Objective To explore the effect of budesonide combined with ipratropium bromide in the treat-ment of acute exacerbations of chronic obstructive pulmonary disease,and observe the adverse reactions during treat-ment.To analyze the treatment of safety and to provide the basis for clinical treatment.Methods 160 cases of acute exacerbations of chronic obstructive pulmonary disease were selected,they were randomly divided into the control group A,B,C and the observation group,with 40 cases in each group.The control group A was treated with prednisone and other conventional,control group B was treated with aminophylline and other conventional treatment,the control group C application included prednisone,aminophylline and other conventional treatment,all the control group were treated with 0.9% sodium chloride solution inhaled as a placebo spray.And the observation group application of budesonide was combined with ipratropium bromide based on the routine treatment.Mainly the effect of treatment was observed,and the blood carbon dioxide partial pressure (PaO2 ),partial pressure of oxygen (PaCO2 ),forced expiratory volume in one second (FEV1 ),forced expiratory volume in one second (FEV1 )and forced expiratory volume in one second to forced vital capacity ratio of FVC (FEV1 /FVC)before and after treatment were detected.And the adverse reactions were observed to evaluate its safety.Results The total effective rate of the observation group was 95.00%(38 /40),which were higher than the control group A,B and C,the differences were statistically significant (χ2 =9.68,9.70,9.91,all P <0.05).The PaO2 level of the observation group after treatment was (76.89 ±0.63)mmHg, which were higher than that of the control group after treatment (73.66 ±0.47)mmHg,and that of two groups after treatment were higher than those before treatment,the differences were statistically significant (t =10.48,13.72,12.83,all P <0.05).The PaCO2 of the observation group after treatment was (50.06 ±0.60)mmHg,which were lower than that of the control group A,B and C after the treatment,each group after treatment was lower than that before treatment,the differences were statistically significant (t =11.72,12.69,10.74,all P <0.05 ).FEV1 and FEV1 /FVC of the observation group after treatment were (2.19 ±0.29)L and (69.27 ±0.59)%,which were higher than those of the control group A,B and C after treatment,and each groupafter treatment was higher than that before treatment,the differences were statistically significant (t =12.68,13.10,12.41,9.89,10.63,11.29,all P <0.05). Comparison of adverse reactions in each group,the difference was not statistically significant (χ2 =1.38,P >0.05). Conclusion It has good clinical curative effect on budesonide combined with ipratropium bromide for the treatment of acute exacerbations of chronic obstructive pulmonary disease patients,which can significantly improve the pulmona-ry function of patients,shorten recovery time,and has high security.It is worthy of clinical application.

Objective:To enhance hospital equipment information management standards for the purpose of measurement instruments.Methods:Using solutions based on Web technology, database technology, database through the establishment of measurement devices, implement life cycle management method.Results: To solve the many hospital only attach importance to the management of medical equipment, ignore the metering device management, lead to measuring instruments record disorder, query the inconvenience problem.Conclusion: Medical device measurement equipment management system improves the ability of the hospital information management, strengthens the efficiency of communication and exchanges of various departments and produces good economic and social benefits.

BACKGROUND: Chitosan and sodium alginate are the good natural materials for microcapsule, and also used widely in tissue engineering. Our research teams have made thorough work at anticoagulant materials, but these materials are inert or simulate the liquid crYstal form of blood vessel wall. While in this experiment, on the base of our previous study, we microencapsulated heparin with biotic anticoagulation activity and other specific performances in order to enable microcapsule to have a long time releasing effect of medicine.OBJECTIVE: To microencapsulate the low molecular heparin so as to ensure the stability of heparin in vivo and analyze the effect of content of chitosan on the performance of heparin microcapsules basing on the natural chitosan and sodium alginate as the enwrapped materials of microcapsules.DESIGN: Open experiment.SETTING: Department of Material Science and Engineering, Jinan University.MATERIALS: The experiment was performed at the laboratory of Department of Material Science and Engineering, Jinan University from October 2004 to June 2005. Heparin, with relative molecular mass＜ 5 000, was provided by Shandong Freda Biochem Co., Ltd.,; Chitosan was provided by Shanghai Bio Life Science & Technology Co., Ltd, DD≥90%, η＜ 100 cps;Sodium alginate was provided by Qingdao Bright Moon Seaweed Industrial Co., Ltd. Emulsions were Span80, and CaCl2, which were both made in China.METHODS: ①Preparation of heparin/chitosan microcapsules (HCM):Some heparin aqueous solution was emulsified in liquid paraffin. The reaction system was stirred fully and presented emulsion. Then the whole reaction system was warmed to be at 50 ℃ and maintained for 20 minutes. Afterwards, 20 g/L chitosan solution was added slowly, subsequently with raising the temperature to be at 60 ℃ and then glutaraldehyde was dropwised keeping the reaction system at 80 ℃ for 1hour. Centrifugation, filtration and washing followed by washing with kerosene fully, remain organic was extracted by dehydrated alcohol with extractor were performed.Drying and xeransis in vacuum were done at last. ② Preparation of heparin-sodium alginate-chitosan microcapsules (HSCM) :Heparin aqueous solution and sodium alginate were emulsified in paraffin, and the reaction system was stirred into emulsion at room temperature for 20 minutes, then 3% CaCl2 solution containing different concentrations of chitosan was added slowly. 30 minutes later, Microcapsules were separated, washed and dried as the treatments as before. ③ Drug content and envelope efficiency were measured, heparin standard curve was determined and in vitro releasing effect of heparin microcapsules was also measured.MAIN OUTCOME MEASURES: ①Effect of chitosan solution concentration on preparation of heparin-chitosan microcapsules; ② Effect of glutaraldehyde dosage on preparation of heparin-chitosan microcapsules; ③Effect of sodium alginate concentration on hepatin-sodium alginate; ④Effect of chitosan concentration on hepatin-sodium alginate-chitosan microcapsules. ⑤ In vitro release of heparin microcapsules enwrapped by different materials. ⑥Measurement of heparin content and envelope efficiency. ⑦ Observation of heparin microcapsule under scanning electron microscope RESULTS: ①With the increasing concentration of chitosan, the color of production changed from yellow to dark, and microcapsules were increscent, but the microcapsules uniformity and property of balling were increased. ②The increasing content of glutaraldehyde led darker production.Increase of glutaraldehyde content made production bond each other severely. The glutaraldehyde, which did not react with chitosan, can solidify itself and presented anomalous microcapsules forming. ③There was not obvious balling property of the production with the change of concentration of sodium alginate. ④The balling property of microsphere was good with increasing concentration of chitosan. However, microcapsules conglutinated with each other. 2% chitosan would be better. ⑤With the increase of chitosan content, the releasing speed ofheparin became slow. ⑥The envelope efficiency was about 58% when microcapsule contained 20%(wt) of chitosan, and used chitosan only the envelope efficiency could approach to 79.9%. ⑦ The surface of microcapsules with chitosan was very compact,and with increasing of content of glutaraldehyde, microcapsules would bond each other.CONCLUSION: Chitosan at certain concentration will affect the uniformity and balling property of microcapsules. Chitosan dosage can alter the envelope efficiency of heparin. Envelope efficiency of heparin is increased and releasing speed of heparin is decreased with the increase of content of chitosan.

Objective To explore the effect of clinical nursing pathway (CNP) in perioperative nursing for breast cancer,especially the instructive important role in the rehabilitative excises postoperation and after discharge.Methods In accordance with the standard for the entry and exit of the CNP,102 patients with breast cancer were randomly divided into the experimental group (50 patients) and the control group (52 patients),the experimental group received the care of clinical nursing pathway and the control group received the traditional care.The effect of clinical nursing pathway on the following aspects such as the level of mastering knowledge about hospitalization,self-care ability after discharge,the degree of satisfaction about nursing were compared between the two groups.Results Compared with the control group,the level of mastering knowledge about hospitalization and self-care ability after discharge in the experimental group were significantly better,the degree of satisfaction about nursing reached 98.92%,which was higher than that of the experimental group.Conclusions Application of the full care model with CNP demonstrated good effect on the perioperative nursing for breast cancer,it encourages patients to do the limb functional training,promotes the recovery of disease,and then shortens hospital stay and saves hospital costs.

Objective To observe whether hydrogen sulfide modulates adipocytes to secrete adiponectin.Methods Thirty-two male SD rats were randomly divided into normal diet group (n =8),high-fat diet group (n =8),high-fat + cysteine group (n =8),and high-fat + propargylglycine (cystathionine-γ-lyase inhibitor) group (n =8).The fatty liver animal model was established using the high fat diet; meanwhile,L-cysteine was applied to the animals to produce endogenous hydrogen sulfide and propargylglycine to inhibit the production of endogenous hydrogen sulfide.Fatty degeneration of the hver of animals and plasma within the adiponectin concentration was observed after 8 weeks.The omental adipose tissues were excluded and digested using collagenase Ⅰ to isolate fat cells.Sodium hydrosulfide and propargylglycine was applied to stimulate the cells in vitro for 7 days before the detection of the cell supernatant adiponectin content.Results Liver steatosis was established after highfat diet for eight weeks.Steatosis was significantly extenuated after the application of L-cysteine and aggravated by propargylglycine.Plasma hydrogen sulfide and adiponectin levels in fat diet group animals were (21.13 ± 7.06) mmol/L and (3.16 ± 1.15) mg/L respectively,which significantly decreased when compared with the normal diet group with the levels of hydrogen sulfide (29.13 ± 13.06) mmol/L and adiponectin (8.98 ± 2.84) mg/L (P=0.0229,P=0.0062).Hydrogen sulfide [(35.47 ±9.04) mmol/L] and adiponectin [(6.54 ± 1.38) mg/L] levels in the high fat + cysteine group significantly increased (P =0.0032,P =0.0131).However,hydrogen sulfide [(16.65 ±8.79) mmol/L] and adiponectin [(2.50±0.91) mg/L] in high fat + propargylglycine group were significantly decreased (P =0.0191,P =0.0021).Hydrogen sulfide was not significantly differem in the supematam of adipocyte isolated from normal diet group [(26.77 ± 12.65) mmol/L] and from high-fat diet group [(28.76 ±9.09) mmol/L] (P =0.0927),but that in the sodium hydrosulfide and propargylglycine ceils supematants significandy either increased or decreased (P =0.0000,P =0.0000).Adiponectin in the supematants of high-fat diet group and normal diet group adipocyte showed no significant difference [(4.21 ± 1.61) mg/L vs (4.49 ± 1.09) mg/L,P =0.1076)].The levels of adiponectin in sodium hydrosulfide and propargylglycine cell supernatants increased and decreased respectively than that in higher fat diet group cells [(5.77 ±0.86) mg/L vs (4.21 ±1.61) mg/L,P =0.0094; (3.01 ±1.26) mg/L vs (4.21 ± 1.61) mg/L,P =0.0108].Conclusion Hydrogen sulfide promotes adipocytes to secrete adiponectin.

Objective To investigate the diagnostic value of MSCT with multi-planar reconstruction(MPR)and maximum intensity projection(MIP)in diagnosis of spinal burst fracture.Methods 45 patients(53 vertebras)with vertebral burst fracture were examined by MSCT and processed with MPR and MIP.The imaging features were analyzed comparatively.Results The axial images clearly demonstrated the vertebral body vertically or transversely burst crack in 49 vertebras(92.5%),bony fragment inserted into the spinal canal and stenosis of spinal canal in 34 vertebras(64.2%).The sagittal images showed kyphosis in 28 vertebras(62.2%).The sagittal and coronal images showed decreased height of the vertebral body in 37 vertebras(69.8%)and depressed fracture of vertebral end plate in 19 vertebras(35.8%).Total 44 fractures were located at spinal appendix,39 were showed by axial images,35 by sagittal images and 33 by coronal images.MIP displayed the space changes of bone structures in all cases and rotary dislocation fracture in 6 cases(11.3%).Conclusion MPR and MIP are of significant values in diagnosis and clinical treatment of spinal burst fracture.

Tumor cell plasticity, including epithelial to mesenchymal transition (EMT) and its reverse program, mesenchymal to epithe-lial transition (MET), regulates circulating tumor cells and carcinoma metastasis. Twist is overexpressed in rhabdomyosarcoma, breast cancer, gastric cancer, and other tumors. Twist, as a transcriptional factor, cross-talks with multiple signaling pathways, forming a com-plex network to participate in the regulation of EMT/MET in circulating tumor cells, which in turn promotes metastasis of tumor cells. Therefore, monitoring the level of Twist and epithelial–mesenchymal phenotypic molecules is important as it may be beneficial for in-creasing the detection ratio of circulating tumor cells as tumor biomarkers and for evaluating the effects of anticancer drugs.

Sepsis is a life-threatening organ dysfunction caused by dysregulated host responses to infection. Despite decades of research, it remains the leading cause of death in intensive care units (ICUs). None of the current treatment, including antibiotics, organ protection and liquid resuscitation, is specifically effective for sepsis. Immunosuppression is one of the currently accepted pathogenesis and immunotherapy is one of the hot spot of current sepsis research. Immune related treatments include restricting the release of pathogen toxin and its removal, controlling the excessive inflammatory reaction and apoptosis inhibition, etc. Numerous pre-clinical studies using immunomodulatory agents such as interleukin-7 (IL-7), anti-programmed cell death-1 (PD-1) antibody and others, have demonstrated reversal of T cell dysfunction and improved survival resulting from reviewing recent advances in immunotherapy of sepsis. Therefore, immunotherapy may be a new way of sepsis treatment.

OBJECTIVE: To evaluate the cost-effectiveness of 3 therapeutic schemes in the treatment of chronic Hepatitis B with YMDD mutation.METHODS: 90 patients were randomly assigned into three groups: the patients in Group A were assigned to receive Adefovir Dipivoxil in combination with Lamivudine for 12 weeks followed by administration of Adefovir alone for 36 weeks;Group B received Adefovir in combination with Lamivudine for 48 weeks,while Group C received Entecavir alone for 48 weeks.The cost-effectiveness of the 3 groups were analyzed.RESULTS: In the three groups(A,B,and C),the cost-effectiveness ratios for HBV DNA negative-conversion ratewere 12 685.6,15 481.3,and 31 462.2,respectively and the incremental cost-effectiveness ratios of Group B and Group C were 29 501.5 and 106 907.8 respectively as against Group A.The cost-effectiveness ratios of the three Groups(A,B,and C) for serum alanine aminotransferase normalization rate were 12 685.6,14 284.9,31 462.2 respectively,and the incremental cost-effectiveness ratios of Group B and Group C were 19 618.5 and 106 907.8 respectively as against Group A.The cost-effectiveness ratios of the three Groups(A,B,and C) for HBeAg/HBeAb seroconversion rate were 76 227.9,93 120.3,and 209 664.0 respectively,and the incremental cost-effectiveness ratios of Group B and Group C were 178 350.0 and 1 267 621.4 respectively as against Group A.In Group A,1 case showed rtA181V mutation and another one showed rtN236T mutation after 48-week treatment.CONCLUSION: Group B(ADV in combination with LAM) is more cost-effective in the treatment of chronic hepatitis B with YMDD mutation.

A novel HPLC-CAD method coupled with on-line solid phase extraction ( SPE ) for the determination of erythrocin which was widely used in livestock farming was developed. After mixed with diatomite, 5. 0 g manure sample was put into the cell and extracted with hot water at 70℃ and 10. 3 MPa. An on-line SPE methodology was applied to pre-treat the sample, and the sample was seperated on an Acclaim 120 C18 column and analyzed by corona CAD detector using acetonitrile and 0. 1% formic acid as mobile phase. Good linearity for erythrocin was obtained in the range of 21-2000 μg/kg. The detection limit was 6. 3 μg/kg. The average recoveries were 79. 2%-87. 5%.