Objective To investigate the clinical effect of Xuanfei Zhike Pingchuan decoction combined with budesonide in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods84 patients with AECOPD in our hospital from June 2014 to June 2016 were selected and randomly divided into the observation group and the control group.The control group was given budesonide and the observation group on the basis of the control group was given Xuanfei Zhike Pingchuan decoction.The clinical efficacy, the levels of inflammatory cytokines and pulmonary function were compared between the two groups.ResultsThe total effective rate for clinical treatment in the observation group was significantly higher than the control group(P<0.05).The levels of IL-6 and TNF-α in the observation group after treatment were significantly lower than the control group (P<0.05),while the levels of FEV1% and FEV1/FVC were obviously higher than the control group (P<0.05).ConclusionXuanfei Zhike Pingchun decoction combined with budesonide on ARCOPD has a significantly curative effect and can effectively improve the inflammatory response and recovery of pulmonary function.

Objective To study the effect of method for activating blood circulation, removing blood stasis and resolving phlegm on hypercoagulable state and cardiopulmonary function in patients with COPD and pulmonary heart disease.Methods68 cases of patients with COPD and pulmonary heart disease treated in our hospital were enrolled in the study.According to different treatment methods, they were divided two group.Both groups were treated with routine western medicine and the study group were additionally treated by method for activating blood circulation, removing blood stasis and resolving phlegm.The curative effect was compared between the two groups.ResultsThe condition of respiratory and cardiac insufficiency in the study group was significantly better than that in the control group (P<0.05).The total effective rate of treatment in the study group was significantly higher than that in the control group (94.12% vs 76.47%) (P<0.05).The PT and APTT in the study group were significantly longer than those in the control group, and FIB was significantly lower than that in the control group (P<0.05).ConclusionThe method for activating blood circulation, removing blood stasis and resolving phlegm is effective in the treatment of patients with COPD and pulmonary heart disease.The method can effectively improve the cardiopulmonary function and relieve the hypercoagulable state in patients.

Ethmo-maxillary bone buttress (EMBB) is a special complex bone structure in the interface between the internal wall and inferior wall of the orbit, which plays a vital role in maintaining the stability of the orbit, ethmoidal sinus and maxillary sinus.Although the incidence of compound fractures in orbital blowout fractures is lower than that of single orbital wall fractures, they have more obvious clinical symptoms such as enophthalmia and binocular diplopia.The mechanism of EMBB may be more supportive of the orbital floor compression theory, that is, the external force will lead to torn periostum and bone seam separation at the ethmoidomaxillary suture, and the orbital contents will form a funnel-like hernia due to extrusion and gravity.Or the extrusion results in the fracture and displacement of the orbital lamina of ethmoid bone, the upper wall of the maxilla and the ethmoidomaxillary plate, causing a large area of orbital wall collapse and obvious expansion of the orbital cavity.Recently, the study of orbital internal wall and inferior wall joint fracture has become a new hotspot, but research on the orbital blowout fracture involving ethmo-maxillary bone buttress is still in its infancy.The current orbital fracture repair technique can only restore the connection between the two orbital walls, and there is no surgical plan can overall recover EMBB's scaffolds role.Therefore, how to restore the scaffolds role of EMBB, and to regain the part of ostiomeatal complex in normal sinus drainage is the challenge we need to conquer.In this article, the anatomy and clinical characteristics of the supporting structure, fracture mechanism, and the research progress and prospect of surgical repair technique were reviewed.

Objective To establish the database of brain trigeminal evoked potentials for our laboratory,latency and interpeak latency of brain trigeminal evoked potentials were measured in normal volunteers.Methods Trigeminal nerves in 40 normal volunteers were stimulated with the evoked potential instrument.The results were collected with three-channel records in different ways at the same time.Results It showed two main waves,T1′(-) and T2′(+),in the brain trigeminal evoked potential records with C3,and their latencies were (3.020 5?0.828 9)ms and(6.736 0?1.393 9)ms;its T2-T1 interpeak latency was(3.743 8?1.206 0)ms.Conclusion C3 records showed more stability on brain trigeminal evoked potentials in normal volunteers,it would be helpful to investigate the brain trigeminal evoked potentials in patients.

Objective To investigate the relationships between axillary lymph node metastasis and clinicopathologic features in the patients with cT1-2 N0 breast cancer and clarify the law of axillary lymph node metastasis,and to find the risk factor,and provide the theoretical basis for individuation therapy.Methods 687 patients with cT1-2 N0 breast cancer were divided into negative group and positive group according to the pathological results of axillary lymph node,and the clinicopathologic features were layered.The risk factors of axillary lymph node metastasis were screened out by Chi-square test and Logistic regression analysis.Results In 687 cases of cT1-2 N0 breast cancer,156 (22.7%)cases were observed with axillary lymph node metastasis. The age,cT stage,pT stage, pathological type,vascular invasion,perineural invasion estrogen receptor (ER),progesterone receptor (PR), and molecular subtyping were the factors that influenced axillary lymph node metastasis in univariate analyses.The age < 35 years, cT2 , invasive ductal carcinoma, vascular invasion positive and Luminal subtyping were the independent risk factors of axillary lymph nodes metastasis in multivariate analyses (r = 3.440,P = 0.010;r =1.770,P =0.007;r = 3.397,P = 0.001;r = 7.434,P = 0.000;r = 2.212,P = 0.015).Conclusion In the patients with cT1-2 N0 breast cancer,the age,cT,pathological type,vascular invasion and molecular subtyping are important predictors of axillary lymph node metastasis and vascular invasion was the most important predictor.The preoperative comprehensive analysis and evaluation of clinical data and preoperative pathological results obtained will help to select the right surgical operation.

Objective To investigate the effect of acupuncture at Zusanli, Sanyinjiao and Danzhong on mammary estrogen receptor (ER) and progesterone receptor (PR) expressions in rats with dimethylbenzanthracine (DMBA)-induced mammary cancer. Methods One hundred and twenty female SD rats aged 6-8 weeks were randomized into a model group of 60 rats and a blank group of 30 rats. The model group received an oral gavage of DMBA for model making. The blank group received an oral gavage of equal volume of sesame oil. At 15 weeks after model making, the model group of rats was randomized into treatment and control groups. The treatment group received acupuncture at Zusanli, Sanyinjiao and Danzhong, and the control and blank groups, only the same grasp and release. After the completion of acupuncture treatment (twenty-seventh week), abdominal venous blood was taken and serum tumor markers were determined by electrochemiluminescence immunoassay. Tumor masses were counted and their shapes were recorded. The mass was taken and its height, maximum diameter and vertical diameter were measured using a 1 mm precision vernier caliper. Pathological changes in tumor tissues, and ER and PR positive areas and mean optical densities were observed under an Olympus optical microscope.Results There were statistically significant post-treatment differences in the average number and volume of mammary tumors between the treatment group and the control or blank group (P<0.01,P<0.05) and between the control and blank groups (P<0.01). There were statistically significant post-treatment differences in the concentrations of various tumor markers (CA724, CA125, CA199, AEP, CA15-3, CEA and CA50) between the treatment or control group and the blank group (P<0.01,P<0.05) and between the control and blank groups (P<0.01). There was a statistically significant post-treatment difference in CA15-3 concentration between the treatment and control groups (P<0.01). There were statistically significant post-treatment differences in ER and PR positive areas and mean optical densities between the treatment group and the control or blank group (P<0.01) and between the control and blank groups (P<0.01).Conclusions Acupuncture can reduce the occurrence of rat DMBA-induced mammary tumor (including the number and volumes of the tumors). The mechanism of its action may be related to decreasing the concentrations of tumor markers CA724, CA125, CA199, CA15-3, AEP, CEA and CA50 and especially to decreasing CA15-3 concentration, and ER and PR positive areas and mean optical densities.

phological changes in rat liver tissues. TLR4 and NF-κB expression in the liver tissues were measured by im-munohistochemistry . The results showed that compared with the normal group , the serum levels of transaminase ( ALT , AST ) and endotoxin of the model group were higher ( P < 0 . 01 ); and the degree of liver pathology injury was significantly increased; the TLR4 and NF-кB expression were increased (P < 0.01). Compared with the model group, the serum levels of transaminase (ALT, AST) and endotoxin of the experimental group were lower (P < 0.01), the degree of liver pathology injury was significantly lighter; the TLR4 and NF-кB expression were significantly lower (P < 0.01). It was concluded that the WYJDHY granules has a good role in the prevention and treatment of liver injury of rat model of hepatic failure IETM through the downregulation of liver expression of TLR4 and NF-кB in rat liver tissues , reducing serum levels of endotoxin , which may be one of the mecha-nisms on hepatic failure treatment .

Two cases of frontal fibrosing alopecia (FFA) were reported.Case 1,a 44-year-old woman,presented with progressive recession of the frontotemporal hairline for 4 years and multiple skincolored facial papules for 2 years.Skin examination showed that the frontotemporal hairline was receded,the local skin was smooth and thin,and a few remaining fine hairs could be seen.Additionally,eyebrows,axillary and pubic hairs were partly shed,and plenty of millet-sized skin-colored papules were diffusedly distributed on the frontotemporal region and bilateral mandibular angles.Dermatoscopy showed reduced hair follicular openings,different hair shaft diameters,cicatricial white patches and perifollicular erythema.Case 2,a 55-year-old woman,presented with progressive frontotemporal hair loss for 2 years.Skin examination revealed the recession of bilateral frontotemporal hairline and partial loss of eyebrows,axillary and pubic hairs.Histopathological examinations of the 2 patients both revealed perifollicular infiltration of lymphocytes,liquefaction degeneration of basal cells and perifollicular lamellar fibrosis.Clinical manifestations and histopathological features of the 2 patients both confirmed the diagnosis of FFA.

Objective To evaluate the safety and efficacy of the valve sparing aortic reimplantation in selected patients with acute type A aortic dissection(AAAD).Methods From October 2012 to March 2014, 65 AAAD patients with entry tear located in the sinus of Valsalva and/or genetic: syndrome underwent emergent operation.Of them, 34 patients had valve sparing aortic reimplantation(David Ⅰ group) , and 31 patients underwent aortic composite replacement(Bentall group).Results No operative mortality was observed in this study.In-hospital mortality(8.8％ vs.9.7％ , P ＞ 0.05) and morbidity (25.4％ vs.27.9％, P ＞0.05) were comparable between two groups.All the patients underwent arch replacement and stented elephant trunk implantation concomitantly.Mean cross-clamp time [(149 ± 23) min v s.(124 ± 21) min, P ＜ 0.05] was longer for David Ⅰ group, while mean cardiopulmonary bypass time[(186 ± 77) min vs.(193 ± 89) min, P ＞0.05] and mean operation time [(341 ± 137) min vs.(378 ± 174) min, P ＞ 0.05] had no significant difference between two groups.The blood transfusion was significantly reduced in David Ⅰ group than that in Bentall group[(1 180 ±490) ml vs.(1 790 ±560) ml, P ＜0.05].The mean follow-up was(17.6 ± 5.4) months(range, 8-26 months).In David Ⅰ group, one patient with genetic syndrome died of ruptured abdominal aortic aneurysm 18 months postoperatively.Two late deaths occurred in Bentall group due to intracranial hemorrhage after 9 months and ruptured infective pseudoaneurysm after 13 months respectively.In David Ⅰ group, average grade of aortic regurgitation 6 months postoperatively was 0.6 ± 0.4.At the latest visit, no pseudoaneurysm on anastomosis was observed.Besides two patients from Bentall group were in NYHA class Ⅱ , all the other patients presented in NYHA class Ⅰ.Conclusion David Ⅰ aortic root reimplantation can be performed safely and obtain excellent short-term results in selected patients with AAAD.Long-term results need continuing follow-up.

Objective To investigate the clinical application value of retroperitoneal laparoscopic nephrectomy for nonfunctioning kidney.Methods Fifty-four cases of retroperitoneal laparoscopic nephrectomy for nonfunctioning kidney were reviewed,including 9 cases with nonfunctioning tuberculosis pyonephrosis,18 cases with infection nonfunctioning pyonephrosis and 27 cases of nonfunctioning hydronephrosis.Fifty-four cases were received retroperitoneal laparoscopic nephrectomy,tuberculous and infection pyonephrosis underwent laparoscopic resection surrounding adipose capsule,nonfunctioning hydronephrosis underwent laparoscopic resection by pumping water to increase the peritoneal space.Results The operation of 54 cases were perfomed successfully.None of the patient required conversion to open surgery.During the surgery,1 case showed mild extravasation of cheese-like pus induced by laceration of the kidney capsule;2 cases had injuried on the peritoneum.The mean operation time was 125 (95-230) min,the mean blood loss was 84 (50-420) ml.All patients showed primary healing of the wound,the patients were discharged from the hospital in 6 to 11 d (mean 7.5 d).After followed up for 5-27 months,none of them had long-term complication.Conclusions Retroperitoneal laparscopic nephrectomy for nonfunctioning kidney has advantages of minimal invasion,less blood loss and quicker recovery,so it is a fairly safe and effective procedure for nonfunctioning kidney.