A probe into the management of outpatient medical records written by rural doctors:Such a record is indispensible for technical appraisal of medical accidents; yet writing of such a record might involve illegal medical practice or go beyond the scope of practice.It is recommended to normalize the behavior of rural doctors in their writing of outpatient medical records,stipulating that the Basic Regulations on Medical Records do not apply to rural doctors at present.It is also recommended that separate regulations for rural doctors be formulated,along with a promotional period before these regulations are in practice.An alternative would be clarifying that Article 28 of the Regulations of Medical Malpractice Settlement do not apply to rural doctors.

Secretome includes all the gene products secreted by a cell. The development of proteomicbased approaches and genome-based computational prediction technology have gradually revealed secretome plays an important role in pathogen infection recently. Secretome facilitates pathogen to proliferate and invade the host by inhibiting the host's immune system, resisting acidic PH conditions, snatching nutrition and so on.Identification of pathogenic secretome helps discovering new drug targets and biomarkers, and supporting the diagnosis and treatment.

BACKGROUND:Mechanotransduction is an issue of concern in the study on the relationship between stress and growth. Mechano-growth factor (MGF) holds stress sensitivity, and exerts similar effect with stress in bone metabolism regulation. OBJECTIVE: To explore the mechanotransduction during bone remodeling, and investigate the relationship between stress and growth at molecular level. METHODS: The governing equations about the relationship between MGF and mechanical stimulation, regulation of MGF on osteoblasts and osteoclasts, regulation of MGF on RANK-RANKL-OPG signaling axis were established, and then the MGF-mediated bone reconstruction model was established to simulate the bone remodeling process under mechanical stimulation. RESULTS AND CONCLUSION:Under the condition of disuse, there was a decrease in osteoblasts/osteoclasts ratio, bone mass and bone volume fraction, and bone resorption was more than bone formation. Under the condition of overload, there was an increase in osteoblasts/osteoclasts ratio, bone mass and bone volume fraction, and bone formation was more than bone resorption. The simulation results were in accordance with Frost mechanostat theory. These findings show that the mechanobiological model of bone remodeling based on MGF can simulate the bone remodeling process under mechanical stimuli, and achieve mechanotransduction.

0.05), but were highly significant at doses of 100 ?mol/L or above (P

Objective To discuss the effect and feasibility of BiPAP in refractory asthma patients. Methods A total of 15 coses of refractory bronchial asthma admitted by our hospital during Feb 2003 to May 2006 were treated by BiPAP in addition to medical therapy。 The symptoms、signs and the arterial blood gases were observed and analyzed。Results Among 15 patients,2 gave up treatment,13 patients were successfully treated with the BiPAP therapy。There were significant improvement of PaCO2、PaO2、pH and respiratory rate ,heart rate after 2h BiPAP。Conclusions Ventilation in BiPAP is an effective method for refractory asthma ,which can save the patients life and decrease the complications.

AIM To set up the model of stom- effects of its treatment drugs. METHODS To ap-ach smooth muscle cells contraction and assess the ply the culture of isolated stomach fundus smooth muscle cells in rats in vitro and to obtain the mixture of stomach smooth muscle cells. The cells were examined with the Trypan blue dilution technology under microscope and the length of cells and the contraction rate of muscle cells were adopted to the evaluation index of effects. The change of cells in different time was observed and calculating the survival rate and time of cells. The selected neuro-medium and its antagonist, such as acetyl-choline chloride (ACh) and atropine, 5-HT and domperidone(Domp) , histamine( His) and diphen-hydramine(Diph) were added to the mixture cells so as to provoke irritant reaction observe the effects of drugs. RESULTS Obtaining cells in stomach fundus smooth muscle was more than 1 X 106 in each rat by this way, and the survival rate and time of cells was 95% and 2. 5 h. The contraction of cells was observed after adding ACh 5-HT or His ,and the effects of these agents were antag- onized by antagonist atropine, Domp and Diph respectively. The effects of maximum contraction of ACh in concentration 1?10-8 mol ? L-1 was 38%, and in 5-HT may exist two receptors, and the maximum rate was 20. 7% and 10. 5% respectively. The effective dose of contraction was 1 X 10-13 -1?10-10 mol ? L-1 induced by His, the contraction effects was significantly weakened in high of 1 ?10-10 mol ? L-1 and antagonized by Diph. CONCLUSION The smooth muscle cells by digesting stomach fundus smooth muscle of rats would be more than 95% survivors and survival time was more than 2. 5 h. ACh,5-HT and His could induce the contraction of smooth muscle cells, and the effects of contraction were antagonized by atropine, Domp and Diph respectively.

Objective:To evaluate the clinical significance of pattern visual evoked potential (P-VEP) parameters on amblyopic patients with normal-vision atfer pleoptic therapy. Methods:We investigated 60 amblyopic children (8-12 years old) who gained normal-vision atfer pleoptic therapy. hTese patients were assigned to a unilateral amblyopia group (40 patients)and a bilateral amblyopia group (20 patients). Another 20 healthy children served as a control group. All patients underwent a full initial ophthalmologic and orthoptic evaluation. P-VEP test was performed in all. Amplitude and latencies were analyzed and compared among groups. The latencies of P100 waves in the amblyopic eyes were used to generate a multiple linear regression formula from sex, ifrst treatment age, baseline visual acuity, and cycloplegic refraction. Results:hTere was no signiifcant difference in the mean levels of best-corrected visual acuity among groups (P>0.05). A signiifcant prolongation of the latency and a decrease of amplitude of P100 waves were observed in the unilateral amblyopia group and the bilateral amblyopia group compared with the healthy control group (P<0.05). Amplitude and latencies of the fellow eyes in the unilateral amblyopia group were abnormal compared with the healthy control group (P<0.05). Multiple linear regression analysis revealed that the latencies of P100 waves were signiifcantly correlated with the ifrst treatment age, baseline visual acuity, and cycloplegic refraction (R2=0.52, P<0.05). Conclusion:Deifcits exist in the fellow eyes and in normal-vision eyes atfer pleoptic therapy. hTe delayed P100 latency is affected by the ifrst treatment age, baseline visual acuity, and cycloplegic refraction. Traditional amblyopic therapy may be not enough for vision function recovery.

Objective To explore ureaplasma urealyticum (UU) infection of recurrent candida vaginitis (RVVC) and bacterial vaginosis(BV) ,and their clinical characteristics. Methods The vaginal discharge of 81 patients with RVVC and BV were taken for detection of UU. Results The positive rate of UU was 59.3% (48/81). There were significant differences between the patients with UU infection and those without UU infection (P>0.05 ). Conclusion RV VC is correlated with alteration of vaginal milieu internae, dysbacteria and infection of varied pathogen. The comprehensive treatment should be considered according to different pathogen.

Objective To discuss the effect and possibility of NIPPV in ILD combined with respiratory failure. Methods A total of 37 cases of ILD combined with respiratory failure admitted by our hospital during Feb 2004 to Oct 2007 were divided into treatment group (20 cases) and control group (17 cases). Routine pharmaceutical intervention was adopted in both groups while NIPPV was given in the patients of treatment group. The symptoms、signs and the arterial blood gases were observed and analyzed. Results Among 20 patients,3 gave up treatment , 17 patients were successfully treated with the NIPPV therapy. There were significant improvement of PaCO2、PaO2、pH and respiratory rate ,heart rate after 2h NIPPV. Conclusion NIPPV is an effective method for ILD combined with respiratory failure,which can save the patients life and decrease the complications.

Objective To investigate the therapeutic effect of ambroxol in bleomycin-induced pulmonary fibrosis of rats.Methods Sixty Wistar rats were divided into three groups:The normal control group(group N),the model group treated with bleomycinA5(group B)and the group treated with ambroxol(group A).Pulmonary fibrosis was induced by intratracheal instillation of bleomycin.Then the rats received daily ambroxol 35mg/kg(group A),or normal saline(group B).Five rats in each group were killed on 3.7.14 and 28 days after intratracheal instillation.Histological changes of the lungs were evaluated by HE stain and Masson's trichrome stain.The levels of tumor necrosis factor-?(TNF-?)in lung homogenates were measured by radioimmunoassay.Results Pulmonary fibrosis of Group A was significantly improved as compared with that of Group B(P