Photoplethysmography (PPG) is a non-invasive technique to measure heart rate at a lower cost, and it has been recently widely used in smart wearable devices. However, as PPG is easily affected by noises under high-intensity movement, the measured heart rate in sports has low precision. To tackle the problem, this paper proposed a heart rate extraction algorithm based on self-adaptive heart rate separation model. The algorithm firstly preprocessed acceleration and PPG signals, from which cadence and heart rate history were extracted respectively. A self-adaptive model was made based on the connection between the extracted information and current heart rate, and to output possible domain of the heart rate accordingly. The algorithm proposed in this article removed the interference from strong noises by narrowing the domain of real heart rate. From experimental results on the PPG dataset used in 2015 IEEE Signal Processing Cup, the average absolute error on 12 training sets was 1.12 beat per minute (bpm) (Pearson correlation coefficient: 0.996; consistency error: -0.184 bpm). The average absolute error on 10 testing sets was 3.19 bpm (Pearson correlation coefficient: 0.990; consistency error: 1.327 bpm). From experimental results, the algorithm proposed in this paper can effectively extract heart rate information under noises and has the potential to be put in usage in smart wearable devices.
Algorithms ; Heart Rate/physiology* ; Photoplethysmography/methods* ; Signal Processing, Computer-Assisted ; Wearable Electronic Devices

Objective To compare the effect of whether rotator cuff pathological tissue cleaning and tendon insertion reconstruction or not under shoulder arthroscopy on the surgical treatment of rotator cuff tendinopathy. Methods From September 2015 to January 2017,the clinical data of forty-one patients with rotator cuff tendinopathy treated by surgical medicine ward in Shengjing Hospital of China Medical University were retrospectively analyzed. According to different surgical methods,41 patients were divided into A group and B group. In group A,21 patients were treated with shoulder arthroscopic bursa debridement combined with selective acromioplasty. In group B,20 patients were treated with cleanup of pathological changes tissue and reconstruction of tendon insertion on the basis of A. All patients were followed up for one year. Constant-Murley shoulder function score,visual analog scale (VAS),University of California Los Angeles (UCLA) and Hawkins sign,arc of pain sign and infraspinatus muscle test were used as the evaluation indexes. The shoulder joint function was evaluated so as to compare the efficacy of two surgical methods for rotator cuff disease. Results Compared with the preoperative,the postoperative VAS score,UCLA score and Constant-Murley score in both groups were significantly improved. In group A,the preoperative in group A (5. 0±1. 3) points,(15.5±1.4) points,(65.1±5.7) points) were increased to (0.7±0.4) points,(33.0±1.7) points,(90. 9±3. 1) points. The preoperative scores of group B were (5. 2±1. 0)points,(15. 6±2. 0) points, (65. 4±5. 9) points, and increased to ( 0. 4 ± 0. 5) points, ( 34. 3 ± 0. 9) points, ( 93. 3 ± 2. 3) points respectively,and the differences were statistically significant (group A: t＝14. 77,P＜0. 001; t＝－ 74. 44,P＜0. 001; t＝－ 29. 19,P＜0. 001; group B: t＝23. 13,P＜0. 001; t＝－ 61. 52,P＜0. 001; t＝－ 26. 38,P＜0. 001). The UCLA score and Constant-Murley score of shoulder joint in group B were higher than those in group A (t＝－3. 27,P＝0. 003; t＝－2. 90,P＝0. 007). Postoperative positive rates of Hawkins sign,pain arc sign and infraspinatus muscle test in group A decreased from 90%(18/20),90%(18/20),95%(19/20) to 15%( 3/20),10%( 2/20) and 15%( 3/20) respectively. There was a significant difference between preoperative and postoperative (χ2＝13. 067,P＜0. 001) . χ2＝14. 063,P＜0. 001; χ2＝14. 063,P＜0. 001), group B decreased from 90. 5%( 19/21), 85. 6%( 18/21), 90. 5%( 19/21) to 9. 5%( 2/21), 4. 8%(1/21),9.5%(2/21).There were significant differences between preoperative and postoperative (χ2＝15. 059,P＜0. 001;χ2＝12. 500,P＜0. 001;χ2＝15. 059,P＜0. 001) . Conclusion Both group A and group B are effective in the treatment of rotator cuff tendon disease,and group B is more effective than group A in the treatment of rotator cuff tendon disease.

Objective To compare the outcomes between conservative treatment and reconstruction with LARS in patients over 50 years old with chronic forward instability of knee joint.Methods Forty patients with chronic forward instability of knee joint from May,2005 to September,2013 in Shengjing Hospital of China Medical University were included in this study and were divided into conservative treatment group(16 cases) and LARS group(19 cases) besides that were ineligible according to different treatment methods.All patients were followed up for two years.The evaluation indicators included Lysholm,IKDC,Tegner,ROM,Kneelax and Kellgren-Lawrence rating.Results At the end of two-year follow-up,the knee joint function score of conservative treatment group was significantly higher than that before treatment (Lysholm score after treatment (83.4± 12.5) points,before treatment (69.6 ± 10.4) points,t =-11.502,P =0.00;IKDC after treatment,abnormal 2 cases,and before treatment,abnormal 10 cases,P =0.00;Tegner after treatment 6 (1,9) points,before treatment 3 (1,5) points,Z =-3.471,P =0.01).The knee joint function score and Kneelax measurement in the LARS ligament reconstruction group were significantly improved after operation(Lysholm score after treatment (80.0±14.2) points,before treatment (68.7±9.6) points,t =-7.875,P =0.00;IKDC score after treatment,abnormal 2 cases,and before treatment,abnormal 13 cases,P =0.00;Tegener score after treatment 8 (1,9) points,before treatment 3 (1,5) points,Z =-3.879,P=0.00;Kneelax score after treatment (1.5 ± 0.8) mm,before treatment (4.2 ± 0.8) mm,t =9.955,P =0.00).At the end of two-year follow-up,kneelax and Tegner scores in LARS ligament reconstruction group were significantly higher than those in conservative treatment group (Z =6.109,P=0.00;Z =2.672,P =0.01).Conclusion Compared with conservative treatment,LARS ligament reconstruction is more conducive to the stability and functional recovery of knee joint in patients over 50 years old with chronic anterior instability of knee joint.

Adult ; Aged ; Coma ; physiopathology ; Consciousness ; physiology ; Consciousness Disorders ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Persistent Vegetative State ; physiopathology ; Photic Stimulation ; methods ; Recovery of Function ; physiology ; Treatment Outcome

Visual fixation is an item in the visual function subscale of the Coma Recovery Scale-Revised (CRS-R). Sometimes clinicians using the behavioral scales find it difficult to detect because of the motor impairment in patients with disorders of consciousness (DOCs). Brain-computer interface (BCI) can be used to improve clinical assessment because it directly detects the brain response to an external stimulus in the absence of behavioral expression. In this study, we designed a BCI system to assist the visual fixation assessment of DOC patients. The results from 15 patients indicated that three showed visual fixation in both CRS-R and BCI assessments and one did not show such behavior in the CRS-R assessment but achieved significant online accuracy in the BCI assessment. The results revealed that electroencephalography-based BCI can detect the brain response for visual fixation. Therefore, the proposed BCI may provide a promising method for assisting behavioral assessment using the CRS-R.
Adolescent ; Adult ; Aged ; Brain ; physiopathology ; Brain-Computer Interfaces ; Consciousness Disorders ; diagnosis ; physiopathology ; Diagnosis, Computer-Assisted ; methods ; Electroencephalography ; methods ; Evoked Potentials ; Female ; Fixation, Ocular ; physiology ; Humans ; Male ; Middle Aged ; Neurologic Examination ; Pilot Projects ; Severity of Illness Index ; User-Computer Interface

A number of studies have indicated that disorders of consciousness result from multifocal injuries as well as from the impaired functional and anatomical connectivity between various anterior forebrain regions. However, the specific causal mechanism linking these regions remains unclear. In this study, we used spectral dynamic causal modeling to assess how the effective connections (ECs) between various regions differ between individuals. Next, we used connectome-based predictive modeling to evaluate the performance of the ECs in predicting the clinical scores of DOC patients. We found increased ECs from the striatum to the globus pallidus as well as from the globus pallidus to the posterior cingulate cortex, and decreased ECs from the globus pallidus to the thalamus and from the medial prefrontal cortex to the striatum in DOC patients as compared to healthy controls. Prediction of the patients' outcome was effective using the negative ECs as features. In summary, the present study highlights a key role of the thalamo-basal ganglia-cortical loop in DOCs and supports the anterior forebrain mesocircuit hypothesis. Furthermore, EC could be potentially used to assess the consciousness level.
Adult ; Bayes Theorem ; Connectome ; Consciousness Disorders ; diagnostic imaging ; physiopathology ; Female ; Humans ; Machine Learning ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neural Pathways ; diagnostic imaging ; physiopathology ; Prognosis ; Prosencephalon ; diagnostic imaging ; physiopathology ; Young Adult

Objective To evaluate the changes of brain metabolism with 18F-fluorodeoxyglucose (FDG) PET/CT in patients with disorders of consciousness (DOC).Methods This retrospective study,from January 2007 to October 2016,included 40 patients (26 males,14 females,age range:17-73 years)in the vegetative state (VS),12 patients (11 males,1 female,age range:25-53 years) in the minimally conscious state (MCS),and 11 patients (10 males,1 female,age range:12-68 years) in the state of recovering from DOC.All patients underwent 18F-FDG PET/CT imaging.The standardized uptake value (SUV) of multiple brain areas among 3 groups of patients was calculated and compared.One-way analysis of variance was used for data analysis.Results The SUV in different encephalic regions among 3 groups were significantly different (F values:6.214-13.642,all P＜0.01) except for mesencephalon.Compared with MCS group,the SUV of cerebral cortex of VS group was lower (t values:2.263-3.548,all P＜0.05).Compared with the recovered group,the SUV of cerebral cortex and cerebellum of VS group was lower (t values:1.299-5.136,all P＜0.05).Compared with the recovered group,the SUV of parietal lobe,temporal lobe,occipital lobe,thalamus and cerebellum of MCS group was lower (t values:1.962-2.841,all P＜0.05).Conclusion 18F-FDG PET/CT may be significant in evaluating brain function of DOC patients.

With the global warming, the incidence of heat stroke was significantly higher than before. Severe heat stroke has a high mortality, high morbidity and consolidated central nervous system injury characteristics. The main features of severe heat stroke cerebral injury include cognitive impairment, delirium, convulsions and coma. Its mechanism is related with heat shock induced cerebral tissue ischemia and hypoxia, vascular dysfunction, secondary cascade inflammation and so on. Currently, the main treatment of heat stroke cerebral injury is the hypothermia therapy, dehydration for the reduction of intracranial pressure, naloxone and other cerebral protection and nutrition treatments. Hyperbaric oxygen therapy (HBOT) is effective in treating brain injury. HBOT can alleviate tissue ischemia and hypoxia, improve circulation, reduce cerebral edema, and anti-inflammatory, anti-oxidative damage, anti-apoptosis and other molecular biological effects. HBOT also play a wake up-promoting effect of nerve repair in the cerebral injury. The treatment of cerebral injury has been the difficulty and weakness of heat stroke research. Therefore, this article reviewed the epidemiology, pathogenesis, the therapeutic effect and mechanism of hyperbaric oxygen on cerebral injury in severe heat stroke to clarify the advantages of HBOT and to provide experimental basis for further research.

OBJECTIVETo conduct a clinical trial of ketogenic diet (KD) in patients with acute spinal cord injury (SCI) and evaluate its safety and feasibility by measuring blood ketone bodies and blood glucose levels.

METHODTen patients with acute SCI were recruited in the trial during the period from May, 2012 to October, 2013. The patients received a standard KD after fasting for 48 h. The levels of blood ketone, blood glucose and uric ketone were tested daily, and routine blood examination, electrolytes, liver and kidney function, body mass index (BMI), sensory and motor function, and adverse reactions were monitored weekly to assess the safety and feasibility of KD.

RESULTSKD treatment lasted for a mean of 12.9 days (4 to 29 days) in these patients. In all the patients, blood ketone level increased during the fasting and maintained a level above 2.0 mmol/L after taking KD, while the uric ketone level ranged from +++ to ++++. The blood glucose level was in the normal range during KD. Except for blood chloride level and BMI, routine blood test results, electrolytes, liver and kidney function showed no significant changes after KD. No significant changes were observed in the sensation of light touch and pinprick. The average motor ASIA score increased from 33.3 to 35.1 after KD. Gastrointestinal dysfunction (diarrhea, nausea, poor appetite, gastric pain, and abdominal distension) was recorded in 5 patients, hypoglycemia occurred in one patient early after KD, and one patient experienced urticaria during KD. All the adverse reactions were relieved after symptomatic treatments.

CONCLUSIONThis preliminary clinical trial demonstrated that KD could increase ketone bodies level and maintain a normal blood glucose level, suggesting its safety and feasibility in patients with acute SCI.

Adolescent ; Adult ; Aged ; Diet, Ketogenic ; adverse effects ; methods ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Spinal Cord Injuries ; diet therapy ; Treatment Outcome ; Young Adult

Objective To conduct a clinical trial of ketogenic diet (KD) in patients with acute spinal cord injury (SCI) and evaluate its safety and feasibility by measuring blood ketone bodies and blood glucose levels. Method Ten patients with acute SCI were recruited in the trial during the period from May, 2012 to October, 2013. The patients received a standard KD after fasting for 48 h. The levels of blood ketone, blood glucose and uric ketone were tested daily, and routine blood examination, electrolytes, liver and kidney function, body mass index (BMI), sensory and motor function, and adverse reactions were monitored weekly to assess the safety and feasibility of KD. Results KD treatment lasted for a mean of 12.9 days (4 to 29 days) in these patients. In all the patients, blood ketone level increased during the fasting and maintained a level above 2.0 mmol/L after taking KD, while the uric ketone level ranged from+++to++++. The blood glucose level was in the normal range during KD. Except for blood chloride level and BMI, routine blood test results, electrolytes, liver and kidney function showed no significant changes after KD. No significant changes were observed in the sensation of light touch and pinprick. The average motor ASIA score increased from 33.3 to 35.1 after KD. Gastrointestinal dysfunction (diarrhea, nausea, poor appetite, gastric pain, and abdominal distension) was recorded in 5 patients, hypoglycemia occurred in one patient early after KD, and one patient experienced urticaria during KD. All the adverse reactions were relieved after symptomatic treatments. Conclusion This preliminary clinical trial demonstrated that KD could increase ketone bodies level and maintain a normal blood glucose level, suggesting its safety and feasibility in patients with acute SCI.