Objective To evaluate the efficacy and safety of tulobuterol patch in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) in the elderly. Methods Totally 165 elderly patients with moderate to severe AECOPD were divided into trial group and control group randomly.83 patients of trial group were treated with tulobuterol patch,2 mg once a day,and fluticasone inhalation 250 μg twice a day; 82 patients of control group were treated with inhalation of salmeterol/fluticasone 250 μg/50 μg twice a day.Basic therapy was the same in two groups. Results After 10-14 days' treatment,forced expiratory volume in one second(FEV1),peak expiratory flow (PEF),6-min walking distance and symptom scores were ( 1.30 ± 0.31 ) L,(245.3 ± 56.1 ) L/min,(263.0±53.2)m,(33.2±12.1)scores in trial group,and (1.21±0.23)L,(213.9±58.4) L/min,(230.0±45.6)m,(37.8± 14.5) scores in control group,respectively.The lung function,6 minute walk distancc and symptom score were improved (t=2.120,3.521,4.279,2.212,all P＜0.05).The frequencies of rescue medication,waking-up suffocating at night and the days of hospital stay were deceased significantly in trial group as compared with control group[(2.5 ± 0.6) time/d,( 1.8 ± 0.5)time/week,(12.9±1.6)dvs.(2.90.8) time/d,(2.2±0.7) time/week,(14.1±1.8) d,t=3.610,4.219,4.524,all P＜0.05].The incidence of adverse reactions was not significant difference between two groups[8 cases(9.6％)vs.7 cases(8.5％),P＞0.05] and the adverse reactions were mild.Conclusions Tulobuterol patch is a newly formulated,effective and safe medication for the treatment of acute exacerbation of AECOPD.

BACKGROUND:The glial scar is a major obstacle to the regeneration of the central nervous system, which plays a physical and chemical barrier role to central nervous system regeneration. How to effectively inhibit glial scar formation and promote axonal regeneration has great significance.
OBJECTIVE:To explore the effect of the immune response in the formation of the glial scar after spinal cord injury.
METHODS:A computer-based online search was performed in the PubMed database and the CNKI database for the articles on the mechanisms of spinal cord injury, immune cel s and spinal cord injury as wel as the glial scar formation after spinal cord injury from January 1990 to January 2013. The key words were “spinal cord injury, immunity, glia scar”in Chinese and English. The languages of the articles were limited in Chinese and English. Final y, 72 articles were included for the further analysis according the inclusion criteria.
RESULTS AND CONCLUSION: After spinal cord injury, the effect of autoimmune response in which stil been much debated. Studies showed that spinal cord injury can cause suppression of cel ular immunity and non-specific immune function, causing immune function decreasing. Monitoring immune indicators and improving immune function have great significance in promoting the ful rehabilitation of patients with spinal cord injury. Glial scar is the most important factor to prevent the repairing after spinal cord injury. Immune and inflammatory response is the main reason to secondary spinal cord injury. Degree of repair after spinal cord injury mainly depends on the protection of the residual neurons in order to keep them off secondary damage. However, autoimmune T cel s can protect the residual neurons, the specific effect of T lymphocytes in glial scar formation after spinal cord injury is stil unclear, and further exploration is needed.

Objective To study the effect of hyperbaric oxygen on cognitive dysfunction in patients with leukoaraiosis (LA). Methods 48 cases of moderate or severe LA with cognitive dysfunction were divided into 2 groups: the experimental group accepted hyperbaric oxygen (HBO) besides routine therapy, while the control group accepted routine therapy only. Both groups were assessed with Montreal cognition assessment (MoCA). Results The scores of MoCA in patients in the experimental group improved after treatment（P<0.05）, and was more than that of the control group（P<0.05）. Conclusion HBO can improve the cognitive function in patients with LA.

Objective To explore the characteristics of cognitive function in patients with leukoaraiosis(LA)at different extent.Methods The cognitive function of 66 patients with different extent of LA and 49 healthy controls were measured using the MoCA scale,and the relationship between the cognitive function and the extent of LA was evaluated.Results The LA was more severe,the cognitive function of patients was more poor.The cognitive function of patients with type Ⅳ LA significantly decreased than the patients with type Ⅰ LA and the controls,especially in the language,memory,visuoconstructional and executive functions(P<0.05).While the function of naming,attention,abstraction and orientation showed no significant difference between the patients with LA and the controls(P>0.05).Conclusion Moderate and severe LA may cause impairment of cognitive function.

Objective To investigate the abnormal expression of proto-oncogene YES-associated protein (YAP) in gastric cancer tissues in the elderly and its correlation with poor prognosis.Methods Clinical data of 80 elderly patients with gastric cancer treated in our hospital from March 2011 to October 2014 were statistically analyzed.Results The positive expression rate of YAP was significantly higher in gastric carcinoma than in adjacent tissues [71.3％ (57/80) vs.13.8％ (11/80),P＜0.05].The positive expression of YAP were significantly associated gastric tumor size,tumor stage,invasion depth and lymph node metastasis (all P＜0.05),but had no correlation with tumor differentiation (P＞0.05).The 5-year survival rate was significantly lower in patients with YAP-positive expression than in patients with YAP-negative expression (P ＜ 0.05),but the differences in 1-year,3-year survival rates were not significant between the two groups (all P＞0.05)The YAP expression,tumor stage,lymph node metastasis were significantly associated with the prognosis of gastric cancer in patients (all P＜0.05).Conclusions YAP-positive expression rate is significantly higher in gastric cancer tissues than in adjacent tissues in the elderly,which indicates poor prognosis of patients with gastric cancer.

AIM: To determine astragaloside Ⅳ in Qixiu Granule (Radix Astragali seu Hedysari, Radix Salviae Miltiorrhizae, Radix Paeoniae Rubra, etc.) by HPLC ELSD. METHODS: HPLC ELSD was used in the quantitative analysis by using Alltima C 18 chromatography column and acetonitril water (34∶66) as a mobile phase. The flow rate of mobile phase was 1mL?min -1 . The tube temperature of the detector was 100?C. The flow rate of pure air was 2.7L?min -1 . RESULTS: The regressione quation was Y=-4.40?105+2.07?105X, r=0.9992 (3.73～13.59?g). The average recovery of astragaloside Ⅳ was 100.73%, RSD was 3.97%. CONCLUSION: The method is simple, reliable, accurate and can be regard as the quantity control method of Qixiu Granule.

BACKGROUND: There are currently many cryopreservation methods for the aminotic membrane, which have varying effects on the ultrastructure and biological activity of amniotic membrane, but on no one is effective.
OBJECTIVE: To compare the effects of different cryopreservation methods on the ultrastructure and viability of aminotic membrane and to seek the ideal cryopreservation method.
METHODS: Aminotic membrane separated from the fresh placenta was preserved respectively with deep-frozen cryopreservation and vitrification, and everyway was run for 3 and 6 months. Fresh aminotic membrane was used as control. The ultrastructure of aminotic membrane was observed by transmission electron microscopy, and the viability of aminotic membrane was assessed by microcomputer analysis system for biological oxygen consumption, and immunohistochemical staining combined with image analysis system was used for lactate dehydrogenase activity.
RESULTS AND CONCLUSION:After 3 and 6 months of crypreservation, the damage to the ultrastructure of aminotic membrane by vitreous cryopreservation was slighter than that of amniotic membrane cryopreserved at-80℃. Compared with the fresh aminotic membrane, the gray value of lactate dehydrogenase and partial pressure of oxygen were significantly decreased in the cryopreserved aminotic membrane by deep-frozen cryopreservation at 3 and 6 months (P < 0.05) and by vitreous cryopreservation at 6 months (P < 0.05), but there was no statisticaly significant difference in the change rate of oxygen partial pressure and the gray value of lactate dehydrogenase between the fresh aminotic membrane and the cryopreserved aminotic membrane by vitreous cryopreservation at 3 months. The present study led to the conclusion that vitreous cryopreservation protocol alows to not only maintain the integrity of AM, but also to preserve the viability of the cels. So the vitreous cryopreservation is superior to the deep-frozen cryopreservation for cryopreservation of aminotic membrane.

Objective To explore the diagnosis and surgical treatment of ileosigmoid fistulas (ISF) complicated by Crohn's disease (CD).Methods 13 CD patients with ISF were collected.Patients' clinical data,diagnostic methods,surgical procedures and outcomes were reviewed.Results Suspected or definite diagnosis was suggested by preoperative imaging in 12 patients.All 13 patients received surgery.Ileal lesions were all removed,while sigmiod fistula were repaired in 11 patients and partially resected in 2 patients.11 patients had a temporary ileostomy.All the patients recovered well,with 3 cases suffering from postoperative complications.Conclusions The diagnosis of ISF can be established preoperatively,and treatment should be individualized to patient' condition.

Objective To investigate the effects of ethyl pyruvate (EP) pretreatment on the liver injury in rats undergoing orthotopic liver transplantation (OLT).Methods Forty male adult SD rats,weighing 220-250 g,served as liver transplant donors and recipients.The recipient rats were randomly divided into 3 groups ( n =8 each):sham operation group (group S),OLT group and EP group.Group S only underwent simple laparotomy.The model of OLT was established according to the modified Kamada's two-cuff technique in groups OLT and EP.EP 40 mg/kg was injected via the caudal vein at 1 h before skin incision in group EP.Venous blood samples were taken at 2 h of neohepatic phase to determine the serum activities of alanine amino-transferase (ALT) and aspartate amino-transferase (AST).Hepatic specimens were obtained to detect the content of malondialdehyde (MDA) and activity of superoxide dismutase (SOD).Results Compared with group S,the levels of serum ALT and AST and MDA were significantly increased and the activity of SOD was significantly decreased in groups OLT and EP ( P ＜0.05 or 0.01).The levels of serum ALT and AST and MDA were significantly lower and the activity of SOD was significantly higher in group EP than in group OLT ( P ＜ 0.05 or 0.01 ).Conclusion Ethyl pyruvate pretreatment can attenuate the liver injury in rats undergoing OLT.

Objective To investigate the value of medical thoracoscopy in diagnosis of pleural effusion of unknown aetiology in aged people.Methods The patients aged 65 years and over,with exudative pleural effusion of unknown aetiology,were enrolled in this study.And they underwent medical thoracoscopy for diagnosis.Results The 49 patients,33 males and 16 females,aged 65-82years (at average age of 70.5 yeas),were enrolled.The 83.7% (41 cases) of pleural effusion was unilateral,and 16.3% (8 cases) was bilateral.The 28.6% (14 cases) of them suffered from tuberculosis,16.3 % (8 cases) malignant tumor.The pathology results of 16 cases showed nonspecific inflammation and normal pleural tissue.The other 10 patients showed a normal pleuracy or abnormal pleuracy undergoing a failure biopsy.Considering the clinical data of the 27 cases,8 cases (16.3 %)had infectious disease,18 cases (38.8%) remained unknown.Diagnostic accuracy of medical thoracoscopy was 61.2%.Complications of these patients undergoing medical thoracoscopy were fever (n=8,16.3%) and subcutaneous emphysema (n=7,14.3%).Conclusions Medical thoracoscopy is a standard option for diagnosing pleural effusion.It could be easily managed by physicians.The complications appear more often in aged people.