Search

Summary Given the lack of defining features in the clinical manifestations and radiographic findings for children with mycoplasma pneumoniae pneumonia (MPP), quantitative polymerase chain reaction (qPCR) has become a useful diagnostic method. This study was performed to explore the relationship between the qPCR findings, clinical symptoms, and inflammatory markers in children with MPP. Four hundred children with MPP have been enrolled in this retrospective analysis. All clinical and analytical information, including mycoplasma pneumoniae (MP) PCR results, has been collected. Based on the PCR results, the patients were divided into groups with load values (copy number) < 105 (54 cases), ≥105 and 108 (49 cases). The clinical features (including symptoms and signs) and inflammatory indicators were compared among the groups. The incidence of high fever (above 39°C), thermal peak during the entire hospitalization period, fever duration, days of hospitalization, and plasma lactate dehydrogenase (LDH) levels were statistically correlated with the MP PCR load value in children with MPP. The analysis of relevance degree showed the correlative order as a thermal peak of hospitalization > duration of fever > period of hospitalization > LDH value > C-reactive protein value. The host immune response was significantly greater in the complication group than in the non-complication group.

Background The aim of this study was to explore the potential mechanism of circular RNA (circRNA) CirCHIPK3 on the malignant proliferation and metastasis of breast cancer (BC). Methods Human BC samples and their matched normal adjacent tissues were obtained from 50 patients to assess the expression of CirCHIPK3 and its relationship with BC prognosis. A series of in vitro and in vivo functional experiments were carried out to elucidate the role of CirCHIPK3 in BC progression and its underlying molecular mechanisms. Moreover, the interaction of CirCHIPK3, miR-193a, and HMGB1 was examined using bioinformatics, FISH, RIP, RNA-pull down and luciferase reporter assays. Western blot analysis was performed to examine the expression of HMGB1, p-PI3K, total PI3K, p-AKT, and AKT after si-CirCHIPK3 transfection. Results Upregulation of CirCHIPK3 was identified in BC, which predicted a worse prognosis in BC patients. Furthermore, it was found that CirCHIPK3 facilitated cell proliferation, migration, and invasion in BC by regulating miR-193a/HMGB1/PI3K/AKT signaling. CirCHIPK3 acted as a sponge for miR-193a to facilitate HMGB1 expression. si-CirCHIPK3 also inhibited tumor growth of BC in nude mice. si-CircCHIPK3 decreased HMGB1/PI3K/AKT signal expression in MDA-MB-231 cells, whereas overexpression of CircCHIPK3 enhanced HMGB1/PI3K/AKT signal. Conclusions CirCHIPK3 regulated miR-193a/HMGB1/PI3K/AKT signaling to facilitate BC development and progression, providing a novel therapeutic target for BC.

The removal of trichloroethylene (TCE) by corona discharge plasma was investigated. The influences of initial concentration, gas flow rate, injection of water vapor and ozone (O3) on removal efficiency were discussed. The results show that removal efficiency reduces with the initial concentration and gas flow rate increasing. A proper quantity of water vapor injection can improve the removal efficiency, but which is not always increased, due to the electronegative characteristic of water molecule. The maximum removal efficiency of 90.7% can be obtained in wet air flow with relative humidity of 70.6%. The removal efficiency increases obviously with O3 injection. The decomposition products are 2,2-Dichloroacetyl chloride (CHCl2COCl), carbonyl chloride (COCl2), hydrogen chloride (HCl) and carbon dioxide (CO2), based on which the decomposition mechanism is discussed. The oxygen chain reaction is the primary decomposition mechanism, and high energy electrons and active oxygen species play a leading role in the decomposition process. Therefore, removal efficiency of TCE can be improved greatly when water vapor and O3 is injected.

Background Traditional Chinese medicine (TCM) plays an important role in contributing to the public health in China. However, non-standardized outcomes in TCM related studies posed great difficulty in data synthesis for healthcare decisions. An agreed set of standardized outcomes, or termed as a core outcome set (COS), can solve this existing problem of outcome heterogeneity. This review aimed to analyze outcome heterogeneity, assess the quality of outcome reporting and providing a list of potential outcomes for COS development of SAP using TCM. Methods 8 literature databases were searched to identify clinical studies about TCM for SAP (SAP-TCM) of yearly samples of 2005, 2010, 2015, 2016, 2018 and 2019. 2 clinical registry databases were searched from inception to October 2020. Outcomes definition, measurement methods and time-point were extracted and categorized into 7 themes which include clinical symptoms and signs, physical and chemical examination, TCM-related outcomes, adverse events, quality of life, long-term prognosis and economic evaluation. Timing and quality assessment of the outcomes reported were analyzed and evaluated. Results A total of 1166 studies were included from 12962 potential studies, involving 111426 patients. 231 outcomes were identified and a total of 89 outcomes reported at least twice in the studies. The most commonly reported theme was clinical symptoms and signs. The most frequently reported outcomes were total rate of ECG efficiency and angina attack in clinical studies of published literature and clinical registries databases respectively. Outcomes reported in a single study ranged from 1 to 15, and 5 outcomes on average per study. 80% of the studies lack reporting of primary outcomes. A wide variation of measurement instruments or methods was used. A range of 1–17 measurement time-points were recorded. Quality assessment of outcome reporting was generally low, with 65.6% of the studies scoring 3 to 4 points. Conclusion Outcomes reported in studies on SAP-TCM are heterogeneous. A lack of standardization complicates comparisons of outcomes across studies. Developing a COS for SAP-TCM could contribute to the standardization of outcome reporting and offer a stronger evidence for health decision-making.

In this paper, we develop a class of parallel semismooth Newton algorithms for the numerical solution of the American option under the Black–Scholes–Merton pricing framework. In the approach, a nonlinear function is used to transform the complementarity problem, which arises from the discretization of the pricing model, into a nonlinear system. Then, a generalized Newton method with a domain decomposition type preconditioner is applied to solve this nonlinear system. In addition, an adaptive time stepping technique, which adjusts the time step size according to the initial residual of Newton iterations, is applied to improve the performance of the proposed method. Numerical experiments show that the proposed semismooth method has a good accuracy and scalability.

The decomposition of ethanethiol by a corona radical injection system, using water vapor and O3as radical source, was investigated. It is found that only 83.6% of ethanethiol can be decomposed in dry air flow with relative humidity of 13.4%. A proper quantity of water vapor injection can improve the decomposition efficiency, but which is not always increased. The maximum decomposition efficiency of 99.1% can be obtained in wet air flow with relative humidity of 74.7%. 97.6% of ethanethiol can be decomposed when the relative humidity of gas flow is 51.6%, but it is found that only 76.3% of element sulfur is converted to SO2, based on sulfur balance. However, the conversion efficiency of sulfur to SO2increases obviously with the increasing of O3injection. The decomposition efficiency of ethanethiol and conversion efficiency of sulfur to SO2can reach 99.8% and 95.3% respectively, when O3is injected into the reactor by high voltage electrode tubes with concentration of 1 g/m3 and flow rate of 300 L/h. The decomposition products are SO2, CO2and H2O, while no organic product is found, based on which the decomposition mechanism is discussed. The weakest chemical bond C-S in ethanethiol molecule is firstly decomposed to ·SH and ·C2H5radicals. ·SH can be oxidized to elemental sulfur and SO2, and ·C2H5is oxidized to CO2and H2O.

Fe/BaFeO 2.5 laminated composite particles were successfully prepared by hydrogen-thermal reducing BaFe 12 O 19 particles. The average diameter of Fe/BaFeO 2.5 composite particles is about 1 μm and the lamellar thickness is about 100 nm. The effective permittivity and permeability of Fe/BaFeO 2.5 laminated composite particles were measured and EMA performance was evaluated. Compared with Fe particles with a similar diameter, the permeability of Fe/BaFeO 2.5 composite particles is remarkably improved by the induction of insulator BaFeO 2.5 phase. Due to the unique 2-dimension shape characteristic, e′ and μ′ of Fe/BaFeO 2.5 laminated composite particles is obviously higher than that of Fe/BaFeO 2.5 composite particles without lamellar structure. EMA performance of coating containing Fe/BaFeO 2.5 laminated composite particles as fillers is excellent, and a maximum reflection loss ( RL max ) up to −29.94 dB was achieved in a coating of 1.36 mm. Meanwhile, the operation frequency band of coating containing Fe/BaFeO 2.5 laminated composite particles as fillers covers completely X-band and Ku-band, which considerably wider than most of reported EMA coatings.

This systematic review aims to systematically evaluate the efficacy and safety of Chinese patent medicines with resolving hard lump function for the treatment of cyclomastopathy. We searched CNKI, WanFang, SinoMed, PubMed, EMbase, and The Cochrane Library from the inception to January 3 2018, to collect the randomized controlled trials（RCTs）on Chinese patent medicines with resolving hard lump function in treating cyclomastopathy. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies. Then, statistical analysis was performed by using Stata 12.0 and WinBUGS 1.4.3 software. A total of 52 RCTs involving 9 605 patients were finally included. The inventions included 11 commercial Chinese patent medicines with functions of resolving hard lump, such as Rupi Sanjie Capsules, Xiaoru Sanjie Capsules, Ruhe Sanjie Pills, and Hongjin Xiaojie Capsules. The result of direct Meta-analysis showed that: as compared with the simple western medicine group, the Chinese patent medicines such as Hongjin Xiaojie Capsules, Ruhe Sanjie Pills, Rupi Sanjie Capsules, Xiaoru Sanjie Capsules and Xiakucao Oral Liquid could significantly improve the clinical efficacy. In addition, the incidence of adverse reactions of Chinese patent medicines with resolving hard lump function was lower than that in Western medicine group in gastrointestinal reactions, menstrual disorders, leucorrhea abnormalities, liver dysfunction and estrogen-like effect. The network Meta-analysis showed that: Xiaoru Sanjie Capsules, Ruhe Sanjie Pills, Yanlu Rukang Capsules, Quyu Sanjie Capsules, and Hongjin Xiaojie Capsules were the top five in terms of treatment effect. Chinese patent medicines with resolving hard lump function had better clinical efficacy. Due to the low quality of included studies， more high quality RCTs are needed to verify the above conclusion.

This systematic review aims to evaluate the efficacy and safety of Huoxiang Zhengqi formulas in treating gastrointestinal type cold. Seven electronic databases,including CNKI, WanFang Data, Vip, SinoMed, PubMed, Cochrane Library, Embase will be searched from the inception of the study until March 2017.All randomized controlled trials that evaluate the treatment of Huoxiang Zhengqi formulas for gastrointestinal type cold will be eligible. The methodological quality will be assessed using the Cochrane risk of bias tool for randomized clinical trials and Review Manager 5.3 software is used for analyzing the data.The results are： eight RCTs and 680 patients are included .Meta-analysis are performed according to the stratification of the treatment strategy. Eight studies report clinical efficacy, among them four studies show Huoxiang Zhengqi formulas are better than western medicine(RR and 95%,1.2[1.08, 1.33]), another four studies showHuoxiang Zhengqi formulas in conjunction with conventional treatment are better than conventional treatment(RR and 95%, 1.32[1.20,1.46]).About symptom remission rate, one study shows the treatment group effect is better than the control group from the following clinical symptoms：chills,fever,bowel diarrhea,the effect of treating sore throat itchy is same with western medicine treatment.No adverse reactions are found about Huoxiang Zhengqi formulas in this study.Current evidence shows that Huoxiangzhengqi formulas are better than Western medicine group and western medicine routine treatment group from clinical efficacy. Limited by the quantity and quality of studies, more large-scale and rigorously designed randomised controlled trials with large sample size are warranted to clarify the conclusions.

This systematic review aims to systematically evaluate the efficacy and safety of Guizhi Fuling Capsule/Pill on the treatment of chronic pelvic inflammatory disease. We searched CNKI datebases,WanFang,SinoMed,PubMed,Embase,The Cochrane Library from the inception to February 2017,to collect randomized controlled trials（RCTs）of Guizhi Fuling Capsule/Pill in treating chronic pelvic inflammation disease.Two reviewers independently screened literature,extracted date and assessed the risk of bias of included studies.Then,the risk assessment of included references was evaluated according to criteria recommended by Cochrane Handbook 5.3.A total of 30 RCTs involving 3 586 patients were finally included.30 studies reported the clinical efficacy,the result of meta-analysis showed that：compared with the western medicine group,Guizhi Fuling (capsule,pill) combined with western medicine could significantly improve the clinical efficacy [RR=1.20,95%CI（1.16,1.23）];3 studies reported recurrence rate,the result of meta-analysis showed that：compared with the western medicine,Guizhi Fuling (capsule,pill) combined with western medicine could decrease the recurrence rate [RR=0.33,95%CI（0.18,0.62）]; Their secondary indicators mainly included hs-CRP, plasma viscosity ratio and tumor necrosis factor and fibrin,the result of meta-analysis showed that： Guizhi Fuling (capsule,pill) combined with western medicine was better than western medicine in terms of anti-inflammatory and improving blood circulation.17 studies reported adverse reactions,most of the adverse events were the irritation of gastrointestinal tract. The result showed that： compared with the western medicine group, the incidence of adverse reactions in Guizhi Fuling (capsule,pill) combined with western medicine group is low.Guizhi Fuling（capsule,pill） did not increase the adverse reactions. The available evidence suggests that： Guizhi Fuling（capsule, pill） compared with the western medicine group, Guizhi Fuling (capsule,pill) combined with western medicine was more effective than the western medicine group in terms of clinical efficacy, recurrence rate, anti-inflammatory and plasma viscosity.Due to the limited quality and quantity of included studies,more high quality RCTs are needed to verify the above conciusion.

The Chitosan flocculant characteristics of natural, non-toxic, safe and have a good adsorption performance. This article briefly describes the physical properties and mechanism of flocculation of Chitosan, focuses on Chitosan flocculant in water treatment applications.

Flow characteristic of motorcycle electronic injector is one of the most important factors to determine the electronic control system design, and directly affects the accuracy of fuel control unit of the motorcycle engine. Combined with the LabVIEW software programming, the experiment on research and development of electronic injector could control the lower computer rapidly and conveniently. As well it could accurately obtain the flow characteristics of small injection pulse width and the normal one of motorcycle electronic injector. It will achieve the goal of high efficiency, fast and accurate measurement of flow characteristic of motorcycle electric injector.

H2O2 aerosol was used to oxidize dichlorvos vapor. 80.7% of dichlorvos, with the initial concentration of 90.9 mg/m3, was decontaminated when the H2O2 concentration kept in the range of 110~130 mg/m3 within 60 min. According to the oxidation products, analyzed by GC-MS, the decontamination reaction mechanism was discussed. Radical chain reaction is the main decontamination mechanism. H2O2 is dissociated to HOO-, which can induce the formation of ·OH. The double bond in dichlorvos molecule is attacked by ·OH to form molecule radical, which is further oxidized to 1,1-dichloro ethoxy dimethyl phosphate, 1,1,1-trichloro-2-hydroxyl-ethyl dimethyl phosphate, dimethyl phosphite, dimethyl phosphate, trimethyl phosphate, methyl phosphate, dichloro acetaldehyde, oxalic acid, CH2Cl2, CHCl3, parts of which are mineralized to phosphoric acid, CO2, H2O and chloridion.

Color of the historical and cultural districts is the product of culture in a certain historical period and certain regions. This article systematically investigates the present color situation of Drum Backstreet's historical and cultural district in Yu county of Hebei province. From the analysis of color attributes including hue, brightness, saturation and tonal statistics characteristics, we can conclude three main characteristics of color of Drum Backstreet's historical and cultural district. One is ancient and modern architecture color difference is large, and color is no order, and color continuity of district is poor. Another one is the visual effect of architectural color individual relatively monotonous, low degree of saturation and high brightness. The third is the reddish yellow tone retaining the typical cultural characteristics. Three color planning suggestions are put forward, including protecting traditional color, following the principle of overall harmony and regulating building classification.

The Dielectric Barrier Discharge plasma (DBD) plasma was used to treat Diisopropyl fluorophosphate (DFP, a stimulant of sarin) in the air. The influence factors of degradation efficiency, including power, carrier gas flow velocity and initial concentration of DFP were investigated. As a result, the degradation efficiency increased with the power increasing. The degradation efficiency increased fastly when the power less than 105W, but slowly when the power more than 105W. The degradation efficiency decreased obviously with the carrier gas flow velocity increasing, because the time of DFP stayed in plasma reactor decreased and the concentration of DFP increased. The degradation efficiency rose firstly and then fell with the initial DFP increasing, when the initial concentration was less than 80 mg/m3, but decreased with the the initial concentration increasing, when the initial concentration was more than 80 mg/m3. The main products were acetone, isopropanol, phosphoric acid, pyrophosphoric acid, carbon dioxide and water, analyzed by GC-MS. Reaction mechanism was discussed according to degradation products.

Cam signals, crankshaft signals and angle signals were simulated by analogue crankshaft position sensors developed by C8051F series micro processors to emulate the operational environment of motorcycle engine. In the software development platform of gasoline engine, software running status of control system was tested. MP424 high-speed sampling card was applied to actually observe properties of ignition advance angle and fuel injection advance angle. The experiment suggested that practically observed fuel injection pulse width, ignition pulse width, properties of ignition advance angle and fuel injection advance angle were the same as those of models of control system software. This proved that the analogue crankshaft position sensor that has been developed is practical and feasible.

Improving design of some automotive muffler is introduced, according to the existing problem of original exhaust muffler in is modified, using sound software attenuation characteristic is analyzed, and pressure distribution of muffler inner is performed to calculate adopting three-dimension flow field tool, and the muffler is tested on engine bench. Result shows that Compared with the original muffler, power loss is decreased by about 30%, set-net noise of the original muffler all has dropped dramatically, and it is in the target.

Background The prone position (PP) improves ventilation homogeneity in acute respiratory distress syndrome. The aim of this study was to investigate whether the alleviation of ventilation inhomogeneity in PP was due to changes in regional lung compliance. Methods Ten lung-lavaged piglets were mechanically ventilated in supine position (SP) and in PP. In each position, positive end-expiratory pressure (PEEP) was reduced from 20 to 6 cmH2O in steps of 2 cmH2O every 10 min after full lung recruitment. Respiratory mechanics, blood gas, haemodynamic data and whole-lung computed tomography scans were recorded at each PEEP. The compliances of normally aerated (C normal) and newly recruited (C recruited) lung regions were calculated. Open lung PEEP (OL-PEEP) was defined as the lowest PEEP to maintain full lung recruitment. Results At OL-PEEP, PP significantly increased normally aerated lung regions, decreased poorly aerated and hyperinflated lung regions and decreased tidal recruitment and hyperinflation. C normal was significantly reduced in PP compared with SP (12.8 ± 4.2 ml/cmH2O vs. 20.1 ± 6.2 ml/cmH2O, P

The hydro-mechanical differential turning mechanism is the new type of double power flow turning mechanism of tracked vehicle. The hydraulic stepless speed regulation and the high efficiency of mechanical transmission are integrated into the turning mechanism. The stepless turning of tracked vehicle can be achieved. Basing on hydro-mechanical differential turning theory, the scheme design of steering wheel control system of tracked vehicle of hydro-mechanical differential turning is finished. By establishing model of steering wheel control system, its working stability and following characteristic is simulated and analyzed in this paper. The demand of hydro-mechanical differential turning of tracked vehicle can be realized by the steering wheel control system designed through the simulation results.

In order to find activity of herbicide safener, The MM+ and Polak-Ribiere algorithm were employed to calculate the properties of dichloroacetyl oxazolidine compounds. The QSAR equation of this series compounds was obtained by using (Least-Squares Regression) PLS regression. The results showed that log p and dipole moment played a major role, variable surface area (aprox), hydration energy, refractivity and polarizability played a secondary role. The equation building of this series compounds can not only forecast the activity of new compound, but also lead design of higher activity herbicide safener.

Presence problem of exhaust muffler is anal sized, using three three-dimension numerical calculation of fluid and sound field improvement on original structure is performed, and improving results are certificated. It is shown that insert loss under every rotational speed all reach to the standard of 28dB（A）, and the noises of stationary end tube on the attention frequency band are all smaller than 5 dB（A） , and its pressure loss is decreased by about 32% than 7.6kPa of original structure muffler. So performance of the muffler is evidence increased, an important method is provided for decreasing whole vehicle noise, improving aerodynamic quality and reducing environmental pollution.

Recently, there is an increasing number of clinical trials on Traditional Chinese medicine (TCM) published, but the implementation of Clinical Trial Registration (CTR), Ethical Review (ER), and Informed Consent (IC) in clinical trials of TCM is unclear. This study aims to investigate the status of CTR, ER, and IC in clinical trials of TCM.Clinical trials of TCM published in 10 high-quality Chinese journals in 2016 were selected as a sample. Information of clinical trial registration, ethical review, and informed consent of clinical trials was extracted for analysis. Two authors independently screened the literature and extracted the relevant information.A total of 659 clinical trials met the criteria and were included for analysis. Only 9 clinical trials reported information of clinical trial registration (1.4%). The number for ethical review and informed consent were 156 (23.7%) and 502 (76.2%).Trial registration, protocol approval, and informed consent were not well executed. Especially registration and ethical review of clinical trials in TCM should be carefully concerned by researchers, clinicians, and journal editors. Training on methodology of clinical trial should be strengthened.

Isotropic negative permeability composite, composed of BST-MgO dielectric cubes with high permittivity dispersed in the Teflon substrate with low permittivity, was designed and fabricated based on Mie resonance and the effective medium theory. Measurements and simulations showed that the dielectric composite exhibited a strong sub-wavelength magnetic resonance at the first Mie resonance and possessed isotropic negative permeability, which resulted from the displacement current excited in the cubes. The dielectric particle was equivalent to a magnetic dipole at the magnetic resonance, which could be adjusted by the size and permittivity of the particles. It may provide a convenient method to design isotropic metamaterials and invisible cloak at infrared and visible frequencies.

Objective: The purpose of this retrospective study was to evaluate the clinical value of serum cytokeratin-19-fragment (cyfra21-1) as a biomarker in nonsmall cell lung cancer (NSCLC). Methods: Sixty-six patients with NSCLC and 48 cases with benign lung disease were retrospectively analyzed in the department of thoracic surgery in our hospital. The serum level of cyfra21-1 was detected in the above patients. The diagnosis sensitivity, specificity and the receiver operating characteristic curve were calculated by using the stata11.0 statistical software to evaluate the clinical diagnosis value of serum Cyfra21-1 as NSCLC serologic biomarker. Results: The mean of serum cyfra21-1 were 8.95 eat. 01 μ/L and 4.28 eat. 89 μ/L in NSCLC patient and control groups respectively, which indicated that the NSCLC group were much higher (P < 0.05). The diagnosis sensitivity and specificity were 77.08% and 63.64% at the threshold of 6.32 μ/L respectively. Moreover, the area under the curve was 0.78 (95% confidence interval: 0.70-0.87). Conclusion: Serum cyfra21-1 can be a potential serologic biomarker in evaluation of NSCLC.

The effect of Co-substitution on the complex permeability of LiZn ferrite was studied. The polycrystalline ferrite samples with a composition of ((Li0.5Fe0.5)0.8Zn0.2)1-xCoxFe2.05O4, where x varies from 0 to 0.08, were prepared by solid-reaction method. The sintered samples were annealed at 490oC for 96 h to produce perminvar effect. The complex permeability was measured in the frequency range from 1 MHz to 2 GHz. The Co-substitution can enhance the real part of complex permeability (μ’). The maximum μ’ appears when x=0.02. The Co-substituted LiZn samples, especially for x=0.02 and 0.04, present resonance-type magnetic spectra obviously. The μ’ of the sample for x=0.02 increases because the damping of domain wall movement decreases after the annealing treatment. The resonance character of the annealed sample becomes even more remarkable due to its domain wall stabilization.

The effects of Bi-substitution on the complex impedance spectra of yttrium iron garnet (YIG) were studied in this paper. The polycrystalline yttrium iron garnet Y2BiFe5O12 (YIG: Bi) and Y3Fe5O12 (YIG) samples were prepared by solid-reaction method. The complex impedance spectra were measured in the frequency range from 1 KHz to 100MHz at several temperatures between 210oC and 500oC. The complex impedance sample shows that the YIG: Bi can be represented by double Cole-Cole semicircles, and the YIG can be represented by a single Cole semicircle. The physical structure of the specimen was visualized as comprising of small resistance grains separated by large resistance grain boundaries in accordance with the impedance spectra observations. The electrical processes in the sample were modeled in the form of an electrical equivalent circuit made up of a series combination of two parallel RC circuits attributed to grains and grain boundaries. The temperature dependence of bulk resistance indicated an evidence of Arrhenius-type thermally activated process, showing a close to linear variation up to a temperature of 740 K.

Background: In the acute respiratory distress syndrome (ARDS), lung-protective ventilation strategies combine the delivery of small tidal volumes (VT) with sufficient positive end-expiratory pressure (PEEP). However, an optimal approach guiding the setting of PEEP has not been defined. Monitoring volumetric capnography is useful to detect changes in lung aeration. Objectives: The aim of this study was to determine whether volumetric capnography may be a useful method to determine the optimal PEEP in ARDS. Methods: In 8 lung-lavaged piglets, PEEP was reduced from 20 to 4 cm H2O in steps of 4 cm H2O every 10 min followed by full lung recruitment. Volumetric capnography, respiratory mechanics, blood gas analysis, hemodynamic data and whole-lung computed tomography scans were obtained at each PEEP level. Results: After lung recruitment, end-expiratory lung volume progressively decreased from 1,160 ± 273 ml at PEEP 20 cm H2O to 314 ± 86 ml at PEEP 4 cm H2O. The ratio of alveolar dead space (VDalv) to alveolar VT (VTalv) and the phase III slope of volumetric capnography (SIII) reached a minimum at PEEP 16 cm H2O. At this PEEP level, overaerated lung regions were significantly reduced, nonaerated lung regions did not increase, and partial pressure of oxygen in arterial blood/fraction of inspired oxygen (P/F) and static respiratory system compliance (Crs) reached a maximum. At PEEP levels 2O, nonaerated lung regions significantly increased, P/F and Crs deteriorated, and VDalv/VTalv and SIII began to increase. Conclusions: In this surfactant-depleted model, PEEP at the lowest VDalv/VTalv and SIII allows an optimal balance between lung overinflation and collapse. Hence, volumetric capnography is a useful bedside approach to identify the optimal PEEP.

To assess the value of central venous-to-arterial carbon dioxide difference [P((cv-a))CO₂] in evaluation of disease severity and prognosis in patients with septic shock.There were 45 consecutive resuscitated septic shock patients from April 2009 to October 2010 included immediately after their admission into our ICU. The patients were divided into low P((cv-a))CO₂ group and high P((cv-a))CO₂ group according to a threshold of 6 mm Hg (1 mm Hg = 0.133 kPa). All patients were treated by early goal directed therapy (EGDT). The parameters of hemodynamics, lactate clearance rate, the Acute Physiology and Chronic Health Evaluation II (APACHE II) score, the sequential organ failure assessment (SOFA) score, 6 h rate of EGDT achievement, the ICU mortality and 28 days in-hospital mortality were recorded for all patients.There were 30 patients in the low P((cv-a))CO₂ group, and 15 in the high P((cv-a))CO₂ group. There were no significant differences between low P((cv-a))CO₂ and high P((cv-a))CO₂ patients in age, APACHE II score and SOFA score (all P0.05). Compared with the high P((cv-a))CO₂ group, the low P((cv-a))CO₂ group had higher cardiac index (CI) and 24 h CI, higher delivery O₂ (DO₂) and 24 h DO₂, higher central venous oxygen saturation (ScvO₂) [(74 ± 9)% vs (67 ± 8)%], lower lactate [(3.4 ± 2.1) mmol/L vs (5.7 ± 4.5) mmol/L] and higher ΔSOFA score [(0.7 ± 1.8) vs (-0.4 ± 1.1)], lower 24 h SOFA score [(7.8 ± 2.0) vs (9.8 ± 2.0)], higher 6 h rate of EGDT achievement (83.3% vs 53.3%) (P0.05), however, there were no differences in 28 days mortality and ICU mortality between the two groups (P0.05).P((cv-a))CO₂ might be an indicator for predicting the severity of patients with septic shock and evaluating tissue perfusion.

The accuracy of end-expiratory lung volume measurement by the modified nitrogen wash-out/wash-in method (EELV-N(2)) depends on the precise determination of carbon dioxide elimination (V(CO(2))), which is affected by alveolar dead space (V(D-alv)). The purpose of this study was to investigate the influence of V(D-alv) on EELV-N(2).Six piglets with lavage-induced acute lung injury were mechanically ventilated in a decremental PEEP trial that was reduced from 20 to 4 cm H(2)O in steps of 4 cm H(2)O every 10 min. EELV was measured by the modified EELV-N(2) method and computed tomography scan (EELV-CT), volumetric capnography, blood gas measurements, and hemodynamic data were recorded at each PEEP level. The data were divided into higher and lower PEEP groups.During the decremental PEEP trial, EELV-N(2) exhibited a high correlation (r(2) = 0.86, P.001) with EELV-CT, with a bias of -48.6 ± 150.7 mL (1 ± 18%). In the higher PEEP group, EELV-N(2) was not correlated with EELV-CT, with a bias of -168.1 ± 171.5 mL (-14 ± 14%). However, in the lower PEEP group, EELV-N(2) exhibited a high correlation (r(2) = 0.86, P.001) with EELV-CT, with a bias of 11.2 ± 97.2 mL (6 ± 17%). The measurement bias was negatively correlated with V(D-alv) (r(2) = 0.44, P = .04) and V(CO(2)) (r(2) = 0.47, P = .03) in the higher PEEP group.In this surfactant-depleted model, EELV measurement by the modified EELV-N(2) method reveals a systematic underestimation at high PEEP levels that is partly due to an increase in V(D-alv).

The differentiation of mesenchymal stem cells (MSCs) into type II alveolar epithelial (AT II) cells in vivo and in vitro, is critical for reepithelization and recovery in acute lung injury (ALI), but the mechanisms responsible for differentiation are unclear. In the present study, we investigated the role of the canonical wnt pathway in the differentiation of mouse bone marrow-derived MSCs (mMSCs) into AT II cells. Using a modified co-culture system with murine lung epithelial-12 (MLE-12) cells and small airway growth media (SAGM) to efficiently drive mMSCs differentiation, we found that GSK 3β and β-catenin in the canonical wnt pathway were up-regulated during differentiation. The levels of surfactant protein (SP) C, SPB, and SPD, the specific markers of AT II cells, correspondingly increased in mMSCs when Wnt3a or LiCl was added to the co-culture system to activate wnt/β-catenin signaling. The expression of these factors was depressed to some extent by inhibiting the pathway with the addition of DKK 1. The differentiation rate of mMSCs also depends on their abilities to accumulate and survive in inflammatory tissue. Our results suggested that the activation of wnt/β-catenin signaling promoted mMSCs migration towards ALI mouse-derived lung tissue in a Transwell assay, and ameliorated the cell death and the reduction of Bcl-2/Bax induced by H(2) O(2), which simultaneously caused reduced GSK 3β and β-catenin in mMSCs. These data supports a potential mechanism for the differentiation of mMSCs into AT II cells involving canonical wnt pathway activation, which may be significant to their application in ALI.

In this paper, we present the design of multilayer microwave absorbers comprised of CoFe alloy nano-particles and nano-flakes as fillers. The thickness of the unite layer is optimized by using the Genetic Algorithm. Efficient microwave absorptions over a wide frequency band and a range of incident angles are achieved by using multilayer absorbers. We show that the absorbers are effective not only for a planar surface but also for arbitrarily shaped objects as well.

Professor Xue Li-gong is engaged in clinic, scientific research and teaching of acupuncture and moxibustion for over 30 years, being good at treatment of numbness and pain of the aponeurotic system with richer learning and experiences. His theories about the aponeurotic system develop a school of one's own, including conception of the aponeurotic diseases, differentiation of the aponeurotic system with channels, the anatomic basis of the twelve aponeurotic systems, causes and pathogenesis of diseases of the aponeurotic system, and special treatment principles of the aponeurotic diseases, needling instruments for treatment, and manipulation methods. Professor XUE's long-round needle therapy has obvious clinical therapeutic effect on numbness and pain of the aponeurotic system.