Objective To evaluate the effects and side effects of three different recruitment maneuvers (RM) in acute respiratory distress syndrome (ARDS) caused by extrapulmonary disease.Methods Forty-four patients of extrapulmonary ARDS, according to crossover design methods, were undergone three RM in different periods, including sustained inflation (SI), increase progressively positive end expiratory pressure (IP), pressure control ventilation (PCV). Heart rate (HR), mean arterial blood pressure (MAP), central venous pressure (CVP), oxygenation index, lung compliance were recorded before and after RM, and were analyzed for statistical analysis. Results Oxygenation index and lung compliance were increased obviously in a short time after RM, improvement of IP method were better more obviously than the other two methods [1 h oxygenation index after RM:227 ± 42 vs 190 ± 19,186 ± 21; lung compliance:(59.4±12.5 ) ml/cm H2O(1 cm H2O = 0.098 kPa) vs (50.1 ± 9.3 ), (49.7 ± 10.6) ml/cm H2O;P＜ 0.05], 2h after RM,there were no statistical difference among the three methods (P＞0.05). After RM,HR and CVPwere increased, MAP was decreased in a short time, changes of SI method were smaller than the other two inethods [10 min HR after RM: (94.0±10.3 ) beats/min vs (116.0 ± 14.8 ), ( 107.0 ± 5.7 ) beats/min; CVP:(13.7±3.1 )cm H2O vs ( 18.4 ± 6.7 ), ( 15.4 ± 2.7 )cm H2O; MAP: ( 87.0 ± 12.1 ) mm Hg( 1 mm Hg = 0.133 kPa) vs (73.0 ± 4.8), (81.0 ± 6.6) mm Hg;P＜ 0.05), 20 min after RM, there were no statistical difference among the three methods (P＞ 0.05). Conclusion When extrapulmonary ARDS undergo RM ,IP method is the most effective on increasing oxygenation index and lung compliance, SI method has the smallest side effect on hemodynamics.

Objective To research the clinical significance of acetated Ringer solution and succinylated gelatin in the fluid resuscitation of sepsis patients.Method Fifty-nine sepsis patients were divided into two groups:lactic acid Ringer solution and hetastarch (group A,27 cases)and acetated Ringer solution and suecinylated gelatin (group B,32 cases),compared the fluid resuscitation and other parameter.Results There were no significant difference in the central venous pressure,mean arterial pressure and the dose of noradrenaline (P ＞ 0.05).The activated partial thrombeplastin time in group A was longer than that in group B[(58±10),(74±13)s vs(48±7),(54 ±11) s in 6,24 hours],fibrinogen concentration was lower than that in group B [(3.3 ±0.8),(1.6±0.3)g/L vs (4.2±1.1),(2.1±0.2)g/L in 6,24 hours] (P＜0.05).Serum lactic acid,creatinine,calcium concentration in group A [(6.9±0.8)retool/L,(289 ~ 27)μ mol/L,(2.1 ±0.3)mmol/L]were higher than those in group B [(3.2 ±1.1)mmol/L, (193 ±42)μmol/L, (1.7±0.2)mmol/L](P＜0.05),there was no difference in APACHE Ⅲ scores on the third day between two groups (P＞0.05).Conclusions Acetated Ringer solution and succinylated gelatin in the fluid resuscitation of sepsis patients has the same effect,but fewer impacts on serum coagulation,serum lactic acid and renal function than lactic acid Ringer solution and hetastareh.They may be more suitable for fluid resuscitation of sepsis patients,but hypecalcemia is easy to happen,and there is no significant evidences proving the prognosis.

Objective To evaluate the degree of hypothermia cerebral resuscitation patients by acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and judge the prognosis,so as to prove the effectiveness of its application.Methods Data of 34 cases of patients with mild hypothermia cerebral resuscitation in ECIU or ICU were continuously observed,calculated the scores of APACHE Ⅱ and verify for establishing the regression model.Results The APACHE Ⅱ score was 20-47 (33.86 ± 5.12) scores.The APACHE Ⅱ score in 9 patients who were survived within 72 h was (27.83 ± 4.89) scores,and in 25 patients who were dead within 72 h was (35.56 ± 7.12) scores,there was significant difference (P ＜ 0.01).Logistic regression analysis showed that APACHE Ⅱ score was the risk factor (P ＜ 0.01).Conclusion APACHE Ⅱ score can be applied to evaluate the degree of mild hypothermia cerebral resuscitation and prognosis,it can guide the clinical decision making.

Objective To compare the clinical efficacy of three kinds of replacement fluid for continuous hemofiltration in severe sepsis,and to develop a more rational composition.Methods Fifty severe sepsis patients with continuous hemofiltration were divided into four groups randomly.The configuration of the replacement fluid in accordance with the random number table,randomly selected from four different formulations:group A (13 cases):Ports composition provided by Nanjing general hospital;group B (12 cases):Zhongshan hospital composition; group C (11 cases):an improved composition; group D (14 cases):an improved composition by Donghua hospital affiliated to SUN Yat-sen university.Blood electrolytes,blood gas analysis,renal function,blood glucose(highest and lowest serum glucose in treatment period),high sensitive C-reactive protein(hs-CRP) concentration,calcium concentration in filter were tested before and after every treatment period.Results The concentration of blood electrolytes during treatment had no significant change (P ＞ 0.05).Renal function were improved significantly after treatment among four groups (P ＜ 0.05).The level of hs-CRP decreased significantly after treatment (P ＜ 0.05) and there was no significant difference among four groups (P ＞ 0.05).The change of serum glucose during treatment was the smallest in group D than that in group A,B,C [(3.0 + 0.9) mmol/L vs.(11.2 + 2.0),(3.8 + 1.1),(5.5 +1.3) mmol/L](P ＜ 0.05).Calcium concentration in filter was the lowest in group D than that in group A,B,C [(1.5 + 0.5) mmol/L vs.(2.0 + 0.7),(2.3 + 0.5),(2.1 + 0.4) mmol/L] (P ＜ 0.05).The dosage of heparin was the least during treatment in group D than that in group A,B,C[(6.5 ± 2.8) U/(kg·h) vs.(8.9 ± 3.4),(7.9 ± 3.0),(8.7 ± 3.1) U/ (kg· h)] (P ＜ 0.05).Conclusions Improved composition by Donghua hospital affiliated to SUN Yat-sen university hospital compared to other compositions can better maintain a stable blood glucose levels,have a better anticoagulant effect,reducing the application of heparin,maintain a stable homeostasis.It is worthy of using in clinic.

Objective To observe the effects of excessive fluoride on osteocalcin and glucose metabolism in mice.Methods Thirty-two male C57 mice (body mass:18-24 g) were selected as study subjects which were randomized into four groups (8 mice in each group) according to their body mass by random number table method:0 mg/L group (control group),50 mg/L fluorine group,100 mg/L fluorine group and 150 mg/L fluorine group.Sodium fluoride in distilled water was freely taken by these animals to replicate fluorosis animal model.After 12 weeks,total osteocalcin,uncarboxylated osteocalcin,insulin and glucagon were measured by enzyme-linked immunosorbent assay,fasting blood glucose and glycated hemoglobin were measured by chemiluminescence.Results After 12 weeks of intervention with sodium fluoride,serum total osteocalcin,uncarboxylated osteocalcin,fasting blood glucose,glycated hemoglobin,insulin,and glucagon were significantly different between different groups (F =17.23,22.29,4.43,45.57,4.45,55.21,P ＜ 0.05).Total osteocalcin,uncarboxylated osteocalcin,fasting blood glucose,glycated hemoglobin,and insulin in the 100,150 mg/L fluorine groups were higher than those of control group [(30.02 ± 5.35),(35.22 ± 4.98) vs (20.23 ± 3.22) μg/L;(8.72 ± 1.34),(11.01 ± 1.02) vs (5.80 ± 1.60) μg/L;(7.53 ± 2.29),(8.53 ± 2.81) vs (4.99 ± 1.60) mmol/L;(6.74 ± 0.68),(7.12 ± 0.25) vs (4.95 ± 0.28) mmol/L;(2.65 ± 0.25),(2.74 ± 0.47) vs (2.13 ± 0.28) mU/L,P＜ 0.05].The serum glucagon levels in the 50,100,150 mg/L fluorine groups were lower than that in the control group [(20.90 ± 3.00),(23.68 ± 2.58),(21.63 ± 2.42) vs (38.61 ± 3.73) ng/L,P ＜ 0.05].Conclusion Excessive fluoride can lead to elevated osteocalcin level and abnormal glucose metabolism in mice.

Atherosclerosis(AS) is an important pathological feature of cardiovascular diseases such as myocardial infarction,stroke and other highly fatal diseases. Phlegm and dampness are considered to be an important pathogenesis of AS,which is difficult to heal and can cause complications. The establishment of an animal model with AS and phlegm-dampness syndrome,which could reflect the features of traditional Chinese medicine(TCM),and objective evaluation system are an important element of modern integrated TCM and western medicine research on cardiovascular diseases. It is of great significance for TCM to prevent and treat cardiovascular diseases. This article summarizes the scientific connotations of traditional Chinese and western medicine for AS and phlegm-dampness syndrome,comprehensively summarizes the current status of construction and evaluation in experimental animal model,analyzes the problems of current model,and discusses the factors of model construction and evaluation. Our aim is to establish normalized and standardized animal model with AS of phlegm-dampness syndrome.

OBJECTIVE: To establish the system software of multi-parameter monitoring by embedded Linux kernel and Qt library. METHODS: To determine the hardware system needed for the development of the system, carry out system Bootloader (Bootloader), Linux kernel, file system and Qt/Embedded (QtE) tailoring and transplantation and application development on the basis of the hardware system, and achieve the characteristic UI design. RESULTS: The changes of physiological parameters were observed in real time to improve the stability and real-time performance of the whole system and increase users' experience with QtE. CONCLUSIONS The embedded Linux+Qt multi-reference monitoring system can improve the stability, operability and functionality of real-time monitoring and multi-physiological information, and has good extensibility and maintainability.
Computers ; Electrocardiography ; Humans ; Monitoring, Physiologic/instrumentation* ; Software

Objective To construct HEK 293T cells that express tardigrade Dsup protein fused with green fluorescent protein copGFP in order to study the effect of Dsup protein on proliferation of HEK 293T cells.Methods The CRISPR/Cas9 gene knock-in system was constructed.The target gene fragments of Dsup,copGFP,EF1α and puromycin were amplified by PCR and inserted into pAAVS1-SFFV to construct the fusion vector of Dsup and copGFP,which was known as pAAVS1-SFFV-Dsup-copGFP-EF1α-Puro.pAAVS1-SFFV-Dsup-copGFP-EF1 α-Puro and pAAVS1-CRISPR-Cas9 vector were co-transfected into HEK 293T cells before Dsup gene was inserted into the AAVS1 region of HEK 293T cells via homologous recombination.The HEK 293T cells expressing Dsup gene were obtained following puromycin selection,flow cytometry sorting and genome identification.The expression of Dsup at mRNA and protein levels and proliferation-related genes(MCM2,MCM4,PCNA,Ki-67)were examined to investigate the effects of Dsup gene on the proliferation of HEK 293T-Dsup-copGFP cells.Results The pAAVS1-SFFV-Dsup-copGFP-EF1α-Puro recombinant vector was constructed,and the HEK 293T-Dsup-copGFP cells with Dsup gene inserted in the AAVS1 region were obtained,where both Dsup mRNA and protein were expressed.The cell proliferation rate of HEK 293T-Dsup-copGFP was higher than that of HEK 293T-Control-copGFP(P＜0.001).Further investigation revealed that the expressions of Ki-67 and MCM4 protein in HEK 293T-Dsup-copGFP were significantly higher than in the control group,indicating that the knock in of Dsup gene might enhance the proliferation ability of human cells by promoting the expression of Ki-67 and MCM4 protein.Conclusion A gene editing vector is constructed,and stable cell line HEK 293T-Dsup-copGFP for Dsup fusion expression with copGFP is established.The expression of Dsup gene in HEK 293T cells can promote cell proliferation,possibly by upregulating the expressions of Ki-67 and MCM4 protein.

This study designs an intermittent pneumatic pressurization device with STM32 series single chip as the core. The working state of the air pump and the plurality of air chambers is controlled by the IO port of the single chip microcomputer, and the circulating inflation of the plurality of air bags is realized. The pressure monitoring system consists of a silicon piezoresistive pressure sensor, a high-precision operational amplifier and a 12-bit AD converter which monitors the gas pressure of each gas path in real time to ensure the safety of the equipment. The system is easy to operate, simple in function, and has strong practicability.
Blood Circulation ; Cardiovascular System/physiopathology* ; Equipment Design ; Humans ; Microcomputers ; Pressure

OBJECTIVE： To screen the quality control components of Chrysanthemum morifolium based multiple component metabolism， and study its network pharmacology effect. METHODS： The water extract of C. morifolium was prepared. A total of one rats were selected， water extract of C. morifolium was perfused in jejunum segment after abdominal anesthesia； plasma sample 1 was collected by double perfusion collection. Other 3 rats were given water extract of C. morifolium intragastrically， and plasma sample 2 was collected by abdominal aorta blood collection. UPLC-MS/MS was used to analyze water extract of C. morifolium and plasma sample component， and prototype blood-entry component in water extract of C. morifolium was identified after metabolism. TCMSP and Swiss Target Prediction database were used to screen the core target of prototype blood-entry component. DAVID database was used to enrich the related pathways of core target. The quality control components were screened according to topological parameters. Cytoscape software was used to analyze pharmacological effect of quality control components of C. morifolium. RESULTS： After UPLC-MS/MS analysis， 27 compounds were identified in water extract of C. morifolium， among which there were 12 prototype blood-entry components. After network pharmacology analysis， 7 quality control components were identified， i.e. cosmosiin， apigenin-7-O-glucuronide， luteolin， tilianin， apigenin， hesperetin， acacetin. It was possible to treat cancer， cardiovascular and cerebrovascular diseases， and neurological diseases by acting on metabolic pathway， cancer related pathway， signal transduction related pathway， adipocyte lipolysis regulatory pathway， etc. CONCLUSIONS： The study screen the possible quality control components of water extract of C. morifolium. The theoretical pharmacological effect of it can be clarified through network pharmacology， which can provide a new idea for the utilization of C. morifolium.