Hypoxia is a commenest pathological process. The cellular oxygen sensors and signal transduction involved in hypoxic responses are so far not fully elucidated. There are many theories. Perhaps the oxygen sensors are different among different kinds of cells, and between acute and chronic hypoxic responses. The mitochondria cytochrom-oxidase-H_2O_2 might be the principal pathway leading to the constrictive response of pulmonary smooth muscle cells to hypoxia. The heme protein - reactive oxygen pathway might mediate the response of glomus cells in carotid body to hypoxia. The NADPH oxidase might be the oxygen sensor in airway chemoreceptor. As for chronic hypoxic responses, the oxygen dependent regulation of hypoxia-inducible factors by prolyl and asparaginyl hydroxylation has been paid great attention in recent years.

Objective To discuss curative effects of the AO Less Invasive Stabilization System(LISS) in the treatment of complex fractures around the knee joint.Methods The internal fixation at distal femur or proximal tibia was performed in 15 cases of closed complex fractures at the metaphysic area near the knee joint by using the LISS(left-sided in 9 cases and right-sided in 6 cases) from April 2004 to June 2005. Results All the 15 cases were followed for 5~26 months(mean,13.2 months).The time to full weight bearing was 12~26 weeks,and the time to bone union under X-ray was 11~24 weeks.No delayed union or disunion was observed.There were 1 case of superficial infection and 2 cases of skin blister,all of which were cured with dressing changes.No deep infection,skin necrosis,or osteofascial compartment syndrome occurred.Functional evaluation according to the Johner-Wruhs system revealed "excellent" results in 11 cases,"good" results in 3,and "fair" in 1,the total satisfactory rate being 93.3%(14/15).Palpable shift and separation inside tibia had occurred in 1 case of tibial plateau fracture(type C3) 2 weeks after operation,and a steel bar was inserted to fix the tibial plateau in a second operation.Bone union was achieved in this case 20 weeks after operation,with "good" evaluation results.Genu varum(tibial plateau angle,82?) had occurred in 1 case of tibial plateau fracture(type C3) 8 weeks after operation,and bone union was noted 20 weeks after operation,with "fair" evaluation results.Conclusions The LISS is indicated for fractures at distal femur or proximal tibia,or osteoporotic fractures of distal femoral shaft.For type C3 complex tibial plateau fracture,fixation with a steel bar on the entocondyle should be employed,rather than relying on the LISS.

Objective To investigate the specific humoral immunity and the therapeutic effect of nasal tolerance with a dual analogue (Lys262-Ala207) in the patients with myasthenia gravis (MG). Methods The levels of serum anti-AChR IgG and anti-AChR IgG isotype were determined with ABC-ELISA in 39 MG patients before and after treatment with Lys262-Ala207 and also in controls. cAMP was measured at the same time. The clinical severity and prognosis of MG were evaluated with Xu′s clinical scoring system. Results There was different in total IgG content among all groups. However the IgG 2 content was lower after the treatment and that of control (P

Vaspin,a serine protease inhibitor derived from visceral adipose tissue,has been identified as an adipokine with insulin-sensitizing effects in a rat model of type 2 diabetes.Recent studies showed that the administration of recombinant human vaspin significantly improved insulin sensitivity and glucose tolerance,and reversed the expression of genes that may promote insulin resistance in diet-induced obese mice.However,the regulation of serum vaspin concentration in individuals with insulin resistance,and the association of vaspin with obesity,type 2 diabetes,and insulin resistance related disorders remain unclear.

Betatrophin,discovered in 2013,is a protein secreted by liver,white adipose tissues,and brown adipose tissues.Betatrophin can improve glucose tolerance in mice by promoting islet β cell proliferation and increasing the number of β cells significantly and specifically.At the same time,Betatrophin is involved in lipid metabolism.Betatrophin may work as the new target for treatment of diabetes and disorders of lipid metabolism.

In order to serve soldiers in new period,the author summarized the effect of serving soldiers,analyzed the causes and proposed the countermeasures.

In order to promote the healthy development of military hospitals under the new situation,the article summarized the effect of construction,analyzed the main problems and put forward the countermeasures.

Based on the patient,bundled payment was known as episode-based payment,which pay the overall treatment cost on a or multiple medical service providers.In the current,there were 3 main bundled payment model in the United States,including confirm service,Prometheus and service improvement payment.The series of research showed that,bundled payment could decrease the cost of medical service based on keeping even improving medical service quality.Based on diagnosis related groups (DRGs),bundled payment increased total prepayment control and introduced the calculation method on cost prepayment ratio and potential avoidable allowance and reward for complication.The cost control based on the evidence and the incentive mechanism based on the encourage were all worth for references.

Objective To investigate the relationship among HBV genotypes ,nucleoside analogues drug resistance-mutations and the patients with chronic hepatitis B in Yongchuan area .Methods The gene chip was used to detect the nucleoside analogues drug resistance-mutations of 605 cases with chronic hepatitis B ,and the HBV-DNA level was analysised after the antiviral therapy .Re-sults Among 605 cases ,63 .1% genotype were genotype B ,116 cases(19 .17% ) were found to be resistance mutants .The major drug resistance-mutations was genotype B ,49 .14% drug resistance-mutations was Adefovir drug resistance-mutations ,and the re-sistance rate of genotype B with reverse transcriptase 236T mutation was 35 .09% .The resistance rate of genotype B Lamivudine drug resistance-mutations with reverse transcriptase 108M mutation was 34 .29% ,the virus replication between resistance and non-resistant virus were significant difference (P<0 .05) .Conclusion To monitor the hepatitis B patients with HBV resistance gene mutations is beneficial to detect the patients with drug resistance-mutations early ,which is important for selecting reasonable treat-ment methods in clinical practice .

Objective To evaluate the value of volumetric modulated arc therapy ( VMAT) in postopera-tive radiotherapy for cervical cancer .Methods Eighty four cases of cervical cancer patients were retrospectively analyzed after surgery .Thirty-nine patients received volumetric modulated arc therapy , while the other forty -five patients received three -dimensional conformal radiation therapy (3DCRT).The images were collected both before and after treatment.We recorded the setup errors including x (lift-right),y(ventral-dorsal),and z(an-terior-posterior)axes in thirty -nine patients with cone beam CT (CBCT).These images were compared with correponding planning images to calculate the position errors .We also analyzed the radiation dosimetry parameters and adverse reactions .Results The setup errors before and after radiation therapy in x ,y,and z axes were (1.07 ±0.91)cm,(0.76 ±1.07)cm,(0.74 ±0.81)cm and(0.11 ±0.04)cm,(0.11 ±0.09)cm,(0.08 ±0.20) cm,respectively.These data showed that the application of CBCT reduced the setup errors of treatment significant -ly.We analyzed the illuminated volume of bladder and rectum with dose volume histogram (DVH),and found there was no difference between VMAT and 3DCRT groups when 20 Gy irradiation dose was adopted .When the ir-radiation dose increased to 30 Gy and 40 Gy, the corresponding illuminated volume of bladder and rectum in VMAT group were 69.45 ±1.13,41.78 ±2.8 and 75.66 ±3.34,30.12 ±9.59,respctively.In the 3DCRT group,the corresponding illuminated volume of bladder and rectum were 93.37 ±6.59,88.32 ±12.13 and 95.26 ±8.95,90.32 ±6.98,respectively.VMAT can obviously decrease the illuminated volume of bladder and rectum when compared to 3DCRT.Conclusion VMAT can not only decrease the setup errors to improve the accuracy of radiotherapy ,but also reduce the reaction of normal tissues effectively in the cervical cancer patients who accepted postoperative radiotherapy .Therefore,the VMAT technology can improve both patients′treatment compliance and their quality of life .