Predictors of bleeding risk in patients with high international normalized ratio (INR) values in warfar in therapy / 中华全科医师杂志

Objective:To investigate the risk factors of bleeding events in patients with high international normalized ratio (INR) values (INR>3.5) in warfarin therapy.Methods:Two hundred and one patients with high INR values (INR>3.5) during warfarin therapy admitted in Beijing Tongren Hospital from August 2013 to August 2019 were enrolled. The bleeding occurred in 75 patients (bleeding group) and did not occur in 126 cases (non-bleeding group) during hospitalization. The bleeding group included 12 major bleeding patients and 63 minor bleeding patients. The baseline information, laboratory results and medication of other drugs were recorded.Results:There were no significant differences in age, sex, smoking history, drinking history, previous bleeding history and the proportion of first application of warfarin between the two groups ( P>0.05).The proportion of patients with liver dysfunction [7.14%(9/126)], renal dysfunction [11.90%(15/126)], anemia [4.76%(6/126)], hypoproteinemia [4.76%(6/126)], infectious diseases [20.63%(26/126)] in non-bleeding group were significantly lower than that in bleeding group [16.00% (12/75), 32.00% (24/75), 29.33%(22/75), 16.00%(12/75), 44.00%(33/75); χ 2=3.942, 12.140, 23.675, 7.283, 12.377, respectively; all P<0.05]. A total of 54 kinds of drugs were associated with the INR elevation. The most commonly used drugs were cardiovascular system drugs ( n=162, 80.60%), blood system drugs ( n=155, 77.11%), anti-infective drugs ( n=112, 55.72%), digestive system drugs ( n=82, 40.80%), and endocrine system drugs ( n=56, 27.86%). The INR values [4.58(3.94, 5.90), 4.96(4.03, 8.27)] and the HAS-BLED scores [3.00 (2.00,3.00), 3.00(2.25,3.00)] in minor bleeding group ( n=63) and major bleeding group ( n=12) were higher than those in non-bleeding group [4.00(3.74, 4.35), 2.00 (1.00,3.00), P<0.01), but there was no significant difference in INR values and HAS-BLED scores between minor bleeding group and major bleeding group ( P>0.05). Conclusion:There are many factors leading to the increase of INR in patients taking warfarin, such as abnormal liver and kidney function, anemia, hypoproteinemia, and the use of antibacterial drugs. It is necessary to be cautious about co-administration in these patients.

Research progress of unmanned aerial vehicle in wounded search and rescue / 国际生物医学工程杂志

With the increasing maturity of unmanned aerial vehicle (UAV) technology, UAVs have become an indispensable part of search and rescue activities. In this paper, the background, advantages and classification of UAVs in the field of wounded search and rescue were briefly introduced. The application scenarios and research progress of UAVs were introduced from two aspects, including wounded search and target rescue. In the wounded search process, according to the configuration difference of the UAVs configuration under the active target and the passive target, the difference of the load was analyzed. During the target rescue process, the UAV-based rescue material delivery, telemedicine assistance, and wounded evacuation were analyzed. Through the introduction of the entire search and rescue process, the development direction of UAVs in the application of wounded search and rescue was prospected.

Desmoglein 3 gene mediates epidermal growth factor/epidermal growth factor receptor signaling pathway involved in inflammatory response and immune function of anaphylactic rhinitis.

OBJECTIVE: To investigate the effects of desmoglein 3 (DSG3) gene mediating epidermal growth factor/epidermal growth factor receptor (EGF/EGFR) signaling pathway on inflammatory response and immune function of anaphylactic rhinitis (AR). METHODS: Ten of the seventy male BALB/c mice were randomly selected as the normal control group, and the remaining 60 were used to construct the AR mice model. AR model mice were divided into 6 groups: model group (instilled with 5 µL saline), empty vector group (instilled with 5 µL of liposome and empty vector mixture), siRNA-DSG3 group (instilled with 5 µL of liposome and siRNA-DSG3 carrier mixture), AG1478 group (instilled with 5 µL of EGF/EGFR inhibitor AG1478), siRNA-DSG3+AG1478 group (instilled with 5 µL of liposome and siRNA-DSG3 carrier and EGF/EGFR inhibitor AG1478 mixture) and oe-DSG3 group, 10 in each group. After taking serum, each group of mice was sacrificed to get nasal mucosa tissues. HE staining was used to observe the pathological changes of nasal mucosa tissues in each group. The expression levels of DSG3, EGF and EGFR in nasal mucosa tissues of mice in each group were detected by qRT-PCR and western blot methods respectively. TUNEL staining was used to observe the apoptosis of nasal mucosa cells in mice. The expression of IgE, INF-γ, TNF-α, IL-2, IL-4 and IL-6 in serum of mice was determined by ELISA method. The immune adhesion function of red blood cells was detected by complement sensitization yeast hemagglutination method. RESULTS: All the mice with AR showed different degrees of nasal mucosa injury and inflammatory cell infiltration, and silencing DSG3 or inhibiting the activity of EGF signaling pathway could alleviate the nasal mucosa injury. Compared with control group, the INF-γ and IL-2 levels of serum in AR model mice were significantly decreased; IgE, TNF-α, IL-4 and IL-6 levels were significantly increased (all P < 0.05); the mRNA expression levels and protein levels of DSG3, EGF and EGFR were significantly increased (all P < 0.05); C3b receptor rosette rate and Ic rosette rate were significantly decreased (all P < 0.05). Detected by ELISA method, the expression levels of IgE, TNF-α, IL-4 and IL-6 were increased, while the expression levels of INF-γ and IL-2 were decreased after DSG3 silencing or using AG1478. Detected by qRT-PCR and western blot methods, the expression of DSG3, EGF and EGFR did decrease after DSG3 silencing. There was no significant difference in the EGF and EGFR expression between DSG3 silencing and using AG1478, and the expression decreased even more under the double effect. The mRNA and protein expression levels of DSG3, EGF and EGFR in the nasal mucosa tissues of mice with overexpression of DSG3 plasmid were significantly higher than those of normal mice (all P < 0.05). CONCLUSION: Silencing DSG3 gene can inhibit the activation of EGF signaling pathway, alleviate the inflammation of AR nasal mucosa, and enhance red blood cells immune adherence function.

The efficacy and safety of salvage surgery for local recurrent nasopharyngeal carcinoma: a systematic review and Meta-analysis / 中华耳鼻咽喉头颈外科杂志

Objective@#To assess the current evidence regarding the efficacy, safety, and potential advantages of endoscopic compared with open salvage surgery for patients with local recurrent nasopharyngeal carcinoma.@*Methods@#A systematic search of Pubmed/Medline, Embase, and Cochrane databases ranged between 2000 and 2017 was conducted. Included studies reported specific residual or local recurrent nasopharyngeal cancer survival data. Proportional Meta-analysis was performed on both outcomes with a random-effects model and the 95% confidential intervals were calculated by Stata 12.0 software.@*Results@#A total of 24 case series studies were included in the Meta-analysis.The pooled 2-year overall survival rates of endoscopic and open group were 84% (95%CI:72%-93%), 68%(95%CI:59%-77%),respectively.The pooled 2-year disease-free survival rates of endoscopic and open group were 68%(95%CI:53%-81%), 65%(95%CI:54%-75%),respectively. The pooled 5-year overall survival rates of endoscopic and open group were 72%(95%CI:37%-97%), 48% (95%CI:40%-56%),respectively.The pooled 5-year disease-free survival rates of endoscopic and open group were 65%(95%CI:29%-93%), 50%(95%CI:43%-57%),respectively.The combined outcome of endoscopic was higher than open procedure. In addition, less severe complications, lower local recurrence rates(27%vs32%).The 2-year overall survival rates of endoscopic was higher than open procedure in the staging of rT1, rT2, and rT3 (93%vs87%; 77%vs63%; 67%vs53%) , but was equal to open in the staging for rT4 (35%vs35%) .Meta-regression showed that the heterogeneity was correlated with advanced tumor ratio.@*Conclusions@#The present Meta-analysis reveals that endoscopic approach offers a safe and efficient alternative to open approach with better short-term outcome and fewer postoperative complications in selecting patients strictly.

Rethinking on ethics and principle of surgery / 中华外科杂志

Surgery is an important part of medicine, it has undergone huge changes in recent decades in China.The concepts of damage control surgery, minimally invasive surgery, and enhanced recovery after surgery are all new with the date, laparoscopic surgery, robotic surgery, natural orifice transluminalendoscopic surgery are not new words to all of us. Surgical operations are becoming more and more specialized, surgical technique is becoming more and more mature, and surgeons are becoming more and more specialized. Medical ethical issues, as the common language of surgeons and basic principle of surgery, should be recognized and understood more stronger than ever, which will enable surgeons to retrieve original intention of surgery. This paper takes this as starting point and explore the common principles of surgery, aims to arouse some mutual encouragement to growing youth surgeons.

Academic contribution of Masatoshi Makuuchi: a master of hepatobiliary surgery, an example to learn from / 中华消化外科杂志

The famous professor,Masatoshi Makuuchi was known as "the king of the liver surgery".Authors concluded main contributions of Masatoshi Makuuchi by reviewing literatures.(1) He was the first to use intraoperative ultrasonography during liver operations.Furthermore,he pioneered anatomical hepatectomy and ultrasound guided transhepatic cholangiography and cholangial drainage.(2) He was the first to adopted preoperative selective portal vein embolization (PVE) and hemihepatic blood flow occlusion.(3) He performed the first adult-toadult living donor liver transplantation (A-ALDLT) worldwide and established the well-known formula to predict standard liver volume.(4) The more laudable achievement is promoting these advanced concepts and techniques to the world,training a large group of contemporary hepatobiliary surgeons and benefiting a great number of patients.Masatoshi Makuuchi is a well-deserved master and a good example for contemporary hepatobiliary surgeons to follow.

Research status of contact-free detection technology of human walking gait based on bio-radar / 国际生物医学工程杂志

Human gait involves a complex mechanism of muscular skeletal coordinated operation,which is specific and can be used as the basis of identity recognitions and clinical disease diagnoses.Human gaits have wide application value in the field of disaster rescue,battlefield ambulance,counter-terrorism,security,and medical and healthcare.The traditional contact-free gait detection technology mainly depends on optical images or ultrasound,which is susceptible to light,low visibility,obstacles,etc.In recent years,with the rapidly development of bio-radar technology,the bio-radar based contact-free human gait signal detection technology has shown more advantages.It can not be affected by light,can penetrate clothing,camouflage or even walls,and can operate in all-weathe,including low visibility weather conditions such as smog,smoke and fog.In this paper,the technical principles and methods of bio-radar based contact-free human gait detection technologies were discussed,the research status was summarized,and the development trendency was prospected.

Implementation of undergraduate tutorial system of biomedical engineering specialty in medical college / 医疗卫生装备

Objective To explore the tutorial system of biomedical engineering students in medical colleges and universities,and provide useful references for the implementation of undergraduate tutorial system in medical colleges and universities in China.Methods Based on the compulsory professional knowledge and skills of biomedical engineering students,the undergraduate tutorial system of biomedical engineering specialty was analyzed and summarized with thatof School of Biomedical Engineering of the Fourth Military Medical University taken as an example.Results The necessity,problems and new mode were pointed out for the undergraduate tutorial system of biomedical engineering specialty.Conclusion The implementation of undergraduate tutorial system is a new idea of deepening the reform of undergraduate education in biomedical engineering specialty,and is of important significance to improve the professional skills of students.

Experimental study on shadowing effect of multi static human targets respiration detection with UWB bio-radar / 医疗卫生装备

Objective To study the shadowing effect when using UWB bio-radar to detect multiple static human targets to solve the problem in multi-target detection.Methods With simulated breathing apparatus as detection targets,the UWB bioradar multi static targets respiration detection experiment was designed,and the influences of distance and angle between targets and its respiratory frequency and amplitude on the shadowing effect were studied.Result The shadowing effect was mainly affected by the relative position of the multiple targets,while the respiratory frequency and amplitude of the target had less influence on it.Conclusion When multi static human targets are detected the shadowing effect does exist,and the effect mainly derives from the block of electromagnetic wave by the front target,while the change of respiratory parameters of the front target has little influence on the effect.

Hotspots analysis of splenic surgery based on bibliometrics / 中华消化外科杂志

Objective To explore the hotspots and developing direction of splenic surgery in China.Methods The biliometric analysis was adopted.Database including Chinese Database of Literature on Biomedicine were searched with “脾,外科,移植”.The time for retrieving was from January 1984 to December 2013.Chinese articles on splenic surgery which were published by academic journals were retrieved,and data were analyzed and evaluated by 2 independent researchers,including published year,distribution of journals,key words,authors and publication type.The P-value was calculated according to P =2Ln(eE × Y),and Euler's number =0.577 2 and Y was maximum amount of published articles in each journal.Results (1) Published year:1 977 articles were retrieved.There were 168 articles from 1984 to 1993,and number of articles in every year was less than 30.There were 562 articles from 1994 to 2003 and increasing number of articles in every year,with a maximum number of 88.There were 1 247 articles from 2004 to 2013,and average number of articles in every year was 125,with a maximum number of 165 in 2009.(2) Distribution of journals:all the articles have been published in 489 journals,including 9 surgical journals in the core journal such as Chinese Journal of Hepatobiliary Surgery and 7 journals from Chinese Science Citation Database.The maximum number of published articles of each journal was 54,and literature number in the core journals P≈9.(3) Distribution of key words:occurrence frequencies of “脾破裂”and“脾切除术”were very high in 3 periods (from 1984 to 1993,from 1994 to 2003,from 2004 to 2013) and percentages of occurrence frequencies were respectively 9.524％,24.911％,51.163％ and 12.500％,19.217％,38.813％,showing an increasing trend.Occurrence frequencies of“回顾性研究”“手术后期间”“胰腺切除术”and“脾动脉”reached the top 20 of key words from 1994 to 2003 and then continued to increase from 2004 to 2013,and occurrence frequency of“回顾性研究”was significantly increased witha growth rate of 23.742％.The percentages of occurrence frequencies of“回顾性研究”“手术后期间”“胰腺切除术”and“脾动脉”were respectively 3.203％,8.185％,4.448％,3.559％ from 1994 to 2003 and 26.945％,16.279％,7.939％,6.496％ from 2004 to 2013.“创伤和损伤”and“腹腔镜”first appeared on the top 20 of key words from 2004 to 2013,with percentages of occurrence frequencies of 15.958％ and 11.307％.Occurrence frequencies of“胰腺”and“肝”were gradually increased in 3 periods,with the percentages of 2.976％,3.915％,10.906％ and l.786％,4.804％,6.496％.The percentage of occurrence frequency of“移植,自体”in 3 periods was respectively 15.476％,20.107％,8.821％.Conclusions The Chinese articles of splenic surgery are rising obviously in the past 30 years.The splenic injury and splenectomy have always been research hotspots in splenic surgery.The preservation of spleen function and minimal invasive surgery are the developing direction of splenic surgery.

Th subsets in peripheral blood and IL-1 7 in gingival crevicular fluid of the patients with periodontitis / 实用口腔医学杂志

Objective:To study the correlation of Th subsets in peripheral blood(PB)and IL-1 7 in gingival crevicular fluid(GCF)in the patients with periodontitis.Methods:1 0 healthy controls,1 1 cases with chronic periodontitis(CP)and 8 cases with aggressive pe-riodontitis(AgP)were included.Th1 ,Th2 and Th1 7 in PB were measured by flowcytometry,IL-1 7 in GCF was examined by ELISA. Periodental indexes(PLI,PD,AL and BI)were measured.Results:In the CP group and the AgP group,Th1 and Th1 7 were signifi-cantly higher,Th2 was lower than those in the control group(P 0.05),and IL-1 7 in GCF were significantly higher(P 0.05).In group CP IL-1 7 leve in GCF was positively correla-ted with PD and AL(P =0.000),in group AgP with PD(P =0.007).Conclusion:Deficiency of immunologic function and increase of IL-1 7 in the GCF is related with the onset and development of periodontitis.

Experimental study on effects of different breathing modes on separation of bioradar signals / 医疗卫生装备

To separate the biological radar echo signals in different breathing modes. Echo signals of bioradar-based vital signs monitoring system were acquired in different breathing modes, and an improved signal separa-tion algorithm was used to obtain respiratory and heartbeat signals as well as their parameters. Under two breath-ing modes, the center frequencies of the signals from the self-adaptive filter were kept consistent with those of heartbeat signals, and the signals with other frequencies were suppressed effectively. The algorithm can be used to sep-arate heartbeat signals while suppress other interference signals effectively. ZHANG Jing and LIU Qian are the first au-thors who contributed equally to the article.

Development of Non-Contact Monitoring Device for Breathing and Heartbeat / 中国医疗器械杂志

Physiological monitoring devices in modern clinical area are basically used electrodes or sensors directly touching the surface of human subject body, which will increase physiological and psychological load of the subjects. In order to realize non-contact monitoring of respiration and heartbeat, firstly, the micro bioradar was used to detect human body motion signal. Then, the respiration signal and heartbeat signal was extracted from the body-motion signal by using signal and conditioning circuits, digital filter and signal processing. Finally, the results of heart rate and breathing rate was wirelessly transmitted. The experimental results showed that the device for non-contact monitoring of respiration and heartbeat waveforms has advantages of small volume, low power consumption, which can realize the monitoring of physiological parameters in real time.

Research progress of signal processing method for bioradar / 国际生物医学工程杂志

Bioradar is based on the integration of theory of radar and bio-medical engineering,which can detect the life-parameters in farther distance.It is new concept radar presented by foreign experts.The technology can be widely used in detection of lifeform signal and non-contact clinical monitoring.Biomedical signal processing method is the premise that the technology can be realized.The signals can be interfered by the environmental factors,breath motion and so on,especially the influences of breath motion which can not be solved by average methods.A large number of signal processing methods are used in various aspects of the technology.This review introduces the progress of bioradar technology and the application of the current signal processing methods in the field.

Research progress of the measurement technology for respiration signal / 国际生物医学工程杂志

The measurement methods of respiration can be mainly divided into contact and non-contact.Contact detection methods include volumetric flowmeter,velocity flowmeter,temperature detection,displacement detection,impedance detection,wearable technology and sleep mattress,etc.Although these methods are noninvasive and mature,they all require electrodes or sensors to touch the body of human subjects,which limit the users’ freedom and are not suitable for severely bumed patients and newborns.In non-contact monitoring,the respiration is measured by using the media such as electromagnetic waves,optical media,etc,and without any electrodes or sensors to touch the body whiles the human subject keeping natural status.Non-contact detection method using infrared and biological radar has been a research focus both at home and abroad,which can be used for clinical,community and family care.

The sensitivity of different reagents for laboratory monitoring of low molecular weight heparin: an in vitro study / 中国医师杂志

Objective This study was designed to determine the in vitro sensitivity of LMWH caused by different reagents,and to explore whether the ACT can be used to monitor LMWH.Methods This study was performed in vitro.ACT was measured with different reagents(glass beads,celite,and kaolin)on volunteer(n =30)blood samples spiked with increasing concentrations of LMWH(datleparin,0.2-1.8IU/ml).Linear regression analysis was performed to establish a regression equation from different concentration of datleparin and corresponding ACT values.Results Analysis of dose-response curves obtained in vitro,an excellent linear relationship was observed between the ACT and dalteparin concentrations for all three reagents(p less than 0.01).Differences in slope of the regression curves of ACT were observed with all the reagents tested(glass beads 249.7s/IU,celite 77.7s/IU,and kaolin 59.3s/IU,p less than 0.01).Reagents vary widely in their in-vitro sensitivity related to dalteparin.In the concentration range of 0.2-1.8 IU/ml,the gaolin reagent was insensitive to dalteparin,and glass beads was the most suitable reagent for monitoring the anticoagulant effect of dalteparin.Conclusions Glass beads,celite,and kaolin.Glass beads were the most suitable reagent for monitoring the anticoagulant effect of dalteparin.Vary widely in their in-vitro sensitivity related to datleparin.

Study of the ballistocardiogram signal in life detection system based on radar.

In this article, our study of non-contact method via radar for monitoring the heart and respiratory rates of human subject is reported. The system is constructed which synchronously detects the electrocardiogram signals by the electrocardiograph and the ballistocardiogram signals by the non-contact life parameter detecting technology. Also, the detected signals are analyzed respectively in the time and frequency domain. The results show that the cycle of the ballistocardiogram is obvious in time domain and that the rhythm of the two kinds of signals keeps consistent. And their characteristic points in frequency domain are also the same. The clinical medicine usefulness of ballistocardiogram detected by the non-contact technology is approved and the credible evidence for the succeeding signal analysis and the clinical application is provided. Furthermore, the characters of the heartbeat signal detected by our system and the reasons for that are also discussed in detail in our paper.

Study on second filtering algorithm based on tracing the interfering spectral peaks of radar non-contact life-parameter detection system / 生物医学工程学杂志

To develop a filtering algorithm which could trace the spectral peaks of the interference and which was used to extract the breath signal with the same band interference in radar non-contact life-detecting system, second filtering algorithm was studied. Through first filtering,the probable interfering spectral peaks (ISP) could be detected by Yule-Walker spectrum estimating and could be located by calculating the coefficients of normalized cross-correlation function according to standard breath signal. Thus the breath signal could be extracted through a second filtering. By using the second filtering algorithm (SFA), the same band interfering spectral peaks with breath signal could be recognized and inhibited. So we conclude that the same band mono-ISP could be inhibited by using SFA and breath signals could be effectively extracted.

A study on technology to identify human beings or animals in life-detector based on radar / 生物医学工程学杂志

To determine whether a living object is human being or animal by detecting the respiration signal using the life-detector based on radar to penetrate the building or debris. To fully utilize the nonstationary character of the respiration signal, short time Fourier transform (STFT) is employed to get the signal's time-frequency representation. Singular value decomposition (SVD) is then used in the spectrogram to extract feature vector for pattern identification. Human beings and animals can be identified from the respiration sensed by the life-detector based on radar. Experimental results show that the method based on STFT and SVD is stable and efficient to differ from the human being and animal.

Measurement and amendment of complex-permittivities of distilled water and NaCl solution / 生物医学工程学杂志

In this experiment, the complex-permittivities at 2 450 MHz of distilled water and various NaCl solutions were measured separately, and acquired data were analyzed and amended. The system develooped on the basis of this experiment is of great significance to studying the measurement of complex-permittivities of high-loss biologic tissues by perturbational method.