This article introduces a measurement circuit for Respiratory Mechanics Parameters which is based on differential pressure sensor. The circuit detects the flow and airway pressure signals from the sensors, then more than ten Respiratory Mechanics Parameters are identified. The system meets the clinical need of Respiratory Mechanics measurement, and improves the performance of domestic Patient Monitor.

AIM To investigate the effect of tocotrienol rich fraction of palm oil (TRF) on glucose metabolism in atherosclerotic mice and the possible mechanism. METHODS Apolipoprotein E gene deficient(ApoE~(-/-)) mice were divided into 3 groups as model control, TRF 0.05% and 0.2%(W/W) groups. 10% (W/W) fat and 0.2% (W/W) cholesterol were added into the diets to induce atherosclerosis formation. Oral glucose tolerance test and insulin tolerance test were conducted after mice were treated by TRF for 12 and 14 weeks respectively. Serum cholesterol, triglyceride, free fatty acid, and insulin levels were measured using corresponding kits. The mRNA expression levels for peroxisome proliferator-activated receptor γ(PPARγ), adiponectin and glucose transporter 4 (Glut4) in white adipose tissue (WAT) were determined by using quantitative real-time PCR. Activation of PPARγ by TRF was tested using luciferase reporter assays. RESULTS Compared with the model control group, TRF decreased non-fasting or fasting blood glucose levels and improved insulin sensitivity of ApoE~(-/-) mice. Both TRF groups showed decreased levels of triglyceride and free fatty acid. The mRNA level of adiponectin in WAT was up-regulated by (1.73±0.32) times in TRF 0.2% group compared with the control group. Glut4 mRNA level was increased (1.89±0.24) and (2.01±0.61) times compared with control group in TRF 0.05% group and TRF 0.2% group respectively. The fold inductions of TRF on PPARγ-ligand-binding domain, PPARγ1 and PPARγ2 activities were (2.7±0.2), (6.1±0.65) and (5.3±0.1) times compared with DMSO by using luciferase reporter assay. CONCLUSION TRF can improve glucose metabolism in atherosclerotic mice and this effect may be partly due to modulating the activity of PPARγ.

This article summarizes our experience in nursing 40 gastric carcinoma patients receiving fast track(rapid recovery) surgery,proposing that the emphasis of nursing should be placed on psychological care and health education before the operation,warm-keeping during the operation,pain control,early food intake,early movement and management of complications after the operation,and necessary follow-up after discharge.

Endoscopic ultrasound was initially introduced in 1980s as a diagnostic modality combining echoendoscopes with radial scanning, which permitted reconstruction of cross-sectional images similar to computed tomography. Many studies showed that endogastric ultrasonography is more accurate than endoscopy or CT in evaluating the depth of invasion ( T category) and the involvement of lymph nodes (N category) in patients with gastric carcinoma. In addition to being very useful in tissue acquisition for diagnostic purposes, the principles behind endoscopic ultrasound-guided fine needle aspiration ( FNA) paved the way for the development of therapeutic endoscopic ultrasound, which improve the prognosis of patients with gastric cancer.

Objective To describe the clinical characteristics of 9 cases of idiopathic pulmonary alveolar proteinosis (iPAP) with secondary infections. Method The clinical and radiological data of 9 patients with iPAP and secondary infections admitted into Peking Union Medical College Hospital from 1 st January 1990 to 1st January 2010 were retrospectively analyzed. Results In that period, there were 97 patients of iPAP were admitted in our hospital. There were 9 patients of iPAP with secondary infections,aged (46.4±14.6)y. There were 5 males and 4 females. Among them, 6 patients were misdiagnosed as interstitial pneumonia and corticosteroids were given to them. When the infection appeared, corticosteroids were still given to 3 patients, and the other 3 patients had stopped corticosteroids for 3 to 15 and a half months. Five patients had accepted mono-lung or whole lung lavage before 1,2, 9, 14,24 months. The clinical manifestations were fever(8 cases) ,cough(9 cases) , expectoration(8 cases) ,hemoptysis(2 cases),chest pain(1 case) and moist rales(1 case). Glass-ground opacities (9 cases) and cavitations(4 case)were the main manifestations of chest radiology. Pleural effusions(1 case) was not common. The locations of infection was limited in chest:9 cases had pulmonary infection and one case was associated with pleurisy.The infectious pathogens were the acid-fast tubercle bacillus (4 cases), fungus (3 cases, candida albicans,penicillium and aspergillus fumigatus for each one) and norcardia (2 cases, one case was associated with cytomegalovirus infection). Follow-up: 6 patients were cured, 1 patient was improved and 2 patients were died. Conclusions For patients with iPAP, especially when they had been receiving corticosteroids, if they had fever and/or recently exaggerated dyspnea, especially whose chest radiology showed nodules and cavitations, the clinicians should be aware of infections diseases for them. Further specific microbiological studies and sufficient therapy should be obtained as quickly as possible.

Objective To measure the serum levels of endothelin-1 (ET-1) and transforming growth factor-β(TGF-β) in the newborns with respiratory distress and investigate its clinical significance. Methods Newborns with respiratory distress hospitalized into the Newborn Intensive Care Unit were included. The serum levels of ET-1 and TGF-β were all detected with ELISA in the first six hours,3,7,14 and 28 days after birth. Results The highest levels of ln ( 1 + ET-1 ) and ln ( 1 + TGF-β) were obtained from newborns with diagnosis as meconium aspiration syndrome ( 1.95 ± 1.02) ng/L and ( 1.51 ±0.99) ng/L,respectively) in the samples obtained in the first six hours after birth, and these were statistically different from those of the control group ( P ＜ 0. 05 ). Following were obtained for newborns with respiratory distress syndrome ( ( 1.52 ± 0.74 ) ng/L and ( 1.13 ± 0. 48 ) ng/L, t = 2.28,2. 13,respectively). After oxygen treatment, ET-1 levels obtained in the first six hours of life decreased gradually in the following days (P ＜0.05 ). Conclusions The measurements of ET-1 and TGF-β levels will help in differentiating diagnosis of the respiratory distress of newborns. The ET-1 levels will help to assess the therapy effectiveness and prognosis.

Objective To research the effect of perioperative thermal preservation on hemostatic function in elderly patients with laparoscopic rectal cancer resection.Methods Eighty-six elderly patients with laparoscopic rectal cancer resection with ASA Ⅰ-Ⅱ were randomly divided into control group (43 patients) and test group(43 patients).Control group was given routine operation,test group was given routine operation and thermal preservation.The nose pharynx temperature was monitored and recorded respectively on preanesthesia,30,60,90 min post-anesthesia and after operation.The level of prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT),platelets (PLT),D-dimer(DD),fibrinogen (FBG),yon Willebrand factor (vWF) were detected on preanesthesia,30,60,90 min post-anesthesia and 24,48 h post-operation.Results The temperature in control group on 30,60,90 min pest-anesthesia and after operation [(36.1 ± 0.2),(36.0 + 0.1),(35.7 + 0.1),(35.6 ± 0.2) ℃] was significantly lower than that on preanesthesia [(36.8 ± 0.2) ℃] and the same time in test group [(36.8 ± 0.0),(36.7 ± 0.1),(36.7 +0.2),(36.8 ±0.2) ℃] (P ＜0.05).The level of PT,APTT and TT in control group on 30,60,90 min post-anesthesia and after operation were significantly longer than those on preanesthesia and the same time in test group (P ＜0.05).The level of PLT in control group after operation and on 24,48 h post-operation were significantly lower than preanesthesia and the same time in test group(P ＜ 0.05).The level of DD and vWF in control group on 24,48 h post-operation were significantly higher than preanesthesia and the same time in test group (P ＜ 0.05).The level of FBG in control group on 24,48 h post-operation were significantly lower than preanesthesia and the same time in test group (P ＜ 0.05).The hemostatic function had no significant change in test group (P ＞0.05).Conclusion The perioperative thermal preservation in elderly patients with laparoscopic rectal cancer resection can alleviate hemostatic function suppression and promote recovery.

Objective To investigate the mid-term effect of SolitaireAB stent-assisted interventional embolization with spring coils for the treatment of intracranial wide-necked aneurysms. Methods During the period from May 2009 to April 2013, a total of 49 patients with intracranial wide-necked aneurysm (49 aneurysms in total) received SolitaireAB stent-assisted interventional embolization treatment at authors’ hospital. In 41 patients, a total of 41 aneurysms were detected, of which ruptured aneurysm with bleeding was confirmed in 26 and un-ruptured aneurysm in 15. These 41 patients were followed up for 12-48 months. Based on modified Rankin scoring and DSA, CTA or MRA manifestations, the clinical results were evaluated. Results After the embolization treatment, re-bleeding of the aneurysm occurred in 2 cases, cerebral infarction in 3 cases, occlusion of the parent artery in one case and death in one case; the occurrence rate of complications was 14.2%. DSA, MRA or CTA performed at 12 months after the embolization treatment, showed that 32 aneurysms (78.0%) were completely obstructed, which was obviously higher than that observed on DSA performed immediately after the embolization procedure (21 aneurysms, 42.9%), the difference was statistically significant (P=0.02);residue of aneurismal neck was seen in 7 cases (17.1%) and partial occlusion in 2 cases (4.9%), which were much better than those observed on DSA that was performed immediately after the embolization procedure. Twenty-four aneurysms (58.5%) remained stable, showing no any change, and recurrence of aneurysm was observed in 4 cases (9.7%). At the last follow-up exam, the modified Rankin scoring showed that 0 point was seen in 18 cases (43.9%), one point in 10 cases (24.4%), 2 points in 5 cases (12.2%), 3 points in 4 cases (9.8%), 4 points in 2 cases (4.85%) and 5 points in 2 cases (4.85%). The self-care rate for daily activities was 80.5%, the prognosis was good. Conclusion For the treatment of intracranial wide-necked aneurysms, SolitaireAB stent-assisted interventional embolization with spring coils is safe and effective. This technique can improve the embolization rate and reduce the procedure-related complications.

BACKGROUND:As the epiphyseal plate has an important role in the growth and development of femur, the design of internal fixation should avoid the damage to the epiphyseal plate. Therefore, the positioning of pediatric femoral epiphyseal plate is particularly important.
OBJECTIVE:To investigate the biomechanical property of the new femur neck screw internal fixation in treatment of children femoral neck fracture.
METHODS:Twelve femurs were col ected from six fresh children cadavers provided by Dissecting Room of University of South China. After exclusion of bone disease with X-ray film, three new children femoral neck screws and three Kirschner wires with the diameter of 2.0 mm were used for fixation. The biomechanical tests were conducted to detect the axial compression and torsion stiffness.
RESULTS AND CONCLUSION:In the children femoral neck screw group, the axial compression stiffness and torsion stiffness under the torsional torque of maximum 3 N?m were (190.74±20.88) N/mm and (0.18±0.045) N?m/° respectively;(138.95±15.19) N/mm and (0.120±0.036) N?m/° respectively in the Kirschner wire group;there were significant differences in the axial compression stiffness and torsion stiffness between two groups (P<0.05). The results showed that the compressive strength and torsional capacity of the children femoral neck screw were strong than those of Kirschner wire. The experiment suggested that the femoral neck screw for children is a new type of ideal internal fixation device which consist with the anatomical features of children proximal femur and can meet the requirement of children femoral neck fracture with good biomechanical property.

Objective To explore the value and advantage of intracranial pressure (ICP) monitoring in the treatment of hypertensive intracerebral hemorrhage (HICH) through minimally invasive surgery. Methods Seventy-three HICH cases were randomly selected and then divided into control group and treatment group. Thirty-four of them in control group received soft-channel minimally invasive hematoma removal. The head of the soft-channel was placed in the center of the hematoma. One third to half of the initial hematoma was extracted during the operation. Urokinase was injected into the soft channel to dissolve the hematoma. Thirty-nine of them in treatment group underwent the same operation procedure but with ICP monitoring to control aspirating hematoma during the operation. The target ICP was 15 mmHg. The aspiration of hematoma may stop once the ICP down to the target. Treatment such as urokinase injection was adjusted according to the value of ICP monitoring throughout the operation. The incidence of rebleeding, hematoma evacuation time and the average length of stay between two groups were compared. Results The results showed that one fifth of hematoma extracted was enough for a desired ICP. There found no rebleeding case in treatment group while 4 cases in control group and the difference had statistical significance. The hematoma evacuation time and the average length of stay between two groups had statistical significance. Conclusion Continuous ICP monitoring combined with directional software channel minimally invasive surgery changes the concept of empirically intraoperative hematoma evacuation and postoperative drug injection and proposes the idea of controlling drainage. It can shorten the course, provide sensitive and objective indicators and basis, reduce the secondary brain injury and improve prognosis.