Objective To investigate the influence of oxygen supply flow rate in high-flow nasal cannula(HFNC)oxygen therapy on pressure distributions in the upper airway.Methods A three-dimensional(3D)model of the upper airway was reconstructed using CT images from an adult male,and then coupled with a high-flow nasal cannula model to establish a coupled model of the nasal cannula and the upper airway.Subsequently,a physical model of this upper airway,which was combined with a head model,artificial lungs,and a monitoring system was created by 3D printing technology to form a physical simulation platform in vitro.Computational and physical simulations were carried out respectively to determine the air pressure at typical locations in the upper airway under different oxygen supply flow rates.Results Pressures at typical upper airway locations obtained by computational and physical simulations turned out to be in good agreement;both peak inspirational pressure(PIP)and positive end-expiratory pressure(PEEP)increased quadratically with the increase of oxygen supply flow rate;and the air pressure distribution was more uniform in the laryngeal cross-section as compared to the nasal part of the upper airway.Conclusions This study may provide a theoretical support for optimization of the setting of oxygen suppy flow rate and the selection of PEEP effect assessment position in the clinical application of HFNC oxygen therapy.

Objective To investigate the influence of oxygen supply flow rate in high-flow nasal cannula(HFNC)oxygen therapy on pressure distributions in the upper airway.Methods A three-dimensional(3D)model of the upper airway was reconstructed using CT images from an adult male,and then coupled with a high-flow nasal cannula model to establish a coupled model of the nasal cannula and the upper airway.Subsequently,a physical model of this upper airway,which was combined with a head model,artificial lungs,and a monitoring system was created by 3D printing technology to form a physical simulation platform in vitro.Computational and physical simulations were carried out respectively to determine the air pressure at typical locations in the upper airway under different oxygen supply flow rates.Results Pressures at typical upper airway locations obtained by computational and physical simulations turned out to be in good agreement;both peak inspirational pressure(PIP)and positive end-expiratory pressure(PEEP)increased quadratically with the increase of oxygen supply flow rate;and the air pressure distribution was more uniform in the laryngeal cross-section as compared to the nasal part of the upper airway.Conclusions This study may provide a theoretical support for optimization of the setting of oxygen suppy flow rate and the selection of PEEP effect assessment position in the clinical application of HFNC oxygen therapy.

Pulmonary fibrosis is a respiratory system disorder characterized by damage to alveolar epithelial cells,pathological proliferation and transformation of fibroblasts,excessive deposition of extracellular matrix,leading to structural damage and loss of function in lung tissues,with a high mortality rate and limited effective treatment methods.This article was based on the TCM understanding of"lung connecting to large intestine",namely the theory of"lung and the large intestine being interior-exterior related",and set the modern medical understanding of"lung connecting to large intestine",namely the theory of"gut-lung axis"as the key.Combining the TCM pathogenesis of pulmonary fibrosis and the related mechanisms of"gut-lung axis"in pulmonary fibrosis,it preliminarily expounded the connotation of TCM regulating the"gut-lung axis"to treat pulmonary fibrosis,aiming to provide new ideas for clinical treatment of pulmonary fibrosis through the"gut-lung axis".

Acute ischemic stroke (AIS) is a kind of central nervous system disease that seriously threatens human health and life. Current treatment for AIS is mainly reperfusion. However, the time-sensitive of reperfusion limits its clinical application, and a considerable part of patients within the time window cannot achieve the expected effect after reperfusion; related complications of reperfusion have not been completely solved. So far, some clinical trials have confirmed that neuroprotectants are useful supplements and adjuncts to reperfusion. This paper reviews the recent advance in neuroprotectants combined with reperfusion in AIS to provide references for AIS treatment.

Objective To study the hemodynamic effects of enhanced external counter pulsation(EECP)on typical coronary artery disease and microcirculation angina.Methods A physiological model of the right dominant coronary artery,including the coronary conduit arteries and coronary microcirculation,was established using lumped parameter models.Pathological conditions,such as one-vessel lesions,three-vessel lesions,and microcirculation angina,were simulated.EECP intervention models were established,and the hemodynamic effects of EECP on pathological models was simulated.Results The simulation results of the coronary physiological model,pathological models,and EECP intervention model established in this study were consistent with experimental data in related literature.EECP improved coronary blood flow in all three pathological conditions.For one-vessel lesions,EECP could not recover the blood flow of left main coronary artery to a normal level after the stenosis rate reached 80%-85%.For three-vessel lesions,EECP treatment could not be used if the stenosis rate in one of the three vessels exceeded 90%.For microcirculation angina,EECP was effective when critical condition myocardial blood flow was>1.03 mL/min·g and coronary flow reserve was>1.64.Conclusions The model of coronary disease under EECP interference established in this study meets expectations,and the obtained simulation data have certain reference values for the clinical application of EECP.

Objective:The aim of this study was to explore whether hydroxysafflor yellow A (HSYA) combined with hyaluronidase (HAase) can enhance the therapeutic effect of arterial embolism caused by hyaluronic acid (HA) .Methods:Thirty-two white male rabbits were randomly divided into four groups, with 8 rabbits in each group, of which group A, B and C were experimental groups and group D was group control. An axial rectangular composite tissue flap sized 2.0 cm × 5.0 cm, with 1.0 cm pedicle width, and 4.0 cm from the root, was designed with the central auricular artery as the long axis on the dorsal side of the ear. The depth of incision reached the ventral perichondrium of the ear, and the flap was sutured continuously in situ and divided into three equal parts (area Ⅰ, Ⅱ, Ⅲ) from the proximal area to the distal area. The proximal end 1 cm to the flap and the central artery was the intersection point, into which 50 μl HA was injected, by which the model of HA arterial embolism was established. Each group was treated after 60 min. Group A: 20 ml solution HSYA was injected slowly into the thigh saphenous vein (the dosage of HSYA is calculated at 10 mg/kg) . Group B: 0.5 ml solution HAase was injected into the central auricular artery (400 U/ml) . Group C: 0.5 ml solution HAase with the same dosage of group B was injected into the central auricular artery and 20 ml solution HSYA with the same dosage of group A was injected slowly into the thigh saphenous vein. Group D and other parts of group A and B were injected with the same dosage of normal saline (NS) . The thigh saphenous veins of all groups were injected with the same dosage of solution once a day for 14 days. Flaps were observed immediately, 1, 7 and 14 days after establishment of hyaluronic acid arterial embolism models of tissue flaps, and dorsal and backlight auricular photographs were taken. On the postoperative 14th day, percentages of survival areas of the flaps were calculated, and samples were taken from areas II of tissue flaps, which were stained by hematoxylin-eosin (HE) and Masson, and were detected the activity of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) . The measurement data conformed to normal distribution was represented as Mean ± SD. Single factor analysis of variance (ANOVA) was used to compare the differences among groups, and head-to-head comparison by LSD test. P <0.05 was considered statistically significant. Results:Tissue flaps of all groups were pale immediately after operation. On the first day after operation, the dark ischemic area appeared at the distal end of each group. On the postoperative 7th day, the ischemic area of each group was necrotic and blackened to varying degrees, and the non-necrotic area swelled obviously. On the postoperative 14th day, the ischemic area of each group was further necrotic, blackened, curled and the boundary was clear. Group C was the best, group D was the worst, and both group A and B were between the two. The swelling of non-necrotic areas in group A and C were basically reduced. HE staining showed that numerous thrombi and inflammatory cells infiltration were formed in group D, and group B was behind it, and thrombi were rare in group A and C. Masson staining showed that collagen fibers were arranged regularly in group C, and abundant collagen fibers were disintegrated and disordered in group D, and both group A and B were between the two. The percentages of survival areas of the flaps in group A, B, C and D were as follows: (69.87 ± 5.04) %, (85.03 ± 6.58) %, (93.93 ± 4.25) % and (49.22±9.64) %. There were statistical differences in pairwise comparison between groups (all P <0.05) . SOD activity of group A, B, C and D were as follows: (49.83±8.08) , (36.65±5.49) , (55.61±7.93) and (22.45 ± 5.47) U/mg prot. Except that group A vs. C, there were statistical differences between groups (all P <0.05) . MDA content of group A, B, C and D were as follows: (0.77±0.17) , (1.03±0.16) , (0.68±0.12) , and (0.41±0.09) nmol/mg prot. Except that group A vs. C, there were statistical differences between groups (all P <0.05) . Conclusions:Under the condition of animal experiment, compared with HAase, HSYA combined with HAase can significantly enhance the therapeutic effect of HA arterial embolism and increase the proportion of survival area of tissue flap.

Objective:To explore the therapeutic effect of hydroxysafflor yellow A (HSYA) combined with hyaluronidase (HAase) for arterial embolism caused by hyaluronic acid (HA).Methods:Thirty-two white male rabbits were randomly divided into four groups, with 8 rabbits in each group. Groups A, B and C were experimental groups, while group D served as the control group. An axial rectangular composite tissue flap sized 2.0 cm × 5.0 cm, with a pedicle width of 1.0 cm, and located 4.0 cm from the root, was designed with the central auricular artery as the long axis on the dorsal side of the ear. The incision depth reached the ventral perichondrium of the ear, and the flap was sutured continuously in place and divided into three equal parts (areas Ⅰ, Ⅱ, Ⅲ) from the proximal to the distal area. The proximal end, located 1 cm from the flap, and the central artery was the intersection point, where 50 μl of HA was injected to establish the model of HA arterial embolism. Each group was treated after 60 minutes. Group A: 20 ml of HSYA solution was slowly injected into the saphenous vein of the thigh (the dosage of HSYA was calculated at 10 mg/kg). Group B: 0.5 ml of HAase solution was injected into the central auricular artery (400 U/ml). Group C: 0.5 ml of HAase solution with the same dosage as in group B was injected into the central auricular artery, while 20 ml of HSYA solution with the same dosage as in group A was slowly injected into the saphenous vein. Group D and other parts of groups A and B were injected with the same dosage of normal saline (NS). The thigh saphenous veins of all groups were injected with the same dosage of solution once daily for 14 days. Flaps were observed immediately, 1, 7 and 14 days after establishing hyaluronic acid arterial embolism models of tissue flaps. Dorsal and backlight auricular photographs were taken. On the 14th day postoperatively, the survival areas of the flaps were calculated. Samples were taken from areas Ⅱof tissue flaps, stained with hematoxylin-eosin (HE) and Masson, to detected the activity of superoxide dismutase (SOD) and the content of malondialdehyde (MDA). The measurement data that conformed to a normal distribution was represented as Mean ± SD. Single-factor analysis of variance (ANOVA) was used to compare the differences among groups, followed by head-to-head comparison using the LSD test. P<0.05 was considered statistically significant. Results:Tissue flaps from all groups appeared pale immediately after the operation. On the first day after the operation, a dark ischemic area appeared at the distal end of each group. On the 7th day postoperatively, the ischemic area of each group showed varying degrees of necrosis and blackening, while the non-necrotic area exhibited significant swelling. On the 14th day post-operation, the ischemic area in each group showed further necrosis, blackening, and curling, with clear boundaries. Group C was the best, group D was the worst, and both group A and B were in between the two. The swelling of non-necrotic areas in groups A and C was reduced. HE staining revealed numerous thrombi and infiltration of inflammatory cells in group D, with group B following closely behind. Thrombi were rare in groups A and C. Masson staining showed that collagen fibers were organized regularly in group C, while abundant collagen fibers were disintegrated and disordered in group D. Groups A and B exhibited characteristics that fell between the other two groups. The percentages of survival areas of the flaps in groups A, B, C and D were as follows: (69.87±5.04)%, (85.03±6.58)%, (93.93±4.25)% and (49.22±9.64)%. There were statistical differences in pairwise comparisons between groups (all P<0.05). SOD activity of groups A, B, C, and D were as follows: (49.83±8.08), (36.65±5.49), (55.61±7.93) and (22.45±5.47) U/mg prot. Except for the group A vs. C, there were statistical differences between the groups (all P<0.01). The MDA content of groups A, B, C and D were as follows: (0.77±0.17), (1.03±0.16), (0.68±0.12), and (0.41±0.09) nmol/mg prot. Except that group A vs. C, there were statistical differences between groups (all P<0.01). Conclusion:In animal experiments, it was found that compared to HAase alone, the combination of HSYA with HAase significantly improves the therapeutic outcomes of HA arterial embolism and increases the proportion of tissue flap survival area.

Objective:The aim of this study was to explore whether hydroxysafflor yellow A (HSYA) combined with hyaluronidase (HAase) can enhance the therapeutic effect of arterial embolism caused by hyaluronic acid (HA) .Methods:Thirty-two white male rabbits were randomly divided into four groups, with 8 rabbits in each group, of which group A, B and C were experimental groups and group D was group control. An axial rectangular composite tissue flap sized 2.0 cm × 5.0 cm, with 1.0 cm pedicle width, and 4.0 cm from the root, was designed with the central auricular artery as the long axis on the dorsal side of the ear. The depth of incision reached the ventral perichondrium of the ear, and the flap was sutured continuously in situ and divided into three equal parts (area Ⅰ, Ⅱ, Ⅲ) from the proximal area to the distal area. The proximal end 1 cm to the flap and the central artery was the intersection point, into which 50 μl HA was injected, by which the model of HA arterial embolism was established. Each group was treated after 60 min. Group A: 20 ml solution HSYA was injected slowly into the thigh saphenous vein (the dosage of HSYA is calculated at 10 mg/kg) . Group B: 0.5 ml solution HAase was injected into the central auricular artery (400 U/ml) . Group C: 0.5 ml solution HAase with the same dosage of group B was injected into the central auricular artery and 20 ml solution HSYA with the same dosage of group A was injected slowly into the thigh saphenous vein. Group D and other parts of group A and B were injected with the same dosage of normal saline (NS) . The thigh saphenous veins of all groups were injected with the same dosage of solution once a day for 14 days. Flaps were observed immediately, 1, 7 and 14 days after establishment of hyaluronic acid arterial embolism models of tissue flaps, and dorsal and backlight auricular photographs were taken. On the postoperative 14th day, percentages of survival areas of the flaps were calculated, and samples were taken from areas II of tissue flaps, which were stained by hematoxylin-eosin (HE) and Masson, and were detected the activity of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) . The measurement data conformed to normal distribution was represented as Mean ± SD. Single factor analysis of variance (ANOVA) was used to compare the differences among groups, and head-to-head comparison by LSD test. P <0.05 was considered statistically significant. Results:Tissue flaps of all groups were pale immediately after operation. On the first day after operation, the dark ischemic area appeared at the distal end of each group. On the postoperative 7th day, the ischemic area of each group was necrotic and blackened to varying degrees, and the non-necrotic area swelled obviously. On the postoperative 14th day, the ischemic area of each group was further necrotic, blackened, curled and the boundary was clear. Group C was the best, group D was the worst, and both group A and B were between the two. The swelling of non-necrotic areas in group A and C were basically reduced. HE staining showed that numerous thrombi and inflammatory cells infiltration were formed in group D, and group B was behind it, and thrombi were rare in group A and C. Masson staining showed that collagen fibers were arranged regularly in group C, and abundant collagen fibers were disintegrated and disordered in group D, and both group A and B were between the two. The percentages of survival areas of the flaps in group A, B, C and D were as follows: (69.87 ± 5.04) %, (85.03 ± 6.58) %, (93.93 ± 4.25) % and (49.22±9.64) %. There were statistical differences in pairwise comparison between groups (all P <0.05) . SOD activity of group A, B, C and D were as follows: (49.83±8.08) , (36.65±5.49) , (55.61±7.93) and (22.45 ± 5.47) U/mg prot. Except that group A vs. C, there were statistical differences between groups (all P <0.05) . MDA content of group A, B, C and D were as follows: (0.77±0.17) , (1.03±0.16) , (0.68±0.12) , and (0.41±0.09) nmol/mg prot. Except that group A vs. C, there were statistical differences between groups (all P <0.05) . Conclusions:Under the condition of animal experiment, compared with HAase, HSYA combined with HAase can significantly enhance the therapeutic effect of HA arterial embolism and increase the proportion of survival area of tissue flap.

Objective:To explore the therapeutic effect of hydroxysafflor yellow A (HSYA) combined with hyaluronidase (HAase) for arterial embolism caused by hyaluronic acid (HA).Methods:Thirty-two white male rabbits were randomly divided into four groups, with 8 rabbits in each group. Groups A, B and C were experimental groups, while group D served as the control group. An axial rectangular composite tissue flap sized 2.0 cm × 5.0 cm, with a pedicle width of 1.0 cm, and located 4.0 cm from the root, was designed with the central auricular artery as the long axis on the dorsal side of the ear. The incision depth reached the ventral perichondrium of the ear, and the flap was sutured continuously in place and divided into three equal parts (areas Ⅰ, Ⅱ, Ⅲ) from the proximal to the distal area. The proximal end, located 1 cm from the flap, and the central artery was the intersection point, where 50 μl of HA was injected to establish the model of HA arterial embolism. Each group was treated after 60 minutes. Group A: 20 ml of HSYA solution was slowly injected into the saphenous vein of the thigh (the dosage of HSYA was calculated at 10 mg/kg). Group B: 0.5 ml of HAase solution was injected into the central auricular artery (400 U/ml). Group C: 0.5 ml of HAase solution with the same dosage as in group B was injected into the central auricular artery, while 20 ml of HSYA solution with the same dosage as in group A was slowly injected into the saphenous vein. Group D and other parts of groups A and B were injected with the same dosage of normal saline (NS). The thigh saphenous veins of all groups were injected with the same dosage of solution once daily for 14 days. Flaps were observed immediately, 1, 7 and 14 days after establishing hyaluronic acid arterial embolism models of tissue flaps. Dorsal and backlight auricular photographs were taken. On the 14th day postoperatively, the survival areas of the flaps were calculated. Samples were taken from areas Ⅱof tissue flaps, stained with hematoxylin-eosin (HE) and Masson, to detected the activity of superoxide dismutase (SOD) and the content of malondialdehyde (MDA). The measurement data that conformed to a normal distribution was represented as Mean ± SD. Single-factor analysis of variance (ANOVA) was used to compare the differences among groups, followed by head-to-head comparison using the LSD test. P<0.05 was considered statistically significant. Results:Tissue flaps from all groups appeared pale immediately after the operation. On the first day after the operation, a dark ischemic area appeared at the distal end of each group. On the 7th day postoperatively, the ischemic area of each group showed varying degrees of necrosis and blackening, while the non-necrotic area exhibited significant swelling. On the 14th day post-operation, the ischemic area in each group showed further necrosis, blackening, and curling, with clear boundaries. Group C was the best, group D was the worst, and both group A and B were in between the two. The swelling of non-necrotic areas in groups A and C was reduced. HE staining revealed numerous thrombi and infiltration of inflammatory cells in group D, with group B following closely behind. Thrombi were rare in groups A and C. Masson staining showed that collagen fibers were organized regularly in group C, while abundant collagen fibers were disintegrated and disordered in group D. Groups A and B exhibited characteristics that fell between the other two groups. The percentages of survival areas of the flaps in groups A, B, C and D were as follows: (69.87±5.04)%, (85.03±6.58)%, (93.93±4.25)% and (49.22±9.64)%. There were statistical differences in pairwise comparisons between groups (all P<0.05). SOD activity of groups A, B, C, and D were as follows: (49.83±8.08), (36.65±5.49), (55.61±7.93) and (22.45±5.47) U/mg prot. Except for the group A vs. C, there were statistical differences between the groups (all P<0.01). The MDA content of groups A, B, C and D were as follows: (0.77±0.17), (1.03±0.16), (0.68±0.12), and (0.41±0.09) nmol/mg prot. Except that group A vs. C, there were statistical differences between groups (all P<0.01). Conclusion:In animal experiments, it was found that compared to HAase alone, the combination of HSYA with HAase significantly improves the therapeutic outcomes of HA arterial embolism and increases the proportion of tissue flap survival area.