This paper introduces the principle and control technique of the intelligentized respirator and the applications of the modes of SmartCare and AutoFlow. The possible malfunctions of the intelligentized respirator during mechanical ventilation and their countermeasures are analyzed. The influence of the malfunction alert grade on the patient during mechanical ventilation is also discussed. It's the trend to develop the intelligentized respirator. The staff has to be educated and trained to make full use of the intelligentized respirator.

OBJECTIVE To investigate nosocomial pulmonary infection in elderly patients receiving long-term(at least 30 day) mechanical ventilation. METHODS Retrospective survey was carried out in the aged patients with long-term mechanical ventilation,who admitted from Jan 2002 to Jun 2005.The risk factors of common pneumonia were studied by means of Logistic regression analysis. RESULTS In 69 cases with long-term mechanical ventilation,53 patients were caught common pneumonia(76.81%).Pulmonary tuberculosis and plural tuberculosis were(7(10.14%)) and(1(1.14%)),respectively.Nontuberculous mycobacterial infection was identified in 3 cases(4.35%).There were 8 cases suffered from Pneumocystis carinii pneumonia(11.59%).The length of mechanical ventilation and aspiration seemed to be the important risk factors for the development of common bacterial pneumonia. CONCLUSIONS The most significant preventive measures of common pneumonia include short mechanical ventilation and prevention of aspiration of gastric contents.Mycobacterium tuberculosis,nontuberculous mycobacteria and P.carinii induced pneumonia also should be considered in the elderly with(long-term) mechanical ventilation.

Objective To investigate the status of biological membrane(biofilm) formation in the bronchi of old patients treated with mechanical air,and clarify its correlations and risk factors.Methods The retaining time in 25 bronchi from 22 cases of old patients and the results of bacterial culture were analyzed.Results Bacteria culture-positive samples are 22 cases isolated from 25 endotrached tube,accounting for 88%.Negative samples are 3 cases,accounting for 12%.Conclusion The density of bacteria is corresponding to the time of tubing in the bronchi.With the extension of tubing time,the quantity of bacteria is greatly increased.

Objective To study the protective effects of anisodamine (ADM) on ventilator-induced lung injury (VILI) in rats. Methods After anesthesia was induced and tracheostomy was performed, 36 healthy male Sprague-Dawley rats were randomly assigned into three groups: control group (group A, VT=8ml/kg); injury group (group B), in which the animals received mechanical ventilation with large tidal volume (VT=40ml/kg); and ADM protective group (group C), in which the animals received the same amount of tidal volume and same respiratory rate with mechanical ventilation as in group B, but were pre-treated with ADM (15mg/kg?iV) at 24h, 12h, 0h time points before ventilation. Arterial blood gases were measured every one hour, and neutrophils in bronchoalveolor lavage fluid (BALF) were counted. Wet to dry (W/D) weight ratio of left lung was determined, and the content of TNF-? and IL-1? in BALF and blood, malondialdehyde (MDA), superoxide dismutase (SOD) levels in the pulmonary tissue and blood were measured respectively. The histopathological changes in pulmonary tissues in the three groups were compared. Results The oxygenation index (PaO2/FiO2) of the animals in group B was significantly lower than that in group A and C, and the BALF neutrophil count was remarkably increased in group B. W/D value of group B was significantly higher than that of group A and C. The levels of TNF-?, IL-1? in BALF were remarkably increased in group B , but decreased in group C . MDA levels in pulmonary tissue and blood in group C were lower than that of group B, but SOD level in group C was significantly higher than that of group B. Histopathologic findings demonstrated there were more neutrophil infiltration and destructive change in the alveolar wall in group B than in other groups. Conclusion ADM appears to have obvious protective effects on VILI through anti-inflammation and antioxidation.

Objective To investigate the temporal activation of p38MAPK signaling transduction cascade,and the relationship between the activation and reactive oxygen species(ROS)in a well-defined experimental model of water-immersion restraint(WIR)stress-induced gastric mucosa ulceration.Methods Male Sprague-Dawley rats were randomly divided into control group,WIR group and tempol treated group.Animals were restrained and immersed in water bath to induce gastric mucosal lesions,with or without pretreatment with the free radical scavenger,tempol,and the WIR group animals were killed at different time points after WIR stress.Tempol treated animals underwent the same protocol followed 30min or 360min of stress,then the gastric mucosa was harvested,and the activity of gastric mucosal p38 was analyzed by Western blot.Malondialdehyde(MDA)activity and pro-inflammatory cytokine expression were detected.Results A rapid activation of p38MAPK in gastric mucosa occurred as early as 15 min after stress,and this activation was maximal after 90min of stress and still persisted until 360min after stress.Pretreatment with tempol prevented stress-induced p38MAPK activation at 30 min and 360min time points(0.77?0.24 and 0.58?0.12,respectively)compared with that in model groups(1.22?0.16 and 1.73?0.09,respectively,P

Objective Analysis the clinical data of high-EuroSCORE 114 patients due to ronary surgery to elucidatethe surgical advantages between on-pump and off-pump CABG.Methods From September 2008 to March 2011,114 highEuroSCORE patients due to coronary surgery were randomly divided into off-pump group 48,and on-pump gronp 66 cases.Preoperative,intra-operative and peri-operative clinical data of all the patients were collected.All patients were followed up for 1 month postoperatively.Results The baseline of the two groups had no significant difference.Application of internal mammary artery,positive inotropic drugs and IABP assistance between the two groups were similar,P ＞0.05,Compared with the offpump group,patients in on-pump gnup had longer operation time,hut more graft counts and a higher rate of revascularization [ (3.71±0.55)gnifis vs.(2.82±0.39)grafts ],P ＜ 0.05.There were no significant differences of peri-operative mortality and post-operative complications between the two groups,P ＞0.05.The patients in on-pump group had more post-operative chest drainage in the first 24 hours[ (875.0±134.2)ml vs.(589.4±102.5)ml] and blood transfusion[ (656.3±84.4)ml vs.(433.3±62.9) ml ] compared with the off-pump group,P ＜ 0.05.The data of l-month follow up denonstrated that echocardiographic data,NYHA and symptoms of angina of the two groups had no significant difference,P ＞ 0.05.Conclusion Compared with OPCAB,CCAB did not increase postoperative renal failure,neurological complications and lung injury in highrisk patients,but had more complete revascularization.The disadvantage of CCAB was postoperative bleeding,blood productsuse.

Objective To objectively evaluate the effectiveness of reminder system in reducing catheter-associated urinary tract infections.Methods Databases were electronically searched to collect the trials.According to the inclusion and exclusion criteria,the literatures were screened,the data were extracted and the methodological quality of the included studies was assessed.Then Meta-analysis was performed by using RevMan 5.0 software.Results A total of 10 literatures involving 5 662 participants were included.The results of Meta-analysis showed that the reminder system group was superior to the control group in decreasing the incidence rate of catheter-associated urinary tract infections,shortening the days of indwelling catheter,and there were statistical differences.Conclusions Reminder system can shorten the days of indwelling catheter,decrease catheter-associated urinary tract infections,

AIM: To investigate the effect of mfn2 on mitochondrial function in steatosis hepatocytes. METHODS: Plasmid pEGFP-mfn2 was transfected into hepatocyte strain L02 by Lipofectamine 2000 in vitro, then the steatosis model of hepatocytes was establish by oleic acid induction. RT-PCR was used to evaluate mRNA expression and Western blotting was use to detect the protein expression. ATP level was determined by firefly luciferase bioluminescent. ROS production was measured by fluorescence probe DCFH-DA. Chondrosome transmembrane potential of L02 was observed by labeling of JC-1 and FCM. RESULTS: The stable expression of ectogenesis mitofusin2 in L02 cells was confirmed by RT-PCR and Western blotting. In the model of oleic acids induced lipid formation, Mfn2 obviously inhibited the descent of chondrosome transmembrane potential and ATP level, and increased ROS production in L02 cells. CONCLUSION: Up-regulated expression of mfn2 attenuates mitochondria dysfunction caused by oleic acids induced lipid formation.

Objective To assess the application of Xpert MTB/RIF assay in rapid diagnosis of tuberculous lymphadenitis.Methods Lymph node samples were collected from 1 02 clinically diagnosed patients with lymph node tuberculosis and 65 patients with other lymph node diseases from Zhejiang Provincial Hospital of Traditional Chinese and Western Medicine during January 201 4 and February 201 5. Xpert MTB/RIF,pathological examination and mycobacterium tuberculosis culture were conducted in all specimens of two groups.Taking clinical comprehensive diagnosis as the gold standard,the diagnostic sensitivity,specificity,positive predictive value,negative predictive value and diagnosis efficacy of three detection methods were assessed.The sensitivity of Xpert MTB/RIF in determining rifampicin resistance was analyzed using drug susceptibility testing as gold standard.Results The mean detection time of Xpert MTB/RIF was (2.2 ±0.2)h.Among 1 02 patients,Xpert MTB/RIF achieved higher sensitivity (96.1 %, 98 /1 02 ) than pathological examination (76.5%,78 /1 02 ) and mycobacterium tuberculosis culture (33.3%,34 /1 02)(χ2 =1 6.558 and 87.91 9,both P <0.01 ).Among 65 patients with other lymph node diseases,the specificity of all three detection methods was 1 00%.The receiver-operating-characteristic curve analysis demonstrated that diagnostic performance of Xpert MTB/RIF was better than that of other two methods.In 8 patients resistant to rifampicin confirmed by drug susceptibility testing,Xpert MTB/RIF detected 6 resistant-resistant patients.Conclusion Xpert MTB/RIF shows higher sensitivity and specificity in diagnosis of lymph node tuberculosis with the advantages of easy and rapid performance.

Objective To evaluate the clinical and imaging features of the sellar region lesions in children.Methods The clinical and imaging features of 112 cases with sellar region lesions were analyzed retrospectively,which were confirmed by pathology.Results 37 cases were craniopharyngiomas, which had two main symptoms of intracranial hypertension(57%)and diabetes insipidus(11%).On imaging it demonstrated as a calcified cystic tumor(81%).18 cases were gliomas, the main clinical feature of which was decreased visual acuity,13 of them were pilocytic astrocytoma, which manifested as a solid tumor with significantly enhancement(94%).16 cases were germ cell tumors,the main complaint was diabetes insipidus (75%),13 of them were germinoma, which showed iso-high density on CT and moderate enhancement after administration of contrast.And it showed high signal intensity on DWI.7 cases were hamartoma,86% patients of which showed gelasmus epilepsy,the imaging showed iso-signal masses with no enhacement in the hypothalamic papillary region.5 cases were LCH,80% of which had the complaint of diabetes insipidus,imaging findings manifested as thinkened pituitary stalk and loss of hyperintensity of posterior pituitary on T1WI.3 cases were pituitary tumors.23 cases were Rathke's cleft cysts,3 cases were arachnoid cyst.Most of the patients presented with headache.Conclusion The clinical and imaging features shows some specific features, which is helpful to improve the correct rate of diagnosis and provide the basis for further treatment.