Objective To compare large dose or conventional dose of budesonide/formoterol fumarate powder in treatment of stable chronic obstructive pulmonary disease(COPD).Methods 120 patients with stable COPD from March 2015 to March 2016 in Jiaxing Second hospital were selected,were treated with budesonide/formoterol,and were divided into the conventional dose group and high dose groupaccording to different doses,60 cases in each group.Pulmonary function tests,CAT Chinese version scale assessment and 6 min walking distance(6MWD)test were performed before and after treatment,and adverse reactions and acute attack were observed.Results FEV1/FVC and FEV1％were significantly improved after treatment in the two groups,and those in the high dose group were significantly better than those in the conventional dose group,the difference was statistically significant(P<0.05),CAT score and 6MWD were significantly improved after treatment in the two groups,and those in the high dose group were significantly higher than those in the conventional dose group,the difference was statistically significant(P<0.05),adverse reactions such as palpitations,tachycardiain the high dose group were significantly higher than those in the conventional dose group,while the acute attack rate was significantly lower than that of the conventional dose group,the difference was statistically significant(P<0.05).Conclusion High dose of budesonide/formoterol inhalation in the treatment of patients with stable COPD powder can improve the pulmonary function and health status,but adverse reactions increase.

Response surface analysis (uniform precision of central composite design, SAS 9.1.3 software) was applied to optimize the four major factors (ratio of soybean meal to water, enzyme quantity, fermentation time and inoculation quantity) for soybean meal solid fermentation. According to the change of the hydrolyzation degree of soybean protein, the equation of polynomial regression was established between those factors and the response. The result showed that the optimum condition included as follows: ratio of soybean meal to water 1∶1.00,enzyme quantity 2.55%, fermentation time 65h and inoculation quantity 1.00%. Under the optimum level, the degree of hydrolyzation reached 13.3%, which increased 56% over pre-optimization.

Characters of one Candida intermedia yeast strain which isolated from nature can produce ethanol from xylose-fermenting been systemic studied. In conditions 28?C, 120 r/min, 72 h, it can produce 6.480 g/L ethanol from 7% xylose and 43.70% theoretical production of ethanol from 3% xylose. It can produce up to 21.225 g/L ethanol when incubation time prolong to 156 h from 8% xylose. It also can ferment 13% glucose produce 47.647 g/L ethanol and reach 76.90% of theoretical ethanol production, respectively. Compared to CK, ethanol productivity can be improved 9.91% when add 8% xylose in three times as 3%, 2% and 3%, respectively. Glucose can be first utilized in the mixture sugar medium. When the ratio of xylose vs. glucose is 3:1in mixture sugar, the productivity of ethanol can be improving 25%.

Objective To investigate the effects of different tidal volume mechanical ventilation on pulmonary function and inflammatory factors in gynecologic laparoscopic surgery.Methods 45 patients undergoing gynecological laparoscopic surgery without lung disease,ASA Ⅰ-Ⅱ,aged 20-45 years old,weight 45-65 kg,operation time 2-3 hours,were randomly divided into A,B,C three groups,15 cases in each group.Mechanical ventilation with different tidal volume of the three groups,A group,B group and C group were 8mL/kg,9mL/kg,10mL/kg.Blood gas analysis was performed before anesthesia (T0),30 minutes (T1),(T2),PA-aDO2 (60 minutes) (T3),and 120 min (T4),respectively,and the peak airway pressure and mean pressure were recorded.IL-6,TNF-α and IL-10 levels in plasma by radial artery blood sampling were simnultaneously determined.Results Comnpared with A group,the concentrations of Ppeak and Pmean were increased in B group at T1-T4 (t =5.13,4.78,6.54,5.32 and t =7.54,4.88,5.37,4.95;all P ＜ 0.05),the concentration of Ppeak and Pmean in C group at T1-T4 increased (t =7.76,8.87,7.23,8.99 and t =6.42,7.38,7.62,9.86;all P ＜ 0.05).Compared with B group,the concentrations of Ppeak and Pmean were increased in C group at T1-T4 (t =4.76,5.87,4.23,3.99 and t =4.76,3.99,6.06,4.52;all P ＜ 0.05).Compared with A group,the A-aDO2 values of B group and C group were increased at T1,T2,T3 and T4 (t =5.32,5.48,4.88,5.69 and t =7.85,7.32,8.45,6.67;all P ＜ 0.05).Compared with B group at the same time point,the A-aDO2 value of C group increased at four times of T1-T4 (t =5.62,4.38,6.94,4.22,P ＜0.05).Compared with group A,the concentration of A-aDO2 in C group was higher than that in B group at the same time point (t =4.45,4.87,5.32,4.79 and t =7.68,7.59,7.44,8.38;all P ＜ 0.05).The levels of IL-6 and TNF-α in C group were significantly higher than those in the control group (t =4.78,5.56,7.62,8.03 and t =3.98,4.52,5.46,6.23;all P ＜ 0.05).Compared with T0,IL-6 and TNF-α concentrations AT T2-T4 in A group had no statistically significant differences (all P ＞ 0.05).Compared with B group,the levels of IL-6 and TNF-α in C group were significantly higher (t =4.58,4.99,6.53,4.77 and t =5.62,7.89,6.43,4.52;all P ＜ 0.05).Compared with T0,IL-6 and TNF-α concentrations at T2-T4 in A group had no statistically significant differences (all P ＞0.05).There was no significant difference in IL-10 concentration among the thrce groups.Conclusion Laparoscopic surgery according to the end tidal carbon dioxide partial pressure (PetCO2) ventilation frequency,8 mL/kg tidal volume mechanical ventilation has no effect on the IL-6,TNF-alpha,IL-10 and other inflammatory factors,mechanical ventilation tidal volume is more appropriate.

To adapt to the need of current public heath reform and education reform ,the aim of this study is to explore and improve practical teaching mode in preventative medicine for students in specialty of clinical medicine and set up normalized practical teaching base to enhance their concept of preventative medicine and enlarge their knowledge and increase their practical ability and social adoption.

A novel raw-starch-digesting glucoamylase producer,Rhizopus sp.W-08,was used in a novel fermentation system of solid-state followed by submerged,and high enzyme activity of 72 IU/mL was obtained.In the following simultaneous saccharification and fermentation process, Saccharomyces cerevisiae Z-06 directly converted raw corn flour to ethanol with the concentration of 21 % (V/V) at 30℃ after 48h.The conversion efficiency of raw corn flour to ethanol was 94.5 % of the theoretical ethanol yield.

Objective To study the effect of a polysaccharide from cuscuta chinensis lam (PCCL) on antisenility and its mechanism. Methods Sixty Kunming mice were randomized into 6 groups. The three PCCL groups were administrated with PCCL of 100, 200, 400 mg?kg -1?d -1 orally, the positive control group with vitamin E of 200 mg?kg -1?d -1, the model group and control group with the same volume of control solution only. At the same time, the model group, the positive group and the three PCCL groups were subcutaneously injected of 5% D-gal at the dose of 0.5 ml at the nape, and the control with the same volume of saline solution. Seven weeks later, the MDA, SOD activity, GSH-PX activity in the liver and kidney of mice and lipofuscin (LF) in mouse brain were detected with the methods of TBA, Nitrate, DTNB and Sohal, respectively. The data were analyzed with SPSS software and the data between groups were analyzed with one-factor variance analysis. Results Thymus index and spleen index dropped, LF rose in brain, malondialdehyde (MDA) content rose and the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX) dropped in liver and kidney in senile mouse model. PCCL administration of 100, 200, 400 mg?kg -1?d -1 made thymus index and spleen index rising, LF dropping in brain, MDA content dropping,SOD and GSH-PX LF rising in liver and kidney of senile mouse model. Conclusion PCCL may postpone senility, which mechanism probably connected with rising immunity, eliminating oxygen free radicals and antilipoperoxidation.

Objective To evaluate the effect of operation on aged women with breast cancer. Methods The clinical data of the 166 patients recruited from 1989 to 2004 were retrospectively analyzed. Results One hundred and sixty six patients were all treated by operation. The modified radical mastectomy was performed in 98 cases(59.0%), radical masteetomy in 21 cases(12.7%), mastectomy in 29 cases (17.5%), palliative operation in 18 cases (10.8%). After operation, one hundred and twenty six patients received chemotherapy, twelve radiotherapy and 73 endocrine therapy. The rates of postoperative complications were 10.8%, no patients died during operation. The overall postoperative 3-and 5-year survival rates were 82.2% and 65.2% respectively. Conclusions The effect of surgical treatment and its combination with other adjunct therapies is satisfactory for aged women with breast cancer. Different types of operations should be performed for different patients. Ageing is not a contraindication of the operation. Surgery should be combined with medical therapy to reduce the concomitant diseases and postoperative complications.

Objective To evaluate the therapeutic value of endoscopic band ligation in gastric stromal tumors.Methods Twenty-nine patients with small gastric stromal tumors(diameter<12mm)underwent endoscopic band ligation,and were followed up with routine endoscopy and EUS.Results Twentyeight patients recovered completely,with the surface healing up 4-6 weeks(average 4.8 weeks)thereafter.The neoplasm did not slough off in one patient,so he underwent a second ligation.Hemorrhage occurred in one patient three days after ligation,but was successfully managed with hemoclips.Other patients showed no complications.All the patients were followed up for 36 to 51 months,and there was one case of recurrence.Conclusion Endoscopic band ligation is an effective and safe treatment for small GISTs of less than 12 mm.

Objective: To observe the effects of electroacupuncture (EA) on the protein and gene expressions of Bax, Caspase-3 and Bcl-2 in cerebral cortex of type 2 diabetic rats with cognitive impairment (CI), and to explore the mechanism of EA in improving the learning and memory abilities. Methods: A total of 100 Sprague-Dawley (SD) rats were divided into a normal group (n=10) and a model group (n=90) by random number table method. Rats in the model group were intraperitoneally injected with a small dose of streptozotocin (STZ) to establish the type 2 diabetic models, after being fed with high-fat and high-sugar diet for 1 month. Twenty CI rats were selected from the 50 successful model rats by the Morris water maze (MWM) test and randomly divided into a model group and an EA group according to the blood glucose level and MWM data (n=10). Rats in the EA group received acupuncture at Zusanli (ST 36), Neiting (ST 44) and Yishu (Extra), of which Zusanli (ST 36) and Neiting (ST 44) were stimulated by EA apparatus, 20 min/time, once a day for 6 d a week and 4 consecutive weeks. The rats in the model and the normal groups were fixed without treatment. After 4-week treatment, the random blood glucose level of the rats was measured; the learning and memory abilities of rats were measured by MWM; terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay was used to detect apoptotic cells; Western blot (WB) and real-time quantitative polymerase chain reaction (RT-qPCR) were used to detect the protein and gene expressions of Bax, Caspase-3 and Bcl-2 in cerebral cortex. Results: After modeling, the random blood glucose level and the escape latency tested by MWM were significantly increased, and the number of crossing the platform tested by the MWM was decreased in the EA and model groups, and were significantly different from those in the normal group (P<0.05 or P<0.01), while the differences between the model group and the EA group were not statistically significant (all P>0.05). After 4-week treatment, the random glucose level and the escape latency tested by MWM were significantly increased (both P<0.05), and the number of crossing the original platform tested by the MWM was significantly reduced (P<0.01), the protein and gene expressions of Bax and Caspase-3 were significantly increased (all P<0.001), the protein and gene expressions of Bcl-2 were significantly reduced (both P<0.001), and the number of neuron apoptosis was significantly increased (P<0.001) in the model group than in the normal group; the random blood glucose level was significantly reduced (P<0.05), the escape latency tested by MWM was significantly shortened (P<0.05), and the number of crossing the original platform tested by MWM was significantly increased (P<0.05), the protein and gene expressions of Bax and Caspase-3 were significantly reduced (all P<0.001), the protein and gene expressions of Bcl-2 were significantly increased (both P<0.001), and the number of neuron apoptosis was significantly reduced (P<0.001) in the EA group than in the model group. Conclusion: EA can improve the learning and memory damages induced by type 2 diabetic model rats with CI; the action mechanism may be achieved via anti-apoptosis.