Objective:To investigate the clinical application of noninvasive high frequency oscillatory ventilation(nHFOV)and heated humidified high flow nasal cannula(HHHFNC)in sequential ventilator evacuation of preterm infants with very low birth weight with respiratory distress syndrome(RDS).Methods:A total of 88 preterm infants of very low birth weight with RDS were enrolled in the study, who had received endotracheal intubation invasive ventilation and were ready to be replaced by non-invasive ventilation at neonatal intensive care unit(NICU)of Xuzhou Central Hospital from May 2017 to January 2020.All premature infants were routinely treated with caffeine citrate.They were divided into two groups through random number table: nHFOV/HHHFNC group(45 cases)and continuous positive airway pressure(nCPAP)/oxygen hood group(43 cases). nHFOV was given after invasive ventilator removal and HHHFNC transition was followed after nHFOV withdrawal in the nHFOV/HHHFNC group, while nCPAP was given after invasive ventilator removal and oxygen hood was followed after nCPAP withdrawal in the nCPAP/oxygen hood group.The main observation consequences were compared with arterial blood gas indexes after invasive ventilator evacuation, weaning effect and the incidence of related complications.Results:(1)There were no statistically differences between the two groups in terms of gender, gestational age, birth weight, Apgar score at 1 min and 5 min after birth, the number of glucocorticoid usage in 24 h before delivery, the number of pulmonary surfactant usage, invasive ventilation time and RDS grading( P>0.05). (2)The PaO 2, PaCO 2and oxygenation index(OI=100×MAP×FiO 2/PaO 2)of the nHFOV/HHHFNC group at 1 h and 24 h after invasive ventilator removal showed significant difference compared with the nCPAP/oxygen hood group( P<0.05). The differences as the following listed were statistically significant( P<0.05)between the two groups, including the failure rate of invasive ventilation weaning during 72 h [9%(4/45)vs.26%(11/43)], the incidence of frequent apnea [7%(3/45)vs.23%(10/43)], the failure rate of nHFOV and nCPAP noninvasive ventilation weaning [4%(2/45)vs.21%(9/43)], the oxygen-used time [12.02(9.08~12.31)d vs.14.44(11.32~13.26)d] and the incidence of nasal injury [4%(2/45)vs.26%(11/43)]. (3)The time of the first noninvasive ventilation of nHFOV and nCPAP, the incidences of lung air leakage, neonatal necrotizing enterocolitis, grade Ⅲ to Ⅳ intraventricular hemorrhage, above stageⅡretinopathy, bronchopulmonary dysplasia and the mortality rate between the two groups showed no statistical significance( P>0.05). Conclusion:nHFOV and HHHFNC used in the sequential ventilator evacuation of RDS in preterm infants with very low birth weight could improve oxygenation, reduce CO 2retention, improve the success rate of machine weaning and reduce the occurrence of apnea and nasal injury.

OBJECTIVETo explore the crew and passengers' comfort on the Shijiazhuang-Taiyuan passenger dedicated line and physical factors, such as air pressure, noise, wind speed.

METHODSComfort investigation of all the crew (n = 244) and passengers (n = 377) on the Shijiazhuang-Taiyuan passenger dedicated line at speed of 250 km/h and 200 km/h and the detection of the air pressure, noise and wind speed were performed in 2011.

RESULTSSignificantly higher ratio of comfortable feeling, lower ratio of seriously discomfortable feeling were observed in crew and passengers at 200 km/h compared with those at 250 km/h (P < 0.05), as well as rapid disappearance of discomfortable feeling in crew (P < 0.05) and significantly higher ratio of lightly discomfortable feeling and lower ratios of tinnitus and eardrum discomfort induced by air pressure and noise in passengers at 200 km/h. No significant difference was observed in ear discomfort induced by air pressure and noise among crew, and the duration of disappearance of discomfortable feeling among passengers between 200 km/h and 250 km/h. The noise in carriages exceeded the related standard when the high-speed train passing through the tunnels.

CONCLUSIONThe individuals feel more comfortable at 200 km/h than 250 km/h in this line., which may be related with rapid variation of wind speed and noise when the train passes through the tunnels with high speed.

Adolescent ; Adult ; Atmospheric Pressure ; Female ; Humans ; Male ; Noise, Occupational ; Noise, Transportation ; Occupational Health ; Railroads ; Sensation ; Surveys and Questionnaires ; Wind ; Workplace ; Young Adult

Objective To summarize the technique and the clinical value of Solitaire AB stents combined with Axium detachable coil in treatment of wide-necked posterior communicating artery aneurysms.Methods Twenty-eight patients with wide-necked posterior communicating artery aneurysms,admitted to our hospital from March 2010 to September 2012,were performed endovascular procedures by intracranial Solitaire AB stent and Axium detachable coil.Their clinical data and treatment efficacy were retrospectively analyzed.Results All patients were identified as having wide-necked intracranial aneurysms suitable for stent-assisted Axium treatment.Total occlusion in 24 patients and partial occlusion in 4 patients were achieved.All patients recovered well.All patients were angiographically followed-up 3 months after the procedure; among them,no filling was shown for the 23 aneurysms which were densely packed,1 case of parent artery occlusion and 4 aneurysms with neck remnant did not change.Conclusion The Solitaire AB stent is safe intracranial stent-assisted coil for embolization of wide-necked intracranial aneurysms; it is very suitable for treating the wide-necked posterior communicating artery aneurysms with severely tortuous intracranial artery,enjoying few complications.

OBJECTIVETo establish human hepatocellular carcinoma multidrug-resistance cell line (HepG2/ADM) and to determine the effect of low-frequency pulse ultrasound (US) on MDR cells and investigate its mechanism.

METHODSUsing gradual increase of adriamycin (ADM) concentrations in culture, an adriamycin-resistant human hepatocellular carcinoma cell sub line (HepG2/ADM) was established in vitro. HepG2/ADM cells were cultured in vitro and randomly divided into 4 groups: the control group (HepG2/ADM only), the group ADM by 1.0 mug/ml adriamycin for 1 h, the group US by low-frequency pulse ultrasound for 10 min, and the group US by low-frequency pulse ultrasound and treated with adriamycin simultaneously at same time. A sonication at a frequency of 0.8 MHz, was delivered with an intensity level of 0.5W/cm2, with continuous exposure of 10 min was applied. The ability of US to induce the apoptosis of MDR was evaluated by analyses of fluorescence microscopy, DNA fragmentation assay and flow cytometry assay.

RESULTSHepG2/Adm was resistant to many anti-tumor agents, and its IC50 of ADM was 26 times higher than that of parent cell line HepG2. Significant over expressions of P-gp, MRP, LRP and GSTs were detected. HepG2/ADM cells radiated by US had the typical characteristics of apoptosis. Compared with the control group (HepG2/ADM, 3.47%); the apoptosis rates were higher in US (12.23%). The therapeutic alliance of US with ADM for MDR cells, have a significant change in the ratio of apoptosis (18.81%, t=1.46 to 5.36, P<0.01).

CONCLUSIONHepG2/ADM could have the biological characteristics of human multidrug-resistance cell line. The US sonication of 0.8 MHz could induce apoptosis of HepG2/ADM cell in vitro, and could act synergistically with Adriamycin.

Apoptosis ; Carcinoma, Hepatocellular ; drug therapy ; pathology ; Cell Line, Tumor ; DNA Fragmentation ; Doxorubicin ; pharmacology ; Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; Flow Cytometry ; Humans ; Liver Neoplasms ; drug therapy ; pathology ; Ultrasonics

Aim To investigate whether adiponectin is involved in the protective effect of sevoflurane preconditioning on myocardial ischemia/reperfusion (MI/R) injury. Methods C57 mice were randomly divided into four groups; the Sham Control (sham group), the MI/R-Control (model group), the MI/R-Sevopre (pretreatment group) and the APN-KO-MI/R-Sevopre (knockout pretreatment group). The plasma adiponectin level was detected 24 h after MI/R modeling. Meanwhile, the left ventricular end-systolic diameter, end-diastolic diameter and ejection fraction were measured at 24 h. In addition, TUNEL staining was used to detect the left ventricular end-systolic diameter, end-diastolic diameter and ejection fraction and the morphology and apoptosis of myocardial cells in each group were observed. What' s more, the infarct area was observed by Evans blue TTC staining. Results Compared with sham group, model group had impaired heart function, decreased ejection fraction and increased end-diastolic and end-systolic diameters. Meanwhile, the myocardial infarction area and apoptotic cells significantly increased in model group, and the plasma adiponectin level decreased. However, compared with model group, mice in sevoflurane pretreatment group had improved heart function, decreased myocardial infarction area, decreased apoptotic cells and increased plasma adiponectin levels. And then, compared with pretreatment group, sevoflurane pretreatment in knockout pretreatment group reduced Ml/R injury. Conclusion The sevoflurane pretreatment protects MI/R injury by increasing plasma adiponectin levels.

Objective To develop a liquid chromatography-tandem mass spectrometry (LC-MS/MS) analytical method for the determination of oleandrin in blood and liver tissues, which could be applied to the cases of death caused by oleander poisoning.Methods Blood or liver tissues underwent a liquidliquid extraction (LLE) using ethyl acetate, and the extract was separated on an Agilent ZORBAX SB-C18column and eluted with a gradient of acetonitrile and 20 mmol/L ammonium acetate (containing0.1％formic acid).Oleandrin was detected using electrospray positive ionization (ESI+) with multiplereaction monitoring (MRM) mode.Results Oleandrin showed excellent linearity in both blood and liver samples in the corresponding linear range (r＞0.995 0), with detection limits 1 ng/mL and 2 ng/g, respectively, extraction recovery rates greater than 70.50％, both intra-and inter-day precisions less than10.71％, accuracies 98.42％-111.63％, and matrix effects 91.52％-106.39％.The method was successfully applied to a case of suspected oleander poisoning.Oleandrin was detected in the blood, urine, liver tissues, bile, stomach wall tissues and stomach contents of the cadaver, with the content ranging from65.5 to 29 600.0 ng/mL (ng/g).Conclusion The method developed in this study is simple and convenient to operate with good selectivity, and is suitable for the analysis of oleandrin in biological samples such as blood and liver tissues, which can provide technical support for forensic identification and clinical diagnosis and treatment of oleander poisoning.

In recent years, new orthopaedic implantable devices continue to emerge, which require higher requirements for technical evaluation. Animal study is an important part of the research and development process for the new orthopedic implantable devices, which provides relevant evidence for product design and stereotyping. By introducing the purpose of animal study, and the application of 3R principle (replacement, reduction, refinement) in this field, we summarize the concern on the animal study, in order to provide reference for the development and research of new orthopedic implantable devices and biomaterials. At the same time, the application of evidence-based research methods such as systematic review in the field is introduced, which provides new tools and approaches for the technical review and regulatory science.
Animals ; Orthopedics ; Biocompatible Materials ; Prostheses and Implants ; Research Design

The ossicular replacement prosthesis should have good biocompatibility, stability, easy to install, and excellent sound transmission capacity. In this study, the characteristics of ideal materials for the ossicular replacement prosthesis were analyzed by searching the types of materials used in clinical practice and comparing the advantages and disadvantages of various materials and structures. At the same time, in combination with the current evaluation requirements and evaluation experience, the focus of the performance research project of ossicular replacement prosthesis in the process of registration is discussed to clarify the performance evaluation requirements of these products, so as to provide reference for the future work of manufacturers and regulators. The performance evaluation of ossicular replacement prosthesis focuses on its mechanical properties, fixation stability, sound transmission characteristics, biological characteristics, and magnetic resonance compatibility.
Ossicular Prosthesis ; Ossicular Replacement ; Sound ; Prosthesis Design ; Treatment Outcome

Objective To determine the survival rate of HIV/AIDS patients after receiving free antiretroviral treatment in Dehong prefecture, Yunnan province. Methods A retrospective cohort analysis was conducted on all the HIV/AIDS patients aged over 16 years who had started antiretroviral treatment during January 2007 throughout December 2009 in Dehong prefecture.Results A total of 3103 HIV/AIDS patients had received antiretroviral treatment during the study period. Among them, the mean age was (36.0 ± 9.9) years and 62.4% were males. 66.2% of them were infected with HIV through heterosexual transmission, and the mean treatment follow-up time was 21.7 months. Most patients well complied with the treatment, i.e., the average times of not taking the medicine were less than 5 per month. The cumulative survival rate of antiretroviral treatment after 1, 2, 3, 4, and 5 years were 0.95, 0.94, 0.93, 0.92, and 0.92, respectively. Data from the Cox proportional hazard regression model analysis indicated that, after adjustment for age, gender, and marital status, the baseline CD4+T cell counts and transmission route could significantly predicate the rates of survival. Those who were with baseline CD4+T cell counts as 200-350/mm3 were less likely to die of AIDS than those with CD4+T cell counts ＜200/mm3 (Hazard Ratio or HR=0.16, 95%CI:0.09-0.28), and HIV-infected through mother-to-child transmission or routes other than heterosexual transmission were less likely to die of AIDS than through injecting drug use (HR=0.35, 95% CI:0.13-1.00). Conclusion Free antiretroviral treatment had significantly improved the survival of HIV/AIDS patients. Earlier initiation of antiretroviral treatment was likely to have achieved better survival effects.

OBJECTIVES: To detect the genotype of ABO blood group by SNaPshot technology. METHODS: DNA were extracted from the peripheral blood samples with known blood groups （obtained by serology） of 107 unrelated individuals in Yunnan. Six SNP loci of the 261th, 297th, 681th, 703th, 802th, and 803th nucleotide positions were detected by SNaPshot Multiplex kit, and relevant genetics parameters were calculated. RESULTS: In 107 blood samples, the allele frequencies of types A, B, O^A, and O^G were 0.355 1, 0.168 2, 0.230 0 and 0.247 6, respectively, while that of types A^G and cis AB were not detected. The genotyping results of ABO blood group were consistent with that of serologic testing. CONCLUSIONS SNaPshot technology can be adapted for genotyping of ABO blood group.
ABO Blood-Group System/genetics* ; Alleles ; Asian People/genetics* ; China ; DNA ; Ethnicity ; Gene Frequency ; Genotype ; Humans ; Polymerase Chain Reaction/methods* ; Polymorphism, Restriction Fragment Length