Objective:To discuss the effects and clinical significance of MRV on respiratory mechanics in patients with respiratory failure.Methods:19 patients with respiratory failure type Ⅱwere firstly ventilated with CMV for 60 minutes,then MRV and SIMV mode were adapted .Tidal volume (VT) and minute ventilation(MV) in MRV mode was as the same as that in CMV and SIMV.PIP,PP,Pm,PEEPi and arterial blood gas were recorded during above three modes of ventilation.Results:With MRV PIP,Pp and Pm were significantly lower than that with CMV(P0.05).Conclusion:In patients with respiratory failure type Ⅱ,MRV results in lower PIP,PP,Pm as compared with CMV,PEEPi with MRV mode was significantly lower than these with CMV.

0.05).But the rates of thrombocytopenia and phlebitis in GEM group were significantly lower than NVB group.Conclusions: The short-time clinical efficacy,MST,DPT and one-year survival rate of GEM+CBP regimen were similar to those of NVB+DDP regimen,but the toxicity of GEM+CBP regimen were lower than those of NVB+DDP regimen.The GC regimen is a safe and effective regimen for old age advancde NSCLC.

Objective To study the effects of BCG-PSN on the expression of the receptor of selectins——one of the important cell adhesion molecules, and the characteristics of cytoskeleton structure in lung cancer cells. Methods The effects of BCG-PSN on the expression of sialyl Lewis X (slex) and the cytoskeleton structure of highly metastatic human pulmonary giant cell carcinoma (PG) cells and lowly metastatic human pulmonary adenocarcinoma (PAa) cells were observed by flow cytometry and transmission electron microscopy. Results Flow cytometric results showed that the expression of slex on the surface of PAa cells (66.8%) was higher than that on PG cells (5.72%). After treatment with BCG-PSN, the expression of slex on PAa cells decreased in a dose-dependent manner. Transmission electron microscopy showed that the microtubules and microfilaments were sparse in the PAa cells and diminished in PG cells. After treatment with BCG-PSN, the microfilaments were more abundant than before in PG cells and showed a branch-like appearance, but still remained sparse in PAa cells. Conclusion Changes in the components of the cytoskeleton structure are associated with the ability of the migration and movement of the tumor cells. The inhibitory effect of BCG-PSN on the adhesiveness of lung cancer cells may not be the cytoskeleton-mediated enhancement of adhesion, but the start-up process resulted from the down-regulation of cell adhesion molecules on the surface of lung cancer cells.

Clinical teaching constitutes a critical content of clinical course system.To that aim,we formulate typical case archive for teaching and apply bed-side teaching combined with PBL(problem based learning) method.Still supported by personating,case investigation and casuistics as well as multimedia means,we teach students in accordance with their aptitude and in so doing,initiatives of students can be mobilized to ensure sound teaching effects.

The role-experience teaching method,including writing medical record,doctor-patient and doctor-nurse communications,preoperative anesthetic interview and theory teaching,was close to clinical practice and had strong operability,which was helpful to switching the role from medical student to clinical doctor successfully.This artical explores the application and experience of this teaching method in clinical practice of Respiratory Medicine.

Today,improving teaching quality and cultivating thinking innovation are the emphasis and difficulties in clinic teaching and will directly affect the ability of medical team and medical occupation in the future.This article begins with analyzing the disturbances of culturing innovation ability,discusses the change of medical teaching mode and induction of thinking innovation in order to provide theoretical foundation and practical reference for solving this teaching difficulty.