OBJECTIVE: To evaluate nasal ventilation in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) after nasal cavity ventilation expansion techniques by using acoustic rhinometry. METHOD: Thirty-eight patients with mild OSAHS and 17 patients with moderate OSAHS who were diagnosis by PSG were selected. The acoustic rhinometry and rhinomanometry were used to assess the nasal cavity volumes (NCV), nasal airway resistance (NR), nasal minimal cross-section area (NMCA) and distance of nasal minimal cross-section area from nostril (DCAN) before and after the surgery (6 month later). RESULT: The state of mild OSAHS group in NCV, NMCA and NR: before surgery (2.41 ± 1.33) cm³, (0.37 ± 0.39) cm², (2.07 ± 1.48) cmH₂O/(L · min), after surgery (2.53 ± 1.54) cm³, (0.45 ± 0.34) cm², (1.69 ± 1.03) cmH₂O/(L · min), has significant difference (P < 0.05). The state of moderate OSAHS group in NCV, NMCA and NR: before surgery (2.03 ± 1.54)cm³, (0.29 ± 0.39) cm², (3.47 ± 2.56) cmH₂O/(L · min), after surgery (2.31 ± 1.47) cm³, (0.39 ± 0.33) cm², (1.89 ± 1.03)cmH₂O/(L · min), also has significant difference (P < 0.05), while DCAN in two group had no difference (P > 0.05). CONCLUSION There was an objective evaluation of nasal ventilation in OSAHS patients after surgery by using acoustic rhinometry.
Humans ; Nasal Cavity ; surgery ; Rhinometry, Acoustic ; Sleep Apnea, Obstructive ; surgery

Objective To evaluate the accuracy of an expiratory resistance device assisting pulse pressure variation (PPV) in predicting volume responsiveness in the spontaneously breathing patients.Methods Forty spontaneously breathing patients of both sexes,aged 22-61 yr,weighing 51-73 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective operation,were enrolled.Before induction of anesthesia,mean arterial pressure (MAP),heart rate (HR),central venous pressure (CVP),cardiac index (CI) and pulse pressure variation (PPVB) were recorded after haemodynamics were stable.Then the expiratory resistance device was used,and MAP,HR,CVP,CI,and PPVA were recorded.The device was then removed.Volume expansion was carried out.6％ hydroxyethyl starch 130/0.4 6 ml/kg was infused over 10 min.MAP,HR,CVP,CI and PPVB were recorded within 3 min after volume expansion.The device was used again,and 1 min later MAP,HR,CVP,CI and PPVA were recorded.The device was then removed.The patients were divided into 2 groups according the percentage of increase in CI after volume expansion (△ CI):△ CI≥ 15％ considered to be a positive response group (group P),and ACI＜15％ considered to be a negative response group (group N).A receiver-operating characteristic (ROC) curve for PPV was plotted.According to the ROC curve,the diagnostic threshold,sensitivity,specificity,area under the curve,and 95％ confidence interval of the expiratory resistance device assisting PPV in predicting volume responsiveness were determined.Results The area under the curve (95％ confidence interval) of PPVA was 0.880 (0.70-0.98),the diagnostic threshold was 13.5％,and the sensitivity and specificity in determining volume responsiveness were 87％ and 88％,respectively.Compared with the value before administration of the loading dose,the CVP and CI were significantly increased,and PPVB and PPVA were decreased after volume expansion in group P,and the CVP and CI were significantly increased after volume expansion in group N (P＜0.05).Compared with group P,the PPVA was significantly decreased before volume expansion,and the CI was increased after volume expansion in group N (P＜0.05).Conclusion The expiratory resistance device can assist PPV in predicting volume responsiveness in the spontaneously breathing patients.

Objective To discuss the feasibility and value of routine clinical preoperative examination predicting benign and malignant thyroid nodules. Methods The clinical data of 1630 patients undergoing thyroidectomy for nodular thyroid disease were analyzed retrospectively.The relationship between pathological diagnosis and physical examination,ultrasonographic parameters,the results of laboratory test and nuclear medicine test were examined to build a risk prediction model.The sensitivity,specificity and accuracy of the formula were tested. Results In 387 cystic nodules 0.78％ were malignant; In 1243 solid nodules 17.2％ were malignant.Among the 1243 cases,characters significantly related to malignancy were:age younger than 40 years,solitary lobe involvement,hypoechoic nodule,irregular margins,solid nodule,microcalcification,macrocalcification,max diameter ≤ 2 cm. The prediction formula was: malignancy indicator =0.80 × age + 0.59 × solitary lobe + 0.72 × hypoechoic + 0.82 × irregular margin + 1.32 × solid nodule + 1.90 × microcalcification + 0.70 × macrocalcification + 0.71 × max diameter.The threshold limit value was 2.8,and the sensitivity,specificity and accuracy of which were 74.4％,80.4％ and 75.2％,respectively. Conclusions Benign and malignant thyroid nodules could be differentiated roughly with the combination of patients' general information and the results of routine examination before operation.

After the definition and emergence of MOOC and its development at home and abroad were described, the position of library under MOOC environment was discussed with stress laid on how to deepen the service in medical library by making use of MOOC and the challenges medical library is faced.

OBJECTIVE: To evaluate nasal ventilation in allergic rhinitis patients after nasal provocation with acoustic rhinometry. METHOD: Twenty AR cases were selected. Each one was assessed for the nasal cavity volumes (NCV), nasal airway resistance (NR), nasal minimal cross-section area (NMCA) and distance of nasal minimal cross-section area from nostril (DCAN) by using acoustic rhinometry before and after nasal provocation 1 hour and 6 hours later. The results were statistically analyzed. RESULT: After nasal provocation 1 hour 1 later, NCV and NR had a significant difference compared with before nasal provocation(P<0. 05), but NMCA and DCAN had no difference (P > 0.05). After 6 hours later, NCV, NR, NMCA and DCAN had a significant difference compared with before nasal provocation (P < 0.05). NCV,NR,DCAN had a significant difference between 1 hour later and 6 hours later after provocation (P < 0.05), while NMCA had no difference (P > 0.05). CONCLUSION The nasal ventilation in allergic rhinitis after nasal provocation had declined over time.
Airway Resistance ; Humans ; Nasal Cavity ; physiopathology ; Respiration ; Rhinitis, Allergic ; physiopathology ; Rhinometry, Acoustic

Through the study on mathematical logic relation in the syndrome theory of traditional Chinese medicine (TCM), it revealed that the mathematical logic relation among three basic elements in the judgment of syndromes, which were the disease cause (a), disease location (b), disease nature (c) and syndrome (z), was f(z)=a+b+c. The mathematical logic relation between syndrome (z) and symptom (zi) was f(z)= z1+z2+z3+…+zi. The obvious feature reflected by the complexity of syndromes was the construction number of symptoms. During the syndrome differentiation process, the mathematical logic relation between symptom and disease cause, location, nature and syndrome was z1+z2+z3+…+zi =a+b+c= f(z). However, syndromes generally exhibited a nonlinear relationship of point-set topology. After calculation, 79 major single TCM syndromes had a total of more than 6.5×105 different forms. The number within a certain range of syndrome group was approximately 6.6×10100. The super huge data “Googol” may be the root of complex TCM syndromes. The results showed that the researches on “element of syndrome” using the bayesian networks, the neural network algorithm and the algorithm of double levels of frequency power were irrelevant to the mathematical logic relation of the intrinsic relations of syndrome theory. Therefore, “element of syndrome” was a false proposition feature in the study of TCM basic theory. The established syndrome differentiation method with“element of syndrome” as its core was not conformed to the inherent law of TCM theory and clinical practice.

Objective To discuss the effect of hemodilution on brain tissue oxygen pressure and prognosis in patients with severe craniocerebral trauma. Methods A total of 42 cases of severe craniocerebral trauma were randomized divided into two groups, ie, control group and treatment group, to observe the changes of brain tissue oxygen pressure ( PbtO2 ) , hematocrit (HCT) and 6-month Glasgow outcome scale (COS) after injury. Then, PbtO2, HCT and GOS were compared between two groups. Restilts ( 1 ) There was a positive correlation between PbtO2 and HCT when HCT was lower than 0.25( r =0. 732 ,P ＜0. 001 ) in the treatment group; while a negative correlation was found between PbtO2 and HCT when HCT was higher than 0.25(r = - 0. 698 ,P＜0. 001 ). (2) Compared with control group, the index of brain tissue oxygen in treatment group was obviously higher ( t = 2.27, P = 0. 029 ) , with better prognosis (X2= 5.09, P ＜ 0.05 ). Conclusion Hemodilution can significantly increase brain tissue oxygen supply and improve the prognosis of cases of severe craniocerebral trauma.

).The complication rate in RIVVH was lower than that in the control group (P<0.05).Conclusions Early RIVVH was effective in the treatment of SAP,and may be an option as adjuvant treatment measure.

We reconstructed the erythromycin macrocyclic lactone (6-deoxyerythronolide B, 6dEB) synthesis pathway in Escherichia coli. We first cloned all the genes needed to synthesize the 6dEB into multi-gene co-expressed vectors. Then using the recognition sequences of isoschizomers Xba I/Spe I of vectors, we assembled the related genes into a series multiple-genes recombinant plasmids pBJ144, pBJ130. The recombinant plasmids pBJ144, pBJ130 were cotransformed into BAP1 to get the recombinant BAP1(pBJ144/pBJ130). SDS-PAGE analysis showed that individual genes were expressed correctly. After inducing at low temperature, adding propionate as substrate, we validated the crude product by mass spectrometry and the 6dEB yield was about 10 mg/L. These results indicated that the synthetic pathway of 6dEB was successfully assembled and reconstructed in Escherichia coli, which will greatly facilitate the reconstruction of whole erythromycin synthesis pathway and finally help to establish a stable research platform for developing of new derivatives of erythromycin and combinatorial biosynthesis of polyketide-type antibiotics.
Anti-Bacterial Agents ; biosynthesis ; Cloning, Molecular ; Electrophoresis, Polyacrylamide Gel ; Erythromycin ; analogs & derivatives ; biosynthesis ; Escherichia coli ; genetics ; metabolism ; Genetic Vectors ; genetics

OBJECTIVE: To establish an in vitro method to culture mesenchymal stem cells(MSCs) derived from human nasal mucosa, and explore their stemness and differentiation potential. METHOD: Based on the observation of distribution of MSCs in human nasal mucosa, we cultured and proliferated MSCs in vitro and identified the expression of stem cell markers on them including Nestin, CD133, Vimentin and Sa114 with immunofluorescence. The MSCs were induced to differentiate to osteoblasts with medium containing dexamethasone, ascorbic acid and beta sodium glycerophosphate, and to neurons with Neurobasal medium containing B27, ATRA and TSA. Histochemistry and immunofluorescence were applied to evaluate the differentiation. RESULT: The nestin and vimentin immunofluorescence-positive MSCs existed extensively in human nasal mucosa. While the MSCs were cultured in the osteogenic-inducing medium, activities of alkaline phosphatase were increased significantly, and bone nodules were found on the surface of the osteoblasts by alizarin red staining. After the induction by neural-inducing medium, the MSCs adopted neuron like appearance with many slim protrusions interconnected as a network. The induced cells expressed neural markers NF-200 and BM88 strongly. CONCLUSION The MSCs derived from human nasal mucosa are multipotent stem cells and can be utilized as seed cells to repair bone or neural injury.
Alkaline Phosphatase ; metabolism ; Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; Humans ; Mesenchymal Stem Cells ; cytology ; metabolism ; Multipotent Stem Cells ; Nasal Mucosa ; cytology ; Neurons ; Osteoblasts ; cytology