Medical clinical practice plays an important role in medical education, which influences the quality of medical peoples. In clinical practice teaching of respiratory medicine, many factors have a major impact on the quality of training. This article focuses on chnical practice teaching in influence factors and puts forward some countermeasures.

Objective To study how to enhance the effectiveness of international disaster relief in order to explore the features and applications of two different patterns of medical rescue.Methods A retrospective analysis of the experiences of the China International Relief Team,including the constitution of the team,working hours on the disaster area,and the numbers of patients rescued per doctor per day,during the 12 occasions of international mission over the past 10 years since the team founded.Results Since the first time for international rescue operation acted in Algeria in 2003,the China International Search and Rescue (CISAR) team has taken part in 12 humanitarian relief operations which can be categorized into two patterns of medical rescue:the first pattern is integrated by search,rescue and initial medical service on site,the second one is exclusively for medical relief (the first pattern consisting of 15.4％ medical staff and 61.4％ medical staff in the second pattern).According to the former pattern,CISAR team should arrive at the stricken area of earthquake less than 3 days and withdraw after 7 - 10 days of work with about 10.8average working days.Four survivors trapped in collapsed buildings were rescued during the six international rescue operations,and 662 sick and casualties on average were treated each time.The latter pattern often carried out by CISAR team after the work of the former pattern (over 10 days after the disaster) had been done with average working time of 17.8 days.There were 6812 patients on average treated in each time.Comparison between the two patterns showed that the latter one needed more medical staff and longer working days.The data of these two patterns varies significantly. Conclusions The search and rescue pattern is different from the pattern of exclusively medical rescue,and the urban search and rescue team is integrated the search and rescue with medical service,which was proposed by the United States,because of its versatility in the stricken areas of earthquake.It gives lot of useful information to the developing countries for setting up modern relief teams.The time and mode of sending a search and rescue team or a medical team to the stricken area of disaster depend on the assessment of disaster and the requirements of the local government.The capability of the search and rescue team can be extended beyond the ruins,but the capability of the medical team can hardly extend deep enough beneath the ruins,so that the first pattern is much superior to the second one.To set up a local relief team should meet the requirement of the local government to deal with different kinds of disaster.

0.05).The clearance rate of pathogens of teicoplanin was 87.5% and vancomycin was 88.9%.There was no significant difference between them.Both drugs had side effects.The side effects of vancomycin was a little more than teicoplanin.CONCLUSIONS Both vancomycin and teicoplanin are effective drugs in the treatment of G+ cocci in lower respiratory tract infection.The side effects of teicoplanin are smaller than of vancomycin.

Objective To study the relationship between smoking and the incidence of pulmonary tuberculosis(TB) in Chinese people.Methods The Pubmed database and three Chinese databases such as Wanfang Data,Veipu data(VIP) and China national knowledge infrastructure database (CNKI) were retrieved.The literatures on the relationship between smoking and pulmonary TB incidence in Chinese people published before April 2016 were analyzed.Results Fifteen studies were included,after excluding 1 low quality study,the rest had no statistical heterogeneity.The merged odd ratio (OR) was 1.71,95 ％ confidence interval (CI) 1.51-1.90.Two studies observed the relationship between the amount of cigarettes and TB pathogenesis,but there was heterogeneity and could not be further merged the OR value for conducting analysis.No subgroup analysis of gender was performed in all studies.Conclusion The risk suffering from pulmonary TB in Chinese smokers is 1.71 fold of non-smokers,and smoking increases the risk of pulmonary TB onset.

Streptolysin S (SLS),one of the important virulence factors of Streptococcus,exist in several kinds of human and animal pathogenic bacterial,including Streptococcus pyogenes,Strepstococcus iniae and Streptococcus anginosus.SLS is a peptide toxin encoded by nine consecutive genes (sagA-sagⅠ).The functions of SLS include contributing pathogenic bacterium to pass through epithelial barrier,causing tissue damage,resisting to phagocytic clearance of host immune cells and interacting with other virulence factors.In addition,SLS as a signaling molecule of cell quorum sensing is involved in regulating the expression with other virulence factors.This paper summarized the structures and the biological functions of SLS in Streptococcus infection.

Objective To explore if obesity is related to bronchial hyperresponsiveness in different sexuality.Methods A total of 1180 patients with provocation test positive were studied.We analysed the relation of body mass index(BMI)and FVC,FEV1,the relation of BMI and PC_20 FEV1 in all patients and in the men and the women,respectively.Results There was negative correlation between BMI and FVC,FEV_1 of the whole patients.There was also negative correlation between BMI and PC_20FEV_1 of the whole patients and the women but no correlation of the men.PC_20 FEV_1 of men was higher than that of women.Conclusion Obesity is related to the decrease of lung function and the increase of airway responsiveness,this affection is obviously in women.The airway responsiveness of women is higher than that of man.

Objective To investigate quitting motivation of smoking patients with mild and moder-ate chronic obstructive pulmonary disease ( COPD) and evaluate the effects of smoking cessation methods based on cognitive intervention.Methods A total of 102 smoking patients with mild and moderate COPD from the outpatient department was divided into 4 blocks according to their intention of quitting smoking.Pa-tients in each block were randomly divided into intervention and control groups.Results ⑴All the re-spondents were at an average age of (61.3 ±12.3) years old.The sex ratio of men to women was 99∶3. The average smoking index (bag/year) in all the respondents was (39.81 ±11.53).The average daily smoking was (14.22 ±2.30) packs.The respondents with a lower degrees accounted for 55.9%and the respondents with high nicotine dependence 49.0%.A total of 39 people (38.2%) hoped to give up smok-ing, 20 people (19.6%) strongly hoped to give up smoking.⑵The main reasons for smoking included en-joyment (7.02), dependence (6.88), and calm (6.55).⑶There were statistically significant difference in the half-year continuous abstinence rates (χ2 =4.993, P =0.025) and in June quit rates (χ2 =6.668, P =0.010) between the intervention (58.82%) and control (33.33%) groups.The weight gain had sig-nificant difference between the intervention and control groups at the 3rd month ( t =2.65, P <0.01) or 6th month ( t =2.07, P <0.05) after quitting smoking.Conclusions The quitting motivation of smoking patients with mild and moderate COPD is not strong, while the smoking cessation methods based on cogni-tive intervention are effective for those patients.

?Proliferative diabetic retinopathy ( PDR ) is a group of disease characterized by neovascular disease complication of diabetes mellitus. Neovascular diseases of eye are one of the major causes of blindness of the world. Recent studies showed that vascular endothelial growth factor ( VEGF) and pigment epithelium-derived factor ( PEDF ) are now accepted as the key cytokine in the development of diabetic retinopathy. Recent progress in the investigation of VEGF and PEDF of PDR are summarized in this review.

Objective To evaluate the efficacy of pressure support ventilation ( PSV ) in the infants undergoing laparoscopic hernia repair under sevoflurane anesthesia. Methods Thirty ASA physical statusⅠpediatric children, aged 9 months-1 yr, weighing 8.0-11.5 kg, undergoing elective laparoscopic hernia repair, were randomly assigned into 3 groups ( n=10 each) using a random number table: pressure control ventilation ( PCV) used for muscle relaxants in combination with low?concentration sevoflurane group ( group PCV1 ) , PCV used for high?concentration sevoflurane group ( group PCV2 ) , and PSV used for low?concentration sevoflurane group ( group PSV) . Anesthesia was induced with inhalation of 4%-6%sevoflurane and iv fentanyl 2 μg∕kg and succinylcholine 1.5 mg∕kg. The pediatric children were endotracheally intubated and mechanically ventilated. In PCV1 and PCV2 groups, PCV was used during operation. In group PSV, PCV was used first after intubation, and then PSV was applied after spontaneous breathing recovered. Anesthesia was maintained as follows: in group PCV1 , the end?tidal concentration of sevoflurane was maintained at 2.5% - 3.0%, and cisatracurium besylate 0.1 mg∕kg was injected intermittently as required; in group PCV1 , the end?tidal concentration of sevoflurane was maintained at 3.5%-4.0%; in group PSV, the end?tidal concentration of sevoflurane was maintained at 2.5%-3.0%, and succinylcholine 1.0 mg∕kg was injected intravenously before pneumoperitoneum. Narcotrend index value was maintained at 50-60 in PCV1 and PSV groups, or at 37-45 in PCV2 group. Heart rate ( HR) and mean arterial pressure (MAP) were recorded before induction of anesthesia (baseline), at the beginning of pneumoperitoneum, at 5 and 10 min of pneumoperitoneum, at the end of pneumoperitoneum, at the end of operation and immediately after extubation. The time interval from the end of surgery to extubation was recorded. Results Pulse oxygen saturation was 100% during anesthesia, and>95% during recovery from anesthesia in the three groups. Compared with the baseline value, HR was significantly faster, and MAP was increased during extubation in PCV1 and PCV2 groups, and no significant change was found in HR and MAP at each time point in group PSV. The time interval from the end of surgery to extubation was 30.3± 5.4, 18.4±4.3 and (4.1±1.2) min in PCV1, PCV2 and PSV groups, respectively. Compared with PCV1 and PCV2 groups, the time interval from the end of surgery to extubation was significantly shortened in group PSV. Conclusion When PSV is applied in the infants undergoing laparoscopic hernia repair under sevoflurane anesthesia, it can provide adequate ventilation, recovery from anesthesia is rapid, and no cardiovascular responses occur during extubation.

Animals ; Autophagy ; Biomarkers, Tumor ; metabolism ; Caveolin 1 ; deficiency ; metabolism ; Drug Delivery Systems ; Humans ; Myofibroblasts ; pathology ; Neoplasms ; metabolism ; pathology ; Prognosis ; Stromal Cells ; metabolism ; Tumor Microenvironment