Objective:To investigate the clinical effects and safety of triple therapy based on ipratropium bromide inhalation in the treatment of acute exacerbation of chronic obstructive pulmonary diseases ( AECOPD) . Methods:Totally 150 patients with acute exac-erbation of AECOPD were randomly divided into control group (75 patients) treated with budesonide combined with salbutamol by in-halation, and treatment group (75 patients) treated with ipratropium bromide inhalation additionally. The clinical effects, dyspnea score, pulmonary function index and blood gas analysis index before and after the treatment and the incidence of adverse reactions of the two groups were compared. Results:The clinical effects of the treatment group was significantly better than that of the control group (P<0. 05). The dyspnea score, pulmonary function index in and blood gas analysis index in the two groups after the treatment were significantly better than those before the treatment(P<0. 05), and the improvement of the treatment group was significantly better than that of control group (P<0. 05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0. 05). Conclusion:Triple therapy including ipratropium bromide inhalation in the treatment of acute exacerbation of AECOPD can ef-fectively alleviate clinical symptoms and signs and improve the lung ventilation function without increased risk of adverse reactions.

Objective: To establish the Perfect Systematization and Informatization for the Management of Medical Equipment Archive, so as to ensure the integrity and traceability of each data. Methods: Analysis on Present Situation and the Problems of Medical Equipment Management, Establish Medical Equipment archive Management System from purchasing of medical equipment, Measurement Controls, the Maintenance to Scrap processing the whole-process of medical devices. Results: In this paper, we discussed all kinds of information and archives network information management in the whole-process of medical devices. To clarify the plan, argument, purchase, installation, acceptance, use, quality control, maintenance, transfers and scrap processing, management at different levels. To establish a complete electronic file system is the main direction of medical equipment information management in the future. Conclusion: Realization of the functions on medical equipment archives network information and dynamic management, that can offer necessary for safe treatment,to can also reduce the operation cost of the equipment.

Objective: To improve the whole-process management of medical devices in purchase, use and maintenance. Methods: In this paper, we clarify the purchase, use and maintenance requirements of large-scaled medical devices including justification, invitation organization, comprehensive estimation, contract signing protocol, advantage analysis, rational control of availability, efficacy measurement and detection, management at different levels, high-efficacy check-up and scrap procedure to adapt the new challenges during the introduction of more and more advanced, complex and high-tech medical devices. Results:The results being analyzed could be used as important evidence for future purchasing of medical equipment, which was important for scientific and reasonable purchasing and utilizing of medical equipment. Conclusion: Strengthen the management to adapt the new challenges during the introduction of more and more advanced, complex and high-tech medical devices.

Objective:This paper makes analysis of problems of emergency equipment existing in clinical application and their causes and puts forward corresponding measure. Methods:Analysis of emergency medical equipment characteristic and the difference between conventional equipment. Find the first aid equipment management problems and reasons existing in the use, and risk assessment. Results:Hospital first aid equipment has the characteristics of more free time, emergency and risks, widely distributed in each department. By the personnel management, periodic inspection, cleaning and disinfection. Risk assessment shall be conducted by experts, the risk value high priority arrangement first aid equipment maintenance, to expect to minimize risk. Conclusion:First aid equipment management is a systematic and important work, to need department, maintenance personnel, equipment manufacturers and so on various aspects to cooperate with each other, to ensure the normal use of equipment.

Objective To compare the effect of single-tube drainage with that of two-tube drainange in non-small cell lung cancer(NSCLC) patients with VATS upper-lobectomy.Methods Between August 2012 and August 2014,100 NSCLC patients who had received VATS upper-lobectomy performed by a single surgeon were prospectively enrolled and randomly classified into a single-tube drainage group(A) and a two-tube drainage group(B),consisting of 49 and 51 patients respectively.Upper-lobectomy and systematic mediastinal node dissection or sampling were performed in all cases.Clinical and surgical variables were collected prospectively.Results There were no significant differences in demographic and pathologic features between two groups.The amount/duration of drainage,the postoperative hospitalization days,postoperative morbidity and mortality between two groups showed no significant difference either.Group A patients had significantly lower VAS pain scores in the second day (4.06 ± 0.97 vs 4.47 ± 0.86,P =0.027) and one month after surgery (1.31 ± 0.68 vs 1.61 ± 0.64,P =0.024)compared with group B patients.Conclusion Single-tube drainage is as safe and effective as the conventional use of two-tube drainage after VATS upper-lobectomy in NSCLC patients.Moreover,single-tube drainage can relieve the post-operative pain for the patients.

Objective To investigate the causes and preventive measures of upper gastrointestinal bleeding in hyperbaric oxygen therapy for patients with severe closed head injury.MethodsThe clinical data of 24 cases of patients with upper gastrointestinal hemorrhage treated by hyperbaric oxygen therapy in the first people's Hospital of Fuyang District Hangzhou from May 2011 to May 2016 were analyzed, the occurrence time and clinical effect of upper gastrointestinal bleeding were analyzed.ResultsAmong the 24 cases of patients, 14 cases were treated for the first time that overt bleeding, including bleeding from the stomach liquid outflow of blood from 2 cases, gastric outflow 2 cases, hemorrhage after cure again received hyperbaric oxygen therapy 3 times again dominant bleeding 2 cases;6 cases hyperbaric oxygen treatment for third, 7, 10 times brown liquid or bloody fluid from the stomach outflow;4 cases hyperbaric oxygen treatment in patients with second and 3 courses of coffee liquid from the outflow tube, which accounted for 58.3%, 25.0%, 16.7% of the total, retrospectively;8 cases were with good recovery, 10 cases moderate disability, 4 cases severe disability, 2 cases vegetative state, 0 case died, the good recovery rate was 33.3%.ConclusionNot correctly grasp the time of hyperbaric oxygen therapy in the treatment of patients with severe closed craniocerebral injury will cause upper gastrointestinal hemorrhage, correct application of H2 receptor binding agent, developing targeted therapy programme can effectively prevent and treat upper gastrointestinal bleeding, so is worthy of the clinical's full attention.

Objective To investigate the brain protective effects of isoflurane preconditioning for local cerebral is-chemia adult rat model by detecting HIF-1α, HO-1 and Bcl-2 expression level. Methods 84 two-month old Spra-gue-Dawley male rats were randomly divided into sham group, ischemia-reperfusion group ( MCAO group) and isoflurance preconditioning group (ISO group). ISO group was exposed to isoflurane for 30 min and then underwent a 90 min middle cerebral arterial occlusion (MCAO), while MCAO group underwent MCAO only. At 24 h after reperfusion all the groups were investigated by modified neurological severity score for neurological deficits, TTC staining for infarct percentage. Cerebral cortices were harvested for HIF-1α, HO-1 and Bcl-2 protein expression level detection at 6 h, 24 h and 72 h after reperfusion using RT-PCR and western blot. Results The mNSS score and infarct percentage in ISO group decreased significantly compared with those of MCAO group at 24 h after reper-fusion(P < 0. 05). Compared with the MCAO group, ISO group had significantly up-regulated protein levels of HIF-1α, HO-1 and Bcl-2 at 6 h and 24 h after reperfusion(P < 0. 05). There was no difference between ISO group and MCAO group for 3 gene expression at 72 h(P > 0. 05). Conclusion Isoflurane preconditioning plays short-term cerebral protective effect through the up regulation of HIF-1α, HO-1 and Bcl-2 gene expression.

0.05). No death, pseudoarthrosis, or implantation failure occurred. Conclusions One-row portal pattern is suitable for patients with long-segment deformity and short anteroposterior thoracic diameter, while double-row portal pattern is suitable for patients with short-segment deformity and long anteroposterior thoracic diameter.

Objective To observe the anatomic landmarks in the thoracic cavity under thoracoscope in procedures for scoliosis,so as to facilitate the intraoperative localization and the prevention of complications. Methods During 23 cases of thoracoscopic anterior procedure,anatomic landmarks,including the segmental vessels,azygous vein,intervertebral discs,rib heads and great splanchnic nerve,were observed. Results The segmental vessels of T 6～10 were situated at the center of the vertebral body and their position was relatively constant.The T 7～10 intervertebral discs were a little bit prominent and white-colored,which were easily distinguished.The rib heads corresponding to their vertebral bodies were good landmarks.The great splanchnic nerve crossed over the T 7～9 vertebral bodies arrisways. Conclusions With the assistance of anatomic landmarks,accurate localization of the vertebral body is possible,which is helpful to the prevention of spinal cord injury and the decrease of frequency of radiation exposure.

The part-time graduate student education is the important part of the graduate student system in Chinese medicine education.Developing and regulating the part-time graduate student education in Chinese medicine is helpful to the consummation of Chinese medicine graduate student system,the cultivation of the high lever talents in Chinese medicine,and keeping up with international graduate student educational system.