Cardiovascular disease (CVD) is the leading cause of death worldwide. As the key pathological basis of CVD, arteriosclerosis holds great significance for early screening. However, existing clinical and homecare detection devices have many shortcomings; for instance, the commonly used non-invasive indicator PWV (pulse wave velocity) is easily interfered by blood pressure.This study developed a homecare arteriosclerosis monitoring system, which integrates the measurement functions of cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI). The hardware design of the system includes an integrated structure of flexible silver ion electrodes and clip-type cuffs, a contact heart sound sensor, and a stepped deflation blood pressure measurement module. Meanwhile, a high-precision analog-to-digital conversion module and the STM32F405 main control chip are used to realize the synchronous acquisition of multiple signals.In terms of software, the underlying driver program was designed through MDK (Keil5), and a user interface was built on the Visual Studio platform to achieve functions such as data acquisition, display, and storage. At the algorithm level, the system adopted algorithms like the Pan-Tompkins algorithm to identify key feature points of physiological signals, and then calculate CAVI and ABI.System test results show that the ECG input noise of the system is less than 20 μV, the common-mode rejection ratio is 95 dB, and the blood pressure measurement error does not exceed 2 mmHg, which meets the design goals. Clinical data analysis indicates that CAVI is highly positively correlated with pulse wave velocity (PWV) ( r=0.85, P<0.001), but CAVI is less affected by blood pressure fluctuations. In addition, with the increase of risk factors (such as hypertension, hyperlipidemia, coronary heart disease, etc.) and age, arteriosclerosis indicators (CAVI, PWV, ABI) all show an upward trend.In conclusion, the homecare arteriosclerosis monitoring system proposed in this study not only overcomes the problems of traditional devices that rely on professional operation and are susceptible to blood pressure interference, but also provides a reliable tool for arteriosclerosis screening in home scenarios, and has important reference value for clinical diagnosis.
Humans ; Cardio Ankle Vascular Index ; Home Care Services ; Atherosclerosis/diagnosis* ; Ankle Brachial Index ; Algorithms ; Pulse Wave Analysis ; Arteriosclerosis/diagnosis* ; Monitoring, Physiologic/instrumentation*

【Objective】 To retrospectively analyze the indexes of autologous blood transfusion during heart valve replacement, in order to provide reference for allogeneic blood transfusion during heart valve replacement surgery under direct vision. 【Methods】 The data of 180 patients who underwent heart valve replacement in our hospital from January 2020 to December 2021 were analyzed retrospectively. The patients were divided into allogeneic and non-allogeneic blood transfusion group based on whether allogeneic blood was transfused during the operation, and the general data and 24 hours pre- and post-operative clinical examination indexes were compared. 【Results】 Multivariate logistic regression analysis showed that age (OR=1.110, 95% CI: 1.058-1.165, P<0.05) and intraoperative cardiopulmonary bypass time (OR=1.062, 95% CI: 1.038-1.086, P<0.05) were risk factors for allogeneic blood transfusion, and preoperative Hb content (OR=0.910, 95%CI: 0.868-0.953, P<0.05) was a protective factor. The RBC count(4.16±0.73 vs 4.52±0.71)×10¹²/L and Hb(120.94±17.97 vs 136.57±19.33) g/L at 24 hours preoperative in the allogeneic transfusion group were lower than those in the non-allogeneic transfusion group, and the RBC(3.51±0.53 vs 4.13±0.78)×10¹²/L, Hb(114.15±11.68 vs 124.79±14.96)g/L and platelet count(124.28±32.11 vs 148.29±26.62)×10⁹/L at 24 hours postoperative were significantly lower than those in the non-allogeneic transfusion group (P<0.05). 【Conclusion】 Age and intraoperative cardiopulmonary bypass time are the risk factors for autologous and allogeneic blood transfusion during heart valve replacement under direct vision, and the preoperative Hb content is a protective factor. It is necessary to evaluate the symptomatic treatment of patients before operation and reduce allogeneic blood transfusion.

Objective:To explore the establishment of a surgical complication monitoring mode based on data on the medical record homepage, and analyze its impact on the trend of changes in surgical complication incidence.Methods:A monitoring mode of surgical complication was developed based on the " structure-process-results" framework by using surgical complication rates derived from performance appraisal for a tertiary general hospital in Guangzhou. The number of surgical complications and the number of discharged surgical patients was collected from the hospital from January 2019 to June 2022 through the home page collection system for performance appraisal of national tertiary public hospitals. Descriptive analysis was used to analyze the incidence of surgical complications, and Joinpoint regression was used to analyze the trend of changes in the incidence of surgical complications. Monthly percentage change ( MPC) and average monthly percentage change ( AMPC) were calculated. Results:Since the hospital began implementing the surgical complication monitoring mode in May 2021, the incidence of surgical complications had decreased from 2.55% in June 2021 to 0.82% in June 2022, with an MPC of -5.58% ( P=0.024), which was better than the changes from January 2019 to May 2021 ( MPC=0.18%, P=0.755). Conclusions:The surgical complication monitoring mode constructed by the hospital can effectively reduce the incidence of surgical complications, providing reference for optimizing hospital′s medical quality management process and decision-making mode.

: Objective: To investigate the effects of ezrin enhancer knockout on ezrin gene expression, cell proliferation and migration of human esophageal carcinoma Eca-109 cells. : Methods: The CRISPR/Cas9 recombinant plasmids targeting upstream/downstream of human ezrin enhancer were co-transfected into human esophageal carcinoma Eca-109 cells, and the cell line Eca-C2 with ezrin enhancer knockout was screened by purinomycin. Then the expression levels of ezrin mRNAand protein in Eca-C2 cells were detected by Real-time quantitative PCR (qPCR) and Western blotting, respectively; The expression levels of MAPK-pathway-related proteins were detected by protein array technology; and the effects of ezrin enhancer knockout on the proliferation and migration of Eca-C2 cells were analyzed by WST-1 method and wound-healing assay, respectively. : Results:The human esophageal carcinoma cell line Eca-C2 with stable ezrin enhancer knockout was established successfully. Compared with control cells, the mRNA and protein expressions of ezrin in Eca-C2 cells were significantly reduced (all P<0.05).Among the 17 detected MAPK pathway related proteins in Eca-C2 cells, 9 proteins (AKT, CREB, GSK3b, MKK6, mTOR, P38, P53, P70S6K and RSK1) were down-regulated, and the cell proliferation and migration were significantly inhibited (all P<0.05). Conclusion: ezrin enhancer knockout can significantly inhibit the cell proliferation and migration of human esophageal carcinoma Eca-109 cells.