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 determine the concentration of pantoprazole in human plasma and evaluate the bioequivalence of two kinds of pantoprazole sodium enteric-coated tablets. METHODS: The concentration of pantoprazole in human plasma was determined by LC-MS/MS, and the pharmacokinetic parameters for evaluation of bioequivalence were calculated with DAS2.0. RESULTS: The main pharmacokinetic parameters of test and reference formulation were as follows; t1/2 (1.96±0.66) and (1.98±0.59) h, (3.17±0.84) and (3.09±0.81) h, pmax(3.53±0.78) and (3.41±0.79) μg · mL-1, AUC0-∞ (10.12±4.09) and (10.86±3.99) μg · h · mL-1. The relative bioavailability was (97.9±22.3)%. CONCLUSION: The method is repeatable and sensitive. The test and reference formulation are bioequivalent.

Low molecular weight heparin(LMWH)is a kind of anticoagulant used in both the prevention of clot formation in the blood vessels(thrombosis)and the treatment of conditions caused by clot formation or embolization.They are agents formulated from chemical or enzymatic depolymerization of unfractionated heparin.In the past decade,LMWH has been extensively evaluated in many clinical settings.The applications of LMWH in recent years are reviewed.

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.

Background Recent research showed that stromal cell-derived factor-1 (SDF-1) plays critical role in mediating inflammation,metastasis of tumour and neovascularization of tumour.However,There is still no report about the research of the effects of SDF-1 on alkali-burn-induced corneal neovascularization (CNV).Objective The aim of this study attempts to investigate the role of SDF-1 and chemokine receptor CXCR4 in alkali-induced corneal neovascularization in mice.Methods Alkali-induced-corneal neovascularization animal models were constructed of in 15 eyes of 15 clean C57/BL mice by placing the filter paper with 1 mol/L NaOH to the central cornea for 10 seconds.The animals were sacrificed and specimens of cornea were obtained in 3,7,14 days after alkali burn of cornea.The expression of SDF-1/CXCR4 protein in the corneal tissues was detected by immunohistochemistry and Western blot,and expression of SDF-1/CXCR4 mRNA was detected by reverse transcription PCR (RT-PCR).Results SDF-1 was absent expressed and CXCR4 was faintly stained in normal cornea.The expression level of SDF-1 and CXCR4 was significantly enhanced in different time points after alkali burn in comparison with normal control mice by RT-PCR(P＜0.05),and the same trend was seen in the expression level of SDF-1 and CXCR4 proteins by Western blot (P＜0.05).The expression level of SDF-1 and CXCR4 in cornea peaked in the seventh day and began to decline in the fourteenth day but was still higher than normal level.Conclusion The study indicates that SDF-1/CXCR4 plays an important role in the formation of corneal new vessel in alkali-burn-induced animal model.

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.

Objective To explore the clinical significance of plasma D-dimer and fibrinogen level in cervical carcinoma . Methods Sxity-two patients with cervical cancer pathologically proved ,34 cases of benign uterine tumors and 42 cases of CIN were detected plasma DD and Fib levels preoperative , compared with normal control group .Results DD and Fib levels in patients with cervical cancer group were significantly higher than those of control group;With the lesions of cervical cancer malignant degree of plas-ma DD and Fib levels increased;DD and Fib increased cervical cancer occur more frequently in patients with lymph node and distant metastasis .Conclusions Along with the increase of the malignant degree of tumor ,Micro thrombosis or thromboembolism risk increa-ses,In clinical,they can be used as auxiliary index to predict clinical cancer staging and transfer .