Clinical significance and survival analysis of hyperbilirubinemia after heart transplantation / 中华器官移植杂志

Objective:To explore the postoperative hyperbilirubinemia after heart transplantation(HT)and examine its related in-hospital mortality and long-term survival status.And the relationships between preoperative pulmonary hypertension or postoperative right heart dysfunction and hyperbilirubinemia are also elucidated.Methods:From 2014 to 2021, the relevant perioperative data are retrospectively reviewed for 142 HT recipients at Tongji Hospital of Tongji Medical College of Huazhong University of Science & Technology.Based upon the presence or absence of postoperative bilirubin, they were divided into two groups of hyperbilirubinemia(group A, 73 cases) and non-hyperbilirubinemia(group B, 69 cases). And the correlation between preoperative pulmonary hypertension, postoperative right ventricular dysfunction and postoperative hyperbilirubinemia is examined by contingency table; Kaplan-Meier survival curve of postoperative hyperbilirubinemia is plotted.Results:This cohort is composed of 109 males(76.76%)and 33 females(23.24%)with an average age of(47.01±15.31)years.Hyperbilirubinemia occurred in 51.41% of recipients.Logistic analysis revealed in-patient mortality become markedly elevated in hyperbilirubinemia group (OR: 3.855; 95% CI: 1.202~12.367). However, no significant difference existed in 8-year survival curve post-transplant( P=0.09). For group A, 24 cases(32.87%)have pulmonary hypertension pre-operation and duration of CPB was(188.15±63.18)min, 37 and 30 cases(50.68%, 1.67%)have either right or left ventricular dysfunction post-operation.Intra-aortic balloon pump(IABP, 17cases, 23.29%)and extracorporeal membrane oxygenation(ECMO, 11 cases, 15.07%)are employed.The above parameters are all higher in group A than those in group B. Conclusions:The incidence of postoperative hyperbilirubinemia and related in-hospital mortality remains high after HT.However, no significant difference exists in medium/long-term survival rate after adequate treatment.Preoperative pulmonary hypertension and postoperative right heart dysfuncion are associated with hyperbilirubinemia postoperatively.Clinical interventions for risk factors of hyperbilirubinemia are required during perioperative period.

Analysis of risk factors and threshold of hyperbilirubinemia after cardiovascular surgery assisted by cardiopulmonary bypass / 中华胸心血管外科杂志

Objective:To investigate the perioperative risk factors in contribution of hyperbilirubinemia following cardiopulmonary bypass(CPB) assisted cardiovascular surgery, of which cutoff values of key factors are defined.Methods:1 286 patients received cardiac surgery assisted by CPB from January 2017 to March 2019 were included in the study. The perioperative data and the peak serum total bilirubin at selected timepoints were recorded. Logistic regression of multi-factor analysis was used to define risk factors and then broken-line analysis was applied to predict the risky threshold. Results:312(24.26%)patients developed hyperbilirubinemia after surgery, with the in-hospital mortality rate up to 34.62%(108 cases). In those patients, valve surgery(45.51%, 142/312), great vessel open surgery(37.82%, 118/312) and heart transplantation(7.69%, 24/312) were mostly performed. The duration of postoperative ICU stay and the use of ventilation were 6 days and 68 hours, which were significantly higher than those in non-hyperbilirubinemia group( P<0.01). Multivariate logistic regression showed that the postoperative ventilation time>49 h, the cardiopulmonary bypass(CPB) time>181 min and the abnormal preoperative liver function, use of intra-aortic balloon pump and extracorporeal membrane oxygen, unplanned re-exploration for bleeding were the risk factors for postoperative hyperbilirubinemia( P<0.01). The cutoff duration of postoperative mechanical ventilation and CPB affecting the incidence of hyperbilirubinemia, ICU days and in-hospital mortality were 120.21 h and 143.26 min, 248.20 h and 239.51 min, 259.50 h and 190.60 min, respectively. Conclusion:Preoperative abnormal liver function, intraoperative CPB time, postoperative mechanical ventilation time, postoperative use of IABP or ECMO assistance, and unplanned secondary thoracotomy were high-risk factors for hyperbilirubinemia after CPB-assisted cardiovascular surgery.

Association of Lipids, Lipoproteins, and Apolipoproteins with Stroke Subtypes in an International Case Control Study (INTERSTROKE) / 대한뇌졸중학회지

Background@#and Purpose The association of dyslipidemia with stroke has been inconsistent, which may be due to differing associations within etiological stroke subtypes. We sought to determine the association of lipoproteins and apolipoproteins within stroke subtypes. @*Methods@#Standardized incident case-control STROKE study in 32 countries. Cases were patients with acute hospitalized first stroke, and matched by age, sex and site to controls. Concentrations of total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (apoA1), and apoB were measured. Non-HDL-C was calculated. We estimated multivariable odds ratio (OR) and population attributable risk percentage (PAR%). Outcome measures were all stroke, ischemic stroke (and subtypes), and intracerebral hemorrhage (ICH). @*Results@#Our analysis included 11,898 matched case-control pairs; 77.3% with ischemic stroke and 22.7% with ICH. Increasing apoB (OR, 1.10; 95% confidence interval [CI], 1.06 to 1.14 per standard deviation [SD]) and LDL-C (OR, 1.06; 95% CI, 1.02 to 1.10 per SD) were associated with an increase in risk of ischemic stroke, but a reduced risk of ICH. Increased apoB was significantly associated with large vessel stroke (PAR 13.4%; 95% CI, 5.6 to 28.4) and stroke of undetermined cause. Higher HDL-C (OR, 0.75; 95% CI, 0.72 to 0.78 per SD) and apoA1 (OR, 0.63; 95% CI, 0.61 to 0.66 per SD) were associated with ischemic stroke (and subtypes). While increasing HDL-C was associated with an increased risk of ICH (OR, 1.20; 95% CI, 1.14 to 1.27 per SD), apoA1 was associated with a reduced risk (OR, 0.80; 95% CI, 0.75 to 0.85 per SD). ApoB/A1 (OR, 1.38; 95% CI, 1.32 to 1.44 per SD) had a stronger magnitude of association than the ratio of LDL-C/HDL-C (OR, 1.26; 95% CI, 1.21 to 1.31 per SD) with ischemic stroke (P<0.0001). @*Conclusions@#The pattern and magnitude of association of lipoproteins and apolipoproteins with stroke varies by etiological stroke subtype. While the directions of association for LDL, HDL, and apoB were opposing for ischemic stroke and ICH, apoA1 was associated with a reduction in both ischemic stroke and ICH. The ratio of apoB/A1 was the best lipid predictor of ischemic stroke risk.

Research on performance of motor-imagery-based brain-computer interface in different complexity of Chinese character patterns / 生物医学工程学杂志

The traditional paradigm of motor-imagery-based brain-computer interface (BCI) is abstract, which cannot effectively guide users to modulate brain activity, thus limiting the activation degree of the sensorimotor cortex. It was found that the motor imagery task of Chinese characters writing was better accepted by users and helped guide them to modulate their sensorimotor rhythms. However, different Chinese characters have different writing complexity (number of strokes), and the effect of motor imagery tasks of Chinese characters with different writing complexity on the performance of motor-imagery-based BCI is still unclear. In this paper, a total of 12 healthy subjects were recruited for studying the effects of motor imagery tasks of Chinese characters with two different writing complexity (5 and 10 strokes) on the performance of motor-imagery-based BCI. The experimental results showed that, compared with Chinese characters with 5 strokes, motor imagery task of Chinese characters writing with 10 strokes obtained stronger sensorimotor rhythm and better recognition performance (

The comparison of two surgical decompressions for patients with upper urinary tract calculi and sepsis / 中华泌尿外科杂志

Objective:To compare the effectivity and safety of ureteral stenting and percutaneous nephrostomy for patients with upper urinary calculi and sepsis.Methods:From June 2013 to June 2019, 429 patients with upper urinary calculi and urosepsis were accepted in the second hospital of Tianjin Medical University. According to surgical decompression, patients were divided into two groups, ureteral stenting (US, n=304) and percutaneous nephrostomy (PCN, n=125).121 patients were accompanied with septic shock in US group, 56 in PCN group. The effectivity of decompression was analyzed separately in patients with or without shock. For decompression, data included the success rate of decompression, the time of infection related parameters (temperature, blood WBC and CRP) returning to normal and the complications (progress of infection within 30min after decompression, perforation of ureter or pelvis). When urosepsis was cured, ureteroscopic lithotripsy was followed for all patients. The operation time, the stone free rate, the rate of using RIRS and the complications were compared.Results:For patients without septic shock, the success rate of decompression in PCN was higher (68/69)than that of US(165/183)( P =0.025); there was no significant difference in hospital stay for infection control and the time of infection related parameters (temperature, blood WBC and CRP) returning to normal ( P>0.05). The rate of infection progress within 30min in US(25/183) was higher than PCN(3/69)( P=0.036). When ureteroscopic lithotripsy was mentioned, the operation time in US(38.5±6.8 min) was longer than PCN(32.8±4.5 min)( P=0.000), the stone free rate and the rate of using RIRS were lower in PCN( P=0.044, P=0.0002). For patients with septic shock, the success rate of decompression in PCN was higher (55/56)than that of US(106/121)( P=0.022). The rate of infection progress within 30min after decompression was still higher in US ( P=0.048), the time of infection related parameters (temperature, blood WBC and CRP) returning to normal was shorter in PCN ( P=0.000, P=0.003, P=0.000). For lithotripsy, the operation time was longer in US ( P=0.017), the stone free rate and the rate of using RIRS were lower in PCN ( P=0.024, P=0.005). Conclusions:For patients with upper urinary calculi and urosepsis, both ureteral stenting and percutaneous nephrostomy can drainage the pelvis effectively. PCN provides quick recovery, especially when septic shock is involved. For the following ureteroscopic lithotripsy, PCN contributes to less operation time and higher stone free rate, reduces the use of flexible ureteroscope.

Differentiation analysis on the health education needs for clinical medical students and clinicians / 中华健康管理学杂志

Objective To understand the current situation of health education contents as well as the differences in their requirements between clinical medical students and clinicians,and to provide reference for the optimization of health education curricula for medical students.Methods A stratified sampling method was adopted to select 511 medical students (303 females and 208 males) from a medical university,and the survey results of 436 clinicians (144 females and 292 males) were taken as reference.Differences in the degrees of need between clinical medical students and clinicians were compared by chi-square tests.Results There were statistical differences in needs between clinical medical students and clinicians regarding drug compliance,smoking cessation intervention,balanced diet,application of Chinese traditional rehabilitation medicine,mobile health technology education,exercise rehabilitation guidance,and theory of health promotion (P＜0.01).With regard to drug compliance,smoking cessation intervention,and exercise rehabilitation guidance,the proportions of clinical medical students' needs were just 87.1％,82.2％,and 81.2％,respectively,but for clinicians the proportions reached up to 96.3％,93.8％,and 92.8％,respectively.Whereas,there were no statistical differences for mental stress management,chronic infectious disease health education,and acute infectious disease health education (P＞0.05).Conclusion There is still a big gap between medical students and clinical doctors when it comes to the knowledge of chronic disease management and healthy lifestyles;clinical medical students have not yet realized the importance of such knowledge and skills.Therefore,the strengthening of course construction for clinical medical students is suggested.

Non aromatic hydrocarbon receptor dependent regulatory mechanism of cytochrome P4501A1 and its role in infection and inflammation / 中华危重病急救医学

Infectious and inflammatory diseases are important diseases threatening human health. Without timely control, a series of complications will occur in patients, such as sepsis, inflammatory factor storm, and even lead to death. It has been found that cytochrome P4501A1 (CYP1A1) plays a key role in the development of infectious and inflammatory diseases through aromatic hydrocarbon receptor (AhR) dependent and non-dependent pathways in different cells and organs induced by different substances. The non AhR dependent regulatory mechanism of CYP1A1 and the different roles of CYP1A1 in infection and inflammation is reviewed in order to provide reference for further research on the relationship between CYP1A1 and infection and inflammation.

Progress on changes and regulation measures of dendritic cell after severe trauma/burn / 中华危重病急救医学

Severe trauma or massive deep burn can cause significant immunosuppression associated with sepsis and multiple organ failure. Dendritic cell (DC), as the professional antigen presenting cells and activating factor of immune response, plays an extraordinary role in initiating and regulating congenital and adaptive immune response. The quantity, functional changes, relevant molecular mechanisms and reverse measures of DC after trauma/burn were reviewed in order to intensively study the changes of DC after trauma/burn and provide a reference for exploring effective intervention measures for trauma/burn.

Progress on nuclear factor-E2 related factor 2 transcription factors in sepsis / 中华危重病急救医学

Sepsis is a critical complication of severe trauma, large area burns, infection, and major surgery etc., which can induce septic shock and multiple organ dysfunction syndrome (MODS), and its incidence and mortality are always high. Nuclear factor-E2 related factor 2 (Nrf 2) is an important transcription factor of antioxidant stress response. It plays a key role in the treatment of sepsis by regulating the expression of antioxidant enzyme and phase Ⅱ detoxification enzyme mediated by antioxidant response element (ARE). In this article we review the changes, related regulation mechanism and reversing measures of Nrf 2 in sepsis, aiming to provide a reference for the effective intervention measures of sepsis.

Progress of therapeutic strategies for glucose metabolic disorders in sepsis / 中华危重病急救医学

Glucose metabolic disorder is a common issue in sepsis and it leads to an increase in mortality. However, the therapeutic methods of the glucose metabolic disorders in sepsis patients need to be improved. Studying the mechanism of glucose metabolism disorder, and adjusting the existing treatment measures are especially significant in curing the sepsis. This review summarizes recent animal experiments and clinical studies about glucose change after septic complications, focusing on the treatment of three disorders including hyperglycemia, hypoglycemia, and blood glucose variability. They definitely provide new ideas for the control of blood glucose in sepsis patients.

Fufang Lishao Pills Improves Chronic Migraine by Inhibiting Neuroinflammation through the Blockage of JAK2/STAT3 Pathway in Cortex of Rat with Nitroglycerin Induction / 世界科学技术-中医药现代化

Objective: To observe the effects of Fufang Lishao Pills (FFLSP) on the proinflammatory factors, pain-relatedproteins and JAK2/STAT3 signaling pathways in nitroglycerin-induced chronic migraine model, and exploring thepharmacological target and mechanism of FFLSP on chronic migraine rats. Methods: Male Sprague-Dawley rats wererandomly divided into 6 groups: Control, Migraine, FFLSP-L (420 mg·kg-1), FFLSP-M (840 mg·kg-1), FFLSP-H (1680mg·kg-1) and Flunarizine Hydrochloride group (FH, 1 mg·kg-1) . Chronic migraine model was made by subcutaneousinjection of nitroglycerin (10 mg·kg-1) once every 3 days for 5 times. The rats were treated with FFLSP by intragastricadministration once a day for 30 days. Western blot was used to detect the protein expression of iNOS, COX-2, CGRPand c-Fos and the phosphorylation levels of JAK2 and STAT3 in cortex of rats. The production of IL-1β and TNF-αwere detected by enzyme linked immunosorbent assay (ELISA) . Results: Compared with Control rats, and the level ofiNOS, COX-2, CGRP, c-Fos expression (P ＜ 0.01) and IL-1β, TNF-α production remarkably up-regulated (P ＜ 0.05), and the phosphorylation of JAK2 and STAT3 also significantly increased in cotex of Migrainerats (P ＜ 0.01) . However, compared with Migrainerats, the levels of iNOS, COX-2, CGRP, c-Fos expression and IL-1β, TNF-α productionobviously declined (P ＜ 0.05; P ＜ 0.01), and the phosphorylation level of JAK2 and STAT3 showed a significantlydecrease in the cortex of Migraine rats with FFLSP treatment (P ＜ 0.01) . Conclusion: This study demonstrates that thepharmacological mechanism of FFLSP in improving chronic migraine may be achieved by inhibiting neuroinflammationthrough the blockage of JAK2/STAT3 pathwayin the cortex of rat with nitroglycerin induction.

Analyzed the distribution of pathogenic spectra and antibiotic resistance by isolating from 4 238 blood cultures / 国际检验医学杂志

Objective To explore the distribution features of pathogenic spectra and antibiotic resistance of the isolates from blood cultures in hospital from June 2012 to June 2016.Methods A total of 4 238 blood samples from June 2012 to June 2016 were evaluated by BD Bactec FX-200,the identification results were used for retrospective analysis.Results A total of 455 positive pathogens were isolated from 4 238 blood cultures sample,the positive rate was 10.74％,Gram-positive accounts for 38.02％,Gram-negative bacilli accounts for 60.00％,Fungi accounts for 1.98％.Positive pathogens were distributed in newborn baby and middle-older patients,accounting for 6.78％ and 76.17％respectively.Which the Enterobacteriaceae accounting for 54.10％,the major consists were Escherichia coli and Klebsiellapneumoniae;Non-fermentative bacterial which consists of Pseudomonas aeruginosa and Acinetobacterbaumannii accounting for 2.90％.The major pathogens in Gram-positive cocci was Staphylococcus,accounting for 25.87％.Enterobacteriaceae were more sensitive to Meropenem,Imipenem and so all.Non-fermentative bacterial were more sensitive to Piperacillin/Tazobactam.Staphylococcus were more sensitive to Vancomycin and Linezolid.Streptococcus were sensitive to Vancomycin.Conclusion Combined with the distribution features of pathogenic spectra and antibiotic resistance,clinicians should pay attention to use of drugs reasonably to enhance the cure rate of bacteremia and Fungalemia.

Resting-state functional MRI amplitude of low-frequency fluctuation in drug-naive idiopathic epilepsy / 医学研究生学报

Objective The aim of this study was to investi-gate the changes of brain function in patients with drug-naive idiopath-ic epilepsy ( DNIE ) using resting-state functional MRI ( rs-fMRI ) amplitude of low-frequency fluctuation ( ALFF) , analyze the correlation of abnormal brain regions with the clinical variable ( disease course) , and gain a deeper insight into the pathophysiological mechanisms of idiopathic epilepsy. Methods This study included 25 cases of DNIE (15 males and 10 females) and 34 cases of drug idiopathic epilepsy (DIE, 22 males and 12 females).Another 25 healthy volunteers matched with the DNIE patients in sex, age, education and handedness were recruited as normal controls.The rs-fMRI data obtained from all the subjects were processed, subjected to ALFF analysis, and compared among the DNIE, DIE, and nor-mal control groups.The correlation was evaluated between the ALFF statistical brain mapping and the course of disease. Results Obvious differences were found in ALFF among the DNIE, DIE and control subjects.Compared with the normal controls, the DNIE pa-tients showed increased ALFF in the right inferior temporal gyrus, right lingual gyrus and right cuneus, but decreased ALFF in the right insula, left hippocampus, right midbrain, right middle frontal gyrus, left anterior cingulated gyrus, left middle cingulate gyrus and right inferior parietal lobule.In comparison with the DIE patients, those of the DNIE group exhibited increased ALFF in the left inferior occipital gyrus, right middle occipital gyrus and left middle occipital gyrus, but decreased ALFF in the right inferior frontal gyrus, left insula, right superior temporal gyrus and right middle frontal gyrus.In the DNIE patients, the disease course was found to be correlated positively with ALFF in the right cerebellum posterior lobe, left cerebellar tonsil, right lingual gyrus, left orbital gyrus, left middle oc-cipital gyrus, left corpus callosum, left caudate nuclear, left superior frontal gyrus, left medial frontal gyrus, right precuneus and left middle frontal gyrus, but negatively with ALFF in the right parahippocampal, right superior temporal gyrus, left superior temporal gyrus and right post-central gyrus. Conclusion The ALFF of resting-state cerebral function is abnormal in DNIE patients.The correlation between ALFF and the clinical variable ( disease course) provides a new insight into the pathophysiological mechanisms of epilepsy.

Effects of Ginkgo biloba extract 50 preconditioning on contents of inflammation-related cytokines in myocardium of rats with ischemia-reperfusion injury / 中西医结合学报

Objective: To investigate the effects of Ginkgo biloba extract 50 (GBE50) preconditioning on contents of inflammation-related cytokines in rats with myocardial ischemia-reperfusion. Methods: Fifty-eight SD rats were divided into sham-operated group, untreated group, Salviae miltiorrhizae (SM) injection group and low-, medium- and high-dose GBE50 groups. After intragastric administration for 7 d, the left anterior descending (LAD) coronary artery was occluded for 30 min followed by 60-min reperfusion to induce ischemia-reperfuion injury. Myocardium histopathologic change was observed by HE staining under a light microscope; myeloperoxidase (MPO) activity in myocardium was measured by colorimetric detection; tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and IL-8 were detected by radioimmunoassay; IL-4 and IL-10 were tested by enzyme-linked immunosorbent assay (ELISA). Results: Compared with untreated group, rats in medium-dose GBE50 group had lower inflammatory reaction and MPO activity (P<0.01). GBE50 also decreased the content of IL-6 (P<0.05, P<0.01) and increased the content of IL-4 in myocardium (P<0.05, P<0.01) as compared with the untreated group. The content of TNF-alpha in myocardium in the medium-dose GBE50 group was lower and IL-10 was higher than those in the untreated group, but without significant differences. Conclusion: GBE50 can decrease the content of IL-6 and increase the content of IL-4 in myocardium after ischemia-reperfusion injury. It suggests that GBE50 can regulate the inflammatory reaction after ischemia-reperfusion injury via inhibiting inflammatory cytokines and promoting anti-inflammatory cytokines.

Effects of GBE50 on physiological characteristics and intracellular free calcium of myocardium / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate effects of GBE50 on the physiological characteristics and intracellular free calcium of myocardium.</p><p><b>METHOD</b>The preparations of isolated atria of guinea pigs were used for recording the myocardial physiological characteristics and the technique of Fluo-3/AM was used for measuring the concentration of free calcium in myocytes.</p><p><b>RESULT</b>GBE50 (10, 20, 40, 80, 160 mg x L(-1)) prominently inhibited the contractive force and decreased spontaneous beat of right atrium in concentration-dependent manner. GBE50 (10, 20, 40, 80, 160 mg x L(-1)) inhibited the contractive force of left atrium, and markedly decreased the post rest potentiation of myocardial contractility in left atrium in concentration-dependent manner. GBE50 (10, 20, 40, 80, 160 mg x L(-1)) prolonged the function refractory period of isolated guinea pig left atrium. 50 mg x L(-1) GBE50 decreased [Ca2+]i of guinea pig ventricular myocytes in normal Tyrode's solution by (46.53 +/- 8.44)% in 12 minutes.</p><p><b>CONCLUSION</b>GBE50 induces inhibitory effects of the spontaneous beat, contractility, post-rest potentiation and prolonged the function refractory period. GBE50 may decrease [Ca2+]i of guinea pig ventricular myocytes.</p>

Effect of GBE50 on experimental arrhythmias / 中国中药杂志

<p><b>OBJECTIVE</b>The action and mechanism of ginkgo leaf extract (EGB50) in fighting arrhythmia were studies.</p><p><b>METHOD</b>The animal model of arrhythmia was established by intravenous drip of aconitine and ouabain, and the standard microelectrode technique was used.</p><p><b>RESULT</b>In Oua model, threshold doses of ouabain induced VP, VT, VF, CA were observed. GBE50 significantly increased threshold doses of ouabain. In Aco model, threshold doses of Aco induced VP, VT, VF, CA were observed, GBE50 significantly increased threshold doses of Aco. Effects of GBE50 on delayed afterdepolarization and triggered activity induced by ouabain in guinea pig papillary muscles DADs and TA were markedly suppressed by GBE50. The amplitude and duration of DADs were reduced by GBE50 (50 mg x L(-1)) from (13.25 +/- 2.38) mV and (198.38 +/- 53.62) ms to (4.04 +/- 1.44) mV and (57.00 +/- 18.62) ms, respectively, and the induced time of DADs was prolonged from (12.37 +/- 2.26) to (23.00 +/- 4.00) min. TA was reduced from 87.5% to 16.67% (P<0.05, P<0.01). GBE50 (2,10 mmol x L(-1)) had significant therapeutic effects on DADs. The amplitude and duration of DADs were reduced to (10.41 +/- 3.06) mV, (8.92 +/- 2.68) mV and (128.33 +/- 18.91) ms, 103.33 +/- 20.64 ms (P<0.05, P <0. 01 vs control).</p><p><b>CONCLUSION</b>GBE50 can fight arrhythmia following aconitine and ouabain. GBE50 has inhibitory effects on DADs and TA induced by ouabain and high Ca2+ in guinea pig papillary muscles.</p>

Five cases of invasive rhino-orbital-skull base aspergillosis with orbit apex syndrome initial presentation / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Although rare, invasive rhino-orbital-skull base aspergillosis usually is fatal and necessitates prompt diagnosis, surgical intervention and antifungal treatment.@*METHOD@#A case series of 5 patients, with review of treatments and outcomes.@*RESULT@#Five patients initially presented with orbital apex syndrome without apparent rhino-sinus disease. Histologic examination revealed invasive aspergillosis. Four patients underwent transnasal endoscopic surgical exploration of rhino-orbital-skull base, and three of them simultaneously underwent optic nerve decompression. One patient underwent the rhinopharyngeal biopsy. Following surgical debridement and antifungal drug, Two patients achieved various degree of recovery, 1 patient (case 5) showed vision improvement, from counting fingers to 0.1 and symptom-free during 65 months follow-up. One patient (case 1) showed no recovery of vision from no light perception, but symptom-free during 43 months follow-up. Other three patients respectively died of massive intracranial spread (case 3), postoperative brainstem hemorrhage (case 2) and sepsis (case 4).@*CONCLUSION@#Invasive sino-orbital-skull base aspergillosis often may resemble inflammatory conditions. Early diagnosis and surgical intervention are required to improve vision and survival. The endoscopic surgical exploration and biopsy often are necessary to rule out fungal sinus infection before considering steroid use, especially in immunocompromised individuals. The patients with invasive rhino-orbital-skull base aspergillosis usually have a poor prognosis.

An improved weighted median filter and its application in EOG processing / 生物医学工程学杂志

As a classic eye movement method, electrooculogram (EOG) has been extensively used in many applications. There are many different types of eye movements and artifact in the EOG signal. Noise attenuation and signal separation have received special attention in the EOG research. In this paper, we introduce a novel Linear-nonlinear combinational filter based on weighted FIR-median-hybrid (WFMH) with the characteristic of the EOG signal. The result of the simulation shows that this filter has the property of removing random noise more efficiently when preserving sharp edges. Finally, it is shown that the new filter is effective in separating saccadic and eye blink in the EOG signal.