Ventilator is broadly used in the hospital all over the world,The paper describes three case of common troubles in clinical practice for Bird-brand ventilator and its troubleshooting.

The construction of traditional theory of Chinese herbalism cannot do without the accumulated understanding of herb effect in clinical practice.Meanwhile,it closely relates to the natural history of using different theories of herb property to explain effect and mechanism at different stages.The compilation of Inner Canon of Yellow Emperor 《(黄帝内经》) and Shennong Bencao Jing 《神农本草经》) represent the initial formation of traditional herbalism in Chinese medicine.These two books have a relatively complete description of property and effects of herbs,but with different focus of concerning.After Shennong Bencao Jing,explaining the effect from property of herbs gradually become the developing trend and basic characteristics of herbalism.During the Ming-Qing Dynasties,publication of a large number of herbal annotation works further highlights this feature.

Objective To construct a yeast two-hybrid recombinant bait plasmid of human programmed cell death ligand 1(PD-L1)immunoglobulin variable region(IgV)domain gene,detect its expression in yeast and detect the cytotoxicity and self-activation of PD-L1 IgV protein as well as the interaction between PD-L1 IgV and human thioredoxin(hTrx).Methods Human PD-L1 was analyzed by bioinformatics method,and primers were designed to amplify PD-L1 IgV domain based on the coding region of PD-L1 gene registered in NCBI GenBank database. PCR amplification was carried out with pENTERPD-L1 plasmid as template,and then cloned into yeast two-hybrid bait vector pGBKT7. The recombinant bait plasmid and pGBKT7 empty vector were transformed into Y2HGold yeast cells respectively,and the PD-L1 IgV gene and its expression were detected by PCR and Western blot;Meanwhile,the protein toxicity and self-activation of PD-L1 IgV were detected,and the interaction between PD-L1 IgV and hTrx was detected by drip plate method.Results The bioinformatics analysis results of PD-L1 were consistent with related reports. The recombinant bait plasmid pGBKT7-PD-L1 IgV was correctly constructed,and Y2HGold positive clone was obtained,in which PD-L1 IgV was stably expressed. The empty vector pGBKT7 and recombinant bait plasmid pGBKT7-PD-L1 IgV grew well on SD/-Trp and SD/-Trp/X-α-Gal plates with the same colony size and number and white colony,but they did not grow on SD/-Trp/X-α-Gal/AbA plates,which indicated that PD-L1 IgV protein had no toxicity and no self-activation effect on yeast. The results of drip plates test showed that all experimental groups grew well on SD/-Trp/-Leu plate,while only positive control group grew on SD/-Trp/-Leu/X-α-Gal/AbA plate and showed blue color,which indicated that bait protein PD-L1 IgV and hTrx did not self-activate,and there was no interaction between them.Conclusion Recombinant human PD-L1 IgV bait plasmid was successfully constructed. PD-L1 IgV protein showed no toxicity and self-activation effect on yeast cells,and there was no interaction between PD-L1 IgV and hTrx. Subsequently,hTrx can be used to construct a peptide aptamer library,from which peptide aptamers that specifically bind to PD-L1 IgV can be screened.

BACKGROUND:In the treatment of primary knee osteoarthritis, total knee arthroplasty is a common treatment, but there are some shortcomings in the traditional operation, which maylead to early failure of the prosthesis.
OBJECTIVE:To explore the difference of computer-assisted total knee arthroplasty by vastus medialis approach from the traditional total knee arthroplasty.
METHODS:A total of 79 patients with primary knee osteoarthritis were randomly divided into control group (41 cases) and observation group (38 cases), which underwent conventional total knee arthroplasty and computer-assisted total knee arthroplasty by vastus medialis approach. Surgical incision, operation time, total blood loss and drainage volume were recorded and compared in both groups. In 12 months of folow-up, Hospital for Special Surgery knee score was evaluated, and the complications were recorded and compared between the two groups.
RESULTS AND CONCLUSION:(1) Operative incision was significantly less in the observation group than in the control group. Operation time was significantly shorter in the observation group than in the control group. Total blood loss and drainage volume were significantly lessin the observation group than in the control group (alP< 0.05). (2) Patients in both groups were folowed up for 12 months. Index score and total score of knee function were significantly higher in the observation group than in the control group (al P< 0.05). (3) No adverse events such as infection, prosthesis loosening or fracture appeared in the observation group. In the control group, four cases affected prosthesis loosening. One case suffered from wound infection. Above events were improved obviously after active treatment. No serious complications occurred. The incidence of complications was significantly lower in the observation group than in the control group (P< 0.05). (4) The results show that, compared with the traditional operation, the choice of the femoral medial approach and the use of computer aided design technology can simulate the knee replacement process, set the cutting position, improve the accuracy and success rate of surgery, have less trauma, and effectively improve knee function, and reduce the incidence of postoperative complications.

Objective To observe the therapeutic effect of triclabendazole in patients with paragonimiasis skrjabini. Methods Four patients were treated with triclabendazole at dosage of 10 mg/kg bid for 3 days and were followed up for 6～10 months. The clinical symptoms, chest X ray, hemogram and liver function tests were observed before and after treatment. Results Migratory subcutaneous nodules in three patients all disappeared. Small amount of pleural effusion were absorbed in two patients. Severe headache subsided in a patient with cerebral lesion. MRI showed a bean sized calcified spot in the right frontal region. Chest X ray in 2 patients showed that pulmonary lesions were markedly absorbed and disappeared. There was no adverse effect of the drug.Conclusion Triclabendazole has marked therapeutic effect on paragonimiasis skrjabini. It is safe in administration and well tolerated.

Objective To investigate the methods for the detection of serum samples with low-concentration HBsAg and its clin-ical value.Methods Serum samples with HBsAg weak positive were measured by ELISA or using Roch cobas e601 were collected from the clinical laboratory.The samples with low-concentration HBsAg were confirmed by neutralization assay by using Lizhu ELISA reagent Kit or Roch cobas e601 analyzer.at the same time,ALT/AST concentrations and HBV DNA copies were also deter-mined.Results Among 53 samples that showed weak positive reaction by using Kehua reagent kit,37 samples were positive in neu-tralization test,while the other 16 samples were negative.Among 18 samples that showed weak positive reaction tested by using Roch cobas e601 analyzer,13 samples showed positive in neutralization test,and the other 5 samples showed negative.Conclusion The results of HBsAg test varies in different detection System.The clinical significance of samples with low-concentration HBsAg needs further study.

Objective: The FDA regulation requirements for medical device software are relatively mature and systematic, and the research on the FDA regulation thinking of medical device software helps to promote the regulation work of the medical device software in our country. Methods:Based on the comparison of the 1998 edition and 2005 edition FDA software submission guidance, the trend of the FDA regulation requirements for medical device software was analyzed, and then its regulation thinking was discussed according to other current effective software-related guidance. Results:FDA integrally improves the submission requirements for all medical device software, especially for the minor Level of Concern software, and simplifies the requirements for design specification, verification and validation, but strengthens the requirements for traceability analysis and revision history. Conclusion: The regulation work of the medical device software in our country needs to fully consider the particularity of the medical device software, strengthen the audit of software quality management system, implement the software traceability analysis, and determine the regulation requirements for software change.

Objective To investigate the clinical features of ulcerative colitis(UC).Methods Based on typical clinical manifestation,enteroscopy and pathological results,138 in-hospital patients were diagnosed UC during 1998 to 2006.Their clinical features were analyzed in this report.ResultsUC was more commonly seen in people aged 20～60(n=108,78.3％).Nearly forty-six percent of the patients (n=63,45.7％)had the disease less than one year.More patients(n=100,72.4％)showed mild or moderate UC.Bloody stool was the most common manifestation.erythrocyte sedimentation rate,hemoglobin,albumin and α1 or α2 globulin levels were closely related with the condition.The mean value of platelet counting was in the upper limit of the normal value.Enteroscopy found more lesion located in the whole colon (n=78,56.5％).Pathological results showed infiltration of inflammatory cells,especially in patients with chronic inflammation.Salieylazosulfapyridine(SASP)and/or 5-Aminosalicyclic(5-ASA)were effective in most UC patients(n=70,50.7％).ConclusionsChinese patients usually had mild to moderate UC,and their courses were often shorter than abroad.The disease was closely related with α1 and α2 globulin levels.Most of the patients had response to SASP and/or 5-ASA.

BACKGROUND: Fiber post is widely used in front teeth aesthetic repair, but some defect teeth cannot form ferrule or thick root canal, which resulted in fiber post prosthetic replacement defluxion and a failure of repair. Presently, new-style resin cement had self sticking component, showing good effects in sticking of fiber post. Whether combination of new-style resin cement can repair affected teeth using fiber post deserves further investigation.OBJECTIVE: Through fatigue test, residual flexural strength and scanning electron microscope (SEM) observation to compare the strength of severely weakened roots restored with three resin cements. METHODS: Eighteen intact maxillary central incisors were collected and formed to severely weakened canals at the same size. Three kinds of resin cements were used to restore. Rely X Unicem, Panavia F and Super-Bond C&B resin cement and identical glass fiber post were used. All the specimens were restored using Ni-Cr ceramic crown, and placed on TCML chewing machine that loaded 1 200 000 cycle forces, and the cycle times when failure occurred were recorded. The samples were intact following loading received residual flexural strength testl SEM was employed to observe breakage surface of the samples. RESULTS AND CONCLUSION: Mean cyclic loading was significantly greater in the Super-Bond C&B Group (1 200 000 times) than in the Relyx Unicem Group (640 000 times) and Panavia F Group (550 000 times) (P< 0.05). No significant difference was detected between the Rely X Unicem and Panavia F Groups. Residual flexural strength was 747.99 N in the Super-Bond C&B Group. SEM demonstrated that Super-Bond C&B formed longer resin processes, which were more than other two groups. Results confirmed that Super-Bond C&B demonstrated better results when restoring flared roots with prefabricated glass fiber posts.

Objective To summarize the clinical features of Budd-Chiari syndrome.Methods A total of 151 Budd-Chiari syndrome admitted in Peking University People's Hospital from 1996 to 2012 were analyzed retrospectively.Results Abdominal distension was the most common complaint,with 62.9％ (95/151)of lower extremity edema,53.0％ (80/151)of typical bottom-up flow of the abdominal wall longitudinal varicose veins and 60.9％ (92/151) with ascites.Laboratory tests results showed median of alanine aminotransferase (ALT) was 21.5 (15.0,30.0) U/L,aspartate aminotransferase (AST) was 30.0 (23.8,42.0) U/L,total bilirubin was 31.1 (23.3,47.8) μmol/L,blood albumin 37.5 was (31.8,41.5) g/L,prothrombin activity was 71％ (61％,84％).WBC was 5.2 (3.5,7.5) × 109/L,hemoglobin concentration was 126.5 (108.8,144.2) g/L,and platelet count was 117.0 (85.5,155.5) × 109/L.Abdominal B-ultrasound examination showed hepatomegaly existed in 68.9％ (104/151) patients.Intraoperative angiography and surgical exploration showed that 41.1％ (62/151) patients were simple inferior vena cava obstruction or stenosis,15.9％ (24/151)were simple hepatic vein obstruction or stenosis and 43.0％ (65/151) suffered from the inferior vena cava combined with hepatic vein stenosis or obstruction.Surgically confirmation of the lesions showed that inferior vena cava membrane-like structure combined with thrombosis was in 59.6％ (90/151) cases.Conclusions Liver congestion,inferior vena cava congestion and portal hypertension are the main clinical manifestations of Budd-Chiari syndrome.With slightly liver function injury,liver dysfunction of Budd-Chiari syndrome isn't parallel with its portal hypertension.