It is difficult to select the appropriate ventilation mode in clinical mechanical ventilation. This paper presents a nonlinear multi-compartment lung model to solve the difficulty. The purpose is to optimize respiratory airflow patterns and get the minimum of the work of inspiratory phrase and lung volume acceleration, minimum of the elastic potential energy and rapidity of airflow rate changes of expiratory phrase. Sigmoidal function is used to smooth the respiratory function of nonlinear equations. The equations are established to solve nonlinear boundary conditions BVP, and finally the problem was solved with gradient descent method. Experimental results showed that lung volume and the rate of airflow after optimization had good sensitivity and convergence speed. The results provide a theoretical basis for the development of multivariable controller monitoring critically ill mechanically ventilated patients.
Exhalation ; Humans ; Lung ; physiology ; Models, Biological ; Nonlinear Dynamics ; Pulmonary Ventilation ; Respiration ; Respiration, Artificial ; Tidal Volume

ObjectiveTo observe the effect of mometasone furoate on serous eotaxin in children with allergic rhinitis.MethodsThe observation group included 30 cases who got allergic rhinitis and treated by mometasone furoate.The level of eotaxin before and after treatment was detected by ELISA,and was compared with normal children in control group.ResultsBefore treatment,the signs scores of observation group was (9.4 ± 2.3 ),and after treatment was(3.1 ± 1.8),the difference was statistically significant(t =2.148,P ＜0.05).The treatment effect contained 19 cases(63.3％ ) 9 cases(30.0％ ) effective and 2 cases(6.7％ ) ineffective.Before treatment,the level of eotaxin in observation group was remarkably higher than control group [ (221.41 ± 137.96 ) ng/L vs ( 128.71 ± 60.73 ) ng/L,t =- 2.721,P ＜ 0.05 ],after treatment,symptom and sign was mitigated and eotaxin level was remarkably lower than before treatment[ ( 115.50 ± 52.71 ) ng/L vs (221.41 ± 137.96 ) ng/L,t =- 3.661,P ＜ 0.05 ].There was no serious adverse reaction in observation group.ConclusionTreated allergic rhinitis by corticosteroids could inhibit the allergic inflammation and down-regulate the eotaxin level.

Objective To evaluate the value of ultrasonic quantitative method in the diagnosis of liver fibrosis in chronic hepatitis B (CHB) patients. Methods Ultrasonography was performed in 186 CHB patients who underwent liver biopsies. Fifteen indices including liver capsule thickness and fourteen texture parameters of gray level co-occurrence matrix were extracted from standard sonograms and compared with fibrosis stages by histopathology. The status of liver fibrosis was divided into five stages from S0 to S4 by histopathology based on the disease severity. ANOVA and Spearman correlation analysis were applied to analyze the differences and relationships between these indices and pathological stage, respectively. Then discriminant analysis models were established based on the indices for quantitative diagnosis of liver fibrosis. Results Among the fifteen indices, including liver capsule thickness, only the variance (F=0. 55, r=0. 06; both P＞0. 05), sum average (F=0.61, both r=0.05 ; P＞0.05), sum entropy (F=1.68, r=0.09; both P≥0.05) and entropy (F=1.39,r=0.12; both P＞0.05) were not significantly associated with the stages and not manifested linear correlation. Using biopsy results as gold standard, the correct rank rate of discriminant analysis model analysis in the patients staged from S0 to S4 were 80. 0%, 64. 9%, 61.3%, 74. 1% and 80.6 %, respectively. There were 73.1% of cross-validated cases who were accurately classified by the model analysis. The sensitivity, specificity and accuracy in patients with stage ≥ 1 were 97. 6%,80.0% and 91.9%, respectively; those in patients with stage≥2 were 92.1%, 89.7% and 90.9%,respectively; those in patients with stage≥3 were 94.8%, 96.1% and 95.7%; and those in patients with stage 4 were 80. 6%, 97.4 % and 94.6%, respectively. When considered S0 as no fibrosis, S1 as mild fibrosis, S2 and S3 as moderate to severe fibrosis and S4 as early cirrhosis, the consistence rates between discriminant analysis model and biopsy result were 81.7%, 78. 4%, 56. 9% and 90.3%,respectively. There were 74.7% of cross-validated cases who were correctly classified. The sensitivity, specificity and accuracy of the models for determining the fibrosis severity in patients≥mild fibrosis were 97.6%, 81.7% and 92.5%, respectively; those in patients ≥ moderate to severe fibrosis were 83. 1%, 94.8% and 89.2%, respectively; those in patients with early cirrhosis were 90.3%, 93.5% and 93.0%, respectively. Conclusion As a novel and noninvasive method, ultrasonic texture analysis could quantitatively determine liver fibrosis in CHB patients and is worthy of further investigation.

Objective To produce the experimental pig model of obstructive sleep apnea hypopnea syndrome(OSAHS) through raising pigs in the lower pressure container in order to study the effect of low pressure on morphology of upper respiratory soft tissue in pig.Methods The pigs were living in a container of low pressure for 6 months to make up the pig models of OSAHS.When the symptoms like OSAHS appearing and the pharyngeal respiratory pressure changing like the characteristics of OSAHS,the pigs were scanned by CT and compared with controls.Results The pharyngeal rear wall and soft palate in model pigs were thickened(0.94 cm?0.16 cm and 1.06 cm?0.23 cm respectively),while in control groups were(0.60 cm?0.11 cm and 0.59 cm?0.13 cm respectively).The cross-sectional area of upper airway in anterior,middle and rear parts were(1.49?0.12) cm2,(1.37?0.32) cm2 and(1.00?0.21) cm2 respectively,the narrowest part was in rear area,and in control groups were(1.30?0.14) cm2,(1.57?0.32) cm2 and(2.48?0.42) cm2 respectively.Conclusion The lower pressure condition can be used to produce animal experimental model of OSAHS,the low pressure is the important factor to cause OSAHS.

Objective To study the association of single nucleotide polymorphisms (SNPs) of the frizzled 6(FZD6) gene with neural tube defects(NTDs) in a northern Han Chinese population.Methods Three nonsynonymous SNPs in the FZD6 gene (rs827528,rs3808553,rs12549394) were examined.The SNPs were genotyped by polymerase chain reaction (PCR) and sequencing in 135 NTD patients and matched normal controls.The allele,genotype and haplotype frequencies were calculated and analyzed to examine the association between FZD6 SNPs and NTDs.Results Both T allele and TT genotype frequencies of the rs3808553 polymorphism in the NTDs group were significantly higher than those in the controls,and children with T allele and TT genotype were associated with increased risk of NTDs (OR =1.575,95％ CI 1.112-2.230,P =0.010 and OR =2.811,95％ CI 1.325-5.967,P =0.023 respectively).There were no significant differences among different genotypes or alleles in both rs827528 and rs12549394.Haplotypes AG-C and A-T-C were found associated with NTDs in the case-control study (OR =0.560,95％ CI 0.378-0.830,P=0.004 and OR=1.670,95％CI 1.126-2.475,P =0.011 respectively).Conclusions The rs3808553 polymorphism of FZD6 is obviously associated with NTDs in children of northern Han Chinese population.The TT genotype may increase the risk for NTDs.The rs827528 and rs12549394 polymorphisms of FZD6 may have no association with NTDs.

In this cross-sectional study, consecutive Chinese Han ethnic inpatients in the Division of Cardiology, the First Affiliated Hospital of Soochow University from January 1, 2010 to December 31, 2013 were included. According to the exclusion criteria, 9 587 patients [1 604 with type 2 diabetes mellitus (T2DM) and 7 983 without T2DM]were obtained for final analysis. Logistic regression model was used to analyze the association of ApoB/A-1 ratio with T2DM and the possible interactions between ApoB/A-1 ratio and other risk factors. The results showed that the distribution of ApoB/A-1 ratio was positively skewed in Chinese Han ethic population. The median of ApoB/A-1 ratio of female was lower than that of male (0.68 vs 0.73,P<0.01). In all groups, the proportion of T2DM was increased with the raised ApoB/A-1 ratio. By the stratification analyses of sex, age, coronary artery disease, and the use of statins, ApoB/A-1 ratio was still correlated with T2DM. There existed significant interactions between ApoB/A-1 ratio and the smoking status or creatinine in T2DM.

Objective To explore ICSI treatment process in the different proportion of oocytes maturation and dosage of gonadotropin affecting embryo quality and clinical outcome. Methods From Jan. to Dec. 2015,we retrospectively analyzed the patients from the center line of ICSI cycle ,divided them into three groups according to the maturity of oocytes. The 3 groups were due to maturity rate of oocytes in 50% in group A(n = 19),50% 0.05). Group A had the best egg rate,high quality embryo rate,clinical pregnancy rate than the other two groups (P < 0.05). In pregnancy and non-pregnancy groups ,the dosage of gonadotropin in the non-pregnancy group was obviously higher than that in the pregnancy group in oocyte maturation in the same proportion interval(P<0.05). Conclusion In ICSI treatment process,the high dose of gonadotropin and rising rates of oocytes maturation are not conducive to the development potential of the egg and clinical outcome,so the dose of gonadotropin and oocyte maturation ratio should be controlled in a certain range to collect and protect the best dominant egg which matches to the state of the patient.

Objective To explore risk factors for healthcare-associated infection (HAI)in patients undergoing craniocerebral operation,and provide guidance for the prevention of HAI in patients in department of neurosurgery. Methods 200 patients who underwent craniocerebral operation in a department of neurosurgery from November 2013 to November 2014 were surveyed,risk factors for HAI were analyzed.Results Among 200 patients undergo-ing craniocerebral operation,81 patients developed 99 cases of HAI,HAI rate was 40.50%,HAI case rate was 49.50%;the top five HAI sites were lower respiratory tract,urinary tract,intracranial site,bloodstream,and in-testinal tract.Univariate analysis showed that patients’age ≥60,Glasgow Coma Scale (GCS)<15,intraoperative blood loss ≥800 mL,staying in intensive care unit(ICU),indwelling gastric tube,ventricular drainage,using ventilator,tracheotomy,and using H2 receptor antagonists were important risk factors for HAI in patients undergo-ing craniocerebral operation (all P <0.05).Multivariate logistic regression analysis showed that patients’age ≥60, GCS<15,staying in ICU,and using H2 receptor antagonists were independent risk factors for HAI in patients un-dergoing craniocerebral operation.Conclusion Strengthening the surveillance of HAI patients undergoing cranioce-rebral operation and realizing risk factors for HAI are helpful for taking comprehensive prevention measures and re-ducing the incidence of HAI.

Objective To establish a Wuzhishan minipig model of atherosclerosis(AS) induced by high fat/cholesterol diet,and observe the changes of expression of lipoprotein associated phospholipase A2(Lp-PLA2) in plasma and plaques.Methods 10 Wuzhishan minipigs were randomly divided into 2 groups:The normal control(Ctr,n=4) group was fed with normal diet,and AS model(n=6) group fed with high fat/cholesterol diet for 24 weeks.After the modeling for 24 weeks,the changes of total cholesterol(TC),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),triglyceride(TG),C-reactive protein(CRP),Lp-PLA2 activity and composition were detected.The changes of vascular lipid deposition and plaques were assessed by pathology using oil red O staining and HE staining,respectively,and immunohistochemical staining for IL-6 protein expression.Moreover,the expression of Lp-PLA2 mRNA determined by RT-PCR and protein by Western blot were observed in the abdominal aortic tissues.Results Compared with the control group,the body weight,body mass index(BMI),TC,LDL-C,HDL-C,CRP,Lp-PLA2 activity and composition and aortic lipid deposition were significantly increased,and AS plaque formation was observed in the AS model group(P<0.05,P<0.01).The expression of Lp-PLA2mRNA and protein and IL-6 protein in abdominal aortic tissues were also significantly increased(P<0.05).Conclusions Long-term high fat/cholesterol diet feeding for 24 weeks can induce atherosclerosis in Wuzhishan minipigs,and Lp-PLA2 plays a key role in the vascular inflammation and plaque formation.

Objective The aim of this study was to explore the effect of testosterone deficiency on serum lipid levels and hepatic lipid accumulation in miniature pigs fed a high-fat diet (HFD).Methods Eighteen sexually mature male Chinese Wuzhishan miniature pigs (6~7 months old) were used in this study.The pigs were divided in three groups ( n =6 animals/group ) as follows: intact male pigs , castrated male pigs and castrated male pigs with testosterone replacement .They were fed a HFD diet for 12 weeks and body weights were recorded weekly .Serum levels of testosterone , total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were measured.Hepatic TG and TC levels were also determined , and liver tissues were embedded in paraffin and stained with hematoxylin and eosin (H&E).Results (1) The body weights of pigs in each group were found to be linearly elevated over time .Though castrated pigs gained less weight than did pigs in the other groups , no significant differences were found between them .( 2 ) Castration caused a significant decrease in serum testosterone levels in pigs . This effect was recovered by testosterone treatment .(3) Serum levels of TC, LDL-C and TG were significantly increased in castrated pigs.However, castration had no significant effect on serum HDL-C levels.Testosterone treatment reduced the increased serum lipids in castrated pigs .(4) Hepatic TG and TC contents in castrated pigs were also significantly higher than those in other groups of pigs .Testosterone treatment reduced the increased hepatic lipids in castrated pigs .( 5 ) Compared with other groups of pigs , castrated pigs showed increased steatosis .However , testosterone treatment attenuated hepatic steatosis in castrated pigs .Conclusion Testosterone deficiency caused severe dyslipidemia , and increased hepatic lipid accumulation in miniature pigs fed a high-fat diet.