Objective:To explore the clinical efficacy of Budesonide and Formoterol Fumarate Powder in the treatment of patients with bronchial asthma and its effect on the serum levels of inflammatory factors.Methods:123 cases treated and diagnosed as bronchial asthma in our hospital from February,2014 to February,2016 were randomly divided into the observation group (65 cases) and control group (58 cases).The serum levels of IL-17,IL-33,MMP-9,pulmonaryfunction,quality of life,total effective rate and incidence of adverse reactions were compared between the two groups.Results:The total effective rate of observation group was 92.3％,which was significantly higher than that of the control group (81.03％,P＜0.05).After therapy,the serum level ofIL-17,IL-33 in both groups were largely decreased compared with those before therapy (p＜0.05),and those of observation group were significantly lower than the control group (p ＜0.05);the serum level of MMP-9 in both groups showed no statistical difference compared with that of before therapy.Similarly,the level of FEV1,PEF and FEV1/FVC of observation group were obviously increased compared with those before therapy (p＜0.05) and were significantly higher than those of the control group (p＜0.05);the quality of life in the observation group was better than that of the control group based on the SGRQ score (p ＜0.05).Conclusion:Budesonide and Formoterol Fumarate Powder was effective on the patients with chronic bronchial asthma,which could control the inflammatory reactions,improve the pulmonary function as well as the quality of life.

Objective To define the peroneal nerve’ s safety zone and study its clinical value in treatment of MIPPO for proximal tibia fracture. Methods The peroneal nerve’ s safety zone was defined according to dead body anatomy. Patients with proximal tibia fracture were divided into traditional therapy group ( control group) and peroneal nerve’ s safety zone therapy ( observation group) . The curative effects and complications were compared. Results The peroneal nerve’s safety zone of R1 was (45. 30 ± 1. 55) mm,R2 was (45. 61 ± 1. 40) mm,R3 was(45. 42 ± 1. 62) mm,angle A was(33 ± 2. 1)°,angle B was(97 ± 2. 3)°. The operating time,bleeding volume,hospitalization time and fracture time in observation group were significantly lower than those in the control group,but there was no siginificant difference in post-ther-apy infection,delayed healing and other complications. Conclusion The curative effects according to peroneal nerve’ s safety zone are better than traditional MIPPO in proximal tibia fracture.

Objective To observe the effect of kallikrein and ozagrel on hemorheology in the treatment of patients with acute cerebral infarction,provide a theoretical basis for clinical treatment.Methods 100 patients with acute cerebral infarction met the inclusion criteria were randomly divided into 50 cases of observation group and 50 cases of control group,the control group were received conventional drug therapy,the observation group were given kallikrein and ozagrel on the basis of the control group,kallikrein 0.15PNA /times,ozagrel 80mg one time,bid,14d for a course of treatment.The symptoms improvement were observed,the NIHSS score and ADL score were calculated after treatment,then the blood were extraced for detecting high shear viscosity of whole blood,red blood cell aggrega-tion index,hematocrit,fibrinogen,erythrocyte sedimentation rate,and the clinical efficacy were judged.Results The total effective rate of the observation group were 96% (48 /50),which of the control group were 66% (33 /50),the total effective of the observation group was significantly higher than the control group (χ2 =16.105,P <0.01);The high shear viscosity of whole blood,red blood cell aggregation index,hematocrit,fibrinogen,erythrocyte sedimentation rate,NHISS of the observation group and the control group after treatment were lower than before treatment (t =6.589 and 3.762,6.204 and 3.661,8.112 and 5.774,5.542 and 3.529,9.429 and 3.962,9.621 and 6.586,all P <0.05),the ADL score was significantly higher than before treatment(t =7.673 and 5.446,all P <0.05),the high shear viscosity of whole blood,red blood cell aggregation index,hematocrit,fibrinogen,erythrocyte sedimentation rate, NHISS of the observation group after treatment were lower than those of the control group (t =3.387,3.545,3.525, 3.288,3.302,4.988,all P <0.05),the ADL score was significantly higher than the control group (t =3.446,P <0.05).Conclusion The method containing kallikrein and ozagrel has exact clinical efficacy,can effectively improve blood rheology and cerebral blood perfusion ischemic area,promote neurological deficits and recover the ability of daily life,and its security is good,which is worthy of promotion.

Objective To study the clinical value of rapid prototyping oriented template for total hip replacement in patients with adult developmental dysplasia of the hip .Methods Totally 51 cases with adult developmental dysplasia of the hip who were admitted into our hos -pital from January 2014 to March 2015 were randomly divided into the observation group and the control group .The observation group were treated by total hip arthroplasty assisted with rapid prototyping oriented template , while the control group were treated with traditional surgical method for total hip replacement.The curative effect, operation time, amount of bleeding, hospitalization time and satisfaction rate were compared between the two groups .Results The operation time , intraoperative blood loss and length of hospital stay of the observation group were significantly lower than those in the control group , and the differences were statistically significant (P<0.01).The Harris hip function score and satisfaction rate of the observation group were significantly higher than those in the control group with statistically significant differ -ences (P<0.05).Conclusion Total hip arthroplasty assisted with rapid prototyping oriented template could shorten the operation time , re-duce the intraoperative blood loss , cut down the hospitalization time , quicken the hip joint function recovery , and improve the satisfaction rate of patients .

This paper introduces such instrumental induced abortions without vacuum aspiration in China as rotary instrument-induced abortion, ultrasound termination pregnancy, acupuncture antiearly pregnancy and microwave radiation induced abortion. This paper can be referred to when new abortion method and apparatus developed.

Objective To investigate the effects of dexmedetomidine combined with sevoflurane on elderly patients with postoperative recovery quality.Methods Selected 60 cases of abdominal rectal cancer resection for elderly patients,which were ASA I or II,were randomly divided into two groups by a random number table method, while each groupincluded 30 cases:the control group( group N) and the dexmedetomidine group( group D) .Before the induction of anesthesia,group D vein was injected with micro pump ( more than 10 min) of dexmedetomidine 1μg/kg ( which was formulated with physiological saline as 4μg/mL) ,and then was given to maintain the dexmedetomidine 0.5μg/h and N group was injected with micro pump of the same volume of normal saline.The two groups of anesthesia were same,by which the static inhalation of composite general anesthesia.Observation were recorded before induction of anesthesia(T0),given dexmedetomidine(TI),after intubation 1 min(T1),5 min(T2),drawing tube immediately (T3),extubation after 5min(T4),30min(T5)the time of HR,BP,SpO2,BIS;propofol and remifentanil dosage,opera-tive time,operation time,a nesthesia time,recovery time,drawing tube time,extubation after Ramsay Sedation score, pain score,patient satisfaction and adverse reactions were recorded.Results In T3 period,the changes of HR (82 ± 14)times/min,SBP (130 ±8)mmHg,DBP (85 ±13)mmHg in group N were more obvious than (70 ±12)timse/min, SBP (121 ±7)mmHg,DBP (79 ±9)mmHg in group D,the difference between the two groups had statistical signifi-cance(t=6.28,4.63,2.08,all P<0.05).In T5 period,the levels of blood glucose (5.3 ±1.1)mmol/L and cortisol (402 ±78) nmol/L and ( 0.260 ±0.044 ) ng/L in group D were significantly lower than ( 5.9 ±1.2 ) mmol/L, (550 ±92)nmol/L,IL-6 (0.300 ±0.066)ng/L in group N(t=2.02,6.72,2.76,all P<0.05).However,the composite of dexmedetomidine group D patients with respiratory recovery time(7.5 ±2.3)min,calling the eyes open time(7.8 ±2.5) min,pull out the time of endotracheal tube (14.2 ±3.3) min compared with groups N of patients with respiratory recovery time (7.8 ±2.5)min,calling the eyes (14.8 ±3.2)min,pull out the time of endotracheal tube (13.9 ±3.1)min,showed no statistical significance (t=0.88,0.44,0.36,all P>0.05).In group N,postoper-ative restlessness in 8 cases,nausea and vomiting in 10 cases,chills in 9 cases,which were significantly higher than 2 cases,2 cases,2 cases in group D(χ2 =4.32,6.67,5.45,all P<0.05).At the same time,the satisfaction score of patient in group D (3.0 ±0.3)point,which was significant higher than (2.7 ±0.5)points in group N (t=1.88,P<0.05).Conclusion Dexmedetomidine detomidine composite sevoflurane anesthesia can improve the postoperative re-covery quality of elderly patients with rectal cancer radical surgery.

Objective To compare the detection rate of esophageal and cardiac mucosal lesions be?tween screening endoscopy and conventional routine endoscopy. Methods Using iodine staining,a total of 8 918 patients aged 40?69 were screened for esophageal and cardiac early cancer in Xianju and Tiantai county of Zhejiang Province from January 2010 to July 2013.Matched with age, data of 43 834(the conven?tional group) patients who underwent routine endoscopy during the same time period were also retrieved. The detection rates of esophageal and cardia mucosa lesions in both groups were compared and analyzed. Results The detection rate of esophageal mucosal lesions in screening group was significantly higher than that in the conventional group[7?? 48%(667/ 8 918)VS 2?? 17%(953/ 43 834),P<0?? 001].The total detection rate was the lowest in 2010 among 4 years, while that in 2011?2013 were higher and similiar. The detection rate of cardiac mucosal lesions in screening group was higher than that in the conventional group [ 0?? 78%(70/ 8 918)VS 0?? 70%(309/ 43 834)] without significant difference(P>0?? 05). The detection rates of low grade intraepithelial neoplasia, high grade intraepithelial neoplasia and mucosa cancer and total detection rates between 2 groups were similar(P>0?? 05). Conclusion Through training, endoscopists can grasp the skills of finding esophageal mucosal lesions. Iodine staining should be used as addition to conventional endos?copy in areas with high incidence of esophageal cancer. Conventional white light endoscopy plays a limited role in detection of cardia mucosal lesion, depending on joint inspection of other related methods.

Objective To evaluate the value of MR threedimensional arterial spin labeling (3D-ASL) perfusion imaging and intravoxel incoherent motion(IVIM) DWI in differential diagnosis and quantitative analysis of musculoskeletal tumors.Methods Forty-four patients with musculoskeletal tumors were included.According to pathologic results,there were 12 cases of benign tumors,10cases of intermediate tumors and 22 cases of malignant tumors.3D-ASL and IVIM DWI were both performed on forty-four patients to gain tumor blood flow (TBF),standard ADC (ADCstandard),slow ADC (ADCslow)and fast ADC (ADCfast).Immunohistochemical staining of specimens was performed by using CD34 monoclonal antibody to calculate microvessel density (MVD) counts.MVD,TBF,ADCfast and ADCslow of different groups were compared by one-way ANOVA analysis.ADCstandard was compared by Kruskal-Wallis test.ROC curve was used to analyze ASL and IVIM DWI,in order to determine the threshold and diagnostic reliability.Results The MVD of benign tumors was 10±4,the MVD of intermediate tumors was 15±6,and malignant tumors was 33 ± 1 1.There was significant difference among three groups of MVD(F=28.33,P＜0.05).There was better intra-observer agreement for ADCstandard,ADCfast,ADCslow and TBF(ICC=0.970,0.885,0.778,0.891,respectively,P＜0.05).The TBF of benign tumors was(30±10)ml· min-1· 100 g-1,intermediate tumors was(30± 12) ml·min 1· 100 g-1,and malignant tumors was(84±29)ml·min 1· 100 g-1.There was significant difference among three groups of TBF(F=32.34,P＜0.05).According to the ROC analysis,when the cut-offvalue of TBF was 45.5 ml·min-1· 100 g-1,the area under ROC curve was 0.95 1,and the sensitivity and specificity of TBF in diagnosing malignant tumors were 90.9％ and 95.5％ respectively.There was no significant difference among three groups of ADCstandard,ADCfastand ADCslow of benign tumors were(9.9±5.1)× 10-3,(1.9±0.5) × 10-3mm2/s respectively.ADCfast and ADCalow of intermediate tumors were(8.2 ± 3.6) × 10-3,(1.5 ± 0.6) × 10-3mm2/s respectively.ADCfast and ADCalow of malignant tumors were (16.9 ± 5.8) × 10 3,(1.4 ± 0.6) × 10-3mm2/s respectively.There were significant difference of ADCfast and ADCslow among three groups (F=12.75,5.60,P＜ 0.05).According to the ROC analysis,when the cut-off value of ADCfast was 9.4× 10-3mm2/s,the area under ROC curve was 0.861,the sensitivity and specificity of them in diagnosing malignant tumors were 95.5％ and 68.2％ respectively.Conclusion 3D-ASL and IVIM DWI are valuable in the differential diagnosis of musculoskeletal tumors.

Objective To explore the relationship between the tumor angiogenesis index (microvessel density,MVD)and biological behavior of the tumor.To analyze the correlations between TBF,standard ADC,fast ADC,slow ADC and MVD counts.Methods From March 2013 to June 2013,a total of 40 patients were involved in the study.3D-ASL and IVIM DWI were both performed on patients with musculoskeletal tumors.TBF,standard ADC,slow ADC,fast ADC were measured by regions of interest.Immunohistochemical staining of specimens were performed by using CD34 monoclonal antibody to calculate MVD counts.Group differences in MVD were assessed by using one-way ANOVA.The correlations between TBF,standard ADC,fast ADC,slow ADC and MVD counts were evaluated using Pearson correlative analysis.Results The MVD of benign tumors was (10.38±4.58)/0.26 mm2,the MVD of intermediate tumors was (14.64±6.69)/0.26 mm2,and the MVD of malignant tumors was (32.97±11.61)/0.26 mm2.The differences of MVD among three groups were statistically significant (F=28.83,P＜0.05).The differences of MVD between benign and malignant group were statistically significant (P＜0.05),as well as intermediate and malignant group (p=0.000).There was a significant positive correlation between TBF and MVD (r=0.784,P=0.000),as well as the correlation between TBF and fast ADC(r=0.727,P=0.000).There was a moderate positive correlation between fast ADC and MVD (r=0.516,P=0.000).There were no significant correlation between slow ADC and MVD,or between standard ADC and MVD.Conclusion The MVD represents the angiogenesis of musculoskeletal tumors,reflecting biological behavior of the tumor.ASL and IVIM DWI can be applied to evaluate the angiogenesis of musculoskeletal tumors by reflecting MVD of musculoskeletal tumors in vivo as a completely noninvasive technique.

Objective To evaluate the effect of dexmedetomidine and tramadol on perioperative insulin resistance in patients undergoing radical resection of rectal carcinoma.Methods Sixty ASA I or II patients undergo-ing radical resection of rectal carcinoma were randomly divided into 3 groups(n =20 each):dexmedetomidine group (group D),tramadol group(group T),control group(group C).Group D was given dexmedetomidine intravenously at 1μg/kg 15min before induction of anesthesia followed by a continuous infusion of 0.5μg·kg -1 ·h -1 until the abdo-men was closed,and group T was given tramadol intravenously at 1.5mg/kg 15min before induction of anesthesia fol-lowed by a continuous infusion of 0.5mg·kg -1 ·h -1 until the abdomen was closed,whereas group C received the same volume of normal saline.Venous blood samples were taken at 30min before anesthesia induction(T1 ),1 h after the beginning of the operation(T2 ),1h after operation(T3 ),24h after operation(T4 )for determination of blood con-centrations of glucose(BG),insulin(INS),interleukin -6 (IL -6),tumor necrosis factor -α(TNF -α).Insulin resistance(HOMA -IR)and insulin sensitivity index(QUICKI)were calculated.The numbers of patients with PONV were studied respectively.Results The serum IL -6,TNF -α,BG,INS concentrations and HOMA -IR were signifi-cantly lower while ISI was significantly higher in both group D[t =7.71,3.37,8.78,8.73,11.45,2.82(T2 ),3.04, 2.95,12.75,10.73,16.09,2.92(T3 ),11.26,2.45,11.40,5.10,14.5,2.51(T4 ),all P <0.05]and group T[t =3.02,2.59,2.93,7.76,6.32,2.03(T2 ),8.78,2.27,4.14,8.83,7.68,2.12(T3 ),6.10,2.05,3.71,2.35,7.12, 2.09(T4 ),all P <0.05]at T2 ,T3 and T4 than those in group C.The serum TNF -αconcentration and HOMA -IR were significantly lower while ISI was significantly higher in group D[t =6.68,4.58,2.05 (T2 ),9.01,6.66,2.23 (T3 ),7.54,5.5,2.02(T4 ),all P <0.05]at T2 ,T3 and T4 than those in group T.The numbers of patients with PONV were significantly higher in group T than those in group D and group C (χ2 =26.13,18.75,all P <0.05 ). Conclusion Both dexmedetomidine and tramadol can attenuate perioperative insulin resistance in patients undergo-ing Radical Resection of Rectal Carcinoma,and the decrease the consentrations of IL -6 and TNF -αmay be involved in the mechanism.The roles of prevention of perioperative insulin resistance in dexmedetomidine group are superior to tramadol group.The incidence of PONV is less in a dexmedetomidine group than that in a tramadol group.