Objective To evaluate the therapeutic effects of noninvasive bi-level positive airway pressure (BiPAP) ventilation after extubation in chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure.Methods Forty-one intubated COPD eases with severe respiratory failure due to pulmonary infection (pneumonia or purulent bronchitis) were involved in the study.At the time of pulmonary infection control (PIC) window,the extubation was conducted and followed by BiPAP ventilation in 21 cases (the experimental group),while the other 20 COPD cases with similar clinical characteristics,as the control group,who continuously received invasive mechanical ventilation after PIC window.Outcomes including the duration of invasive ventilation,the total duration of ventilation support,success rate,the incidence of ventilator associated pneumonia (VAP) and mortality rate were observed and compared between the two groups.Results The two groups had similar clinical characteristics and gas exchange at the time of PIC window (P ＞ 0.05 ).Compared with the control group,the experimental group had shorter duration of invasive mechanical ventilation (6.9±3.0) d vs.(13.1 ±4.3) d,t=5.38,P＜0.001),lower rate of VAP (1/20 vs.8/20,x2 =5.51,P=0.02) andhigher extubation rate (20/21 vs.13/20,x2 =4.19,P =0.04).Conclusion In COPD patients with intubation and mechanical ventilation for respiratory failure,BiPAP ventilation after extubation at the point of PIC window may improve patients' prognosis.

Objective To evaluate the effect of combination of surgery and transcatheter hepatic arterial chemotherapic embolism(THACE) with or without placement of drug deliery system(DDS) of portal vein for hepatocellular carcinoma with portal vein tumor thrombus (PVTT). Methods Fifteen cases of advanced HCC with PVTT were treated by hepatectomy, thrombectomy of portal vein with THACE,and 5 of the 15 cases received postoperative chemotherapy via portal vein. Results All patients survived after operation. The survival rate of 6,12,18 months was 15,12 and 9 cases respectively. Conclusions Operation is still an effective method for advanced HCC , postoperative comprehensive treatment can improve the survival rate.

Objective To study the surgical treatment of major blood vessels invaded by tumors in order to raise the resection rate and postoperative survival rate. Methods Clinical data were analyzed on 26 patients undergoing (resection) of tumors along with reconstruction of major blood vessels from October 1998 to February 2004. Results Tweety-three cases were followed up for 2～65 months with median 42.8 months. Doppler ultrosonography and CTA examination were performed respectively during the follow-up process.In 5 patients with carcinoma of the head of pancreas who had inferior vein cava replaced and in 1 patient with cholangiocarcinoma who had portal vein replaced,3 were complicated with carcinoma embolism formation at 3,12 and 15 months respectively after surgery,(postoperative) graft patency was 50%;all of the 6 patients had recurrence of the tumor at 3,6,8,12,24 and 31 months respectively after surgery.Seven patients with tumor in pelvic cavity or in posterior space of peritoneum were followed up for about 2 years,1 of them had tumor recurrence ,but the graft kept patent,2 patients with sarcoma in the limbs were followed up for 1 year without tumor recurrence or vessel obstruction.Eleven patients with tumors in the neck were followed up for 3 months to 5 years without tumor recurrence or vessel obstruction. Conclusions (Combination) of resection of neoplasm and reconstruction of major blood vessels is safe,effective and practical method for patients with major wessels invaded by tumor.

Objective To explore imaging manifestations of hepatic epithelioid hemangioendothelioma (HEH). Methods CT and MR images in 14 patients with HEH proven by histopathology were retrospectively analyzed. Plain and two-phase contrast-enhanced CT scan were performed in 5 cases, non-contrast and multiphase contrast-enhanced MR scan were performed in 7 cases, CT and MRI were both performed in 2 cases. Characteristics of CT and MR T2WI images were classified and analyzed. All lesions were classified into three types:multiple, diffuse and solitary form. Results (1) Multiple form of HEH:228 lesions were found in 11 patients, including 178 lesions on MRI and 50 lesions on CT. On T2WI, three or two layered-target-signs with hyperintensity core were found in 79.2% (141/178) of the lesions. Three layer-target-sign included hyperintensity core, hypointensity rim and slightly high signal halo from the inside out. Two layer-target-sign included hyperintensity core and slightly high signal halo from the inside out. Characteristics of dynamic contrast-enhanced scan included peripheral two or three layered-rim-like enhancement in 66.3%( 118/178) of the lesions;peripheral, gradual rim-like enhancement with enhanced core in 27.0%( 48/178) of the lesions;heterogeneously mild enhancement in 2.2%( 4/178) of the lesions;centripetal enhancement in 4.5%( 8/178) of the lesions. Fifty lesions were found in CT, which showed low density nodules or masses with clear margins. Two-layered-black-target sign were found in 42 lesions in contrast-enhanced images, white-target sign were found in 3 cases, and centripetal enhancement was found in 5 cases. (2) Diffuse form of HEH:in one of the two cases of this type, the lesions could not be separated from normal liver parenchyma, gradual enhancements were found along with the vessels in the center of the lesions. (3) Solitary form of HEH: one case, the lesion showed heterogeneous density in non-contrast CT images and gradual enhancement in contrast-enhanced images. Conclusions We found some imaging characteristics of HEH. Two or three layered-target-sign on T2WI and black-target sign, white-target sign on contrast-enhanced images were unique imaging features of HEH.

OBJECTIVETo investigate the effect of different length and diameters on the stability of mini implant and to select optimal length and diameter using continuous variation of parameters.

METHODSTo perform 3-dimensional finite element analysis, finite element models of a maxilla, and mini implants with length of 6-12 mm and diameters of 1.2-2.0 mm were generated. Load of two different forces were applied to the head of mini implant. One type was horizontal force (HF), the other was composite force (CF). The maximum equivalent stress (Max EQV) in maxilla and the maximum displacement (Max DM) of mini implant were evaluated.

RESULTSThe Max EQV in maxilla and Max DM of mini implant decreased as length and diameter increased. When length was more than 9 mm, the evaluation indexes were small and had a less change. Datas indicated that diameter played a more important role in reducing target, and was a more effective parameter in reducing Max EQV when CF was loaded.

CONCLUSIONFrom biomechanical point of view, the choice of the length should not be more than 9 mm. When CF is loaded using the mini implant, diameter exceeding 1.2 mm are optimal design for mini implant.

Objective　To investigate the effect of breast milk and some other kinds of infant foods on the adhesion of EPEC to Hela cells and intestinal mucosa so as to understand the possible protective mechanism of breast-feeding in the intestine of infants. Methods　The adhesion of EPEC to Hela cells and intestinal mucosa were examined by cell culture, bacterial adherence test, light and electron microscopy in the mediums that contain breast milk, cow's milk and formula milk or contain ecal filtrate of the infants fed by breast milk and formula milk respectively. Results　Adhesive index for EPEC to Hela cells was significantly lower in the medium containing breast milk than in control and so did in the fecal medium containing breast fed infants than artificial feeding infants. Conclusion　Breast milk may inhibit the adhesion of EPEC to infant intestine.

After comparing the varieties of parameters in batch culture under different dissolved oxygen tension by Bacillus pumilus, we found that the demand of cell on oxygen in different phase isn' t consistent. Based on the analys is of the metabolic pathway of oxygen and the mechanism of the effect of dissolved oxygen tension on fermentation of D-ribose, a two-stage oxygen-supply control mode was proposed and experimentally proved to be available. High ribose yield and high glucose consumption rate were achieved during whole process for 44h, and the ultimate ribose concentration and cell concentration were 5.0% and 18.8% higher than former respectively.

Metabolic abnormalities were identified and carotid intima-media-thickness(IMT)was measured in 221 individuals at risk for metabolic syndrome(MS).The results indicated that IMT was significantly thicker in MS individuals than that in non-MS individuals(P＜0.01).And there was a tendency of progressive increase in IMT with increasing components of metabolic syndrome.

Objective To evaluate the current status of treatment and prophylaxis of ischemic stroke associated with atrial fibrillation(AF),and to assess the opportunities for improvement. Methods Ninty-seven consecutive patients with acute ischemic stroke and AF were evaluated and compared with 173 acute ischemic stroke patients without AF.Medical records were reviewed using a pre-defined questionnaire developed from the guidelines.Functional outcome was measured according to modified Rankin scale. Results The patients with stroke and AF was older than the control group(years vs years,P