50 tracheotomy patients with mechanical breathing were performed respiratory tract control for suitable breathing. Result 5 patients recovered and had spontaneously breathing without respirator in 3~5days, then the trachea cannulas were pulled out in 1~2 weeks. Conclusion effective respiratory tract control may enhance the curative rate and improve patients' life quality.

Refractory macular hole (MH) includes large MH, traumatic MH, secondary MH, high myopic MH, unclosed MH and reopening MH.Refractory macular hole (MH) still has low anatomical closure rate and poor recovery of visual acuity after treatment of the current gold standard of pars plana vitrectomy (PPV), induction of posterior vitreous detachment, internal limiting membrane peeling and gas tamponade.Current surgical treatments include extended internal limiting membrane peeling, inverted internal limiting membrane flap, autologous internal limiting membrane transplantation, lens capsular transplantation, autologous neurosensory retinal transplantation, mesenchymal stem cells or exocrine transplantation and vitreous replacement.Stem cells or exocrine transplantation, the application of new long-acting vitreous replacement and the improvement of surgical techniques can promote the in situ healing of macular hole, which is a promising future.At present, the goal of all surgical methods is to induce or help stimulate glial tissue proliferation to enhance MH contraction and repair.Targeted individualized treatment according to the existing evidence-based medical evidence is a future trend.This article reviewed the researches on the treatment of refractory MH in recent years, in order to improve clinician' understanding of refractory MH and provide reference for optimizing and standardizing the treatment scheme.

Pregnancy complicated by Marfan syndrome (MFS) could increase adverse pregnancy outcomes. The most serious MFS-induced complication is aortic dissection (AoD), which could endanger both the mother and the fetus. This article summarizes the research progress in China and overseas in the diagnosis and treatment of pregnancy complicated by MFS in recent years in order to raise awareness and improve prenatal diagnosis and pre-conception counseling, thereby facilitating early diagnosis and timely perinatal multi-disciplinary standardized treatment with a view to improving the prognosis.

Medical purpose is a concept of viewing the situation as a whole, development and perpetuity. It is important that how to realize the medical purpose but not define itself.There are similar main conten of medical purpose extending directly from various stages and existing between eastern and western countries, and this is determined by characteristics of mde-icine. However, the fommer concept of medical purpose will show relative partial deficiency, and its intension will enlarge in the new stage of social, ecconomic and medical development. It also brings us new methods, ideas of thought, and make them fit for the requirement of society to medicine and the non-fungible function of medicine to human health. So the central content of medical purpose is running after the health of person and human based on elevating life quality, maintain and enhance social productive forces. This is extreme purpose of medicine and common adimission of world medicine.The realization of medical purpose is guided and restricted by the concept of humanistic ethics. So, understanding and discussion of medical bepose must be carried out guided by it and its theory frame. The centre of mordern medical humanism is the respection to the human valuation related to medicine, including that of person, group and society. Primarily, the valuation is emphasized on the human life quality and health valuvation, which are directly and first reflected not only in mordern medical humanism, but also in medical purpose.In this sense, the intension of medical humanism is equivalent to the central content of medical prupose defined above all, and the medical humanism is medical purpose. The focus reflection of medical purpose is the thought of medical humanism, one is objective of medical developmant another is the thought and principle defined for achieving the objective.

Phylogenetic markers are the gene fragments that demonstrate the gene tic relationships between organisms To differentiate close taxa, many new phyl oge n etic markers were used, with which the polyphasic taxonomy was enriched This a r ticle chiefly described the characters of several phylogenetic markers and their applications in the studies of the phylogenetics of bacteria

AIM To study the reversal effect of erythromycin on multidrug resistance of human liver cancer cells BEL 7402. METHODS Cultivated the parental cells BEL 7402 in the presence of doxorubicin to obtain a multidrug resistant subline designated BEL 7402/ADM. The expression of P glycopro tein in BEL 7402 and BEL 7402/ADM cells was determined by using cell ELASA method. The cytotoxicity of drugs was determined by using MTT assay, and the intracellular concentration of doxorubicin in BEL 7402/ADM was determined using a spectrofluorometer. RESULTS After growing BEL 7402 cells in the presence of ADM for some time, the resulting cells (BEL 7402/ADM) became not only resistant to ADM but cross resistant to VCR and MMC, the P gp on the subline cells' surface was highly expresssed. Erythromycin, which is a lipophilic antibiotic, enhanced the anti tumor functions of ADM, VCR and MMC to BEL 7402/ADM cells and increased the intracellular concentration of ADM with no effect on the expression of the P gp in BEL 7402/ADM cells. CONCLUSUON Erythromycin can significantly reverse the multidrug resistance in BEL 7402/ADM cells, it may do so by saturating the P gp pathway to reduce the efflux of intracellular concentration of the drugs.

Objective: To study the chemical constituents of Chinese herb Fructus Ligustri lucidi , providing theoretic evidence for its exploitation and utilization. Methods: Chemical constituents of Fructus Ligustri lucidi were isolated and purified by solvent extraction and chromatography; their structures were identified by physiochemical properties and spectroscopic analysis. Results: Seven compounds were isolated from the ethanol extract of the fruits and identified as oleanolic acid(Ⅰ), luteolin 7 O ? D glucoside(Ⅱ), quercitrin(Ⅲ), ? sitosterol 3 O ? D glucoside(Ⅳ), p hydroxyphenethyl ? D glucoside(Ⅴ), D mannitol(Ⅵ) and hexitol(Ⅶ). Compounds Ⅱ,Ⅲ and Ⅶ were obtained from this plant for the first time. Conclusion: Seven compounds have been obtained from the title plant, which provides a base for its future use.

Objective: To explore the effects of acupuncture on nutritional status in patients in a persistent vegetative state. Methods: A prospective randomized controlled trial was designed. A total of 66 patients in a persistent vegetative state were randomized into a control group and an observation group, with 33 cases in each group. The control group was given conventional treatment plus enteral nutrition support. The observation group was treated with additional Tiao Shen Jian Pi acupuncture therapy (acupuncture for spirit-regulating and spleen-invigorating) based on the same interventions in the control group. Both groups were treated for 8 weeks. The levels of total protein (TP), prealbumin (PA), albumin (Alb), and hemoglobin (Hb) were measured before and after treatment. The upper arm circumference and skinfold thickness of triceps brachii were measured. And the intestinal flora and fecal short-chain fatty acids contents were determined.Results: After treatment, the levels of TP, PA, Alb, and Hb in the control group were decreased (P<0.05), while in the observation group, compared with those before treatment, the levels of TP, PA, Alb, and Hb had no statistical differences (P>0.05), and the levels were all higher than those in the control group (P<0.05). The upper arm circumference and skinfold thickness of triceps brachii in both groups decreased (P<0.05), and the values of these two items in the observation group were higher than those in the control group (P<0.05). In the control group, the contents of Bifidobacterium and Lactobacillus in feces decreased (P<0.05), and the content of Enterococcus increased (P<0.05). In the observation group, the contents of Bifidobacterium and Lactobacillus in feces increased (P<0.05), and the content of Enterococcus decreased (P<0.05). The differences between the two groups were statistically significant (P<0.05). In the control group, the total content of fecal short-chain fatty acids and the contents of acetic acid and butyric acid in feces decreased (P<0.05). In the observation group, the total content of fecal short-chain fatty acids and the contents of acetic acid and butyric acid in feces increased (P<0.05) and were all higher than those in the control group (P<0.05). Conclusion: Acupuncture can improve nutrition-related blood indicators in patients in a persistent vegetative state and delay the decrease of upper arm circumference and skinfold thickness of triceps brachii, which may be related to the regulation of intestinal flora and fecal short-chain fatty acids contents.

Objective To investigate the role of the pulmonary function, arterial blood gas analysis, the St George respiratory questionnaire (SGRQ) score and nutritional status in evaluating the development of chronic obstructive pulmonary disease (COPD). Method Changes of the above-mentioned parameters were analyzed in hospitalized patients suffered from moderate to severe COPD and compared with parameters of those who had acute exacerbations when admitted to hospital. Results The forced expiratory volume in one second (FEV1)% pred and oxygenation index of the patients declined significantly with the development of the disease after one, two, three, four times in hospital [(68.43 ± 3.09)%, (61.27 ± 3.38 )%, (42.05 ± 4.16)%, (33.64 ± 3.34)% and 435.55 ± 10.23, 404.35 ± 11.56, 358.38 ± 13.21, 321.29 ± 11.78] (P < 0.05), while the level of PaCO2 increased significantly in moderate COPD [(36.23 ± 3.62), (45.44 ± 4.67), (57.82 ± 4.12), (78.28 ± 5.21 )mm Hg (1 mm Hg = 0.133 kPa) ] (P<0.05). The oxygenation index was declined significantly in severe COPD. The scores of SGRQ score declined significantly in all patients while the level of hemoglobin, albumin and body mass index did not change significantly. Conclusions Acute ex-acerbation attributes to the deterioration of pulmonary function and life quality of COPD patients. Monitoring the changes of pulmonary function, arterial blood gas analysis and SGRQ score may be useful in the evaluation of the development of COPD.

Since the first successful establishment of human embryonic stem cell line in 1998,embryonic stem cell research has attracted much attention in recent years.Theoretically,embryonic stem cells are pluripotent 0f in vitro proliferation and in vivo differentiation.which could serve as a promising seed cell source for cell thera PY or tissue engineering.Differentiation of the embryonic stem cells into a certain type of cell still remains a big challenge.Studies regarding chondrogenic ifferentiation have been reported.This article summarizes the chon drogenic process in developing embryo and the currently known factors involved in the in vitro chondrogenic differentiation of embryonic stem cell.Foreground of the study in this field is discussed.