Acute respiratory failure (ARF) is one primary cause of intensive care unit (ICU) admittance, which is usually treated with intubation and mechanical ventilation in order to maintain a necessary ventilation and oxygenation function. After the remove of trachea tube, available oxygenation supports include nasal cannula, venturi mask, non-invasive ventilator and high flow nasal cannula (HFNC). In this articlewe reviewed the physiological mechanism related to HFNC therapy and trails about the application of HFNC in extubated patients. HFNC can provide well heated and humidified high flow gas with a high concentration of oxygen, which can improve the oxygenation and degree of comfort of patients after extubation. Furthermore, HFNC can improve the prognosis of these patients. However, HFNC has little influence on non-ventilation related factor and severe dysfunction of ventilation, so its indication and risk factor of treatment failure should be further evaluated with randomize controlled trials.

A major challenge in bone tissue engineering is to amplify cell numbers with maintaining the desired phenotype. As a crucial element in bone tissue engineering,the field of scaffold is in the forefront of developments. Due to superiority in both cell expansion and conveyance,the approach of microspherical scaffold has latterly been adopted as the substrate of cell propagation,carrier of expanded cells,as well as scaffold of regenerated bone tissue. Combined with injectable matrices after cell encapsulation or attachment,the microsphere-based system provides an attractive method for highly efficient cell amplification and minimally invasive cell delivery for bone tissue engineering.

Insulin sensitivity index (SI).glucose effectiveness (SG) and insulin secretion function were assessed by modified minimal model method (MMM) with frequently sampled intravenous glucose tolerance (FSIGT) test in the controls, in patients with impaired glucose tolerance (IGT), and type II diabetes mellitus (NIDDM). There was significant correlation between modified MMM and standard MMM in evaluating SI and SG. The results indicated that SI and SG were significantly elevated in the control than in the IGT and NTDDM groups. SI diminished much more in IGT group than in NIDDM group (P

The observations on cytomorphology and cytodynamics of cultured rabbit arterial smooth muscle cells(SMC)under concentrations of glucose 5.55,11.1,16.7,33.4 and 55.5 mmol/L with or without hyperlipidemic serum(HLS)were carried out by light microscopy and transmission election microscopy. The results showed that①The extent of disruption in SMC was positively correlated with concentrations of glucose,and negatively correlated with the multipication ralte of DNA,a parameter of cytodynamics.②There was no synergistic effect between glucose and HLS in the development of atherosclerosis.③In high glucose concentration groups(glucose 16.7mmol/L)a calcifies particle of high electronic density like substance,probably the core of atherosclerosis was found in SMC. Our results suggest that to keep lower levels of blood glucose and blood lipids may delay the development of atherosclerosis.

A study of the effects of glucagon in concentrations of 100,1000 and 10000 ng/L with or without hyperlipidemic serum(HLS)on the cytomorphology and cytodynamics of cultured rabbit arterial smooth muscle cells(SMC) was carried out by light microscopy,transmission electron microscopy and isotope technique,The results were as follows:①No effect of glucagon in concentration of 100 ng/L on SMC in both cytomorphology and cytodynamics was found.②Glucagon in concentration of 1000 or 10000 ng/L caused slight damage of SMC,and tended to inhibit the multiplication rate of DNA,a parameter of cytodynamics.Furthermore,lipidic substance in SMC was found under such concentrations of glucagon without HLS,which was favorable for formation of foam cells,③There was positively synergistic effect between glucagon and HLS in the development of atherosclerosis.Our results suggest that to keep lower levels of plasma glucagon and lipids in diabetic patients may delay the development of atherosclerosis.

0.025) was found.Conclusion Our study showed the lack of association between HSPG polymorphism and diabetic nephropathy in Chinese type 2 diabetics.There may be association between genotype frequencies of HSPG polymorphism and diabetes in statistics.

Objective　To explore the association between th e heparan sulfate proteoglycan gene (HSPG) polymorphism and diabetic nephropathy in Chinese.Methods　A case control study of 326 Chinese s ubjects including 136 type 2 diabetics with or without nephropathy and 190 non- diabetic control was performed.Genotype frequencies of HSPG2 polymorphism were s tudied by PCR-RFLP analysis with BamHI digestion.Results　There was no difference in genotype frequencies or allele frequencies between normal albuminuria and abnormal albuminuria patients.Moreover,there was no assoc iation between diabetic patients and non-diabetic control in allele frequencies as well,but obvious difference in genotype frequencies(0.05＞P＞0.025) was found.Conclusion　Our study showed the lack of association between HSPG polymorphism and diabetic nephropathy in Chinese type 2 diabetics. There may be association between genotype frequencies of HSPG polymorphism and d iabetes in statistics.

Objective To assess the clinical application value of vector flow mapping (VFM) in evaluating the left ventricular diastolic function in patients with uremia.Methods Forty patients with uremia and forty healthy volunteers were enrolled.The quantitative parameters,including vorticity,sum total energy loss (sEL),average energy loss(aEL),and the alteration circulation were measured in the VFM imaging mode.Difference was evaluated between two groups at apical,mid and basal segments at different periods.E/e'was derived via dual-Doppler imaging technology.And correlationship was analyzed between vorticity,sEL,aEL,circulation and E/e',separately.Results ①At apex segment of isovolumetric relaxation time and at three segments of atrial systole,there were difference in vorticity,sEL,aEL between two groups (P ＜0.05).Circulation in rapid filling phase of anterior mitral valve and slow filling phase of posterior mitral valve were different[(15.94 ± 8.40) m2/s vs (8.36 ± 7.84) m2/s,(5.34 ± 5.24) m2/s vs (13.37 ± 10.42) m2/s,P ＜0.05].②In control group,vorticity,sEL and aEL were different in different segments of same phase or at different phases of same segment,and also did in the uremia group(P ＜0.01).③In uremia group,vorticity had a good correlation with E/e'at basal segment of rapid filling phase(r =0.34,P =0.046)and atrial systole(r =0.38,P =0.02).And sEL had a good correlation with E/e'at basal segment of rapid filling phase,isovolumetric relaxation time and at mid segment of rapid filling phase(r1 =0.44,P1 =0.008;r2 =0.48,P2 =0.003;r3 =0.50,P3 =0.002),and in time phase mentioned above,there were also the correlationship between aEL and E/e'(r1 =0.39,P1 =0.017;r2 =0.49,P2 =0.002;r3 =0.48,P3 =0.003).Conclusions VFM can be utilized to analyze left ventricular hemodynamics features of uremia patients and it may be a good supplement for assessing cardiac diastolic function.

Objective To assess the clinical application value of vector flow mapping (VFM) in evaluating the left ventricular diastolic function in hypertensive patients with different left ventricular geometric patterns.Methods One hundred and sixty-nine patients with hypertension and 50 healthy volunteers were enrolled.Hypertensive patients were divided into four groups with different ventricular configurations according to ASE guide line in 2005:normal geometry group,concentric remodeling group,concentric hypertrophy group and eccentric hypertrophy group.The quantitative parameters,including average energy loss(aEL) and circulation were measured.Difference was evaluated among five groups at apical,mid and basal segments and at different periods.The correlationship was analyzed between aEL,circulation and E/e',respectively.Results ① Compared to control group,aEL was higher in four hypertension groups at three segments of atrial systole(P ＜0.05).aEL in eccentric hypertrophy group was higher than those in control group,normal geometry group or concentric remodeling group at apical and mid segments of atrial systole,and higher than those in other hypertensive groups at basal segment (P ＜ 0.05).In four hypertension groups,circulations in rapid filling phase of anterior mitral valve were lower than that in control group,but circulations in slow filling phase of posterior mitral valve were higher than that in control group(P ＜0.05).The circulation in slow filling phase of posterior mitral valve in concentric remodeling group was higher than that in normal geometry group,and that in eccentric hypertrophy group was higher than those in normal geometry group and concentric remodeling group(P ＜0.05).②When intra-group comparison,aEL were different in different segments of same phase or at different phases of same segment(P ＜0.05).③aEL had a good correlation with E/e'at basal segment of atrial systole in four hypertension groups(r =0.66,P ＜0.01).Conclusions VFM can be utilized to analyze left ventricular hemodynamics features of hypertensive patients with different left ventricular geometric patterns,it may be a good supplement for assessing cardiac diastolic function and reflect the extent of damage.

Objective To monitor the association between the expression of ve-cadherin and mesentery microcirculation blood flow of sepsis CASP rats,Analysis the relationship of each other.Methods Based on the standard criteria,we established sepsis CASP rats,and the rats were divided into several groups according to the gauge of the vein detained needle in the ascending colon,every group has six rats.The groups consisted of Sepsis A group 22 G(0.9 mm× 25 mm,33 ml/min),sepis B group 20 G(1.1 mm ×32 mm,54 ml/min),sepsis C group 18 G(1.3 mm ×32 mm,80 ml/min),sepsis D group 14 G(2.0 mm ×45 mm,270 ml/min),in addition we established the control group.Real-time observation was performed by microscope on the 6 h's blood velcocity of each sepsis CASP rats group.Then we applied the immunohistochemistry to quantitatively analyze the expression of ve-cadherin of each group.Results The blood velcocity of the mesentery microcirculation in control group was (583.21 ±52.39) μm/s,it was higher compared with the sepsis D group(213.30 ±52.39) μm/s (P ＜0.05),the blood velocity in sepsis A group was (482.71 ± 58.62) μm/s,higher compared with the sepsis D group(P ＜ 0.05).The score of the immunohistochemistry quantitative analysis of mesentery ve-cadherin in control group was 11.17 ±0.34,higher compared with the sepsis D group(5.43 ±0.43)(P ＜0.01).The score of sepsis A group was 10.07 ±0.30,higher compared with the sepsis D group(P＜0.05).Conclusions The expression of ve-cadherin of sepsis CASP rats had positive correlation with the blood velocity of the mesentery microcirculation of sepsis CASP rats,and it can indirectly reflect the degree of the sepsis.