Objective To observe the effect of Pulmicort Respules combined with Tiotropium Bromide in the treatment of chronic obstructive pulmonary disease (COPD) and its influence on inflammatory cytokines.Methods 130 COPD patients which met inclusion criteria were randomly divided into the observation group (65 cases) and control group (65 cases).Both two groups were given conventional therapy,the control group was given a separate aerosol inhalation of Pulmicort Respules,the observation group was inhaled Tiotropium Bromide on the basis of the control group.Both two groups were treated for 14d,the symptoms and signs were observed before and after treatment.The respiratory function and blood gas were monitored,and induced sputum was used to determine inflammatory cytokines levels of airway.Results (1) After treatment,the FEV1,FEV1/predicted,FEVi/FVC,PaO2 of the observation group were significantly increased,the PaCO2 was significantly reduced,but FEV1/FVC of the control group had no significant change after treatment.(2) The lung function and blood gas between the two groups had no statistically significant differences before treatment.After treatment,the FEV1,FEV1/predicted,FEV1/FVC,PaO2 of observation group were obviously higher than those of the control group,PaCO2 was significantly lower than the control group.(3) After treatment,the IL-8,TNF-α,neutrophil cell ratio of two groups were significantly lower than before treatment.(4) The IL-8,TNF-α,neutrophil cell ratio had no statistically significant differences before treatment between two groups.After treatment,the IL-8,TNF-α,neutrophil cell ratio of observation group were significantly lower than control group.Conclusion Pulmicort Respules combined with Tiotropium Bromide in the treatment of COPD can be targeted to the lesion site,and relieve symptoms,reduce airway inflammation,improve pulmonary function,the effect was better than simplely use Pulmicort Respules.

Objective:To investigate the effects of laparoscopy assisted complete mesocolon resection on the stress response and immune function of patients with colon cancer.Methods:From January 2013 to January 2016,130 patients with colon cancer in our hospital were selected and randomly divided into the observation group and the control group with 65 cases in each group according to the random lottery envelopes.The observation group was treated with laparoscopy assisted complete mesocolon resection,the control group was treated with open operation.The changes of semm IL-6,TNF-α and amours of CD4+ cells,blood loss,bowel function restoration time,hospital stays and complication rate of two groups were compared before and after treatment.Results:Both groups of patients were successfully completed the surgery and there was no serious complications occurred in both groups.The amount of bleeding,postoperative intestinal recovery time and postoperative hospital stay in the observation group were significantly less than those of the control group (P＜0.05).The chylous fistula,wound infection,pulmonary infection and complication rate on the 14th day postoperation in the observation group was 1.5％,which was 12.3％ in the control group and significantly higher than that of the control group (P＜0.05).The contents ofCD4+ cells in the observation group and the control group were 36.34± 7.83％ and 33.66± 9.82％,respectively,which were significantly higher than those before treatment(30.33± 6.49％ and 30.49± 5.33％)(P＜0.05),and the contents of CD4+ cells of observation group was significantly higher than that of the control group after treatment (P＜0.05).The serum levels ofIL-6 and TNF-α in both groups were significantly lower than those before treatment on the 14th day postoperation (P＜0.05),and the serum IL-6 and TNF-α levels of observation group were significantly lower than those in the control group on the 14th day postoperation (P＜0.05).Conclusion:Laparoscopy assisted complete mesocolon resection could promote the immune function and inhibit the stress response,which further promoted the rehabilitation and induced the complications in the treatment of patients with colon cancer.

A 58-year-old female was admitted to the hospital for a 3-month history of erythema,pustules and vegetating plaques on the lips and scalp,as well as in intertriginous areas.She had a 2-year history of ulcerative colitis,which had been aggravated before the development of skin lesions.Skin examination demonstrated diffuse thickening of both lips covered with multiple granule-to mung bean-sized confluent pustules.Yellow crusts were observed at the lip margins.A 1.5 cm × 2 cm vegetating plaque surrounded by anular pustules was found in the left buccal mucosa.There were multiple irregularly-sized vegetating plaques with erosions and yellow crusts on the scalp,neck,as well as in the periumbilical and left inguinal and axillary region,and annular vesicles and pustules were observed in the center and margin of these plaques.The lesions subsided leaving hyperpigmented macules.There were four fresh pustules in the right axillary region.Histological examination of a biopsy specimen taken from the lower lip margin revealed mild hyperplasia of and neutrophil microabscess in the epidermis,as well as a dense inflammatory infiltrate composed mostly of neutrophils and eosinophils with microabscess formation in the dermis.Direct immunofluorescence examination of the normal-appearing skin next to the lesions was negative.The percentage of peripheral blood eosinophil was slightly elevated.Bacterial and fungal cultures of pustular contents were negative.A diagnosis of pyodermatitis-pyostomatitis vegetans was made.

BACKGROUND:There are currently various surgical methods of patel a fracture, and they have advantages and disadvantages, thus cannot wel meet the requirements of patients.
OBJECTIVE:To evaluate biomechanical properties of internal fixation plate to treat patel ar fracture and to provide theoretical evidence for clinical application.
METHODS:According to the statistics of patel a in the Chinese population, a titanium al oy spider internal fixation plate was designed and manufactured for the treatment of patel ar fractures. Knee joint specimens in six fresh cadavers were randomly divided into two groups and the comminuted fracture model of patel a were established. The models were fixed with internal fixation plate of patel a and NiTi patel ar concentrator. Biomechanical tests were carried out to compare the biomechanical properties.
RESULTS AND CONCLUSION:Both the two fixation methods could meet the 1-kN quadriceps femoris contraction. The internal fixation plate of patel a was superior to NiTi patel ar concentrator in the patel ar isolation shift, muscle strength and joint strength, as wel as mechanical properties of patel a-point surface. There were significant differences between the two groups (P<0.05). The internal fixation plate of patel a is designed in accordance with the anatomical and biomechanical properties of the patel a, the fixation strength can completely meet clinical requirement and deserve further application.

ObjectiveTo investigate the value of early fluid resuscitation endpoints in evaluating blood volume in patients with acute pancreatitis. MethodsA retrospective analysis was performed for the clinical data of 445 previously untreated patients with acute pancreatitis who were admitted to The First Affiliated Hospital of Guangxi Medical University from 2003 to 2016 and had an onset time of less than 24 hours, and according the fluid resuscitation endpoints of mean arterial pressure (MAP), hematocrit (HCT), and blood urea nitrogen (BUN), the patients were divided into standard-reaching group (MAP ＞65 mm Hg, BUN ＜7.14 mmol/L, and HCT ≥0.35 and ≤044, n=219) and non-standard-reaching group (MAP ≤65 mm Hg or BUN ≥7.14 mmol/L or HCT ＞0.44 or ＜0.35, n=226). The standard-reaching group represented normal volume, while the non-standard-reaching group represented insufficient volume. The two groups were compared in terms of symptoms, signs, etiology, severity, complication, and prognosis. The chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups, and the Mann-Whitney U test was used for comparison of continuous data between two groups. ResultsCompared with the standard-reaching group, the non-standard-reaching group had significant increases in white blood cell count, BUN, and Computed Tomography Severity Index of the pancreas (Z=-2.85, -6.725, and -2.293, all P＜0.01). As for local complications, compared with the non-standard-reaching group, the standard-reaching group had significantly lower incidence rates of peripancreatic exudation (45.2% vs 54.9%, χ2=4.15, P＜0.05) and pancreatic necrosis (10.0% vs 186%, χ2=6.59, P＜0.05). As for systemic complications, compared with the non-standard-reaching group, the standard-reaching group had significantly lower incidence rates of acute respiratory distress syndrome (ARDS) (0.5% vs 4.4%, χ2=7.26, P＜0.05) and renal dysfunction (1.4% vs 6.6%, χ2=7.95, P＜0.05). The standard-reaching group had significantly lower proportion of patients with severe pancreatitis and hospital costs than the non-standard-reaching group (both P＜0.05). ConclusionFluid resuscitation endpoints can be used to evaluate the blood volume of patients with acute pancreatitis in the early stage after admission, and the patients not reaching the standard of fluid resuscitation tend to develop the complications such as peripancreatic exudation, pancreatic necrosis, ARDS, and renal dysfunction and may have higher hospital costs.

The many-banded krait, Bungarus multicinctus, has been recorded as the animal resource of JinQianBaiHuaShe in the Chinese Pharmacopoeia. Characterization of its venoms classified chief phyla of modern animal neurotoxins. However, the evolutionary origin and diversification of its neurotoxins as well as biosynthesis of its active compounds remain largely unknown due to the lack of its high-quality genome. Here, we present the 1.58 Gbp genome of B. multicinctus assembled into 18 chromosomes with contig/scaffold N50 of 7.53 Mbp/149.8 Mbp. Major bungarotoxin-coding genes were clustered within genome by family and found to be associated with ancient local duplications. The truncation of glycosylphosphatidylinositol anchor in the 3'-terminal of a LY6E paralog released modern three-finger toxins (3FTxs) from membrane tethering before the Colubroidea divergence. Subsequent expansion and mutations diversified and recruited these 3FTxs. After the cobra/krait divergence, the modern unit-B of β-bungarotoxin emerged with an extra cysteine residue. A subsequent point substitution in unit-A enabled the β-bungarotoxin covalent linkage. The B. multicinctus gene expression, chromatin topological organization, and histone modification characteristics were featured by transcriptome, proteome, chromatin conformation capture sequencing, and ChIP-seq. The results highlighted that venom production was under a sophisticated regulation. Our findings provide new insights into snake neurotoxin research, meanwhile will facilitate antivenom development, toxin-driven drug discovery and the quality control of JinQianBaiHuaShe.