Objective To explore the combination clinical effects of salbutamol and budesonide on bronchial asthma .Methods 120 patients withbronchial asthma in First People's Hospital of Yuhang District were selected and randomly divided into two groups of control group and experimental group with 60 cases in each group.Patients in the control group was treated monotherapy with salbutamol, patients in the experimental group were given albuterol and budesonide combination therapy.The treatment effect on symptoms and lung function of the two groups were compared after two weeks . Results After treatment, the breathing, wheezing sound, gasp and cough remission time were significantly shorter in the experimental group than in the control group,the difference was statistically significant ( P <0.05 ) .The effective rate of the control group was 78.33%, the effective rate of the experimental group was 95.00%,the difference was statistically significant(P<0.05).The improvement of lung function in the experimental group was significantly higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion Compared with monotherapy, the combination of salbutamol and budesonide can improve the efficacy of bronchial asthma patients and improve the quality of life of patients .

Objective To observe the clinical efficacy of low-dose erythromycin combined with salmeterol-fluticasone in the treatment of stable COPD, focus on the quality of life and respiratory function of patients.Methods 87 patients with stable COPD admitted to Hangzhou Red Cross Hospital from January 2014 to January 2016 were selected.Patients were divided into two groups by therapeutic methods, observation group ( salmeterol-fluticasone+erythromycin) 46 cases and control group (salmeterol-fluticasone) 41 cases.Six months of treatment, the quality of life of two groups of respiratory function assessment, acute COPD and peripheral inflammatory factor and other indicators of change.Results After treatment, both of the two groups got significantly decreased in SGRQ and MMRC scores, while the observation group was significantly lower than the control group, the difference was statistically significant(P<0.05).After treatment, FEV1/FVC%levels were significantly increased in both groups, but the observation group was significantly higher than the control group, the difference was statistically significant(P <0.05).The cumulative incidence of acute exacerbation of COPD was 10.87%(5/46) in the observation group, which was significantly lower than that in the control group 29.27%(12/41), the difference was statistically significant(Log-rankχ2 =4.833, P=0.028).After treatment, the levels of IL-1βand TNF-αin the peripheral blood of the patients in the observation group were significantly lower than those in the control group, the difference was statistically significant (P <0.05).Conclusion In the treatment of stable COPD, low-dose erythromycin could significantly improve the clinical efficacy, improve the quality of life and respiratory function.

Objective To study the effect improvation of lung function and prognosis of singulair and seretide for moderate to severe AECOPD . Methods 78 patients associated with moderate to severe AECOPD from January 2014 to June 2016 in our hospital were researched.They were divided randomly into observation and control groups according to the order of admission, 39 cases in each group.In the control group, they were treated by conventional anti-infective, expectorant, oxygen, suction seretide.In the observation group, using singulair on the basis of the control group.Clinical data, clinical efficacy, clinical symptoms begin to improve time, hospitalization time, blood gas analysis (PaO2, PaCO2) after five days and pulmonary function after treatment forced expiratory volume in one second ( FEV1 ) , call gas peak velocity ( PEF) , forced expiratory volume in one second than the forced vital capacity (FEV1/FVC), maximum mid-expiratory flow rate (MMEF) were compared with each other.Results Their clinical data of patients and other general information and basic condition had no significant difference between each other.The effective rate of observation group and control group were 97.44%and 87.18%, clinical effecicy of observation group was better than the control group, the difference was statistically significant (u=2.2805, P<0.05).Postoperative hospital stay, time of symptoms began to improve of the observation group were shorter than the control group, the difference was statistically significant (P<0.05), PaO2 of 5-day post-treatment of observation group was higher, and PaCO2 was lower, the difference was statistically significant (P<0.05).Lung function of two groups of patients had no significant difference before treatment, after treatment, pulmonary function in the observation group (including FEV1, PEF, FEV1/FVC, MMEF) was better than the control group, the difference was statistically significant (P<0.05).Conclusion Seretide combined with singulair to treat severe AECOPD has a good effect, it can significantly improve the therapeutic effect and improve the patient's lung function.

Objective To observe the effect of montelukast on bronchial asthma and influence on the immune state , in order to provide support for the treatment of montelukast.Methods 92 patients with bronchial asthma in our hospital from December 2014 to January 2016 were selected in the study and randomLy divided into two group.The control group was treated with the conventional therapy of bronchial dilation and glucocorticoid inhalation , and on this basis, the treatment group was loaded with montelukast, 10 mg/times, one times of one day, and the course of treatment was one months.Then the frequency of acute attack of asthma and the number of beta receptor agonist were before and after treatment were recorded , and the lung function the level of T lymphocyte subsets and the levels of inflammatory cytokines before treatment and after treatment were detected , and the difference between the two groups was compared.Results After treatment, t the frequency of acute attack of asthma of day and night and the number of beta receptor agonist of the treatment group were significantly lower than the control group, the FEV1%, FVC% and PEF% of the treatment group were significantly higher than the control group, the level of CD8 + was significantly lower than the control group, the ratio of CD4 +/CD8 + was higher than the control group; the levels of IL-2, INF-γwere higher than the control group, while the levels of IL-4, IL-8 were lower than the control group (P<0.05).Conclusion The montelukast has certain regulation effect on imbalance of CD4 +/CD8 +and Th1/Th2 in children with bronchial asthma, and have a good effect on the prevention of asthma.

Objective To observe the effects of dexmedetomidine combined with propofol on the hemodynamics level in elderly patients undergoing gastroscopy.Methods 68 patients undergoing endoscopy from January 2014 to January 2015 in our hospital were selected and randomly divided into observation group and control group, 34 cases in each group.Propofol anesthesia combined with dexmedetomidine was used in the observation group and propofol anesthesia was used in the control group.The RR ( respiratory rate) and HR ( heart rate) of the two groups were observed before the administration (T0), after the administration (T1), when the gastroscope was inserted (T2), after the examination (T3), 5 min after the examination (T4), MAP (mean arterial pressure) and SpO2(pulse oxygen saturation) were measured.The postoperative consciousness, orientation recovery time and surgical tolerance were compared between the two groups.The anesthetic adverse reactions were recorded during the operation.Results The observation group in T1, T2, T3, T4 time point HR were lower than the control group, and the data remained relatively stable level, the difference was statistically significant (P<0.05).There was no significant difference in consciousness recovery time and recovery time of orientation force between observation group and control group.The tolerance of the observation group was higher than that of the control group, the difference was statistically significant (P<0.05).The total adverse reaction rate of the observation group was 32.35% lower than that of the control group 88.24%, the difference was statistically significant ( P <0.05 ) .Conclusion Dexmedetomidine combined with propofol for the elderly patients with painless gastroscopy , analgesic effect is good, and can better maintain hemodynamic fluctuations, reduce propofol anesthesia adverse reactions, does not Affect the patient's awareness and ability to restore the direction.

Objective To investigate the effects of sevoflurane combined anesthesia on the early cognitive function of the elderly patients.Methods 120 patients underwent laparoscopic surgery in our hospital from August 2014 to August 2016 were selected and randomly divided into two groups:sevoflurane group 60 cases, sevoflurane anesthesia during operation and propofol anesthesia 60 cases, propofol anesthesia during operation.MMSE was used to detect the cognitive function at one day before operation, one day, three days and seven days after surgery respectively.The blood samples were taken from the patients of the two groups at the time of one day before operation, one hour after operation and one day after operation, the levels of serum TNF-αand IL-6 were measured by enzyme-linked immunosorbent assay ( ELISA ) . The recovery time and adverse reactions were observed after operation.Results The average recovery time was (18.94 ±3.32) min in the propofol group and (10.62 ±2.31) min in the sevoflurane group, the sevoflurane group was better than the propofol group, the difference was statistically significant (P<0.05).The scores of MMSE were significantly lower in the sevoflurane group one day after operation than those in the one day before operation, the difference was statistically significant (P<0.05).The scores returned to the preoperative level three days and seven days after operation.In the propofol group, the MMSE score was significantly lower at one day after operation than that before operation, the difference was statistically significant (P<0.05), but increased three days after operation but did not reach the preoperative level, and sevoflurane group, the difference was statistically significant.After treatment, the levels of TNF-and IL-6 in serum of two groups increased, the level of TNF-αand IL-6 in the propofol group one hour after operation and one day after operation were significantly higher than those in the sevoflurane group, the difference between the two groups was statistically significant ( P <0.05 ).Conclusion The sevoflurane compound anesthesia in patients after surgery, the recovery of cognitive ability faster, fewer side effects in patients.

Objective To observe and investigate the effect of esomeprazol in the elderly patients with gastric ulcers and influence for the pepsinogen,cAMP and cGMP.Methods 86 elderly patients with gastric ulcers in our hospital from June 2015 to August 2016 were selected as the research object,and they were randomly divided into control group 43 cases and observation group 43 cases, the control group were treated with omeprazole,the observation group were treated with esomeprazol,the total effective rates,symptom score and pepsinogen, cAMP, cGMP levels before and after the treatment of two groups were compared.Results The total effective rates of observation group at different time after the treatment were higher than those of control group,the symptom scores after the treatment were all lower than those of control group ,the serum pepsinogen were all lower than those of control group,the plasma cAMP and cAMP /cGMP were lower than those of control group,the plasma cGMP were higher than those of control group, (P<0.05), the differences were all significant.Conclusion The clinical effect of esomeprazol in the elderly patients with gastric ulcers is better,and it can significantly improve the expression situation of pepsinogen, cAMP and cGMP of patients, so its application value in the elderly patients with gastric ulcers is higher.

Objective To analyze the clinical value of low molecular heparin calcium combined with early rehabilitation intervention in the prevention of deep vein thrombosis after internal fixation of intertrochanteric fractures.Methods 100 patients with internal fixation for treatment of femoral intertrochanteric fracture from January 2014 and October 2015 were selected and randomly divided into two groups:the control group of 50 cases, treated with low molecular weight heparin low molecular weight heparin by abdominal subcutaneous injection of drug therapy and routine nursing intervention service, observation group of 50 cases, in the control group based on the use of early rehabilitation intervention.The incidence of deep venous thrombosis after operation in two groups was recorded, and the changes of platelet count and coagulation markers were observed before and after intervention in the two groups.Results The observation group of patients with postoperative deep venous thrombosis incidence rate of 4%, significantly lower than the control group 16%, the difference was statistically significant (P<0.05), the two groups after the intervention each time the platelet count was higher than that of before intervention, four weeks after the intervention, the observation group of platelet count (239.51 ±34.62) ×109/L, significantly higher than the control group (235.23 ±28.87) ×109/L, the difference was statistically significant (P<0.05), the two groups before the intervention of each marker concentration, the difference was not statistically significant, patients in the observation group after the intervention, the blood coagulation markers concentrations were significantly lower than before treatment, and were significantly lower than the control group after the intervention.The comparison between the two groups, the difference was statistically significant (P<0.05).There was no chest pain, chest tightness, dyspnea and other symptoms of pulmonary embolism in the two groups , and no adverse reactions were found.Conclusion The application of low molecular weight heparin calcium combined with early rehabilitation intervention can effectively reduce the incidence of deep venous thrombosis after intertrochanteric fracture fixation.

Objective To investigate the clinical efficacy and value of low molecular weight heparin calcium combined with vertebroplasty in the treatment of osteoporotic vertebral compression fractures in elderly patients .Methods 67 elderly patients with osteoporotic vertebral compression fractures in our hospital from January 2013 to January 2016 were selected and randomly divided into control group 30 cases and treatment group 37 cases. All patients were treated with percutaneous vertebroplasty, the control group was given calcium carbonate D3 conventional treatment, the treatment group was treated with low molecular weight heparin calcium anti osteoporosis treatment, the course of treatment was one month.Measurement of bone mineral density before and after the operation of different follow-up time points ( BMD ) and the changes of the oswestry disability index ( ODI ) evaluation activities and the visual analogue scale (VAS) to assess the degree of pain, and the changes of vertebral height before and after operation were analyzed. Results All patients were followed up for an average of 16.4 months (12 to 21 months).Compared with before vertebroplasty, the BMD of the patients in the treatment group was higher than that in the control group at one month, three months and six months, the difference was statistically significant (P<0.05), the low molecular weight heparin treatment after January, treatment group VAS and ODI scores were significantly lower than the control group, and the subsequent different follow-up time points ODI and VAS score can effectively maintain, the difference was statistically significant ( P<0.05) .Compared with before vertebroplasty, postoperative anterior vertebral height, middle height better than preoperative vertebral height, the difference was statistically significant (P<0.05), and after one months of treatment, the treatment group of anterior vertebral height, middle height were better than the control group, the difference was statistically significant (P <0.05).Conclusion After treatment with low molecular weight heparin calcium, the healing process of vertebral body after vertebroplasty, to a certain extent, it can increase the bone mass and prevent bone destruction, increase bone strength, and further achieve the treatment of osteoporosis and prevention of osteoporotic fracture in elderly patients with osteoporotic vertebral compression fractures.

Objective To explore the clinical efficacy of rosuvastatin combined with oxycodone sustained release tablets in patients with advanced non-small cell lung cancer and its effects on serum IL-6 and TNF-αlevels.Methods 62 cases with advanced non-small cell lung cancer from May 2014 to May 2016were divided into observation group and control group according to random number table, each group with 31 cases.Control group were treated with oxycodone sustained-release tablets, and observation group were treated with rosuvastatin and oxycodone sustained-release tablets.The levels of serum IL-6 and TNF-αwere compared pre-and post-treatment betweene two groups.The effective dose, the number of painful pain, the NRS score, the improvement of quality of life of oxycodone hydrochloride sustained-release tablets after treatment and adverse reaction rate were observed. Results After treatment, serum IL-6, TNF-αlevels in two groups were significantly lower than pre-treatment (P <0.05), and which in observation group were significantly lower than control group (P<0.05).Compared with control group, the effective dose of Oxycodone Hydrochloride Prolonged-release Tablets, broke out pain, NRS score in observation group were significantly higher ( P <0.05 ) .The effective rate of cancer pain treatment in observation group was 96.77% (30/31), significantly higher than 74.19% (23/31) of control group (χ2 =12.269, P<0.0001).The improvement of quality of life incontrol group was 32.25%, significantly lower than 80.64% in observation group (P<0.05).There was no significant difference in adverse reactions between two groups.Conclusion Rosuvastatin combined with oxycodone sustained release tablets in treatment with advanced non-small cell lung cancer were effective, and can reduce the patient's serum IL-6, TNF-αlevels effectively.