Objective To evaluate the effect of tiotropium on pulmonary function in patients with mild to moderate chronic obstructive pulmonary disease(COPD).Methods Eighty mild to moderate COPD patients were divided into tiotropium group and control group with 40 cases in each group,the treatment period was 12 weeks.Patients in both groups after one week washout period,patients inhaled cleaning 0.9％ sodium chloride.Two to 12 weeks of treatment period,patients in tiotropium group were given tiotropium bromide inhalation powder capsules (18 μ g/grain),administered morning a daily times; patients in control group continued inhalation of 0.9％ sodium chloride.The pulmonary function was assessed before treatment and on 6 and 12 weeks after treatment.Results After successive 12 weeks' treatment,the pulmonary function in tiotropium group were significantly enhanced.The inspiratory capacity,forced expiratory volume in one second and forced vital capacity were increased (0.43 ± 0.15),(0.17 ± 0.11) and (0.41 ± 0.14) L,respectively; significantly higher than that in control group [(0.10 ± 0.12) L,(0.01 ± 0.05) L and (0.05 ± 0.12) L],respectively; there were significant differences (P＜ 0.05).There was no significant difference in the incidence of adverse reaction and the occurrence rate of COPD acute attack (P ＞ 0.05).Conclusion The pulmonary function was signifcantly improved in patients with mild to moderate COPD treated with tiotropium 18 μ g once daily.

Objective:To explore the values of electroencephalogram (EEG) combined with glial fibrillary acidic protein (GFAP) in the early diagnosis and prognosis evaluation of viral encephalitis (VE).Methods:A total of 63 patients with VE admitted to the Hangzhou Seventh People′s Hospital from January 2016 to December 2019 were selected as the observation group. In addition, 80 healthy people suspected of central nervous system disease in the same period were selected as the control group. The data of gender, age, body mass and body mass index (BMI) were recorded, the Niolet V32 digital EEG instrument of American Nigolli Company was used for EEG inspection, and the level of serum GFAP was detected by enzyme-linked immunosorbent assay (ELISA). The general data, abnormal EEG results and the level of serum GFAP of the control group and the observation group were compared. The diagnostic values of EEG and its combination with serum GFAP in VE were analyzed by four grid table; and the diagnostic value of serum GFAP for VE was evaluated by drawing receiver operating characteristic (ROC) curve.Results:There was no significant difference in sex, age, body mass and BMI between the two groups ( P>0.05). The results of EEG diagnosis for VE showed that 11 of 63 cases were missed and 10 of 80 cases in the control group were misdiagnosed, and the sensitivity, specificity and accuracy of EEG diagnosis for VE were 82.54%, 87.50% and 85.31%, respectively. Compared with that of the control group, the level of serum GFAP of the observation group was higher: (460.19 ± 126.53) ng/L vs. (217.36 ± 53.17) ng/L, t =15.525, P<0.05. ROC curve showed that area under curve (AUC) of serum GFAP for VE diagnosis was 0.907 and cutoff value was 238.37 ng/L. The sensitivity, specificity and accuracy of EEG combined with serum GFAP in diagnosing VE were 93.65%, 83.75% and 88.11%, respectively, and the sensitivity and accuracy of EEG combined with serum GFAP were higher than those of EEG and GFAP alone. The results of 12-month follow-up showed that 20 of 63 VE patients had sequel (poor prognosis group), 43 patients had good prognosis (good prognosis group), and the incidence of adverse prognosis was 31.75%(20/63). There were significant differences in EEG and GFAP between the good prognosis group and poor prognosis group ( P<0.05). Conclusions:The sensitivity and accuracy of EEG combined with serum GFAP in the diagnosis of VE are good, which may be used for the early diagnosis and prognosis evaluation of VE.

BACKGROUND:Because of deficiency of nerves and blood vessels of articular cartilage, its nutrition is mainly derived from the synovial fluid or synovial vascular osmosis. Limited in their ability to repair itself, so how to repair articular cartilage damage better become medical problems to be solved. OBJECTIVE:To review to the literatures on the repair of cartilage damage method and al ogeneic cartilage in vitro preservation method in recent years, and to find the optimal preservation conditions and the culture medium composition that suitable for in vitro preservation of al ogeneic cartilage tissues, thus enhancing the effect of al ogenic cartilage in vitro preservation. METHODS:A computer-based online search was performed in the PubMed database and the CNKI database to search papers on the in vitro liquid preservation of al ogeneic cartilage graft published from January 1990 to February 2013. The key words were“osteochondral al ograft, tissue culture, chondrocyte survival rate, in vitro”in English and“articular cartilage;al ogeneic transplantation;liquid preservation”in Chinese. The articles published earlier and repetitive researches were excluded. RESULTS AND CONCLUSION:At present, there are two methods for the preservation of al ogenic osteochondral grafts. After cryopreservation, the survival rate of chondrocytes is decreased significantly which can affect the transplantation effect, therefore there is less clinical application. Liquid preservation method can enhance the survival rate of cells, maintain the organization activity, but the preservation time is short that cannot be widely used. Scholars have further improved the environment of liquid preservation and composition of liquid culture medium, extended the in vitro preservation time of cartilage tissue, and improved the effectiveness of cartilage tissue preservation.

Objective To study the effects of pioglitazone on visceral fat tissue metabolic activity in patients with type 2 diabetes mellitus or impaired glucose tolerance by using 18 fluoro deoxy glucose (FDG)‐positron emission tomography (PET)andcomputed tomography (CT)imaging. Methods FDG‐PET and CT imaging were performed in 62 patients with type 2 diabetes mellitus (T2DM ) or impaired glucose tolerance (IGT ). Lipid and glycemic profiles and inflammatory markers were detected in all patients. These patients randomly received treatments with either pioglitazone or glimepiride for 16 weeks.Results After 16 weeks ,pioglitazone‐treated group versus glimepiride‐treated group showed a significantly decreased visceral fat area[(109.1 ± 45.0) vs(122.5 ± 52.0 )cm2 ] and a significantly decreased visceral fat metabolic activity[(0.47 ± 0.11)vs(0.55 ± 0.11)](P<0.05). Conclusion Our study indicates that pioglitazone decreases the visceral fat volume and its metabolic activity in patients with T 2DM or IGT.

Objective This study was to investigate the effects of branched-chain amino acid (BCAA) supplementation on the metabolism of glucose and gluconeogenesis. Methods 20 rowers were randomly assigned to supplemental group and control group. During 4 weeks of training, all athletes followed the same training program. After 4 weeks, tests were done on a rowing ergometer, which included an incremental test for 4 mmol/L lactate anaerobic threshold and 2km, 5km maximum intensity exercise. Blood samples were taken prior to, immediately post and 30min post exercise. Results The results showed that serum glucose, alanine values had no significant difference between BCAA group and control group in anaerobic threshold test. In 2km and 5km rowing ergometer exercise, serum glucose values in BCAA group were significant decreased immediately post exercise, but the values in control group were significant decreased both immediately post exercise and 30min post exercise. Serum alanine values in BCAA group were significant increased both immediately post exercise and 30min post exercise, but the values in control group were significant decreased immediately post exercise. Lactate concentrations increased in BCAA supplementation group and were significantly lower (P

Objective To determine the berberine chloride content in Lianpu Shuangqing Tablet and to develop a steady and reliable method for the quality control of the tablet.Method A HPLC method was adopted.The column was Dionex C18 (5 ?m,4.6 mm ?150 mm)with the column temperature of 28 ℃,the mobile phase was acetonitrile-0.033 mol/L potassium dihydrogen phosphate(25 ∶75) with the flow rate of 1.0 mL/min,and the detection wavelength was at 346 nm.Results Berberine chloride has a linearity in the range of 0.153～1.224 ?g,and the average content in the tablet was 1.26 mg/tablet.Conclusion This method is simple,accurate,and can be used for the quality control of Lianpu Shuangqing Tablet.

Objective To investigate the coagulation function,the related factors and prognosis of preterm infants with periventricular hemorrhage-intraventricular hemorrhage (PVH-IVH).Methods Eighty-one preterm infants with PVH-IVH and 81 infants with non-PVH-IVH as a control were enrolled in the study.The changes in activated thromboplastin time(PT),activated partial thromboplastin time (APTT),Fibrinogen and D-dimer were determined by enzyme-linked immunosorbent assay.Clinical factors which were related to PVH-IVH in infants were analyzed with statistical analysis and prognosis was assessed with neonatal behavioral neurological assessment (NBNA).Results The average of gestational age in PVH-IVH group was(30.9 ± 1.79)weeks,in control group were (31.36 ± 1.39)weeks,and there was significant difference between the 2 groups (F =6.52,P =0.012).There were significant differences in APTI,and D-dimer between PVH-IVH and non-PVH-IVH infants(all P ＜ 0.05).Multivariate Logistic regression analysis showed that the related factors included gestational age,neonatal respiratory distress syndrome(NRDS),hyperoxia,and mechanical ventilation(OR =3.98,1.72,2.99,5.65,all P ＜ 0.05).The NBNA scores of the 2 groups were also significantly different(t =9.16,P ＜ 0.05).Conclusions The occurrence of PVH-IVH is very complex resulted from gestational age,NRDS,hyperoxia,mechanical ventilation and other factors.In order to avoid the occurrence of intracranial hemorrhage and improve the life quality of preterm infants,the NRDS was prevented as far as possible,coagulation abnormalities were managed positively and the mechanical ventilation was shortened.

Objective To explore the clinical effect of remifentanil and ketamine with sevoflurane in pediatric surgery. Methods 80 cases of ASAⅠ～Ⅱ grade line surgery in children, were randomly divided into remifentanil group(A group) and the ketamine group(B group). Intramuscular midazolam 0.3mg/kg basic anesthesia catheter later. A group 2min before skin incision to give 0. 5μg/kg remifentanil infusion pump micro pump remifentanil 30μg(kg/h) add sevoflurane inhalation 3MAC until surgery. B group 2min before skin incision 2mg/kg ketamine infusion then pump ketamine 3mg(kg/h) add sevoflurane inhalation 3MAC until surgery; Record separately the two groups before skin incision in children with 2 min(T0) ,atskin incision(T1),after skin incision 15min(T2) ,when surgery (T3) in children with the mean arterial pressure (MAP),heart rate(HR),respiratory frequency(R)and oxygen saturation (SpO2) ,and record the total number of children with secretions (sputum volume) , awake time and the availability of laryngeal spasm,restlessness,nausea, vomiting and other adverse reactions. Results A group sputum volume was less than B group(P＜0.01) and A Group awake time was shorter than B Group(P＜0.01) ;Two groups of patients R infants had no inter-group differences(P＞0.05) ,two groups of children during quiet sleep,analgesic perfect, no significant respiratory depression,no laryngeal spasm,restlessness and nausea,vomiting and other adverse reactions. Conclusion Remifentanil composite Sevoflurane for surgery in children than ketamine was more stable during the cycle, secretions less quickly after waking up was a safe and reliable method of anesthesia.

This paper introduce the observation and nursing care of toxicity reactions in thirty-two advanced cancer patients treated with cetuximab combined chemotherapy. The nursing measures focused on pre-treatment psychological nursing,strictly abiding by the cetuximab combined chemotherapy protocols,as well as close monitoring and nursing interventions of toxicity re-actions. All the thirty-two patients accomplished the cetuximab combined chemotherapy. During the drug therapy,two patients suf-fered from allergic reaction and three patients with grade Ⅲ skin rash. All the toxicity reactions were alleviated after treatment.

Objective:To study the expressions of E-cadherin(E-cad) an d CD44V6 in normal oral mucous,oral atypical hyperplasia and oral squamous cell carcinoma(OSCC).Methods:The expression of E-cad and CD44V6 in 1 7 cases of normal oral mucous,6 of oral atypical hyperplasia and 52 of OSCC was examined with immunohistochemistry. Results: E-cad expression was observed in all the cases of normal oral mucous and oral atypical hyperplasi a,and in 43/52( 82.69% ) of OSCC. CD44V6 expression was observed in all the ca ses of normal oral mucous and oral atypical hyperplasia,and in 32/52(61.54%) of OSCC.In OSCC, the expression of E-cad was decreased with the decrease of differ entiation degree(P