Objective To study the assessment of airway inflammation in asthma patients with airway remodeling by high resolution spiral CT(HRCT).Methods Retrospective analysis on 60 cases of chronicity-persistent period asthma patients with induced sputum IL-4 test,airway mucosa biopsy,HRCT scan; while 20 patients only used HRCT scan as control group.To compare the difference of sputum IL-4,HRCT test of airway wall thickness(WT),wall area(WA)and airway wall relative area(WA％)in different degrees of asthma paitents.Results WA,WA％and WT were significantly increased in different degrees of asthma patients when compared to control group(P<0.05),there were significant difference among each group(P<0.05).WA％and WT were positively correlated with induced sputum IL-4.Conclusion HRCT can effectively evaluate the airway inflammation in airway remodeling of asthma patients,which can be used to evaluate the severity of asthma,treatment effect and follow-up observation.

ObjectiveTo explore the Clinical effect of Tiotropium Bromide combined with seretide in patients with chronic obstructive pulmonary disease at stable period.Methods84 patients with stable COPD from March 2015 to February 2016 in our hospital outpatient respiratory department were randomly divided into control group and treatment group.The control group was treated with Seretide, the treatment group was treated withtiotropium bromide on the basis of control group.Compared the lung function, blood gas analysis, 6-minute walking distance, dyspnea score and quality of life were between the two groups after six months of treatment.ResultsFVC, FEV1and FEV1/ FVC (%) in the treatment group were significantly higher than those in the control group (P<0.05).The score of quality of life and dyspnea in the treatment group were significantly lower than those in the control group (P<0.05).The 6MWD in treatment group was significantly longer than that in control group (P<0.05).PaCO2 was significantly lower in the treatment group than that in the control group, but PaO2 was significantly higher than that in the control group after six months treated(P<0.05).ConclusionThe combination of tiotropium bromide and seretide in patients with chronic obstructive pulmonary disease (COPD) is effective in improving pulmonary function, improving life therapy, and reducing the symptoms of dyspnea.

Objective To investigate the clinical effect of milrinone injection combined therapy in patients with cor pulmonale complicated with respiratory failure and observe the effect of milrinone on blood gas index, blood viscosity and pulmonary arterial pressure.Methods The clinical data of 100 patients with cor pulmonale complicated with respiratory failure were retrospectively analyzed from April 2014 to April 2016.Among them, 50 cases were treated with conventional oxygen therapy, diuretic, asthma and anti-infection treatment.In the control group, 50 cases were treated with milrinone injection as the treatment group.The clinical curative effect and adverse reaction were analyzed.The blood gas analysis index, blood viscosity and pulmonary arterial pressure were measured before and after the treatment.The sputum normal and cyanosis, cough, wet rales and edema time were recorded in the two groups.Results The total effective rate of the treatment group was 92.0%, which was significantly higher than that of the control group 70.0%(P <0.05).After treatment, the hemorheological indexes and blood gas analysis indexes of the two groups improved significantly, However, the improvement of the indicators of the treatment group were significantly better than the control group (P<0.05).The pulmonary arterial pressure in the treatment group was (18.36 ±7.38) mmHg, which was significantly lower than that in the control group (23.79 ±6.14) mmHg (P<0.05); After treatment, the sputum normal and cyanosis in the treatment group, cough, wet rales, edema time were significantly shorter than the control group ( P <0.05 ) .No significant adverse effects were observed in both groups during the treatment.Conclusion The use of milrinone injection comprehensive treatment of pulmonary heart disease with respiratory failure in patients with significant efficacy and safety , but also can help improve blood viscosity and blood gas analysis indicators, reduce pulmonary artery pressure, better promote the rehabilitation of patients.

Objective:To investigate the clinical efficacy and safety of anlotinib combined with docetaxel for the treatment of advanced non-small cell lung cancer.Methods:A total of 118 patients with advanced non-small cell lung cancer who received treatment in Jinhua Guangfu Cancer Hospital from March 2018 to June 2019 were included in this study. They were randomly assigned to receive treatment with either anlotinib combined with docetaxel (study group, n = 59) or docetaxel alone (control group, n = 59) for two treatment courses. Clinical efficacy, progression-free survival, 1-year survival rate, and adverse drug reactions were compared between the study and control groups. Results:There was no significant difference in the objective remission rate between the two groups (22.03% vs. 32.20%, χ2 = 1.544, P = 0.214). The disease control rate in the study group was significantly higher than that in the control group (88.14% vs. 69.49%, χ2 = 6.141, P = 0.013). Progression-free survival in the study group was significantly longer than that in the control group [6.92 months (95% CI: 3.83-9.54 months) vs. 3.84 months (95% CI: 2.08-6.17 months), χ2 = 5.934, P = 0.019). The 1-year survival rate in the study group was significantly higher than that in the control group [52.47% (31/59) vs. 32.20% (19/59), χ2 = 4.998, P = 0.025]. During the treatment, the proportion of patients having leucopenia, erythropenia, gastrointestinal adverse reactions and abnormal liver and kidney function in the study group was 20.34%, 13.56%, 28.81% and 5.08%, respectively, which was significantly higher than 16.95%, 10.17%, 23.73% and 3.39%, respectively in the control group ( χ2 = 0.211-0.835, P = 0.361-0.646). Conclusion:Arotinib combined with docetaxel can effectively inhibit the progression of non-small cell lung cancer, prolong the progression-free survival, increase the 1-year survival rate, and does not increase adverse drug reactions.

Objective To investigate the effects of a novel standardized training program on the satisfaction and training quality of general practitioners (GPs). Methods 114 GPs trained in Wuxi People's Hospital between 2009 and 2013 were included, 52 GPs and 62 GPs were trained before and after the reform respectively. The measures of teaching reform included improvements in curriculum provision, theory teaching, learning modality and skills training. The evaluation indexes of satisfaction questionnaire and examination were confirmed by literature method and small-group discussion. Self-report satisfaction ques-tionnaire were distributed to graduate GPs and valid questionnaires were collected, while the results of entrance examination and graduation examination of GPs were recorded before and after the teaching reform. The research data were analyzed by chi-square test using SPSS 16.0 software. Results The basic characteristics of GPs and results of entrance examination before and after the teaching reform were compa-rable (P>0.05), however, GPs' satisfaction with curriculum, theoretical education, study form and skill training were increased significantly after teaching reform (P<0.05). Besides that,the results of graduation examination of GPs after the teaching reform, both the theory and skill examination, were improved signifi-cantly (P<0.05). Conclusion The study showed that GPs satisfaction with training modality and the results of graduation examination were improved greatly through our innovative teaching reform.

Objective To understand the willingness to receive human papillomawrus (HPV) vaccination of men who have sex with men (MSM) and the male clients of sexually transmitted disease (STD) clinics and related factors in China.Methods MSM were enrolled from the community through snowball sampling and male clients of STD clinics were enrolled from a sexual health clinic through convenience sampling in Wuxi,China.A questionnaire survey on the subjects' socio-demographic characteristics and the awareness of HPV was conducted.Results A total of 186 MSM and 182 STD clients were recruited.The awareness rates of HPV were 18.4％ and 23.1％,respectively and the awareness rates of HPV vaccination were 10.2％ and 15.4％,respectively.STD clinic clients (70.9％) were more likely to receive HPV vaccination than MSM (34.9％) (x2=47.651,P＜0.01).Only 26.2％ of MSM and 20.2％ of STD clinic clients were willing to receive free HPV vaccination before the age of 20 years.Multivariate logistic regression analysis showed that MSM who had passive anal sex (OR=2.831,95％ CI:1.703-13.526),MSM who never used condom in anal sex in the past 6 months (OR=3.435,95％CI:1.416-20.108),MSM who had been diagnosed with STDs (OR=1.968,95％CI:1.201-8.312) and STD clinic clients who had commercial sex with females in the past 3 months (OR=1.748,95％ CI:1.207-8.539),STD clinic clients who never used condom in commercial sex in the past 3 months (OR=1.926,95％CI:1.343-5.819) and STD clinic clients who had been diagnosed with STDs in past 12 months (OR=2.017,95％CI:1.671-7.264) were more likely to receive free HPV vaccination.Conclusion Sexually active MSM and male clients in STD clinics in China had lower awareness of the HPV related knowledge.Their willing to receive HPV vaccination were influenced by their behavior related factors.It is necessary to strengthen the health education about HPV and improve people's awareness of HPV vaccination.

Objective:This study aimed to discover the HIV infection and associated factors among male sex workers (MSW) who provide sexual services for men. Data from this study thus can be used to provide evidence for designing related intervention programs.Methods:In this observational study, MSW were recruited from May to July, 2019 in KTV venues in Wuxi, China. A questionnaire was used to collect information with blood sample collected and tested for HIV and syphilis. EpiData 3.0 and SPSS 17.0 software were used to clean up data and statistical analysis.Results:A number of 500 MSW were involved including 243 (48.6 %) heterosexual and 257 (51.4 %) homosexual MSW. The overall HIV prevalence was 5.4 %(27/500) among all the MSW. there were significant differences between the HIV prevalence rates, the heterosexual MSW (3.3 %, 8/243) and the homosexual MSW (7.4 %, 19/257)( χ2=4.112, P=0.043). In the past 3 months, 28.0 % (72/257) of the homosexual MSW mainly engaged in receptive anal sex which was higher than 11.5 %(28/243) of the heterosexual MSW. Compared to 15.6 % (40/257) of the homosexual MSW who engaged in heterosexual behavior, a higher proportion of 98.4 % (239/243) was noticed among the heterosexual MSW. Higher percentage (44.9 %, 109/243) appeared among the heterosexual MSW who had not been tested for HIV than the homosexual MSW (20.6 %, 53/257). Results from logistic regression multivariate analysis showed that age ≥30 (a OR=7.54, 95 %CI: 2.53-37.11), having unprotected anal sexual practice (a OR=3.76, 95 %CI:1.15-12.23), having anal sex after drinking alcohol (a OR=10.91, 95 %CI: 2.29-51.87) and syphilis tested positive (a OR=8.23, 95 %CI:1.29-52.51) were risk factors associated with HIV infection among the heterosexual MSW. Having unprotected anal sexual behavior (a OR=2.94, 95 %CI: 1.17-7.37), having group anal sex (a OR=4.08, 95 %CI:1.05-15.81), without record on HIV testing (a OR=6.58, 95 %CI: 2.01-18.06) and syphilis tested positive (a OR=4.55, 95 %CI: 1.15-18.06) were risk factors associated with HIV among the homosexual MSW. Conclusions:High HIV prevalence was discovered among both heterosexual and homosexual MSW in Wuxi, China. Differences in sexual behaviors between these two groups should be considered when designing targeted HIV intervention programs for these populations.

Objective:To study the neural mechanism between abnormal brain functional activity and alertness function in temporal lobe epilepsy (TLE) patients with or without hippocampal sclerosis.Methods:A total of 21 TLE patients with hippocampal sclerosis (TLE-HS), and 18 TLE patients without hippocampal sclerosis (TLE-N) diagnosed in the Department of Neurology of the First Affiliated Hospital of Guangxi Medical University from May 2016 to November 2022 and 28 healthy controls (HC) matched with demographic data were recruited.All the 67 participants completed the attention network test (ANT) and resting-state fMRI (rs-fMRI) scans. The REST software was used to analyze fractional amplitude of low-frequency fluctuation (fALFF) and functional connectivity (FC) based on one-way ANOVA in order to obtain differential brain regions in abnormal spontaneous neuronal activity and functional connectivity among the three groups. The SPSS 26.0 software was used to analyze the correlation between fALFF/FC values in differential brain regions and alertness network efficiency by Pearson correlation analysis.Results:There was a significant difference in the alerting network effect among the three groups ( F=4.621, P=0.013), and the post-hoc analysis showed that the alerting network effect in the TLE-HS group((59.40±22.85)ms)was significantly higher than that in the HC group((38.85±21.08)ms)(Bonferroni correction, P=0.017). The fALFF analysis showed that the fALFF values of the right superior frontal gyrus in the TLE-HS group (0.16±0.52) and the TLE-N group (0.49±0.51) were significantly lower than that in the HC group (1.01±0.46), while the fALFF values of the left precentral gyrus in the TLE-HS group (0.60±0.55) was significantly higher than that in the TLE-N group (-0.19±0.51) and the HC group (-0.15±0.36) (Bonferroni correction, all P<0.05). The functional connectivity analysis revealed that the FC values between the left inferior frontal gyrus and the right superior frontal gyrus in the TLE-HS group (0.11±0.16) and TLE-N group (0.02±0.19) were significantly higher than those in the HC group (-0.18±0.18). The FC values between the right supramarginal gyrus and the right superior frontal gyrus in the TLE-HS group (0.10±0.21) were significantly higher than those in the HC group (-0.18±0.16). The FC values between the left supplementary motor area and the right superior frontal gyrus in the TLE-HS group (0.20±0.21) were significantly higher than those in the TLE-N group (-0.03±0.31) and the HC group (-0.10±0.15) (Bonferroni correction, all P<0.05). The correlation analysis showed that the FC values between the left supplementary motor area and the right superior frontal gyrus in the TLE-HS group were significantly positively correlated with alertness network efficiency ( r=0.436, P=0.048). Conclusions:There are abnormal spontaneous neuronal activity and brain functional connectivity in TLE patients with or without hippocampal sclerosis, and the abnormality is more pronounced in the TLE-HS group. The abnormal brain functional connectivity may play an essential role in alertness dysfunction.

Objective To understand the willingness on acceptance of a short-message-service (SMS) program provided for HIV/STD testing and the related factors,among male clients at the STD clinics in China.Methods Convenience sampling method was used to select study subjectsat a STD clinic in Wuxi,Jiangsu province.A questionnaire survey was conducted among the subjects to collect the information on socio-demographic characteristics and willingness of acceptance to the SMS.Results A total of 368 SMS subjects were surveyed,in which 75.5％ expressed the willingness of acceptance,while 57.2％ and 38.1％ of them wanted to receive the short message every 3 months or 6 months,respectively.53.8％ of the respondents showed their willingness to share the news with their sexual partners about SMS and 44.8％ of them would do the same to their friends.Data from the Multivariate logistic regression analysis showed that those who had received senior high school or above education (aOR =3.632,95％CI:1.939-6.715),having homosexual behavior (aOR =1.973,95％ CI:1.234-8.358) or those having received AIDS related intervention service in the past year (aOR=9.416,95％CI:4.822-18.309) were more likely to accept the SMS.Conclusion SMS seemed to be acceptable among the male STD clinic clients in Wuxi,suggesting that it is feasible to conduct the SMS as a strategy to improve the HIV/STDs testing program at the STD clinics in the future.Promotion of SMS should be strengthened and the provision of general AIDS intervention service at the STD clinics should be established in order to make more STD clinic clients understand this SMS.

Objective To understand the current status of synthetic drug use and associated factors among men who have sex with men (MSM) at high risk of HIV infection.Methods A crosssectional study was conducted in Guangzhou,Wuxi and Shenzhen through January to August 2017.MSM at high risk of HIV infection were recruited from attendants at the health clinics,through internet advertisement and snowball sampling method.Eligible MSM were the ones who had met the following criteria:≥ 18 years old,having either 2 male sex partners,or condomless anal sex with a casual male sex partner,or a STD historg during the past 6 months.Data regarding demographic,sexual behavior,HIV/STD testing history and previous drug use were collected by sely-administered questionnaires.Blood was also drawn for HIV testing.Results Of the 603 MSM at high risk of HIV,25.5％ (154/603,95％CI:22.0％-29.0％) of them had used drugs in the past 6 months,including 29.1％ (88/302,95％CI:24.0％-34.3％) in Guangzhou,26.3％ (40/152,95％CI:19.2％-33.4％)in Shenzhen,and 17.4％ (26/149,95％CI:11.3％-23.6％) in Wuxi.'Rush'(85.1％,131/154) was the most commonly used drug.Results from the multivariable logistic regression revealed that drug use was associated with the following factors:having multiple casual sexual partners (aOR=3.24,95％CI:1.29-7.43) and alcohol use (aOR=1.78,95％CI:1.12-2.80) in the past 6 months after adjusting for age,education and monthly income.Conclusions Drug use seemed common among MSM population at high risk of HIV infection and was associated with higher risk behavior that leading to HIV infection.Synthetic drug use among MSM deserved more attention.