[Effect of connecting airbag in different filling state at the front end of piezometric tube in noninvasive ventilation circuit on man-machine synchronization].

Objective: To investigate the effect of connecting airbag in different filling state at the front end of piezometric tube in the noninvasive ventilation circuit on pressure transmission and human-machine synchronization. Method: In test 1, the airbag was connected to a piezometric tube which was placed in a closed container, the filling state of the airbag was regulated, and the pressure inside the container was changed to observe the corresponding pressure change in the piezometric tube. In test 2, the airbag in different filling state was connected at the front end of piezometric tube in noninvasive ventilation circuit. Twelve subjects were connected to the ventilator such that dynamic changes in the pressure inside the mask (Pmask) and piezometric tube (Ptube) could be measured. Data with normal distribution was analyzed by t test, while data with abnormal distribution was analyzed by K-W test. Results: In test 1, the pressure inside the container changed between 0 and 50 cmH(2)O(1 cmH(2)O=0.098 kPa), when the big airbag was filled at 1/5, 2/5, 3/5, 4/5, the medium-sized airbag was filled at 3/5, 4/5, 5/5, and the small airbag was filled at 4/5, the pressure inside the piezometric tube changed synchronously with the pressure inside the container with no statistically significant difference(P>0.05). In a state of no filling in the small airbag and the medium-sized airbag, and filled at 1/5 in the small airbag, the pressure inside the piezometric tube no longer changed with the pressure in the container when the pressure reached a certain level .When the small airbag was filled at 1/5, 2/5, 3/5, 5/5, the medium-sized airbag at 1/5, 2/5, and the big airbag at 5/5, and all the airbags were in the state of no filling , the difference in the pressure between the piezometric tube and the container was statistically significant. In test 2, respiratory ventilation parameters were set on 10/4 cmH(2)O-30/14 cmH(2)O , and the connecting airbag at the front end of piezometric tube in noninvasive ventilation circuit. The platform pressure in the mask was slightly higher than that in the piezometer tube, and the baseline pressure in the mask was slightly lower than that of the piezometer tube. When the big airbag was filled at 1/5, 2/5, 3/5, 4/5 and medium-sized airbag at 2/5, 3/5, 4/5, the pressure difference between Pmask and Ptube was less than 0.5 cmH(2)O, which was acceptable clinically. When the big airbag was filled at 1/5, 2/5, 3/5 and the medium-sized airbag at 2/5, 3/5, there was no significant difference in trigger work before and after connecting the airbag at the front end of the piezometric tube(P>0.05). Conclusion: Connecting the airbag at the front end of the piezometric tube could avoid the forming of condensate in piezometric tube. The airbag showed good properties of pressure conductivity under ideal size and filling state.

The non-motor symptoms of Parkinson's disease of different motor types in early stage.

OBJECTIVE: We aimed to compare the different non-motor symptoms of different motor phenotype Parkinson's disease (PD) at an early stage. PATIENTS AND METHODS: From January 2013 to November 2016, 120 cases of PD patients who were hospitalized in Neurology Department of the First Hospital of Huai'an in Jiangsu Province and 120 cases of healthy controls with matched age and gender, were included into the research. PD patients were administered with Non-Motor symptom questionnaire (NMSQuest), the Unified Parkinson's Disease Rating Scale III (UPDRS-III), the Mini-Mental State Examination score (MMSE), the Hoehn-Yahr classification, the MoCA, and GDS-15. The relationship between NMS burden and PD subtypes, age, gender and disease severity were examined using linear regression models. The prevalence of each NMS among different PD motor subtypes was analyzed using x2 test. RESULTS: Compared with the healthy controls, PD patients had a higher number of NMS. The prevalence of NMS in postural instability gait difficulty (PIGD) group is higher than that in tremor dominant (TD) group. There is no significant correlation between age, gender, MMSE scores, MoCA scores and the number of NMS. PD patients with higher UPDRS-III scores and a longer course of disease had a higher prevalence of NMS. CONCLUSIONS: NMS is also common in PD patients at an early stage. The PIGD group who have more axial injuries and more severe motor symptoms, have a higher risk of NMS burden than PD patients in TD group.

[Thoracoscopy in diagnosis and treatment of pleural diseases in children].

Objective: To investigate the value of thoracoscopy in diagnosis and treatment of pleural diseases in children. Method: Clinical manifestations and treatment outcomes of 19 patients who had refractory pleural diseases treated with thoracosocy during May 2011 to August 2016 in Hunan Provincial People's Hospital were retrospectively analyzed. In 19 cases, 15 were male and 4 were female, with an average age of (4.8±2.0) years. Thirteen patients had left pleural lesion, while 5 patients had right lesion, and 1 had bilateral lesions. Result: All cases were successfully treated with thoracoscopy without emergent thoracotomy. Pre- and post operative diagnosis was compatible in 10 cases, including 8 cases of empyema (Streptococcus pneumoniae infection in 6 cases, and Staphylococcus Aureus infection in 2 cases), and 2 cases of tuberculous pleuritis. Nine patients who had not been clearly diagnosed before surgery were diagnosed to be empyema (4 case), tuberculous pleuritic (3 cases), mycoplasma infection (1 case), and foreign body with infection (1 case) by thoracoscopy. The average duration of post-op closed thoracic drainage was (4.7±2.3) days. The average time to get normal temperature was (2.4±2.6) days. And the average length of hospital stay was (6.7±1.8) days. No hemothorax, chylothorax, or need for analgesic occurred. Conclusion: Thoracoscopy can be recommended for diagnosis and treatment of refractory pleural lesions diseases in children, with minimal trauma and complications.

Systolic hypertension related single nucleotide polymorphism is associated with susceptibility of ischemic stroke.

OBJECTIVE: Isolated systolic hypertension (ISH) is the most important risk factor for ischemic stroke. Genetic variants influencing hypertension can also be risk factors for ischemic stroke. Here, we examined the how single nucleotide polymorphisms (SNPs) associated with blood pressure impact the risk for ischemic stroke. PATIENTS AND METHODS: We selected 300 ischemic stroke patients and 300 controls. Then, we genotyped three single nucleotide polymorphisms associated with systolic hypertension in both groups. RESULTS: Logistic regression analysis showed that the rs11099098 genotype was associated with a significantly decreased risk of IS (Dominant model: OR = 0.55, 95% CI = 0.37-0.82, p = 0.003). Two other SNPs, rs880315 and rs11072518, showed a trend towards association with stroke risk, but did not reach statistical significance. CONCLUSIONS: Our study suggests that genetic variants in systolic pressure-related genotypes may contribute to the etiology of ischemic stroke.

[SOX10 mutation is relevant to inner ear malformation in patients with Waardenburg syndrome].

Objective: To determine the relevance between the SOX10 mutation and Waardenburg syndrome (WS) accompanied with inner ear abnormality by analyzing the inner ear imaging results and molecular and genetic results of the WS patients with the SOX10 mutation. Methods: This study included 36 WS in patients during 2001 and 2015 in the department of otorhinolaryngology head and neck surgery, Chinese Peoples's Liberation Army General Hospital. The condition of the inner ear of each patient was assessed by analyzing HRCT scans of the temporal bone and MRI scans of the brain and internal auditory canal. Meanwhile, the possible pathogenic genes of WS, including SOX10, MITF, and PAX3, were also screened. Patients were divided into two groups according to SOX10 mutation.The Fisher accuracy test was used to determine statistical difference of inner ear deformation incidence between the two groups. Results: Among all 36 patients, 12 were found to have inner ear abnormality. Most abnormalities were posterior semicircular canal deformations, some accompanied with cochlear deformation and an enlarged vestibule. Among all patients, 9 patients were SOX10 heterozygous mutation carriers, among which six showed bilateral inner ear abnormality. Fisher accuracy test results suggested a significant correlation between the SOX10 mutation and inner ear abnormality in WS patients (P=0.036). Conclusion: This study found that WS patients with the SOX10 mutation are more likely to have deformed inner ears when compared to WS patients without the SOX10 mutation.

[Establishment of a mathematical model for calculating cochlear length].

OBJECTIVE: To compare the cochlear length of the miniature pig calculated by 3-dimensional reconstruction technique and an Archimedean spiral model, and to evaluate the feasibility of determining the length of the cochlea using a mathematical model. METHODS: The temporal bones of three miniature pigs with normal hearing were selected and scanned by micro-CT. The pictures were input into Mimics software, the 3D structure of the inner ear was reconstructed, and the following parameters were determined through Mimics: cochlear length, diameter of each turn, cochlear height, and apical turn angle. The cochlear length was calculated using the Archimedean spiral model. RESULTS: The length of the cochlea was (35.30±0.88)mm based on the three-dimensional reconstruction technique compared to (34.85±0.64)mm based on the Archimedean spiral model. The differences between the two values were not statistically significant. The height of the cochlea is (2.64±0.24)mm. The capsule of the cochlea had 3.67 turns. CONCLUSIONS: The three-dimensional reconstruction technique provides accurate and reliable results, but the reconstruction process is time-consuming and is unsuitable for clinical application. The Archimedean spiral model method is simple, feasible, reliable, and therefore suitable for clinical applications, in particular to provide references for cochlear implantation surgeries.

Expression of anti-inflammatory mediator lipoxin A4 and inflammation responsive transcriptive factors NF-kappa B in patients with preeclampsia.

OBJECTIVE: To evaluate the role of lipoxin A4 (LXA4), NF-kappaB p65 in preeclampsia. MATERIALS AND METHODS: LXA4 in blood serum and the lipoxin A4 receptor (ALX-R), NF-kappaB p65 mRNA, protein expressions in placenta-specific tissues were obtained from patients with preeclampsia and normal pregnancy. RESULTS: Levels of lipoxin A4 in women with mild preeclampsia was significantly high (p < 0.05). There was no significant statistical difference between normal pregnancy and severe preeclampsia (p > 0.05). The mRNA expression of ALX-R was significantly low in women with preeclampsia than in control group (p < 0.01) and mRNA expression of NF- kappaB p65 was significantly high in preeclampsia (p < 0.01). The immunohistochemical staining of NF-kappaB p65 protein was stronger in severe preeclampsia group whereas staining of ALX-R in placental tissue was weaker than in control group (p < 0.01). ALX-R mRNA was negatively correlated with NF-kappaB (p < 0.0001), but there was no correlation between LXA4 and ALX-R mRNA. CONCLUSION: There was an excessive maternal inflammatory response in preeclampsia. LXA4, ALX-R, and NF-kappaB p65 may be involved in the disease process ofpreeclampsia.