Objective To evaluate the clinical efficacy and safety of high-dose Ambroxol in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Retrieved from PubMed, EMbase, Cochrane Library, CNKI, VIP and WanFang databases by computer, randomized controlled trials (RCTs) about high-dose of Ambroxol in treatment of AECOPD were included. According to the inclusive and exclusive criteria, literatures and data were independently screened and extracted by two researchers, and the quality of the studies were assessed, Meta-analysis was conducted by RevMan 5.2 software. Results A total of 7 RCTs were included, involving 534 patients. Meta-analysis showed that experiment group can obviously improve the overall effective rate [OR = 4.11, 95%CI (2.31, 2.31), P < 0.000 01), shorten hospital stays(OR = 3.60, 95% CI (4.66, 2.55), P < 0.00001), compared with the control group was statistically difference, and no obvious adverse reactions. Conclusion High-dose of Ambroxol could improve AECOPD overall effective rate, shorten hospital stays, improve pulmonary function and blood gas analysis, and no serious adverse reactions, be worth clinical promote using.

OBJECTIVE:To systematically evaluate the efficacy and safety of cetuximab in the adjuvant chemotherapy treat-ment of advanced non-small cell lung cancer(NSCLC),and to provide evidence-based reference for clinical treatment. METH-ODS:Retrieved from Cochrane Library,PubMed,CJFD and Wanfang database,randomized controlled trials (RCT) about cetux-imab adjuvant chemotherapy (test group) versus single chemotherapy (control group) in the treatment of advanced NSCLC were collected,and Meta-analysis was performed by using Rev Man 5.2 statistical software after extracting data and evaluating quality. RESULTS:A total of 8 RCT were included,involving 2 367 patients. Results of Meta-analysis showed survival rate in 1 year [OR=1.33,95%CI(1.08,1.64),P=0.006],partial remission rate [OR=1.48,95%CI(1.23,1.78),P<0.001],total effective rate [OR=1.34,95%CI(1.19,1.51),P<0.001],incidence of leucopenia [OR=1.50,95%CI(1.23,1.83),P<0.001],incidence of rash [OR=53.26,95%CI(13.09,216.65),P<0.001] and incidence of infusion reactions [OR=3.72,95%CI(1.86,7.42),P<0.001] in test group were significantly higher than those of control group,there were significant differences in 2 groups. However,there were no significant differences in the complete remission rate [OR=1.57,95%CI(0.91,2.70),P=0.11] and incidences of other ADR(P>0.05). CONCLUSIONS:Cetuximab has good efficacy in the adjuvant chemotherapy treatment of advanced NSCLC,however,the incidence of ADR should be prevented in clinic. Duo to the methodology limit of included studies,large-scale and high quality RCT are required for further validation of the conclusions.

Objective To evaluate the results and side effects in three dimensional conformal radiation therapy (3DCRT) for esophageal carcinoma. Methods From December 1996 to December 1998,67 patients with esophageal carcinoma were treated with 3DCRT(3DCRT group),in which all were treated once every other day to a total dose of 40 42 ?Gy in 13 15 days at 5 6?Gy per fraction totally 7 8 fractions, and during the same interval, another 112 patients treated by conventional fractionation radiotherapy(CF group) to a total dose of 64 68?Gy over 44 48 days at 2.0?Gy per fraction 5 days per week were analyzed and compared. Results The 1 ,2 ,3 and 4 year local control rates in 3DCRT group were 71.6% ,62.7%,49.3% and 43.3% ,compared to 53.6%, 43.8% ,33.9% and 25.9% in CF group (P = 0.011). And the survival rates in 1 ,2 ,3 and 4 years in 3DCRT group were 62.7%,52.2%,43.3% and 38.8%, as compared with 49.1%, 41.1% ,30.4% and 22.3% in CF group (P = 0.027). However, in the 3DCRT group, the incidence of acute radiation esophagitis was higher (P=0.003) and those of hematogenous side effects and B symptom were lower(P=0.007,0.021). Conclusion Compared with conventional fractionation radiotherapy,3DCRT is able to improve the local control rate of esophageal carcinoma, with tolerable acute and late radiation side effects.

Objective To investigate the difference of complication incidence, death rate, quantity of lymphadeneetomy, lymphatic metastasis rate and long-term survival rate in thoracic squamons cell carcinoma of esophagus between three fields lymphadenectomy (3-FL) and traditional method. Methods Homoehronous 96 esophageal cancer patients were fractionated in two groups, 46 patients for 3-FL, the other 50 patients for traditional method. Results The average quantity of lymphadenectomy was 39.28 pieces per patient in 3-FL, and was significantly higher than 13.30 pieces per patient in traditional method (P <0.01). The rate of metastatic lymphatic nodes was 73.91%(34/46) in 3-FL patients, significantly higher than38.00%(19/50) in traditional method patients. For incidence of postoperative complications, recurrent laryngeal nerve damage and respiratory complication in 3-FL patients was significantly higher than patients in traditional method (P <0.05). The chest fluid obviously inereasod in 3-FL patients than in traditional method patients. There was significant contrast in 3-year survival rate between 3-FL patients and traditional method patients. Conclusion The there fields lymphadenectomy expand scope of lymphdenectomy effectually, accurate the staging of thoracic esophageal carcinoma. At the same time, a lot of evidence was found in raising survival rate for 3-FL. Disadvantage of 3-FL was severe surgical trauma, high incidence of complication, and a long recovery time after operation.

Objective To observe the effects of two different warming patterns on body temperature changes in patients undergoing orthopedic surgery. Methods A total of 60 patients undergoing orthopedic surgery under general anesthesia were randomly divided into the observation group and the control group,with 30 cases in each group.In the observation group,the warming blanket was set at 38℃ in an intermittent warming pattern, i.e. every 1 hour heating period was followed by a 40 min interval.In the control group,the warming blanket was set at 38℃in a continuous warming pattern.Anal temperature was continuously monitored during operation to compare the preventive effects of the two warming patterns on hypothermia. Results Anal temperature changes were recorded at 8 time points including pre-anesthesia, the beginning of operation, 30 min, 60 min, 90 min and 120 min after the beginning of operation, completion of operation (after skin closure) and recovery of consciousness. The observation group were(36.68±0.34)℃,(36.69±0.41)℃,(36.60±0.37)℃,(36.54±0.40 )℃,(36.53± 0.49) ℃, (36.50 ± 0.58) ℃, (36.49 ± 0.61) ℃, (36.53 ± 0.52) ℃, the control group were (36.76 ± 0.43) ℃, (36.64±0.40)℃,(36.50±0.39)℃,(36.45±0.41)℃,(36.51±0.52)℃,(36.65±0.42)℃,(36.65±0.44)℃, (36.69±0.44)℃.There were no statistical differences in anal temperature at all time points between the two groups (t=-1.332~1.083, P>0.05). In addition, the comparison of post-operation shivering, skin injury,recovery time of consciousness post-anesthesia,the observation group were,16.67%(5/30),0(0/30), (10.13±6.51)min,the control group were,10.00%(3/30),10.00%(3/30),(10.07±7.49)min,there were not significantly difference between two groups(P>0.05).However,the incidence of sweating during operation in the control group was higher than that of the observation group (χ2=4.286, P<0.05), the observation group was 0(0/30),the control group was 13.33%(4/30). Conclusions Application of warming blanket in an intermittent warming pattern showed a similar preventive effect on hypothermia as the continuous warming pattern in patients undergoing orthopedic surgery. Moreover, intermittent warming reduced the incidences of sweating and skin injury during operation,reduce health care costs.

BACKGROUNDBronchoplasty plus pulmonary arterioplasty has become one of the standard surgical operation for central-type lung cancer. The aim of this study is to review the surgical experience of bronchoplasty and pulmonary arterioplasty in treatment of central-type lung cancer.

METHODSFrom 1987 to 2005, 56 patients with central-type lung cancer underwent bronchoplasty and pulmonary arterioplasty. There were 45 males and 11 females with a mean age of 56 years. According to pTNM classification, 18 cases were in stage IIB, and 32 in stage IIIA and 6 in stage IIIB. Histologically, there were 35 cases of squamous cell carcinoma, 14 cases of adenocarcinoma, 4 cases of small cell lung cancer and 3 cases of carcinoid. The surgical procedures included sleeve resection of bronchus for 30 cases, wedge resection of bronchus for 26 cases, and sleeve resection of pulmonary artery for 16 cases and wedge resection of pulmonary artery for 40 cases.

RESULTSOne patient died in the perioperative period. The overall 1-, 3-, and 5-year survival rate was 79.6% (43/54), 48.1% (25/52) and 34.0% (17/50), respectively.

CONCLUSIONSThe results suggest that bronchoplasty and pulmonary arterioplasty can decrease the proportions of total pneumonectomy and exploratory thoracotomy and expand the indication of operation. Bronchoplasty and pulmonary arterioplasty can be achieved with satisfactory outcome for central-type lung cancer, especially for those patients with advanced lesions or poor pulmonary function.

Objective To evaluate the schistosomiasis control effect of the measures of replacing cattle with machine for cul?tivation and forbidding depasturage of livestock on marshlands in marshland and lake regions. Methods The retrospective re?view and field survey were implemented in the Jiangling and Gongan counties of Hubei Province where were implemented with the measure of replacing cattle with machine for cultivation,and Yuanjiang and Huarong counties of Hunan Province where were implemented with the measure of forbidding the depasturage of livestock on marshlands. The schistosome infection status of hu?man,cattle,and Oncomelania hupensis snails,and schistosome?infested field excreta were surveyed from 2007 to 2013. The ef?fects of the interventions were compared before and after their implementations. Results The 6 villages of Hubei Province were implemented with the measure of replacing cattle with machine for cultivation,and 7 villages of Hunan Province were imple? mented with the measure of forbidding the depasturage of livestock on marshlands. From 2007 to 2013,the schistosome infection rates of residents declined from 3.95%to 0.70%(χ2 =128.376,P<0.05),with the descend range of 82.53%. The descend ranges of the measures of replacing cattle with machine for cultivation and forbidding the depasturage of livestock on marshlands were 83.081%and 81.62%respectively,and there was no significant difference between the two measures(χ2 =0.132,P>0.05). The infection rate of cattle decreased from 3.66%in 2007 to 0.65%in 2013,and the descend range was 82.24%(χ2=13.692,P<0.05). The field excreta was surveyed in the snail breeding place in 2013. The investigated area was 157.435 hm2, and 625 samples of field feces of cattle were collected with the density of field excreta of 3.97/hm2,and the positive rate was 1.12%(7/625). The schistosome infection rate of snails and the density of infected snails decreased successively from 2007, and no infected snails were detected from 2011 to 2013. Conclusions The schistosomiasis endemic situation are decreased sig?nificantly after the interventions of replacing cattle with machine for cultivation and forbidding the depasturage of livestock on marshlands. Therefore,schistosomiasis control effect of these measures is notable in the marshland and lake regions.

Objective To evaluate the efficacy of different treatment options for cholecysto-choledocholithiasis (CCL),and try to find the ideal treatment.Methods From January 2006 to January 2016,a total of 3 107 patients with CCL from the Affiliated Hospital of Inner Mongolia Medical University were enrolled.Among them,1 283 patients were in open cholecystectomy (OC) and open common bile duct exploration (OCBDE) group,964 patients were in laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) group,and 860 patients were in endoscopic retrograde cholangiopancreatography (ERCP) + LC group.The clinical data of the three groups were analysed.One-way analysis of variance and chi-square test were performed for statistical analysis.Results From 2006 to 2010,the percentage of patients treated with OC + OCBDE,LC + LCBDE,and ERCP + LC were 56.05％ (829/1 479),25.15％ (372/1 479) and 18.80％ (278/1 479),respectively;from 2011 to 2016,the percentage of patients received the above three treatments were 27.89％ (454/1 628),36.36％ (592/1 628) and 35.75％ (582/1 628),respectively.The difference in the proportion of the same treatment at different times was statistically significant (x2 =4.775,4.168 and 0.669,all P ＜ 0.05).The success rate of surgery in the OC + OCBDE group was 100.00％ (1 370/1 370);while the success rate of surgery in the LC + LCBDE group was 94.26％ (920/976),and 56 patients converted to OC + OCBDE;the success rate of surgery in the ERCP + LC group was 95.00％ (817/860),and 31 patients converted to OC + OCBDE,and 12 patients to LC + LCBDE.The intraoperative complication in OC + OCBDE,LC + LCBDE and ERCP + LC were 2.85％ (39/1 370),3.48％ (32/920) and 1.22％ (10/817),respectively.The incidence rates of postoperative complication were 4.89％ (67/1 370),5.34％ (50/920) and 5.51％ (45/817),respectively.The incidence rates of intraoperative complication of the ERCP + LC group was lower than that of OC + OCBDE group and LC + LCBDE group,and the differences were statistically significant (x2 =6.203 and 3.001;both P ＜ 0.05).However there was no significant difference in incidence rate of postoperative complications among the three groups (all P ＞ 0.05).The hospital stay of the OC + OCBDE group,the LC + LCBDE group and the ERCP + LC group were (6.7 ± 1.3) days,(5.6 ± 1.2) days and (10.9 ± 1.6) days,respectively,and the differences were statistically significant (F =90.010,P ＜ 0.01).The hospitalization expenses of OC + OCBDE group,LC + LCBDE group and ERCP+LC group were (13 720±1 910) yuan,(18 150±1 490) yuan and (25 830 ± 2 430) yuan,respectively,and the differences were statistically significant (F =302.991,P ＜ 0.01).Conclusion The first choice of patients with CCL is endoscopic minimally invasive treatment and open surgery can be used as a remedial method for endoscopic treatment.

The fundus appearance of polypoidal choroidal vasculopathy (PCV) often demonstrates orange-red nodular lesions.ICGA reveals terminal dilation of the polyps with or without branching vascular networks.Currently,pachychoroid spectrum disease is a series of conditions included choroidal vasodilatation and increased permeability due to choroidal ischemia,choroidal thickening,retinal pigment epitheliopathy,and secondary pigment epithelial detachment,choroidal neovascularization and polyps included uncomplicated pachychoroid,pachychoroid pigment epitheliopathy,pachychoroid neovascularization,central serous chorioretinopathy,and PCV.These entities have the similar characteristics and prognosis,suggesting that they have the similar pathology.The recognition of PCV based on the pachychoroid spectrum disease can provide new ideas for the prevention and intervention of PCV.

Objective: To discuss the safety and efficacy of simultaneous procedures of vibrant soundbridge implantation and auricular reconstruction with congenital external and middle ear malformation. Methods: This is a retrospective study, including 6 patients, 5 boys and 1 girl, aged 7-12 years. All patients received simultaneous operations of vibrant soundbridge implantation and auricular reconstruction. The mean preoperative air conduction threshold was 64.8 dB HL at 0.5, 1, 2, and 4 kHz. The VSB was placed in the third stage of auricle reconstruction, if the soft tissue expansion was performed; otherwise, the VSB was implanted in the second stage. The satisfaction with reconstructed auricle, surgical complications, hearing improvement and speech discrimination scores were evaluated 6 months after surgery. Results: All patients and their families reported satisfaction with their reconstructed auricle. There was no complications, including cartilage framework exposion, infection, hematoma, skin flap necrosis, facial paralysis, tinnitus, vertigo or others. Post-operatively, mean VSB-aided hearing threshold was 36.7 dB HL, which was reduced by 28.1 dB HL. The mean speech discrimination scores measured in a sound field with a presentation level of 65 dB SPL and 80 dB SPL were improved. Conclusions The simultaneous operations of auricle reconstruction and Vibrant Soundbridge implantation is an alternative method for patients with congenital microtia and atresia.