This article introduces a measurement circuit for Respiratory Mechanics Parameters which is based on differential pressure sensor. The circuit detects the flow and airway pressure signals from the sensors, then more than ten Respiratory Mechanics Parameters are identified. The system meets the clinical need of Respiratory Mechanics measurement, and improves the performance of domestic Patient Monitor.

AIM To investigate the effect of tocotrienol rich fraction of palm oil (TRF) on glucose metabolism in atherosclerotic mice and the possible mechanism. METHODS Apolipoprotein E gene deficient(ApoE~(-/-)) mice were divided into 3 groups as model control, TRF 0.05% and 0.2%(W/W) groups. 10% (W/W) fat and 0.2% (W/W) cholesterol were added into the diets to induce atherosclerosis formation. Oral glucose tolerance test and insulin tolerance test were conducted after mice were treated by TRF for 12 and 14 weeks respectively. Serum cholesterol, triglyceride, free fatty acid, and insulin levels were measured using corresponding kits. The mRNA expression levels for peroxisome proliferator-activated receptor γ(PPARγ), adiponectin and glucose transporter 4 (Glut4) in white adipose tissue (WAT) were determined by using quantitative real-time PCR. Activation of PPARγ by TRF was tested using luciferase reporter assays. RESULTS Compared with the model control group, TRF decreased non-fasting or fasting blood glucose levels and improved insulin sensitivity of ApoE~(-/-) mice. Both TRF groups showed decreased levels of triglyceride and free fatty acid. The mRNA level of adiponectin in WAT was up-regulated by (1.73±0.32) times in TRF 0.2% group compared with the control group. Glut4 mRNA level was increased (1.89±0.24) and (2.01±0.61) times compared with control group in TRF 0.05% group and TRF 0.2% group respectively. The fold inductions of TRF on PPARγ-ligand-binding domain, PPARγ1 and PPARγ2 activities were (2.7±0.2), (6.1±0.65) and (5.3±0.1) times compared with DMSO by using luciferase reporter assay. CONCLUSION TRF can improve glucose metabolism in atherosclerotic mice and this effect may be partly due to modulating the activity of PPARγ.

Objective To research the effect of perioperative thermal preservation on hemostatic function in elderly patients with laparoscopic rectal cancer resection.Methods Eighty-six elderly patients with laparoscopic rectal cancer resection with ASA Ⅰ-Ⅱ were randomly divided into control group (43 patients) and test group(43 patients).Control group was given routine operation,test group was given routine operation and thermal preservation.The nose pharynx temperature was monitored and recorded respectively on preanesthesia,30,60,90 min post-anesthesia and after operation.The level of prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT),platelets (PLT),D-dimer(DD),fibrinogen (FBG),yon Willebrand factor (vWF) were detected on preanesthesia,30,60,90 min post-anesthesia and 24,48 h post-operation.Results The temperature in control group on 30,60,90 min pest-anesthesia and after operation [(36.1 ± 0.2),(36.0 + 0.1),(35.7 + 0.1),(35.6 ± 0.2) ℃] was significantly lower than that on preanesthesia [(36.8 ± 0.2) ℃] and the same time in test group [(36.8 ± 0.0),(36.7 ± 0.1),(36.7 +0.2),(36.8 ±0.2) ℃] (P ＜0.05).The level of PT,APTT and TT in control group on 30,60,90 min post-anesthesia and after operation were significantly longer than those on preanesthesia and the same time in test group (P ＜0.05).The level of PLT in control group after operation and on 24,48 h post-operation were significantly lower than preanesthesia and the same time in test group(P ＜ 0.05).The level of DD and vWF in control group on 24,48 h post-operation were significantly higher than preanesthesia and the same time in test group (P ＜ 0.05).The level of FBG in control group on 24,48 h post-operation were significantly lower than preanesthesia and the same time in test group (P ＜ 0.05).The hemostatic function had no significant change in test group (P ＞0.05).Conclusion The perioperative thermal preservation in elderly patients with laparoscopic rectal cancer resection can alleviate hemostatic function suppression and promote recovery.

Objective To measure the serum levels of endothelin-1 (ET-1) and transforming growth factor-β(TGF-β) in the newborns with respiratory distress and investigate its clinical significance. Methods Newborns with respiratory distress hospitalized into the Newborn Intensive Care Unit were included. The serum levels of ET-1 and TGF-β were all detected with ELISA in the first six hours,3,7,14 and 28 days after birth. Results The highest levels of ln ( 1 + ET-1 ) and ln ( 1 + TGF-β) were obtained from newborns with diagnosis as meconium aspiration syndrome ( 1.95 ± 1.02) ng/L and ( 1.51 ±0.99) ng/L,respectively) in the samples obtained in the first six hours after birth, and these were statistically different from those of the control group ( P ＜ 0. 05 ). Following were obtained for newborns with respiratory distress syndrome ( ( 1.52 ± 0.74 ) ng/L and ( 1.13 ± 0. 48 ) ng/L, t = 2.28,2. 13,respectively). After oxygen treatment, ET-1 levels obtained in the first six hours of life decreased gradually in the following days (P ＜0.05 ). Conclusions The measurements of ET-1 and TGF-β levels will help in differentiating diagnosis of the respiratory distress of newborns. The ET-1 levels will help to assess the therapy effectiveness and prognosis.

Objective To describe the clinical characteristics of 9 cases of idiopathic pulmonary alveolar proteinosis (iPAP) with secondary infections. Method The clinical and radiological data of 9 patients with iPAP and secondary infections admitted into Peking Union Medical College Hospital from 1 st January 1990 to 1st January 2010 were retrospectively analyzed. Results In that period, there were 97 patients of iPAP were admitted in our hospital. There were 9 patients of iPAP with secondary infections,aged (46.4±14.6)y. There were 5 males and 4 females. Among them, 6 patients were misdiagnosed as interstitial pneumonia and corticosteroids were given to them. When the infection appeared, corticosteroids were still given to 3 patients, and the other 3 patients had stopped corticosteroids for 3 to 15 and a half months. Five patients had accepted mono-lung or whole lung lavage before 1,2, 9, 14,24 months. The clinical manifestations were fever(8 cases) ,cough(9 cases) , expectoration(8 cases) ,hemoptysis(2 cases),chest pain(1 case) and moist rales(1 case). Glass-ground opacities (9 cases) and cavitations(4 case)were the main manifestations of chest radiology. Pleural effusions(1 case) was not common. The locations of infection was limited in chest:9 cases had pulmonary infection and one case was associated with pleurisy.The infectious pathogens were the acid-fast tubercle bacillus (4 cases), fungus (3 cases, candida albicans,penicillium and aspergillus fumigatus for each one) and norcardia (2 cases, one case was associated with cytomegalovirus infection). Follow-up: 6 patients were cured, 1 patient was improved and 2 patients were died. Conclusions For patients with iPAP, especially when they had been receiving corticosteroids, if they had fever and/or recently exaggerated dyspnea, especially whose chest radiology showed nodules and cavitations, the clinicians should be aware of infections diseases for them. Further specific microbiological studies and sufficient therapy should be obtained as quickly as possible.

Endoscopic ultrasound was initially introduced in 1980s as a diagnostic modality combining echoendoscopes with radial scanning, which permitted reconstruction of cross-sectional images similar to computed tomography. Many studies showed that endogastric ultrasonography is more accurate than endoscopy or CT in evaluating the depth of invasion ( T category) and the involvement of lymph nodes (N category) in patients with gastric carcinoma. In addition to being very useful in tissue acquisition for diagnostic purposes, the principles behind endoscopic ultrasound-guided fine needle aspiration ( FNA) paved the way for the development of therapeutic endoscopic ultrasound, which improve the prognosis of patients with gastric cancer.

This article summarizes our experience in nursing 40 gastric carcinoma patients receiving fast track(rapid recovery) surgery,proposing that the emphasis of nursing should be placed on psychological care and health education before the operation,warm-keeping during the operation,pain control,early food intake,early movement and management of complications after the operation,and necessary follow-up after discharge.

Objective To investigate the mid-term effect of SolitaireAB stent-assisted interventional embolization with spring coils for the treatment of intracranial wide-necked aneurysms. Methods During the period from May 2009 to April 2013, a total of 49 patients with intracranial wide-necked aneurysm (49 aneurysms in total) received SolitaireAB stent-assisted interventional embolization treatment at authors’ hospital. In 41 patients, a total of 41 aneurysms were detected, of which ruptured aneurysm with bleeding was confirmed in 26 and un-ruptured aneurysm in 15. These 41 patients were followed up for 12-48 months. Based on modified Rankin scoring and DSA, CTA or MRA manifestations, the clinical results were evaluated. Results After the embolization treatment, re-bleeding of the aneurysm occurred in 2 cases, cerebral infarction in 3 cases, occlusion of the parent artery in one case and death in one case; the occurrence rate of complications was 14.2%. DSA, MRA or CTA performed at 12 months after the embolization treatment, showed that 32 aneurysms (78.0%) were completely obstructed, which was obviously higher than that observed on DSA performed immediately after the embolization procedure (21 aneurysms, 42.9%), the difference was statistically significant (P=0.02);residue of aneurismal neck was seen in 7 cases (17.1%) and partial occlusion in 2 cases (4.9%), which were much better than those observed on DSA that was performed immediately after the embolization procedure. Twenty-four aneurysms (58.5%) remained stable, showing no any change, and recurrence of aneurysm was observed in 4 cases (9.7%). At the last follow-up exam, the modified Rankin scoring showed that 0 point was seen in 18 cases (43.9%), one point in 10 cases (24.4%), 2 points in 5 cases (12.2%), 3 points in 4 cases (9.8%), 4 points in 2 cases (4.85%) and 5 points in 2 cases (4.85%). The self-care rate for daily activities was 80.5%, the prognosis was good. Conclusion For the treatment of intracranial wide-necked aneurysms, SolitaireAB stent-assisted interventional embolization with spring coils is safe and effective. This technique can improve the embolization rate and reduce the procedure-related complications.

Objective To master the epidemic situation and control effect of schistosomiasis in Yugan County,Jiangxi Prov-ince. Methods The data of the schistosomiasis prevalence in human and cattle as well as Oncomelania hupensis snail status were collected and the change trends were analyzed in Yugan County from 2008 to 2012. Results The schistosome infection rates of residents in Yugan County have declined every year since 2008,and currently,the prevalence of schistosomiasis was at a low lev-el. No acute schistosomiasis case was found during the past 5 years. In 2012,the infection rate of bovine was above 1%in 88 en-demic villages,and the area with schistosome infected snails was 10 hm2. Conclusion In order to achieve the goal of schistosomi-asis transmission control in the whole county in 2015,the comprehensive control measures based on infection source control should be strengthened.

In 1989, Fitz defined and classified severe acute pancreatitis (SAP) and he thought that surgical treatment of SAP is feasible. Since then, the strategy of treating SAP was a controversial issue over past decades. Currently, relevant literatures reported that medical or minimally invasive treatments are superior to surgical treatment, while it is too early to make the final conclusion because of the complexity of SAP. From 1989 to 2008, 1852 patients with acute pancreatitis were treated at the General Hospital of PLA, and the clinical data of 18 patients who died of SAP were retrospectively analyzed. Based on the analysis, we concluded that medical conservative therapy and surgical operative therapy should not be opposed to each other. Selecting ideal timing and appropriate operation on the basis of pathological changes of retroperitoneum and pancreatitis should be considered seriously, and the new concept of "miniaturization of trauma" should also be introduced in treating SAP.