Objective To investigate the relationships of pulmonary arterial pressure (PAP) with serum protein S100B, cytokines and plasma procalcitonin (PCT) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A prospective controlled study was conducted, 160 subjects admitted in the Critical Care Medicine and Respiratory Disease Departments in the Affiliated Hospital of Shanxi Medical University/Changzhi Municipal People's Hospital from January 2012 to August 2013 were enrolled in the study, including 80 patients with AECOPD (AECOPD group) and 80 COPD under stable condition (SCOPD group). Meanwhile 100 healthy people having passed physical examinations were chosen as healthy control group. The levels of blood routine and plasma PCT were examined, PAP was evaluated by modified Simpson, sequation with echocardiography, serum S100B was measured by radioimmunoassay, and enzyme linked immunosorbent assay (ELISA) was used to measure interleukins (IL-18, IL-1β) and tumor necrosis factor-α(TNF-α). The linear correlation analysis was carried out for the various indicators. Results The gender and age in different groups were matched. Compared with the healthy control group, the levels of white blood cell count (WBC), ratio of neutrophil granulocyte (PMN), PAP, PCT and S100B, IL-18, IL-1β, and TNF-αwere significantly higher in SCOPD and AECOPD groups [WBC (×109/L):0.84±0.22, 1.94±0.64 vs. 0.73±0.12, PMN: 0.70±0.09, 0.85±0.08 vs. 0.54±0.05, PAP (mmHg, 1 mmHg = 0.133 kPa): 39±5, 47±8 vs. 24±5, PCT (μg/L): 0.41±0.08, 6.35±2.14 vs. 0.11±0.01, S100B (μg/L): 0.081±0.017, 0.101±0.028 vs. 0.041±0.011, IL-18 (ng/L): 162±19, 181±27 vs. 112±19, IL-1β(ng/L): 55±12, 75±14 vs. 34±10, TNF-α(ng/L):67±17, 89±18 vs. 35±17, all P<0.05], and the increase in level of indexes was more significant in AECOPD group than that in the SCOPD group (all P < 0.01). Serum S100B was significantly positively correlated with PCT, IL-18, PMN and PAP (r value was 0.36, 0.41, 0.39, 0.35, all P<0.05), and plasma PCT was also significantly positively correlated with PMN and PAP (r value was 0.41, 0.37, both P<0.05). Conclusion The level of serum S100B might have positive obvious correlation to the changes of plasma PCT, cytokines and PAP.

Objective:To explore the intervention effect of swallowing function training based on swallowing function assessment and aspiration risk classification in elderly patients with dysphagia.Methods:From January 2018 to December 2019, convenience sampling was used to select patients with dysphagia admitted to the Department of Geriatrics of the First Affiliated Hospital of Zhengzhou University. The patients were divided into a control group and an observation group according to the hospital stay. The patients hospitalized from January to December 2018 were in the control group, and the patients hospitalized from January to December 2019 were in the observation group. The control group carried out routine nursing for swallowing dysfunction, and the observation group implemented swallowing training based on dynamic swallowing function assessment and aspiration risk classification for 6 weeks. The Standardized Swallowing Assessment (SSA) score and aspiration risk grade, Deglutition Handicap Index (DHI) score, and the incidence of aspiration and aspiration pneumonia were compared between the two groups.Results:Among the 185 patients, 3 cases were eliminated without completing all training. There were 83 cases in the control group and 99 cases in the observation group. The SSA score and aspiration symptom scores of DHI of the control group after intervention were higher than those before intervention, and the differences were statistically significant ( P<0.05) . After the intervention, the SSA score, total score and scores of all dimensions of DHI of the observation group were lower than those before and of the control group after intervention, and the differences were statistically significant ( P<0.05) . After the intervention, the aspiration risk classification of the two groups was compared, and the difference was statistically significant ( Z=9.143, P<0.001) . The aspiration rate and the incidence of aspiration pneumonia in the observation group were 13.13% (13/99) and 7.07% (7/99) respectively, and the aspiration rate and the incidence of aspiration pneumonia in the control group were 25.30% (21/83) and 18.07% (15/83) , the differences were statistically significant ( P<0.05) . Conclusions:Swallowing function training based on dynamic swallowing function assessment and aspiration risk classification can effectively improve the swallowing function and quality of life of elderly patients with dysphagia, and reduce the incidence of aspiration and aspiration pneumonia.

Objective: To investigate the clinical characteristics of diabetic patients combined with acute myocardial infarction (AMI) and to compare the prognosis between diabetic and non- diabetic patients in 4-5 years after the onset of AMI. Methods: Followed the certain inclusive and exclusive criteria, a total of 420 patients with acute myocardial infarction were included and divided into diabetes group (group D) and non-diabetes group (group N) with numbers as 161 people and 259 respectively. Baseline data, clinical information, short-term outcome and long-term prognosis of the two groups were compared and analyzed. Results: Among the patients with diabetes, the average age was older (65.65±11.33 vs. 63.30±15.34), with fewer males (64.59% vs. 79.92%); and more likely to have other complications as hypertension (64.60% vs. 53.28%) or hyperlipidemia (42.24% vs. 26.25%). 59.29% of the patients in group D showed pathological changes in 3 major coronary arteries, which were significantly more than its counterpart (40.83%). The proportion of patients that had undergone the coronary artery bypass, grafting (11.11% vs. 5.31%) appeared also higher. There was no significant difference seen in the short-term outcomes between the two groups, but results from the long-term follow-up program showed that both the incidence of Major Adverse Cardiovascular Events (MACE) (50.67% vs. 27.72%) and the all-cause mortality (20.00% vs. 9.90%) in group D were higher than those appeared in group N (27.72%). Conclusions Patients suffered from the combination of both diabetes and acute myocardial infarction appeared older in age, more in females, with more complications and the coronary artery lesions were more severe and wider. During hospitalization, no significant difference was seen regarding the short-term outcomes between the two groups but the results from long-term follow-up process showing that the risk of MACE events was significantly higher in patients with type2 diabetes.