Objective To assess the clinical efficacy of budesonide in combination with salbutamol sulfate and ambroxol through fog inhalation in the treatment of elderly patients older than 70 years with acute exacerbation chronic obstructive pneumonia disease (AECOPD). Methods A total of 58 elderly patients older than 70 years with AECOPD were randomly assigned to receive medication of budesonide in combination with salbutamol sulfate and ambroxol through fog inhalation in addition to conventional therapy ( n = 58 treatment group). In the control group,56 AECOPD patients received conventional therapy (including oxygen uptaking,anti-infection, medication, relieving asthma, eliminating sputum, nutritional support, et al). Results The overall effective rate in the treatment group was 76.79% (43/56) ,which was significantly lower than that in the control group 89. 66% (52/58) ( χ2 = 6. 46, P = 0. 007 ). Blood gas analysis ( pH, PaCO2, PaO2 ) and lung function ( FEV1/FVC, FEV1 occupy prospect% ) outcome were significantly improved after treatment (Ps ＜ 0.05 ). We found no significant difference in the comparison of the blood gas analysis improvement between the treatment and control ( Ps ＞ 0. 05 ), whereas significant difference was observed in the improvement on lung function between the two groups (P ＜ 0. 05 ). Conclusion Combined budesonide with salbutamol sulfate and ambroxol through fog inhalation in addition to conventional therapy has a significant better effect and less side effects on the treatment of AECOPD patients older than 70 years.

Objective: To evaluate the application of CT in the diagnosis of fracture position and the cause of diplopia after orbital trauma. Methods:The CT findings and the clinical informations of orbital fractures accompanying diplopias in 68 patients (70 orbits) were retrospectively analysed. Results: Orbital fractures in 70 orbits were diagnosed by CT. There were burst orbital floor fractures in 45 orbits ( among them orbital floor fracture combined with medial wall fracture in 15 orbits), non-burst obital floor fractures in 10, medial orbital fractures in 5, zygomatic-orbital fractures in 5, orbit roof fractures in 5. The accuracy of CT in diagnosing orbital fracture was 100 percent. In 68 cases, there were 64 patients with vertical diplopia and 4 with horizontal diplopia . Conclusion: CT can correctly locate the orbital fracture and diagnose the cause of diplopia.

Complement system is a reaction system comprising 35 proteins with enzyme activity common in serum,tissue fluid and cell membrane. It plays an important role in anti-infection. Abnormal complement activation is involved in incidence and progression of many inflammatory diseases. The complement is activated through typical,alternative and agglutinin pathways. Following cardiovascular stent implantation,the vessel endothelium of patients with coronary atherosclerotic heart disease is damaged; serum complement C3 could enter the arterial wall to damage arterial cells to enhance the permeability release antigenic components of vessel wall,and induce antibody production. The fixing immune complex is formed and induces platelet aggregation,attachment or lipidoses. Although humoral immunity becomes accentuated following cardiovascular stent implantation,the capability to resist microorganism is reduced,which stimulates self-protection of C3,aggravates inflammation,increases circulation complex,activates complement system and aggravates endothelial injury. C3 plays an essential role in occurrence and development of ischemic cardiovascular disease,and is an important cause for restenosis and thrombosis following cardiovascular stent implantation.

Objective To discuss the distributions and drug resistance of gram-positive cocci and provide scientific basis for reasonable use of antimicrobial drugs.Methods One hundred and twenty-five strains were isolated and cultured in our department from January 2009 to December 2011.The drug susceptibility was tested by K-B method and the results were judged by the criteria guideline of CLSI 2009.Results The main strains of separated cocci were Staphylococcus aureus (68,54.4％),Enterococcus faecium (22,17.6％),coagulase-negative staphylococcus (CNS) (20,16.0％),Enterococcus faecalis (6,4.8％),Staphylococcus haemolyticus(7,5.6％)and other gram-positive cocci (2,1.6％).Methicillin-resistant S.aureus (MRSA) and Methicillin-susceptible S.aureus (MSSA) detected were 40 and 28 strains(accounted for 58.8％ and 41.1％ of S.aureaus).The results of drug susceptibility tests showed that the drug resistant rate of MRSA to Gentamicin,Clidamycin,Erythromycin and Ciprofloxacin was up to 87.5％-95.0％,and the drug resistant rate of coagulasenegative staphylococcus to Penicillin,Erythromycin,Clidamycin and Gentamicin was up to 65.0％-95.0％,besides,the drug resistant rate of E.faecalis and E.faecium to Erythromycin,high level Gentamicin and Ciprofloxacin were 86.4％-100％ and 50.0％-66.7％,respectively.No strains with drug resistant to Vancomycin,Teicoplanin and Linezolid were detected.Conclusion S.aureus was the main strains of nosocomial infection of gram cocci.The resistance of gram-positive cocci is severe,so clinicians should attaches great importance to high drug resistance of gram-positive cocci.

Objective To investigate the correlation of epidermal distribution of lamellar bodies and expression of ceramidase with skin barrier dysfunction in polymorphous light eruption.Methods Forty-seven patients with polymorphous light eruption and 40 healthy volunteers were recruited into this study.Noninvasive instruments were used to measure skin sebum content,transepidermal water loss(TEWL)and water content in stratum corneum in all of the subjects.Then,tissue specimens were obtained from the lesions at sunexposed sites in the patients and normal skin of the healthy volunteers.The ultrastructure and distribution of lamellar bodies were observed with transmission electron microscopy in five lesion and control specimens.Immunohistochemistry was performed to detect the expression of ceramidase in the tissue specimens.Results Compared with the normal skin from healthy volunteers,the lesions from patients showed decreased number of lamellar bodies in the granular layer and prick cell layer with a disorganized arrangement.Ceramidase was positively expressed in 20 lesion specimens and 36 normal control specimens,weakly expressed in 21 lesion specimens and 4 normal control specimens,and negative in 6 lesion specimens; there was a significant difference in the expression of ceramidase between the lesion specimens and normal control specimens(P ＜ 0.01).The lesions also showed high TEWL(34.2191 ± 12.70 vs.16.8350 ± 6.50,P ＜ 0.01),lower water content in stratum corneum(22.7319 ± 8.71 vs.29.4250 ± 5.08,P ＜ 0.01)and similar skin sebum content compared with the normal skin.Conclusions There is a disturbance in the synthesis of ceramide in patients with polymorphous light eruption,which may contribute to the impairment of skin barrier.

Objective:To observe the effects of point application,ear point pressing therapy,plus mometasone furoate nasal spray on inflammatory cells and immune function in patients with allergic rhinitis(AR). Methods:Fifty AR patients who received point application,ear point pressing therapy,and mometasone furoate nasal spray for treatment were recruited as an observation group.Simultaneously,another 50 AR patients who only used the same nasal spray were enrolled as a control group.The clinical efficacy was compared between the two groups,and the inflammatory cell count and immune function changes were observed after treatment. Results:The observation group had a higher total effective rate than the control group(P<0.05).After treatment,significant decreases were noticed in the total nasal symptom score,eosinophils count in nasal secretions,and serum immunoglobulin E(IgE)level in both groups(P<0.05),and the observation group was significantly lower than the control group(P<0.05). Conclusion:Combining point application,ear point pressing therapy,and mometasone furoate nasal spray can produce satisfactory treatment results for AR.This method is safe and can reduce inflammatory responses and improve immune function.

OBJECTIVE: To investigate the effects of interventional therapy with norcantharidin-alginic acid/poly acid anhydride microspheres (N-MS) infusion via hepatic artery on hepatoma in rats. METHODS: N-MS was prepared by emulsion-chemical crosslink technique. Eighty-nine hepatoma-bearing rats were randomly divided into five groups, which were normal saline group, norcantharidin (NCTD) group, blank microsphere (B-MS) group, NCTD-lipiodol group and N-MS group. Normal saline, NCTD, B-MS, NCTD-lipiodol and N-MS were injected via hepatic artery accordingly. After the interventional therapy, eight rats from each group were observed for survival time, and the rest rats were killed on the 8th day after intervention to measure the tumor volume and necrostic degree. The apoptotic index of liver tumor cells was detected by TUNEL staining, and the expression of ki-67 was assayed by immuno-histochemical streptavidin-biotin peroxidase method. RESULTS: The survival time of the rats in the N-MS group was prolonged as compared with those in the other four groups, and the tumor volume of the rats in the N-MS group was smaller than those in the other four groups. The tumor growth rate and the expression level of ki-67 in the N-MS group were both significantly lower than those in the other four groups. The tumor necrotic degree and the apoptotic index in the N-MS group were significantly higher than those in the other four groups. CONCLUSION: Interventional therapy with N-MS could yield preferable therapeutic effects on hepatomas in rats. This anti-tumor efficacy may be associated with microvessel embolization in liver tumor and the sustained releasing of NCTD. Its inhibiting effect on tumor cell proliferation maybe result from decreasing the expression of Ki-67 and inducing the tumor cell apoptosis.

Objective To observe the effect of ultraviolet irradiation comparising 95％ ultraviolet A (UVA)and 5％ ultraviolet B(UVB)on the proliferation of human epidermal keratinocytes(HEKs),in hope to offer a basis for the construction of a photodamaged skin model induced by sunlight.Methods HEKs were isolated from foreskin tissue and cultured in vitro.After several passages,the HEKs were irradiated with different doses(0,2.5,5,10,20,30,40,60 J/cm2)of UV comprising 95％ UVA and 5％ UVB.Methyl thiazolyl tetrazolium(MTT)assay was used to evaluate cell viability after 24 hours of additional culture.SPSS 17.0 software was used to calculate the median lethal dose(LD50)of ultraviolet radiation in HEKs.Results The proliferation of HEKs was inhibited by 0,1.03％,6.60％,17.28％,31.28％,49.59％,59.67％ and 70.99％ respectively after irradiation with UV of 0,2.5,5,10,20,30,40 and 60 J/cm2.A significant inhibition of cell proliferation was observed in HEKs irradiated with UV at a dose of no lower than 10 J/cm2 compared with unirradiated HEKs(F =62.11,P ＜ 0.05).The LD50 of UV in HEKs was 31.31 J/cm2.Conclusions Aas the dose of UV irradiation increases,the proliferative activity of HEKs decreases,with the LD50 of UV being 31.31 J/cm2.

Objective To evaluate the results of thoracic endovascular aortic repair (TEVAR) for chronic type B aortic dissection.Methods From September 2005 to January 2013,30 patients with chronic type B aortic dissection received TEVAR.All patients were followed for 2-90 months [mean (33 ±25) months].Results All of the procedures finally achieved technical success.However,during TEVAR,there were transient endoleaks in 8 patients including type Ⅰ endoleaks in 3 patients,type Ⅱ endoleaks in 5 patients and persistent endoleaks in 3 patients which are type Ⅳ endoleaks.Type Ⅰ and type Ⅱ endoleaks were successfully managed during the procedures.There was no mortality or major complication during the perioperative period.Three patients died during follow-up:one patient died of carcinoma of the colon and two patients died of the complications of secondary interventions related to aortic dissection.Totally there were seven patients receiving secondary interventions.The Kaplan Meier actuarial survival curve showed a 5-year survival rate of 87.9％ and the 5-year survival rate without secondary intervention was 72.8％.Conclusions Early and midterm results showed that TEVAR was effective in treating chronic type B aortic dissection.

ObjectiveTo explore the effects of epidermal proteins and lamellar bodies on skin barrier in glucocorticoid-dependent dermatitis.MethodsTotally,60 patients with glucocorticoid-dependent dermatitis and 40 normal human controls were eligible for this study.A noninvasive method using TewameterTM was applied to determine transepidermal water loss (TEWL) value in these subjects.Tissue specimens were obtained from the lesions of 13 patients with glucocorticoid-dependent dermatitis and normal skin of 10 human controls.Subsequently,haematoxylin and eosin(HE) staining was performed to observe the histopathological changes,immunohistochemistry to detect the protein expressions of K6,K10,K14,K15,loricrin,filaggrin,involucrin in epidermis,and electron microscopy(EM) to estimate the density of lamellar bodies in tissue specimens.ResultsCompared with the normal controls,the patients displayed an elevated TEWL value (P ＜ 0.05),which suggested an impaired epidermal barrier.Histopathology of lesions revealed nonspecific inflammatorychanges withmarkeddifferencesbetweendifferentclinicaltypesofglucocorticoid-dependentdermatitis.Immunohistochemistry revealed an attenuated expression of K10,K14,loricrin,filaggrin,involucrin and abnormal expression of K15 in lesional epidermis compared with the normal epidermis (all P ＜ 0.05),hinting a suppression of epidermal differentiation and proliferation as well as an impairment of cornified envelope structure.The number and density of lamellar bodies were also reduced in lesional epidermis compared with the control epidermis.ConclusionsCompared with normal skin,the structure of skin barrier is impaired in lesions of glucocorticoid-dependent dermatitis,to restore skin barrier is essential for the treatment of this entity.