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 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

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 develop an assay with polyclonal antibodies against a fragment derived from human albumin for determination of a peptide in urine, and to provide an early diagnostic tool for GVHD. Methods A small peptide composed of 16 amino acids (LVRYTKKVPQVSTPTL) was synthesized artificially. The immunogen was then diluted into 100 μg/kg body weight of rabbit. Subcutaneous injection in the immune animals was performed on both sides of spine and groin with 2.5 ml antigen suspension for three times, in order to prepare the polyclonal antibodies. The peptide antigen was then labeled with fluorescein isothiocyanate (FITC), and detected by LIF-CE-IA with the pre-prepared antibodies. Results The titer of serum. The migration time of the labeled antigen was 5.93 min, while the migration time of antigen-antibody complex was 6.47 min. The linear range of the method was 16 to 512 ng/ml, and the minimum detection limit was 10 ng/ml. Conclusions The polyclonal antibodies against the peptide antigen was isolated successfully, which possessed high titer and specificity. These results indicated that the assay was simple and rapid and could be applied for the early diagnosis of patient with GVHD.

Objective To study the clinical efficacy of Akin combined Scarf osteotomies for moderate and severe hal?lux valgus. Methods Thirty-nine (58 feet) patients received Akin combined Scarf osteotomies, in which 12 patients (16 feet) with moderate hallux valgus received the single scarf osteotomy. Hallux valgus angle (HVA), intermetatarsal angle (IMA), tibial sesamoid position and American orthopedic foot and ankle society score (AOFAS) were measured and compared before and after operation respectively. Results All operations were successfully completed patients were followed up for 8-22 months. The mean operation time was (55.0±6.8) min. The amount of intraoperative bleeding was 3-20 mL with an aver?age of (11.0±5.4) mL. All patients were healed except for a delayed union of Akin on a severe hallux valgus patient. Two cas?es (2 feet) were found inflammation in surgical incision. Two cases (2 feet) were found numbness in dorsal medial side of hal?lux, which was considered nerve damage and improved in 3-5 months. There was no recurrence of hallux valgus in the peri?od of following up. After surgery, HVA (14.1°±5.3°), IMA (7.7°±3.8°) and tibial sesamoid position (2.58±0.61) were signifi?cantly decreased compared with those before operation (39.6° ± 6.8° , 18.7° ± 5.4° and 4.87 ± 0.59, P<0.05). AOFAS score (84.4±8.7) was significantly higher after surgery than that before surgery (37.3±9.5, P<0.05). Conclusion Akin combined Scarf osteotomies can achieve a excellent therapeutic effect for moderate and severe hallux valgus with very few complica?tions and recurrence, which is worth for clinical application.

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.

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: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.

Objective To investigate the association between FcγRIIA H/H131 genotype and pneumonia through a comprehensive meta‐analysis .Methods Databases including PubMed ,Embase ,and China National Knowledge Infrastructure (CNKI) were searched with such terms as “FcgammaRIIa” ,“FCGR2A” ,“Fcgamma receptor IIA” ,“CD32” and“pneumonia” ,“polymorphism” ,“variant” ,“genotype” ,“allotype” ,as well as“pneumonia”and“polymorphism”in Chinese to identify relevant studies .Two reviewers independently extracted the data .Crude odds ratios (ORs) and corresponding 95%confidence intervals (CIs) were estimated .Heterogeneity across studies and publication bias were evaluated and sensitivity analyses were performed .Results Six case‐control studies were finally included in this analysis .The results indicated an association between FcγRIIA H/H131 genotype and pneumonia susceptibility (OR 1 .67 , 95% CI 1 .11‐2 .51 ) , but no significant association with R/R genotype(OR 1 .09 ,95% CI 0 .85‐1 .40) or H/R genotype(OR 0 .81 ,95% CI 0 .60‐1 .19) . Statistically significant heterogeneity was found during data pooling (I2 was 75 .4 % ,51 .8% and 71 .9% ) .Sensitivity analyses further indicated the reliability of the study .Egger′s and Begg′s tests identified publication bias in R/R genotype ,but not in H/H or H/R genotype .Conclusions We preliminarily find an association between FcγRIIA H/H131 genotype and pneumonia susceptibility .

Objective:To review and compare the clinical features and treatment outcomes of oral and maxillofacial space infection (OMSI)between diabetic and non-diabetic patients.Methods:Clinical data of 43 diabetic patients with OMSI(simultaneoustly treated by blood sugar control)and 84 of non-diabetic patients with OMSI were reviewed,the clinical features and treatment outcomes were compared.Statistical analyses were conducted by T test,the chi square test and variance analysis.Results:Diabetic patients with OM-SI were older(P =0.000),had more spaces involved concurrently(P =0.035 )and had higher blood sugar at presentation(P =0.000).There was no significant difference between groups about the use and change of antibiotics,the incision times,hospital stay durition and the incidence of the complications.Conclusion:The prognosis of the diabetic patients with OMSI under the strict control of the blood glucose concentration has no significant difference from the non-diabetic patients with OMSI.Diabetic patients with OMSI have older age and more spaces involved,and special attention should be paid.