The detection of electrocardiogram (ECG) characteristic wave is the basis of cardiovascular disease analysis and heart rate variability analysis. In order to solve the problems of low detection accuracy and poor real-time performance of ECG signal in the state of motion, this paper proposes a detection algorithm based on segmentation energy and stationary wavelet transform (SWT). Firstly, the energy of ECG signal is calculated by segmenting, and the energy candidate peak is obtained after moving average to detect QRS complex. Secondly, the QRS amplitude is set to zero and the fifth component of SWT is used to locate P wave and T wave. The experimental results show that compared with other algorithms, the algorithm in this paper has high accuracy in detecting QRS complex in different motion states. It only takes 0.22 s to detect QSR complex of a 30-minute ECG record, and the real-time performance is improved obviously. On the basis of QRS complex detection, the accuracy of P wave and T wave detection is higher than 95%. The results show that this method can improve the efficiency of ECG signal detection, and provide a new method for real-time ECG signal classification and cardiovascular disease diagnosis.
Objective To summarize the research progress of the adenocarcinoma of esophago-gastric junction (AEG) in recent years, in order to improve the further understanding of this disease. Method The literatures about application and research progress of AEG were researched and reviewed. Results Siewert classification was a widely recognized classification for AEG, according to this classification, AEG was divided into typeⅠ, Ⅱ, and Ⅲ. Gastroesophageal reflux, Barrett’ sesophagus, and the infection of Helicobacter pylori may be the important pathogenic factors. For SiewertⅠAEG, thoracic approach was preferred commonly, and for SiewertⅡand Ⅲ AEG, total gastrectomy through abdominal approach and distal partial resection of esophagus through diaphragmatic hiatus approach were recommended. Endoscopic submucosal resection, neoadjuvant therapy, targeted therapy, and multidisciplinary team were becoming more and more important in the treatment of AEG. Conclusions The choice of surgical method and resection range should according to the types of AEG. Comprehensive assessment and comprehensive treatment would be performed, so that effect of treatment may be improved.
Objective To systematically review the diseases constitution of children in Chinese medical institutions from 2010 to 2016, and to provide evidence for establishing essential medicine list for children (EMLc) of China. Methods We searched PubMed, EMbase, The Cochrane Library, CBM, CNKI, VIP and WanFang Data from January 2010 to February 2016 to collect studies about diseases constitution of Chinese children. Two reviewers independently screened literature, extracted data, and assessed the risk bias of included studies, then data was descriptively analyzed. Results A total of 33 studies of diseases constitution were included, involving 1 797 696 children among 0 to 18 years from 17 provinces of China. Neonatal hyperbilirubinemia, neonatal pneumonia and premature were the main diseases of inpatient newborns. The main diseases of children hospitalized were pneumonia, upper respiratory tract infection and tumor. Upper respiratory tract infection, bronchopneumonia, bronchitis and diarrhea were the main diseases of outpatients. Hyperspasmia, upper respiratory tract infection and pneumonia were the main diseases of emergency patients. Diseases constitution of different medical institution: the main diseases were pathological jaundice, neonatal asphyxia and neonatal pneumonia in both tertiary and secondary medical institution in the newborn group. In the children group, the main diseases were pneumonia, upper respiratory tract infection and bronchitis in both tertiary and secondary medical institution. Besides these diseases, indigestion and fever of unknown origin were also the main diseases of primary medical institution. Disease constitution of different areas: in the newborn group, pathological jaundice, neonatal pneumonia and neonatal hyperbilirubinemia were the main diseases in coastal areas. Neonatal pneumonia, neonatal hyperbilirubinemia and premature were the main diseases in inland areas. Neonatal hyperbilirubinemia, neonatal pneumonia and neonatal hypoxic-ischemic encephalopathy were the main diseases in remote areas. In children group, pneumonia, bronchitis and premature were the main diseases in coastal areas. Pneumonia, bronchitis and hand-foot-and-mouth disease were the main diseases in inland areas. Upper respiratory tract infection, bronchopneumonia and bronchitis were the main diseases in remote areas. Conclusion Diseases constitutions of children vary in different medical institution, and because of extreme lack of date from primary medical institution, we suggest to carry out investigation in primary medical institution to provide evidence for EMLc. Diseases constitutions of children vary in different area, additions should be made according to local conditions when essential drugs of children selected. Newborn, as a special group of children, should be considered separately when EMLc of China established.
Objective To evaluate the efficacy and safety of pimecrolimus for oral lichen planus (OLP). Methods We searched The Cochrane Library, MEDLINE (1990 to 2007), EMBASE (1990 to 2007), and the Chinese Biomedicine Database (1990 to 2007) to collect parallel group randomized controlled trials (RCTs) and cross-over trials comparing pimecrolimus with triamcinolone acctonide or placebo. The Cochrane Collaboration’s RevMan 4.2 software was used for data analyses. Results Three RCTs were included. Meta-analyses showed that pimecrolimus did not improve oral cavity ache measured by VAS (visual analogue scale) (WMD –0.5, 95%CI –9.77 to 8.77), OHIP (oral health impact profile) (WMD 0.9, 95%CI –0.6 to 2.4) and CSS (clinical status score) (WMD 0.00mm2, 95%CI –0.40 to 0.40); compared with triamcinolone acctonide. In comparison to placebo, pimecrolimus did not improve oral cavity ache measured by VAS (WMD –3.30, 95%CI –20.20 to 13.92) or CSS (WMD –56.57, 95%CI -134.02 to 20.88) and did not reduce burning sensations (OR 4.98, 95%CI 0.49 to 50.22) as well. Conclusion Pimecrolimus should not be regarded as a better choice than triamcinolone acctonide or placebo for improving the VAS, OHIP or CSS of patients with oral lichen planus. Since the RCTs available for this systematic review are too small, further high-quality large-scale RCTs with standard clinical evaluation are required to provide more reliable evidence.
Objective To compare the in-hospital and midterm outcomes after simultaneous hybrid coronary revascularization (HCR) with off-pump coronary artery bypass grafting (OPCAB) in diabetic patients with multivessel coronary artery disease. Methods One hundred thirty-two diabetic patients with multivessel coronary artery disease underwent one-stop HCR at Fuwai Hospital from January 2010 to January 2015. These patients were 1∶2 matched with those who underwent OPCAB using propensity score matching. Results Simultaneous HCR had less chest tube drainage (618 (420, 811) ml vs. 969 (711, 1 213)ml, P<0.001), lower transfusion rate (19.7%vs. 34.1%, P=0.026), shorter mechanical ventilation time (11.6 (8.2, 14.8) h vs. 16.0 (12.1, 18.7) h, P<0.001), and shorter stay in intensive care unit (21.5 (18.8, 42.0) hvs. 44.6 (23.7, 70.1) h, P<0.001) than OPCAB. During over median 40 months follow-up, simultaneous HCR offered similar major adverse cardiac or cerebrovascular events (MACCE) rate (6.8%vs 9.0%, P=0.826), but lower stroke rate (0% vs 3.0%, P=0.029), compared with OPCAB. Conclusion For selected patients with diabetes, simultaneous HCR provides a safe and effective revascularization alternative. It decreases perioperative invasiveness and incurred similar and favorable midterm outcomes with OPCAB.
ObjectiveTo investigate the early clinical results of MitraClip system in domestic patients. Methods We retrospectively analyzed the clinical data of 36 patients who underwent transcatheter edge-to-edge repair procedure using MitraClip system in Beijing Fuwai Hospital, Shenzhen Fuwai Hospital and Fuwai Yunnan Cardiovascular Hospital between January and June 2021. There were 24 males and 12 females, with a median age of 70 (47-86) years. Ten (27.8%) patients had 3+ mitral regurgitation (MR) and 26 (72.2%) patients had 4+ MR preoperatively. ResultsAll procedures were successfully performed. The reduction in MR was 2+ at least immediately after surgery, and 91.7% of patients had MR≤2+ at 3 days postoperatively. There was no statistical difference in left ventricular ejection fraction change postoperatively. Forward velocity and peak gradient of mitral valve were increased after the procedure. Mean gradient of mitral valve were increased at 3 days postoperatively than immediately after surgery (P<0.001). Two patients had acute pericardial effusion intraoperatively, and received pericardial puncture and drainage immediately. ConclusionMitraClip system has been applied well in domestic patients and can significantly improve MR. This sutdy has a good consistency with foreign studies, and the early results are satisfactory.