In order to improve the accuracy of blood pressure measurement in wearable devices, this paper presents a method for detecting blood pressure based on multiple parameters of pulse wave. Based on regression analysis between blood pressure and the characteristic parameters of pulse wave, such as the pulse wave transit time (PWTT), cardiac output, coefficient of pulse wave, the average slope of the ascending branch, heart rate, etc. we established a model to calculate blood pressure. For overcoming the application deficiencies caused by measuring ECG in wearable device, such as replacing electrodes and ECG lead sets which are not convenient, we calculated the PWTT with heart sound as reference (PWTTPCG). We experimentally verified the detection of blood pressure based on PWTTPCG and based on multiple parameters of pulse wave. The experiment results showed that it was feasible to calculate the PWTT from PWTTPCG. The mean measurement error of the systolic and diastolic blood pressure calculated by the model based on multiple parameters of pulse wave is 1.62 mm Hg and 1.12 mm Hg, increased by 57% and 53% compared to those of the model based on simple parameter. This method has more measurement accuracy.
ObjectiveTo study the effect of bacillus calmette-guerin(BCG) polysaccharides nucleic acid on humoral immunity, interleukin(IL)-8 and tumor necrosis factor(TNF)-αin patients with chronic obstructive pulmonary disease (COPD), and to provide theoretical basis for evaluation of its clinical effectiveness. MethodsThirty hospitalized elderly patients with AECOPD treated from March 2012 to February 2013 and 60 patients with stable COPD treated at the same time were randomly selected as the study subjects. At the same time, 60 healthy people from our physical examination center were also enrolled and divided into two groups:the elderly healthy group (n=30) and nonelderly healthy group (n=30). IL-8, TNF-α, IgA, IgG and IgM levels were determined. The stable COPD group was randomly divided into two groups:group A (n=30) and group B (n=30). Group A received only routine therapy; group B received both routine therapy and intramuscular injection of BCG polysaccharide nucleic acid (0.35 mg/day, three times a week). IL-8, TNF-α, IgA, IgG and IgM levels in peripheral blood were investigated before treatment and one month later. ResultsThere were no statistically significant differences in IL-8 and TNF-αlevels in peripheral blood between elderly healthy group and nonelderly healthy group (P > 0.05), but the IgA, IgG and IgM levels were lower in the nonelderly healthy group than in the elderly healthy group (P < 0.05). Compared with the elderly healthy grouping, IgG and IgM levels were significantly lower in AECOPD group and stable COPD group (P < 0.05), but IL-8 and TNF-αlevels were significantly higher (P > 0.05). There were statistically significant differences in TNF-α, IgA, IgG and IgM levels between group B before and after treatment (P > 0.05). ConclusionsHuman's humoral immunity decreases with age. Elderly COPD patients are at high risks of abnormal immunologic function, particularly in the acute exacerbation period. The BCG polysaccharides nucleic acid can strength patients' humoral immunity. The levels of inflammatory cytokines can be reduced using BCG polysaccharides nucleic acid.
ObjectiveTo investigate the role of protease-activated receptor-2 (PAR-2) activation on the expression of vascular endothelial growth factor (VEGF) in MKN28 gastric cancer cells. Methods①MKN28 cells were treated with increased concentrations of trypsin (0, 0.1, 1.0, 10.0, and 100.0 nmol/L respectively) for 6 hours, or treated with 10.0 nmol/L trypsin for 3, 6, 12, and 24 hours (blank control group was treated with PBS) respectively, then the expression levels of VEGF mRNA and its protein in MKN28 cells were detected by real-time reverse transcription polymerase chain reaction (qRT-PCR) and Western bolt method, with the concentration of VEGF protein in broth was detected by enzyme linked immunosorbent assay (ELISA) method.②MKN28 cells were divided into blank control group (treated with PBS), trypsin group, trypsin+PD98059 group, trypsin+SB203580 group, PD98059 group, and SB203580 group, then the expression levels of VEGF mRNA and its protein in MKN28 cells were detected by qRT-PCR method and Western bolt method respectively. Results①The effect of different concentration of trypsin. Compared with blank control group, the expression levels of VEGF mRNA and its protein in 0.1, 1.0, 10.0, and 100.0 nmol/L group were higher (P < 0.05); compared with 0.1 nmol/L group, the expression levels of VEGF mRNA and its protein in 1.0, 10.0, and 100.0 nmol/L group were higher (P < 0.05); compared with 1.0 nmol/L group, the expression levels of VEGF mRNA and its protein in 10.0 and 100.0 nmol/L group were higher (P < 0.05); but there was no significant difference between 10.0 nmol/L and 100.0 nmol/L group (P > 0.05). The broth concentration of VEGF protein in blank control group, 0.1, 1.0, 10.0, and 100.0 nmol/L group crept upward (P < 0.05).②The effect of different treated time of 10.0 nmol/L trypsin. The expression levels of VEGF mRNA in blank control group, 3, 6, 12, and 24 hours group crept upward, and there was significant difference between any 2 groups (P < 0.05). But the expression of VEGF protein was not similar with VEGF mRNA. Compared with blank control group, the expression levels of VEGF protein in 3, 6, 12, and 24 hours group were higher (P < 0.05); compared with 3 hours group, the expression levels of VEGF protein in 6, 12, and 24 hours group were higher (P < 0.05); but there was no significant difference among 6, 12, and 24 hours group (P > 0.05). The broth concentration of VEGF protein in blank control group, 3, 6, 12, and 24 hours group crept upward, and there was significant difference between any 2 groups (P < 0.05).③The effect of extracellular regulated protein kinase (ERK) inhibitor (PD98059) and p38 inhibitor (SB203580). The expression levels of VEGF mRNA and its protein in trypsin group were all higher than corresponding indexes of blank control group, trypsin+PD98059 group, trypsin+SB203580 group, PD98059 group, and SB203580 group (P < 0.01), but there was no significant difference among blank control group, trypsin+PD98059 group, trypsin+SB203580 group, PD98059 group, and SB203580 group (P > 0.05). ConclusionActivation of PAR-2 can induce the expressions of VEGF mRNA and its protein in MKN28 gastric cancer cells, that is mediated by ERK1/2-and p38-dependent pathway.
ObjectiveTo discuss the reason and treatment strategy of gallbladder muddy stones after cholecysto-lithotomy. MethodsThe clinical data of 62 patients with gallbladder muddy stones after cholecystolithotomy who were treated in our hospital from December 2008 to December 2014 was analyzed retrospectively. ResultsThere were 43 patients without any symptom and 19 patients with acute cholecystitis in 62 patients. Four patients were diagnosed with septation gallbladder, 6 patients with long and tortuous cystic duct, 3 patients with calculus of cystic duct, 4 patients with common bile duct stones, 39 patients with periampullary diverticula, 18 patients with pancreaticobiliary maljunction, 6 patients with duodenal papilla stenosis, 29 patients with duodenal papillitis, and 3 patients with duodenal papilla adenocarcinoma. Two patients were treated with laparoscopic cholecystectomy (LC), 1 patient with endoscopic sphincterotomy (EST) /endoscopic balloon dilation (EPBD) and LC, 1 patient with percutaneous transhepafic gallbladder drainage (PTGD) and open cholec-ystectomy, 14 patients with PTGD and EST/EPBD, 1 patient with PTGD and hepatocholangioplasty with the use of gallbladder (HG), 34 patients with EST/EPBD, 3 patients with EST/EPBD and endoscopic biliay metal stent drainage (EBMSD), 5 patients with HG, and 1 patient with EST/EPBD and HG. The gallbladder muddy stones disappeared after operations in 55 patients with gallbladder reserved, and gallbladder ejection fraction increased from (42±12) % to (59±16) %. Of the 62 patients, 53 patients were followed up for 6 months to 6 years (the median time was 3.6-year). During the follow-up period, 3 patients were diagnosed with gallbladder stones, 2 patients with common bile duct stones, and 2 patients with intrahepatic and extrahepatic bile duct stones. ConclusionBile efferent tract obstruction is the important reason for the formation of gallbladder stones. HG, EST, and balloon expansion are the efficient methods to resolve the bile efferent tract obstruction.
ObjectiveTo optimize HSP65-MUC1 fusion protein purification in pilot scale through protein purification techniques and identify the methods for biological activity detection. MethodsE. coli expressing HSP65-MUC1 was obtained by fermentation, then homogenized to obtain the supernatant. To acquire high-purity, high-quality HSP65-MUC1, the supernatant was treated with saturated ammonium sulfate, phenyl sepharose FF column and Q FF ion-exchange chromatography column purification. The expression of CD86 on the surface of DC cells treated with HSP65-MUC1 was determined with flow cytometry. ResultsE. coli containing pET28a-HSP65-MUC1 recombinant plasmid can effectively express target protein. A total of 413.7 mg of HSP65-MUC1 was obtained after 10 g of fermented cells was treated with saturated ammonium sulfate, phenyl sepharose FF column and Q FF ion-exchange chromatography column, and the purity was nearly 96%. Compared with negative control (10.13%±0.89%), purified HSP65-MUC1 could significantly improve the expression of CD86 on the surface of DC cells (29.98%±1.02%). ConclusionThe pilot scale production of purified HSP65-MUC1 has been effectively optimized, and the methods of its biological activity detection have been identified, which simultaneously provides the basis for clinical studies.
ObjectiveTo discuss the clinical effects of T-tube with side holes in the gallbladder-common hepatic duct anastomosis. MethodsThe clinical data of 60 cases that performed gallbladder-common hepatic duct anastomosis from Jul. 2009 to Jul. 2012 were retrospectively analyzed. The contractile functions and mucosal recovery of gallbladder were compared between the conventional T-tube and T-tube with side holes. ResultsTwenty-four cases of gallbladder-common hepatic duct anastomosis used conventional T-tube, the gallbladder were not developing in 6-8 weeks after operation by T-tube cholangiography, the gallbladder mucosa of 17 cases were normal without edema, congestion and edema were observed in 6 cases, and the normal gallbladder mucosa structure disappeared in 1 case. The gallbladder were developing in 6-8 weeks after operation by T-tube cholangiography in 36 cases that used T-tube with side holes, the gallbladder mucosa structure had not congestion, edema, and erosion. The gallbladder contractile function were normal. ConclusionsThe floc, blood clots, and inflammatory substances in gallbladder can be discharged into the intestine or drainage in vitro, and the bile can go into gallbladder and can be concentrated through the T-tube with side holes. Physiological flow of bile can return to normal and the function of gallbladder can recover early.
ObjectiveTo discuss the relation between bile duct anastomotic stricture and bile duct injury by endo-scopic observation following liver transplantation and it, s efficacy of endoscopic treatment. Method The clinical data of 24 cases of bile duct anastomotic stricture following liver transplantation diagnosed by cholangiography were analyzed retro-spectively. Results①Twenty-four cases of bile duct anastomotic strictures were included in 3 cases of typeⅠa, 2 cases of typeⅠb, 4 cases of typeⅡ, 1 case of typeⅢa, 5 cases of typeⅢb, and 9 cases of typeⅢc.②The redness of intrahepatic bile duct mucosa, banding erosion, ulcer and fusion of anastomotic stricture mucosa could be seen in typeⅠa andⅢa. The redness of intrahepatic bile duct and anastomotic stricture mucosa could be seen in typeⅡwithout ulcer and fusion. The extensive erosion and ulcer of intrahepatic bile duct and redness of anastomotic stricture mucosa could be seen in typeⅢb. The extensive erosion, ulcer and partial necrosis of intrahepatic bile duct and anastomotic stricture mucosa could be seen in typeⅠb andⅢc.③Seventeen cases were cured by choledochoscopy through T tube, the biliary casts were moved out and the anastomotic strictures were relieved by balloon dilatation and placement of plastic stenting for 2 to 6 months, no recurrence happened. One case of typeⅠb treated by percutaneous transhepatic cholangial drainage(PTCD) and percuta-neous transhepatic cholangioscopy(PTCS) was developed into the stricture of typeⅡduring following-up for 19 months. Two cases of typeⅠa were treated by ERCP, the biliary casts were moved, one of which was cured, another 1 case was developed into the stricture of typeⅡduring following-up for 5 months. Two cases of typeⅡwere treated by ERCP, the biliary casts were moved, balloon dilatation and placement of plastic stent were performed, one of which was cured, another 1 case was recurrent during following-up for 1 months. The strictures were not relieved by multiple plastic stents for 4 to 6 months in 3 patients with recurrence and progress, but which was relieved by full-covered self-expanding removable metal stents for 4 to 7 months, there was no recurrence during following-up. One case of typeⅢb and one case of typeⅢc received the secondary open operation or choledochoscopy and placement of plastic stent for biliary infection and jaundice after the treatment of ERCP were cured. ConclusionsBiliary stricture following liver transplantation accompanies different degree biliary injury. The slightest is typeⅡand typeⅠa, typeⅢa is the second, typeⅢb is more serious, and typeⅠb and typeⅢc are the worst. Choledochoscopy is a better choose for anastomotic strictures. ERCP is not a better choose for anastomotic strictures of typeⅠb, Ⅲb, andⅢc.
ObjectiveTo sum up the clinical characteristics,surgical management,and effectiveness of pressure sore of sinus type. MethodsBetween January 2009 and April 2013,17 patients with 19 pressure sores of sinus type after traumatic paraplegia were treated,and the clinical data were analyzed retrospectively.There were 11 males and 6 females with an average age of 27.4 years (range,17-49 years).The median disease duration was 1.5 years (range,6 months to 7 years).Of 17 cases,there were 14 primary cases and 3 recurrent cases; 10 focuses of 8 cases were classified as simple sinus type,and 9 focuses of 9 cases as complex sinus type,which had a false synovial sheath complicated with one to four "second sinus".The pressure sore of sinus type majorly located at the ischial tuberosity.The size of pressure sore ranged from 1.5 cm×1.0 cm to 3.0 cm×2.0 cm,and the length of "second sinus" ranged from 8 to 32 cm with an average of 17 cm.After the false synovial sheath was totally excised,the wound was repaired by local sliding or rhombus flaps at the first or second stage in patients with simple sinus type pressure sore.On the basis of excising the false synovial sheath,the "second sinus" was totally removed in the patients with complex sinus type pressure sore. ResultsWound dehiscence occurred in 1 case of simple sinus type pressure sore at 4 days,which was cured after it was sutured again.Wound infection occurred at 9,17,and 23 days respectively in 3 cases of complex sinus type pressure sore,which was cured after second debridement and necrosis tissues removal.The other wounds healed by first intention,and the flaps totally survived.All patients were followed up 6-12 months (mean,9.3 months).No recurrence was observed. ConclusionAccording to the clinical characteristics,pressure sore of sinus type could be divided into simple sinus type and complex sinus type.The key of successful treatment is to thoroughly excise false synovial sheath and "second sinus".