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Yunan Lin, Qiang Li, Jinlu Liu, Ruimin Yang, Jingchen Liu Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China Background: This study aims to investigate differences between continuous epidural infusion (CEI) and programmed intermittent epidural bolus (IEB) analgesia for the Chinese parturients undergoing spontaneous delivery and to approach their safety to parturients and neonates.Methods: Two hundred healthy American Society of Anesthesiologists class I or II, term (≥37 weeks’ gestation), nulliparous women who requested analgesia for labor were recruited. Epidural analgesia was initiated with a solution of 0.15% ropivacaine 10 mL and maintained with 0.1% ropivacaine mixed with sufentanil 0.3 µg/mL by CEI at a rate of 5 mL/h combined with a patient-controlled epidural analgesia (PCEA) bolus of 5 mL of ropivacaine sufentanil mixture or IEB of 5 mL of ropivacaine sufentanil mixture combined with a PCEA bolus of 5 mL of ropivacaine sufentanil mixture. The lockout interval was 20 minutes in each arm between the CEI and the IEB group. After 20 minutes of first dosage, visual analog scale (VAS) score was obtained every 60 minutes. The maternal and fetal outcome and total consumption of analgesic solution were compared.Results: There was no difference in demographic characteristics, duration of first and second stages, delivery methods, sensory block, fetal Apgar scores, and the maternal outcomes between the CEI and IEB groups. There was a significant difference in VAS scores and epidural ropivacaine total consumption between the two groups (IEB vs CEI: 51.27±9.61 vs 70.44±12.78mg, P

In this paper, we propose a microfluidic device capable of generating a retarding flow field for the sorting and separation of human motile sperm in a high-throughput manner. The proposed sorting/separation process begins with a rapid flow field in a straight-flow zone to carry sperm into a sorting zone to maintain the sperm’s mobility. The sorting zone consists of a diffuser-type sperm sorter to differentiate sperm with different motilities based on the flowing upstream nature of human sperm in a retarding flow field. The dead sperm will then be separated from the live ones by passing through a dumbbell flow field to the outlet for disposal. The proposed flowing upstream sperm sorter (FUSS) is designed to imitate the selection mechanism found in the female body when sperm swim into the uterus. The experimental results demonstrate the utility of this device with regard to throughput (approximately 200 000 sperm per minute and a maximum of 200 million cells per mL), efficiency (90% of selected sperm are mobile), and the ability to select sperm with high motility (∼20% of sperm with a velocity exceeding 120 μm s−1). The proposed device is suitable for intrauterine insemination as well as in vitro fertilization thanks to the highly efficient sorting process not interfering with the natural function and energy resource of human sperm.

This paper proposes a selection and extraction strategy to acquire high quality sperms from a biomimetic microfluidic device capable of generating a dual gradient flow field for motile sperm sorting. The sorter consists of a straight flow zone, a rapidly expansion sector for sperm sorting by gradient up-stream flow, and a dumbbell channel for dead sperms separation at the outlet. A collateral runner is set at the front area of the expansion sector, but mostly kept in dry state without affecting the sorting process. At the end of sorting, a pressure was applied from both the inlet and outlet to flush the high quality sperms into the collateral runner for collection. Controllable numbers, ranging from 1 to 15000, of sperms can be collected with a motility (>60µm) ratio higher than 60%, suitable for in-vitro fertilization (IVF).

We evaluated the long-term efficacy and safety of low dose oral desmopressin in elderly patients with benign prostatic hyperplasia with more than nocturnal voids and nocturnal polyuria more than 30% of total daily urine volume.Eligible patients with benign prostatic hyperplasia older than 65 years with nocturia, nocturnal polyuria and International Prostate Symptom Score 14 or greater were included in the study. All patients received placebo or 0.1 mg desmopressin orally at bedtime. Patients were required to visit the outpatient clinic from the first visit, and after 1, 3, 6 and 12 months of treatment. Patients maintained flow volume charts and used diaries to record voiding data throughout the study. During followup urinalysis, urine sodium, urine osmolality, serum electrolytes, prostate specific antigen, International Prostate Symptom Score, quality of life, transrectal ultrasonography of prostate, uroflowmetry and post-void residual urine volume were performed at each visit.A total of 115 patients were enrolled in the study and randomized as 58 in the placebo group and 57 in the desmopressin group. Desmopressin significantly decreased nocturnal urine output and the number of nocturia episodes, and prolonged the first sleep period (p0.01). Compared to before treatment desmopressin gradually decreased serum sodium and induced statistically but not clinically significant hyponatremia after 12 months of treatment. No serious systemic complications were found during medication.Low dose oral desmopressin is an effective and well tolerated treatment for nocturnal polyuria in the lower urinary tract symptoms of patients with benign prostatic hyperplasia. Long-term desmopressin therapy gradually decreases serum sodium and it might induce hyponatremia even in patients without initial hyponatremia. For long-term desmopressin administration serum sodium should be assessed carefully, at least at 1 week after treatment.

Objective: To identify whether programmed intermittent epidural bolus analgesia is effective and safe to the parturients and neonates. Methods: Sixty healthy ASA class I or II, term (?37weeks’ gestation), nulliparous women were recruited in our study. Epidural analgesia was initiated with a solution of 0.15% ropivacaine 10 mL and maintained with 0.12% ropivacaine combined with fentanyl 2ug/mL by continuous epidural infusion at a rate of 5mL/h and combined with a patient-controlled epidural analgesia bolus of 5 mL and intermittent bolus of 5mL and combined with a patient-controlled epidural analgesia bolus of 5 mL, lockout interval was 20 minutes. After 20 minutes of the first dosage the VAS score was obtained in every 60 minutes. The maternal and fetal outcome, total consumption of analgesic solution and were oxytocin compared among the groups. Result: There was no difference of the maternal and fetal outcomes among the groups. The dosage consumption of oxytocin in non-labor analgesia group was significant lower than analgesia groups, the first and second stage of labor in non-labor analgesia group was significant longer than two analgesia groups. There was a significant difference in the epidural ropivacaine total consumption between the two analgesia groups. (51.27±9.61mg vs 70.44±12.78 mg, P=0.00 ) Conclusion: The use of programmed intermittent bolus combined with PECA was more effective than continuous infusion combined with PECA, it could be useful as the mode of maintenance for epidural labor analgesia.

Background Muscle infarction is a rare complication of spontaneous ischemic necrosis occurring in skeletal muscle. It is particularly common in patients with diabetes who have impaired sugar regulation. However, muscle infarction is frequently misdiagnosed due to varied clinical manifestations. Methods We presented 3 cases of muscle infarction reported during April 2009 to April 2014. After a comprehensive literature review, we selected 147 muscle infarction cases from the literature, first investigating the relationships between type of muscle blood supply and infarcted muscle. Results The result indicated that muscle infarction 25.85% belonged to type I vascular supply and 61.21% belonged to type II vascular supply, according to the definition by Mathes and Nahai. Conclusions Poor glucose regulation, intense exercise without adequate hydration, vascular disease, and type I and II muscular blood supply were critical predisposing factors. For preventing muscle infarction, we recommend strict glucose regulation and a gradual increase in exercise with adequate hydration.

The purpose of the study was to determine the effect of ginseng-based steroid Rg1 on TNF-alpha and IL-10 gene expression in human skeletal muscle against exercise challenge, as well as on its ergogenic outcomes. Randomized double-blind placebo-controlled crossover trials were performed, separated by a 4-week washout. Healthy young men were randomized into two groups and received capsule containing either 5 mg of Rg1 or Placebo one night and one hour before exercise. Muscle biopsies were conducted at baseline, immediately and 3 h after a standardized 60-min cycle ergometer exercise. While treatment differences in glycogen depletion rate of biopsied quadriceps muscle during exercise did not reach statistical significance, Rg1 supplementations enhanced post-exercise glycogen replenishment and increased citrate synthase activity in the skeletal muscle 3 h after exercise, concurrent with improved meal tolerance during recovery (P

In the next generation mobile telecommunications, any third party that provides wireless data services (e.g., mobile banking) must have its own solution for end-to-end security. Existing mobile security mechanisms are based on public-key cryptosystem. The main concern in a public-key setting is the authenticity of the public key. This issue can be resolved by identity-based (ID-based) cryptography where the public key of a user can be derived from public information that uniquely identifies the user. This paper proposes an efficient ID-based encryption algorithm. We actually implement the ID-based encryption schemes and compare the performance to show the advantage of our approach. Our study indicates that our solution outperforms a previously proposed algorithm by 20 - 35%

In this study, we propose a microfluidic device with a diffuser type chamber to differentiate the sperm velocity by gradually lowering down the flow speed in diffuser by gradually increasing the width of the channel. When the sperms' moving speed match the flow speed, the sperms tend to have the ability to flow against the stream, thus separating the sperms at different specific positions along the diffuser according to their motility becomes gentle and fast. Most of the motile sperm will stay in the expanding area and the non-motile sperms will drift to outlet. Different from the previous study we proposed in IEEE NEMS, 2012 , here we have three improvements: (1) Sperms can be separated in more detailed quality level. (2) Sperm will be more activated by passing through a dumb bell area than by the traditional methods. (3) The space in the device can accumulate large amount of sperms (~millions).

In this study, we propose a microfluidic device with a diffuser type chamber to differentiate the sperm velocity by gradually lowering down the flow speed in diffuser by gradually increasing the width of the channel. When the sperms' moving speed match the flow speed, the sperms tend to have the ability to flow against the stream, thus separating the sperms at different specific positions along the diffuser according to their motility becomes gentle and fast. Most of the motile sperm will stay in the expanding area and the non-motile sperms will drift to outlet.

To investigate the sensory block onset time, duration time, and side effects of adding dexmedetomidine to ropivacaine for cervical plexus block.Forty American Society of Anesthesiologists (ASA) Class I or II adult patients who were scheduled to undergo thyroid surgery were randomly allocated to the following groups to receive cervical plexus block: 30 mL of 0.375% ropivacaine combined with 1 μg kg(-1) of dexmedetomidine; 30 mL of 0.375% ropivacaine combined with saline (control). The sensory block onset time, duration of analgesia, mean arterial pressure (MAP), heart rate (HR), and the incidences of side effects, such as hypotension, bradycardia, and hypoxemia were recorded.The addition of dexmedetomidine to ropivacaine (Group D) shortened the sensory block onset time compared with the ropivacaine group (Group C) (95% confidence interval [CI] 4.18-5.26; p0.05). The duration of analgesia of cervical plexus block in Group D was significantly longer than that in Group C (95% CI 295.96-311.12; p0.05). The Ramsay sedation score at 5, 10, 20, 40, 60, 90, and 120 minutes after local anesthetic administration in Group D was significantly higher than that in Group C (p0.05). MAP level and HR level in Group D were significantly lower than that in Group C (p0.05).The addition of 1 μg kg(-1) dexmedetomidine to ropivacaine for cervical plexus block could shorten the sensory block onset time and extend the duration of analgesia, and increased the quality of analgesia, with the patients being sedated and arousable.

The capacity of conventional direct-sequence code-division multiaccess (DS-CDMA) systems is limited by multiaccess interference (MAI) that arises from correlation among user signals, especially in multipath channels. While inducing an intersymbol-interference (ISI) problem, chip-interleaved DS-CDMA (CIDS-CDMA) can preserve the orthogonality among user signals and effect MAI-free transmission. We propose a multicode CIDS-CDMA (MCIDS-CDMA) technique which can also remove ISI in addition to MAI when a sufficient number of multicodes are assigned. This design facilitates a low complexity receiver structure. In addition, a low complexity ISI canceller can be used to deal with the residual ISI, should the number of codes be insufficient.

Multiple access interference (MAI) is a major limiting factor of DS-CDMA system capacity. Parallel interference cancellation (PIC) is an effective means to mitigate MAI. However, if the initial decisions on which the PIC is based have high error probabilities, then PIC cannot perform well. To improve the performance of PIC, we propose chip-interleaving to provide intra-bit diversity. Then the initial decisions can be more accurate so as to enhance the PIC's performance. We design a chip-interleaving scheme based on some 3GPP WCDMA system features, such as the use of the Q-branch to transmit control bits and the I-branch to transmit data bits in a QPSK-like modulation scheme. Simulation results show that the proposed chip-interleaved WCDMA (CI-WCDMA) transmission can have significant performance advantage compared to simple WCDMA in transmission over fading multipath channels with MAI.

Parallel interference cancellation (PIC) is a widely considered approach to multiuser detection in CDMA communication. While PIC receivers normally involve nonlinear functions, previous performance analyses mainly addressed linear PIC. We find that the performance of purely hardlimiting PIC may not improve after the second stage. In addition, for the two-user case, one stage usually suffices. Further, the performance of hardlimiting PIC does not approach the single-user limit. We also develop approximate expressions for numerical evaluation of the hardlimiting PIC performance. Simulation results agree well with the analysis.

In mobile wireless communication, the signal is usually subject to fading. Gain-combining diversity is a common remedy for fading effects. Practical channel coded direct-sequence code-division-multiple-access (DS-CDMA) uses bit interleaving to effect gain-combining time diversity through the redundancy provided by the channel code. Recently, some have proposed chip-interleaved DS-CDMA (CIDS-CDMA). Simple CIDS-CDMA considers a set of bits at a time. Similarly indexed chips in the bits are grouped together for transmission. Such interleaving has been shown to yield diversity gain in uncoded transmission. This paper considers the performance of CIDS-CDMA with channel coding. For simplicity, synchronous DS-CDMA is considered. In addition to simple CIDS-CDMA, we also consider combined bit-and-chip interleaving (BCIDS-CDMA). We present theoretical analysis and simulation results for both cases under long-code and short-code spreading. It is concluded that the code period is vital for simple CIDS-CDMA but is of no importance for BCIDS-CDMA. Another conclusion is that BCIDS-CDMA yields the best performance for it provides the largest diversity gain.

Successive interference cancellation (SIC) is an effective technique to reduce multiple access interference and thereby increase capacity. While a conventional receiver attains best performance under equal received power for all users, a SIC-based receiver favors unequal powers. We consider ways to assign powers to the received user signals for the benefit of SIC-based multiuser detection. Two power assignment methods, both allocating user signal powers according to their sequence of detection in SIC, are investigated. Through numerical simulation, the methods are shown to greatly improve the bit error rate (BER) performance compared to equal-power assignment. The simulation results also show that, under these methods of power assignment, SIC yields superior performance to parallel interference cancellation (PIC) in high-data-rate transmission.