With the accelerating process of aging society, people's life style is changing accordingly, elderly patients due to physical decline in daily activities, often prone to hip fracture, its basic reason is osteoporosis, which belongs to brittle fracture, evaluation of preoperative examination and the systemic function is very important.Perioperative treatment is the key to the success of surgery treatment , a considerable part of the success of surgery depends on the factors of internal diseases.The incidence of cardio cerebral stroke in hip fracture surgery is also increasing , especially in elderly patients, often and there are a variety of medical diseases, the majority of organ function reserve is low, tolerance to anesthesia, surgery and other stress ability is poor, Patients in the perioperative period of traumatic stress, easily lead to stroke secondary cardiovascular disease, in clinical treatment, we should strengthen the prevention measures of perioperative stroke in elderly patients with hip fracture , Salvia miltiorrhiza ligustrazine injection can effectively prevent the occurrence of myocardial ischemia, myocardial infarction, or cerebral infarction by reducing platelet aggregation function and blood viscous degree, expanding coronary artery, cerebrovascular, improving the flow rate of red blood cells and microcirculation.In this paper mainly for Salvia miltiorrhiza ligustrazine in recent years in elderly hip fracture patients perioperative cardio cerebral apoplexy therapy application review to provide some reference value for clinical research .

Secretion of the salivary glands of leeches contains more than 100 bioactive substances,in recent years it has become the focus of many researchers'attention, which was the most extensive and in-depth study of the salivary glands of leeches anticoagulant and inhibit the biological activity of platelet aggregation substance, and some species have been successfully applied to the treatment of cardiovascular diseases.in addition, a growing number of studies have found that leech salivary gland secretion also has antibacterial, antitumor, analgesic, vasodilator, anti-inflammatory, wound healing and other biological functions.Thus, leech salivary gland secretion with functions of biological diversity.Moreover, the leech is not just for the treatment of human diseases, but also applied to the treatment of several diseases of animals.This review expatiating the functional diversity of leech salivary secretions by consulting a large number of iterature , that the use of leech salivary gland secretion and other blood-sucking animal salivary gland secretions functions provide a useful reference.

Hirudin as a novel anticoagulant and antithromotic agent, is a kind of protein that is obtained from the salivary gland secretion of one kind blood-sucking leech.It increases the difficulty extraction and purification of hirudin that composition of no anticoagulant activity of peseudo-hirudin in the body of leech and a large number of complex material from the salivary gland secretion of one kind blood-sucking leech.This article focuses on reviewing the structure of hirudin, genetic makeup, extraction and purification of hirudin according to the related research.Analysis of the pros and cons of various extraction and purification methods.Looking forward to its developing tendency, so as to provide reference for extraction and purification of Hirudin.

Cancer stem cells are thought to be the seed of tumor formation, through complex signalings and cytokines in the surrounding microenvironment regulate the development and metastasis of tumor.Tumor stem cells have the characteristics of self-renewal and differentiation, the intracellular signaling pathways regulating self-renewal and differentiation of cancer stem cell include Wnt, Hedgehog signaling pathway.The tumor microenvironment is the dimensional environment surrounding the tumor,including the extracellular matrix, surrounding blood capillary,stromal cells ( fibroblasts, mesenchymal stem cells, tumor-associated endothelial cells, inflammatory cells) and cytokines secreted by stromal cells.Cancer stem cells maintain a close communication with the cells in the tumor microenvironment.In this paper, the cell surface maker of cancer stem cell,cancer stem cells and regulation of cytokine in the microenvironment,intracellular signaling pathways of cancer stem cells are reviewed to show complex regulatory networks in the tumor microenvironment.This review should help providing a new direction on specific cancer therapy for cancer stem cells in cacer treatment.

Objective To compare the influence degree of laparoscopic operation and open operation on peripheral blood T lymphocyte subsets and Th1Th2 in patients with severe acute pancreatitis.Methods 54 patients who underwent surgical treatment in our hospital from February 2013 to December 2014 were selected as the subjects, 27 patients with severe acute pancreatitis who were treated with open operation as group A , 27 cases who were treated with laparoscopic operation at the same time were selected as group B , and then the peripheral blood T lymphocyte subsets and serum Th1Th2 indexes of two groups before the operation and at first,third and seventh day after the operation were respectively detected, then the detection results of two groups were compared.Results The peripheral blood T lymphocyte subsets and serum Th1Th2 indexes of group B at first, third and seventh day after the operation were all significantly better than those of group A , the difference was statistically significant ( P<0.05 ) , and the detection results of group A and group B at third day after the operation were worse than those at other time , the difference was statistically significant (P<0.05).Conclusion The influence of laparoscopic operation and open operation on T lymphocyte subsets and Th1Th2 in peripheral blood of patients with severe acute pancreatitis, the adverse effects of laparoscopic operation on the above indicators were relatively small.

Objective To compare the detection rate of Xpert MTB/RIF test and sputum smear and culture method, and to investigate the value of the detection of the smear negative pulmonary tuberculosis.Methods 69 patients with tuberculosis diagnosed in Tianjin Haihe Hospital from July 2014 to July 2015 were examined by fiberoptic bronchoscopy ( and check of tubercle bacillus in sputum smear negative three times ) .With final diagnosis of pulmonary tuberculosis patients the number of statistical smear, culture method and Xpert MTB/RIF test their tuberculosis detection rate.Results A total of 69 patients with sputum smear negative patients with final diagnosis of 54 cases of pulmonary tuberculosis, confirmed 54 cases of tubercle bacillus in sputum smear negative pulmonary tuberculosis patients, Xpert MTB/RIF test was positive in 33 cases accounted for 61.11%(33/54).Among the 35 cases, 17 patients with Xpert MTB/RIF positive, can improve the detection rate of bacterial negative tuberculosis 31.48%(17/54), 19 cases of patients with negative smear positive, 16 cases of Xpert MTB/RIF positive, and the culture method was 84.21%(16/19).BALFXpert MTB/RIF test of tuberculosis found in 61.11%(33/54), the culture method of tuberculosis found 35.19%(19/54).The report is more than 50%, also has reached to 80%, and the selection has a great relationship.Xpert method and culture method, the difference was statistically significant (P<0.05).The positive rate of Xpert test was positive in 2 cases of positive MTB/RIF in the patients with positive smear positive 100%.Conclusion It is a simple, rapid and accurate method to do Xpert MTB/RIF test for BALF, and it can improve the smear negative tuberculosis patients found rate of 48.75%.The positive rate of the sputum smear negative is 59.62%(14+17/35+17), which is better than that of sputum smear and culture.

Objective To investigate the relationship between BRCA1 protein expression in lung cancer tissues and the effect of gemcitabine and Cisplatin based chemotherapy.Methods 80 cases of squamous cell carcinoma confirmed by pathology from May 2013 to May 2015 were selected, and treated with gemcitabine plus cisplatin chemotherapy and Ginseng and Astragalus assisted theropy.BRCA1 protein expression of all patients were detected, and relationship between the effect of chemotherapy and prognosis of patients with BRCA1 protein expression in lung cancer tissues were studied.Results In 80 cases, BRCA1 protein was positive in 40 cases, 40 cases were negative, CR 5 patients, PR 6 patients with BRCA1 positive expression, the remission rate was lower than the BRCA1 negative patients ( P <0.05 ) .80 cases of adverse reactions were seen as leukopenia, gastrointestinal symptoms (nausea and vomiting), abnormal liver function, BRCA1 expression of peripheral neurotoxicity, the incidence of complications in patients with positive expression were significantly higher than BRCA1 negative patients(P<0.05).N stage (P=0.03), BRCA1 gene (P=0.02) were independent risk factors of the prognosis of patients.Conclusion BRCA1 protein positive patients in lung cancer tissue had poor chemotherapy effect, more adverse reactions, and poor prognosis.

Objective To explore the clinical expression of P53, Livin and PARP in the epithelial ovarian cancer and its correlation with the chemotherapy resistance and clinical prognosis.Methods 74 specimen of epithelial ovarian cancer confirmed from January 2009 to June 2011 in our gynecology department were selected.During the follow-up visit, the subjects were divided into chemotherapy sensitivity group and chemotherapy resistance group according to the recurrence cases, the clinical expression and survival rate for two groups were compared, the influence factors of survival time were analyzed.Results The positive rate of P53, Livin and PARP for chemotherapy sensitivity group was 47.1%, 56.9%and 52.9%;the positive rate for chemotherapy resistance group was 73.9%, 95.7% and 95.7%,the diyforences were significant(P<0.05).After 1, 3 and 5 years of treatment, the survival rate for chemotherapy sensitivity group was 100.0%, 82.4% and 66.7%,The survival rate for chemotherapy resistance group was 87.0%, 26.1% and 8.7%,the diyforences were significant(P<0.05).Based on the Cox regression model, the influence factors of the patient's age, pathological differentiation degree, clinical staging and chemotherapy sensitivity were introduced.It was known that the patient's survival time was greatly influenced by clinical staging and chemotherapy sensitivity (P<0.05).Conclusion For patients with epithelial ovarian cancer, the expression of P53, Livin and PARP is correlated with chemotherapy resistance.Therefore, the clinical effect is predictable, for patients with higher expression, the personalized therapy can improve the patient's prognosis.

Objective Through clinical observation and research with persistent atrial fibrillation in patients with blood-brain natriuretic peptide ( BNP) level change detection renin, angiotensin Ⅱ, aldosterone, analyze their data, investigate persistent atrial fibrillation ( PAF ) serum brain natriuretic hormone levels change and the relationship between the renin-angiotensin-aldosterone system (RAAS).Methods 80 patients with coronary artery disease in our hospital from December 2013 to October 2015 were selected, randomly divided into experimental principle PAF group (40 cases) and control group ( patients in sinus rhythm,with 40 cases) , BNP, renin, angiotensinⅡ, aldosterone levels were measured in two groups, and left atrial diameter (LAD) measurements.Results Under the same condition of cardiac function, the blood BNP concentration in PAF group was higher than that in control group (P <0.05).The results of the linear regression analysis showed that the correlation coefficient of blood BNP level and AngII concentration in PAF group was 0.301, the correlation coefficient of blood BNP level and LAD indicators in PAF group was 0.373, the concentrations of BNP and RAAS were positively correlated with LVMI, the differences were statistically significant (P<0.05), the blood BNP level was closely related to the level of RAAS in the PAF group (P<0.05).Conclusion Blood BNP concentration was significantly higher in patients with PAF and blood BNP concentration is closely related with the RAAS, LAD indicators, and a positive correlation.

Objective To investigate the correlation of plasma brain natriuretic peptide (BNP) level with serum albumin, serum total bilirubin and thrombin time in patients with liver cirrhosis.Methods RandomLy selected from January 2014 to June 2016 to our hospital diagnosis and hospitalization of 200 cases of cirrhosis patients, according to the standard of Child-Pugh classification provided by Chinese Medical Hepatology Division in 2006, 48 cases were Child A group, 96 cases were Child B group and 56 cases were Child C group.The plasma BNP, serum albumin, serum total bilirubin, prothrombin time and QTc interval of electrocardiogram were analyzed in the clinical data of each group of patients and the correlation between plasma BNP and their correlation.Results The levels of plasma BNP in Child A, B and C groups were higher than those in B group and B group.The correlation between plasma BNP and Child's grade showed a positive correlation, and the results of each group were statistically different (P<0.05).The plasma BNP level was negatively correlated with ALB ( P<0.05 ) .The level of plasma BNP was positively correlated with ALB ( P <0.05 ) .The correlation between plasma BNP and PTIL was correlated with TBIL.The correlation between plasma BNP and TBIL was significantly correlated with TBIL ( P <0.05), The higher the plasma BNP, the regression analysis showed that plasma BNP and TBIL were positively correlated, the difference was statistically significant (P<0.05).The correlation between plasma BNP level and QTc was analyzed.The QTc interval of plasma BNP level was higher than that of the control group ( P<0.01 ) , and the difference was statistically significant ( P <0.01 ) .Conclusion The plasma BNP level in patients with liver function is closely related to ALB, TBIL, PT, QTc interval, and has the value of evaluating and predicting liver function.