The time-dependent evolution spectrum of acute care surgery patients: a real world study based on 23 795 electronic admission medical records / 中华急诊医学杂志

Objective One of the major challenges to emergency department is to provide high quality and time sensitive service under limitation of human/material resources,along with patients population with extremely complex conditions.We presented a study that based on a big data got from real world and used wavelet transform technique to analyze time-dependent diseases spectrum patterns and evolution patterns,which will provide solid methodological support for optimizing resources configuration for acute care surgery service.Methods Record data of patients admitted to acute care surgery from 2007-2014 were collected by using data management tool (Avaintec,Helsinki,Finland).The data were cleansed and were transformed to continuing spectrum according to time series of admission time points (per 9 hours).Matlab was used for wavelet transform,and applied five levels of wavelet decomposition and calculated the best decomposition levels by K-mean algorithm for each level.Then we used aprori algorithm for data mining (frequent patterns mining).Results A total of 23 795 cases were enrolled and acute abdomens were made up biggest proportion of admission.Meanwhile,it is found that the spectrum of acute care surgery admission frequency was a complex rising sequence.After wavelet decomposition,signal wave A reflexed trends evolution in a given time scale,and noise wave D reflexed minutia at relevant time scale.In another words,a principal wave A1 represented fluctuation at a cycle of 16 days.Noise wave D1 reflected intensity level in this 16 days' cycle.For example,the 5 · 12 episodes of massive earthquake in 2008 were included in the study,it is found that a significant noise wave at D3 level that indicated a 4 days' cycle.Clinically,it indicated explosive admissions to acute care surgery in 4 days.Conclusions The admission spectrum to acute care surgery is a phenomenon of multi-scale.Based on wavelet decomposing,we can easily analyze the rule of admission spectrum from electronic records of patients and can be used for optimization the emergency medicine resources.

Effects of endogenous histamine on transient forebrain ischemia-induced neuronal damage at late phase of reperfusion in mice / 中国病理生理杂志

AIM: To determine the effect of endogenous histamine on transient forebrain ischemia-induced neuronal injury at the late phase of reperfusion using histidine decarboxylase knockout ( HDC-KO) mice.METHODS:Wild-type (WT) and HDC-KO mice were subjected to bilateral common carotid artery occlusion for 30 min followed by 3 d or 15 d of reperfusion.At different time points after reperfusion, the body weight, mortality rate, learning and memory in fear conditioning test and hippocampal CA 1 neuronal density were evaluated .RESULTS: At 1 d after reperfusion , the body weight loss was observed in both WT and HDC-KO mice.At 4 d, 5 d, 6 d and 7 d after reperfusion, the increment in the body weight of the HDC-KO mice was significantly smaller than that of the WT mice .During the period between 8 d and 14 d after reperfusion, the mortality rate of the HDC-KO mice was higher than that of the WT mice (P<0.05).At 14 d after reperfusion , the HDC-KO mice exhibited more aggravated deficits in contextual and cue memory compared with the WT mice.Correspondingly , a more severe CA1 neuronal injury in the HDC-KO mice than that in the WT mice was ob-served at 15 d but not at 3 d after reperfusion (P<0.05).CONCLUSION:Endogenous histamine may attenuate learn-ing/memory deficits and neuronal injury at the late phase of ischemia /reperfusion.However, the involved mechanisms need to be further investigated .

Expression of the Snail,Slug,and E-cadherin and their clinical significance in nasopharyngeal carcinoma / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the expression of transcription factors Snail,Slug and cell adhesion molecule E-cadherin in nasopharyngeal carcinoma(NPC)and evaluate their relationship with clinical pathological features and metastases.METHODS Immunohistochemistry and quantitative polymerase chain reaction were carried out to detect the expression of Snail,Slug and E-cadherin in 65 NPC samples and normal nasopharyngeal mucosa(18 cases).The expression of Snail and Ecadherin in distinct differentiation nasopharyngeal carcinoma was analyzed and the relationship of them with clinical pathological features was discussed.RESULTS Real-time PCR analysis and immunohistochemistry showed that Slug was elevated with increasing tumor grade.E-cadherin expression was reduced corresponding with prognostic indices and tumor.Snail showed no obvious change.The relative expression levels of E-cadherin mRNA were significantly different between lymph node metastasis group and nometastasis group(P

CT measure of pharynx of OSAHS patients / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the location and degree of pharyngeal narrowing in patients with ob-structive sleep apnea-hypopnea syndrome(OSAHS). METHODS Fifty patients with OSAHS were divided into two groups. The first group was examined with single layer helix CT at an awaken state. The second group was examined with single and 16 layer helix CT at an asleep state. Control group was 225 healthy adults. RESULTS The average minimum diameter of pharynx at soft palate level was 5.85 mm and the aver-age minimum section proportion was 50.3 mm2 in the first group. The average minimum diameter and the av-erage minimum section proportion of pharynx at soft palate level were 2.88 mm and 31.5 mm2, and 1.62 mm and 6.3 mm2 as examined with single layer and 16 lay-ers helix CT scan respectively in the second group. CONCLUSION CT can be used as a method for esti-mating the degree of pharyngeal narrowing in patients with OSAHS. 16 layer helix CT scan can reflect the actual pharyngeal narrowing in OSAHS patients while sleeping more accurately.

Caspase-3 expression in the gentamycin-induced apoptosis of guinea pig hair cells / 中国耳鼻咽喉头颈外科

OBJECTIVE To discuss the gentamycin-induced ototoxity and mechanism on cochlear outer hair cells. METHODS All the guinea pigs were randomly divided into 3 groups. Gentamycin, gentimycin plus furosemide and normal saline were intraperitoneally injected for 6 days respectively. The amplititude of distortion product otoacoustic emissions (DPOAE)urface prepration of cochlear basilar membrane, hair cells’ apoptosis and expression of caspase-3 after injection were analyzed. RESULTS Reduction of the DPOAE amplitude, hair cell damage, apoptosis and Caspase-3 expression were observed in group injected with gentamycin as well as in group injected with gentamycin plus furosemide. CONCLUSION Gentamycin should induce hair cell damage in the cochlea of guinea pigs and Caspase-3 plays an important role in the process of hair cell apoptosis.