Objective To investigate the therapeutic efficacy of tiotropium bromide powder inhalant combined with meglumine adenosine cyclophosphate in the treatment of acute exacerbation of chronic pulmonary heart disease.Methods A total of 148 cases of acute exacerbation of chronic pulmonary heart disease were divided into observation group (n =74) and control group (n =74).The observation group received tiotropium bromide powder inhalant combined with meglumine adenosine cyclophosphate,while the control group was given meglumine adenosine cyclophosphate.Results Before treatment,the forced expiratory volume in one second(FEV1),forced vital capacity(FVC),arterial oxygen tension(PaO2),arterial carbon dioxide partial pressure(PaCO2) and pH of the observation group were no significant differences [(1.27 ±0.44)L vs (1.24 ±0.47)L,(2.49 ±0.74)L vs (2.43 ±0.77) L,(51.6 ±6.6) mmHg vs (51.2 ±6.7) mmHg,(69.1 ± 8.4) mmHg vs (69.5 ± 8.7) mmHg,7.27 ± 0.03 vs 7.26 ± 0.04,P ＞ 0.05].After treatment,The FEV1,FVC,PaO2,PaCO2 and pH were significant differences between the 2 groups[(1.45 ±0.39)L vs (1.31 ±0.41)L,(2.71 ±0.63)L vs (2.49 ±0.54)L,(72.8 ±5.3) mmHg vs (62.5 ±6.2)mmHg,(47.7±5.7)mmHgvs (56.2±7.2)mmHg,7.34±0.02 vs7.31±0.03,t =2.13,2.28,10.86,-12.65,7.16,P ＜0.05].Before treatment,the Ⅰ ～ Ⅳ NYHA cardiac functional grading were no significant differences between the 2 groups(0,17.6％,47.3％,35.1％ vs 0,18.9％,44.6％,36.5％,P ＞0.05).After treatment,theⅠ ～ Ⅳ NYHA cardiac functional grading of the observation group were 25.7％,44.6％,20.3％,9.4％ respectively,and the NYHA cardiac functional grading of the observation group was significantly better than that of the control group(20.3％,27.0％,36.5％,16.2％,t =2.27,P ＜0.05).Conclusions The tiotropium bromide powder inhalant combined with meglumine adenosine cyclophosphate showed good therapeutic efficacy in the treatment of acute exacerbation of chronic pulmonary heart disease,and this combined treatment program is able to improve the heart and lung function simultaneously.

Objective To evaluate and compare the therapeutic effect among intravenous rt2PA thrombolysis,thrombolysis plus delayed intracoronary stenting for acute ischemic stroke onset using 99mTc2ECD SPECT imaging.Methods 45 cases of acute ischemic stroke onset were divided into two groups which were the thrombolysis group( n = 23 ) ,thrombolysis plus delayed stenting group (n = 22), 99mTc2MIBI SPECT imaging was performed 3 weeks after thrombolysis therapy or 1 week after intracoronary stenting. The score of 99mTc2MIBI brain uptake were analyzed semiquantitatively and the total score of myocardial 99mTc2ECD uptake was calculated. Results The scores of the 2 groups were( 12. 4 ± 4. 6) and( 9. 7 ± 3. 8 ) respectively, Significant difference was shown in the thrombolysis plus delayed stenting group compared with the thrombolysis group (P ＜ 0. 01 ). Conclusion 99mTc2ECD SPECT imaging had been proved to be an objective parameter for evaluating the therapeutic effect of the various treatments of AMI. Thrombolysis plus delayed stenting was more effective than thrombolysis.

OBJECTIVE: To study the preventive effect of Breviscapus Injection on the chronic hypoxic myocardium injury in rats and its mechanism. METHODS: Transmission electron microscope and biochemical analysis were used to assay the therapeutic effect of Breviscapus Injection in rat model induced by 4 week's hypoxia. RESULTS: The contents of malondialdehyde (MDA) and Ca(2+) in the homogenate of myocardial tissue of the hypoxic rats were significantly higher than those of the control rats. The activities of superoxide dismutase (SOD), nitric oxide synthase (NOS) in the homogenate of myocardial tissue and the plasmic NO levels of the hypoxic rats were significantly lower than those of the control rats. Breviscapus Injection reduced the contents of MDA and Ca(2+), and increased the levels of SOD, NOS and NO. Ultrastructural examination revealed that the injuries of the ultrastructure of heart in hypoxic rats were improved by treatment with Breviscapus Injection. CONCLUSION: Breviscapus Injection can effectively prevent and treat the hypoxia-induced myocardial damage. One of its mechanisms may relate to its adjusting NO level, anti-damaging of free radicals and inhibiting calcium overload.

Objective: To investigate the quality of life and its influencing factors among patients with gestational diabetes mellitus (GDM), so as to provide insights into the improvements in the quality of life among patients with GDM. Methods: GDM patients admitted to Department of Obstetrics and Gynecology, Hangzhou First People's Hospital Affiliated to Zhejiang University Medical School from June 2021 to June 2022 were recruited. Participants' demographics, diagnosis and treatment, sleep quality, depression and social support level were collected. Patients' quality of life was evaluated using the Quality of Life Scale for Pregnant Women with Gestational Diabetes Mellitus, and the factors affecting the quality of life were identified among patients with GDM using a multivariable linear regression model. Results: A total of 300 questionnaires were allocated, and 284 valid questionnaires were recovered, with an effective recovery rate of 94.67%. The respondents had a mean age of (32.81±4.93) years, and the mean scores for the quality of life was (92.63±14.10) points. Multivariable linear regression analysis identified depression (β'=-0.293), sleep disorder (β'=-0.177), insulin therapy (β'=-0.316), regular exercise (β'=0.272) and social support level (medium: β'=0.153; high: β'=0.381) as factor affecting the quality of life among GDM patients. Conclusions GDM patients have a low quality of life. Depression, sleep disorders, insulin therapy, and lack of exercises may cause a decline in the quality of life among GDM patients, and strong social support facilitates the improvements in the quality of life among GDM patients.

Adenocarcinoma ; drug therapy ; secondary ; surgery ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Benzenesulfonates ; adverse effects ; therapeutic use ; Carcinoma, Renal Cell ; drug therapy ; secondary ; surgery ; Diarrhea ; chemically induced ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; drug therapy ; pathology ; surgery ; Liver Neoplasms ; drug therapy ; secondary ; Lung Neoplasms ; drug therapy ; secondary ; Male ; Middle Aged ; Niacinamide ; analogs & derivatives ; Phenylurea Compounds ; Pyridines ; adverse effects ; therapeutic use ; Remission Induction

Purpose　The aim is to develop a synthesis method of the silver carboxymethyl chitosan and to study its bacteriostasis to Staphlococcus aureus(S.aureus),Pseudomonas aeruginusa(P.aeruginusa),Escherichia Coli(E.coli),Klebsiella pneumoniae(K.pneumoniae) and Proteus vulgaris(P.vulgaris).Methods　Chitosan was modified by way of chemistry.The structure analysis of its derivate was analysed by infra-red absorption spectroscopy,using methods of dilution and concavering to study the bacteriostasis to some ordinary bacteria which cause infection in burn.Results　The infra-red spectragram of the derivate showed the chitosan had been modified by chloroacetic acid.When the concentrationl of silver carboxymethyl chitosan was 1.028 mg/ml and the concentration of the five bacteria were 104CFU/ml，the rate of bacteriostasis was 88%、80.2%、75.3% to S.aureus、P.aeruginusa and E.coli respectively.The MIC of silver carboxymethyl chitosan was similar to that of AgNO3 when they act on S.aureus and P.aeruginusa,but the former was lower than later when acting on E.coli.Conclusion　Silver carboxymethyl chitosan could inhibit some bacteria which caused infection in burn.It was a novel pharmaceutical in preventing and curing burn infection.

Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis ; complications ; Coronary Vessels ; Humans ; Syphilis, Cardiovascular ; complications

AIM: To establish HPLC-fingerprints and quantitatively determine platycodin-D from Platycodon grandiflorum.METHODS: HPLC analysis was carried out on Hypersil C18 column(250 mm ? 4.6 mm,5 ?m),with a mobile phase of acetonitrile-0.05 mol/L phosphoric acid system,gradient elution,with a flow at 0.5 mL/ min,an ultraviolet detection wavelength was at 210 nm for fingerprint and at 206 nm for platycodin-D,column tem-perature at 30 ℃.RESULTS: Twelve common peaks were identified in chromatograms with reference to platycod-in-D peak from the 18 batches of the samples.CONCLUSION: The method of the HPLC-fingerprint and quantita-tive analysis is rapid,simple and accurate with a good reproducibility and can be used for the quality control of Platycodon grandiflorum.

Objective To discuss the clinical features and therapeutic effects of adrenogenital syndrome in children. Methods Clinical and follow up data were summarized for 42 children with adrenogenital syndrome, including 30 cases of congenital adrenal hyperplasia (CAH) and 12 cases of adrenal cortex tumor. Results Endocrine function examination in 15 cases of CAH showed that 24h urine 17 KS was elevated in 10 cases and normal in 5.There was obvious clitorism in all 30 CAH children and urogenital sinus malformation in 28.Of the 12 cases of adrenal cortex tumor 7 had sexual abnormality and hypercortisolism simultaneously.Clitoris shortening or clitoridectomy was performed in CAH cases plus vaginal vestibule plasty simultaneously.Of the 12 cases of adrenal cortex tumor 10 underwent complete tumor resection;1 partial tumor resection and the remaining 1 declined treatment.During the follow up 8 case of cortex tumor,4 cases of adenoma survived tumor free with an average survival time of 7.5 years;2 cases of cortex carcinoma survived tumor free for 3 and 4 years;while the other 2 cases died soon after discharge. Conclusions The diagnosis can be established based on clitorism,labium confluence or male sexual precocity,increase in urine 24h 17 KS and blood testrone.Cortex hormone should be taken early,properly,life long in CAH patients,and appropriate perineoplasty should be performed.Early detection and resection of tumor is the key point for treating adrenogenital syndrome caused by cortex tumor.

Objective:To investigate the door-to-balloon (D2B) time and its influencing factors for Percutaneous Coronary Intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI).Methods:180 cases of patients with STEMI in our hospital from January 2014 to April 2016 were selected.PCI therapy were operated on all patients after their consent.The pre-hospital delay time and D2B time of the patients were recorded.The related information of the patients,including demographic data,clinical factors,background of the disease and psychological factors,were investigated by the questionnaire survey.The patients were divided into short D2B group (D2B time≤ 126 min,n=96) and long D2B group (D2B time＞126 min,n=84).Univariate and multivariate logistic regression methods were used to analyze the influencing factors of D2B time.Results:The median D2B time of all the patients was 126 min,and only 26.7％ of patients' D2B time controlled within 90 min.Univariate analysis showed that differences of sudden attack,pay attention to symptoms,someone was present when attack,symptoms progress was fast,in hospital during holiday,no symptom in CCU,outpatient treatment,transfered by emergency medical service system (EMSS),time in CCU (6 am-10 pm),angina before infarction and pre-hospital delay time between the two groups were statistically significant (P＜0.05).Multivariate logistic regression analysis showed that in hospital during holiday,outpatient service,no symptom in CCU,pay attention to symptoms,use of transfered by EMSS,time in CCU (6am-10pm) are the factors affecting the time of D2B (OR=2.62,2.04,1.59,0.52,0.28,0.61 P＜0.05).Conclusion:The D2B time of most patients with STEMI can not reach the guidelines.The factors of patients,doctors,accepting mechanism of hospital are all related with D2B time.