Objective To compare the curative effect of tiotropium bromide combined with salmeterol flutica-sone of different specifications in treatment of chronic obstructive pulmonary disease(COPD)at stable stage in senile patients.Methods 84 senile patients of COPD were selected.All the patients were divided into observation group (42 cases)and control group(42 cases).And both groups were provided with basic treatment of tiotropium bromide, on the basic treatment,the patients in the observation group were provided with 50μg/250μg salmeterol fluticasone, and the control group with 50μg/500μg salmeterol fluticasone.The course of treatment in the two groups was 12 months.The arterial blood gas,lung function,motor function and clinical efficacy were compared between the two groups after treatment.Results 12 months after treatment,the arterial oxygen partial pressure(PaO2 ),arterial carbon dioxide partial pressure(PaCO2 ),forced expiratory volume in one second(FEV1 ),forced vital capacity(FVC),1 second forced expiratory volume accounted for the percentage of forced vital capacity(FEV1 /FVC)of the control group were (51.66 ±3.96)mmHg,(66.58 ±4.90)mmHg,(1.39 ±0.09)L,(2.41 ±0.09)L,(60.40 ±4.25)%,(366.01 ± 17.21)m respectively,which of the observation group were (46.29 ±3.38)mmHg,(75.83 ±5.09)mmHg,(1.59 ± 0.12)L,(2.65 ±0.10)L,(67.33 ±485)%,(325.69 ±15.62)m respectively.The arterial blood gas,lung function and exercise capacity of the two groups were significantly improved,among them,PaO2 of the control group was significantly better than that of the observation group,the difference was statistically significant (t =6.684,P <0.001).PaCO2 of the control group was significantly better than that of the observation group,the difference was statistically significant(t =-8.485,P <0.001).FEV1 of the control group was significantly better than that of the observation group,the difference was statistically significant(t =-8.641,P <0.001).FVC of the control group was significantly better than that of the observation group,the difference was statistically significant(t =-11.561,P <0.001).FEV1 /FVC of the control group was significantly better than that of the observation group,the difference was statistically significant(t =-6.964,P <0.001).6MWD of the control group was significantly better than that of the observation group,the difference was statistically significant(t =-11.243,P <0.001).After 12 months of treatment, the total effective rate of the observation group was 97.62%,which was significantly higher than that of the control group 85.71%(χ2 =3.896,P =0.048).Conclusion The comprehensive effect of tiotropium bromide combined with 50μg/500μg salmeterol fluticasone is better than that of tiotropium bromide combined with 50μg/250μg salmeterol fluticasone.

Skeletal muscle is essential for the glucose disposal in organism, which is one of the major sites of insulin resistance.The over-activity of classical renin-angiotensin system ( RAS) induces the oxidative stress, leads to the impairment of insulin signaling and glucose transport, resulting in insulin resistance of skeleton muscle.The activation of non-classical RAS by inhibiting classical RAS activity, can ameliorate insulin resistance in skeletal muscle tissue.

0 05) Conclusions Mifepristone with misoprostol for terminating early pnegnaney might be affect the expression of lymphocyte and cytokines and induce the disorder of decidual micro environment which might be the reason of medical abortion

Objective To investigate the regulatory effects of mifepristone and progesterone on the secretion of interleukin 6 (IL 6) by endometrial and endometriosis cells in vitro. Methods Primary cultures of eutopic and ectopic endometrial cells from 9 cases of endometriosis were exposed to mifepristone (10 -6 mol/L, 10 -4 mol/L) and progesterone (1?10 -7 mol/L, 1?10 -5 mol/L) respectively. IL 6 secretion was analyzed in the culture medium by enzyme linked immunosorbent assay (ELISA). Results Mifepristone inhibited the IL 6 secretion of ectopic endometrial cells, with the concentrations of IL 6 was (1 914 33?799 28) ?g/L in the 1?10 -6 mol/L group ( P 0 05). Conclusion The inhibitory effects on the secretion of IL 6 by ectopic and (or) eutopic endometrium may provide one of the cellular therapeutic mechanisms of mifepristone and progesterone on endometriosis.

Objective To compare the efficacy and safety of mifepristone and danazol after conservative surgery in the treatment of patients with endometriosis Methods Sixty one patients with endometriosis (RAFS stage Ⅰ～Ⅳ) after conservative surgery were treated orally either with mifepristone 10 mg/d (group M, n =31) or danazol 200 mg 2～3 times/d (group D, n =30) for 3 months Changes of symptoms and signs, serum reproductive hormone levels as well as side effects were assessed before and at the end of therapy Moreover, biochemical parameters of bone metabolism: urinary deoxypyridine /creatinine (UDpd/Cr),serum alkaline phosphatase (AKP) and bone gala protein (BGP) were also measured before and after treatments Results During treatment symptoms and signs were remarkbly relieved in both groups Side effects including hot flushes, irregular vaginal bleeding, back pain, weight gain and acne, were less commnly seen in group M as compared with group D Serum luteal hormone (LH), follicular stimulating homone (FSH) levels remained in the range of follicular phase in both groups So was serum estradiol (E 2) levels in group M[(204 9?45 3 ) pmol/L], but declined to postmenopausal level in group D [(94 3?33 0) pmol/L] About two weeks after discontinuation of the thrapy, serum E 2 levels [(1 221 6? 384 2) pmol/L] was not significantly different from the normal ovulatory range in group M, but significantly lower in group D [(815 1?376 0) pmo/L, P

Objective To explore the expression and clinical significance of CD 8 +CD28 -T lymphocytes in the patients with endometriosis ( EMT) complicating with pelvic fluid .Methods Eighty patients with endometriosis complicating with pelvic fluid ( ca-ses of ⅠtoⅣwere 15, 12, 22, and 31, respectively) were enrolled.The peripheral blood as well as the pelvic fluid were collected and flow cytometry was applied to detect the frequencies of CD 8 +CD28 -T lymphocytes and their intracellular cytokines , including transforming growth factor β1 (TGF-β1) and interleukin 10 (IL-10).Twenty health women with the same range of age were enrolled as the control group .Results Compared with the control ones , the frequencies of peripheral blood CD 8 +CD28 -T lymphocytes , TGF-β1, and IL-10 of the EMT subjects were increased significantly (all P <0.05), which presented the order Ⅳ>Ⅲ>Ⅱ>Ⅰand the difference between every two of the Ⅰ~Ⅳgroups was significant (all P <0.05).Similarly, the data of CD8 +CD28 -T lymphocytes, TGF-β1, and IL-10 in pelvic fluid also presented as Ⅳ>Ⅲ>Ⅱ>Ⅰ.Moreover, the difference of pelvic fluid TGF-β1 between any two groups was more apparent compared with CD 8 +CD28 -T lymphocytes and IL-10 ( P <0.05 ) .Spearman correlation analysis showed that any one of CD8 +CD28 -T lymphocytes, TGF-β1, and IL-10 positively correlated with any stage of ⅠtoⅣ( rs =0.791, 0.753,0.726 and all P <0.05).Conclusions CD8 +CD28 -T lymphocytes, TGF-β1, and IL-10 were closely related to the stages and could be the negative roles in the pathogenesis of EMT .TGF-β1 played a vital role in the formation of pelvic fluid .

Objective To evaluate the clinical efficacy of Bilevel non -invasive positive air pressure ventila-tion(BiPAP)in the treatment of stable COPD patients with typeⅡrespiratory failure.Methods 36 patients had stable COPD with typeⅡrespiratory failure was treated with BiPAP.And observed the changes of clinical symptoms and arte-rial blood gases before and after the treatment.Results The Blood gas index[(7.28 ±0.04)vs (7.37 ±0.06)], heart rate[(116 ±11)times/min vs (85 ±10)times/min],breath rate[(26 ±4)times/min,(17 ±3)times/min], frequence of hospitalization[(3.50 ±0.89)times vs (0.23 ±0.11)times],and hospital days[(22.3 ±8.8)d vs (11.4 ±4.6)d]significantly changed after treatment(all P <0.01),the symptoms,including the shortness of breath, and chest distress improved greatly,and also the exercise tolerance were much better than patients did before treatment.Conclusion BiPAP is an efficient treatment method,and valuable for stable COPD patients with type Ⅱrespiratory failure.

Objective To investigate the change of 25-hydroxyl vitamin D level and its impact on glucose metabolism and bone mineral density in type 2 diabetic patients.MethodsTwo hundred and fifty-eight cases of type 2 diabetic patients in our hospital were collected.In accordance with 25 (OH) D =50 nmol/L for the critical values,they were grouped into vitamin D deficiency group ( n =192) and the relative lack of vitamin D group ( n =66).Dual-energy X-ray absorptiometry (DXA) measurement of the lumbar vertebrae L2 - L4 and femoral neck bone mineral density were undertaking.Taking the total value of the lumbar spine,femoral neck and total value as judgment indicators,homeostasis model assessment of insulin resistance (HOMA-IR),we collected and statistically analyzed glucose metabolism and bone metabolism indicators in patients with diabetes.Results Among 258 cases of type 2 diabetes,there were 57 cases of osteoporosis accounting for 22.1％.There was significant difference on the duration of diabetes [ (7.98 ± 1.09 ) years old vs (3.77 ± 1.21 ) years old,t =4.849,P ＜0.05],FINS [ (6.42 ± 1.30) mU/L vs (5.79 ± 1.08) mU/L,t =3.871,P ＜0.05] and HOMA-IR [ (2.35 ±0.54) vs ( 1.85 ±0.41 ),t =2.705,P ＜0.05],but no significant difference on the FPG and HbA1c ( P ＞ 0.05 ) between two groups.PTH [ ( 36.51 ± 7.59) ng/L vs ( 32.02 ± 6.89 ) ng/L,t =2.008,P ＜ 0.05 ],bone mineral density in the lumbar total value [ (0.87 ±0.14) g/cm2 vs (0.99 ±0.12) g/cm2,t =2.799,P ＜0.05 ],femoral neck Neck [ ( 0.70 ± 0.10 ) g/cm2 vs ( 0.79 ± 0.11 ) g/cm2,t =2.564,P ＜ 0.05 ] and Total [ (0.84 ± 0.14) g/cm2 vs (0.97 ± 0.15 ) g/cm2,t =3.340 P ＜ 0.05 ] were statistically different,but no significant difference on the rest of the indicators.Conclusion The prevalence of vitamin D deficiency was found in patients with diabetes.Vitamin D level could affect insulin resistance and glycemic control and bone mineral density level.Therefore,routine vitamin D testing to the diabetic patients and giving vitamin D replacement therapy to vitamin D deficiency patients in a timely manner were necessary.

Objective To evaluate the effectiveness of cervical intraepitheliar neoplasia grade Ⅰ (CIN Ⅰ) after treated by high intensity focused ultrasound (HIFU) Ⅰ.Methods 155 CIN Ⅰ cases in treatment group started following after HIFU method,548 cases in control group started following after cervical biopsy under the colposcope.The following intermissions were 6 months,12 months,24 months,36 months,Liquid based cytological test (LCT) and hybrid captured-Ⅱ for high rate-humanpapilomavirus (HR-HPV)test were used in every following test,and if the LCT result was atypical squamous cells (ASC-US) and HR-HPV positive,or the LCT result was greater than or equal,cervical biopsy was undergone by the colposcope to make sure the CIN Ⅰ diagnosis.Results (1) The lost rates of treatment group and control group in 36 months were 18.66％ and 10.22％.(2) The inversion rates in 6 months,12 months,24 months and 36 months were 77.51 ％,80.38 ％,86.12 ％ and 88.28 ％,inversion cases were rose up by the treatment gradually,succession rates were 33.01 ％,22.97％,9.33％ and 1.44％,and descended down gradually.(3)The inversion rates in treatment group and control group increased with observation time,there were significant differences during the 6 months,12 months,24 months and 36 months (P ＜ 0.05) ; the succession rates in treatment group and control group descended with observation time,there were significant differences during the 6 months,12 months and 24 months (P ＜ 0.05),and there were not significant differences in the 36 months,but significant differences between treatment group's and control group s progressive rate.Conclusions No solid scar,improving lesions inversion,reducing succession rate,guarding against the canceration were the advantages of HIFU in treatment for CIN I.

OBJECTIVE To investigate the antitumor effect and toxicity of doxorubicin-heparinized mesoporous silicon nanoparticles drug carrier system (DOX-HMSN) on H22 hepatoma mice. METHODS An experimental animal model of H22 hepatoma mice was established. Fifty male Kunming mice were divided into five groups:model control group,HMSN 8 mg?kg-1 group,DOX-HMSN 4,8 mg?kg-1 groups, and DOX 2 mg?kg-1(once every other day)group. Continuous intravenous injection was given once a day for 14 d. Tumor was completely stripped and weighed,and tumor inhibitory rate was determined. Pathological change of tumor tissue was observed by HE staining in H22 mice. White blood cell count was performed and the thymus index and spleen index were calculated. Levels of serum creatinine (Scr),blood urea nitrogen(BUN),glutamic pyruvic transaminase(GPT)and glutamic-oxalacetic transaminase(GOT)in serum were determined. BCL-2,BAX and vascular endothelial growth factor (VEGF)expression of tumor tissue were analyzed using Western blot. RESULTS The inhibitory rate of tumor was 20.5%,40.4%,54.8%,and 67.5%,respectively,in HMSN 8 mg?kg-1 group,DOX-HMSN 4, 8 mg?kg-1 group and DOX 2 mg?kg-1 group(P<0.01). HE results showed that HMSN 8 mg?kg-1,DOX-HMSN 4,8 mg?kg-1and DOX 2 mg?kg-1 induced tumor necrosis and nuclear dissolution of the tumor cells in H22 mice. The white blood cell count,thymus index and spleen index of mice were not signifi?cantly different between control group and HMSN group or DOX-HMSN 4 and 8 mg?kg-1 group. The levels of Scr and BUN of mice did not change obviously in HMSN 8 mg?kg-1or DOX-HMSN 4,8 mg?kg-1 groups. Compared with the model control group,the level of GPT and GOT of mice increased in the DOX 2 mg?kg-1group but decreased in HMSN 8 mg?kg-1 and DOX-HMSN 4 and 8 mg?kg-1 group(P<0.05). Compared with the control,the BAX/BCL-2 ratio(from 0.49 ± 0.06 to 0.79 ± 0.08,1.23 ± 0.14 and 1.04±0.14)increased but the VEGF expression of tumor(from 1.39±0.14 to 1.13±0.12,0.75±0.08 and 0.94 ± 0.09)decreased significantly in DOX-HMSN 4,8 mg?kg-1 and DOX 2 mg?kg-1 group(P<0.05). CONCLUSION DOX-HMSN can inhibit the tumor growth of H22 tumor-bearing mice and its antitumor mechanism might be related to inducing tumor cell necrosis and apoptosis and inhibiting tumor angiogenesis.