Objective To study the efficacy of voice therapy combined with Jinsangsanjie pill in patients with vocal nodule .Methods A total of 146 patients with vocal nodes were randomly divided into three groups :45 cases in group A(single Jinsangsanjie pill therapy) ,47 cases in group B(single voice therapy) and 54 cases in group C(voice therapy combined with Jinsangsanjie pill therapy) ,30 healthy adults were as a normal control group .The treatment lasted 1 month .The results were evaluated by voice handicap index ,voice acoustic analysis and electronic laryngo‐scope which were collected before and after 1 month treatments .Results The VHI ,jitter ,shimmer and NNE of all patients were reduced while the MPT was increased after the treatment .The differences were significant (P<0 .05) .VHI 3 .64 ± 2 .12 ,jitter 0 .30% ± 0 .08% ,shimmer 1 .41% ± 0 .31% ,NNE -16 .83 ± 5 .84 dB of group C were significantly lower while MPT 18 .87 ± 3 .38 s and cure rate(93 .5% ) were significantly higher than those of in groupA(7.39±2.56,0.38% ±0.12% ,1.78% ±0.41% ,-13.38±4.42dB,16.38±3.11s,80.5% )andgroupB (23.6±12.5,0.48% ±0.18% ,1.98% ±0.42% ,-9.42±3.82dB,14.98±3.28s,52.4% )(P< 0.05).The VHI ,,jitter shimmer ,NNE of group A were significantly lower .MPT and cure rate were significantly higher than those of in group B .There were no statistical differences in each vocal indicators between group C and the normal control group (P>0 .05) .Conclusion The voice therapy combined with Jinsangsanjie pill in the treatment of vocal nodules is more efficiently ,and can improve patient’s pronunciation features .

OBJECTIVE: To investigate the clinical effect of nasal packing of pulmicort respules combined withnasopore after endoscopic sinus surgery. METHOD: A total of 30 CRSwNP and CRSsNP patients with bilateral functional endoscopic sinus surgery and finished following up visit were randomly choosed, conventionally select the left nasal cavity as the experimental group, the right nasal cavity as the control group. Experimental group to pack the nasal cavity with pulmicort respules union nasopore after surgery and control group to pack the nasal cavity with only nasopore after surgery. The differences were observed in patients with subjective symptoms and recovery of mucosa of operative cavity between the two groups after two weeks, one month and three months. RESULT: (1) The postoperative VAS symptoms score about nasal obstruction, nasal secretion, headache, dizziness and distending pain after two weeks,one month and three months in the experiment group were significantly better than those in the control group(P<0.05). (2) The postoperative Lund-Kennedy endoscopic mucosa morphology score after two weeks, one month and three months in the experiment group were significantly better than those in the control group(P<0.05); (3) After three months, the experiment group had 28 cases with clinic symptoms cured(93. 3%), Total effective rate was 96. 6%; The control group had 22 cases with clinic symptoms cured (73. 3%), total effective rate was 93. 3%. The cure rate of the experiment group was significantly higher than the control group(P<0.05), but there was no statistic difference between the two groups in the total effective rate (P>0.05). CONCLUSION The application of nasal packing of pulmicort respules combined with nasopore after functional endoscopic sinus surgery can effectively relieve postoperative uncomfortable symptoms, promote recovery of mucosa of perative cavity, which deserves clinical promotion.
Anti-Inflammatory Agents ; administration & dosage ; Bandages ; Budesonide ; administration & dosage ; Endoscopy ; Epistaxis ; Humans ; Nasal Cavity ; Nasal Obstruction ; Paranasal Sinuses ; surgery ; Postoperative Period

Polyunsaturated fatty acids (PUFA) was a functional component extracted from fish oil. The experiment results indicate that PUFA might inhibit platelet agglomeration induced by Adenosine diphosphate (ADP) in rabbit and rat. The results also suggested that PUFA has extent effect of anti-coagulation in mice. These effects are related with dosage of giving drug.

OBJECTIVE:To discuss the influence of drug price reduction and regulation of purchase on the use of anti-infectives in our hospital.METHODS:The use of anti-infectives in5times of drug price reduction was retrospective anal?ysed.RESULTS:The proportion of the sum of money for consumption of anti-infectives in the total sum for drug consumption dropped year by year but the total DDDc of anti-infectives increased year by year.The DDDs and the total DDDc of all kinds of anti-infectives showed different characteristics.CONCLUSION:The macroscopic price reduction for anti-infectives posi?tively affects the rational use of anti-infectives,yet the effect is limited.Microcosmic regulation of purchase offers an indis?pensable effect.

Objective:To investigate the effect of pulmonary vascular dysfunction in the prognosis of patients with acute lung injury (ALI).Methods:Patients with ALI who underwent pulmonary artery catheterization in the department of critical care medicine of Wuhan NO.1 Hospital from June 2017 to June 2019 were enrolled. The general information, clinical and hemodynamic indexes [central venous pressure (CVP), pulmonary artery wedge pressure (PAWP), pulmonary artery systolic pressure (sPAP), pulmonary artery diastolic pressure (dPAP), mean pulmonary artery pressure (mPAP), cardiac index (CI)], acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, arterial blood gas parameters [pH, partial pressure of oxygen (PO 2), partial pressure of carbon dioxide (PCO 2), oxygenation index (PaO 2/FiO 2)], whether there was shock or not; ventilator parameters [platform pressure (Plat), positive end-expiratory pressure (PEEP)], etc. were recorded. Pulmonary artery oxygen saturation, pulmonary vascular function indexes [transpulmonary potential gradient (TPG) and pulmonary vascular resistance index (PVRi)] were calculated. The relationship between TPG, PVRi and mechanical ventilation time, the length of intensive care unit (ICU) stay, cardiovascular days and 60-day mortality were analyzed in patients with different prognosis of 60-day and whether the TPG increased (≥12 mmHg was defined as elevated TPG, 1 mmHg = 0.133 kPa). Results:A total of 65 patients were included in the study, including 30 males and 35 females; aged (48.9±15.2) years old. Forty-eight cases survived in 60-days, 17 died, and the 60-day mortality was 26.2%. At the baseline, there were no significant differences in cardiopulmonary function measurements, such as CVP, sPAP, dPAP, PAWP, CI, etc. between the two groups of patients with different prognosis. The APACHEⅡ score, shock ratio, TPG and PVRi of the death group were significant higher than those of the survival group [APACHEⅡ: 34±9 vs. 28±11, shock: 52.9% vs. 25.0%, TPG (mmHg): 16.2±1.9 vs. 14.6±2.1, PVRi (kPa·s·L -1): 31.8±4.2 vs. 29.7±3.5, all P < 0.05]. The 60-day mortality of 47 patients with TPG ≥ 12 mmHg was significantly higher than that of 18 patients with TPG < 12 mmHg (34.0% vs. 5.6%), and the mechanical ventilation time and the length of ICU stay were also significantly longer (days: 17±9 vs. 11±8, 16±5 vs. 12±5), and the cardiovascular days also increased significantly (days: 23±7 vs. 18±6), and the differences were statistically significant (all P < 0.05). Pearson correlation analysis showed that PVRi was significantly correlated with mechanical ventilation time, the length of ICU stay and cardiovascular days ( r1 = 0.317, P1 = 0.030; r2 = 0.277, P2 = 0.005; r3 = 0.285, P3 = 0.002). In the individual multivariate Logistic regression model, the highest PVRi was an independent risk factor for the 60-day mortality [odds ratio ( OR) = 30.5, 95% confidence interval was 20.4-43.1, P = 0.023]. Conclusion:Pulmonary vascular dysfunction is common in ALI patients and is independently associated with adverse outcomes.