Objective:Toclone the OPGgene ofhuman beingand construct its recombinant adenovirus and then observe its effects on the differentiation of bone marrow stem cells(BMSCs).Methods:The cDNAs of human OPG in hepatic tissue were obtained by using RT-PCR method.The cDNAs then were recombined with competent homologous cells to form the AdOPG and the shuttle vector was used during this stage.The rabbit BMSCs were isolated and cultured in vitro,and were infected with AdOPG.The OPG expression of BMSCs was identified by RT-PCR and Western blot.The expression of ALP was detected by chromatometry and ALP dyeing five days after the infection.Results:The OPG gene of human being was successfully cloned and its sequence consistent with the Gene bank.The titre of constructed AdOPG can reach 109 efu/ml.The ALP activity of BMSCs was(21 024?507)IU five days after the infection of AdOPG,whereas the value was(3 079?89)IU in the control group and(2 156?78)IU in the blank control group.Conclusion:The OPG can induce the osetogeinc differentiation of BMSCs.

Objective To observe the therapeutic efficacy of centro-square needling plus stuck needling with lifting-thrusting manipulations in treating the injury of medial collateral ligament (IMCL) of knee joint. Methods Seventy-eight patients with IMCL of knee joint were randomized into a treatment group of 40 cases and a control group of 38 cases. The treatment group was intervened by centro-square needling plus stuck needling with lifting-thrusting manipulations, while the control group was by local anesthesia treatment. The therapeutic efficacies were compared between the two groups. Results The total effective rate was 97.5% in the treatment group versus 81.6% in the control group, and the difference was statistically significant (P＜0.05). Conclusion Centro-square needling plus stuck needling with lifting-thrusting manipulations is an effective way in treating IMCL of knee joint.

Objective: To explore the relationship among advancod aged hypertension,unstable angina pectoris (UAP)and high homocysteine (Hcy)level.Methods:A total of 208 advanced aged patients with hypertension and angina pectoris,who were diagnosed and treated in our department of cardiology,were divided into H-type hyper-tension group (n=102)and general hypertension group (n=106).Each group was further divided into UAP sub-group and stable angina pectoris (SAP)subgroup.Levels of Hcy,blood glucose,total cholesterol (TC),high densi-ty lipoprotein cholesterol (HDL-C)and triglyceride (TG)were measured;Gensini scoring system was used to score extent of coronary artery lesion in these patients.Results:Compared with general hypertension group,there were significant rise in incidence rate of UAP (25.47% vs.46.08%)and Gensini score [(30.2±15.6)scores vs.(46.1 ±18.7)scores]in H-type hypertension group,P <0.05;in H-type hypertension group,Hcy level in UAP subgroup was significantly higher than that of SAP subgroup [(22.8±7.2)μmol/L vs.(13.1±2.7)μmol/L],and percent-age of paitents with high Hcy level in UAP group was significantly higher than that of SAP group,P <0.05 all;in general hypertension group,compared with SAP group,there were significant rise in levels of Hcy [(7.1 ± 1.5)μmol/L vs.(9.2±2.8)μmol/L]in UAP group,P <0.05 ;Logistic regression analysis indicated that for advanced aged UAP patients,Hcy is an independent risk factor of UAP (OR=1.9,95%CI:1.1~3.0,P =0.03).Conclu-sion:UAP incidence rate of H-type hypertension patients significantly rises than that of general hypertension pa-tients,Hcy is an independent risk factor of UAP.

Objective To develop an informatized continuous education system for theater nurse based on PDCA theory.Methods The system was gifted with the functions of learning planning, learning execution, learning checking, data management and system management based on PDCA theory, informatized technology and other learning systems.Results The system behaved well in overall flow and configuration, man-machine interaction and application, which facilitated the nurses to learn with fragmented time.Conclusion The nursing continuous education is enhanced greatly with the system.

Objective To compare the influences between bronchial blocker (BB) and double lumen tube (DLT) in respiratory mechanics and blood gas in one lung ventilation. Methods Thirty-six patients undergoing pulmonary lobectomy or radical operation of esophageal carcinoma were randomized into group BB (17 cases) and group DLT (19 cases). In group BB,BB was intubated under the guidance of a fibreoptic bronchoscope after intubation of single lumen tube; while in group DLT, the position of the tube was confirmed using fibreoptic bronchoscopy after intubation. The peek airway pressure (Pmax) and pulmonary dynamic compliance (CLdyn) during double lung ventilation and one lung ventilation were recorded in recumbent position. Blood samples were taken from, radial artery 20 min after one lung ventilation for blood gas analysis,partial pressure of oxygen in artery(PaO2), partial pressure of carbon dioxide in artery(PaCO2), saturation of arterial blood oxygen (SaO2) were recorded. Results No significant difference was found in Pmax and CLdyn between two groups during double lung ventilation,but Pmax was significantly lower in group BB [(21.00 ± 3.59) cm H2O,1 cm H2O = 0.098 kPa] than that in group DLT [(26.89 ±4.21) cm H2O] (P＜0.05), and CLdyn was greater in group BB [(28.10 ±6.24) ml/cm H2O] than that in group DLT [(24.00±7.13) ml/cm H2O ] (P ＜ 0.05); there were no significant differences in PaO2, PaCO2, SaO2 betweentwo groups during one lung ventilation (P＞ 0.05). Conclusion The influence to respiratory mechanics in one lung ventilation is smaller using BB than using DLT, BB has blocker well applicable value in clinics.

Objective To explore the common complications and methods of treatment in the malignant obstruction of upper alimentary tract with stent insertion. Methods With interventional procedure under fluoroscopic guidance fourteen self expanding stents were implanted in twelve patients, including nine with strictures or obstructions of esophagus, three with obstructions of gastroduodenum. Of the fourteen, nine were coated stents and five were uncoated stents. Results All stents were implanted successfully, but complications after the procedure occurred sometimes. There complications included: 1. Food bolus obstructed in three patients. 2. Chest pain occurred in four patients. 3. Tumour overgrowth or hyperplasia of granulation tissue in three patients caused restenosis of gastrointestinal tract. 4. Stent replacement in three patients. 5. Hemorrhage occurred in two patients (over 300 ml) causing threat to life. Conclusions The implantation of self expanding stent is a simple and effective method offering good palliation for upper alimentary tract obstructions. The complications shoud be treated correctly.

Objective To assess the use of medical services by patients with chronic hepatitis B, cirrhosis resulting from hepatitis, or hepatic carcinoma and the composition of the expenses incurred. Methods A survey was made on the use of outpatient and inpatient services as well as the details of medical expenses incurred by 1 395 self-funded patients and patients enjoying social medical insurance in Shanghai. And an analysis was made on the composition of the expenses and direct medical expenses per annum. Results There was no significant difference between the self-funded group and the insurance group in the use of outpatient and inpatient services; in terms of medical expenses, those incurred by the insurance group were 30% to 50% higher than those incurred by the self-funded group; an analysis on the composition of outpatient expenses showed that drug expenses accounted for over 80% and examination and test expenses accounted for over 15%; an analysis on the composition of inpatient expenses showed that drug expenses incurred by the two groups both accounted for 45% to 60% of the total expenses and examination and test expenses accounted for 15% to 25%. Conclusion Social medical insurance reduces the economic burden of individual patients but significantly raises treatment expenses. The key to containing the rise of medical expenses lies in controlling the conversion of hepatitis B to cirrhosis and the irrational growth of inpatient drug expenses and examination and test expenses.

The article teased the concept of medical futility and analyzed the issues when implement the medical futility policy.It introduced the medical futility policy by the examples of New York Public Health Code Article 29-B:Orders Not to Resuscitate and relevant regulations in Taiwan and presented some reflections on medical futility.The authors suggested that it should cope with the common and troubled cases of medical futility,establish ethics committee,and make the medical futility policy at the stage of tense doctor-patient communication.

Objective To explore the application of cognitive intervention and drug intervention in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 86 patients with chronic obstructive pulmonary disease(COPD)admitted from February 2016 to July 2016 were included in this study.The patients were divided into experimental group and control group according to the order of admission.43 patients in the control group received routine measures,In the experimental group,43 patients received cognitive intervention and drug intervention,compared the clinical treatment effect and treatment compliance of the two groups after intervention.Results The compliance rate of disease cognition,smoking,medication,pulmonary function,family oxygen therapy,respiration exercise,rehabilitation therapy,nutritional support and influenza vaccination were significantly better in the experimental group than in the control group(P<0.05)(1.2±0.7)times,the number of acute attack was(2.0±0.8)times and the quality of life was(4.4±0.9)points,which was significantly better than that of the control group(P<0.05).Conclusion Cognitive intervention and drug intervention have a positive effect on the treatment compliance of patients with chronic obstructive pulmonary disease,improve the quality of life of patients,and have significant clinical application value.