Objective To properly choose and employ an air disinfect-purifying machine in ICU. Method This paper analyses the principle of air disinfect-purifying machine and put forward some attention-deserved problems such as the value of CADR in clinical application. Conclusion. The disinfect-purifying machine with different CADR value should be chosen according to the area of air disinfect-purifying district, thus can really bring the machine into full play.

Objective To introduce the clinical significance and pathophysiologic aspects of the circulatory and cardiac complications in terminal stage cirrhosis.Methods Recently relevant literatures were reviewed and summarized.Results Haemodynamic changes in cirrhosis arose on the basis of combined humoral and nervous dysregulation,with abnormalities in cardiovascular regulation,volume distribution and cardiac performance.Conclusion Comprehending the mechanisms of cardiovascular complications will contribute a lot for the treatment of terminal stage cirrhosis.

Objective To compare the reliability and effectiveness of anterolateral thigh flap with double vein anastomosis or one vein anastomosis for reconstruction of head and neck defects.Methods Two hundred and sixty four cases of anterolateral thigh flap transfers for head and neck reconstruction from January,2013 to September,2013 in the Second Xiangya Hospital of Central South University were reviewed.260 patients were randomly divided into 2 groups.In the experimental group,there were 138 patients 140 cases of anterolateral thigh flap with one vein one artery anastomosis.In the control group,there were 122 patients 124 cases of anterolateral thigh flap with double vein one artery anastomosis.Results Among 264 anterolateral thigh flaps,the overall success rate of free flap was 98.1％ (259/264),5 free flaps were lost.In the experimental group,there were 6 free flaps occurred venous thrombosis,two of them were lost.In the control group,there were 5 cases occurred venous thrombosis,three of them were lost.No arterial thrombosis occurred in both groups.The time of micromanipulation was 18 to 101 min,with the average of 47 min in the experimental group.In the control group,the time was 45 to 133 min,with the average of 71 min.(P =0.0003).Conclusion Anterolateral thigh flap with one vein one artery anastomosis for head and neck reconstruction did not affect the survival rate but it can absolutely reduce the operation time.

Objective To investigate elderly patients with thoracic radiotherapy nausea result after risk factors associated with radiation pneumonitis.Methods The clinical data of a total of 440 cases of cancer patients with chest radiation therapy during January 2010-January 2014 were collected retrospectively.Of them,76 cases of radiation pneumonitis after radiotherapy were compared with other patients.The unconditional Logistic regression analysis was used to analyze the relationship of radiation pneumonitis and different factors including smoking,pulmonary dysfunction,combination with chemotherapy,radiation dose,and radiation sites.Results Elderly incidence of radiation pneumonitis was 17.27％.Multivariate Logistic regression analysis revealed the chi-square value of smoking,pulmonary dysfunction,combined with chemotherapy,radiation dose,and radiation sites was significant correlation (x2 =16.936,19.633,11.531,17.133,10.178,P ＜0.05),and the correlation degree was gradually decreased from pulmonary dysfunction,radiation dose,smoking,combined chemotherapy,to radiation site.Conclusions Elderly patients with thoracic malignancies after radiotherapy had more radiation pneumonitis,which was related to smoking,previous chemotherapy PO2 ＜ 80％,combined with chemotherapy,radiation dose ≥ 55 Gy,and low-lung radiation.The correlation degree was gradually decreased from chemotherapy before PO2 ＜ 80％,the radiation dose ≥55 Gy,smoking,combined chemotherapy,to low-lung radiation.

Clinical training together emphasized the combination of theory and practice. It not only improved students'clinical thinking and skills and enhanced their communication skills and medical treatment writing skills but also demanded the teachers to have higher sense of responsibility and teaching skills.

AIM:To investigate the role of heat shock protein 70(HSP70)in hepatitis B virus (HBV) replica-tion.METHODS:The effect of HBV replication on the expression of HSP 70 was analyzed by RT-qPCR.The overexpres-sion efficiency of HSP70 was confirmed by Western blot .The effect of HSP70 overexpression on HBV DNA replicative in-termediates was analyzed by RT-qPCR and Southern blot .The effects of HSP70 overexpression on the expression level of HBV 3.5 kb mRNA and HBV core protein were measured by RT-qPCR and Western blot, respectively.The Effect of HSP70 overexpression on HBV promoter activity was detected by dual luciferase reporter system .RESULTS: The mRNA levels of HSP70 were inhibited by HBV replication .Overexpression of HSP70 repressed the expression of HBV DNA repli-cative intermediates, 3.5 kb mRNA and core protein, as well as HBV core promoter activity .CONCLUSION:HBV rep-lication inhibits the expression of HSP70.Overexpression of HSP70 represses HBV replication.These data suggest that HSP70 repressed HBV replication by inhibiting HBV core promoter activity .

Objective To observe the clinical efficacy of mirabilite and rheum officinale combined with pulse high-volume hemofiltration(PHVHF)in treatment of patients with severe acute pancreatitis(SAP). Methods A total of 11 patients with SAP in Department of Critical Care Medicine of Qiannan Traditional Chinese Medicine Hospital of Guizhou Province received the combined treatment of external application of mirabilite,gavage of rheum officinale decoction and PHVHF. The changes in abdominal symptoms,vital signs,blood gas analysis,blood biochemical indicators,and the acute physiology and chronic health evaluation(APACHEⅡ)score,Ranson score and prognosis were observed and compared before and after treatment. Results After treatment,the patients' fever〔body temperature(℃):37.31±0.13 vs. 39.12±0.12〕,tachycardia〔heart rate(beats/min):106±17 vs. 123±22〕, respiratory distress〔respiratory frequency(times/min):23±6 vs. 31±5〕and other symptoms were ameliorated in different degrees,and the APACHE Ⅱ score(9.1±2.2 vs. 21.2±8.2),Ranson score(3.2±1.1 vs. 5.8±1.3)were decreased significantly ,all the above indexes compared before and after treatment being of statistical significant differences(all P<0.05). The indexes of hemodynamics of 10 survival patients were stable,heart rate(beats/min:106±17 vs. 123±22)was decreased,and mean arterial pressure〔MAP,mmHg(1 mmHg=0.133 kPa):73±6 vs. 41±5〕was increased gradually(both P<0.05). After treatment,serum amylase〔AMY(U/L):367.3±102.3 vs. 923.5±351.7〕,alanine aminotransferase〔ALT(U/L):63.3±23.2 vs. 201.5±123.2〕,total bilirubin〔TBil (μmol/L):22.1±20.1 vs. 56.1±63.2〕,serum creatinine〔SCr(μmol/L):132.1±23.5 vs. 392.4±12.2〕,urea nitrogen〔BUN(mmol/L):9.5±4.9 vs. 19.2±5.9〕, K+(mmol/L:4.2±0.2 vs. 5.6±2.1) were significantly decreased,arterial partial pressure of carbon dioxide〔(PaCO2,mmHg):35.1±7.1 vs. 27.2±5.5〕,arterial partial pressure of oxygen〔PaO2(mmHg):93.2±13.2 vs. 49.1±7.2〕and oxygenation index(mmHg:187.1±28.5 vs. 148.2±32.7),Na+(mmol/L:132.1±19.1 vs. 127.1±42.1)were significantly increased compared with those before treatment, there were statistically significant differences(P<0.05 or P<0.01). Conclusion The combined treatment of mirabilite,rheum officinale and PHVHF has significant effects on the treatment of patients with SAP,and it can be one of the assistant therapies of SAP.

Objective To explore the clinical efficacy and safety of transcatheter absolute ethanol injection treatment on varicose veins of lower extremity.Methods twenty-there patients with 25 varicose veins of lower extremity were treated by puncture of great saphenous vein above 1—2 cm of complicated inner ankle,perforating catheter to the point below the 3—4 cm of the conjunction of great saphenous vein and Femoral vein and pressing the conjunction of these two veins.Under the monitor of DSA,inject the absolute ethenal slowly while retrieve the catheter little by little(one limb with varicose veins injected total volume 15—20 ml),in the mean time,using contrast agent to monitor the level of embolism until the formation of total embolism in the all great saphenous veins.Results All the cases were retrospectively followed up with CDFI examination after 3—12 months of the surgery,No blood flow were seen in the 25 embolismic great saphenous vein.Clinical symptom were alleviated obviously after 2—3 weeks of treatment;varicose veins were collapse after 3 to 7 days.Two eases of leg ulceration were healed after 4 to 6 weeks of operation.20 limbs were found mild swelling in the 2 day after the surgery.However,all the cases were disappeared after 1 to 2 weeks;4 treated limbs developed delayed paresthesia in the 3 day after the surgery,and recovered totally in the 2 weeks.No complications of deep vein thrombosis,lung thrombosis etc al,were found after operation.Conclusions Using transcatheter injection of absolute ethanol to treat varicose veins of lower extremity has the advantage of less invasion,more safety and low appearance of complications.The short term efficacy is solid while the long term effect needs further evaluation.

Objective To investigate the expression of endostatin and angiopoietin (Ang)-2 in human ghoma and its significance. Methods The expression of endostatin and Ang-2 were measured by immunohistochemistry and endostatin mBNA by hybridization in situ in 108 cases of brain glioma and 5 cases of normal brain tissues. Results The expression of endostatin (0.0657±0.0038)and Ang-2 (0.0286± 0.0042) were significantly higher in grade Ⅲ-Ⅳ glioma patients than those in grade Ⅰ-Ⅱ ghoma patients (0.0349±0.0048,0.0084±0.0018, respectively) and normal brain tissues (0,0)(P<0.01). The expression of endostatin mRNA were significantly higher in grade Ⅲ-Ⅳ glioma patients (0.0310±0.0041) than that in grade Ⅰ-Ⅱ glioma patients (0.0152±0.0031) and normal brain tissues (0)(P< 0.01 ). Theratio of endo-stalin to Ang-2 was negatively rehted to the grade of glioma (r=-0.810,P <0.01). Conclusion The interaction of endostatin and Ang-2 plays an important role in the invasive growth and malignant development of human glioma, and may be related to the prognosis and the malignant degree of glioma.

BACKGROUND:Pax6 gene plays an important role in eye development and differentiation, and to study how it regulates the differentiation of human bone marrow mesenchymal stem cel s (BMSCs), gaining the BMSCs stably over-expressing Pax6 is crucial, which is also the basis of stem cel replacement therapy. OBJECTIVE:To construct a lentivirus vector containing Pax6 and detect the expression of Pax6 in transfected human BMSCs.
METHODS:Pax6 gene was extracted using PCR. After its connection with lentivirus vector pHIV-EGFP, it was then packaged by 293T cel s. The human BMSCs were transfected with recombinant lentivirus Pax6-EGFP as wel as lentivirus vector pHIV-EGFP, which was considered negative control group. The cel ular morphology was observed by a fluorescence microscope, and the mRNA expression of Pax6 was detected by real-time PCR.
RESULTS AND CONCLUSION:The recombinant lentivirus Pax6-EGFP was constructed successful y with a titer of 3×109 pfu/L. After the transfection, both the green fluorescent protein and Pax6 gene were expressed detected using fluorescence microscope and real-time PCR, showing that the method of lentiviral transfection is a safe and effective way to modify BMSCs.