Chronic obstructive pulmonary disease(COPD) is a common condition among the old,which remains a main cause of death due to its high fatality.Airway remodeling is one of its pathological features.This article reviews the pathological changes and imageological assessment of COPD airway remodeling,its correlation with microbes and its pathogenesis and therapies.

OBJECTIVE:To observe therapeutic efficacy and ADR of oral administration and external application of Qili san in the treatment of trauma-induced swelling and pain. METHODS:70 traumatic patients were randomly divided into treatment group and control group with 35 patients in each group. Treatment group was given Qili san(1.5 g/time,2 times/d)orally,and ap-plied to affected area(blended with 75% alcohol to make paste,1 time/d);control group was only given Qili san(1.5 g/time,2 times/d) orally;a treatment course lasted for 7 d. Pain degree score,pain duration,swelling degree score and improvement rate, total effective rate and ADR were compared between 2 groups before and after treatment. RESULTS:Compared with before treat-ment,pain degree score,pain duration and swelling degree score of 2 groups were decreased after treatment;there was statistical significance(P<0.01 or P<0.05);clinical symptom of treatment group was better than that of control group;there was statistical significance(P<0.01 or P<0.05). There was statistically significant difference in the improvement rate of swelling and total effec-tive rate between 2 groups after treatment(P<0.01 or P<0.05). No obvious ADR was found during treatment. CONCLUSIONS:Oral administration and external application of Qili san is safe and effective for trauma-induced swelling and pain,and its therapeu-tic efficacy is better than only oral administration.

Specialists in the south of the five ridges think that bubonic plague is caused by blood stasis due to noxious heat;they exactly use Wang Qingren' Decoction of Detoxification and Promoting Blood Flow modified for detoxification,clearing heat and removing blood stasis.Peach Seed and Safflower are principal drugs of this decoction;using Rhinoceros Horn,Antelope Horn and Tibet Safflower to clear noxious heat for protecting the heart.The key to make curative effect is that this decoction needs to be obeyed urgently frequently and modified according sighs.They have found the substitutes of precious Rhinoceros Horn,Antelope Horn and Tibet Safflower.

Specialists in the south of the five Ridges LUO Zhi-yuan think that upper-jiao syndrome of bubonic plague appears in the second and third days,middle-jiao syndrome in the period of the third to the sixth days,and lower-jiao syndrome appears at the seventh day.Upper-jiao syndrome of bubonic plague is the most complicated,including the severe syndrome,the critical syndrome,the deadly syndrome.They summarize the six symptoms and signs in middle-jiao of bubonic plague,including "extreme heat and thirst,black and prickly tongue,abdominal distention and pain,stercoroma and delirium,heat accumulation with watery diarrhea,cold feeling of the whole body and hidden pulse",and the four symptoms and signs in middle-jiao,including "pain,distention,stercoroma,heat accumulation with watery diarrhea".They also pointed out that preserving body fluid is key for treating lower-jiao syndrome of bubonic plague.

Objective To obtain an accurate prevalence of dementia and Alzheimer's disease (AD) in large sample of ≥75 year old elderly living in Guangzhou city. Methods From August 1994 to December 1995, the study was conducted in Liwan District of Guangzhou, China. A two stage cluster sampling design was used to obtain a large sample. ‘Jiedao’ (resident unit in China) was the primary sampling units (PSU),‘Jumin Xiaozu’ (resident group) was the secondary sampling units (SSU). Systematic sampling and simple random sampling procedures were used for the first and second stages, respectively. The study was divided into two phases: a door to door survey of the entire sample aged ≥75 years (4 735 persons), followed by a clinical examination of suspected cases for positive and differential diagnosis. In the first phase, mini mental status examination (MMSE) was used as screening method for dementia. In the second phase, dementia and AD were clinically diagnosed according to the criteria of Diagnostic and Statistical Manual for Mental Disorders (DSM III R) , National Institute of Neurological and Communicative Disorders (NINCDS) and Stroke Alzheimer's Disease and Related Disorders Association (ADRDA). Results The sensitivity and specificity of MMSE were 0 7451 and 0 7496 respectively while the positive predictive value was 0 2251. The prevalence of dementia in individuals aged 75 years and over was 8 90%, in which male and female were found to be 2 91% and 13 11%, and that of AD was 7 49%, male and female found to be 2 01% and 11 36% respectively. The prevalence of vascular dementia (VD) was 1 16%. Of the subjects with dementia, 84 24% was diagnosed Alzheimer's disease, 13% VD, and 2 76% dementia with other causes. The proportion of AD increased obviously by every 5 years. Conclusions The prevalence of dementia in ≥ 75 year persons was lower in Guangzhou than that in Shanghai, but was higher than that in other regional studies within China. In ≥75 year male and/or poorly educated female were more easily suffered from AD. The proportion of AD in dementia was higher in this study than that in others. These figures indicated that as a screening tool for dementia MMSE need improving and should be combined with ADL and POD together.

Breast Neoplasms ; genetics ; metabolism ; Carcinoma, Squamous Cell ; genetics ; metabolism ; Colorectal Neoplasms ; genetics ; metabolism ; Endometrial Neoplasms ; genetics ; metabolism ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Head and Neck Neoplasms ; genetics ; metabolism ; Humans ; Insulin-Like Growth Factor Binding Protein 1 ; genetics ; metabolism ; Insulin-Like Growth Factor Binding Protein 3 ; genetics ; metabolism ; Insulin-Like Growth Factor Binding Protein 5 ; genetics ; metabolism ; Insulin-Like Growth Factor Binding Proteins ; genetics ; metabolism ; Lung Neoplasms ; genetics ; metabolism ; Male ; Ovarian Neoplasms ; genetics ; metabolism ; Polymorphism, Genetic ; Promoter Regions, Genetic ; Prostatic Neoplasms ; genetics ; metabolism

Objective To investigate behavioral disposition of nurses in emergency room and analyze influential factors.Methods A total of 200 nurses from the emergency room participated in the survey using demographic questionnaire and the nursing behavior questionnaire.Results The total average score of the nursing behavior was(3.13±0.54),and the influential factors included the level of hospital,the time span for the job and the continued education on the infectious diseases(all P<0.01).Conclusions The nursing behaviors was at the medium level.The nursing administrators should provide the nurses with personal protection apparatus,strengthen education on infectious diseases and use incentive mechanism so as to improve the ER nurses' nursing behavior.

OBJECTIVE:To provide reference for the establishment of work mode of automatic dispensing system in large-scale integrated pharmacy. METHODS:Introducing the establishment and optimization situation of the automatic pharmacy dispensing system in the outpatient pharmacy of our hospital,changes of related deployment indexes before and after optimization were compared,and the main measures for improving the work efficiency of automatic dispensing system were explored. RE-SULTS:Based on setting and regularly adjusting stored drug varieties,numbers of occupied tracks and unbundled drug factors,de-signing deployment operation mode that the system automatically dispensing preparations to immediate-dispensing and pre-dispens-ing windows,establishing operational specifications and management refinement,the outpatient pharmacy had established automat-ic dispensing system with prescription deployment number more than 12000 pieces/d and optimized work mode. Compared with be-fore optimization,host,auxiliary and smart cabinet varieties were increased in the case of the same number of total staff,immedi-ate-dispensing windows were increased and pre-dispensing windows were decreased. Proportion of full-automatically-dispensed pre-scriptions was increased (up from 41.18% to 48.32%) in the case of total prescription increasing in peak hours,and numbers of hourly prescription deployment were increased in both immediate-dispensing and pre-dispensing windows. Average time to wait for medicine of patients was shortened(down from 5.63 min to 5.18 min),supplemental medicine error and inner errors rate of deploy-ment (down from 0.48% to 0.44%) were decreased (P<0.05). CONCLUSIONS:The established automatic dispensing system mode can meet the needs of prescription deployment in large-scale integrated outpatient pharmacy,and improve the work efficiency by continually optimization.

Objective To study the cerebral energy metabolism changes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) through hydrogen magnetic resonance spectroscopy examination (1 HMRS ) and its relationship with partial pressure of oxygen / carbon dioxide tension.Methods Totally 13 cases of AECOPD patients and 10 cases of age-matched healthy people underwent HMRS examination.The ratios of n-acetyl-aspartate(NAA)/creatine(Cr),choline (Cho)/Cr,myo-inositol(MI)/Cr of parieto-temporal and occipital areas of brain were detected.Blood gas analysis were also used to detect partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2).Results NAA / Cr of parieto-temporal and occipital areas of brain (1.32±0.12,1.48±0.12) were lower in AECOPD group than those in control group (1.45±0.11,1.58±0.10) (P＜ 0.05),MI/Cr (0.23±0.07,0.30±0.11) were also decreased compared with control group (0.40±0.14,0.46±0.12) (P＜ 0.01),while Cho/Cr of parieto -temporal and occipital areas of brain between the AECOPD group and control group showed no significant difference (P＞0.05).NAA/Cr of parieto temporal and occipital areas of brain were positively correlated with PaO2 (r=0.46 and 0.44),and MI/Cr of these areas of brain were also positively related with PaO2 (r=0.63 and 0.50),but MI / Cr of parieto tempora was negatively correlated with PaCO2 (r =- 0.472). Conclusions Cerebral metabolite changes may occur in AECOPD patients,and this has relationship with hypoxia and carbon dioxide retention.

Objective To investigate the difference in ocular surface microbiota between dry eye patients and healthy subjects,and discuss the role of microbiota in dry eye.Methods Twenty cases of dry eye patients and 90 cases of healthy subjects were collected in the PLA General Hospital and Zhongshan Ophthalmic Center.The samples of conjunctiva impression cytology were collected from all subjects,and then metagenomic shotgun sequencing was performed following the DNA extraction.The differences in alpha diversity and metabolic pathways of the ocular surface microbiota between dry eye patients and healthy subjects were evaluated.Results There was no significant difference in alpha diversity of the microbial community between dry eye patients and healthy subjects (P =0.13).However,an increase of 15 species and a decrease of 10 species were detected on the ocular surface of dry eye patients.The enriched antibiotic resistance genes in dry eye patients were more than healthy subjects.Conclusion Although the alpha diversity of the microbial community on ocular surface between dry eye patients and healthy subjects are not distinguishable,a significant difference could be found in relative abundance and metabolic pathways,suggest that these specific microbiome may be related to the pathogenesis and disease progression of dry eye.