Objective:To observe the effects of salmeterol and fluticasone combined with the conventional treatment on the airway remodeling and bone metabolism in the patients with severe chronic obstructive lung disease ( chronic obstructive pulmonary disease, COPD. Methods:Totally 90 patients with severe COPD were divided into the observation group and the control group according to the order of admission. The control group was received the conventional treatment, and the observation group was treated with salmeterol and fluticasone additionally. The course of treatment was 8 weeks. Before the treatment and in the 3rd and 12th month after the treat-ment, the changes in the levels of bone mineral density ( BMD) in femoral neck bone, serum osteocalcin ( BGP) , alkaline phosphatase (AKP), the total number of induced sputum cells, neutrophils percentage, forced expiratory volume in one second (FEV1), leukocyte mediated element 8 (IL-8), matrix metalloproteinase 9 (MMP-9) and other indicators were detected and compared. Results: BGP, AKP and BMD of the two groups in the 3rd month after the treatment were not significantly changed (P>0. 05), while in the 12th month after the treatment, BMD in the observation group was significantly lower than that in the control group and that before the treat-ment, and BGP and AKP in the observation group were significantly higher than those in the control group and that before the treatment (P<0. 05). The total number of induced sputum cells, the percentage of neutrophils, FEV1, MMP-P and IL-8 in the two groups were significantly improved in the 12th month after the treatment (P<0. 05), and the difference between the two groups was statistically sig-nificant except IL-8 (P<0. 05). Conclusion:Salmeterol and fluticasone propionate can effectively improve airway remodeling in the patients with COPD. Short time use of salmeterol and fluticasone propionate shows no adverse effect on the bone metabolism, while long-term use would lead to reduced bone mineral density.

Objective To investigate the effect of improved bone plate fixation and bone grafting in the treat ment of intra-articular calcaneal fracture.Methods 80 patients with intra-articular calcaneal fractures were randomly divided into the two groups.The non-bone graft group(47 feet in 40 patients)was given improved bone plate fixation.The bone graft group(50 feet in 40 patients)was given improved bone plate fixation and bone grafting.Results The incidence rate of complication in the non-bone graft group was 25.0％ and that in the bone graft group was 19.1％.The difference between the two groups was not significant(x2 =0.21,P ＞ 0.05).Postoperative Bhler's angle and calcaneal height between the two groups had significant differences (t =14.5,16.99,all P ＜ 0.05).The excellent rate of Maryland functionality in non-bone graft group was 66.0％,which was significantly lower than 86.0％ in the bone graft group(x2 =5.38,P ＜ 0.05).The average full weight bearing time between the two groups had significant difference (t =11.17,P ＜ 0.05).Bhler's angle after 1 year and forwa rd Bhler's angle loss of the non-bone graft group had significant differences compared with the bone graft group (t =29.76,9.81,all P ＜ 0.05).Conclusion Improved bone plate fixation and bone grafting in the treatment of intra-articular calcaneal fracture can obtain better results and avoid the long-term loss of reduction.

BACKGROUND: Eye acupuncture therapy is a technique used to adjust qi-blood circulation, relax muscles and tendons, and activate col aterals by acupuncture at the acupoints around the eye bal s and in the orbital border. This therapy has been widely used in the clinic because it exhibits remarkable therapeutic effects on many ischemic cerebrovascular diseases. However, the precise mechanism behind this therapy remains poorly understood. Neurotrophic factors are a protein family including neurotrophic factors and brain-derived neurotrophic factors that can regulate neuronal survival, development and functioning.
OBJECTIVE: To investigate the effects of eye acupuncture therapy on neurological function and nerve growth factor and brain-derived neurotrophic factor expression in the brain tissue of rat models of cerebral ischemia/reperfusion injury.
METHODS: Fifty-four male Sprague-Dawley rats were randomly divided into three groups with 18 rats per group: sham-operated, model and eye acupuncture therapy groups. Rat models of middle cerebral artery occlusion were established by the intraluminal suture method in the model and eye acupuncture therapy groups. Eye acupuncture was performed at the fol owing acupoints liver area, upper-jiao area, lower-jiao area and kidney area located at the internal orbital margin at 2 hours after cerebral ischemia/reperfusion injury. Rat neurological function was evaluated at 3, 7, and 14 days after injury. Nerve growth factor and brain-derived neurotrophic factor expression in the rat brain tissue was detected using immunohistochemical staining method at 1 and 2 weeks after treatment. Cerebral infarct size was determined using TTC staining at 2 weeks after treatment.
RESULTS AND CONCLUSION: (1) At 1 and 2 weeks after injury, nerve growth factor and brain-derived neurotrophic factor expression was significantly greater in the eye acupuncture therapy group than in the model group (P < 0.05), but nerve growth factor and brain-derived neurotrophic factor expression in the eye acupuncture therapy group was decreased at 2 weeks after injury compared to that at 1 week after injury. (2) At 7 and 14 days after treatment, neurological function scores in the eye acupuncture therapy group were significantly lowered, and there was significant difference between eye acupuncture therapy and model groups (P < 0.05), but they were significantly higher than those in the sham-operated group (P< 0.05). (3) At 2 weeks after treatment, cerebral infarct size was significantly greater in the eye acupuncture therapy and model groups than in the sham-operated group (P < 0.01), and it was significantly smal er in the eye acupuncture therapy group than in the model group (P < 0.05). (4)These results indicate that eye acupuncture therapy shows neuroprotective effects on ischemic cerebral injury by increasing nerve growth factor and brain-derived neurotrophic factor expression, improving neurological function, and reducing cerebral infarct size.