Objective To evaluate the efficacy and safety of tiotropium bromide in treating stable mild and moderate chronic obstructive pulmonary diseases. Methods A randomized,double-blind,parallel comparison clinical trial was conducted in 40 patients with COPD. Twenty patients in tiotropium bromide group were treated by tiotropium bromide powder,and another twenty patients in controll group were given ipratropium,in contrast. The spirometry of both groups was conducted. 4 weeks after treatment. Results The forced expiratory volume in one second ( FEV1 ) and forced vital capacity(FVC) in two groups were significantly increased after treatment( P<0.01 ). The increase of FEV1 in tiotropium bromide group was higher than that in controll group after 4-week. There was no significant differ-ence in rescue medication consumptions. The incidence of adverse effects has no statistical difference between two groups. Conclusion Tiotropium bromide is an effective and safe bronchodilator in treating patients with COPD.

Objective: To evaluate the clinical effectiveness of multi-directional mechanical traction (MT) for the treatment of patients with lumbar disc herniation (LDH) compared with longitudinal traction (LT) as control. Method: This prospective, single-blind, randomized clinical trial was performed in Qi Lu Hospital, Shandong University from January 2008 to December 2008. One hundred and twenty outpatients with LDH were randomly divided into MT group or LT group. MT group was treated with computer-controlled multi-directional mechanical traction.LTgroupwastreatedwithlongitudinaltraction.RolandMorrisLowBackPainandDisability Questionnaire (RMDQ), visual analogue scale (VAS), and straight leg raising (SLR) angle were measured for every patient pre-, 4 weeks post-, and 1 year post-treatment.Result: The results of clinical observations showed significant improvements inRMDQ, VAS, and SLR angle assessments (all P＜0.05) in both groups 4 weeks post- and 1 year post-treatment compared with pre-treatment. Score of RMDQ in MT group was significantly lower than that in LT group(P＜0.05), however, there was no significant difference between two groups in VAS score and SLR angle (P＞0.05). The differences in improvement ratios between two groups were not significant (all P＞0.05). The clinical outcomes were negatively correlated with patient's age and disease duration.Conclusion: The effect of MT is equivalent and probably superior to that of LT in improving the symptoms and clinical findings of patients with LDH.

Objective To observe the morphologic changes of dorsal root ganglion in the lumbar region of rabbits after the nerve root was under chronic compression and inflammatory stimulation. Methods Twenty New Zealand rabbits were recruited for this study, of which 5 served as the control (control group), and the rest were randomized into 3 experimental subgroups: 10d group, 30d group, 90d group, respectively. The autologous nucleus pulposus from the tails (about 5mg) was put into the silastic tube (inner meter of 1.5mm, external diameter 2.5mm and length 12mm), which was inserted into the left L 7 intervertebral foramen to compress the lumbar nerve root. Sham operation was performed with the rabbits in the control group. The nerve root and the dorsal root ganglia were harvested and processed and observed with light microscope and electron microscope after 10d, 30d, 90d, respectively. Results In the 10d group, obvious hyperemia, edema and infiltration of inflammatory cells in the interspace of the intima of the dorsal root ganglia (DRG) could be observed. Pyknosis, degeneration and necrosis were also found in some of the nerve cells. Electron microscopic observation showed that the number of the rough endoplasmic reticulum and mitochondrion decreased, ribosome exfoliated, mitochondrion swelled. In 30d group, typical degeneration and necrosis became more obvious. Electron microscope showed that the number of lysosome and smooth endoplasmic reticulum increased, mitochondrion swelled and its cristae disappeared, nuclei concentrated and deviated. In 90d group, significant proliferation of fibrocyte could be observed. At the same time, dura mater and arachnoid of spinal cord around the nerve root were notably thickened, and became fibrogenesis. Electron microscope also showed the increment of the lysosome and smooth endoplasmic reticulum, the swelling of mitochondrion, the loss of its cristae and the concentration of the nucleolus in the central part of the nuclei. No significant changes were found in the control group. Conclusion Pathological changes of neural degeneration such as edema, inflammatory infiltration could be observed in dorsal root ganglion after the nerve root was under chronic compression and stimulation by autologous nucleus pulposus.

Objective To quantify the temporal changes in the volume of blood flow to the skin of the forearm and lower leg during static maximum inspiratory breath-holding of different durations.Methods Blood flow to the skin of the forearm and lower leg were continuously measured with laser Doppler flowmetry in 12 healthy subjects.They were randomly selected to hold their breath for 10,20 or 40 seconds,or as long as possible.The volume of skin blood flow,the onset latency and the recovery latency were measured before,during and after the breath holding.Results Blood flow decreased significantly during each breath-hold with any durations.The magnitude of the decrease and its latencies were similar with all the durations.The average volume of skin blood flow and it's minimum value during each breath-hold were significantly lower in the forearms than in the lower legs.However,the average onset latency (4.41 ±0.44 s) and the average recovery latency (5.95 ±0.59 s) in the forearms were significantly shorter than in the lower legs (4.83 ± 0.70 s for onset and 7.33 ± 0.91 s for recovery).Conclusion The volume of skin blood flow decreases during a static maximum inspiratory breath-hold,and the magnitude of the increase is not related to the duration of the breath-hold.The generalized increase in skin sympathetic vasoconstrictor activity during a static breath-hold is greater in the forearm than in the lower leg.

Objective: To investigate the current status of knowledge and practice pertaining to nosocomial infection control among medical professionals in grassroots healthcare institutions, so as to provide the evidence of improving the level of infection control in grassroots healthcare institutions. Methods: All medical professionals working in grassroots healthcare institutions in Pukou District, Nanjing City, were enrolled. The participants' demographic features and knowledge and practice of nosocomial infection control were collected using self-designed questionnaires and descriptively analyzed. Results: A total of 402 participants were enrolled, included 116 men ( 28.86% ) and 286 women ( 71.14% ). The respondents were predominantly at ages of 41 years and older ( 187 subjects, 46.52% ), with bachelor and above as the predominant educational level ( 200 subjects, 49.75% ) and intermediate title and above as the predominant professional title ( 168 subjects, 41.79%) , and there were 236 participants ( 58.71% ) with the length of service for more than 10 years. The awareness rate of nosocomial infection control knowledge was 56.22% among medical professionals working in grassroots healthcare institutions, with the highest awareness for COVID-19 prevention and control ( 89.55% ) and the lowest awareness for the key aspects in nosocomial infection control ( 39.55% ). The formation rate of implementing nosocomial infection control practices was 84.08%, with a low rate for “Implement satisfactorily the isolation interventions for patients with multidrug resistant bacteria” ( 71.14% ) and “Implement satisfactorily the control measures for nosocomial infections in key departments and key aspects”( 64.68% ). Conclusions Low levels are seen in the awareness of nosocomial infection control, behaviors of multidrug resistance management and key aspects in nosocomial infection control among medical professionals in grassroots healthcare institutions in Pukou District.

Objective To investigate the biophysical properties of mechanosensitive(MS) channels in cultured dorsal root ganglion neurons of neonatal rats. Methods MS channels current of cultured dorsal root ganglion neurons of neonatal rats were recorded using cell-attached and inside-out patch-clamp technique.The biophysical properties such as pressure response relationship,current voltage relationship,channel kinetics and ion selectivity were analyzed.Membrane stretch was achieved by the application of negative pressure(suction) to a patch-clamp electrode. Results One type of MS non-selective cation ion channels in the membrane patches tested in cultured dorsal root ganglion neurons of neonatal rats were recorded. Those channels were activated rapidly when suction was applied, and kept active during sustained application of negative pressure and quickly turned off when the suction was released.The MS channels exhibited a nearly linear current voltage relationship in the balance solution.The outward chord conductance was (96.2?3.6)pS (mV is between +40 mV and +60 mV) and the inward slope conductance was (62.5?0.4)pS (mV is between -60 mV and 0 mV). This kind of channels appeared to be outward rectifier.The average reversal potential was (-2.3?0.8)mV.The channel kinetics analysis indicated that suction could significantly increase the duration of short-openings and long-openings and decrease that of long-closings,with no effects on short-closings. Conclusion The results of this study could serve as a reference to the understanding of electric activity of DRG neurons.

Objective To investigate the clinical effect of systemic rehabilitation on stiffness of finger joints after hand injury. Methods A total of 213 stiff fingers were observed in patients with hand injury. All the patients were administered with therapeutic exercise, physical modalities and splinting. The improvement of the patients in terms of active range of motion (AROM) and passive range of motion (PROM) of their fingers was graded as excellent, good, adequate or poor according to the standard the authors set. Results With regard to their AROM and PROM, 82.2% and 94.8% of the patients got excellent improvement, 97.7% and 100% of the patients got excellent to adequate improvement, respectively. The finger function was increased from 17% to 56%. Conclusion Systemic rehabilitation can increase the AROM and PROM of stiff finger effectively and improve the patients' hand function.

Objective To investigate the effect of lidocaine on Staphylococcus aureus exotoxin-stimulated peripheral blood mononuclear cells (PBMCs) from patients with atopic dermatitis (AD).Methods Peripheral blood samples were collected from 6 patients with AD,and PBMCs were isolated by a routine method.Then,the PBMCs were stimulated by the Staphylococcus aureus exotoxin toxic shock syndrome toxin-1 (TSST-1) in the absence or presence of lidocaine at varying concentrations.The 3H-TdR incorporation method was performed to detect the proliferation of monocytes,and enzyme-linked immunosorbent assay (ELISA) to quantify the levels of T helper type 1 (Th1) and Th2 cytokines released by PBMCs.Human HaCaT keratinocytes were co-cultured with lidocaine-and TSST-1-stimulated PBMCs from patients with AD for 72 hours,then,Western blot was conducted to examine the expression of filaggrin protein in HaCaT cells.Results TSST-1 (100 μg/L) significantly enhanced the proliferation of PBMCs from patients with AD (stimulation index =75 ± 2.12,P ＜ 0.05),as well as the release of tumor necrosis factor-α (TNF-α),interferon (IFN)-γ,interleukin (IL)-2,IL-12,IL-4,IL-5 and IL-13 by the PBMCs (all P ＜ 0.05).Compared with the blank control group,100 μmol/L lidocaine significantly inhibited the TSST-1-stimulated proliferation of PBMCs from patients with AD (stimulation index =58 ± 3.14,P＜ 0.05),as well as the release of IL-4,IL-5,IL-13,TNF-α and IFN-γ by the stimulated PBMCs (all P ＜ 0.05).Western blot showed that 100 μmol/L lidocaine significantly blocked the down-regulation of filaggrin expression in HaCaT cells (P ＜ 0.01).Conclusion Lidocaine has a significant inhibitory effect on the activation of TSST-1-stimulated PBMCs from patients with AD.

0.05) but a statistically significant negative correlation was noted between serum cholesterol and zinc (r= -0.9986, P

Objective:To explore the effect and safety of the improved treatment of severe neonate hyperbilirubinemia by the automatic and synchronous exchange transfusion of peripheral artery and vein.Methods:From January 2016 to December 2019, 25 newborns with severe hyperbilirubinemia treated by automatic and synchronous exchange transfusion of peripheral artery and vein were selected in the research.During the operation of exchange transfusion, there were two pathways, the bloodletting one through the arteries and the transfusion one through the veins [the latter was connected to the blood-conveying leather pipeline special for Graseby 3000 syringe pump by the indwelling needle.The filter of the leather pipeline is Y-shaped and had two parallel blood transfusion plugs, one inserted into the red blood cell(RBC) bag, and the other into plasma bag.After infusion of 100 mL of RBC, clamped the RBC bag, and infused 500 mL of plasma.Then clamped the plasma bag and infused 100 mL of RBC.They were alternately operated]. The artery and the vein form a blood circuit, which was controlled by three infusion pumps (the first pump was for bloodletting, the second for transfusion, and the third for heparin sodium infusion). Hence the exchange transfusion became full-automatic.The changes of blood routine, total blood bilirubin(TBIL), blood gas analysis, blood glucose, electrolytes, blood culture and vital signs before and after transfusion were observed.Results:A total of 25 patients were studied, and the exchange transfusion time was controlled between 90-120 minutes.After transfusion, there were no statistically significant changes in breathing, heart rate, blood pressure, electrolytes and blood gas analysis(all P>0.05), while the serum TBIL and platelets(PLT) levels were significantly decreased[the amount of TBIL before and after blood transfusion: (485.8±126.5)μmol/L vs.(207.9±68.4)μmol/L; the amount of PLT before and after blood transfusion: (301.6±118.3)×10 9/L vs.(125.3±60.2)×10 9/L] ( t=-6.924, P<0.01; t=-7.986, P<0.01), and white the blood cells(WBC) was decreased [before blood transfusion: (12.57±6.11)×10 9/L, after blood transfusion: (8.98±3.24)×10 9/L, t=-2.922, P<0.05]. The trace blood glucose(TBG) was higher than normal after blood transfusion, with a significant change[before blood transfusion: (4.9±0.7)mmol/L, after blood transfusion: (7.1±1.5)mmol/L, t=3.866, P<0.01]. TBG restored within 24 h after exchange transfusion, PLT and WBC backed to normal within 72 h. Blood bacterial culture was negative in all cases after the exchange transfusion.No serious complications occurred and all patients were cured. Conclusion:It is simple, safe and reliable to treat severe neonate hyperbilirubinemia by the peripheral automatic exchange transfusion controlled by infusion pumps.The treatment is worthwhile to be recommended for clinical use in primary hospitals.