Pulmonary surfactant is a complex mixture of lipids and surfactant proteins (SP) lining the alveolar surface.In addition to the well established ability of the surfactant system to reduce alveolar surface tension and thereby prevent collapse of the alveoli on expiration,it is also involved in pulmonary host defence.Surfacant protein-A (SP-A),one of the most abundant SP,can deal with various pathogens,using a range of innate immune mechanisms,and links innate immunity with adaptive immunity that includes modulation of dendritic cell function and helper T cell polarization.Surfactant-replacement or increasing SP-A generation might be efficacious for the treatment of inflammatory and infectious diseases in the lung.

Objective To explore the clinical effect and safety of cetuximab plus mFOLFOX6 first-line treatment in k-ras wild type patients with liver metastasis from colorectal cancer.Methods 40 k-ras wild-type colorectal cancer patients with liver metastasis diagnosed by histological detection in our hospital were chosen.20 patients in the observation group were treated with cetuximab plus mFOLFOX6.20 patients in the control group were only given mFOLFOX6.To observe the effect and safety of the two groups.Results RR,operation excision rate and R0 removal rate of observation group (60％,45％,35％) were significantly higher than those of the control group (30％,15％,10％),the differences were statistically significant (x2 =3.95,4.36,4.28,P ＜ 0.05);The PFS of the observation group (16.37 ± 7.24) was higher than (11.52 ± 6.85) in the control group,but the difference was not statistically significant (P ＞ 0.05).In the observation group,there were 2 cases with rash,2 cases of leukopenia,1 case with nausea and vomiting,the incidence rate of adverse reaction was 25 ％ (5/20) ;In the control group,there were 2cases with leukopenia,1 case with nausea and vomiting,there was no rash and paronychia,the incidence rate of adverse reaction was 15％ (3/20),there was no significant difference in incidence rate of adverse reaction between the two groups (P ＞ 0.05).Conclusion Cetuximab combined with FOLFOX6 can improve the performance clinical remission rate and lesion resection rate of k-ras wild type patients with liver metastases from colorectal cancer,and has high safety,which is worthy of clinical application.

The co-metabolic carbon sources,dynamics and influence factors of atrazine biotransformation by genetically engineered microor- ganism(GEM)were investigated in the paper.The results showed that glucose was superior to acetate as co-metabolic carbon sources.The concentration of carbon sources affected little on atrazine transformation but much on GEM growth.The specific transformation rate(STR)of atrazine was influenced not by cell density of GEM but by atrazine concentration.Monod model was used to simulate atrazine transformation dynamics and the parameters were v_(max)=0.168/h and Ks=30.49 mg/L.When temperature reduced,STR decreased markedly.The trans- formation was efficient in weak alkaline condition and was inhibited in acidic condition.To some extent,salinity did not affect transformation activity of GEM.Co~(2+),Fe~(2+),Fe~(3+),and Zn~(2+) improved atrazine transformation,but Mn~(2+),Ni~(2+) and Cu~(2+) inhibited atrazine transforma- tion.The results also showed that there existed a direct correlation between adsorption and transformation of atrazine by GEM.

Objective To investigate the optimal surgical timing for rib internal fixation.Methods The clinical data of 143 patients with rib fracture were retrospectively analyzed.The patients were divided into early phase fixation group (62 cases) and late phase fixation group (81 cases) according to the time from trauma to internal fixation.The ratio blood lose and body surface area,pulmonary complications and the changes of C reactive protein level before and 5 days after operation were recorded and compared.Results All the patients were healing.The median C reactive protein before operation in late phase fixation group was 45 mg/L,in early phase fixation group was 23 mg/L,there was statistical difference (P ＜ 0.01).The ratio blood lose and body surface area in early phase fixation group was (334.19 ± 37.53) ml/m2,the rate of pulmonary complications was 22.6％(14/61),in late phase fixation group was (438.99 ± 55.24) ml/m2 and 38.3％ (31/81),there were statistical differences (P ＜ 0.01 or ＜ 0.05).The median C reactive protein 5 days after operation in early phase fixation group was 189 mg/L,in late phase fixation group was 258 mg/L,there was statistical difference (P ＜ 0.05).Conclusion Early phase (72 hours) rib internal fixation is expected to reduce patient trauma of systemic reactions,reduce the incidence of bleeding and pulmonary complications.

ObjectiveTo investigate the effect of different degrees of pressure of sustained inflation (SI) in patients with acute respiratory distress syndrome (ARDS) after lung recruitment as the result of different negative pressure for sputum aspiration.Methods A prospective single-blind randomized controlled trial was conducted. The factorial analysis of variance was adopted. 150 patients with ARDS admitted to the emergency intensive care unit (ICU) of Chongqing Three Gorges Central Hospital from January 2012 to December 2014 were enrolled, and they were randomly divided into S1, S2, S3 group, with 50 patients in each group, suction pressure varying from 150, 175, to 200 mmHg (1 mmHg = 0.133 kPa) was respectively used in each group. Then the patients of each group were randomly subdivided into five subgroups of P0, P1, P2, P3, P4, with 10 patients in each group, and 0, 30, 35, 40, and 45 cmH2O (1 cmH2O = 0.098 kPa) were used for control pulmonary inflation pressure, respectively. The respiratory mechanics and the hemodynamic parameters were recorded, and they were compared before and after the sputum aspiration as well as lung recruitment with sustained inflation.Results The lung recruitment volume (mL: 87.56±28.47 vs. 109.38±34.63, t = 3.573,P = 0.001) and lung static compliance [Cst ( mL/cmH2O): 27.69±13.25 vs. 35.87±17.47,t = 2.814,P = 0.004] after sputum aspiration in the 150 patients were significantly lower than those before the sputum aspiration, and peak airway pressure [PIP (cmH2O): 24.16±8.28 vs. 18.63±6.67,t = 2.957,P = 0.005], airway plateau pressure [Pplat (cmH2O): 21.28±9.14 vs. 17.47±7.26,t = 2.089,P = 0.032], and mean airway pressure [Pm (cmH2O): 13.26±4.65 vs. 10.41±3.54,t = 3.271,P = 0.001] were significantly higher than those before the treatment. There were no significant differences in the lung recruitment volume, Cst, PIP, Pplat and Pm between groups with different negative pressure for sputum aspiration (F value was 0.809, 0.986, 1.121, 0.910, 1.043, andP value was 0.452, 0.381, 0.335, 0.410, 0.361), but statistical significance was found among different groups of different lung recruitment pressures (F value was 3.581, 5.028, 3.064, 3.036, 4.050, andP value was 0.013, 0.002, 0.026, 0.027, 0.007). There was no interaction between the two factors. After pairwise comparison, under the same negative pressure for sputum aspiration, lung recruitment volume and Cst in different lung recruitment pressures subgroups (P1, P2, P3, P4) were significantly higher than those of P0 subgroup, and PIP, Pplat, and Pm were significantly lower than those of P0 subgroup. There was no significant difference among P1, P2, P3 and P4 groups. There were no significant differences in mean arterial pressure (MAP) and pulmonary arterial pressure (PAP) among different groups with negative pressures for sputum aspiration and different lung recruitment pressures (negative pressure for sputum aspiration:F = 0.586,P = 0.561,F= 1.373,P = 0.264; lung recruitment pressure:F = 1.313,P = 0.280,F= 1.621,P = 0.186), there was no interaction between the two factors (F = 0.936,P = 0.497,F = 1.391,P = 0.227). The difference of heart rate (HR) in different negative pressure for sputum aspiration groups was not significant (F = 1.144,P = 0.328), and there were significant differences in different lung recruitment pressure groups (F = 3.297,P = 0.019), there was no interaction between the two factors (F = 1.277, P = 0.280). After pairwise comparison, under the same negative pressure for sputum aspiration, HR in P3 and P4 subgroups was significantly higher than that in P0, P1, and P2 subgroups (allP< 0.05).Conclusion 30 cmH2O and 35 cmH2O were the suitable pressure for SI in ARDS patients, and they were not affected by different negative pressure for sputum aspiration.

OBJECTIVE: To bring forward feasible suggestions for Direct-to-Consumer(DTC) marketing of prescription drugs.METHODS: The importance of analysis of DTC marketing of prescription drugs in solving "unrealistically high" drug price because of asymmetric information and its role in sufferers' participating in self-health care were analyzed.The status quo and the problems faced in US DTC marketing were also analyzed.RESULTS & CONCLUSIONS: The marketing of prescription drugs can be extended to the sufferers in China,but we must pay attention to the checkup for DTC advertisement,the time of DTC advertisement being forbidden after the new drugs launched into the market and the scope for DTC marketing.

Keratoconus is a relatively common, bilateral, non-inflammatory corneal ectasia characterized by thinning and scarring of the central portion of the cornea,seriously destroyed the vision. The aetiology of this condition is probably multiple factors,such as collagen themry,genetic themry,epithelia themry,etc.Now,recent investigations devote to gene,and think it one of the major aetiological factors. Laboratory studies suggest a role for degradative enzymes and proteinase inhibitors and a possible role for the interleukin-1 system in its pathogenesis, but these roles need to be more clearly defined. It has well-described clinical signs, but early forms of the disease may go undetected unless the anterior corneal topography is studied. Contact lenses are the most common treatment modality. When contact lenses fail, corneal transplant is the best and most successful surgical option.

Objective: To explore the relationship between plasma level of N terminal pro brain natriuretic peptide (NT-proBNP) and severity of coronary artery lesion in patients with coronary heart disease (CHD). Methods: A total of 206 patients suspected CHD, who admitted from Jan 2010 to Jun 2012 in our department and underwent coronary angiography (CAG), were divided into single vessel coronary disease group (n=54), double-vessel coronary disease group (n=52), multi-vessel coronary disease group (n=67) and normal group (n=33), according to CAG examination; and divided into acute myocardial infarction (AMI) group (n=45), unstable angina pectoris (UAP) group (n=91), stable angina pectoris (SAP) group (n=43) and normal group (n=27) according to clinic symptom. All patients received measurement for NT-proBNP, creatine kinase-isoenzyme (CK-MB) and cardiac troponin I (cTnI). Stenotic severity of coronary artery lesion was evaluated using Gensini score method. Data of all groups were analyzed statistically. Results: Compared with SAP group and normal group, there was significant increase in plasma level of NT-proBNP [(2.28±0.22) vs. (2.18±0.69) vs. (2.94±0.24) vs. (2.74±0.15), P<0.01 or P<0.05] in AMI group and UAP group. Compared with normal group, there was significant increase in plasma level of NT-proBNP [ (2.07±0.43) vs. (2.44±0.38) vs. (2.69±0.34) vs. (2.98±0.28), P<0.05] in single, double and multi-vessel coronary disease groups. Plasma level of NT-proBNP was positively correlated with Gensini score (r=0.51, 0.67, 0.73 respectively in single, double and multi-vessel coronary disease group, P<0.05 all). Conclusion: NT-proBNP concentration can be regard as an index predicting severity of coronary artery lesion.

To meet the requirement of cultivating talented people,the following problems were explored in the medical biochemistry experiments classes including teaching content,teaching format,teaching management,and evaluation of the teaching performance and strengthening of students' capacity cultivation.