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2017 Vol. 47, No. 3 Published: 2017-03-25   157 Embodied medicine: A modern approach towards Traditional Chinese Medicine HU Zhen, LEE Kang, PAN Shaohua. We propose a new medical model that we call Embodied Medicine (EM). EM integrates both the holistic and dialectic approach of the Traditional Chinese Medicine and the recent advances in modern science. Here, we will discuss how we can use the ideas of Big Data and phenomenological thinking to reveal the nature of health and develop new clinical approaches to treat diseases. We argue that EM will modernize the clinical practices of Traditional Chinese Medicine, and thus will have significant impacts on the future of medicine and human health. 2017 Vol. 47 (3): 157-161 [Abstract] ( 845 ) HTML (1 KB)  PDF (1294 KB)  ( 1082 ) 162 Folic acid inhibits platelet-derived growth factor-induced vascular smooth muscle cell dedifferentiation PAN Sunlei, LIN Hui, MENG Liping, ZHOU Changzuan, JI Zheng, CHI Jufang, GUO Hangyuan. Objective: To explore whether folic acid through the mammalian target of rapamycin (mTOR)/P70S6K signaling pathway to inhibit platelet derived growth factor (PDGF-BB) induced vascular smooth muscle cells (VSMCs) dedifferentiate. Methods: SD rats aortic VSMCs primary cells were cultured and identified, and the 3-7th generations of cells were used for the experiment. The VSMCs were divided into 5 groups: control, PDGF-BB (10 ng/mL), PDGF-BB+1 μmol/L folic acid, PDGF-BB+10 μmol/L folic acid, PDGF-BB+100 μmol/L folic acid. MTT method was used to detection the proliferation of VSMCs in each group. The migratory ability of VSMCs were determined by Wound-Healing assay and Transwell chambers assay. Western blot was used to investigated the expressions of alpha-smooth muscle actin (α-SMA), calponin (Cal), osteopontin (OPN), mTOR, p-mTOR, P70S6K and p-P70S6K in each group. Results: Compared with the control group, the proliferation, migration and the expression of OPN, p-mTOR and p-P70S6K were increased significantly in the VSMCs of PDGF-BB group (<0.05), and the expression of α-SMA and Cal significantly decreased in the VSMCs of PDGF-BB group (P<0.05). Compared with the PDGF-BB group, the proliferation, migration and the expression of OPN, p-mTOR and p-P70S6K were decressed significantly in the VSMCs of each folic acid group (P<0.05), and the expression of α-SMA and Cal significantly increased in the VSMCs of each folic acid group (P<0.05). Folic acid inhibited the PDGF-BB induceing VSMCs dedifferentiation in a dose-dependent manner. Conclusion: Folic acid may inhibit the differentiation of VSMCs induced by PDGF-BB through suppression mTOR/P70S6k signaling pathway. 2017 Vol. 47 (3): 162-167 [Abstract] ( 819 ) HTML (1 KB)  PDF (2296 KB)  ( 924 ) 168 Expression and significance of SIAH2 and MMP2 in non-small cell lung cancer YANG Zhiqiang, WEN Yuanyuan, LI Lue. Objective: To study the SIAH2 and MMP2 expression in non-small cell lung cancer (NSCLC), and analyze the relationship between the expression and clinical pathological features and the malignant degree of lung cancer. Methods: Immunohistochemistry S-P method was used to examine the expression of SIAH2 and MMP2 protein in 120 paraffin-embeded specimens with NSCLC, and analyzed the correlation between the expression and clinical pathological factors. The expressions of SIAH2 and MMP2 were detected by RT-PCR and Western blot in lung cancer cell lines. We transfected SIAH2 siRNA into A549 and SK-MES-1 cells using Lipofectamine 2000, and then detected the SIAH2 and MMP2 mRNA and protein expression by RT-PCR and Western blot, thus tested the cell proliferation and cell invasion by MTT and Transwell respectively. Results: Immunohistochemical analysis showed that SIAH2 and MMP2 expression levels were significantly higher in NSCLC tissues and significantly associated with the higher TNM stage (P=0.019, P=0.020), poor differentiation (P=0.024, P=0.011), and lymph node metastasis (P=0.032, P=0.021). SIAH2 protein expression was positively correlated with MMP2 in NSCLC (r=0.321, P<0.01). The expression of SIAH2 and MMP2 were higher in lung cancer cells than in normal bronchial epithelial cell (P<0.05). Compared with the untreated and control siRNA group, the levels of SIAH2 and MMP2 mRNA and protein were decreased in the cells transfected with the SIAH2 siRNA, respectively (P<0.05). The proliferation rate [P<0.01 (day 2-4); P<0.01 (day 2-4)] was slower, and invasion number (17.61±4.34; 20.12±5.43) was decreased in the cells transfected with the SIAH2 siRNA (P<0.05). Conclusion: Up-regulation of SIAH2 plays an important role in the process of malignant phenotype in human NSCLC, and MMP2 may be involved in this process. 2017 Vol. 47 (3): 168-173 [Abstract] ( 670 ) HTML (1 KB)  PDF (2060 KB)  ( 998 ) 174 The influence of Rab11-FIP4 in cytological characteristics of colorectal cancer  YANG Shouxing, YU Yaojun, WANG Jianzhang, ZHENG Bo, XUE Zhanxiong, XU Changlong Objective: To investigate the effects of Rab11-FIP4 on cytological characteristics of colorectal cancer (CRC). Methods: Western blot was used to detect the expression of Rab11-FIP4 in CRC cell line HCT116, which was transfected with siRNAs that specifically targeting Rab11-FIP4. Proliferation and migration of HCT116 cells were analyzed by CCK-8 assay and Transwell assay. Results: Rab11-FIP4 by siRNA transfection expressing in 100.2±21.5 reduced to 23.5±5.8 (P<0.01). Interference Rab11-FIP4, CRC cell line HCT116 in vitro, proliferation decreased obviously, the second day of the inhibition rate was 29.40%, the inhibition rate of 37.65% on the third day (P<0.05), number of cells migrating from 193.4±22.1 to 113.9±12.7 (P<0.05) and cell invasion number from 113.3±16.7 to 66.5±6.7 (P<0.05). Conclusion: Knockdown of Rab11-FIP4 significantly inhibits proliferation, migration and invasion of CRC cells in vitro, indicating its important role in CRC progression. 2017 Vol. 47 (3): 174-176 [Abstract] ( 715 ) HTML (1 KB)  PDF (1486 KB)  ( 802 ) 178 Long-chain lipid emulsion reverse the decrease of cardiomyocyte membrane fluidity induced by bupivacaine CHEN Zhe, ZHAO Shishi, LIN Tingting, LIU Qiaoyan, DONG Jiaojiao, XU Xuzhong. Objective: To study the effects of long-chain lipid emulsion on the changes of membrane fluidity induced by bupivacaine in H9c2 cardiomyocyte. Methods: By the combination of confocal laser scanning microscope and fluorescence recovery after photobleaching, the effects of long-chain lipid emulsion and bupivacaine on the membrane fluidity in H9c2 cardiomyocyte, whose membrane phospholipid was labelled with NBD-C6-HPC specific fluorescent probes, were determined. Results: Comparing with the Con group, the LCT group showed no significant difference in membrane fluidity. The Bu-1000 group showed a decreased recovery ratio when compared with the Con group (P<0.01), LCT group (P<0.01) and Bu-100 group (P<0.01), and a decreased diffusion coefficient when compared with the Con group (P<0.05) and the LCT group (P<0.01). Compared with Bu-1000 group, the Bu-1000+LCT group showed an increased recovery ratio (P<0.05) and an increased diffusion coefficient (P<0.01). Compared with Bu-100 group, the Bu-100+LCT group showed an increased diffusion coefficient (P<0.01). Conclusion: Long-chain lipid emulsion can reverse the decrease of membrane fluidity induced by bupivacaine in H9c2 cardiomyocyte. 2017 Vol. 47 (3): 178-181 [Abstract] ( 666 ) HTML (1 KB)  PDF (1766 KB)  ( 832 ) 182 Preparation and identification of ovarian decellularized biologic scaffold LAN Li, WANG Yan, FU Yanghua, LIU Shuailiang, LI Ting, WANG Zhibin, XI Haitao, YANG Yunjun, MEI Jin. Objective: To prepare decullularized biologic scaffolds of part of porcine ovarian tissue by soaking with rotating, and then indentify their characteristics. Methods: Thirty ovaries were excised from healthy immature pigs, and then cut transversely into pieces at the thickness of 6 mm uniformly. At room temperature, they were soaked into 1% SDS solutions and rotated on a tablet oscillator at the speed of 120 r/min for 36 h. At last they were washed with deionized water to get rid of residual SDS and DNA fragments. After decellularization, histochemical staining was done, the residual DNA was quantitative determined, examined under scanning electron microscope examination and did immunofluorescence to observe the removal of cells, the three-dimensional structure of the scaffolds, and the reservation of collagens and proteins in the extracellular matrix. Results: Quantitative analysis showed that only 15.4% DNA remained in the decellularized scaffolds compared to the normal control tissues; HE straining, scanning electron microscope and immunofluorescence showed there were no cells left in the scaffolds, at the same time, the three-dimensional structure and the collagens in the extracellular matrix kept intact. Conclusion: The method of soaking with rotating can remove all cells from the ovarian tissue, maintain the supporting structure of extracellular matrix relatively completely, and reserve collagens and proteins at a certain degree.   2017 Vol. 47 (3): 182-186 [Abstract] ( 680 ) HTML (1 KB)  PDF (2164 KB)  ( 848 ) 187 The functional role of microRNA-214 in the differentiation and mineralization of cementoblasts SUN Fucai, LIU Xueting, CAI Zhibin, ZHANG Jinhua. Objective: To construct a silencing plasmid of microRNA-214 and study the functional role of microRNA-214 in the differentiation and mineralization of cementoblasts. Methods: The cementoblasts was cultured in normal condition and expression level of the cementoblastic markers was test during the differentiation and mineralization induction period. Silencing lentiviral vector of microRNA-214 was constructed and then transfected into mouse cementoblasts (OCCM-30 cell lines). Fluorescence microscope was used to detect transfection ability and silencing effects of the construct. Alizarin Red and Von kossa staining was used to test the mineralization ability of cementoblasts. Real-time PCR was used to demonstrate the differentiation ability of cementoblasts. Results: Real-time PCR results showed that the relative expression of cementoblast differentiation marker ALP, Runx2, BSP, OCN, Col1a and CAP mRNA increased gradually as time goes on. The blank group, negative control group and microRNA-214 group infection ratio of silent carrier reached more than 90% cementum cells. Compared with blank group and negative control group, the expression of microRNA-214 in the microRNA-214 silencing group decreased 5 times. The results showed that the microRNA-214 silencing vector played a good role in silence. Compared with blank group and negative control group, microRNA-214 silencing group could significantly increase the proliferation rate of cementoblasts. Compared with blank group and negative control group, microRNA-214 silencing group, the number of mineralized nodules increased and the morphology becamed larger. Cemen-toblast differentiation markers ALP, Runx2, OCN, Col1a, BSP and CAP expression were significantly increased in microRNA-214 silencing group in silence. Conclusion: The research demonstrats that silencing lentiviral vector of MicroRNA-214 can promote the differentiation and mineralization ability of cementoblasts. 2017 Vol. 47 (3): 187-191 [Abstract] ( 670 ) HTML (1 KB)  PDF (1797 KB)  ( 847 ) 192 The relationship between 14-3-3 zeta protein over-expression and tamoxifen resistance in breast cancer LING Ren, LING Jin, CHEN Zhonghua, LIU Dandan, ZHAO Hongqi, KE Youtao. Objective: To investigate the relationship between 14-3-3 zeta protein over-expression and tamoxifen resistance in breast cancer. Methods: The 14-3-3 zeta protein expression was detected in the cancerous tissues of 80 breast patients using immunohistochemistry. Based on the follow-up visits, survival status in both high and low 14-3-3 zeta expression groups were analyzed. Results: The total positive ratio of 14-3-3 zeta protein expression in subjects was 96.25% (77/80). Among the total positive ratio, the strong positive ratio, moderate positive ratio and weakly positive ratio were 51.25% (41/80), 23.75% (19/80) and 21.25% (17/80), respectively. The 14-3-3 zeta protein over-expression was related to clinical pathological features. According to the follow-up results, the patients in 14-3-3 zeta high expression group would cause the relapse easily for a short survival time. The results of vitro experiment indicated that the Tamoxifen resistance was enhanced after increasing the expression of 14-3-3 zeta protein. Conversely, the down-regulation of 14-3-3 zeta protein expression would reduce the tamoxifen resistance. Conclusion: As a biomarker of tamoxifen resistance, 14-3-3 zeta protein can be used for evaluating therapeutic efficacy by detecting its expression in breast cancer tissue. 2017 Vol. 47 (3): 192-196 [Abstract] ( 743 ) HTML (1 KB)  PDF (1597 KB)  ( 811 ) 197 Expression and significance of CD117 and Sox10 in malignant melanoma WEN Lihong, LIN Ruipo, CHEN Ade, HUANG Zhaolang, ZHENG Xiangyan, LI Yangyang, HUANG Kate, CHEN Guorong Objective: To analyze the value of CD117, Sox10 expression and c-kit gene amplification in mucous, acral and non-acral melanoma and explore the relationship between it and clinical pathology. Methods: The gene levels of c-kit in mucosal, acral and non acral melanoma were detected by PCR, with pigmented nevus as control. The protein expressions of CD117, sox10, 1-100 and HMB45 were detected by immunohistochemistry. Results: The expression of c-kit gene from the three MM groups was higher than that of pigmented nevus (P<0.05). The immunohistochemical results demonstrated that the number of positive cells of CD117 from the three MM groups was marginally higher than that of pigmented nevus (P<0.05). The number of positive cells of Sox10 in the three MM groups was higher than that of S-100 and HMB45 (P<0.05). The positive rate of CD117 in mucosal, acral and non acral MM was 78.5%, 73.6% and 73.3% respectively, while 25% in pigmented nevus control (P<0.05). The positive rate of Sox10, S-100 and HMB45 in MM was 100.0%, 87.5% and 70.8% respectively (P<0.05). Conclusion: C-kit gene amplification and its downstream transcription protein CD117 enhanced positive expression can be applied as clinical potential therapy target. The positive rate of Sox10 is higher than S-100 and HMB45, and may be applied as tumor differentiation marker for origins of melanocytes.   2017 Vol. 47 (3): 197-200 [Abstract] ( 915 ) HTML (1 KB)  PDF (2074 KB)  ( 1392 ) 201 Clinicopathological features and prognosis of IgA nephropathy with different proportions of crescentic lesions SUN Qice, YU Dongrong, CHEN Hongyu, ZHU Bin, HU Yunqin, JIANG Fei, WU Jun, WANG Yongjun. Objective: To explore the clinicopathologic features and prognosis of IgA nephropathy (IgAN) with different proportions of crescentic lesions. Methods: In total, 1 054 patients who underwent renal biopsy in our hospital from January 2001 to December 2007 were enrolled. We grouped the patients as follows, based on the proportion of crescentic lesions at diagnosis: mild group (≤10%, n=271), moderate group (>10% to ≤25%, n=182), and severe group (>25%, n=46), and control group (no crescent formations, n=555). Renal survival curves were generated with the Kaplan Meier method. Univariate and multivariate Cox regression model was used to analysis the prognostic value of crescent in IgAN. Results: Of the 1 054 subjects, mean proportion of crescent was 13.2%±15.7%. The proportion of crescents was significantly correlated with the urine protein concentration, serum creatinine concentration, estimated glomerular filtration rate, cholesterol, triglyceride, albumin, and hemoglobin concentration (P<0.05). Pathological indices, such as mesangial proliferation, glomerular sclerosis, and chronic pathological changes (e.g., tubular atrophy/interstitial fibrosis) showed significant differences among the four groups; an increased crescent proportion was especially pathologic (P<0.05). Renal failure was observed in 114 (10.8%) patients at a median of 90.0 months (interquartile range: 62.1-113.7 months). Kaplan Meier analysis revealed that the cumulative renal survival also significantly differed among the four groups (χ2=13.35, P<0.01). In the univariate and multivariable Cox hazards regression, only a higher proportion of crescentic lesions (>25%) had a higher predictive value (P<0.05). Conclusion: The correlation between crescentic lesions and clinicopathologic features in patients with IgAN reflects the degree of disease progression. A higher proportion of crescentic lesions (>25%) in these patients is an independent risk factor for progression to renal failure. 2017 Vol. 47 (3): 201-205 [Abstract] ( 849 ) HTML (1 KB)  PDF (1355 KB)  ( 1300 ) 206 A Meta-analysis of flurbiprofen axetil versus tramadol in postoperative analgesia effect and adverse drug reactions ZOU Liangwang, ZHAO Xiyue, QIU Enyi, XU Lijuan, SHAN Yunfeng. Objective: To compare and analyze flurbiprofen axetil with tramadol in postoperative analgesic effect and the occurrence of adverse drug reactions. Methods: All the randomized controlled trials referring to the comparison of flurbiprofen axetil and tramadol in postoperative analgesia effect and adverse drug reactions were searched in the domestic and foreign databases (such as CNKI, WanFang database, Medline and Pubmed) in January 2006 to May 2015. The enrolled published literatures were analyzed using Meta-analysis method with RevMan 5.1 statistical analysis software. Results: Ten separate clinical randomized controlled trials including 728 cases were researched with the Meta-analysis. Objective responsiveness: there is no significant difference between the  postoperative analgesia effect of flurbiprofen axetil group and that of tramadol group; But in the adverse drug reactions: the incidence of nauses and vomiting were lower in the flurbiprofen axetil group than that in the tramadol group (P<0.001), the RR and 95%CI were 0.36 (0.26-0.50). The incidence of dizziness was lower in  the flurbiprofen axetil group than that in the tramadol group (P=0.01), the RR and 95%CI were 0.46 (0.26-0.83). The funnel plots showed no significant publication bias in each indexes. Conclusion: The roles of postoperative analgesia effect in flurbiprofen axetil group are similar to tramadol group, but the incidence of adverse drug reactions are less in the flurbiprofen axetil group than that in the tramadol group. 2017 Vol. 47 (3): 206-210 [Abstract] ( 793 ) HTML (1 KB)  PDF (1845 KB)  ( 1292 ) 211 Diagnostic value of intraoperative frozen section in thyroid nodule with different Bethesda categories LUO Jieli, CHEN Jianshe, SUN Yang, HUANG Pintong. Objective: To investigate the diagnostic value of intra-operative frozen section (FS) in thyroid nodules with a prior ultrasound-guided fine needle aspiration (FNA) diagnosis of different Bethesda Categories. Methods: Eight hundred and eighty one nodules from January 2011 to February 2013 were retrospective analyzed in the Second Affiliated Hospital of Zhejiang University School of Medicine. All nodules had undergone both preoperative FNA examination and intra-operative FS examination. FNA cytologic diagnosis was classified into six categories based on the Bethesda system and the diagnostic accuracy of intra-operative FS was analysed in different categories of cytology. Results: Among 881 thyroid nodules 57 (6.47%) were classified as Bethesda Category I, 95 (10.78%) were classified as Bethesda Category II, 65 (7.38%) were classified as Bethesda Category III, IV, 664 (75.37%) were classified as Bethesda Category V, VI. 56.14% (32/57) of Bethesda Category I were histologically diagnosed as malignant, the precision of FS was 91.23%, 37.89% (36/95) of Bethesda Category II were histologically diagnosed as malignant and the precision of FS and FNA were 90.53% and 62.11% respectively, 49.23% (32/65) of Bethesda Category III, IV were histologically diagnosed as malignant, the precision of FS and FNA were 87.69% and 50.77% respectively, 97.29% (646/664) of Bethesda Category V and VI were histologically diagnosed as malignant, the precision of FS and FNA was 91.42% and 97.29% respectively. FS diagnosis was more accurate than FNA diagnosis in Bethesda Category II, III, IV, especially in Bethesda Category II (P<0.05), while the accuracy of FNA diagnosis in Bethesda Category V, VI was increasing obviously. The accuracy rate for dedection of malignancy by FNA was higher compared with the precision of FS in those categories (P<0.05). Conclusion: FNA was an accurate method for evaluating thyroid nodules in Bethesda Category V and VI, while FS do not seem to be necessary in those nodules. Intra-operative FS could be avoided when the FNA results were classified as Bethesda Category V and VI, while FS was most helpful when FNA results are Bethesda Category I, II, III, IV, which may increase the diagnostic accuracy of thyroid nodules and guide clinical treatment well. 2017 Vol. 47 (3): 211-214 [Abstract] ( 1002 ) HTML (1 KB)  PDF (1286 KB)  ( 1415 ) 215 The value of MRI in diagnosis of choroid plexus papilloma Tang Kun, Xu Yali, Zheng Xiangwu, Lin Jie. Objective: To evaluate the value of magnetic resonance imaging (MRI) in diagnosis of intracranial choroid plexus papilloma (CPP). Methods: A total of six cases with CPP who were confirmed by surgery and pathology were retrospectively analysed by MRI. Results: In these six patients, there were three lesions in the fourth ventricle, one in the posterior horn of the right ventricle, one in the left temporal lobe and the last in the right temporal lobe. T1WI images showed equal signal in 3 cases, low signal in 2 cases, equal- low signal in 1 case; T2WI images showed high signal in 2 cases, equal- low signal in 1 case, equal signal in 1 case, low signal in 1 case, mixed signal in 1 case. Most of tumors presented strong homogenous enhancement on enhanced MRI. The characteristic enhancement of small granule or mulberry heterogeneous enhancement could be observed in some cases. Conclusion: MRI has high value in diagnosis of intracranial CPP by providing important information of MR characterization. 2017 Vol. 47 (3): 215-217 [Abstract] ( 757 ) HTML (1 KB)  PDF (1443 KB)  ( 930 ) 218 Clinical effect of ultrasound-guided combined peripheral nerve blocks for surgical and postoperative analgesia management in patients with lower extremity venous insufficiency under phlebectomy  Yang Tao, Zhou Riyong, Bao Nana, Xu Xuzhong. Objective: To investigate the efficacy of femoral and sciatic combined with obturator nerve blocks for analgesia in patients with lower extremity venous insufficiency compared with epidural anesthesia. Methods: One hundred ASA physical status I-III patients who were scheduled for lower extremity venous insufficiency were randomly divided into two groups: group NB (n=50) and group EA (n=50). Ultrasound-guided femoral nerve block and sciatic nerve block combined with obturator nerve blocks were performed in patients of group NB. Patients in group EA were performed with epidural anesthesia at the level of L 2/3. The procedure time for anesthesia time, the anesthesia onset time, onset time of motor block, duration of sensory and motor block, the operation time, intraoperative medications, successful rate, visual analog scale at 6 hours, 12 hours, 18 hours and 24 hours after operation were recorded. At the same time, the first time needed for analgesia after surgery, the satisfaction of patients at postoperative 24 hours and perioperative side effects were also recorded. Results: The anesthesia onset time, the operation time and the duration of sensory and motor block in group NB were obviously longer than those in group EA (P<0.05). The total amount of ropivacaine in group NB was significantly higher than that in group EA (P<0.05), while there was no significant difference in the total amount of lidocaine (P>0.05). There was no difference in successful rate between the two group (P>0.05). Lower VAS pain scores, lower morphine consumption and higher satisfaction in group NB were significantly higher than those in group EA (P<0.05). And the first time that needed for analgesia after surgery in group NB was longer than group EA (P<0.05). Conclusion: Femoral and sciatic combined with obturator nerve blocks can provide an effective anesthesia and analgesia for patients undergoing lower extremity venous insufficiency phlebectomy. 2017 Vol. 47 (3): 218-221 [Abstract] ( 741 ) HTML (1 KB)  PDF (1332 KB)  ( 823 ) 222 The efficacy of Batroxobin on early acute ischemic stroke YIN Juan, LIU Bende. Objective: To investigate the efficacy of Batroxobin on early acute ischemic stroke. Methods: Selected 50 patients with early acute ischemic stroke from January 2014 to December 2014, were randomly divided into observation group and control group. The control group was given with conventional treatment, and the observation group based on conventional therapy with batroxobin administering treatment. Fibrinogen levels, functional neurological deficit (NIHSS) score and treatment were observed. Results: Fibrinogen content and NIHSS score in observation group were significantly lower than those in the control group (P<0.05); the cure rate and the total effective rate between two groups was statistically significant (P<0.01). Conclusion: Batroxobin can reduce the fibrinogen, improve the prognosis and quality of life for early acute ischemic stroke. 2017 Vol. 47 (3): 222-224 [Abstract] ( 683 ) HTML (1 KB)  PDF (1304 KB)  ( 934 ) 225 Influence of different intra-abdominal pressure on the electrical activity of the diaphragm and tidal volume for neurally adjusted ventilatory assist WU Huayong, ZHANG Weiwen Objective: To evaluate how IAP affects the EAdi and the tidal volume (VT) during NAVA was meaningful to set parameters of clinical ventilation. Methods: Forty-four patients in ICU were enrolled in this study. Inclusion criteria: over 18 years old adult who was going to use mechanical ventilation for over 72 hours at positive end-expiratory pressure (PEEP) 3-5 cmH2O (1 cmH2O=0.098 kPa). IAP was indirectly measured by injecting saline to bladder with 6 hours interval. The dividing line of high IAP and non-high IAP was set as 12 mmHg (1 mmHg=0.133 kPa) according to WSACS. By a EAdi catheter via nose EAdi was recorded with VT hourly. Results: EAdi was significant lower when IAP was over than 12 mmHg; and VT was significant higher when IAP was less than 12 mmHg. Conclusion: The changes of EAdi and VT under different IAP during NAVA: when IAP was high, EAdi decreases while VT increases and vice-versa. 2017 Vol. 47 (3): 225-228 [Abstract] ( 648 ) HTML (1 KB)  PDF (1289 KB)  ( 1008 )

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