Objective To explore the treatment effect and prognosis of BiPAP non-invasive ventilator of sequential mechanical ventilation for the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with pulmonary encephalopathy,and to provide the basis for clinical therapy.Methods According to the digital table,62 AECOPD patients with pulmonary encephalopathy were selected and randomly divided into the two groups.And 30 cases in the control group received routine treatment,and 32 cases in the observation group received BiPAP non-invasive ventilator sequential ventilation.The partial pressure of oxygen (PaO2),partial pressure of carbon dioxide (PaCO2) and oxygen saturation (SaO2) before and after treatment,the changes of heart rate,respiratory rate and average arterial pressure of the two groups and the improvement time were observed.Results PaO2 and SaO2 of the two groups after treatment were higher than those before treatment (t =12.30,10.37,11.42,13.71,all P ＜0.05).PaO2 and SaO2 of the observation group after treatment were (77.14 ±4.16)mmHg and (90.37 ± 2.04) ％,which were higher than the control group after the treatment (72.96 ± 3.22) mmHg and (85.80 ± 1.96) ％(t =6.58,7.14,all P ＜ 0.05).PaCO2 of the two groups after treatment was lower than that before treatment (t =9.25,10.22,all P ＜ 0.05).PaCO2 of the observation group after treatment was (50.12 ± 2.86) mmHg,which was lower than that before treatment (54.27 ± 3.01) mmHg (t =6.29,P ＜ 0.05).The heart rate,respiratory rate and mean arterial pressure of the control group and the observation group after treatment were lower than before treatment (t =10.11,9.43,8.66,11.28,8.56,9.15,all P ＜0.05).The heart rate,respiratory rate and mean arterial pressure of the observation group after treatment were (76.52 ± 4.35) times/min,(20.35 ± 1.08) times/min and (83.26 ±3.07)mmHg,which were lower than those of the control group after treatment (t =6.44,5.82,6.70,all P ＜ 0.05).The blood gas improvement time,ventilation time and hospitalization time of the observation group were (4.06 ±1.17)d,(4.53 ±0.90) d and (16.18 ±2.20) d,which were lower than the control group (t =6.13,7.05,5.97,all P ＜ 0.05).Conclusion The BiPAP non-invasive ventilator sequential ventilation for the treatment of AECOPD with pulmonary encephalopathy has good treatment effect,which can improve the difficult ventilation of patients,avoid hypoxia and CO2 retention,shorten treatment time.

Objective To study expression of hypoxia inducible factor 1? (HIF 1?) in the lungs of hypoxic rats and to explore the role of HIF 1? in the pathogenesis of hypoxic pulmonary hypertension Methods Twenty Wistar rats were randomly divided into control group and hypoxia group The models of hypoxic pulmonary hypertension were established by exposure to hypoxia for 4 weeks according to our laboratory protocol Digoxin labelled cRNA probe for HIF 1? was prepared by in vitro transcription Northern blot was performed by using the HIF 1? cRNA probe and In situ hybridization was also conducted with rat lung tissue sections Results Northern blot hybridization showed minimally positive in the lung tissue of control group ,but strongly positive in hypoxia group In situ hybridization analysis with hypoxic rat lung tissue revealed that HIF 1? mRNA was expressed in bronchial epithelial cells (strongly positive reaction) and peribronchial proliferative lymphomatic tissue (weakly positive reaction),casually in alveolar wall cells (weakly positive reaction),but not in pulmonary arterial endothelium and smooth muscle cells Conclusions Our data suggested that chronic hypoxia could induce pulmonary hypertension characterized by pulmonary vascular remodeling HIF 1? mRNA expression was elevated in the lungs of rat under hypoxic condition HIF 1 may be involved in the pathophysiological changes in response to hypoxia and play an important role in the development of hypoxic pulmonary hypertension

[Objective]To compare the biomechanical effect of minimally invasive injectable graf X_3(MIIGX_3) on strengthening pedicle screw fixation with that of bone cement.[Method]Eight fresh pig lumbar vertebrae were harvested.One track was made in each vertebral pedicle.Before pedicle screw fixation,one track of one side bertebra was augmented with MIIGX3,and another side vertebra with bone cement.Pullout test was performed 24 hours after the fixation,and maximum axial pullout strength was measured.[Result]The maximum axial pullout strength is 1915 N?375 N in MIIGX3 group,and 3625 N?775 N in bone cement group.There was significant difference between two groups(P

BACKGROUND:The prosthesis fusion rate after total hip replacement is closely related to the reconstruction process of bone,which is affected by the factors around the implant of patient.Trace elements are strongly associated with the ossification.Thus,the content of trace elements in proximal femur may affect the bone fusion and survival rate of the prosthesis.OBJECTIVE:To analyze the correlation of trace elements and bone fusion surrounding the prosthesis in proximal femur.METHODS: Bone samples were obtained from the discarded metaphysis region of the proximal femur in 24 patients with primary total hip replacement.Trace element (calcium,magnesium,zinc,parathyroid hormone,activated vitamin D3) contents were detected aftervitro cel culture.Bone mineral density was tested surrounding the prosthesis at 1 week,3 and 6 months after replacement by dual energy X-ray absorption method with a bone density meter.The difference in trace elements was compared in patients at different ages and different genders.The correlation between above five kinds of trace elements and bone mineral density was analyzed.RESULTS AND CONCLUSION:No significant difference in trace element contents was detected in different age groups and different gender groups (P＞ 0.05).Zinc content was positively correlated with parathyroid hormone and magnesium contents (P＜ 0.05).Zinc was positively associated with bone mineral density in the region 7 (P＜ 0.05).The further studies concerning the trace elements in proximal femur can be used to predict and intervene in the longevity of hip prosthesis.

BACKGROUND:The self-renew and regeneration capacity of the injured spinal cord is thought to be limited. Accordingly, cel transplantation is one potential strategy for promoting functional recovery after spinal cord injury. OBJECTIVE:To explore the effects ofPTEN silencing on the biological properties of bone marrow mesenchymal stem cels, hoping to offer better seed cels for tissue engineering. METHODS:Bone marrow mesenchymal stem cels were transfected with specific siRNA-silencedPTEN gene using the liposome method, and then RT-PCR was used to detect the mRNA expression ofPTEN. Variation of biological properties ofPTEN-transfected cels were detected by the way of MTT assay, cel cycle analysis, and Transwel assay. RESULTS AND CONCLUSION:PTEN is expressed highly in bone marrow mesenchymal stem cels, which is successfuly interfered by siRNA.PTEN-silenced cels have stronger survival, proliferation and migration abilities, which become a kind of better seed cels for tissue engineering.

BACKGROUND:The correlation of zinc with Stro-1+cells and bone morphogenetic protein 7 surrounding the prosthesis may affect the bone fusion and survival rate in hip prosthesis. ＜br> OBJECTIVE:To analyze the correlation of zinc content with Stro-1+cells and bone morphogenetic protein 7 in proximal femur. ＜br> METHODS:Bone samples were obtained from the discarded metaphysis region of the proximal femur in 24 patients with primary total hip replacement. Bone marrow mesenchymal stem cells were cultured in vitro. At 14 days after culture, Stro-1+cells in bone marrow mesenchymal stem cells were detected using flow cytometry. Bone morphogenetic protein 7 expression in cellsupernatant was detected using enzyme-linked immunosorbent assay. Zinc content in supernatant was measured using radio-immunity assay. ＜br> RESULTS AND CONCLUSION:No significant difference in the zinc content was detected in different age groups and different gender groups. Zinc content was positively associated with Stro-1+cells and bone morphogenetic protein 7 expression. The further study of the trace element zinc in proximal femur can predict and intervene the longevity of hip prosthesis.

Objective To detect the clinical features and prognostic factors of nasal cavity malignancy with breast metastasis.Methods 846 Patients with nasal cavity malignancy from January 1999 to December 2011 were enrolled,the clinical and pathological features,clinical diagnostic methods and prognostic factors for breast metastasis patients were analyzed.Results Six female cases (median age 25) were diagnosed with breast metastasis,including 3 rhabdomyosarcoma and 3 olfactory neuroblastoma; consisting 0.7％ of the total 846 cases of primary nasal malignancy group.The metastasis were more likely to be multiple breast lesions with/without metastasis in other site.For the primary tumor,five patients received 66-72 Gy/30-33f of radical radiotherapy,one patient with rest rhabdomyosarcoma received 58 Gy of palliative radiation since breast metastasis was found after 14 Gy of radiation and breast mass resection were performed right after.For the breast metastasis,five of 6 patients received breast surgery,one patients with olfactory neuroblastoma received 6 cycles cyclophosphamide + adriamycin + vincristine chemotherapy.Median survival was 12.7 months.Conclusions For nasal cavity malignancy,breast metastasis more likely occur in younger female patients.Ultrasound may provide useful information in evaluating breast metastasis.Cases combined with metastasis except breast have unfavorable prognosis.

Objective To observe the influence of Ligustrazine on the hemodynamic effects and prognosis in elderly patients with early cerebral ischemia following intracranial aneurysm operation ,and explore the therapeutic value .Methods 43 elderly patients with ECI following intracranial aneurysm operation were randomly divided into the Ligustrazine group (20 cases) ,and the conven-tional treatment group(23 cases)according to the table of random numbers .The patients in the Ligustrazine group were given intra-venously Ligustrazine injection and combined with conventional therapy ,whereas ,other patients were given conventional treat-ments .Results The clinical effective rate in Ligustrazine group was significantly higher than conventional treatment group (P<0 .05) .Patients recovered well in conventional treatment group were 7 cases(30 .43% ) ,mild disability 8 cases(34 .78% ) ,severe dis-ability 4 cases(17 .39% ) ,plant survival 1 case(4 .34% ) ,3 cases died(13 .06% ) ,data peer-based in the Ligustrazine group were 12 cases(60 .00% ) ,5 cases(25 .00% ) ,2 cases(10 .00% ) ,0 case and 1 case(5 .00% ) ,which were significantly lower than that of con-ventional treatment group .The prognostic scores in Ligustrazine group were apparently higher than conventional treatment group by using Glasgow outcome scale and Chinese stroke scale(P<0 .05) .Meanwhile ,the indicators of hemodynamic effects also reflec-ted that the Ligustrazine improved the blood circulation of patients with ECI ,which was better than the conventional treatment group(P<0 .05) .Conclusion The Ligustrazine Phosphate for injection showed better curative effect and prognosis in elderly pa-tients with ECI following intracranial aneurysm operation .

Objective To review the long-term oncologic and functional outcomes of surgical treatment for pelvic chondrosarcoma at a single institution to further delineate surgical strategy of resection and function reconstruction.Methods All of 165 patients with pelvic chondrosarcoma that had been surgically treated between July 2000 and Dec 2013 were reviewed retrospectively.There were 102 male and 63 female patients who had a mean age of 43.5 (range,13 to 75) years.The resection type included Type T 16,type Ⅱ 18,type Ⅲ 11,type Ⅰ+Ⅱ 19,type Ⅱ+Ⅲ 63,type Ⅰ+Ⅳ 15,type Ⅰ+Ⅱ+Ⅲ 10 and type Ⅰ+Ⅱ+Ⅳ 13 cases.The pathology diagnosis was grade Ⅰ in 15,grade Ⅱ in 88,grade Ⅲ in 20,dedifferentiated in 28,mesenchymal in 12 and clear cell chondrosarcoma in 2 patients.Nine cases were secondary lesion following multiple exostoses.114 patients received no previous treatment while others were referred due to recurrent tumor.En bloc resection was achieved in 142 patients and intralesional resection in 23 cases.Twelve patients had a hemipelvectomy to achieve local tumor control,whereas 153 patients underwent a limb-salvage procedure.Spinal screw-rod system was used to reconstruct anterior pelvic ring after ilium resection.Modular hemipelvic endoprosthesis was utilized to reconstruct periacetabular defect after tumor resection while no reconstruction was performed after ischium and pubis resection.Results The median duration of follow-up was 54.1 (range,l0 to 159) months.147 (89.1％) patients were alive at the final follow-up,seven of which were alive with tumor.The estimated 5-year survival was 81.5％.Thirty-three patients (20％) had local recurrence,and twenty (12.1％) had lung metastasis.Recurrent case,sacroiliac joint involvement and intralesional resction were three risk factors for postoperative recurrence.Patients who received type Ⅱ+Ⅲ resection and reconstruction had a mean functional score of 23 according to MSTS 93.The mean MSTS 93 for patients with type Ⅰ+Ⅱ and type Ⅰ+Ⅱ+Ⅳ resection and reconstruction was 18.The wound complication rate was 15.8％.Two aseptic loosening and 2 pubic connection plate breakage were observed in hemipelvic endoprosthesis reconstruction.Conclusion Tumor grade correlates with overall or disease-free survival.For low-grade chondrosarcoma,adequate surgical margin can provide long-term local control while for high-grade cases,distant metastasis is the main case of treatment failure.Adequate surgical margin can be achieved in cases with acetabulum involved.However,aggressive surgical resection of pelvic chondrosarcoma still remains as a challenge for orthopaedic oncologists when the tumor invades the iliosacral joint,which necessitates careful preoperative plan and skilled surgical techniques.

BACKGROUND:Bioactive glass has been largely reported to have perfect clinical results in the bone nonunion and fracture healing, but its effect during spinal fusion progress is rarely reported.
OBJECTIVE:To explore the safety and effectiveness of anterior cervical discectomy and fusion by cervical cage with bioactive glass
METHODS:A total of 68 cases of cervical spondylosis myelopathy were treated with single level anterior cervical discectomy and fusion. Their clinical data were retrospectively analyzed. Al the cases underwent polyetheretherketone cervical cage with autogenous bone (n=32, control group) or bioactive glass (n=32, experimental group). The bone fusion, neurological functional recovery, intervertebral height, change of cervical curve and wound complications in the two groups was recorded and analyzed.
RESULTS AND CONCLUSION:Neurological improvement had no difference between the two groups and there was no complication about wound, such as infection and delayed healing. The average rate of bone fusion was 97%in the control group while 94%in the experiment group 3 months after operation which had no significant differences. Six months after operation, al cases gained bone fusion. The intervertebral height and change of cervical curve both maintained wel in the two groups within 3, 6, 12 months after operation which had no significant differences between the two groups. So, anterior cervical discectomy and fusion by cervical cage with bioactive glass is safe and effective.