OBJECTIVE:To observe the clinical efficacy and safety of tiotropium bromide combined with Salmeterol flutica-sone aerosol in the treatment of severe COPD in elderly patients. METHODS:A total of 90 elderly patients with severe COPD se-lected from May 2013 to May 2015 in our hospital as research objects were divided into control group and observation group ac-cording to random number table,with 45 cases in each group. Control group was given Salmeterol xinafonate and fluticasone propi-onate aerosol 1 press/time,bid;observation group was additionally given Tiotropium bromide powder for inhalation 18 μg,qd,on the basis of control group. Both groups were treated for 8 weeks. The short-term clinical efficacy,dyspnea score,pulmonary venti-lation function indexes [FVC,EFV1,EFV1%],blood gas analysis indexes [p(O2),p(CO2)] and QLI score before and after treat-ment were observed in 2 groups. The re-hospitalization time and the occurrence of ADR were compared between 2 groups. RE-SULTS:The total response rate of short-term treatment in observation group was 97.78%,which was significantly higher than 80.00% of control group,with statistical significance (P<0.05). There was no statistical significance in dyspnea scores,pulmo-nary ventilation function indexes,blood gas analysis indexes or QLI scores between 2 groups before treatment (P>0.05). After treatment,dyspnea scores and p(CO2) of 2 groups were decreased significantly,while pulmonary ventilation function indexes,p??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????(O2)and QLI scores were increased significantly;the observation group was significantly better than the control group,with statis-tical significance(P<0.05). The re-hospitalization time of observation group was significantly less than that of control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P<0.05). CON-CLUSIONS:Tiotropium bromide assisted with Salmeterol fluticasone aerosol show significant therapeutic efficacy for elderly se-vere COPD,and effectively relieve dyspnea symptom,improve pulmonary ventilation function and quality of daily life,reduce the re-hospitalization risk and do not increase the incidence of ADR.

Object To develop an immunoassay method of species-specific protein for Radix Glycyrrhizae (RG) identification. Methods The crude drug of RG as a model was studied in this paper,the antigen of RG protein (RGP) was screened by Western-blot analysis using anti-RG serum. After species-specific protein,RGP was purified,and rabbit antiserum against RGP was prepared,the rabbit IgG of anti-RGP was isolated and biotinylated,then the sandwich enzyme-linked immuosorbent assay (ELISA) was developed. Results The method was only specific to RG,which was harvested from various areas or species,and showed excellent sensitivity and reproducibility. Conclusion The result suggests that the immunoassay method using specific antigen of RGP as a detection objective be a new potential for the unequivocal identification and quality control of RG.

Binding Sites ; Histone-Lysine N-Methyltransferase ; chemistry ; metabolism ; Histones ; chemistry ; metabolism ; Humans ; Methylation ; Multiprotein Complexes ; chemistry ; metabolism ; Nuclear Proteins ; chemistry ; metabolism ; Protein Binding ; Protein Conformation ; Yeasts ; chemistry

Objective To explore the forensic pathological characteristics and the main identification points of fatal cardiac tamponade. Methods 38 cases of fatal cardiac tamponade from department of pathology, the first affiliated hospital of chengdu university of TCM from 2005 to 2015 were reviewed and analyzed retrospectively. Results Fatal cardiac tamponade mostly occurred to men (71.1%) with an average age of 44; Bloody effusion accounted for 85% of the direct causes of death (34 cases). The most underlying causes of death were diseases (73.7%), majorly aortic dissection, coronary heart disease and malignant tumors. Seventy five percent of death occurred within 12 hours of illness. Medical behaviors were involved in 30 cases (78.9%), of which 26 cases (86.7%)were without medical malpractice. The relationship between injury and disease was involved in 15 fatal cases (39.5%). Conclusion The basic requirement for accurately completing forensic medical appraisal of fatal cardiac tamponade cases was to master the forensic pathological characteristics and the path of forensic identification.

An increasing number of studies have demonstrated that exosomes are closely associated with liver fibrosis and mediate the process of liver fibrosis by participating in cytokine secretion, macrophage activation, extracellular matrix remodeling, and hepatic stellate cell activation. This article summarizes that the resolution of liver fibrosis requires the reduction of pro-inflammatory and fibrotic cytokines, the reduction of extracellular matrix protein production, the increase of collagenase activity, and finally the loss of activated myofibroblasts. It is believed that exosomes play an important role in the treatment of liver fibrosis and are potential markers for diagnosis and treatment, and in future studies, it is necessary to improve exosome extraction techniques and standardization of treatment quantification.