Ventilator is broadly used in the hospital all over the world,The paper describes three case of common troubles in clinical practice for Bird-brand ventilator and its troubleshooting.

The construction of traditional theory of Chinese herbalism cannot do without the accumulated understanding of herb effect in clinical practice.Meanwhile,it closely relates to the natural history of using different theories of herb property to explain effect and mechanism at different stages.The compilation of Inner Canon of Yellow Emperor 《(黄帝内经》) and Shennong Bencao Jing 《神农本草经》) represent the initial formation of traditional herbalism in Chinese medicine.These two books have a relatively complete description of property and effects of herbs,but with different focus of concerning.After Shennong Bencao Jing,explaining the effect from property of herbs gradually become the developing trend and basic characteristics of herbalism.During the Ming-Qing Dynasties,publication of a large number of herbal annotation works further highlights this feature.

Objective To construct a yeast two-hybrid recombinant bait plasmid of human programmed cell death ligand 1(PD-L1)immunoglobulin variable region(IgV)domain gene,detect its expression in yeast and detect the cytotoxicity and self-activation of PD-L1 IgV protein as well as the interaction between PD-L1 IgV and human thioredoxin(hTrx).Methods Human PD-L1 was analyzed by bioinformatics method,and primers were designed to amplify PD-L1 IgV domain based on the coding region of PD-L1 gene registered in NCBI GenBank database. PCR amplification was carried out with pENTERPD-L1 plasmid as template,and then cloned into yeast two-hybrid bait vector pGBKT7. The recombinant bait plasmid and pGBKT7 empty vector were transformed into Y2HGold yeast cells respectively,and the PD-L1 IgV gene and its expression were detected by PCR and Western blot;Meanwhile,the protein toxicity and self-activation of PD-L1 IgV were detected,and the interaction between PD-L1 IgV and hTrx was detected by drip plate method.Results The bioinformatics analysis results of PD-L1 were consistent with related reports. The recombinant bait plasmid pGBKT7-PD-L1 IgV was correctly constructed,and Y2HGold positive clone was obtained,in which PD-L1 IgV was stably expressed. The empty vector pGBKT7 and recombinant bait plasmid pGBKT7-PD-L1 IgV grew well on SD/-Trp and SD/-Trp/X-α-Gal plates with the same colony size and number and white colony,but they did not grow on SD/-Trp/X-α-Gal/AbA plates,which indicated that PD-L1 IgV protein had no toxicity and no self-activation effect on yeast. The results of drip plates test showed that all experimental groups grew well on SD/-Trp/-Leu plate,while only positive control group grew on SD/-Trp/-Leu/X-α-Gal/AbA plate and showed blue color,which indicated that bait protein PD-L1 IgV and hTrx did not self-activate,and there was no interaction between them.Conclusion Recombinant human PD-L1 IgV bait plasmid was successfully constructed. PD-L1 IgV protein showed no toxicity and self-activation effect on yeast cells,and there was no interaction between PD-L1 IgV and hTrx. Subsequently,hTrx can be used to construct a peptide aptamer library,from which peptide aptamers that specifically bind to PD-L1 IgV can be screened.

BACKGROUND:In the treatment of primary knee osteoarthritis, total knee arthroplasty is a common treatment, but there are some shortcomings in the traditional operation, which maylead to early failure of the prosthesis.
OBJECTIVE:To explore the difference of computer-assisted total knee arthroplasty by vastus medialis approach from the traditional total knee arthroplasty.
METHODS:A total of 79 patients with primary knee osteoarthritis were randomly divided into control group (41 cases) and observation group (38 cases), which underwent conventional total knee arthroplasty and computer-assisted total knee arthroplasty by vastus medialis approach. Surgical incision, operation time, total blood loss and drainage volume were recorded and compared in both groups. In 12 months of folow-up, Hospital for Special Surgery knee score was evaluated, and the complications were recorded and compared between the two groups.
RESULTS AND CONCLUSION:(1) Operative incision was significantly less in the observation group than in the control group. Operation time was significantly shorter in the observation group than in the control group. Total blood loss and drainage volume were significantly lessin the observation group than in the control group (alP< 0.05). (2) Patients in both groups were folowed up for 12 months. Index score and total score of knee function were significantly higher in the observation group than in the control group (al P< 0.05). (3) No adverse events such as infection, prosthesis loosening or fracture appeared in the observation group. In the control group, four cases affected prosthesis loosening. One case suffered from wound infection. Above events were improved obviously after active treatment. No serious complications occurred. The incidence of complications was significantly lower in the observation group than in the control group (P< 0.05). (4) The results show that, compared with the traditional operation, the choice of the femoral medial approach and the use of computer aided design technology can simulate the knee replacement process, set the cutting position, improve the accuracy and success rate of surgery, have less trauma, and effectively improve knee function, and reduce the incidence of postoperative complications.

Objective To investigate the methods for the detection of serum samples with low-concentration HBsAg and its clin-ical value.Methods Serum samples with HBsAg weak positive were measured by ELISA or using Roch cobas e601 were collected from the clinical laboratory.The samples with low-concentration HBsAg were confirmed by neutralization assay by using Lizhu ELISA reagent Kit or Roch cobas e601 analyzer.at the same time,ALT/AST concentrations and HBV DNA copies were also deter-mined.Results Among 53 samples that showed weak positive reaction by using Kehua reagent kit,37 samples were positive in neu-tralization test,while the other 16 samples were negative.Among 18 samples that showed weak positive reaction tested by using Roch cobas e601 analyzer,13 samples showed positive in neutralization test,and the other 5 samples showed negative.Conclusion The results of HBsAg test varies in different detection System.The clinical significance of samples with low-concentration HBsAg needs further study.

Objective To study the relationship between coagulation abnormal and inflammatory in the TNBS induced rats colitis model as well as the therapeutic effect of heparin on this model Methods Forty SD-rats were separated into 4 groups randomly, including normal control group, colitis group, heparin group and SASP group. PT, APTT and the activity of antithrombin (AT)were chosen as indexs of coagulation. The level of damage ancl inflammatory state of the colitis rats were assessed by macroscopical score, histological score and the level of TNFα in each group. Results Compared with normal control group, TNBS induced colitis group has a shorter PT [(14.83±0.45)s vs(16.68±1.08 )s, P < 0.05] and APTT[(12.49±1.30)s vs(29.06±1.60) s, P<0.05] and a lower activity level of AT [(111.33± 8.50)% vs(122.13±3.52)%,P<0.05]. In heparin group, PT, APTT were prolonged [PT: (17.83± 0.78)s vs (14.83±0.45)s,P<0.05, APTT:(53.34±9.49)s vs (12.49±1.30)s,P<0.05] and AT activity was higher than colitis group [(131.67±6.92)% vs (111.33±8.50) %, P < 0.05]. SASP group has a similar data in PT, APTT compared with colitis group and no statistical significance(P>0.05). The activity of AT in SASP group is higher than in colitis group [(122. 33±5.82)% vs (111.33±8.50)%,P <0.05]. The heparin therapy group showed lower macroscopical score(2.50±0.55 vs 4.75±1.16, P< 0.05), histological scores(3.83±0.41 vs 7.75±1.04, P<0.05) and the level of TNFα[(84.75± 18.03) ng/L vs (149.93±23.52)ng/L, P < 0.05] compared with the colitis group. Conclusion Coagulation was abnormality in the rat colitis model induced by TNBS; heparin therapy is effective in the colitis model It seemed that the abnormality of coagulation plays an important role in the pathogenesis of the rat colitis model.

MicroRNAs (miRNAs)are involved in the pathological and physiological process of life activities,and some of them exist stably and abundantly in serum,plasma,and other body fluids.Previous studies have indicated that there are significant differences in the expres-sion patterns of circulating miRNAs between patients with viral hepatitis,liver fibrosis,liver cirrhosis,hepatocellular carcinoma,drug-in-duced hepatitis,and other hepatobiliary diseases at different disease stages.Among these circulating miRNAs,some can act as novel nonin-vasive biomarkers for the early diagnosis,disease progression,and prognostic evaluation of related diseases.The latest research advances in circulating miRNAs for the diagnosis of hepatobiliary diseases are reviewed.

Objective To investigate the effect of T helper cell type-1(TH 1) cytokines [interferon-? (IFN-?), tumor necrosis factor-a (TNF-?)] and T helper cell type-2(TH 2) cytokines [interleukin-4 (IL-4)] on pathogenesis of intrahepatic cholestasis of pregnancy (ICP). Methods The peripheral blood mononuclear cells (PBMC) from 20 cases of ICP patients (study group) and 20 cases of normal pregnant women (control group) were cultured with photohemglutinin stimulation. TNF-?, IFN-? and IL-4 were determined in the supernatant by enzyme- linked-immunoassay. Results (1) In supernatants of cultured PHA induced PBMC, the levels of IFN-? and TNF-? of study group were (639?156) ng/L and (1 021?231) ng/L, which were significantly higher than those of control group, (464?147)ng/L and (728?175) ng/L( P

Background Recent research showed that stromal cell-derived factor-1 (SDF-1) plays critical role in mediating inflammation,metastasis of tumour and neovascularization of tumour.However,There is still no report about the research of the effects of SDF-1 on alkali-burn-induced corneal neovascularization (CNV).Objective The aim of this study attempts to investigate the role of SDF-1 and chemokine receptor CXCR4 in alkali-induced corneal neovascularization in mice.Methods Alkali-induced-corneal neovascularization animal models were constructed of in 15 eyes of 15 clean C57/BL mice by placing the filter paper with 1 mol/L NaOH to the central cornea for 10 seconds.The animals were sacrificed and specimens of cornea were obtained in 3,7,14 days after alkali burn of cornea.The expression of SDF-1/CXCR4 protein in the corneal tissues was detected by immunohistochemistry and Western blot,and expression of SDF-1/CXCR4 mRNA was detected by reverse transcription PCR (RT-PCR).Results SDF-1 was absent expressed and CXCR4 was faintly stained in normal cornea.The expression level of SDF-1 and CXCR4 was significantly enhanced in different time points after alkali burn in comparison with normal control mice by RT-PCR(P＜0.05),and the same trend was seen in the expression level of SDF-1 and CXCR4 proteins by Western blot (P＜0.05).The expression level of SDF-1 and CXCR4 in cornea peaked in the seventh day and began to decline in the fourteenth day but was still higher than normal level.Conclusion The study indicates that SDF-1/CXCR4 plays an important role in the formation of corneal new vessel in alkali-burn-induced animal model.

Low molecular weight heparin(LMWH)is a kind of anticoagulant used in both the prevention of clot formation in the blood vessels(thrombosis)and the treatment of conditions caused by clot formation or embolization.They are agents formulated from chemical or enzymatic depolymerization of unfractionated heparin.In the past decade,LMWH has been extensively evaluated in many clinical settings.The applications of LMWH in recent years are reviewed.