Objective To observe the clinical efficacy of low-dose erythromycin combined with salmeterol-fluticasone in the treatment of stable COPD, focus on the quality of life and respiratory function of patients.Methods 87 patients with stable COPD admitted to Hangzhou Red Cross Hospital from January 2014 to January 2016 were selected.Patients were divided into two groups by therapeutic methods, observation group ( salmeterol-fluticasone+erythromycin) 46 cases and control group (salmeterol-fluticasone) 41 cases.Six months of treatment, the quality of life of two groups of respiratory function assessment, acute COPD and peripheral inflammatory factor and other indicators of change.Results After treatment, both of the two groups got significantly decreased in SGRQ and MMRC scores, while the observation group was significantly lower than the control group, the difference was statistically significant(P<0.05).After treatment, FEV1/FVC%levels were significantly increased in both groups, but the observation group was significantly higher than the control group, the difference was statistically significant(P <0.05).The cumulative incidence of acute exacerbation of COPD was 10.87%(5/46) in the observation group, which was significantly lower than that in the control group 29.27%(12/41), the difference was statistically significant(Log-rankχ2 =4.833, P=0.028).After treatment, the levels of IL-1βand TNF-αin the peripheral blood of the patients in the observation group were significantly lower than those in the control group, the difference was statistically significant (P <0.05).Conclusion In the treatment of stable COPD, low-dose erythromycin could significantly improve the clinical efficacy, improve the quality of life and respiratory function.

Malignant obstructive jaundice is biliary obstruction caused by malignant tumors.When a patient presents to a doctor,he/she is usually too late to be operated,so endoscopic treatment has gradually replaced surgery in its management.Diagnostic endoscopic methods include endoscopic retrograde cholangiopancreatography (ERCP),endoscopic ultrasonography (EUS),and per oral cholangioscopy (POCS),etc.Biliary stent placement at ERCP is the mainstay of endoscopic palliation for jaundice.Other methods include EUS-guided bilioenteric drainage (EGBD),endoscopic radiofrequency ablation,intraluminal brachytherapy of bile duct,endoscopic photodynamic therapy,etc.Magnetic Compression Anastomosis Technique (MCAT) is a new technology which has been developed recently,and its role in the management of malignant obstructive jaundice remains to be seen.Science and technology have brought along progress in endoscopic and consumable technologies.It is predicted that in the future,endoscopic diagnosis and treatment will have more applications.

Objective To investigate the dissolution rates of glibenclamide and metformin in compound metformin hydrochloride. Methods The concentrations of the glibenclamide and metformin were determined by HPLC method. The rotating basket method was used to measure and compare the dissolution rates of glibenclamide and metformin between the compound metformin hydrochloride and conventional tablets. Results The dissolution rates of glibenclamide and metformin with different preparation came up to the standard of CHP (2005), but the dissolution parameters were different. Conclusion The dissolution rate of glibenclamide indicated significant difference between the compound metformin hydrochloride and the conventional tablets, and no significant difference for metformin.

Objective To study the diagnostic value of digital mammography(DM) and color Doppler ultrasonography (CDUS) for small breast carcinoma and axillary lymph nodes metastasis.Methods DM and ultrasonographic findings of 60 cases with breast nodules less than 2.0 cm in diameter were analyzed and diagnosed by experienced radiologists and ultrasonography doctors with double blind method and compared with pathological results.Results Among 60 cases, 60 breast nodules and 96 axillary lymph nodes (45/96 metastatic nodes) were both found by DM and CDUS,including 36 cases of breast cancer and 24 cases of benign lesions. The sensitivity and accuracy of DM in diagnosis of small breast cancer and axillary lymph nodes metastasis were significantly higher than that of CDUS, especially for the lesions were less than 1 cm in size (P

Objective To assess the feasibility and safety between ALPPS and two-stage hepatectomy (TSH).Methods An electronic search was performed of the MEDLINE,EMBASE using subject heading to identify nearly three-years articles published that related to this topic.Pooled odds ratio was calculated for binary data and mean differences for continuous outcomes,using fixed-effects and random-effects models for meta-analysis.Results Four studies involving a total of 312 patients were used in the analysis.We found that ALPPS produced a higher increase rate of FLR than TSH (MD =24.78;95％CI:0.63 to 48.94;P =0.04).Comparing with TSH,ALPPS produced a shorter FLR growth time (MD =-26.55;95％ CI:-37.13 to -15.97,P ＜ 0.05).There was no statistical significance in overall mortality (OR =2.43;95 ％ CI:0.94 to 6.31;P =0.07),while ALPPS produced a more severe complication rate (≥ Ⅲ b) than TSH (OR =2.47;95 ％ CI:1.14 to 5.36;P =0.02).Conclusions It was better to make the FLR increasing to safe resection for ALPPS than TSH in a short period of time.There was no statistical significance in overall complication and mortality between ALPPS and TSH,but ALPPS produced more severe complication rate (≥ Ⅲb) than TSH.

Critically ill patients often undergo endotracheal intubation to facilitate mechanical ventila-tion in in tensiv e cra e unit.As these patients er coev r,r espiratory support is gradually reduced until the patient can breathe unadi ed and the endotracheal tube can be removed.There are some complications during the en-dotracheal intubation.Some of them are life-threatening.Such complications might lead to a prlo onged stay in intensive care unit,additional costs,potential morbidity,and mortality.In this article,we wi ll talk abotu two special rp oblems during endotracheal inut bation.

Drug Delivery Systems ; Evaluation Studies as Topic ; Gene Targeting ; methods ; Genetic Therapy ; Humans ; Magnetic Resonance Imaging ; methods ; Neoplasms ; diagnosis ; pathology ; therapy ; Positron-Emission Tomography ; Survival Analysis ; Tomography, X-Ray Computed

Pediatric severe sepsis and septic shock is one of leading causes of death in PICU.Although antibiotics and comprehensive treatments have continuous improvements,its mortality rate is still high.Present study confirms early goal-directed therapy can significantly reduce the mortality of severe sepsis and septic shock.The purpose is to introduce the early goal-directed therapy protocol and to guide Chinese pediatrician to improve outcome of pediatric severe sepsis and septic shock and increase the survival rate in clinical practice.