Objective To investigate the Laboratory diagnostic value of COPD with congestive cardiac failure .The clinical signif‐icance on the combined detection of the serum B‐type natriuretic peptide(BNP) ,high sensitive C reactive protein (hs‐CRP) ,and he‐moglobin(Hb) in COPD with congestive cardiac failure .Methods The serum levels of BNP ,hs‐CRP and Hb in 205 patients with different etiological factors and grades(according to the pulmonary function test Ⅰ - Ⅳ) and 100 healthy controls were determined . The sensitivity and specificity of 3 parameters were evaluated .Results The levels of BNP ,hs‐CRP ,and Hb in different grades of COPD had statistical significance(P<0 .05) .In addition ,the grade was worse ,and its concentration was higher .The levels of BNP and Hb showed statistical significance between COPD I grade patients and healthy controls (P<0 .05) ,and the levels of hs‐CRP had no statistical significance between the healthy controls and COPD Ⅰgrade patients(P>0 .05) .The sensitivity of combined detection was 90 .2% in early COPD diagnosis ,which was higher significantly than that of the individual detection (P<0 .05) .Conclusion The significant clinical significance on the combined detection of the serum BNP ,hs‐CRP and Hb provides reference support in the diagnosis of early COPD .

Objective To investigate the effects of DRD1 rs265981,rs4532,rs686 and rs265976 polymorphisms on response to clozapine in resistant schizophrenic patients.Methods DRD1 genotype was determined by SNaPshot SNP technique for 154 patients with resistant schizophrenia.Clinical symptoms were evaluated by Positive and Negative Syndrome Scale (PANSS),and the responder was defined as a reduction of 50％ on PANSS score from baseline after the patients were administered orally clozapine for 8 weeks.Results The frequencies of rs265981 genotypes,alleles and rs265976 genotypes had significant differences between clozapine responder group (88 cases) and nonresponder group(66 cases) in total clinical efficacy ( x2 =10.215,P =0.004 ; x2 =4.082,P =0.041 ; x2 =14.083,P =0.007 ).The frequencies of rs265976 genotypes had significant differences between clozapine response (58 cases) and nonresponse (96 cases) to negative symptom ( x2 =9.805,P =0.046).Conclusion The polymorphisms of DRD1 gene rs265981 and rs265976 may relate with clinical response to clozapine in resistant schizophrenias.rs265981 T/T,allele T and rs265976 genotype A/A are likely to be predictive factors to the improvement of total clozapine therapeutic effects.rs265976 genotype A/A are likely to be predictive factors of negative symptom with treatment of clozapine.

Objective To explore the cytotoxicity of the cytotoxic T lymphocyte (CTL) induced by SW480 sonicate sensitized dendritic cells (DC) on the colon cancer cell line SW480. Methods PBMC were separated from the HLA-A*0201 donor and DC were cultured with rhGM-CSF, rhIL-4 and rhTNF-α. The same donor's primary CTL were stimulated by DC loaded with SW480 sonicate. The cytotoxicity of CTL on SW480 (HLA-A*0201 positive) and K562 (HLA-A*0201 negative) was determined by the MTT method. Results The cytotoxicity of the CTL on SW480 was stronger than that on K562 (P ＜0.05). Conclusion The DC vaccine can stimulate specific CTL which can trigger cytotoxic activity on the target cells and this cytotoxicity is related to MHC restriction.

Objective To study the expressions of metadherin (MTDH) and cyclinD1 in esophageal squamous cell carcinoma (ESCC) and their clinical significances. Methods The protein expressions of MTDH and cyclinD1 were detected by immunohistochemistry in 78 cases of ESCC. Results The positive expression rate of MTDH in ESCC was 71.79%(56/78) and the positive expression rate of cyclinD1 in ESCC was 74.36%(58/78). The expressions of MTDH and cyclinD1 were significantly correlated with the degree of differentiation and lymph node metastasis (both P< 0.05), but not with the age, gender of patients and depth of tumor invasion (all P> 0.05). Conclusion The over expressions of MTDH and cyclinD1 protein may involve in the occurrence and development of esophageal carcinoma, which play important roles in the invasion and metastasis of esophageal cancer.

The physical chemistry is one of the important basic courses for pharmaceutical speciality.This article explores the teaching reform of physical chemistry for pharmaceutical speciality from five aspects,such as the teacher's professional quality,the teaching content,the teaching method,the experiment teaching as well as the evaluating method.

OBJECTIVE:To observe the efficacy and safety of carboprost and Foley catheter for the expand cervix before hys-teroscopic electric resection. METHODS:80 patients with hysteroscopic operation were randomly divided into research group and control group. Research group was placed inside the vagina carboprost 1 mg 30 minutes before operation;control group was placed inside the Foley catheter 12 hour before operation. The relaxation degree of the cervix,average operative time,preoperative pain, postoperative morbidity and incidence of adverse reactions in 2 groups were observed. RESULTS:There were no significant differ-ences in the relaxation degree of the cervix,postoperative morbidity and incidence of adverse reactions between 2 groups(P>0.05). The average operative time and preoperative pain in research group were significantly better than control group,the differ-ence was statistically significant(P<0.05). CONCLUSIONS:Carboprost and Foley catheter have good efficacy and safety for ex-pand cervix before hysteroscopic electric resection,however,carboprost is better than Foley catheter in terms of average operative time and preoperative pain.

ObjectiveTo identify the pathogen of an aseptic meningitis outbreak which occurred in Linyi City of Shandong Province during the summer of 2009,and to analyze the genetic variations of Coxsackicvirus B5 (CVB5) isolates.MethodsForty-two cerebrospinal fluids (CSF) specimens were collected from aseptic meningitis cases and virus isolation was performed. The viral RNA was extracted and amplified from the positive specimens using reverse transcription polymerase chain reaction (RT-PCR).The partial VP1 coding region was purified and sequenced. The phylogenetic trees based on VP1 sequences were constructed among CVB5 isolates and those in GenBank.ResultsSeventeen enteroviruse strains were isolated from 42 CSF samples with 40.5％ isolation positive rate. All these strains were identified as CVB5 using both microneutralization test and molecular typing methods. Homology comparisons indicated that the nucleotide acid identities and amino acid sequence identities were 92.3 ％- 100.0％ and 98.7 ％- 100.0％,respectively among these CVB5 isolate.s,and compared with the Faulkner prototype strain,which were 81.0％-82.4％ and 96.6％97.0％,respectively.Phylogenetic analysis on VP1 sequences showed that all CVB5 could be separated into four genogroups of A,B,C and D.Isolates of this outbreak belonged to genogroup D.Interestingly,two distinct genogroups in the phylogenetic tree were observed among the 17 isolates.Conclusions CVB5 is responsible for the outbreak of aseptic meningitis in Linyi City of Shandong Province,China. The genetic diversity is high among the isolates and all belong to genogroup D.

The influence of exercise at high temperature on adult males' routine blood indexes and biochemical indexes and the expression of HSP72 in peripheral blood lymphocytes (PBLs) was studied in order to provide theoretical ground for health supervision of adults receiving exercise at high temperature. 180 adult males were selected and divided into exercise group and control group, in which the exercise group was subdivided into subgroup 1 and subgroup 2 receiving exercise at high temperature in the afternoon and in the morning, respectively. Peripheral venous blood was phlebotomized before and after the exercise to examine routine blood indexes and blood biochemical indexes. The expression levels of HSP72 in PBLs were detected by flow cytometry. The results showed that the routine blood indexes and biochemical indexes in each group were within the range of normal values of male adults. There was no significant difference between each exercise group and control group in indexes before exercise. After exercise, the expression levels of HSP72 in PBLs in exercise groups were higher than those before exercise, and HSP72 expression levels in subgroup 1 were obviously higher than those in subgroup 2 and control group. The contents of ALT, urea, Na+, Cl-, Ca2+ and K+ in subgroups 1 and 2 were lower than those in control group, but CK level was higher than in control group (P<0.05). The contents of Na+ and Cl- in subgroup 1 were relatively lower than those in subgroup 2 (P<0.05). It was concluded that while receiving exercise at high temperature, adult males' HSP72 levels in PBLs could be increased and the biochemical indexes changed. Attention should be paid to health supervision to avoid obvious body injuries at high temperature.
Blood Chemical Analysis/*methods ; Exercise/*physiology ; HSP72 Heat-Shock Proteins/*blood ; HSP72 Heat-Shock Proteins/metabolism ; Hot Temperature ; Lymphocytes/*metabolism ; Young Adult

Objective:To investigate the effect of ultrasound-guided early removal of indwelling catheter on recovery quality and catheter-related infection of patients with general anesthesia in post anesthesia recovery unit (PACU).Methods:From September 2019 to April 2020, 146 patients with gynecological benign diseases who underwent hysteroscopic surgery in the Department of Anesthesiology, Shenzhen Hospital of Southern Medical University were selected prospectively and randomly divided into two groups, with 4 cases excluded. The function of the bladder was evaluated by ultrasound in the anesthesia recovery room after operation. In the ultrasound group, 71 patients had no abnormality, and the catheter was removed after the residual urine of the bladder was drained. 71 patients in the control group were normal, and the catheter was removed 24 hours after operation. The residual urine volume, urine retention, incidence of restlessness, urinary tract infection rate, time to first walking and hospital stay were observed in the two groups after the first bladder emptying.Results:The incidence of agitation in PACU was 7.0%(5/71) in the ultrasound group and 22.5%(16/71) in the control group, with statistically significant difference ( P<0.01); the first postoperative walking time in the ultrasound group and the control group was statistically significant [(10.5±4.1)h vs (18.9±6.5)h, P<0.05]; the postoperative hospital stay in the ultrasound group and the control group was statistically significant [(3.2±1.3)d vs (5.1±2.5)d, P<0.05]. The incidence of urinary tract infection and urinary tract irritationin in ultrasound group was significantly lower than that in control group (1.4% vs 9.8%, 1.4% vs 14.0%, P<0.05). Conclusions:For uncomplicated patients after gynecological laparoscopic surgery, ultrasound evaluation of bladder function, extraction of residual urine immediately after the removal of catheter, is more conducive to the early recovery of patients than 24 hours after the removal of catheter.

Objective:To understand the current situation of physicians′ competency in China and statistically analyze its influencing factors, hence providing referential evidences for promoting their competency.Methods:The evaluation scale for Chinese physicians′ competency was developed by referring to sophisticated overseas evaluation frameworks. Based on the electronic platform of the medical alliance, stratified sampling was conducted at 39 hospitals in 13 provinces, from which 2 156 physicians were surveyed, and statistical analysis was made on the current situation and influential factor of their competency in 6 dimensions(medical knowledge, diagnosis and treatment, scientific research and teaching, interpersonal communication, spirit of professionalism, population health)Results:The score range in multiple dimensions of physicians′ competency was between 2.85 and 3.89(5 in total), among which spirit of professionalism dimension scores the highest, and teaching and research dimension scores the lowest. Logistic regression analysis shows that their competency level in 6 dimensions is correlated to a range of factors, including gender, degree, title, supervisor qualifications, standardized training program of specialist physicians, and affiliation or not to teaching hospitals( P<0.05). Conclusions:Their overall competency is expected to be elevated. To name a few, they are lack of teaching and research abilities, and need to conduct clinical-oriented scientific research; they are expected to enrich knowledge structure, and need to embrace a wider concept of health; they need to improve their non-technical service abilities, and should further emphasize their humanistic quality; physicians′ practice competency depends upon their extent of medical education, and ensuring the quality of standardized training becomes the key measure.