It is nonlinear relationship between breath sounds and respiratory flow rate, thus breath sounds might be a new solution for respiratory monitoring. The envelope of the breath sounds was created firstly. And the linear relationship between the logarithm of envelope and the respiratory flow rate was proved. Then model parameters were derived from every subject using regression analysis. Finally, using these parameters estimated respiratory flow rate was achieved by the logarithm of envelope with 14.9% error. Therefore, respiratory flow rate estimation and respiration monitoring based on breath sounds are feasible.
Humans ; Monitoring, Physiologic ; Respiratory Sounds

Objective To investigate the effect of recruitment maneuver(RM) on surfactant proteins in young piglets with acute lung injury and the possible mechanisms of lung recruitment after RM.Methods The piglet model of ALI was established by lipopolysaccharide intravenous injection,12 male piglets were randomly divided into two groups:conventional ventilation group(control group) and RM with low tidal volume group(RM group).After 8 hours of ventilation,mRNA expression of surfactant protein-A(SP-A),SP-B,SP-C,SP-D in the piglet lungs were determined by real time PCR and SP-A protein distribution was assessed by immunohistochemistry.Biochemical analyses of TP,total phospholipids(TPL),DSPC were conducted as well.SP-A levels in bronchoalveolar lavage fluid(BALF) and plasma were measured by enzymelinked immunosorbent assay(ELISA).Results As compared with control group,RM group had higher expression of SP-A,SP-B,SP-C and SP-D.SP-A average gray values of control group and RM group were 97.8±6.4 and 106.3±8.5,and there was significant difference(P＜0.01).RM group showed significant increase of TPL,DSPC and DSPC/TP.The concentration of SP-A in BALF was higher in RM group than that of the control group,however,SP-A plasma level was lower in RM group than that of the control group.Conclusion RM can increase suffactant protein expression in ALI animals,alleviate surfactant protein dysfunction and regulate the concentration of SP-A,which may improve alveolar recruitment following the RM and alleviate ventilator-induced lung injury.

Objective To evaluate correlation of CT features of tuberculous adrenal glands with duration of adrenal insufficiency and propose a new staging criteria for adrenal TB Methods CT features of 28 cases of documented adrenal tuberculosis were analysed retrospectively The patients were divided into 3 groups according to the duration of adrenal insufficiency: group A (10 cases , less than 1 year), group B (13 cases, 1 year to 4 years), group C (5 cases, longer than 4 years) The main CT features analyzed included size and shape of the adrenal gland, calcification ,and low density foci Results Enlargement of the adrenal gland: group A(10) , group B (13), group C (1) Basic configuration of adrenal gland were identifiable in group A ,whereas others had more irregular shape Calcification: group A (2) , group B (11),group C (5) Low density foci: group A (3), group B(0), group C (0) Conclusion CT features of adrenal glands correlated with duration of adrenal insufficiency in adrenal tuberculosis It is more reasonable to use tri phase criteria according to CT appearance in adrenal tuberculosis

Objective To overview the clinical and endoscopic features of the ischemic colitis. Methods Retrospective analysis was conducted. Results Of the 60 cases, 87% were over 50 years, and females were more than males. 76.7% of the cases were associated with the basal diseases such as cardio cerebrovascular disorders, diabetes and hematological diseases as well as the history of abdominal operation. Colonoscopy showed mucosal edema, congestion, erosion and ulceration. 87.1% of the cases were cured after treatment and 16.7 % were improved. The outcome may be associated with the age, severity of the lesion, course, basal diseases and the complications. Conclusions Endoscopy plays a vital role in the early diagnosis of ischemic colitis.

Objective　To explore the clinical superiority of two kinds of chopping nucleus methods in phacoemulsification——etch and turn technique, stop and chop technique.Methods　Three hundred and sixty-five eyes were performed with phacoemulsification, among which 85 eyes were performed with turn technique and 280 eyes were performed with chop technique.The results of the two kinds of chopping nucleus were analyzed.Results　(1)Time of chopping nucleus:time of turn technique averaged 81.26 seconds while chop technique averaged 40.71 seconds; (2)Visual acuity in the first week after operation:turn technique:vision of 76 of 85 eyes were 0.5 of better, 7 eyes were 0.2～0.5(8.2%) and 2 eyes were 0.2 or worse; chop technique: vision of 253 of 280 eyes were 0.5 or better (90.4%), 21 eyes were 0.2～0.5(7.5%) and 6 eyes were 0.2 or worse (2.1%);(3)Reaction of corneal endothelial cells after the operation: central endothelium rugosity appeared in 4 eyes (4.7%) with turn techinque and in 7 eyes (2.5%) with chop technique. Conclusion　The operation of the former is less difficult and the chopping nucleus time is longer. The time of the operation on the latter is shorter and it is appriate for hard nucleus and should be applied and spreaded. There are no marked differences as for the vision after the operation and the microcorneal injury between them.

Objective To investigate the distribution of hepatitis B virus(HBV) genotypes ,drug resistance situation of hepatitis B patients and the relation between HBV genotype with drug resistance and mutation sites .Methods Three hundred serum samples of HBV patients were collected and HBV‐DNA was extracted by adopting the centrifugal column method .The HBV genotype and drug resistant mutant were detected by using PCR‐reverse dot blot hybridization method .Results In 300 cases of HBV‐DNA posi‐tive ,genotye B ,C ,B/C and other undetected genotypes were detected out ,but genotype D was not detected out ,in which genotype C was predominant ,accounting for 81 .8% ;in the HBV patients ,the resistant drugs were dominated by‐lamivudine and telbivudine , accounting for 43 .6% ;the HBV drug resistant mutation genotypes were mainly rt204I(24 .35% ) ,rt204V (17 .39% ) and rt180M (17 .39% );the drug resistance mutation rates of genotype B and C were 30 .77% and 42 .42% respectively ;the difference was sta‐tistically significant(P<0 .05) .Conclusion HBV genotype C in Dongying area is more than genotype B ,genotype C is prone to produce drug resistance ,rt204I ,rt204V and rt180M gene mutations are common ,lamivudine and telbivudine combined resistance is common ,the suitable treatment scheme should be selected according to genotyping and drug resistance mutations results .

Objective To determine platelet count (PLT),mean platelet volume (MPV),and hemodynamic changes in patients with cir-rhotic portal hypertension (CPH)post splenectomy plus pericardial devascularization (SPPD),and to assess the surgical effect on coagula-tion function.Methods A retrospective analysis was performed on 83 CPH patients undergoing SPPD in our hospital from January 2008 to December 2012.Results Compared with preoperative levels,postoperative portal venous pressure decreased,blood flow was reduced,and portal vein diameter was significantly reduced;additionally,postoperative hepatic artery diameter was increased,and hepatic artery blood flow increased.Blood alanine aminotransferase,albumin,total protein,and fibrinogen levels,thrombin time,and MPV did not significantly change 30 days postoperatively versus 7 days preoperatively(P>0.05 );the corresponding total bilirubin,activated partial thromboplastin time and prothrombin time relatively declined(P<0.05),whereas PLT and prothrombin time activity increased(P<0.05).There was a significant increase in PLT (P<0.05)but no significant change in MPV 30 days postoperatively versus 7 days preoperatively (P>0.05). Conclusion SPPD can significantly improve liver functional reserve and coagulation function in patients with CPH.

based on the theory of tree structure and followed the characteristics of medical talents growth,Wuxi No.2 People's Hospital carried out hospitalTalent Tree Project innovatively,which is to trained talents corresponding tobase-trunk-crown of a tree.The project has won the 2013 Human Resource Development Excellence Award of Asian hospital management awards.We fostered talents hierarchically according to the talents training echelon structure and this provided a way of guarantee and innovation for the sustainable development of hospital.

Objective To compare the impact on the results tested with arterial blood gas analysis and peripheral blood with glucose meter for critical patients in ICU in different temperature states. Methods The samples of venous biochemical test, blood arterial blood gas analysis and peripheral blood of 196 cases of critical patients in ICU were collected synchronously, and measure the D-value, correlation and bias adjustment factor of glucose blood tested with a synchronous fasting blood glucose test and venous/biochemical analyzer in different temperature states and different blood glucose groups, and the results of blood glucose test were analyzed. Results In normal temperature state, hypoglycemia simultaneous rapid intravenous glucose monitoring blood glucose level results compared with the lowest positive rate 3.31%(5/151), while the pairwise comparison showed there was both statistical signifcance between hypoglycemia group and target group (χ2=38.469), hyperglycemia group and target group (χ2=15.504) when choosing a synchronous fasting blood glucose test and intravenous blood glucose test (P<0.01). In high temperatures state, hypoglycemia simultaneous rapid intravenous glucose monitoring blood glucose level results compared with the lowest positive rate 0. There was both statistical significance between hypoglycemia group and target group (χ2=18.187), hypoglycemia group and hyperglycemia group (χ2=12.857) when choose a synchronous fasting blood glucose test and intravenous blood glucose test (P<0.01). Conclusions In high temperatures state, a synchronous fasting blood glucose test can not reflect the true value of blood glucose for critical patients.