Objective:To evaluate the physiologic work of breathing (WOBphy)as parameter of respiratory weaning and extubation. Method: Patient work of breathing (WOBt) and imposed work of breathing (WOBimp) were measured. WOBphy was obtained with WOBt minuting WOBimp. In the patients who did not meet conventional respiratory weaning parameters ,if WOBphy

Objective To evaluate retrospectively the image quality and detection of nodules with low-dose chest computed tomography (LDCT)by photon detector and iterative reconstruction (IR).Methods Sixty-six patients with lung nodules underwent routine LDCT with image reconstruction using filtered back projection (FBP).These patients were followed up by LDCT with photon detector 6 months later with image reconstruction using FBP and SAFIRE.Image quality and detection rate of the nodules were compared among groups including routine LDCT,photon decector+FBP and photon Decector+IR groups.Results Noise was decreased and SNR was increased in turn for routine LDCT,photon detector+FBP and photon detector +IR,exhibiting statistical differences (all P<0.001).The CT image quality score among routine LDCT,photon decector+ FBP and photon decector+ IR groups were increased in turn with statistical differences (χ2 =32.65,P<0.001).132 lung solid nodules (SN)were all identified in three groups with average diameter of (5.13±1.49)mm, (5.1 1±1.57)mm and (5.08±1.54)mm,respectively,and the difference was not statistically significant (P >0.05).14 ground glass nodules (GGN )in routine LDCT group and 15 in other two groups were identified with the average diameter of (6.44±1.86)mm, (7.23±1.74)mm and (7.31±1.68)mm,respectively.The ability of routine LDCT to detect the GGNs was lower than that of the others.Conclusion Photon detector and IR are able to decrease image noise,improve image quality,and increase detection rate and measurement accuracy of GGN.

Objective To investigate the correlation between Helicobacter pylori (Hp) infection and blood lipid metabolism and atherosclerosis.Methods From October 2015 to October 2020,200 cases of Hp positive subjects were observed as observation group and 200 cases of Hp negative subjects as the control group,all subjects were blood lipid levels of vascular ultrasound and other related checks.Results The levels of total cholesterol (TC) (5.68± 1.46 mmol/L),triglyceride (TG) (1.58 ± 0.76 mmol/L) and low density lipoprotein cholesterol (LDL-C),and the difference was statistically significant (t=6.12,7.69,5.64,all P＜0.05).The detection rate of carotid atherosclerotic plaque in the observation group was 66.00 ％,which was significantly higher than that in the control group (49.50％),the difference was statistically significant (x2=29.61,P＜0.05),and the observation group.The detection rate of stable plaque was 44.5 ％,which was significantly higher than that of the control group 22.5％,the difference was statistically significant (x2 =21.73,P＜0.05).Conclusion Hp infection can affect the level of lipid metabolism in patients,which is an important factor in the occurrence and development of atherosclerosis.

Objective To observe whether hepatitis B vaccine enhance the treating effect of cyto-kine induced kill(CIK) cells on hepatitis B virus transgenic(HBV-Tg) mice. Methods The HBV-Tg mice were treated with CIK cells by peritoneal injection and hepatitis B vaccine by hypodermic injection. The HBV DNA level were tested by real-time PCR,T lymphocyte subgroup were detected by flow cytometry and the pathological diversify of hepatic tissue were observed by HE staining. Results The HBV DNA loading in peripheral blood of HBV-Tg mice decreased after CIK cells were treated and CD3~+ , CD4~+ and CD8~+ cells increased which were enhanced after CIK cells combined with hepatitis B vaccine. Conclusion Hepa-titis B vaccine enhanced the treating effect of CIK on HBV-Tg mice which may be implemented by increased the blood level of CD3~+, CD4~+ and CD8~+ cells, especially CD8~+ cells level.

Objective To explore the feasibility of repairing the large area skin and soft tissue defect in thefront upper of tibia by free flap with anastomosis of saphenous vessels.Methods From June,2009 to April,2014,16 cases (10 males and 6 females) of large area skin and soft tissue defect in the front upper of tibia were treatedwith free flap.The ages ranged from 24 to 56 years old,averaged of 34.5 years old.The supportive therapy and repeated debridement combined with VSD,and designed to use free anterolateral thigh flap with anastomosis of saphenous vessels before repairing operation.Results Fourteen patients accorded with preoperative design,in which 2 cases were adopted cross leg flap anastomosis posterior tibia vessels of the healthy side (1 case of saphenous artery diameter too small,and 1 case of saphenous artery long injury degeneration,unsuitable for vascular anastomosis).All 14 flaps survived,expect 2 cases were part-necrosis in the end of the flap,and gradually healed by dressing exchange.Conclusion Reconstruction of large area skin and soft tissue defect in the front upper of tibia with free flap can use anastomosis of saphenous vessels.

Objective To evaluate the 80 mm volume shuttle cerebral CT perfusion(CTP) and 4D-CT angiography (CTA) in patients with stenosis or occlusion in Willis circle.Methods Conventional cerebral plain CT, 80 mm CTP and dynamic 4D-CTA were performed in 55 patients with unilateral MCA/ ICA stenosis or occlusion.The parameter maps of cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT) and time to peak (TTP) were analyzed.Meanwhile dynamic 4D-CTA images were also obtained.The significance of the differences of CBF, CBV, MTT and TTP between the affected side and the contralateral side was assessed using K Independent Samples analysis.Results In 40 patients with unilateral stenosis or occlusion of MCA/ICA, CTP was found abnormal in 36 patients.MTT and TTP of affected side [(7.18 ±1.34), (19.65 ±1.81) s] were significantly prolonged compared to contralateral side [(5.22±1.14) s, (17.62±1.65) s, X~2 =30.833,25.817, P<0.017].Centrum ovale or parietal lobe ischemic lesions were observed in 16 patients on CTP.In 15 patients with bilateral stenosis or occlusion of MCA/ICA, CTP was observed abnormal in 10 patients.CBF, CBV, MTT and TTP of affected side [(42.85 ±6.09) ml·100 g~(-1)·min~(-1), (2.63 ±0.42) ml·100 g~(-1), (11.27 ±1.43) s, (21.07 ±1.44) s)] were significantly different from those of contralateral side [(71.20 ±6.30) ml·100 g~(-1)·min~(-1), (2.29 ±0.15) ml·100 g~(-1), (3.38 ±0.61) s, (17.64 ±1.70) s (X~2 =17.314, 5.913,17.334,13.834,P<0.017)].On 4D-CTA covering 80 mm (0.625 mm×l28), unilateral stenosis of MCA were observed in 22 patients (13 right MCA and 9 left MCA), unilateral occlusion were observed in 5 patients (1 right MCA and 4 left MCA) and bilateral MCA stenosis/occlusion were observed in 9 patients.4D-CTA covering Willis cycle can display stenosis/occlsion of MCA as same as conventional CTA and DSA.Conclusion 80 mm volume shuttle CTP and 4D-CTA provide valuable information about the hemodynamic changes and the abnormalities of intracranial artery in patients with MCA/ICA stenosis or occlusion.

Objective To study the association between Helicobacter pylori(Hp)infection and chronic obstructive pulmona-ry disease(COPD).Methods A retrospective study was conducted in 130 patients with Hp positive COPD(Hp positive group)and 130 patients with Hp negative COPD(Hp negative group)from August 2015 to October 2016.The patients in the two groups blood gas analysis and lung function.Results The blood oxygen pressure(PaO2)level 62.5 ± 7.4 mmHg and the oxygen saturation(SaO2)86.3%±9.6% in the Hp positive group were lower than those in the Hp negative group (78.6±10.2 mmHg,92.8%±2.9%),(43.3±10.6 mmHg)in Hp positive group was significantly higher than that in Hp negative group(43.2±11.5 mmHg),the difference was statistically significant(t=14.57,7.39 and 9.55,all P<0.01), (FEV1/FVC)(FEV1/FVC)(FEV1/FVC)and FEV1 were the highest in the Hp-positive group(FEV1)(1.56±0.48 L), the first forced expiratory force(1.74±0.32 L,65.9%±5.3% and 58.2%±5.6%),the difference was statistically signifi-cant(t=3.56,12.42,16.41,all P<0.05),and the difference was statistically significant(all P<0.01).Conclusion Hp in-fection was closely related to COPD,which may be an important factor involved in and aggravate COPD disease.

Background The Qingcaosha Reservoir is facing issues of algal blooms and eutrophication, and the resulting increase in the level of chlorination disinfection by-products in the water has been a major concern. Objective To evaluate the impact of "Algae Monitoring and Control Program in Qingcaosha Reservoir" (hereinafter referred to as the program) on the control of trihalomethanes (THMs) in conventional finished water. Methods From 2011 to 2019, water samples were collected from the Lujiazui Water Plant once per season, one sample each time, and the concentrations of four THMs (trichloromethane, dichlorobromomethane, monochlorodibromomethane, and tribromomethane) were measured in the samples. Using 2014 when the program was implemented as a cut-off point, the entire study period was divided into two phases: pre-implementation (2011–2013) and post-implementation(2014–2019). Segmented linear regression with interrupted time series analysis was applied to assess the concentrations and trends of THMs in the finished water before and after the program launch. Results The concentration of total THMs in finished water increased by 1.561 µg·L⁻¹ (P=0.010) for each season of time extension before launching the program. The change in the concentration of total THMs in finished water was not statistically significant after the program launch, but the THMs concentration showed a decreasing trend as the slope was −0.626 (P=0.001). From 2017 until the end of 2019, the average concentration of THMs in finished water of Lujiazui Water Plant dropped to 10 μg·L⁻¹ or less. Conclusions The algae and eutrophication control measures in Qingcaosha Reservoir have achieved good results, controlling THMs in finished water at a low level, and the trend of THMs has changed from a yearly increase pattern before the program to a yearly decrease pattern after the program.