Heated humidified high-flow nasal cannula(HHFNC) is a relatively new noinvasive method for respiratory support,initially used in premature infant apnea.In recent years,the development of HHFNC applications is rapid,and HHFNC is gradually used in older infants and children.Compared to other noninvasive oxygen supply devices,HHFNC can be used effectively in clinic because of its high comfort,good tolerance,easy care,and reducing the rate of endotracheal intubation.

Objective To investigate the eftect of VEGF gene transtection on endothelial progenitor cell derived from murine bone marrow.Methods Wistar rat's bone marrow was obtained, mononuclear cell isolated,and endothelial progenitor cells(EPS)were cultured in EGM-2MV.EPCs were identified by immunocytochemistry and electron microscope.EPCs were transfected by liposome mediated pcDNA3.0-hVEGF165.VEGF protein level was determined in the cultural medium supernatant after VEGF transfection by ELISA.Cultural medium supernatant was used to co-culture with ECV304,VEGF protein activity was evaluated by MTT.EPCs expression of vWF,VEGF,FLK-1 was detected by immunocytochemistry.Results EPCs were effectively enriched by EGM-2MV,and the EPCs obtained express the typical cell surface markers such as CD34,CD133,FLK-1.The concentration of VEGF protein in supernatant reaches 1280 pg/ml in the 7th day after pcDNA3.0-hVEGF transfection.No influence of EPCs proliferation could be found after transfeetion.The cell surface marker expression of VEGF,FLK-1, vWF became higher with time,and the ratios of positive cell were 88.52%,82.65% and 95.97% respectively.Conclusions pcDNA3.0-hVEGF165 transfeet EPCS mediated by liposome could excrete a high concentration of functional VEGF protein.It is helpful for EPC to maintain the characters of endothelial cell after VEGF gene transfection and differentiate to mature endothelial cell.

Objective To investigate the efficacy of four antiviral solutions for chronic hepatitis B (CHB) treatment .Methods 240 cases of patients with CHB were selected ,divided into four groups (group A ,group B ,group C and group D) ,and treated with lamivudine ,adefovir dipivoxil ,adefovir dipivoxil/lamivudine ,and entecavir ,respectively .The recovery rates of ALT and AST ,HBV DNA and its negative conversion rates ,and HBeAg/HBeAb conversion rates of the four groups were compared respectively after 12 ,24 and 48 weeks treatment .And the YMDD mutation rates were compared after 48 weeks treatment .Results The recovery rates of ALT and AST ,HBV DNA and its negative conversion rates ,HBeAg/HBeAb conversion rates ,HBeAg/HBeAb conversion rates of group C and group D were significantly better than those of group A and group B (P<0 .05) .Conclusion The antiviral so‐lutions of adefovir dipivoxil/lamivudine and entecavir are two kinds of rational treatment .

sis were given.

According to the requirements of the ‘three guidance’ talent-cultivation model pro-posed by our university, humanistic spirit was permeated from multi angels during the process of phys-iology. Students'occupation quality was cultivated; physiology knowledge and clinical practice was combined for students; early contacting with clinical knowledge was conducted and teacher-student role reversal method was applied to train students' communication skills. Teaching practice showed that the reformed teaching model not only can ensure the quality of teaching but also can improve the comprehensive quality of students.

Objective To explore the risk factors for asthma in children.Methods A 1:1 matched and hospital-based case-control study was conducted to analyses risk factors for asthma in 300 pairs of children by logistic regression analysis. Results The result of univariate Logistic regression analysis showed that there were 17 related factors for children asthma, including disease history of parents in respiratory system,family income,atopie character,history of acute respiratory infections, eating habit,the amount of sea foods intakes,foam plastics,family decoration,the way of exhaust fume in kitchen,the exhaust effectiveness,raising pet in house,family history of asthma,family history of allergic rhinitis,family history of food allergy,dust allergy of parents,systemic therapy after the first attack.With multivariate Logistic regression analysis,7 factors were entered the model,6 risk factors including father's history of respiratory diseases(OR 3.771,95%CI 1.533～9.278),low family income(OR 1.503, 95%CI 1.258～1.795),atopy(OR 3.788,95%CI 2.368～6.058),meat-eating habit(OR 2.042,95%CI 1.481～2.815),asthma history of family members(OR 1.710,95%CI 0.988～2.958),the family history of allergic rhinitis(OR 1.991,95%CI 1.234～3.211), and 1 protective factor of raising pet in house(OR 0.443,95%CI 0.265～0.739).The coefficients of these factors in multivariate logistic regression model were 1.327、0.407、1.322、0.714、0.536、0.689、and-0.814 respectively.Conclusion Children asthma was a multi-factorial complex disease,and the interaction of environmental and genetic risk factors played an important role in the onset of this disease.

Objective To investigate the influence of RNAi gene silence on the chemosensitivity of human digestive system neo-plasms .Methods Esophageal cancer EC109 cells and gastric adenocarcinoma SGC-7901 cells were selected and divided into the transfection group and the blank control group for culturing .Two cell lines in the transfection group were transferred by siRNA and silenced the expression of Survivin ,giving cisplatin 5 mg/L to co-culture for 72 h .The blank control group was given the conven-tional culture and the same dose of cisplatin for co-culture for 72 h .The in vitro proliferation rate of cells in the two groups were measured by MTT and their sensitivities to the chemotherapy drug cisplatin were compared .Results After siRNA silencing the ex-pression of Survivin in SGC-7901 and EC109 cell lines ,the sensitivity of cells to cisplatin drugs was increased .MTT results sugges-ted that the proliferation activity of cells was significantly lower than that in the non-silence cell lines ,the difference showing statis-tical significance(P<0 .05) .Conclusion Adopting RNAi gene silencing technique can interfere the expression of Survivin gene ,in-hibit the proliferation of tumor cell ,and at the same time significantly improve the sensitivity of tumors to chemotherapy .

Objective:To explore the central neurobiological mechanisms of pleasure effect on rats with neuralgia treated by tuina manipulations of An-pressing and Rou-kneading Huantiao (GB 30).Methods:A total of 64 male Sprague-Dawley (SD) rats were used in this study.Eighteen rats were randomly selected as a normal group,and the other 46 rats were used to duplicate the chronic constriction injury (CCI) model.Ten rats failed in modeling and 36 rats succeeded.These 36 rats were then randomly divided into a model group and a tuina group,with 18 rats in each group.The rats in the normal group and the model group did not receive any interventions,while those in the tuina group received An-pressing and Rou-kneading Huantiao (GB 30),1 min for each time,once a day,3 weeks in total.Heating tests were evaluated to observe the change of pain-sensitivity score before intervention,1 week after intervention,2 weeks after intervention,and 3 weeks after intervention.After 1 week of intervention,2 weeks of intervention,and 3 weeks of intervention,6 rats were randomly selected from each group respectively for brain extraction.The change of Nissl's body and β-endorphin in the accumbens nucleus as well as amygdaloid nucleus of pleasure circuits,and pro-opiomelanocortin (POMC) in the arcuate nucleus were analyzed by methods of histochemistry and molecular biology.Results:After modeling,the pain-sensitivity scores of the tuina group and the model group were statistically different from the score of the normal group (both P＜0.05).After An-pressing and Rou-kneading Huantiao (GB 30) for one week,the pain-sensitivity score of the tuina group had statistical difference compared with that of the model group (P＜0.05).At each different time point:the amounts of Nissl's body in accumbens nucleus and amygdaloid nucleus of the tuina group were significantly more than those of the model group (all P＜0.01).Besides,the numbers of β-endorphin immunoreactive cells in the accumbens nucleus and amygdaloid nucleus of the rats in the tuina group were significantly higher than those in the model group (all P＜0.01),and so was the expression of POMC in arcuate nucleus (all P＜0.01).Conclusion:An-pressing and Rou-kneading Huantiao (GB 30),where the sciatic nerve is ligated,can reduce pain-sensitivity score and increase pain tolerance value of rats with chronic neuralgia.It can increase the activity of neurons in accumbens nucleus and amygdaloid nucleus of pleasure circuits,which indicates that the analgesia effect of tuina therapy may correlate with pleasure effect,and also reveals a part of neurobiological mechanisms of neuralgia.

Objective To compare CT and MR imaging in guiding and monitoring cryoablation of hepatic tumors. Methods A total of 131 lesions in 121 patients with malignant tumors of liver were treated with imaging-guided percutaneous cryotherapy. There were 73 males and 48 females, mean age 60 years. Of the 121 patients, 61 patients had cryoablation under CT guidance and 60 patients under the guidance of MRI. CT-guidance was performed with the Philips big-bore CT in spiral mode, with 5 mm slice thickness.The MR guidance was performed with GE 0.35 T scanner assisted with infrared navigator (Xinaomdt), and both fast gradient echo sequence and fast spin-echo sequence were used. The cryoablation system is a magnetic resonance compatible system (Galil, Israel), equipped with 17 G cryoprobes that are 1.47 mm in outside diameter. A combination of multiple eryo-probes and conformal cryoablation were adopted in accordance with the location, the shape and the adjacent structure of each lesion. Each cryoablation included two freezing-thawing cycles. Scanning was performed intermittently during the operation to monitor the degree of ablation. The mean scanning time, the lesion depiction and ablation process monitoring, the efficacies of lesion ablation, complications,and survival time were analyzed with x2 test Results The mean scanning time was (5.6±1.8)min for CT and (22.0±2.6)min for MR. CT provideda good depiction of the lesion and the ribs which were poorly displayed on MR images. The metal probe could create artifacts on the CT images and it was difficult for CT to show the formation of ice ball of the lesion formed after embolization with lipiodol. MR was superior to CT in displaying, guiding and monitoring of ablation of lesions near such special ragions as the diaphragm dome, the hepatic hilum, and the gallbladder. MR was not affected by high-density embolization material and the metal probes, and thus was superior to CT in depicting the lesion,and monitoring the formation of ice ball and the process of lesion ablation, etc.However, MR scan was time consuming, and image quality of low-field open MR was less desirable than that of CT. The 12-month overall survival rates were 90.2%(55/61) and 90.0%(54/60), respectively. The overall efficacies of lesion ablation were 75.4%(46/61) and 83.4%(50/60), respectively. Conclusion CT has advantages of fast scanning and good display of such structures as ribs in the path of puncture as compared with MR. MR can display a lesion with multi-planar imaging, and is superior to CT in monitoring the procedure of ablation,especially in displaying, guiding and monitoring ablation of lesions near such special regions as the diaphragm dome, the hepatic hilum, and the gallbladder.

Objective To investigate the safety, efficacy and feasibility of CT-guided percutaneous conformal cryoablation for lung cancer. Methods The inclusion criteria were: (1) Poor respiratory function and aged patients who can not bear the thoracic surgical operation. (2) Peripheral lung cancer involving the pleura and chest wall which can not be resected. (3) Residual tumor after other comprehensive treatment. (4) Focal lung cancer but the patient refused surgical resection. The exclusion criteria were: (1) Multifocal lesions. (2) Lesion close to mediastinum with possible risk of vessel injury. (3) Severe impairment of pulmonary functions, the maximum voluntary ventilation is less than 39%. (4) Repeated cough or dyspnea, can not cooperate with the procedure. (5) Poor systemic conditions, cachexia or bleeding. Totally, 76 lung carcinoma lesions on 66 patients were treated by CT-guided percutaneous conformal cryoablation using 17 G cryoprobes. The maximum diameters of the tumors ranged from 1.5 cm to 1.6 cm. For the tumors with the maximum diameter less than 3.0 cm, they were treated by double-needle clamping cryoablation. For those with the maximum diameter between 3.0 and 5.0 cm, they were treated by multiple-needle conformal cryoablation. For those with the maximum diameter larger than 5.0 era, they were treated with multipleneedle conformal cryoablation, with the needle distance less than 1.5 cm. All the patients were followed-up 6 to 24 months after the procedure using contrast-enhanced CT to evaluate the tumor size and enhancement. Results For 18 cases with the maximum diameters less than 3.0 cm, CT scan during the procedure showed that the frozen areas extended beyond the edge of the lesions more than 1.0 cm, the lesion attenuated, narrow-band-like encircled translucency around the lesions and "target sign" with ground-glass density of the peripheral lung tissue. There was no enhancement during the first 1 st、3 rd month follow-up, only fibrosis scar in 6 th month follow-up. Seven patients were followed up 2 years later, 5 of them have no recurrence or metastasis, one had mediastinal lymphopathy and one had bone metastasis 1 year later. For the 22 cases with maximum diameters between 3.0 cm and 5.0 cm, CT scan during procedure showed the frozen areas covered the lesions, lobulation and spiculation disappeared and the tumor size slightly enlarged. The lesions volume reduced during 1 st and 3 rd month follow-up. Nine cases were followed up for 2 years, 4 had no recurrence, 3 were stable and 2 had remote metastasis. For 26 cases with the maximum diameters larger than 5.0 cm, CT scan during the procedure showed the frozen areas covered 70%-90% of the tumor, there was no frozen damage to the surrounding lung tissue. Twenty-six patients had postoperative radiotherapy and chemotherapy. Follow-up in the 6 th month showed that 9 lesions decreased, 11 were stable and 6 progressed with remote metastasis. Complications included hemoptysis (3), bloody sputum (26), pneumothorax (19). Five pneumothorax were treated by close drainage and recovered 5 days. Conclusion CT-guided percutaneous conformal cryoablation is an effective and minimal invasive procedure for the lung carcinoma treatment.