It is difficult to select the appropriate ventilation mode in clinical mechanical ventilation. This paper presents a nonlinear multi-compartment lung model to solve the difficulty. The purpose is to optimize respiratory airflow patterns and get the minimum of the work of inspiratory phrase and lung volume acceleration, minimum of the elastic potential energy and rapidity of airflow rate changes of expiratory phrase. Sigmoidal function is used to smooth the respiratory function of nonlinear equations. The equations are established to solve nonlinear boundary conditions BVP, and finally the problem was solved with gradient descent method. Experimental results showed that lung volume and the rate of airflow after optimization had good sensitivity and convergence speed. The results provide a theoretical basis for the development of multivariable controller monitoring critically ill mechanically ventilated patients.
Exhalation ; Humans ; Lung ; physiology ; Models, Biological ; Nonlinear Dynamics ; Pulmonary Ventilation ; Respiration ; Respiration, Artificial ; Tidal Volume

Objective Our aim is to study the clinical manifestation and endocrine disorder of the bulimia nervosa (BN). Methods 2 cases of BN were clinically analysed. Results Most of the patients were anorexia before the disease happened, with many aspects of endocrine disorders. Conclusions BN and amenorrea could result from hypothalamus function disorders. However, the alteration of corticoid,thyroid hormones may be results of emotion stress and body weight loss.

Objective To investigate the surgical treatment of coronary malperfusion due to acute type A aortic dissection.Methods The clinical data of 305 consecutive patients with type A aortic dissection, who were hospitalized and underwent operation between 2004 and 2015, were analyzed retrospectively.Among that, there were 37 cases with coronary malperfusion due to aortic dissection.Results The right coronary artery was involved in 33 cases, the left in 2 cases, and both coronary arteries in 2 cases.There were 22 coronary bypass grafting using saphenous vein in 21 patients, including 20 patients with the right coronary bypass grafting and 1 patient with the left.Six patients died postoperatively, with the mortality of 16.22％.Conclusion Acute type A aortic dissection with coronary involvement is associated with high mortality rate, which is necessary to restore the coronary revascularization as soon as we can.The methods to reconstruct the involved coronary is depend on the patients' condition and experience of surgeon.

BACKGROUND: The biological functions of platelet-rich plasma (PRP) are affected by multiple factors, such as individual difference, PRP concentration, PRP carder, PRP-activated methods and so on. OBJECTIVE: To evaluate the effect of PRP, activated by different concentrations of thrombin, on the repair of cranial defects. METHODS: Whole blood of the central artery of rabbit ears was extracted to prepare PRP, which was then diluted so that the final platetet count was about 5 times of the whole blood. Four whole-thickness layer of cranial defects at an 8-mm diameter were created in 16 New Zealand rabbits and randomly grafted with β-tdcalcium phosphate (β-TCP) and PRP, activated by 60 U/mL. thrombin; β-TCP and PRP, activated by 1 000 U/mL thrombin; β-TCP and PRP; β-TCP alone. At 1 and 3 months following implantation, X-ray analysis and microscopic observation were performed to onserve cranial repair, the area percent of new bone formation was calculated. RESULTS AND CONCLUSION: At one month post-surgery, the edge of defects was clear in each group, with varying degrees of new bone formation surrounding the defects, β-TCP particles partially degraded and the degradation lesion was replaced by new bone, only a small amount of bone lacunae was seen, fiber wrapped around the defect center β-TCP, only a small number of specimens showed new bone formation; X-ray showed a clear boundary and uniform defect density; the percentage of new bone formation in the PRP groups were higher than β-TCP groups (P < 0.05). However, there was no significant difference between PRP group groups (P > 0.05). At 3 months post-surgery, the defect boundary was unclear in each group, the new bone formation increased, the β-TCP particles surrounding defects partially or all degraded and were replaced by new bones, some regions appeared trabecular bone, bone lacuna in new bone was increased, the central defect of the majority of specimens exhibited new bone formation; X-ray showed defect boundary was unclear in each group, defect surrounding density was higher than the center defect, and bone mineral density was equivalent to other normal parts; the percentage of new bone formation in the PRP groups was significantly higher than that in the β-TCP groups (P < 0.05), PRP +β-TCP group was higher than the other 3 groups (P <0.05), there was no significant difference between two thrombin groups (P > 0.05). It is indicated that although PRP improves the repair of cranial defects, 60 and 1 000 U/mL of thrombin has no effects on PRP rapairing cranial defects in New Zealand white rabbits, compared with PRP+β-TCP group, possible the absence of the optimal concentration of thrombin.

BACKGROUND: Studies have demonstrated that exogenous basic fibroblast growth factor (bFGF) has intensive effects to promote proliferation of gingival fibroblasts (GFs) cultured in vitro and the heeling of gingival wounds. OBJECTIVE: To investigate the effects of bFGF gene transfection on the biological performance of Beagle canine GFs. DESIGN, TIME AND SETTING: An observation and comparison in vitro experiment regarding cells was accomplished in Centre of Cell Biology and Development of Fujian Medical University and Department of Comparative Medicine in Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from April to September of 2008. MATERIALS: Four beagle dogs, male, 12 months old, weighing 10-13 kg were used in this experiment, plRES2-EGFP-bFGF plasmid containing full-length human bFGF gene cDNA was constructed and conserved by our institution. METHODS: Free gingiva of the 2nd, 3rd and 4th premolars were excised from left upper jaw of Beagle dogs, dnsed with aseptic phosphate buffer four times, then cut into pieces and digested with 2.5 g/L pancreetin for 2 hours at 37 ℃. After the cantrifugation and supernatant removal, DMEM containing 10% fetal bovine serum was added to incubate on 6-well plate with coverlips in 5% CO2 incubator at 37 ℃. Logadthrnically growing cells were digested and passaged. GFs were transfected with pIRES2-EGFP-bFGF plasmid using liposome mediated method, while vacant plasmid transfection and un-transfection group served as controls.MAIN OUTCOME MEASURES: Proliferation and apoptosis feature of the GFs were evaluated by M'rE and AOEB, respectively. The activity of alkaline phosphatase was assayed by chemical coledmetry. RESULTS: All of three groups cells entered log phrase on three days after transfection. MTT results showed that the proliferation of GFs transfected with bFGF was greater than cells transfected with vacant vector and untransfected cells (P < 0.05). AO/EB dyeing showed the apoptosis rate of GFs transfected with bFGF was reduced compared with other two groups (P < 0.05). After bGFG gene transfection, the ALP activity remained unchanged and there was no significant difference compared with untransfected cells.CONCLUSION: The transfection of bFGF gene to GFs can promote the proliferation of GFs and depress the apoptosis. No promotion is present with regard to the GFs differentiation.

Objective To investigate the clinical changing trend and CT imaging diagnosis of thyroid cancer associated with thy-roid disease .Methods 1 120 cases of thyroid cancer patients admitted in our hospital in the past 10 years were selected and devided into different groups according to their admission times :patients admitted before 2003 were in one group;from 2003 on ,patients were divided into groups according to their admission time by a time span of 2 years ;then the changing trend and CT imaging diag-nosis of thyroid carcinoma with nodular goiter (NG) ,thyroid adenoma (TA) and merger trend of Hashimoto′sthyroiditis (HT ) of different times were compared and analyzed .Results There were 518 cases of papillary carcinoma(46 .25% ) ,345 cases of follicular adenocarcinoma ,(30 .80% ) ,158 cases of medullary carcinoma (14 .11% ) ,99 cases of undifferentiated carcinoma (8 .84% ) in 1120 patients .The occurrence rate of thyroid carcinoma with nodular goiter (NG) in 2009-2010 ,2011-2012 and the occurrence rate of thyroid carcinoma with HT in 2007-2008 ,2009-2010 ,2011-2012 were significantly higher than that of 2005-2006 (P<0 .05) . Take 2007-2008 as the deviding line of thyroid combined TA ,and it shows that the occurrence rate increased continuously before this line and started to drop down after that .CT of thyroid cancer shows uneven low-density imaging ,blur edge ,and inhomogeneous enhancement .The CT characteristics differ from different diseases .Conclusion In recent years the incidence rates of thyroid with nodular thyroid and HT increased significantly compared with the years before ,while incidence rate of TA decreased .

BACKGROUND: Research on seed cells is the most important aspect in the filed of tissue-engineering research, and because of their various ad vantages, bone marrow mesenchymal stem cells (BMSCs) have been taken as the ideal bone tissue-engineering seed cells. OBJECTIVE: To observes the growth characteristics of in vitro cultured BMSCs and their osteogenetic characteristics under non-inducing conditions. DESIGN: A single sample experiment.SETTING: Implanting Center of Stomatological Hospital of Fujian Medical University MATERIALS: This experiment was conducted at the Central Laboratory of Stomatological Hospital of Fujian Medical University, between May andDecember 2003. BMSCs are derived from the primary passage to the 3rd passage of in vitro cultured cells from 4 one-year old dogs. METHODS: Under the aseptic conditions, bone marrow puncture was made at bilateral femur trochanter and 5 mL of heparin anticoagulatedbone marrow was obtained. Then it was placed in 50 mL of anti-Dulbecco's modified Eagle's culture medium in centrifuge tube for monocyte isolation. The BMSCs single cells were primarily isolated and placed in culture box for subculture. After 48 hours, culture medium was removed and the medium was cha1ged once every 3 days. Then subculture was carried on continuously to observe BMSCs in morphology under inverted the phase contrast microscope with the assistance of HE staining. The number of cells was counted daily to calculate doubling time and to draw a growth curve. Alkaline phosphatase was detected by using calcium-cobalt method,and chinalizarin staining was used to detect the growth state of calcification tubercle. MAIN UTCOME MEASURES: ①Optical microscopic structure of dog BMSCs; ② The growth curve of dog BMSCs; ③Observation of osteogenetic index- alkaline phosphatase and calcification tubercle. RESULTS: ① Morphological observation indicated that BMSCs were adherent to the walls, clonogenic and appearing fibroblastic phenotype, and they presented morphological changes without exposing to osteogenetic inducer. ② The expression of Alkaline phosphatase in primary cells was stronger, and it was strong in the 1st passage cell, but weak in the 2nd and 3rd passage cells. ③Calcium deposition was observed, which was stronger in primary cells than in subcultured cells. CONCLUSION: ①BMSCs massively proliferated during in vitro culture,capable of differentiating into osteoblasts and considered as the optimal seed cells for bone tissue-engineering reconstruction. ② BMSCs derived from the 3rd passage has osteogenic activity, but the osteogenic activity of the primary cultured cells was stronger than thatr of the subcultured cells.

In order to investigate the effects of hyperbaric oxygen (HBO) on the proliferation and differentiation of human osteoblasts isolated from alveolar bone under various pressure and exposure time, osteoblasts from human alveolar bone were seeded in 24 well plates at a cell density of 2 500 cells per well. There are four treatment groups which were 2.4ATA for 90 min, 2.4ATA for 30 min, 1.5ATA for 90 min and 1.5ATA for 30 min. Osteoblasts culture were treated one time everyday for up to 10 days in a temperature and humidity controlled custom-made seven-litre hyperbaric unit. Control samples were incubated in a standard humidified incubator at 37℃ containing 5% CO2 and 95% atmospheric air. Proliferation of osteoblasts were evaluated by WST-1 assay before and 16 h after HBO on day 1,2,3,4,6,8,10. The cytotoxic effect of HBO on osteoblasts was assessed by a toxicology assay kit. For differentiation study, osteoblasts were seeded in 96 well plates at a cell density of 10 000 cells per well. After 3 days normal culture, medium was changed to osteogenic medium. Subsequently, cultures were exposed daily to HBO of 2.4ATA for 90 min and 1.5ATA for 90 min up to 13 days. Mineralization was evaluated by calcium deposition assay, alkaline phosphatase (ALP) activity and von Kossa staining. To assess the effect of pressure on cell proliferation and differentiation, hyperbaric air treatment was observed in this study. It showed that HBO treatment promotes proliferation of osteoblast in the presence of 10% foetal calf serum (FCS). No significant change in extracellular LDH activity before and after HBO treatment. The study of differentiation demonstrated that HBO enhanced differentiation associated with increased bone nodule formation, calcium deposition and alkaline phosphatase activity. These result suggests that HBO treatment significantly stimulated osteogentic differentiation, which implies a potential application of HBO in bone tissue engineering.

Objective This report is to compare the difference outcome between total arch replacement and hemi-arch replacement for Stanford type A aortic dissection.Methods The subjects were 208 consecutive patients,including 121 who received total arch replacement(group A) and 87 who had hemi-arch replacement(group B) for Stanford type A aortic dissection from August 2001 to July 2013 in Nanjing Hospital Affiliated to Nanjing Medical University.The cardiopulmonary bypass (CPB) time,average cross-clamping time,selective cerebral perfusion(SCP) time,complications,in-hospital mortality and follow-up after surgery were retrospectively compared between the A and B groups.Results The age,sex ratio,preoperative complications do not show a significant difference between the A and B groups.The CPB time [(247.68± 58.65) min vs (212.68±60.75) min,P =0.000],cross-clamping time[(154.85±45.96) min vs(137.83± 38.91) min,P =0.000] and SCP time [(36.98± 10.62) min vs(29.85± 13.46) min,P =0.000] of group A are all longer than group B.The incidence of postoperative complications(14.0％ vs 10.3％,P =0.619) and in-hospital mortality(9.1％ vs 8.0％,P =0.791) between the A and B groups do not have a significant difference.The mean time of follow-up differed significantly between two groups [(21.86± 18.89) months vs(61.23± 38.57) months,P =0.000] and did not differ in the rate of follow-up(94.5％ vs 96.3％,P =0.585).The rate of false lumen thrombosed at the proximal descending aorta showed a significant difference between the twogroups(91.8％ vs 23.8％,P =0.000),but the rate of secondary surgical intervention (0 vs 2.3 ％,P =0.095) and follow-up death (6.4％ vs 6.3 ％,P =0.975) do not.Conclusion For the Stanford type A aortic dissection patients,surgery is the only treatment that can save lives.Total arch replacement need more time in CPB,cross-clamping and SCP,but the complications,in-hospital mortality and follow-up death do not show a significant difference compared with hemi-arch replacement,and higher rate of false lumen thrombosed have been showed in total arch replacement.

0.05).In the treat groups seralbumin and plasma osmotic pressure showed significant difference before and after treatment(P0.05).CONCLUSION: There were some adverse effects in the rhGH treatment for malnutritional COPD patients,but they won't influence the treatment.