Objective To study the influence factors affecting the blood sodium level of patients with respiratory system diseases for the first time. Methods A retrospective analysis of 557 cases in our hospital from January 1,2013 to April 31, 2013 were analyzed.According to the serum sodium levels, patients were divided into normal blood sodium group and hyponatremia group.The basic data, clinical indexes, prognosis were collected and the relationships between the epidemiology study of hyponatremia and the diseases of respiratory system were analysed.Results 557 cases of respiratory patients, 121 cases were complicated with hyponatremia, the incidence rate was about 21.72%; hyponatremia incidence of the top three diseases of respiratory system:57 cases of pneumonia ( 47.1%) , 26 cases of chronic bronchitis ( 21.5%) , 11 cases of lung cancer ( 9.1%); temperature, diastolic blood pressure, heart rate, WBC, Hb, Alb, BUN, Cl, might had an impact on the level of serum sodium (P<0.05); hyponatremia group prognosis was significantly worse than normal blood sodium group (P<0.05).Conclusion Patients in the department of respiratory internal medicine are easy suffered with hyponatremia, the factors are more, prognosis is poor, requiring clinical attention.

Objective To evaluate the feasibility and efficacy of laparoscopic tubal anastomosis after tubal sterilization.Methods A total of 27 cases of fallopian tube anastomosis with tubal anastomosis were performed under laparoscopy.After removing the sterilized scar in the tubes the hydrotubation was carried out using Methylene Blue to detect whether the tube was patent.By using 6/0 absorbable thread,we sutured the mesosalpinx with 2 or 3 stitches to close the both ends of the fallopian tube.And then,isthmus-isthmus(1 whole-layer stitch at the 12 o'clock,and then 1-stitch sutures at the serous layer of the 8 and 4 o'clock respectively)ampulla-ampulla(1 whole-layer stitch at the 12 o'clock,and then 1-stitch sutures at the whole layers of the 9,7,5,and 3 o'clock respectively),or isthmus-ampulla(same method as the ampulla-ampulla anastomosis but more closed sutures)was performed.The patients received hydrotubation at the first day after the operation and then 3 to 5 days after the first menstruation.They were followed up for every 6 months till pregnancy.Results In the 27 patients(54 tubes),the rate of patency was 88.9%(48/54).The patent rate in the patients received isthmus-isthmus or ampulla-ampulla anastomosis was 86.5%(32/37)and 100%(15/15)respectively.In the 2 cases of isthmus-ampulla anastomosis,one was patent after the operation,and in the other,the Methylene Blue test showed anastomotic leakage.The hydrotubation performed at the first day after the treatment showed a rate of patent in 25 cases(2.6%,25/27),only two patient showed obstruction of the tube(7.4%,2/27).Follow-up was available in 26 of the patients up to over 6 months,19 of them had intrauterine pregnancy(73.1%,19/26)in 24 months after the procedure,among which 89.5%(17/19)occurred in 12 months;one(3.8%,1/26)patient developed ectopic pregnancy.Conclusions Laparoscopic tubal anastomosis is safe and effective for patients who desire reversal after sterilization.

In recent years,China's science research has entered the high-speed development period,which leads to the increase of the investment of science research funds.At the same time,the safety and effectiveness of the science research management and the funds has caused public concern.So the science management of research work including the use of science research funds is of great significance.This paper will analyze the risk of key positions in science research management and put forward corresponding countermeasures,combining the writer's practical experience in hospital.

Objective:Making single chain antibody(scFv)-alkaline phosphatase(Ap)fusion protein.Methods:An expression vector pSTE2-C66-Ap was constructed by sequentially inserting the Ap coding region into plasmid pSTE2-8E5 and replacing the VH-VL fragment of 8E5 by VH-VL fragment of C66.The fusion protein scFvC66-Ap was expressed in E.coli.and analysed by SDS-PAGE and immunoblotting.Results:Have obtained the scFvC66-Ap fusion protein with a molecular weight of 75 kD.It bound a 60 kD molecule from KG1a cell proteins on immunoblotting membrane detected directly by Ap enzymatic activity.Conclusion:A method permits the production of scFv-Ap conjugates in E.coli.which can replace conventionally prepared Ap-labeled antibodies in immunoassays.

BACKGROUND: As a group of primary cells,stem cells have the potentials of self-renewal and multi-directional differentiation, and can replace the damaged cardiomyocytes to construct new vessels, and enable the asthenic heart to obtain the blood pumping function again.This study summarized the progress of stem cell transplantation in treating cardiovascular diseasesDATA SOURCES:A computer-based online search of Pubmed database was undertaken to identify English articles published from January 2000 to December 2005, the keywords were "stem cell transplantation, cardiovascular diseases".STUDY SELECTION: The articles were primarily checked, and the references of each literature were looked up. Inclusive criteria:articles correlated with the classification and the transplanted pathways of stem cells,the present status,problems and prospect of its basic and clinical application in treating cardiovascular diseases. Exclusive criteria: repetitive study or Meta analysis.DATA EXTRACTION:Totally 50 relative literatures were collected, and 31 of them accorded with the inclusive criteria,and the other 19 were excluded due to the old or repetitive contents. Of the 31 involved literatures, 19 were about the classification of stem cells used in cardiovascular system, 1 about the transplanted pathways of stem cells, 8 about the application of stem cells in treating cardiovascular diseases, and 3 about the existing problems and prospect.DATA SYNTHESIS:With the continuous improvement of living level and aging, cardiovascular diseases have become the main causes for death and disability in modern society.Stem cells have the potentials of multi-directional differentiation, and have become the main seed cells for cell replacement therapy, and provided important investigative and applicating field for the treatment of cardiovascular diseases. At present, there are many stem cells to be used in cardiovascular system, including embryonic stem cells, umbilical cord blood stem cells, peripheral blood stem cells, bone marrow stem cells, skeletal muscle satellite cells, myocardial stem cells, adipose tissue-derived stem cells, etc. The common pathways for stem cell transplantation are direct injection into myocardium,intracoronary artery injection and intravenous injection.Stem cell transplantation can treat cardiovascular diseases by promoting angiogenesis and myocardial regeneration, decreasing myocardial apoptosis and reducing myocardial collagen, then ameliorate the cardiac function, and breakthrough and progress have been made in both animal models and clinical studies. However, problems sill exist to be solved, and there is agreat distance to the routine clinical application.CONCLUSION: Stem cells are the important fields of the basic research and clinical application for preventing and treating cardiovascular diseases,thus it will provide powerful theoretical and practical supports for the more effective prevention and treatment of cardiovascular diseases to solving the key points and difficulties in cardiovascular diseases.

Squamous cell carcinoma is the second most common non -melanoma skin cancer and its morbidity is increasing in recent years .Because of the complicated pathogenesis and non -specific clinical mani-festation of squamous cell carcinoma ,misdiagnosis occurs frequently .Although squamous cell carcinoma usually grows very slowly ,the invasion and metastasis of special types occurs early .With the deep knowledge of squamous cell carcinoma,people get more and more research results in diagnosis ,treatment and prevention .This paper de-scribes the epidemiology ,etiology ,clinical manifestation ,pathology ,clinical staging ,treatment and prognosis .

Objective To investigate the influence to airway responsiveness by using low dose azithromycin in asthmatic children.Methods One hundred and four children with moderate persistent or severe persistent asthma were divided into Group A (include 56 cases) and Group B (include 48 cases) randomly.All of the patients were treated with seretide (50/100 μg/dose) 2 doses/d for4 weeks.Children with severe persistent asthma were added with montelukast 5 mg/d orally,children accompanied with allergic rhinitis were added with nasonex 100 ～200 μg/d intranasal.And four weeks later,all of the patients were given a 12-week observation.Group A kept on treating with seretide (the same dose as before),and azithromycin 7.5mg/ (kg·d) (the maximal dose was 250 mg/d) orally was administered intermittently twice a week.Group B kept on treating with seretide ( the same dose as before) only.At the end of the study,we assessed the number of days with asthmatic symptoms in two groups respectively.At the beginning and the end of the study,we measured the forced expiratory volume in one second (FEV1 ％ ),peak expiratory flow (PEF％),the PD20-FEV1 by histamine challenged at the 15 th day and at the end of the study in two groups.Twenty-four hours before the study and twenty-four hours after the study,we measured the 24-hour urinary 17-OHCS and 17-KS of the patients.Two weeks after the study,we measured the serumal ALT and AST of the patients.Results ( 1 ) The number of days with asthmatic symptoms was ( 2.13 ± 1.18 ) d and ( 2.25 + 1.19 ) d respectively in Group A and B,and there was no significant difference between two groups ( t =0.54,P=0.59).(2) The PEF％ before and after the study in Group A was (49.77 ± 15.02)％ and (82.73 ±7.81 ) ％ respectively ( t =16.59,P =0.000).The PEF％ before and after the study in Group B was (52.69±13.90)％ and (81.15±7.28)％ respectively (t=12.37,P=0.000).The FEV1％ before and after the study in Group A was (50.48 ± 15.08 ) ％ and ( 83.18 ± 6.61 ) ％ respectively ( t =16.25,P =0.000).The FEV1 ％ before and after the study in Group B was ( 53.29 ± 13.89 ) ％ and ( 82.73 ± 6.10 ) ％ respectively (t=12.83,P=0.000).(3) The PD20-FEV1 at the 15 th day and at the end of the study in Group A was (65.13 ±26.08) μg and (460.79 ±221.72) μg respectively (t =13.54,P =0.000).The PD20-FEVt at the 15th day and at the end of the study in Group B was ( 65.27 ± 25.75 ) μg and (65.66 ± 25.09 ) μg respectively (t =1.45,P =0.15).Compared the PD20-FEV1 between the two groups,there was significant difference at the end of the study (t =13.29,P =0.000).(4) The 24-hour urinary 17-OHCS was (14.27 ±3.41)nmol/L and (14.43 ±3.69) nmol/L respectively of Group A and was (14.31 ±3.66)nmol/L and ( 14.56 ± 3.37 ) nmol/L respectively of Group B before and after the study,and there was no significant difference between Group A and Group B.The 24-hour urinary 17-KS was ( 22.43 ± 5.69 ) nmol/L and (22.07±5.21 ) nmol/L respectively of Group A and was (22.40±5.04) nmol/L and (22.54 ±4.74)nmol/L respectively of Group B before and after the study,and there was no significant difference between Group A and Group B.(5) The serumal ALT of Group A and B measured 2 weeks after the study was (20.39± 9.12) U/L and ( 20.83 ± 7.83 ) U/L respectively ( t =0.26,P =0.79 ).The serumal AST of Group A and Group B measured 2 weeks after the study was (20.68 ±8.67) U/L and (21.44±8.60) U/L respectively (t =0.45,P =0.66 ).Conclusion It can significantly decrease the bronchial hyperreactivity of asthmatic children treated with low dose azithromycin orally for 12 weeks and seretide inhaled,but it can not decrease the number of days with asthmatic symptoms in the patients,can not improve the FEV1 and PEF significantly.There wasn't any influence on adrenal glands.function and liver function of the patients.

Objective To accurately understand multi-spot medical practice in China and evaluate its effect.Methods Operation data of 2008 and 2009 were gathered from all medical institutions in Kunming to analyze the effect of the practice trial using the fixed effect model.Results Under control of such factors as the scale and type of the hospitals,clinic visits of the second certified hospital benefited by the practice increased by 14％than before,whereas the medical revenue of the institution increased by 29％.The effect proves more significant in terms of total clinic visits and medical revenues at level-1 and level-2 medical institutions.Conclusion Multi-spot medical practice in Kunming proves successful as it increased medical service supply and medical revenue,especially for level-1 and level-2 medical institutions.This effect possibly results from releasing high-level physicians down to lower-level institutions,helping these institutions to attract patients.

Objective To investigate the effects of isoflurane and sevoflurane at the equivalent depth of subanesthesia on neuronal proliferation and phosphorylation of extraceullar signal-regulated kinase 1/2 (ERK1/2)protein in the hippocampi of neonatal rats.Methods Seventy-two neonatal rats at postnatal day 7 were involved in this study and they were assigned randomly into isoflurane group (Iso group),sevoflurane group (Sev group) and control group (Con group).The rats in I group,S group or C group were separately exposed to 0.75％ isoflurane or 1.2％ sevoflurane (equivalent to 0.3 MAC for neonatal rats) or air for 6 h.Some rats in each group were injected intraperitoneally BrdU 100 mg/kg immediately (D0) (n =6) or 3 days after exposure (D3) (n =6),and their brains were perfusion and embedded by paraffin 24 h after BrdU injection.BrdU positive expressions in the in dentate gyrus (DG) area of hippocampus were detected by IHC staining.Besides,the fresh hippocampi of some rats each group were dissected at the end of anesthesia,caspase-3 and phospho-ERK1/2,ERK1/2 proteins expression were detected by Western blot (n =6).The other rats in each group were used to measure changes of pH and blood glucose (n =6).One way ANOVA test was used for data analysis among groups.Results BrdU-positive cells had no significant difference among group IsoD0 ((1332.43 ± 192.70)/mm2),group SevD0 ((1207.33 ±139.50)/mm2),and group ConDO ((1362.40 ± 227.90)/mm2) at D0,while which had significantly decreased by 32.6％ (P＜ 0.05) in group IsoD3 ((604.56 ± 65.77)/mm2) when compared with those in group ConD3 ((896.90 ± 78.77)/mm2) at D3.There was no significant difference between groups of SevD3 ((808.73 ± 41.27)/mm2) and ConD3.The expression of caspase-3 protein was increased by 195％ (P＜ 0.01) in Iso group while which only increased by 74％ (P ＜ 0.05) in Sev group when compared with Con group.The expression of P44 and P42 of phospho-ERK1/2 protein in the hippocami decreased by 53％ (P ＜ 0.01) and 47％ (P ＜ 0.01))seperately in Iso group when compared with Con group,while there were no significant differences between Sev group and Con group.Conclusion 0.3 MAC isoflurane,not sevoflurane inhibits neuronal proliferation in DG of hippocampi in the neonatal rats.Inhibiting ERK1/2 phosphorylation may involve in the mechanisms of that isoflurane inhibits neuronal proliferation.

Objective:To investigate the expression of Gli-2 protein and nuclear proliferation marker Ki-67 in human thymic tu-mors, as well as its relationship with clinicopathological features and prognosis. Methods: Immunohistochemical staining was per-formed to determine the expressions of Gli-2 and Ki-67 in 64 thymic tumor cases, in which 9 were type A, 6 were type AB, 11 were type B1, 22 were type B2, and 16 were type C. Results:1) Positive expression rates of Gli-2 in types A, AB, B1, B2, and C thymomas were 1/9 (11.11%), 2/6 (33.33%), 2/11 (18.18%), 5/22 (22.73%), and 13/16 (81.25%), respectively. Statistically significant differences existed in the two sets of data (P<0.05). Positive rates of Gli-2 in the Masaoka stages Ⅰ, Ⅱ, Ⅲ, and Ⅳ were 2/10 (20%), 12/41 (29.27%), 4/6 (66.67%), and 5/7 (71.43%), respectively. The statistical differences of these two sets of data were also significant (P<0.05). 2) The expression levels of Gli-2 in tumor tissues were closely correlated with the pleura (P<0.05) but not associated with gen-der, age, myasthenia gravis, and necrosis with hemorrhage (P>0.05). 3) The positive labeling indexes of Ki-67 in invasive and non-inva-sive thymomas were 7.14 ± 6.99 and 15.24 ± 9.13, respectively. The differences between both thymomas were statistically significant (P<0.05). 4) A positive correlation existed in the expression of Ki-67 and Gli-2 in thymomas. Five-year progression-free survival (PFS) rate was lower in the Gli-2 positive group (56.5%, 13/23) than in the negative group (92.7%, 38/41). The Ki-67-positive group (61.5%, 16/26) also showed a lower five-year PFS than that in the negative group (92.1%, 35/38), with statistically significant differences be-tween the two groups (P<0.05). Multivariate Cox's proportional hazard regression analysis indicated that the Gli-2-positive group ex-pression, Ki-67-positive group expression, and invasion of the pleura were independent prognostic factors of thymic tumors. Conclu-sion:The expression of Gli-2 and Ki-67 showed a positive correlation with thymic tumors. Detecting the combined expression of Gli-2 and Ki-67 may elucidate the clinicopathological features and prognoses of patients with thymic tumors.