By making a comparative analysis of the changes in the indexes of total floor area, the floor areas of seven faeihties and their proportion to the total floor area, and some other parts that have been made with regard to the construction of general hospitals, the paper argues that the revised construction standards embody a kind of comprehensive service that is patient-centered, comfortable, fast, and convenient; a kind of medical environment wherein the first importance is attached to people, scientific management is stressed, and the buildings have been designed with the patients in mind; and a desire to keep up with the times and meet people's needs for medical and health care. It is suggested that the scale of construction be moderate, the average floor area of beds be gradually increased, the number of storeys be mainly multiple and low high-rise, the number of parking spaces be gradually increased to match the number of beds, the scale of each nursing unit be moderate, the number of beds per thousand people be gradually raised, and the idea of separated sectors and streamlining design be stressed.

BACKGROUND:The use of bio-membrane guided bone regeneration in maxilary sinus augmentation is a research hotspot in implantology at present. OBJECTIVE:To investigate the osteogenic effect of guided bone regeneration in maxilary sinus augmentation using colagen membranes. METHODS:The first maxilary molars of nine adult female beagle dogs were extracted and ful-thickness flap was reflected bilateraly, then the sinus floors were lifted with simultaneous implantation. Bio-Oss was placed into the new space under the sinus membrane. On the experimental side in each dog, the bio-membrane covered the osteotomy window. On the control side, the flap was sutured directly, and was not covered by bio-membrane. Two animals were sacrificed at 4, 12, and 24 weeks after surgery, respectively. Gross observation, biomechanical testing and histological examinations were performed. RESULTS AND CONCLUSION: In gross view, new bone formation was observed in al maxilary sinuses. The pul-out force increased with time. At week 24, a significant difference in the pul-out force was noted between the two groups (P < 0.05). Histomorphbomatrical analysis showed much more new caluses at the experimental group than the control group at weeks 12 and 24 after surgery (P < 0.05). The bio-membrane guided bone regeneration has a better effect on new bone formation in the sinus augmentation.

Objective To sum up the experience of diagnosis and treatment of paraduodenal hernia. Methods The clinical data of 18 cases of paraduodenal hernia treated by surgery were analyzed retrospectively. Results The average age of the patients was 34 years old.There were 15 cases with left paraduodenal hernia and 3 cases with right paraduodenal hernia.Ten patients usually had no clinical symptoms,while acute abdominal pain occurred after full food in 7 cases,and after vigorous movement in 10 cases respectively.Abdominal X-ray revealed complete or incomplete intestinal obstruction in 16 cases,while abdominal CT revealed abnormal cystic loops of small intestine between the pancreas and the stomach in 10 cases.All 18 cases underwent surgical operation,recovered 10-15 days after operation.After 2-8 years follow-up,there was no hernia recurrence.Conclusion Paraduodenal her-nia is difficult to diagnosis before operation,and the key to correct diagnosis and treatment is to explore the positive exploratory laparotomy.

By combining the teaching environment and taking the multimedia teaching system as the platform,we adopted the nimble utilization teaching method in physiology teaching process which fully aroused the students'enthusiasm in studies,and played the certain impetus role to students' quality enhancement.

objective To explore a new method of repairing skin defects complicated with fracture and tendon rupture at the middle and distal sections of the second to fifth fingers. Methods The reversed dorsal metacarpal island flap was designed to be pedicled on the digital proper artery-common digital artery-fingerweb artery-dorsal metacarpal artery-cutaneous branch of dorsal metacarpal artery.In repairing digital palmar skin defects,after the flap was dissected,the proximal incision was extended along the direction of dorsal metacarpal nerve to harvest an enough length of the nerve so that the dorsal metacrppal nerve can be anastomosed with the digital proper nerve to restore the sensation of finger pulp.From the June 2003 to March 2009,the flap was used to repair 26 fingers in 24 patients with middle and distal digital skin defects complicated with fracture and tendon rupture.They were 17 men and 7 women,aged from 16 to 63 years (average,37 years).There were 15 cases of palmar skin defect and 9 cases of dorsal skin defect.In the 2 cases of combined tendon defects,a section of the extensor tendon of index(or little) finger was dissected together with the flap to repair the tendon rupture. Results The areas of the flap ranged from 3.1 cm ×1.6 cm to 6.0 cm × 4.0 cm.The flaps survived in all 24 cases without any vascular crisis.Twenty-two patients obtained an average follow-up of 14 months (from 4 to 32 months) but 2 were lost to the follow-up.The flaps were fine in texture,colour and appearance.The finger pulps appeared full and recovered sensations of pain and temperature.The average two-point discrimination was 7.5 mm (from 5 to 9 mm).Sensory function evaluation revealed an outcome of S3 + ～ S4.Tendon adhesion occurred in 4 cases which recovered digital function following secondary lysis 3 to 6 months postoperation. Conclusion Application of the reversed dorsal metacarpal island flap pedicled on the digital proper artery is a good way to repair skin defects complicated with fracture and tendon rupture at the middle and distal sections of the second to fifth fingers.

Objective To evaluate the therapeutic effects of noninvasive bi-level positive airway pressure (BiPAP) ventilation after extubation in chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure.Methods Forty-one intubated COPD eases with severe respiratory failure due to pulmonary infection (pneumonia or purulent bronchitis) were involved in the study.At the time of pulmonary infection control (PIC) window,the extubation was conducted and followed by BiPAP ventilation in 21 cases (the experimental group),while the other 20 COPD cases with similar clinical characteristics,as the control group,who continuously received invasive mechanical ventilation after PIC window.Outcomes including the duration of invasive ventilation,the total duration of ventilation support,success rate,the incidence of ventilator associated pneumonia (VAP) and mortality rate were observed and compared between the two groups.Results The two groups had similar clinical characteristics and gas exchange at the time of PIC window (P ＞ 0.05 ).Compared with the control group,the experimental group had shorter duration of invasive mechanical ventilation (6.9±3.0) d vs.(13.1 ±4.3) d,t=5.38,P＜0.001),lower rate of VAP (1/20 vs.8/20,x2 =5.51,P=0.02) andhigher extubation rate (20/21 vs.13/20,x2 =4.19,P =0.04).Conclusion In COPD patients with intubation and mechanical ventilation for respiratory failure,BiPAP ventilation after extubation at the point of PIC window may improve patients' prognosis.

AIM: To prepare gfp-bcl-X L-contained recombinant adenovirus(rAd-gfp-bcl-X L).METHODS: Bcl-X L gene was amplified from pEGFP-C 3-bcl-X L, subcloned into shuttle plasmid and formed transfer plasmid of pAdTrack-CMV-bcl-X L. Then pAdTrack-CMV-bcl-X L was linealinzed with PmeI and co-transformed into BJ5183 bacteria with adenovirus genomic plasmid of pAdEasy-1. The identified recombinant adenovirus plasmid was digested with PacI and transfected into 293 cells to package recombinant adenovirus particles. The target gene was detected by PCR.RESULTS: There were about 35% positive recombinant bacterial clones after the co-transformation of pAdTrack-CMV-bcl-X L and pAdEasy-1 into BJ5183. Recombinant adenovirus particle were produced and further amplified after the transfection of pAdEasy-1-gfp-bcl-X L into 293 cells. PCR test indicated that the recombinant Ad contained bcl-X L gene. The titer of the purified rAd-gfp-bcl-X L was 6 5?10 12 PFU/L. CONCLUSIONS: The homologous recombination in bacteria is a convenient and high efficient method to prepare rAd-gfp-bcl-X L. This affords a good gene transfer vector for the gene therapy in human's diseases.

OBJECTIVE:To study the protctive effect of ginkgo biloba extractEGBon the kindey in the case of is?chemia-reperfusion injury.METHODS:The model of renal ischemia-reperfusion injury in male rats was made by ligation of left renal artery for40min and3h of reperfusion.The rats with pretreatment were fed with EGB at different doses prior to operation.The content of malonadialdihydeMDA,the activity of superoxide dismutaseSODin renal cortex and the levels of blood urea nitrogenBUN,creatinineCrin plasma were measured.The pathological changes of renal tissues were observed by electron microscope.RESULTS:After ischemia-reperfusion,the activity of SOD in renal cortex was decreased,however,the content of MDA in renal cortex and the levels of BUN,Cr in plasma were increased.Pathological changes induced by ischemia-reperfusion in renal tissues were observed clearly.The pretreatment of rats with EGB significantly prevented reduction of SOD activity and increase of MDA content in renal cortex,decreased elevation of concentration of BUN and Cr in plas?ma.Pathological changes of proximal tubular cells in rat kidneys induced by ischemia-reperfusion were also prevented by the pretreatment with EGB.CONCLUSION:EGB can protect rats from renal injuries caused by ischemia-reperfusion.The mechanism of protective effects of EGB may be related to preserving the activity of SOD and alleviating lipid peroxidation.

Objective To evaluate the clinical curative effect of compoundTufuling tablets in the treatment of chronic prostatitis due to damp heat stagnation.Methods A total of 60 patients with chronic prostatitis due to damp heat stagnation were selected from July 2012 to July 2013 in Urology Outpatient of Urology, Xiyuan Hospital and recruited randomly divided into 2 groups, 30 patients in each group. The treatment group was treated with compound SmilaxTufuling tablets, while the control group was treated with Qianliexin capsule. The National Institutes of Health Chronic Prostatitis Symptom Index (NHI-CPSI), and the TCM symptoms score for chronic prostatitis were used to evaluate the treatment outcome.Results The total efficiency in the treatment group was significant higher than that in the control group (89.3%vs. 64.3%;χ2=4.909,P=0.027). After treatment , the NIH-CPSI total score (6.00 ± 2.36vs. 13.61 ± 2.91;t=10.748, P=0.000), and the subscales of pain or discomfort (2.54 ± 1.14vs. 4.82 ± 1.47;t=6.486,P=0.000), urination (1.61 ± 1.45vs. 4.79 ± 2.75;t=5.413,P=0.000), the quality of life (1.86 ± 1.38vs. 7.00 ± 1.36;t=14.038, P=0.000), TCM symptoms score (8.36 ± 3.03vs. 5.32 ± 2.74;t= 9.015,P=0.000) in the treatment group were decreased than those in the control group.Conclusions CompoundTufuling tablets can significantly decrease the NIH-CPSI scale and the TCM symptoms score in patients with chronic prostatitis due to damp heat stagnation, boosting satisfactory clinical effects.

Objective To study the influence of pre-injection of donor apoptotic cells in the survival of islet grafts and the function of T lymphocytes in the peripheral blood. Methods The donor apoptotic cells and necrotic cells were ob-tained respectively by X-irradiation from electron linear accelerator and a heat-shock procedure (water bath box 56℃, 1 h). The diabetic rats for islet transplantation (n=42) were induced by a single intraperitoneal injection of streptozotocin (STZ), then were randomly divided into four groups:rats were injected by physiological saline group (n=9), normal cells group (n=12), apoptotic donor cell group (n=12) and necrotic donor cell group (n=9). On the seventh day, each group received islet transplantation under the renal capsule. The blood glucose level was detected to reflect the survival of the islets. The periph-eral blood samples of three rats in each group were obtained at different observation times. The proliferative activity of T lym-phocytes was determined by MTT method. The levels of cytokines interferon (IFN)-γ, interleukin (IL)-10 in peripheral blood were measured by Luminex 100 Integrated System, and transforming growth factor (TGF)-β1 by ELISA respectively at 0 d, 1 week, 2 weeks and after rejection. Results The survival time of islets was significantly prolonged by the pre-intervention of apoptotic cells, and the proliferative activity of T lymphocytes stimulated by ConA was inhibited. Meanwhile, the extent of the increased level of IFN-γwas inhibited significantly at 1 week and 2 weeks after transplantation (P<0.05), the levels of IL-10 and TGF-β1 were significantly increased before transplantation, 1 week and 2 weeks after transplantation (P<0.05). Conclusion Our results demonstrated that the pre-treatment of donor apoptotic cells can regulate the recipient’s immune reactive state by inhibiting the proliferative activity of T lymphocytes and changing the levels of cytokines from different sub-sets of T lymphocytes, and finally resulted in the prolonging of the survival of islet grafts.