Validation of the doubly labeled water method in Japanese Quail Coturnix c. japonica chicks: is there an effect of growth rate?

The Doubly Labeled Water (DLW) method was validated against respiration gas analysis in growing Japanese Quail chicks (between 1 week and 3 weeks of age) as well as in birds after having achieved sexual maturity (7 weeks of age). A comparison was made between a strain selected for high growth rates (P-strain, n=18), and a non-selected strain (C-strain, n=18). Relative growth rates of individual chicks during the measurement ranged from −13.8% day⁻¹ to 23.1% day⁻¹. When employing a single-pool model (eq. 34, Lifson and McClintock 1966), it was found that the relative error of the DLW method was sensitive to assumptions concerning fractional evaporative water loss. The best fit was obtained after taking a fractional evaporative water loss value of 0.33. When applying this value for all chicks, it was found that neither strain, relative growth rate of the chick during measurement, nor age significantly contributed to the explained variance. When employing two-pool models, it was found that the DLW method significantly underestimated the true rates of CO₂ production at all assumed levels of fractional evaporative water loss. Based on an evaluation of DLW validation studies in growing shorebirds, terns, and quail we recommend Speakman's Eq. 7.17 (Speakman 1997) for general use in young birds. Accepted: 14 April 2000     

A Comparison of ECG Signal Pre-processing Using FrFT,FrWT and IPCA for Improved Analysis

ObjectiveElectrocardiogram (ECG) is a diagnostic tool for recording electrical activities of the human heart non-invasively. It is detected by electrodes placed on the surface of the skin in a conductive medium. In medical applications, ECG is used by cardiologists to observe heart anomalies (cardiovascular diseases) such as abnormal heart rhythms, heart attacks, effects of drug dosage on subject's heart and knowledge of previous heart attacks. Recorded ECG signal is generally corrupted by various types of noise/distortion such as cardiac (isoelectric interval, prolonged depolarization and atrial flutter) or extra cardiac (respiration, changes in electrode position, muscle contraction and power line noise). These factors hide the useful information and alter the signal characteristic due to low Signal-to-Noise Ratio (SNR). In such situations, any failure to judge the ECG signal correctly may result in a delay in the treatment and harm a subject (patient) health. Therefore, appropriate pre-processing technique is necessary to improve SNR to facilitate better treatment to the subject. Effects of different pre-processing techniques on ECG signal analysis (based on R-peaks detection) are compared using various Figures of Merit (FoM) such as sensitivity (Se), accuracy (Acc) and detection error rate (DER) along with SNR.MethodsIn this research article, a new fractional wavelet transform (FrWT) has been proposed as a pre-processing technique in order to overcome the disadvantages of other existing commonly used techniques viz. wavelet transform (WT) and the fractional Fourier transform (FrFT). The proposed FrWT technique possesses the properties of multiresolution analysis and represents signal in the fractional domain which consists of representation in terms of rotation of signals in the time–frequency plane. In the literature, ECG signal analysis has been improvised using statistical pre-processing techniques such as principal component analysis (PCA), and independent component analysis (ICA). However, both PCA and ICA are prone to suffer from slight alterations in either signal or noise, unless the basis functions are prepared with a worldwide set of ECG. Independent Principal Component Analysis (IPCA) has been used to overcome this shortcoming of PCA and ICA. Therefore, in this paper three techniques viz. FrFT, FrWT and IPCA are selected for comparison in pre-processing of ECG signals.ResultsThe selected methods have been evaluated on the basis of SNR, Se, Acc and DER of the detected ECG beats. FrWT yields the best results among all the methods considered in this paper; 34.37dB output SNR, 99.98% Se, 99.96% Acc, and 0.036% DER. These results indicate the quality of biology-related information retained from the pre-processed ECG signals for identifying different heart abnormalities.ConclusionCorrect analysis of the acquired ECG signal is the main challenge for cardiologist due to involvement of various types of noises (high and low frequency). Twenty two real time ECG records have been evaluated based on various FoM such as SNR, Se, Acc and DER for the proposed FrWT and existing FrFT and IPCA preprocessing techniques. Acquired real-time ECG database in normal and disease situations is used for the purpose. The values of FoMs indicate high SNR and better detection of R-peaks in a ECG signal which is important for the diagnosis of cardiovascular disease. The proposed FrWT outperforms all other techniques and holds both analytical attributes of the actual ECG signal and alterations in the amplitudes of various ECG waveforms adequately. It also provides signal portrayals in the time-fractional-frequency plane with low computational complexity enabling their use practically for versatile applications.     

Coronary physiology before and after chronic total occlusion treatment: what does it tell us?

Studies performed in the last two decades demonstrate that after successful percutaneous coronary intervention (PCI) of a chronically occluded coronary artery, the physiology of the chronic total occlusion (CTO) vessel and dependent microvasculature does not normalise immediately but improves significantly over time. Generally, there is an increase in fractional flow reserve (FFR) in the CTO artery, a decrease in collateral blood supply and an increase in FFR in the donor artery accompanied by an increase in blood flow and decrease in microvascular resistance in the myocardium supplied by the CTO vessel. Analogous to these physiological changes, positive remodelling of the distal CTO artery also occurs over time, and intravascular imaging can be helpful for analysing distal vessel parameters. Follow-up coronary angiography with physiological measurements after several weeks to months can be helpful and informative in a subset of patients in order to decide upon the necessity for treatment of residual coronary artery stenosis in the vessel distal to the CTO or in the contralateral donor artery, as well as in deciding whether stent optimisation is indicated. We suggest that such physiological guidance of CTO procedures avoids unnecessary overtreatment during the initial procedure, guides interventions at follow-up, and improves our understanding of what PCI in CTO means.

     

The severity of coronary artery disease and reversible ischemia revealed by N-terminal pro-brain natriuretic peptide in patients with unstable angina and preserved left ventricular function

The association between the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and the severity of coronary artery disease (CAD) diagnosed by coronary angiography and other approaches has been investigated. The clinical application of NT-proBNP is restricted by the drawbacks of these techniques now available in screening out patients who need intensive or conservative treatment. Fractional flow reserve (FFR) is superior to coronary angiography and other functional indicators. Accordingly, we designed to investigate the association between NT-proBNP and myocardial ischemia from the perspective of anatomy and physiology in patients with unstable angina and preserved left ventricular function. Plasma samples were collected from 110 patients and NT-proBNP levels were measured by radioimmunoassay. The severity of coronary artery stenosis in patients was measured by coronary angiography and FFR. Stenosis ≥50% in the left main artery or stenosis of 70%, and fractional flow reserve (FFR) ≤0.80 in one or more coronary branches with diameter ≥2 mm were defined as “positive”, which require revascularization. NT-proBNP levels increased progressively between patients with negative and positive angiographic results (p < 0.05), and between FFR-negative and FFR-positive patients (p < 0.05). A significant correlation was observed between log NT-proBNP and log GS (GS = Gensini score, p < 0.001). NT-proBNP level serves as a predictor of positive results of angiographic stenosis and FFR, with the area under the receiver operating characteristic curve being 0.697 and 0.787, respectively. NT-proBNP levels are correlated with the severity of anatomic coronary obstruction and inducible myocardial ischemia, but NT-proBNP per se is insufficient to identify clinically significant angiographic and physiological stenoses.     

彩色多普勒超声引导下经皮肾镜取石术（PCNL）治疗复杂性肾结石的临床分析

目的：总结彩色多普勒超声引导下经皮肾镜取石术（percutaneousnephrolithotomy,PCNL）治疗的复杂性肾结石的经验及其安全性、有效性以及常见并发症。方法：回顾性分析我院2011年7月-2012年8月采用彩色多普勒引导下经皮肾镜治疗复杂性肾结石患者56例的临床资料。结果：所有患者均I期建立经皮肾通道,平均手术时间（107．5±27．5）分钟,24例行EMS气压弹道联合超声碎石（1001．0±27．9）分钟,20例行钬激光联合超声碎石（119．4±23．6）分钟,10例行单纯超声碎石（108．2±30．2）分钟,EMS气压弹道联合超声碎石组的手术时间少于钬激光碎石组,差异有统计学意义（P〈0．05,单纯超声碎石组与另外两组比较无统计学意义P〉0．05）。术前肾功能损伤患者术后随访,肾功能明显改善。结石完全清除率91％,结石部分残留率9％。术中均无严重出血,无周边脏器损伤。术后出现迟发出血5例,反复发热4例,均经对症治疗后缓解。结论：彩色多普勒超声引导除了具有普通超声引导的优势外,还可有效避开肾实质大血管损伤,减少术中及术后出血风险。彩色多普勒超声引导下经皮肾镜碎石取石术是一种治疗复杂性肾结石安全、有效的方法。     

腹腔镜与开放输尿管切开取石术治疗输尿管结石的临床疗效分析

目的:比较腹腔镜与传统开放手术行输尿管切开取石术治疗输尿管结石的临床效果,评价腹腔镜手术的优势。方法:回顾性分析我院2011年9月~2013年2月45例行开放输尿管切开取石术(开放组)与33例行腹腔镜输尿管切开取石术(腹腔镜组)患者的临床资料并进行比较。结果:78例手术均取石成功,腹腔镜组2例分别因结石逃逸入肾盂和输尿管炎症水肿粘连明显改行开放手术。腹腔镜组在术中出血量、术后下床时间、肛门排气时间、术后引流总量、术后引流时间、住院天数方面均显著优于开放组,而手术时间及住院总费用显著高于开放组,差异均有统计学意义(P0.05)。两组患者术后均未出现尿瘘、伤口愈合不良、严重血尿等并发症。结论:两组术式治疗输尿管结石均能有效取石,腹腔镜术式在很多方面拥有一定优势,传统切开取石也有自己的特点。临床上应综合考虑患者意愿、病情特点、术者操作水平、患方经济条件等一系列因素决定最终手术方式。     

三聚氰胺泌尿系统结石大鼠模型的研究

目的观察工业原料三聚氰胺连续给药诱发SD大鼠尿结石的成模情况。方法60日龄SPF级SD大鼠130只,雌雄各半,体质量（200＋24）g,随机分为给药5个组和空白对照组各20只,溶媒对照组10只。给药组分别给予三聚氰胺0．05、0．1、0．2、0．3、0．4g／（kg·d）连续灌胃;溶媒对照组灌胃10g／L甲基纤维素蒸馏水2mL／（只·d）,空白对照组灌胃无菌水2mL/（只·d）。采用体视显微镜观察大鼠肾脏、输尿管和膀胱形态改变,比较各组肾脏、膀胱的质量和脏器指数,观察大鼠CREA、BUN、UA、Ca、P、Mg含量变化。结果0．4g／kg组给药20d,0．2、0．4g／kg组给药30d,肌酐高于空白对照组;0．4g/kg组给药30d,尿素氮、尿酸高于空白对照组。给药20d各组血钙、磷、镁均偏低。给药30d,0．05、0．2、0．3、0．4g／kg组左肾质量比空白对照组增加。各组肾脏大小、颜色均与正常对照组比较接近,未见结石和明显黄色沉淀物,但有部份肾脏在皮、髓质交界处有点状或片状出血灶。输尿管未见结石。部分膀胱粘膜充血,部分雄性大鼠出现膀胱结石,其中给药20d各组雄性大鼠出现率为52％（13／25）,30d各组出现率为56％（14／25）,膀胱结石颜色多为淡黄色混合白色、白色。结论（0．05～0．4）g/kg三聚氰胺连续给药30d,对肾脏损害轻微,可诱发雄性大鼠产生膀胱结石。