Objective To explore the clinical value of early enteral nutrition in severe acute pancreatitis （SAP） by percutaneous endoscopic gastrostomy/jejunostomy （PEG/J）.Methods Treatment condition of nighty patients with SAP were retrospectively analysed.The 90 patients were collected peripheral venous blood respectively on 1， 12， and 18 d after admission to hospital.Forty-five of them were in PEG/J group， the others were in control group. Serum IL-6，TNF-α and endotoxin were detected by enzyme-linked immunosorbent assay （ELISA），CD4 /CD8 was determinated by indirect immunofluorescence staining method （FITC-labeled）.Results On 12 d and 18 d，the levels of serum IL-6， TNF-α， and endotoxin in PEG/J group were lower than those in control group （P＜0.01）.The CD4 /CD8 was significantly higher than that in control group （P＜0.01）.In control group， 2 cases complicated upper gastrointestinal haemorrhage，4 cases complicated pancreatic pseudocysts， and 2 cases complicated double infection， the temperature became normal after about 13.5 d.In PEG/J group， there were not upper gastrointestinal haemorrhage and double infection，but 2 cases also complicated pancreatic pseudocysts， the temperature became normal after about 10.5 d.Conclusion The clinical effectiveness of early enteral nutrition in SAP by PEG/J is satisfactory.
Clinical studies had demonstrated that slow breathing could lower blood pressure significantly. Based on this knowledge, a portable blood pressure depressor was designed in this study. The device used a miniature variable distance capacitive sensor to collect respiratory signal, an STM32 as the main control chip, a WT588D voice chip to generate voice and music and guide slow breathing, and a 3.5-inch color screen to display breathing state and provide guidance. For patients with difficulty in adapting themselves to the slow breathing training, an intelligent guiding breathing algorithm based on feedback regulation mechanism was proposed to train patients to breathe slowly. Ten volunteers with hypertension were recruited and then trained to breathe slowly, accumulating up to 100 times using this device. The results showed that breath rate of the volunteers decreased from 15.16±0.92 times per minute to 9.40±0.29 times per minute, and meanwhile, time length of breath rate less than 8 times per minute in the proportion of total treatment time increased from 0.079±0.017 to 0.392±0.019 as the training times increased. In a conclusion, the proposed blood pressure depressor worked effectively in guiding slow breathing training.
In order to overcome the influence of stray light and impurity on the image of video laryngoscope, we designed an optical structure by using TracePro, a simulation software, to imitate optical path status. Images are captured by CMOS sensor which has the size of 4.5 mm×18 mm and the pixel size is 1.75 μm×1.75 μm. The sensor is placed in the elbow of the laryngoscope, and the elbow has the size of 9 mm×10 mm. As a result, the video laryngoscope could meet the requirements, including wide viewing angle (80°), short focal length (2.8 mm), long working distance (10 cm), and least impurity. In the test, the image was clear and there was no facula or impurity in the condition of required illumination, and thus stray light and image impurity were eliminated and the image quality was improved.
Real-time continuous glucose monitoring can help diabetics to control blood sugar levels within the normal range. However, in the process of practical monitoring, the output of real-time continuous glucose monitoring system is susceptible to glucose sensor and environment noise, which will influence the measurement accuracy of the system. Aiming at this problem, a dual-calibration algorithm for the moving-window double-layer filtering algorithm combined with real-time self-compensation calibration algorithm is proposed in this paper, which can realize the signal drift compensation for current data. And a real-time continuous glucose monitoring instrument based on this study was designed. This real-time continuous glucose monitoring instrument consisted of an adjustable excitation voltage module, a current-voltage converter module, a microprocessor and a wireless transceiver module. For portability, the size of the device was only 40 mm × 30 mm × 5 mm and its weight was only 30 g. In addition, a communication command code algorithm was designed to ensure the security and integrity of data transmission in this study. Results of experiments in vitro showed that current detection of the device worked effectively. A 5-hour monitoring of blood glucose level in vivo showed that the device could continuously monitor blood glucose in real time. The relative error of monitoring results of the designed device ranged from 2.22% to 7.17% when comparing to a portable blood meter.
ObjectiveTo summarize the diagnosis and treatment process of a patient who underwent laparoscopic local excision of duodenal papillary tumor, and to explore the safety and feasibility of this surgery. MethodThe clinicopathologic characteristics and surgical procedure of the patient with duodenal papillary neuroendocrine tumor admitted to the West China Hospital of Sichuan University in June 2021 were retrospectively analyzed. ResultsThe patient underwent the laparoscopic local excision of duodenal papillary tumor + in situ cholangiojejunostomy and pancreaticojejunostomy. The operation lasted about 3 hours, the blood loss was about 20 mL, and the patient exhausted on the 3rd day after the operation. On the 7th postoperative day, the gastric tube was pulled out and oral feeding was started. On the 8th day, the plasma drainage tube was pulled out and the patient was discharged smoothly. There was no duodenal fistula, bleeding, wound infection, and other complications. After 6 months of follow-up, the general condition of this patient was good, and no tumor recurrence or metastasis was found. ConclusionLaparoscopic local excision is an appropriate option for benign or low-grade malignancies involving the duodenal papillary tumor.