Objective: To analyze the effect of different stress levels noninvasive mask BiPAP ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with type Ⅱ respiratory failure. Methods: From January 2015 to June 2017, 120 patients of AECOPD with typeⅡrespiratory failure in Jincheng People's Hospital were randomly divided into three groups by the random number table, with 40 cases in each group.The suction pressure of A group was set to 10-14cmH₂O.The suction pressure of B group was set to 15-19cmH₂O, while the suction pressure of C group was set to 20-25cmH₂O.The clinical curative effect of three groups was compared. Results: The PaO₂ level of three time points among the three groups were compared by repeated measurements of variance.The results showed that after treatment for 24h, the PaO₂ levels of A group, B group and C group were (57.15±5.03)mmHg, (60.28±5.21)mmHg and (58.38±6.06)mmHg, respectively.After treatment for 72h, the PaO₂ levels of A group, B group and C group were (63.02±6.08)mmHg, (80.16±5.28)mmHg and (70.07±5.23)mmHg, respectively.After treatment for 168h, the PaO₂ levels of A group, B group and C group were (70.11±60.28)mmHg, (86.35±5.01)mmHg, (79.26±5.16)mmHg, respectively.The results showed that the difference in PaO₂ of different groups was statistically significant (F=8.514, P<0.001), and there was significant difference in PaO₂ at different time points (F=13.681, P<0.001), and there was interaction between groups (different processing formulas) and time points (F=9.872, P<0.001). There was an interaction between PaCO₂ and PaO₂/FiO₂ in the groups and time points (P<0.001). The rank sum test was used to compare the curative effect among the three groups.The Z value was 17.512 (P<0.001), and the comparison with the cutting probability method showed that the effective rate of B group was significantly higher than that of A group and C group (P<0.012). Conclusion 15-19cmH₂O inhalation pressure can significantly improve the effect of non invasive mask BiPAP treatment for AECOPD with type II respiratory failure, and the improvement of blood gas index is better with time.

BACKGROUND:Condylar fracture can occur under direct and indirect forces, and however, its risk and correlation with the impact site are rarely reported. OBJECTIVE:To quickly establish normal mandible three-dimensional finite element model and to analyze the strain conditions of the condyle under force at different parts of the mandible. METHODS: An adolescent volunteer was examined by multilayer spiral CT scans, whose mandible was normal and oral cavity was healthy. We used the reverse engineering software Mimics and large finite element software MSC.Patran to establish the three-dimensional finite element model of the mandible and to verify the feasibility of the model in the impact test at the body of the mandible, chin, mandibular angle and condyle. RESULTS AND CONCLUSION:A rapid establishment of mandible dimensional finite element biomechanical model could reproduce the morphology of the mandible, which was able to obtain the overal visual impression of the mandibular condyle. Geometric model included 80 044 nodes and 18 441 units. The mandibular chin, one side of the body, mandibular angle and condyle were given 100 N force respectively. The maximum equivalent stress of the bone cortex appeared in condylar region. So the mandibular condylar fractures were at the greatest risk. Experimental results contribute to mechanicaly analyze the condylar fracture type and to judge the severity of fractures.

Objective To investigate the impact of optical coherence tomography(OCT) imaging on physician decision-making during primary percutaneous coronary intervention(PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Methods From January 2016 to May 2017, OCT was performed in 100 cases pre- and post- primary PCI. The pathogenesis of myocardial infarction was determined and immediate effect of PCI evaluated by OCT. Clinical outcome during a 12-months follow up was analyzed. Results The data from 17 patients were excluded for further study due to poor OCT images quality. The rates of plaque rupture, plaque erosion, calcification nodules, stent malapposition and coronary spasm were 65.1％(54/83), 26.5％(22/83), 3.6％(3/83), 2.4％(2/83) respectively among the remaining 83 patients with sufficient OCT quality images. of the overall rate of stent malposition, tissue prolapse and incomplete stent expansion was 21.7％(18/83). The incidence of edge dissection was 19.3％(16/83), and among them 2 patients required treatment with stent implantation. Among the 17 patients without stenting:coronary spasm were found in 2 cases, thrombus overload in 1 case after thrombus aspiration, plaque rupture in 7 cases , plaque erosion in 4 cases and stent malposition in 3 cases. One patient died in hospital for cardiogenic shock and one patient had subacute stent thrombosis . There were no major adverse cardiac events occurred in the remaining patients during the (11.0±4.0) months of follow-up. Conclusions OCT can identify nonoptimal stent deployment in approximately one-fourth of STEMI patients undergoing primary PCI, thus providing preliminary guidance to the physician for further mangement.

OBJECTIVEThis preliminary study aims to investigate the effects of titanium and titanium alloy micro-nano-dimensional topography on the biological behavior of osteoblasts in vitro.

METHODSElectrolytic etching (EE) method was used to produce micro-nano dimensional titanium surfaces. The surfaces were observed to determine their effects on the adhesion, proliferation, cell morphology, and alkaline phosphatase (ALP) activity of osteoblasts.

RESULTSThe surfaces of the titanium and titanium alloy groups exhibited higher adhesion and proliferation of osteoblasts than those of the mechanical group. The titanium surface was covered with a group of cells, a large number of filopodia, and functional particles. The ALP activity of the titanium group was significantly higher than that of the titanium alloy and mechanical groups.

CONCLUSIONEE method in pure titanium and titanium alloy surfaces result in bowl-like nests and nanostructures of different diameters and depths. The diameters of the pure titanium and titanium alloy surfaces range from 30 to 50 μm and 5 to 8 μm, respectively. The former is more conducive to promote the proliferation and differentiation of cells.

Alloys ; Cell Differentiation ; Cell Proliferation ; Dental Etching ; Humans ; Nanostructures ; Osteoblasts ; Prostheses and Implants ; Surface Properties ; Titanium

Objective To evaluate the therapeutic effect of pulmonary carcinoma by bronchical arterial infusion (BAI) and bronchical arterial infusion with the addition of pulmonary arterial infusion (PAI).Methods Totally 69 cases with pulmonany cancinoma were treated by intervention therapy .Of them ,38 cases were undergone the bronchical arteriography and arterial infusion and 31 cases were undergone the brochical pulmonany arterial dual infusion.Results The bronchical arteryies taken part in the blood supply of neoplasmin all cases ,while the pulmonany artery only in 77% of cases .The effective ratio of BAI +PAI was 87%, and BAI was 65.7%,there were markly different (?

OBJECTIVETo discuss the surgical skill, treatment effect and indications for reconstruction of vertebral lamina with skull titanium plate and autograft in the treatment of thoracolumbar vertebrae fracture.

METHODSFrom March 1999 to April 2007, 33 patients with thoracolumbar vertebrae fracture combined nerve injury were treated by reconstruction of vertebral lamina with skull titanium plate and autograft including 30 males and 3 females with an average age of 41 years ranging from 21 to 66. The fracture involved 3 cases in T11, 9 in T12, 16 in L1, 3 in L2 and 2 in L3. There were 12 cases with flexion fracture, 8 with extension fracture, and 13 with burst fracture. Five cases performed emergency operation and in the others the time from injury to operation was 5 to 12 days. GSS fixation was applied in 25 cases and AF in 8. The volume of vertebral canal, the stability of the spine, the height of vertebrae, and the nerve function were observed before and after operation.

RESULTSThese 33 patients were followed up for 1 to 3 years (means 25 months). The height of anterior column of the involved vertebrae changed from 58% to 96%, the cobb angle return from average of 26 degree to 2 degree, the volume of vertebral canal extended from 43% to 92%, respectively, when compared between preoperatively and postoperatively.

CONCLUSIONReconstruction of vertebral lamina with skull titanium plate and autograft which is a simple and safe treatment for thoracolumbar vertebrae fracture can increase the stability of spine and avoid second canal stenosis.

Adult ; Aged ; Bone Transplantation ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; Titanium ; pharmacology ; Transplantation, Autologous ; methods ; Young Adult

OBJECTIVETo evaluate the effects of ALT, HBsAg and HBV DNA at the baseline, 4 and 12 weeks after lamivudine treatment on the long term (104 weeks) response in e antigen-negative chronic hepatitis B patients.

METHODS127 adult e antigen-negative chronic hepatitis B patients were enrolled in this study. All patients received treatment on LAM 100 mg/d for at least 104 weeks. The liver function, serum HBV markers and HBV viral load were regularly checked during the treatment. The effects of ALT, HBsAg and HBV DNA at the baseline, 4 and 12 weeks after lamivudine treatment on the response at 104 weeks were statistically analyzed.

RESULTSThe proportion of patients with serum HBV DNA less than 1000 copies / ml at 104 weeks after LAM treatment was 50.0% and 86.8% in patients with baseline ALT less than 5 ULN and ALT is more than or equal to 5 ULN, respectively (P less than 0.01). In patients with baseline HBsAg less than 2000 COI and HBsAg is more than or equal to 2000 COI, the proportion of patients with serum HBsAg less than 500 COI at 104 weeks after LAM treatment was 19.1% and 17.5%, respectively (P more than 0.05). the HBsAg serological conversion rates were respectively 2.1% and 2.5% , respectively (P more than 0.05), the proportion of patients with serum HBV DNA less than 1000 copies/ml was 61.7% and 67.5%, respectively (P more than 0.05). In patients with baseline HBV DNA less than 10(6) copies/ml and HBV DNA is more than or equal to 10(6) copies/ml, the proportion of patients with HBV DNA less than 1000 copies/ml were statistically different at 4 weeks and 12 weeks after treatment, however, the proportion of patients with HBV DNA less than 1000 copies/ml at 104 weeks after LAM treatment was 62.7% and 67.1%, respectively (P more than 0.05). In patients with HBV DNA less than 1000 copies/ml and HBV DNA is more than or equal to 1000 copies/ml at 4 weeks after treatment, the proportion of patients with HBV DNA less than 1000 copies/ml at 104 weeks after LAM treatment was 70.7% and 60.9%, respectively (P more than 0.05). In patients with HBV DNA less than 1000 copies/ml and HBV DNA is more than or equal to 1000 copies/ml at 12 weeks after treatment, the proportion of patients with HBV DNA less than 1000 copies/ml at 104 weeks after treatment was 78.8% and 38.1%, respectively (P less than 0.01).

CONCLUSIONe antigen negative chronic hepatitis B patients with baseline ALT is more than or equal to 5 ULN and HBV DNA less than 1000 copies/ml at 12 weeks after treatment have better virological response at 104 weeks after LAM treatment. The baseline HBsAg and HBV DNA load are associated with the virological response at 104 weeks after LAM treatment.

Administration, Oral ; Adult ; Aged ; Alanine Transaminase ; blood ; Antiviral Agents ; pharmacology ; therapeutic use ; DNA, Viral ; blood ; Female ; Follow-Up Studies ; Hepatitis B Surface Antigens ; blood ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; blood ; drug therapy ; virology ; Humans ; Lamivudine ; pharmacology ; therapeutic use ; Male ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Time Factors ; Treatment Outcome ; Viral Load ; Young Adult