Objective To explore the influence pulmonary function and inflammatory factors of symbicort combined with ambroxol hydrochloride in the treatment of acute exacerbation of chronic obstructive pulmonary disease( AECOPD) .Methods 86 patients with AECOPD were divided into control group 43 cases and treatment group 43 cases according to the computer random number table method.The control group was given intravenous injection of ambroxol hydrochloride 60 mg/time, 2 times/day, and the treatment group was given inhalation of symbicort 2 inhaling/times, 3 times/day on the basis of the control group.After 7 day treatment, the clinical efficacy and adverse reactions of two groups were observed.The percentage of forced vital capacity ( FVC%) , percentage of forced expiratory volume of 1 seconds( FEV1 %) , percentage of mid expiratory flow predicted value( MMF%) , percentage of max volume predicted value(MVV%) were measured by pulmonary function test apparatus, and the value of FEV1%/FVC% was calculated.The levels of serum tumor necrosis factor alpha(TNF-α), c-reactive protein(CRP) and interleukin 6(IL-6) were detected by ELISA.Results The total effective rate of treatment group and control group were 93.02%(40/43) and 74.42%(32/43), the difference was statistically significant(P <0.05).After treatment the FVC%(2.58 ±0.25),FEV1%(1.87 ±0.15),MMF%(70.24 ±5.86)and MVV%(72.43 ±4.35) in treatment group were higher than the control group (2.21 ±0.27),(1.68 ±0.16),(63.14 ±5.68)and 65.12 ±4.16), the difference was statistically significant(P<0.05).The levels of serum TNF-α(13.87 ±4.12)μg/mL,CRP(9.14 ±3.76)mg/mLand IL-6(76.07 ±10.14)pg/mL in treatment group were lower than the control group (16.56 ±6.48)μg/mL,(12.46 ±3.89)mg/mL and(89.55 ±11.24)pg/mL,the difference was statistically significant(P<0.05).The adverse reactions were mainly for heartburn, nausea, vomiting and skin rashes in the control group,and the adverse reactions were mainly for heart palpitations, headache, nausea, rashes, vomiting in the treatment group, the incidences of adverse reactions 23.26%(10/43) in treatment group compared to control group 18.60%(8/43) was no statistically significant difference.Conclusion The symbicort combined with ambroxol hydrochloride in the treatment of AECOPD have clinical curative effect, can improve the patient's lung function, reduce inflammation, have less adverse reactions.It was worthy of clinical popularization and application.

Objective To explore the relationship between high sensitive C-reactive protein (hs-CRP) and blood stasis syndrome (BSS) in patients with coronary heart disease (CHD). Method Hs-CRP in 45 patients of CHD of BSS type, 50 CHD patients of non BSS type and 50 healthy subjects (control) was determined. Levels of endothelin (ET), nitricoxide (NO), high density lipoprotein cholesterol (HDL-C), triglyceride (TG), total cholesterol (TC), and low density lipoprotein cholesterol (LDL-C) were also measured. Results The level of hs-CRP, TC, LDL-C and ET/NO was markedly increased in the patients of BSS comparing with non BSS and control group, the difference was significant (P

Objective To discuss the value of preoperative digital design of struetund bone graft for acetabular wall defects. Methods The . dieom data from spiral CT scans were imported into Mimics 10.0 to build the 3D solid model of the pelvis of an old female patient with left acetabular wall defects. The 3D solid model of the defect area was built by Mirror and 3D mask editing. A simulated bone graft was conducted on the 3D model by segmentation and trimming according to the data measured on the reconstructed model. Results The reconstructed 3D model of the patient's pelvis could be presented in different colors, transparenees, or combinations of interested tissues. The acetabular wall defects could be visualized very clearly at different angles. The geometric data of the bone graft could be measured to ensure the bone graft would fit the defects accurately. Conclusion Preoperative digital design based on 3D com-puterized reconstruction of acetabular wall defects may provide a valuable aid to clinical treatment, because it is a simple, rapid, and accurate method of increasing the fitness of bone graft and the defects,

Objective To compare the values of the mangled extremity syndrome index (MESI), the mangled extremity severity score (MESS) and the limb salvage index (LSI) in deciding amputation or salvage in the management of the mangled extremity syndrome (MES). Methods Clinical data of 353 MES patients including 95 with amputation and 258 with salvage admitted in recent eight years were retrospectively evaluated by using MESI, MESS and LSI, the value of which in deciding amputation or salvage was assessed with receiver operating characteristic ( ROC ). Results There was statistical difference in aspect of mean scores of three grading systems between patients with amputation or salvage (P＜0. 01). For MESI, MESS and LSI, the sensitivities was 89.47%, 85.26% and 83.15% respectively, the specificities was 100%, 96.89% and 96.12% respectively, the coincidence was 97.16%,93.76% and 92.63% respectively, the areas under ROC curves was 0. 924, 0905 and 0. 861 respectively and the cut-off points were equal or over 20, 7 and 6 respectively. Conclusions Three scoring systems are all highly capable of predicting early amputation or not in MES management. The MESI is recommended as a quantitative criterion for determining amputation or salvage.

Objective To explore the value of ocular fundus artery hemodynamics in diabetes by the correlation study between ocular fundus artery and glycosylated hemoglobin(GHb).Methods GHb was checked in 98 patients (196 eyes) in diabetes,including 49 cases (98 eyes) before treatment and 49 cases (98 eyes) after treatment,and normal group of 100 cases (200 eyes)An all cases,color Doppler ultrasonography was used for monitorind ophthalmic artery(OA),central retinal artery(CRA) and posterior ciliary artery (PCA).Finally,the differences of the parameters vauels of the the OA,CRA,and PCA between diabetic and normal group were studied in order to find out the relationship with GHb.Results Of 98 patients in diabetes,peak systolic velocity and end diastolic velocity of fundus artery decreased,resistance index increased(RI).There was significant difference between diabetic and normal group(P ＜0.05),and a significant difference was exited between diabetic group before and after treatment(P ＜0.05).GHb were negatively correlated with the velocity of fundus artery,and positively correlated with RI.Conclusions Evaluation of ocular fundus artery hemodynamics in diabetes can provide useful information for diabetic retinal perfusion and function change.For evaluation of diabetic retinal disease,it is of great value in clinical application.

Objective To evaluate the role of breast MRI in detecting the primary malignancy in patients presenting solely with axillary lymph node metastases. Methods Thirty-three patients with axillary lynph node metastases but negative findings on either physical examination or mammography underwent breast MRI to identify occult breast carcinoma. MRI of the breast was assessed according to BI-RADS criteria. The pathologic diagnosis was made according to the standard criteria by the WHO Classification of Tumor. Results Among 33 patients presenting solely with axillary metastases, 30 patients underwent modified radical mastectomy. Primary breast carcinoma was proven in 17 patients. MRI detected lesions in 16 patients, including 10 masses and 6 non-mass lesions. Size of the masses ranged from 0. 5 to 2. 6 cm (mean 1.5 cm). Six lesions were smaller than 1.5 cm in size. Non-mass lesions showed ductal enhancement in 4 cases and segmental enhancement in 2 cases. One patient with tumor detected by histopathology showed no abnormal enhancement on MRI. No tumor was found at mastectomy in the other 13 womeu, and negative MR findings were revealed in 9. Four cases with suspicious enhancement on MRI had no corresponding primary foci on pathology. Three patients didn't undergo surgical procedure. The sensitivity, specificity, and accuracy of MRI in the diagnosis of the primary malignancy were 94. 1%,69. 2%, and 83.3%, respectively. Conclusions Small size of mass and ductal or segmental enhancement of non-mass lesion were common MR features of occult malignancy. MRI showed high sensitivity and accuracy in diagnosing occult breast carcinoma. Breast MRI should be taken in search of occult malignancy in patients with axillary metastases.

Objectives To analyze the risk factors for transfusion in very low birth weight infants and to explore the strategies for prevention of anemia. Methods Neonates with gestational age <37 weeks and birth weight <1500 g admitted from January 2015 to June 2016 were included. The neonates were divided into blood transfusion group and non-blood transfusion group. The general conditions and complications were compared, and the risk factors of blood transfusion and the related factors were analyzed. Results One hundred fifty cases of very low birth weight infants were included, among whom 108 cases were from blood transfusion group and 42 cases were from non-blood transfusion group. Compared with the non-blood transfusion group, the gestational age and body weight of the blood transfusion group were smaller, the basic hemoglobin was lower, the parenteral nutrition time was longer, and the total volume of blood collection in hospital was higher, and these differences were all statistically significant (P all<0.05). The incidence of bronchopulmonary dysplasia (BPD), acute respiratory distress syndrome (RDS) and patent ductus arteriosus (PDA) in the blood transfusion group were higher than those in the non-blood transfusion group, and they were all statistically different (P all <0.05). Multiple linear regression analysis showed that the volume of blood transfusion was higher when the gestational age and body weight were smaller, the longer parenteral nutrition was needed, and the total volume of blood taken from the hospital was higher (P all <0.05). Conclusions The gestational age, body weight, parenteral nutrition time and the total volume of blood collection in very low birth weight infants have different effects on blood transfusion risk and transfusion volume. The incidences of BPD, RDS, and PDA in infants with blood transfusion are higher.

Objective To compare the two-dimensional (2D) and three-dimensional (3D) shear wave elastography (SWE) technology in the diagnosis of early stage breast cancer.Methods 84 patients (94 breast lesions) with breast disease confirmed by pathological examination were enrolled from December 2014 to December 2016.All patients underwent 2D and 3D color Doppler ultrasound and the relevant SWE examinations.The optimal maximum and mean elastic modulus of 2D and 3D SWE for diagnosing the benign and malignant breast lesions were obtained by the receiver operating characteristic curve (ROC).Based on the results of pathological examinations,the sensitivity,specificity and accuracy of 2D SWE and 3D SWE in benign and malignant breast lesions diagnosis were evaluated and compared.Results The optimal maximum and mean elastic modulus of 2D SWE for diagnosing the benign and malignant breast lesions were 98.82 kPa and 43.88 kPa respectively,while the corresponding modulus of 3D SWE were 102.54 kPa and 53.87 kPa.The sensitivity of 2D SWE and 3D SWE in breast cancer diagnosis was 89.5％ and 86.3％ respectively,and the difference was not statistically significant (P＞0.05).The specificity and the accuracy of 2D SWE in breast cancer diagnosis were 95.3％ and 92.7％ respectively,which was significant higher than 83.9％ and 85.1％ of 3D SWE,and the differences were statistically significant (all P＜O.05).Conclusions The efficiency of 2D SWE examination is significantly higher than the 3D SWE in benign and malignant breast lesions diagnosis,which can provide a reliable diagnostic basis and is worthy for clinical application.

Objective To assess the enhancement characteristic of breast lesions of contrast-enhanced ultrasound (CEUS) in comparison with contrast-enhanced magnetic resonance imaging (MRI).Methods Between August 2011 and March 2013,72 women with 72 lesions were enrolled.All patients underwent ultrasound,CEUS and MRI.The histopathologic results obtained from ultrasound-guided core biopsy or operation excisions were used as the reference standard.CEUS section evaluations were made similar with MRI regarding the size and shape of lesions.Different contrast enhancement patterns including homogeneous/heterogeneous,the tumor areas,the perfusion defect areas,and modality of time-intensity curve were evaluated.Pearson's correlation coefficient,Student's t-tests,and the concordance test were used for evaluation.Results Of the 72 lesions,pathologic examination revealed 56 (77.8％) malignant lesions and 16 (22.2％) benign lesions.The tumor areas measured by CEUS and MRI agreed well,with a correlation of r =0.894,P =0.000.The difference between the two measurements was not significant according to a paired t test (P =0.886).The concordance tests gave a value of the coefficient Kappa =-0.153 (P =0.061),indicating a low concordance between the results obtained with CEUS and those obtained with MRI regarding the enhanced uniformity.There were statistically significant differences in the perfusion defect areas as measured by CEUS and MRI (P =0.01).The CEUS estimates [(0.837 ± 0.827)cm2] were consistently higher than the MRI estimates [(0.576 ± 0.524)cm2].The time-intensity curve patterns between the two groups showed no correlation.Conclusions The enhancement patterns evaluated by CEUS and MRI partly agreed well.There was no direct association between the two methods regarding the enhancement patterns because of the different contrast agent.

Objective: To study the 3D positional changes occurring to anchor molars of 37 patients treated with MBT appliance. Methods: Thirty seven patients who needed maximum upper molar anchorage were divided into two treatment groups at random, group Ⅰ was comprised of 19 patients whose anterior teeth were retracted en masse, and group Ⅱ included 18 patients whose anterior teeth were retracted by two step. All the patients were treated with MBT appliance and headgear. Dental casts recorded before and after treatment were analyzed by YM 2115 three dimensional digitizer and related software. The changes of anchor molar tip,torque and rotation were compared between the two groups. Results: During the treatment, average anterior movement of the upper first molars was 4.53 mm, average extrusion of the upper first molars was 1.53 mm; the crown of the upper first molar tipped forward (6?4)?,torque buccally (3?6)?,and mesiolingually rotated 3.15?; In en mass group, the crown of the upper first molar tipped more mesially than the two step group, and the difference was statistically significant. Conclusion:Almost all the upper first molars showed the tendency to rotate and tip mesially and torque bucally; there was no statistically significant difference between the two treatment groups when upper molar positional changes were concerned except for the mesial tip of the crown.