Pulmonary surfactant is a complex mixture of lipids and surfactant proteins (SP) lining the alveolar surface.In addition to the well established ability of the surfactant system to reduce alveolar surface tension and thereby prevent collapse of the alveoli on expiration,it is also involved in pulmonary host defence.Surfacant protein-A (SP-A),one of the most abundant SP,can deal with various pathogens,using a range of innate immune mechanisms,and links innate immunity with adaptive immunity that includes modulation of dendritic cell function and helper T cell polarization.Surfactant-replacement or increasing SP-A generation might be efficacious for the treatment of inflammatory and infectious diseases in the lung.

Objective To explore the clinical effect and safety of cetuximab plus mFOLFOX6 first-line treatment in k-ras wild type patients with liver metastasis from colorectal cancer.Methods 40 k-ras wild-type colorectal cancer patients with liver metastasis diagnosed by histological detection in our hospital were chosen.20 patients in the observation group were treated with cetuximab plus mFOLFOX6.20 patients in the control group were only given mFOLFOX6.To observe the effect and safety of the two groups.Results RR,operation excision rate and R0 removal rate of observation group (60％,45％,35％) were significantly higher than those of the control group (30％,15％,10％),the differences were statistically significant (x2 =3.95,4.36,4.28,P ＜ 0.05);The PFS of the observation group (16.37 ± 7.24) was higher than (11.52 ± 6.85) in the control group,but the difference was not statistically significant (P ＞ 0.05).In the observation group,there were 2 cases with rash,2 cases of leukopenia,1 case with nausea and vomiting,the incidence rate of adverse reaction was 25 ％ (5/20) ;In the control group,there were 2cases with leukopenia,1 case with nausea and vomiting,there was no rash and paronychia,the incidence rate of adverse reaction was 15％ (3/20),there was no significant difference in incidence rate of adverse reaction between the two groups (P ＞ 0.05).Conclusion Cetuximab combined with FOLFOX6 can improve the performance clinical remission rate and lesion resection rate of k-ras wild type patients with liver metastases from colorectal cancer,and has high safety,which is worthy of clinical application.

Objective To explore the influence of behaviour.individuality-personality factors on the intellectual impairment in early period of cerebral infarct.Methods To compare the correlation of the occurence of intellectual impairment and behaviour individuality among 98 cerebral infarct dementia index cases and 80 cerebral infarct without dementia index cases and 87 control subjects.Results A-type behaviour have 63.27％ cerebrol infarct dementia index cases,47.75％ cerebrol infarct without dementia inedx cases,and 35.63％ control subjects.(EPQ)P >60,63.2％ cerebral infarcl domentia index cases,35％ cerebrol infarct without demcntia index cases,and 20.69％ control subjects.(EPO)N>55,42.86％ cerebrol infaret demcntia index cases,38.75％ cerebrol infarct without dementia index cases and 24.14％ control subjects. Conclusion A type behaviour play on important role on intelligence impairment in post cerebral infact.Psychone drviduality and unsteady mood were manly mood feature of cerebral infarct,especially important post cerebral infarct intelligence impairment.

Objective To explore the influence of psychosocial factors and depression-anxiety on the intellectual impairment in early period of cerebral infarct.Method We compared the correlation of the occurence of intellectual impairment and depression-anxiety,negative life events among 98 cerebral infarct dementia index cases and 80 cerebral infarct without dementia index cases and 87 control subjects.Result Anxiety states have 74.49％ cerebrol infarct dementia index cases,60％ cerebrol infarct without dementia index cases,and 14.94％ control subjects,Depression states have 74.49％ cerebrol infarct dementia index cases,51.25％ cerebrol infarct without dementia index cases,and 20.69％ control subjects,Negative life events have 78.57％ cerebrol infarct dementia index cases,63.75％ cerebrol infarct witout dementia index cases and 13.79％ contrbl subjects.Conclusion The mood and sensibilities problems of depression anxity(especially of anxity) have a neagative status on the intellegence impirment of cerebral infarct.The correlates of post stroke depression-anxity states analysis were paralysis and position of focal lesion.The negative life events influenced the occuring of intelligence imparement post-cerebral infarct without anxity-depression mood and sensibilities problemes.

OBJECTIVE: A series of Bobath concept, Bobath theoretical hypothesis and clinical practice were summarized, to proVide a better understanding of Bobath concept involved in nervous tissues repairing and functional reconstruction. METHODS: Articles concerning the Bobath treatment for stroke-related literature were retrieved in Highwire press, MEDLINE, and Google from 2001 to 2009, using the key words of "Bobath concept, stroke physical therapy". Data of each study were extracted and analyzed following retrieval. Inclusion criteria:①Bobath concept and its theoretical hypothesis. ②New development of Bobath concept in clinical practice. Exclusion criteria: Repetitive studies. The results of retrieved literatura were analyzed. RESULTS: The theoretical basis of Bobath concept is based on present-day knowledge of motor control, motor learning, neural and muscle plasticity, and biomechanics. The latest theories and viewpoints are rasourced from International Bobath Instructors Training Association and the British Bobath Tutors Association. They expounded on the Bobath concept from linking participation, activities and underlying impairments, organization of human behavior and motor control, the consequences of injury and dysfunction in the execution of movement, neural and muscle plasticity, motor learning and so. This article also discusses several important questions which meet in clinical practice. CONCLUSION: Bobath therapy, as a traditional method for stroke rehabilitation, is constantly absorbing the research results from current neuroscience, psychology and other disciplines, and blended with other treatments to promote the development of neuro-rehabilitation medicine.

Objective To investigate the optimal surgical timing for rib internal fixation.Methods The clinical data of 143 patients with rib fracture were retrospectively analyzed.The patients were divided into early phase fixation group (62 cases) and late phase fixation group (81 cases) according to the time from trauma to internal fixation.The ratio blood lose and body surface area,pulmonary complications and the changes of C reactive protein level before and 5 days after operation were recorded and compared.Results All the patients were healing.The median C reactive protein before operation in late phase fixation group was 45 mg/L,in early phase fixation group was 23 mg/L,there was statistical difference (P ＜ 0.01).The ratio blood lose and body surface area in early phase fixation group was (334.19 ± 37.53) ml/m2,the rate of pulmonary complications was 22.6％(14/61),in late phase fixation group was (438.99 ± 55.24) ml/m2 and 38.3％ (31/81),there were statistical differences (P ＜ 0.01 or ＜ 0.05).The median C reactive protein 5 days after operation in early phase fixation group was 189 mg/L,in late phase fixation group was 258 mg/L,there was statistical difference (P ＜ 0.05).Conclusion Early phase (72 hours) rib internal fixation is expected to reduce patient trauma of systemic reactions,reduce the incidence of bleeding and pulmonary complications.

ObjectiveTo investigate the effect of different degrees of pressure of sustained inflation (SI) in patients with acute respiratory distress syndrome (ARDS) after lung recruitment as the result of different negative pressure for sputum aspiration.Methods A prospective single-blind randomized controlled trial was conducted. The factorial analysis of variance was adopted. 150 patients with ARDS admitted to the emergency intensive care unit (ICU) of Chongqing Three Gorges Central Hospital from January 2012 to December 2014 were enrolled, and they were randomly divided into S1, S2, S3 group, with 50 patients in each group, suction pressure varying from 150, 175, to 200 mmHg (1 mmHg = 0.133 kPa) was respectively used in each group. Then the patients of each group were randomly subdivided into five subgroups of P0, P1, P2, P3, P4, with 10 patients in each group, and 0, 30, 35, 40, and 45 cmH2O (1 cmH2O = 0.098 kPa) were used for control pulmonary inflation pressure, respectively. The respiratory mechanics and the hemodynamic parameters were recorded, and they were compared before and after the sputum aspiration as well as lung recruitment with sustained inflation.Results The lung recruitment volume (mL: 87.56±28.47 vs. 109.38±34.63, t = 3.573,P = 0.001) and lung static compliance [Cst ( mL/cmH2O): 27.69±13.25 vs. 35.87±17.47,t = 2.814,P = 0.004] after sputum aspiration in the 150 patients were significantly lower than those before the sputum aspiration, and peak airway pressure [PIP (cmH2O): 24.16±8.28 vs. 18.63±6.67,t = 2.957,P = 0.005], airway plateau pressure [Pplat (cmH2O): 21.28±9.14 vs. 17.47±7.26,t = 2.089,P = 0.032], and mean airway pressure [Pm (cmH2O): 13.26±4.65 vs. 10.41±3.54,t = 3.271,P = 0.001] were significantly higher than those before the treatment. There were no significant differences in the lung recruitment volume, Cst, PIP, Pplat and Pm between groups with different negative pressure for sputum aspiration (F value was 0.809, 0.986, 1.121, 0.910, 1.043, andP value was 0.452, 0.381, 0.335, 0.410, 0.361), but statistical significance was found among different groups of different lung recruitment pressures (F value was 3.581, 5.028, 3.064, 3.036, 4.050, andP value was 0.013, 0.002, 0.026, 0.027, 0.007). There was no interaction between the two factors. After pairwise comparison, under the same negative pressure for sputum aspiration, lung recruitment volume and Cst in different lung recruitment pressures subgroups (P1, P2, P3, P4) were significantly higher than those of P0 subgroup, and PIP, Pplat, and Pm were significantly lower than those of P0 subgroup. There was no significant difference among P1, P2, P3 and P4 groups. There were no significant differences in mean arterial pressure (MAP) and pulmonary arterial pressure (PAP) among different groups with negative pressures for sputum aspiration and different lung recruitment pressures (negative pressure for sputum aspiration:F = 0.586,P = 0.561,F= 1.373,P = 0.264; lung recruitment pressure:F = 1.313,P = 0.280,F= 1.621,P = 0.186), there was no interaction between the two factors (F = 0.936,P = 0.497,F = 1.391,P = 0.227). The difference of heart rate (HR) in different negative pressure for sputum aspiration groups was not significant (F = 1.144,P = 0.328), and there were significant differences in different lung recruitment pressure groups (F = 3.297,P = 0.019), there was no interaction between the two factors (F = 1.277, P = 0.280). After pairwise comparison, under the same negative pressure for sputum aspiration, HR in P3 and P4 subgroups was significantly higher than that in P0, P1, and P2 subgroups (allP< 0.05).Conclusion 30 cmH2O and 35 cmH2O were the suitable pressure for SI in ARDS patients, and they were not affected by different negative pressure for sputum aspiration.

To meet the requirement of cultivating talented people,the following problems were explored in the medical biochemistry experiments classes including teaching content,teaching format,teaching management,and evaluation of the teaching performance and strengthening of students' capacity cultivation.

The co-metabolic carbon sources,dynamics and influence factors of atrazine biotransformation by genetically engineered microor- ganism(GEM)were investigated in the paper.The results showed that glucose was superior to acetate as co-metabolic carbon sources.The concentration of carbon sources affected little on atrazine transformation but much on GEM growth.The specific transformation rate(STR)of atrazine was influenced not by cell density of GEM but by atrazine concentration.Monod model was used to simulate atrazine transformation dynamics and the parameters were v_(max)=0.168/h and Ks=30.49 mg/L.When temperature reduced,STR decreased markedly.The trans- formation was efficient in weak alkaline condition and was inhibited in acidic condition.To some extent,salinity did not affect transformation activity of GEM.Co~(2+),Fe~(2+),Fe~(3+),and Zn~(2+) improved atrazine transformation,but Mn~(2+),Ni~(2+) and Cu~(2+) inhibited atrazine transforma- tion.The results also showed that there existed a direct correlation between adsorption and transformation of atrazine by GEM.