Objective Toinvestigate the changes of liver and kidney function and morphology of the renal artery of the metabolic syndrome (MS) rats.Methods The rats were respectively fed with ordinary or high-fructose diet for 10 weeks,and then took the blood and anatomical observation,to explore the changes of liver and kidney function and morphology of the renal artery of the rats.Results The serum levels of ALT,AST,UA,BUN,CR in the control group and MS group were gradually increased with the feeding time.But those in MS rats were significantly increased than the control rats.MS rats showed dysfunction of liver and kidney,which similar to the clinical MS cases.Compared with the control group,the renal artery of MS rats had the same pathological changes as MS cases,presented with intima uneven thickening and structural disorder,medial smooth muscle cells hyperplasia to intimal,the internal elastic membrane with different degrees of damage and fracture,the film elastic fibers thickening and structural disorder,smooth muscle cell proliferation apparently,medial obvious thickening.Conclusion MS rats have mild dysfunction of liver and kidney and abnormal changes in intima and tunica media of renal artery.

AIM: To investigate the effects of nitric oxide (NO) inhalation on nitric oxide synthase (NOS) and endothelin-1 (ET-l) of patients with hypoxic pulmonary hypertension. METHODS: Examined 13 pulmonic blood samples to determine the concentration of NOS in leukocyte and ET - 1 in plasma before NO inhalation, 30 minutes after inhalation, 2 and 12 hours after stopping of inhalation respectiviy. RESULTS: The values taken before inhalation was NOS (0.70 ? 0.21 )mol/min?mg-l, ET-1 (78.89 ? 46.59) Pmol/L; 30 minutes after inhalation (0.74?0.14)mol/min.mg-l, ET - 1 (88 .27 ? 45 .41 )pmol/L; 2 hours after stopping of inhalation NOS (0.64 ? 0.22)mol/min.mg-1, ET - 1 (80.76?42.66)pmol/L; and 12 hours after stopping of inhalation NOS (0. 63? 0. 17)mol/min.mg-1, ET-1(61.07?29.44)pmol/L. NO significant difference was found in the values of NOS and ET- 1 before and after inhalation, P＞ 0. 05. CONCLUSION: The effects of NO inhalation on NOS and ET-l in patients with hypoxic pulmonary hypertension are not significant according to the above investigation.

AIM: To confirm the effects of capillary endothelium injury in the lung with ischemia reperfusion. METHODS: The rabbits pulmonary models of ischemia reperfusion (I-R)injury were established. Plasma nitric oxide and endothelin levels, arterial oxygen tension and wet/dry weight ratios were determined in different periods in control and I-R groups, and the pulmonary ultrastructure abnormities were analyzed under electromicroscope. RESULTS: The plasma levels of NO and ET-1 in I-R animals increased significantly ,compared with those in sham treated control groups. The level of ET-1 had significantly negative correlation with PaO 2 and positive correlation with the value of the wet/dry weight ratios. The swelling and karyopyknosis of capillary endothelium in the lung with I-R groups were observed in ischemia periods. The injuries of endotheliums and typeⅠandⅡ alveolar cells in 0 5 h of reperfusion were more severe than those in ischemia time, and the injuries began to repair in 2 h of reperfusion time. CONCLUSION: In the I-R group, pulmonary capillary endothelium have been injuried, which may play a prominent role in I-R injury and dysfunction of the lung.

Construction of learning-oriented hospital must establish a clear goal,and under the guidance of the target,comrehensive mearures of whole advancement must be adopted and staffs study must be emphasized according to their different needs to motivate them,and meanwhile incentive mechanism should be established to realize the benign circulation and sustainable development of construction of learning-oriented hospital.

Objective To compare the characteristics of pulmonary function between stable chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome (ACO) in the elderly males. Methods Three hundred and eighteen elderly male patients with stable COPD were followed up between January 2014 and December 2017. A11 patients underwent pulmonary function tests and bronchial dilation test (BDT) in the stable condition. According to the occurrence of ACO, the patients were divided into ACO group (54 cases) and non-ACO group (264 cases). The indexes of pulmonary function before and after BDT (T0 and T1) in two groups were statistically compared. Results Among 318 elderly male patients with stable COPD, ACO patients accounted for 17.0％(54/318). Compared with non-ACO group, at T0 ACO group had significantly lower values in forced vital capacity (FVC) pred [(83.5 ± 15.4)％vs. (93.9 ± 5.6)％], in forced expiratory volume in 1 second (FEV1) pred [(61.1 ± 13.6)％vs. (74.5 ± 12.0)％], in forced expiratory volume in 3 seconds (FEV3) pred [(70.5 ± 13.4)％ vs. (81.8 ± 12.9)％] and in forced expiratory flow rat (FEF25％-75％) pred [(26.7 ± 8.5)％vs.(36.7 ± 10.2)％](P<0.05), but at T1 there were no significant differences in FVC pred, FEV1 pred, FEV3 pred and FEF25％-75％ pred between the two groups(all P>0.05). And ACO group also had significantly higher values in residual volume pred [(138.9 ± 25.7)％vs. (117.5 ± 26.6)％] and in residual volume/total lung capacity [(55.8 ± 9.7)％ vs. (45.1 ± 8.9)％] (P<0.05). Conclusions ACO is common in the elderly male patients with stable COPD, and ACO patients have lower time vital capacity as compared with non-ACO patients. But after bronchodilation test, the two groups have similar ventilation function, and the small airway function in ACO patients improves more significantly .

Objective To improve the study on chronic obstructive pulmonary disease (COPD) basicknowledge, and the ability of COPD research and design, organization, implementation andmanagement. Methods Clinical research led stu-dents to participate in the COPD, found the problem from clinical,research students went to COPD, literature, grouping the recent 15 years , the discussion of the COPD design experimental study , lipopolysaccharide ( LPS ) rat model of COPDinduced with smoke, explore the love Luo Ning on the treatment of cough with dyspneaeffect COPD and its mech-anism, integration of traditional Chinese and Western medicineknowledge module to the pathogenesis of COPD, as the core of the problem of the cause. Results 5 graduate students completed COPD in the etiology, pathogenesis andmech-anism of Kechuanning love Luo, master and technology related research methods. Conclusion PBL teaching method helps to promote the quality of postgraduate education,PBL teaching was worth to promoted.

Objective: To explore the clinical features, the serotype distribution and drug resistance of the isolates in patient with invasive pneumococcal disease (IPD). Methods: By retrieving the laboratory information system in 18 children′s hospitals from 2012 to 2017, the children with IPD were enrolled. Streptococcus pneumoniae (Spn) must be isolated from the sterile sites (blood, cerebrospinal fluid, hydrothorax and joint effusion etc.). The clinical characteristics, serotype, drug resistance, treatment and prognosis were reviewed and analyzed. According to the telephone follow up results, the patients were divided into death group and recovered group. The index as an independent risk factor of mortality was demonstrated by multivariate logistic regression analysis. Results: There were 1 138 children with IPD, including 684 male and 454 female. The proportion of male to female was 1.5∶1. The age ranged from one day to 16 years. The median age was 1 year 3 month. The majority was under 5 years of age (89.3%, n= 1 016), especially under 2 years of age (61.9%, n=704). In all cases, 88.2% (n=1 004) were community acquired infection. The infections included meningitis (n=446, 39.2%), pneumonia with bacteremia (n=339, 29.8%), and bacteremia without focus (n=232, 20.4%). Underlying diseases were found in 242 cases (21.3%). Co-infections were determined in 62 cases (5.4%) with mycoplasma, 27 cases (2.4%) with adenovirus and 34 cases with influenza virus (3.0%). The penicillin insensitivity (PNSP) rates in meningitis and non-meningitis isolates were 69.5% (276/397) and 35.9% (221/615), respectively. There were 81 strains serotyped, in which 93.8% (76/81) were covered by 13-valent protein-polysaccharide conjugate vaccine (PCV13). In the 965 patients who were followed up by phone call, 156 cases (16.2%) were confirmed dead. The independent risk factors for the death were under 2 years of age (OR=2.143, 95%CI 1.284-3.577, P=0.004), meningitis (OR=3.066, 95%CI 1.852-5.074, P<0.01), underlying disease (OR=4.801, 95%CI 2.953-7.804, P<0.01), septic shock(OR=3.542, 95%CI 1.829-6.859, P<0.01), disseminated intravascular coagulation (DIC) (OR=4.150, 95%CI 1.468-11.733, P=0.007), multiple organ failure (OR=12.693, 95%CI 6.623-24.325, P<0.01) and complications of central nervous system (OR=1.975, 95%CI 1.144-3.410, P=0.015). Conclusions Most children with IPD were under 5 years of age, having underlying diseases and acquired the infection in community. The independent risk factors for death were under two years old, meningitis, underlying diseases and multiple organ failure. The problem of drug resistance was severe. The universal immunization of PCV13 would be effective to prevent IPD in Chinese children.