mm Hg,P =0.152].During anal squeezing,the maximal contraction pressure and area under the squeeze curve in PD with constipation group were both significantly lower than FC patients [maximal contraction pressure:(136.9 ± 43.8) mm Hg vs (183.0 ± 62.1) mm Hg,P=0.010; area under the squeeze curve:(823.5 ±635.7) mm Hg · s vs (1392.4± 939.9) mm Hg · s,P =0.033].During forced defecation,both of the defecation rectal pressure and defecation anal pressure in PD with constipation group were significantly lower than that of FC patients [22.0(15.0,30.0) vs42.0(31.0,55.0)mm Hg,P=0.000; and (46.3 ±23.3) vs (77.9 ±35.1) mm Hg,P =0.002].The proportions of F3a subtype were 10/15 and 46.7％ (21/45) in PD with constipation and FC patients respectively.There was no significant difference in the constituent ratio (P =0.120).Initial rectal sensory volumes were (91.3 ± 56.9) ml and (67.2 ± 38.9) ml in PD with constipation and FC patients respectively.Even both volumes were higher than the normal controls,there was no significant difference between the two groups (P =0.074).Conclusions Both PD with constipation and FC patients have abnormal anorectal motility and sensation comparing to the FC group,the parameters of anal contraction and defecation are significantly lower,F3b is dominant,and rectal sensory threshold is higher in PD with constipation patients.These parameters could possibly characterize the anorectal manometry for PD with constipation patients,which is helpful to understand the pathogenesis of PD and differentiate from other diseases.

[ ABSTRACT] AIM: To observe the effect of circadian rhythms on wound healing of mouse corneal epithelium. METHODS:The C57BL/6 male mice were used in the study.A part of corneal epithelium (2 mm in diameter) was struck off by a golf-like knife to form a round wound area.The dynamics of epithelial healing in the wound area were ob-served under microscope with fluorescein staining.In addition, with related antibodies and DAPI, the dynamic changes of the neutrophils, platelets and dividing cells were also investigated.RESULTS:The healing rates in LL group (12 h light/12 h light) and DD group (12 h dark/12 h dark) were obviously slower than that in LD group (12 h light/12 h dark), mainly showing delayed re-epithelialization, decreased epithelial cells, increased diameter of blood vessel, and delayed re-cruitment of neutrophils and platelets, but more cell number.CONCLUSION:Disruption of circadian rhythms significant-ly inhibits the wound healing of corneal epithelium, mainly through delaying the inflammation and re-epithelialization, but aggravating the inflammatory responses.

Objective To explore the technique of maximum entropy model for extracting Oncomelania hupensis snail habi?tats in Poyang Lake zone. Methods The information of snail habitats and related environment factors collected in Poyang Lake zone were integrated to set up the maximum entropy based species model and generate snail habitats distribution map. Two Land?sat 7 ETM+remote sensing images of both wet and drought seasons in Poyang Lake zone were obtained,where the two indices of modified normalized difference water index(MNDWI)and normalized difference vegetation index(NDVI)were applied to ex?tract snail habitats. The ROC curve,sensitivities and specificities were applied to assess their results. Furthermore,the impor?tance of the variables for snail habitats was analyzed by using Jackknife approach. Results The evaluation results showed that the area under receiver operating characteristic curve(AUC)of testing data by the remote sensing?based method was only 0.56, and the sensitivity and specificity were 0.23 and 0.89 respectively. Nevertheless,those indices above?mentioned of maximum en?tropy model were 0.876,0.89 and 0.74 respectively. The main concentration of snail habitats in Poyang Lake zone covered the northeast part of Yongxiu County,northwest of Yugan County,southwest of Poyang County and middle of Xinjian County,and the elevation was the most important environment variable affecting the distribution of snails,and the next was land surface tem?perature(LST). Conclusions The maximum entropy model is more reliable and accurate than the remote sensing?based meth?od for the sake of extracting snail habitats,which has certain guiding significance for the relevant departments to carry out mea?sures to prevent and control high?risk snail habitats.

Objective To quantitatively analyze the characteristics of a panel of murine anti-human papillomavirus(HPV)11 L1-derived virus-like particle( VLP ) monoclonal antibodies ( mAbs ) and establish the mAb-based methods for antigen quality analysis.Methods A panel of 22 murine anti-HPV11 mAbs were characterized in details with their isotype, and binding affinity, conformational sensitivity were examined quantitatively in the direct binding ELISA and Western blot.The hemagglutination inhibition activity of mAbs were identified using the hemagglutination inhibition assay and the pseudovirus ( PsV ) neutralization efficiency were examined quantitatively using the PsV-based neutralization assay.The type-specific, highly conformational sensitive and neutralizing mAbs were selected to be used in the sandwich ELISA assay.Results Based on the quantitative and semi-quantitative results, six type-specific, highly conformational sensitive and neutralizing mAbs (2A2, 4A1-3, 16G7, 14A6, 9C1 and 19C7) were identified.These mAbs, along with 10D6 were screened as the capture mAb or as the detection mAb in the sandwich ELISA.Conclusion The binding affinity, conformational sensitivity and neutralization efficiency of anti-HPV11 mAbs were characterized in details.A mAb-based sandwich ELISA assay (14A6:Ag:9C12-HRP) were developed, which could be used in the in vitro potency analysis of HPV11 VLP-based vaccine.