Objective:In the clinical mechanical ventilation practice, the medical workers often set the ventilator parameters only depend on their own experience. In order to change that,we design a Closed-Loop Automatic Mechanical Ventilation Controller.Methods: Design two closed-loop control subsystems to meet the requirements of closed-loop control system. PETCO2 control subsystem used to keep the concentration of PETCO2, and another subsystem design to regulate the respiratory elasticity called PEEP control subsystem. PETCO2 control subsystem can work on its own or work with PEEP control subsystem.Results: Using this closed-loop controller, the partial CO2 pressure and respiratory elasticity of patient was regulated in real time.Conclusion:By using this closed-loop automatic mechanical ventilation controller, the respiratory elasticity was largely reduced with the adequate gas exchange. Therefore, the ventilator using this closed-loop automatic mechanical ventilation controller can improve the ventilation quality and also reduce the risk of lung injury.

Objective To explore the correlation of pulmonary heart disease (PHD) with erythrocyte immunity function and serum erythropoietin(EPO)level. Methods Forty-eight patients with PHD were selected as PHD group, while forty people were chosen as control group. The erythrocyte C3b receptor (E-C3bRR), erythrocyte immunity complex (RBC-ICR) and serum EPO content were detected by yeast rosette method and enzyme-linked immunosorbent assay (ELISA),and blood gas indexes were examined by blood gas analyser.Results The E-C3bRR and serum EPO content were lower, while the RBC-ICR was higher in PHD group than in control group(both P< 0. 01). Compared with control group, PCOz and HCO3-levels were higher, but blood oxygen saturation(SaO2) level was lower in the PHD group than in control group(both P<0. 01). There were no differences in pH value and PO2between two groups(both P>0. 05). The E-C3bRR was positively related to serum EPO content (r=0. 623, P<0.01), and HCO3-was positively related to pH value and PCO2(r=0. 219 ,P<0. 05;r=0. 585,P<0. 01) ,whereas PCO2was negatively related to pH value(r=-0. 529,P<0.01),and PO2was positively related to SaO2(r=0. 682,P<0.01)in PHD group. Conclusions There is a correlation between E-C3bRR and serum EPO content in PHD patients.

ObjectiveTo evaluate the clinical efficacy and toxicity of gefitinib combined with Zhenqi Fuzheng capsule in treatment of senile non-small-cell lung cancer (NSCLC) at the middle and late stages. Methods88 patients with NSCLC at Ⅲ b-Ⅳ were randomly divided into combined drugs group ( gefitinib combined Zhenqi Fuzheng capsule,n =46 cases) and single drug group (gefitinib,n=42 cases).After treatment for 60 d,the short-term efficacy,side effects and quality of life were observed and evaluated. The objective response and survival rate were assessed after following up for 2 years. Results The short-term efficacy rate in the combined drugs group (19.6 ％ ) was higher than single drug group (11.9 ％ ),but there was no significant difference between the two groups (x2=0.096,P＞0.05).The rate of Karnofsky score in improvement and stableness was 71.7％ in combined drugs group and 50.0％ in single drug group,and quality of life improved after combined drugs compared with single drug treatment (x2 =4.376,P＜0.05).The adverse effects in combined drugs group was some lower than in single drug group with no statistical significance.There was no differences in the survival rates of 2 years between the two groups(x2 =0.556,P＞0.05). ConclusionsThe gefitinib combined Zhenqi Fuzheng capsule in treatment of middle-and late-stage NSCLC is worthy to be popularized due to positive efficacy,less side effects and higher quality of life.

Objective To explore the application of adaptive statistical iterative reconstruction (ASIR)scanning technique in low dose pediatric cervical CT, especially in reducing the radiation dose for thyroid. Methods We retrospectivly analyzed 140 pediatric cervical CT. 70 cases of group A scaned with ASIR technology and preseting noise index 12 HU in Discovery CT 750 HD (GE Healthcare), and 70 cases of group B scaned with filtered back projection (FBP) technology and preseting noise index 14 HU in VCT 64 (64 Lightspeed VCT, GE Healthcare). The other scan parameters were same in 2 groups. The distribution characteristics of gender and age were completely consistent between groups. The minimum current, the maximum current, the current of thyroid on CT images and CT dose volume index (CTDIvol), scanning length and dose length product (DLP) on dose reports were all recorded for each child. The noise values of CT images were measured. 4 scores standard was used to evaluate the subjective image quality. The data were analyzed with SPSS 13, Kappa method for the test of consistency and t test for the differences of the measured data. Excel was used for mapping. Results The minimum current, the maximum current, the average current, the current for thyroid of the two groups were respectively (26.8 ± 4.2), (43.2 ± 15.4)mA;(35.8±9.6),(41.8±13.6)mA;(34.6±8.6), (41.0±13.2)mA;(36.8±12.3), (44.7±21.0)mA. The CTDIvol, DLP and the scanning length of the two groups were respectively(1.3 ± 0.3), (1.8 ± 0.6)mGy;(29.0 ± 8.3), (40.3 ± 15.6) mGy·cm and(157.5±20.2), (157.6±21.8)cm. The average current, the thyroid current, CTDI and DLP in group A were 15.8%, 17.9%, 27.3%and 28.4%lower than those in group B (t=-5.50—-0.02, P<0.01). The subjective image quality scores of the two doctors were respectively 3.4 ± 0.9, 3.3 ± 1.0, they were highly consistent (Kappa=0.834, P<0.01). The objective image noise of cancellous bone and neck muscles were respectively (32.5 ± 5.3),(32.9 ± 5.1)HU and (9.2 ± 2.3), (9.1 ± 2.0)HU, there were not statistically difference between the two groups (t=-0.47—0.24, P<0.05). Conclusion Compared with FBP, low dose pediatric cervical CT with 30%ASIR could provide dose reduction for thyroid and the whole neck while maintaining diagnostically acceptable images .

An adverse intrauterine environment due to preeclampsia can not only lead to premature birth,low birth weight and fetal intrauterine distress,but also have long-term impacts on the fetus,such as increasing their susceptibility to metabolic,cardiovascular and neurological disorders.It also increases the risk of preeclampsia in female offspring.Researches focusing on the long-term effects of preeclampsia on the future generation is helpful to understand the pathophysiological mechanism of preeclampsia and to provide timely interventions in early life to reduce the occurrence of chronic diseases in later life.

Objective: To estimate the total number of people infected with HIV and to calculate the diagnosis rate of HIV in Dehong Prefecture, Yunnan Province. Methods: Through the comprehensive AIDS prevention and treatment information system, we collected and analyzed the relevant information of the new diagnosis report of HIV in Dehong Prefecture, Yunnan Province in 2006-2015, mainly including age, sex, infected transmission, CD4⁺ T-lymphocyte counts, diagnostic time and so on. The content of the study was to establish a model method for estimating the diagnosis rate of HIV in Dehong. First, used the first CD4⁺ T-lymphocyte count after HIV diagnosis to estimate the date of infection. Then based on the estimated time from HIV infection to diagnosis we can estimate the diagnosis delay distribution which in turn can be used to account for individuals infected but not yet diagnosed and thus estimated the total number of HIV infections (diagnosed and undiagnosed). Finally, the number of new infections in each year was added to estimate the total number of infected people, and the number of people who had been diagnosed was divided by the total number of infected persons to obtain the proportion of HIV diagnosis rate. Results: There were 8 215 reported cases in Dehong from 2006 to 2015, of which 1 297 cases were reported in 2007 (15. 8%) and 361 cases (4.4%) in 2015. The diagnosis rate of newly infected persons were 88% in 2005 and before. And from 2006 to 2015, the diagnosis rate of newly infected persons were 75%, 71%, 68%, 66%, 61%, 58%, 53%, 45%, 40% and 33%, respectively. The total number of newly infected persons in 2005 and before was 11 197 cases. The annual new infected number from 2006 to 2015 was 653, 671, 723, 640, 509, 468, 369, 375, 285 and 224 cases. The total number of people infected with HIV in Dehong was 16 114 cases, and the diagnosis rate was 87.7%. Conclusion The diagnosis rate of HIV in Dehong was at a high level. Since 2008, the annual number of new infections in Dehong has been declining.

Objective:To study the clinical characteristics and compliance of early-onset gout patients by case-control analysis.Methods:A total of 111 early-onset patients (onset age ≤35 years old) were included as Group A, and 111 non-early-onset patients (onset age >35 years old) with matched disease durationwere included as Group B. The differences ofclinical characteristics, causes of acute gout attack, dairy diet habits, compliance, and misunderstanding of the disease were compared.Results:Compared with the non-early-onsetgoutpatients, the early-onset patients had a higher proportion of obesity (63 cases vs 28 cases), family history (36 cases vs 20 cases) and tophus (39 cases vs 23 cases) and higher level of VAS scores (8.5±1.3 vs 7.6±1.7; χ2=22.988, P<0.01; χ2=5.749, P=0.016; χ2=5.729, P=0.017; t=4.639, P<0.01), lowerproportionof the first metatarsophalangeal joint involvement as the initial joint involvement (45.9%, 51 cases vs 59.4%, 66 cases; χ2=4.066, P=0.044), higher proportion of the ankle involvement as the initial joint involvement (34.2%, 38 cases vs 21.6%, 24 cases; χ2=4.386, P=0.036), higher proportion of alcohol drinkers and high fructose drinkers, which was more likely to relate to alcohol intake, strenuous exercise and high fructose intakeas trigger of the flare ( χ2=6.513, P=0.011; χ2=7.126, P=0.008; χ2=1.978, P=0.160), while the proportion of regular exercisers and on diet in the family was lower ( χ2=22.887, P<0.01; t=-4.917, P<0.01). The proportion of poor diet and medication compliance in Group A was higher than that in Group B(57.7%, 64 cases vs 38.7%, 43 cases; χ2=5.207, P=0.022; χ2=5.867, P=0.015). As for the reason for poor treatment compliance, early-onset gout patients were more worry about the side-effects of drugs than non-early onset patients ( χ2=4.190, P=0.041). There was no significant difference between the two groups in the main misunderstanding of gout. Conclusion:Although early onset gout patients are young, their condition is more serious, and compliance is poorer, this group of patients should be highly valued in clinical diagnosis and treatment.

OBJECTIVE: To comprehend the prevalence status of elevated serum uric acid(SUA) and investigate the relationship between elevated SUA and cardiovascular risk factors and the clustering of the cardiovascular risk factors among outdoor male traffic policemen. METHODS: Selected by convenience sampling,1 039 outdoor traffic policemen in Guangzhou were asked to complete a questionnaire survey,physical and laboratory examination. According to the level of SUA > 420. 00 μmol/L or not,they were divided into elevated SUA group and control group. RESULTS: The median SUA level of outdoor male traffic policemen was 431. 00 μmol/L,and the elevated SUA prevalence was 56. 3%. The length of working years,systolic blood pressure,diastolic blood pressure,and levels of serum triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),and serum creatinine(Scr) in the elevated SUA group were statistically higher than the control group(P < 0. 01). The high density lipoprotein cholesterol level was lower in the control group than that in the elevated SUA group(P < 0. 01). After adjusting for age and alcohol consumption,the results of multivariate logistic regression analyses showed that outdoor traffic policemen who suffer from overweight or obesity,elevated TG and elevated TC have more risk in suffering from elevated SUA(P < 0. 05). The odds ratios(ORs) and 95%confidence intervals(CIs) were 2. 347(1. 772-3. 109),2. 040(1. 517-2. 743) and 1. 431(1. 080-1. 896) respectively.The risk factors of suffering from elevated SUA increased along with the increase of outdoor working years or Scr level(P <0. 05). The ORs and 95% CIs were 1. 028(1. 004-1. 054) and 1. 048(1. 033-1. 062) respectively. The proportion of people with elevated SUA among outdoor traffic policemen increased with the increase of cardiovascular risk factors(P <0. 01). The risk of elevated SUA among outdoor male traffic policemen who have 1,2,3,4 and ≥5 cardiovascular risk factors were 1. 583,2. 351,4. 657,2. 865 and 13. 576 times higher than those without cardiovascular risk factor respectively(P < 0. 05). CONCLUSION: Among outdoor male traffic policemen,elevated SUA are closely associated with the cardiovascular risk factors. The risk factors of suffering from elevated SUA increased with clustering of cardiovascular risk factors.

Objective: To analyze the epidemiological history, clinical manifestations, treatment and the short-term prognosis of 31 cases of 2019 novel coronavirus(2019-nCoV) infection in children from six provinces (autonomous region) in northern China. Methods: A retrospective analysis of the epidemiological history, clinical symptoms, signs, laboratory examinations, chest imaging, treatment and the short-term prognosis of 31 cases of 2019-nCoV was conducted. The patients were diagnosed between January 25th, 2020 and February 21st, 2020 in 21 hospitals in 17 cities of six provinces(autonomous region) of Shaanxi, Gansu, Ningxia, Hebei, Henan and Shandong. Results: The age of the 31 children with 2019-nCoV infection was 7 years and 1 month (6 months -17 years). Nine cases (29%) were imported cases. Other 21 cases (68%) had contact with confirmed infected adults. One case (3%) had contact with asymptomatic returnees from Wuhan. Among the 31 children, 28 patients (90%) were family cluster cases. The clinical types were asymptomatic type in 4 cases (13%), mild type in 13 cases (42%), and common type in 14 cases (45%). No severe or critical type existed. The most common symptom was fever (n=20, 65%), including 1 case of high fever, 9 cases of moderate fever, 10 cases of low fever. Fever lasted from 1 day to 9 days. The fever of fifteen cases lasted for ≤3 d, while in other 5 cases lasted > 3 d. Other symptoms included cough (n=14, 45%), fatigue (n=3, 10%) and diarrhea (n=3, 9%). Pharyngalgia, runny nose, dizziness, headache and vomiting were rare. In the early stage, the total leukocytes count in peripheral blood decreased in 2 cases (6%), the lymphocytes count decreased in 2 cases (6%), and the platelet count increased in 2 cases (6%).Elevation of C-reactive protein (10%, 3/30), erythrocyte sedimentation rate(19%,4/21), procalcitonin(4%,1/28), liver enzyme(22%, 6/27) and muscle enzyme (15%, 4/27) occurred in different proportions. Renal function and blood glucose were normal. There were abnormal chest CT changes in 14 cases, including 9 cases with patchy ground glass opacities and nodules, mostly located in the lower lobe of both lungs near the pleural area. After receiving supportive treatment, the viral nucleic acid turned negative in 25 cases within 7-23 days. Among them, 24 children (77%) recovered and were discharged from hospital. No death occurred. Conclusions In this case series, 2019-nCoV infections in children from six provinces (autonomous region) in northern China are mainly caused by close family contact. Clinical types are asymptomatic, mild and common types. Clinical manifestations and laboratory examination results are nonspecific. Close contact history of epidemiology, nucleic acid detection and chest imaging are important bases for diagnosis. After general treatment, the short-term prognosis is good.