Objective To discuss the influence of respiratory training and prompting effective discharging of sputum for chronic obstructive pulmonary disease (COPD) patients in acute aggravation period. Methods 50 patients were randomized into the intervention group and the control group with 25 cases in each group.The intervention group received respiratory training and prompting effective discharging of sputum while the control was only given routine treatment and nursing.The ratio of first second expiration volume to forced vital capacity, oxygen partial pressure (PaO2),carben dioxide partial pressure (PaCO2) ,blood oxygen saturation (SpO2)and the in-hospital days were compared between the two groups. Results The clinical effect in the intervention group was superior to that of the control group with shorter in-hospital days (P<0.01).Conclusion Better results could be obtained by application of respiratory training and prompting effective discharging of sputum for COPD patients in acute aggravation period.

The compounded prescription of Chinese crude drug is a key problem in the study of traditional Chinese medicine.A new research field that focuses on the group of effective fractions of Chinese crude drugs becomes more important as the result of combination of the theorem of traditional Chinese medicine and techniques of modern medicine.Up to date,the researches on this field are preliminary,remaining a lot of subjects to be explored.

Objective To explore the treatment effect of potato homogenate on the treatment of drug extravasation during intravenous injection.Methods 320 cases of drug extravasation patients during the intravenous infusion were randomly divided into the potato homogenategroup,named group A; patato slice group named group B and magnesium sulfate group as group C.The group A,B and C were separately treated with the external application of potato homogenate,thin slice of fresh potato and 33％ magnesium sulfate.The therapeutic effects of the 3 groups were compared.Results The therapeutic effect of group A was superior to that of group B and C,and the healing time in group A was much shorter than that in group B and C,and group B was batter than group C,there was significant difference between the above comparison groups.Conclusions The therapeutic effect of external application of fresh potato in the treatment of extravasation injury caused by the drugs is remarkable.Potato homogenate can improve the treatment effect and shorten healing time when compared with potato slice.

Objective The interaction between anti-neutrophil cytoplasmic antibaties (ANCA) and receptors at the Fc portion of immunoglobulins (FeγR) is central in the pathogenisis of primary systemic small vasculitis. The aim of this study is to investigate the role and clinical value of ANCA on the expression of neutrophils FCγRⅡ/Ⅲ (CD32/CD16). Methods ANCA IgG was prepared from the sera of patients with active We-gener's granulomatosis (WG) and microscopic polyangiitis (MPA). Neutrophils were isolated from the blood of healthy volunteers. The expression of CD32/CD16 on neutrophils was assessed by flow cytometry after stimulated by ANCA for 1 hour. We compared the expression of CD32/CD16 between 18 primary systemic small vaseulitis (PSV) patients and 35 healthy volunteers. Furthermore, the correlation was also be analyzed between the expression of CD32/CD16 and Birmingham vasculitis activity score (BVAS). Results The expression of CD16 was significandy elevated by ANCA (Mnx 67±23 vs 54±21, P<0.01 ). The expression of CD16 was higher in patients than in healthy volunteers (Mnx 62±12 vs 53±10, P<0.01), which was in correlation with BVAS (r=0.728 86, P<0.01). But no such correlation was found for CD32 . Conclusion ANCA may play a role in the pathogenesis of PSV by modulating the expression of the FCγR. Monitoring the expression of CD16 on neutrophils is helpful for the evaluation of PSV activity.

AIM: The purpose of this study was to observe the morphological features of neuroendocrine cells(NECs),their proliferation and apoptosis in ovarian epithelial tumors,and to discuss their biological and clinical significance.METHODS: 79 specimens of ovarian epithelial tumor samples were collected,of them 20 benign,18 boderline,41 milignant tumors,and 22 normal ovaries were investigated immunohistochemically.Chromogranin A was used to detect NECs and their proliferation and apoptosis were examined by double-label staining of chromogranin A and Ki67 or TUNEL.RESULTS: The positive rate of CgA,distribution and staining intensity in ovarian epithelial tumors were higher than those in normal ovary.NECs showed various shapes with neuronoid protuberances stretching to the neighboring cells or basement membrane.Occasionally,they might touch together.No TUNEL positive coexpression in all NECs was observed by double-label staining,but some NECs were coexpressed with Ki67.CONCLUSION: NECs of ovarian epithelial tumors like cancer cells showed a proliferation,but no apoptosis.Their secretion might promote their neighboring non-NECs to proliferate and prevent them from apoptosis.

Objective To investigate the effects of tg19320,a small peptide,interfering with IgG-FcγR interaction on the adhesion of neutrophils to endothelium and the expression of intercellular adhesion molecule 1 (ICAM-1)in endothelial cells and its possible mechanism.Methods Tg19320 was prepared by solid-phase peptide synthesis.ANCA IgG was isolated from the serum of active ANCA-associated systemic vasculitis(AASV)patients.When primary human umbilical vein endothelial cells(HUVEC)grew into connuence in cytokine-free eonditions,the cells were stimulated with TNF-α,human normal IgG,ANCA IgG and ANCA IgG+tg19320 respectively.HUVEC were pretreated with tg19320 for 45 minutes before being stimulated by ANCA IgG.Non-activated neutrophils was added to treat HUVEC and adhesion was measured by cell count.The expression of ICAM-1 mRNA and protein was assessed by real-time PCR and Western blot respectively.Soluble ICAM-1(sICAM-1)was determined using ELISA technique.Phosphorylation of IκB-α was assessed by Western blot. Results ANCA IgG significantly up-regulated the expression of ICAM-1 in HUVEC and promoted sICAM-1 release(P＜0.05),and TNF-α enhanced the effect of ANCA.These effects were almost completely abolished by tgl9320 both at protein and mRNA level.Furthermore,ANCA IgG increased the IκB-α phosporylation in HUVEC and tg19320could inhibit the effect. Conclusions ANCA IgG can modulate the expression of ICAM-1 and sICAM-1 release in endothelial cells.FcγR probably play a critical role in the ICAM-1 expression up-regulated by ANCA,which is mediated in part through NF-κB signaling pathway.Tg19320 has protective effect on endothelium in AASV in vitro.

Objective To explore the efficacy and safety of arterial embolectomy with Solitaire AB stent in treatment of acute intracranial large artery occlusion.Methods The clinical data of 11 patients with acute intracranial large artery occlusion receiving arterial embolectomy with Solitaire AB stent from March to December 2013 were analyzed retrospectively.Among them,5 cases were with simple middle cerebral artery occlusion,1 case combined with occlusion in the intracranial part of the internal carotid artery,4 cases had simple basilar artery occlusion,and 1 case had occlusion in the intracranial portion of the vertebral arteries extending to intracranial portion of the basilar artery.Revascularization and postoperative hemorrhage were analyzed,and nosocomial as well as clinical outcomes after 3 months were evaluated.Results Ten patients showed successful revascularization,of which 8 cases reached the standard of perfect revascularization.After embolectomy,there was obvious stenosis in offending vessel of 4 cases,who were given balloon dilatation then.In 3 cases,the vessels were still narrow,so Solitaire AB stent was placed in the stenosis area to correct stenosis with the residual stenosis rate of less than 40％.Thus electrolytic interruption was given.There was no symptomatic intracranial hemorrhage.Three months after the operation,5 cases recovered,among whom 2 cases had obvious curative effect instantly,1 case had complete remissions in 1 week,and 1 case remained hemiplegia.Five cases died,and 4 cases discharged from the hospital because their family gave up the subsequent treatment.Conclusions Arterial embolectomy with Solitaire AB stent to treat patients with acute intracranial large artery occlusion has a relatively higher revascularization rate.The clinical outcome after 3 months can be significantly improved.Thus,it provides a safe and effective endovascular treatment for patients with acute intracranial large artery occlusion.

Objective To explore the effect of 3M Tegaderm transparent film on prevention of puncture complications in patients underwent aortocranial angiography via the femoral artery.Methods A retrospective analysis was carried out on 200 patients underwent aortocranial angiography via the femoral artery from February 2012 to February 2014.Eighty patients without using the transparent dressing paste were as the control group,and other 120 patients using 3M Tegaderm transparent film for fixation of arterial sheath were as the observation group.The occurrences of complications,such as arterial sheath breakage,angiographic tube breakage,femoral artery spasm,bruises at the puncture site and subcutaneous hematoma were analyzed,and the feasibility and effectiveness of 3M Tegaderm transparent film for fixation of arterial sheath were assessed.Results The incidence rate of arterial sheath breakage,angiographic tube breakage,femoral artery spasm,bruises at the puncture site and subcutaneous hematoma were significantly reduced in observation group compared with those in control group [5.8％ (7/120) vs.26.2％ (21/80)] (P ＜ 0.05).Conclusion Application of 3M Tegaderm transparent film with a low price and good security for fixation of femoral artery sheath can effectively reduce the occurrence of complications related to femoral artery puncture,which is worthy of wide spreading.

Purpose To explore the clinical pathological features and differential diagnoses and therapeutics of hyalinizing trabecular tumours ( HTT) of thyroid. Methods The clinical manifestations, high-frequency color doppler ultrasonography, histopathological and immunohistochemical features were analysed in six cases of HTT of thyroid. Related literatures were reviewed. Results On his-topathological examination, polygonal and elongated cells arranged in pattern of trabecular and organoid, with a clear perinucleolus ha-lo. Basement membrane-like material deposited intertrabeculae widespreadly. The tumour cells are completely filled with eosinophilic and granular material in their cytoplasm, nuclei with prominent grooves and pseudoinclusions. Immunohistochemically, the tumour cells were positive for TG, TTF-1 and CD56, CK19 and Galectin-3 interspersed expression. And all of them were negative for Calcito-nin, MC, CEA, Syn, CgA, Ki-67, p53 were lower expression. The differential diagnosis included solid variant of papillary carcinoma, medullary thyroid carcinoma and paraganglioma and so on. Conclusion HTT is an uncommon thyroid tumor, the majority of them be-have as benign neiplasms and that, correct pathologic diagnosis may play an important role in standard treatment and prognostic evalua-tion of HTT.

Objective: To investigate the prevalence of scoliosis among primary and middle school students in Jiaxing City, Zhejiang Province, so as to provide insights into scoliosis control among children and adolescents. Methods: Grade 4 to 6 primary school students and grade 1 to 3 junior high school students were recruited using a stratified cluster sampling method in Jiaxing City in 2019. Participants' demographic characteristics, dietary habits and nutritional status, physical activity, learning environments, reading and writing habits were collected using questionnaires. Scoliosis was screened through general examinations, forward bend test and scoliometer, and scoliosis was diagnosed with whole-spine X-ray scans in an erect position. The prevalence of scoliosis was descriptively analyzed among primary and middle school students. Results: A total of 8 026 primary and middle school students were included, 7 304 valid questionnaires were recovered, with an effective recovery rate of 91.00%. The respondents included 3 667 primary school students (50.21%) and 3 637 junior high school students (49.79%), and included 3 776 boys (51.70%) and 3 528 girls (48.30%). There were 659 participants with initial screening positive for scoliosis (9.02%), and the percentages of positive initial screening of thoracic, thoracolumbar and lumbar scoliosis were 2.93%, 4.56% and 4.56%, respectively. A higher percentage of positive initial screening of scoliosis was diagnosed among participants living in Pinghu City (10.45%), junior high school students (11.74%), girls (11.96%), students with a medical history of anemia (22.44%), students with less than 3 days of moderate-intensity physical activity in the past week (9.46%), students with less than 3 days of walking duration of over 10 minutes in the past week (10.18%), students with daily sitting duration of 5 hours and more in the past week (10.74%), students with their class seats exchanged every semester or month (10.28%), students with daily reading and writing duration of 3 hours and more after school (10.93%) and students with less than 10 cm distance from the chest at reading or writing to the edge of the table (9.67%) (all P<0.05). A total of 218 students received whole-spine X-ray scans in an erect position, 132 participants were definitively diagnosed as scoliosis (60.55%), and the estimated prevalence of scoliosis was 5.46%. Conclusion The percentage of positive initial screening of scoliosis was 9.02% among primary and middle school students in Jiaxing City. Gender, stage of learning, nutritional status, exercise frequency and habits of reading and writing may be factors affecting the development of scoliosis.