Objective To explore the effect of montelukast combined with budesonide for treating acute bronchial asthma, pulmonary function improvement and to provide the basis for clinical treatment.Methods 192 patients with acute asthma were selected.They were divided into the control group and the observation group according to the admission order and odd and even numbers randomly, 96 patients in each group.The control group was treated with budesonide based on routine treatment, and the observation group was given budesonide formoterol based on the control group.The clinical effect, pulmonary function (forced expiratory volume in one second (FEV1),FEV1/forced vital capacity (FVC) and peak expiratory flow (PEF) the percentage of predicted value index percentage were observed.The daytime and night asthma symptoms and airway reactivity score: early respiratory resistance (Rrsc) and response threshold (Dmin) were assessed.Results The cough disappeared, shortness of breath, wheezing relieving, moist rales disappeared and wheeze disappeared time of the observation group after treatment were (5.92±1.03)d,(3.48±0.71)d,(3.74±0.69)d,(5.32±0.96)d and (5.12±0.77)d, which were lower than those of the control group (t=9.31,7.26,8.11,9.02,8.31,all P<0.05).The daytime and nighttime asthma symptom scores of the observation group after treatment were (0.54±0.31)points and (0.62±0.29)points, which were lower than those of the control group (t=7.90,7.33,all P<0.05).Rrsc score of the observation group after treatment was (2.20±0.56)points, which was lower than that of the control group (t=7.86,P<0.05).The Dmin score of the observation group after treatment was (8.33±0.81)points, which was higher than that of the control group (t=9.15,P<0.05).FEV1,FEV1/FVC and PEF of the two groups after treatment were significantly higher than those before treatment(all P<0.05).FEV1,FEV1/FVC and PEF of the observation group after treatment were (2.95±0.58)L,(71.91±0.69) and (96.45±6.11), which were higher than those of the control group after treatment (t=7.60,9.45,10.21,all P<0.05).Conclusion Montelukast combined with budesonide formoterol in the treatment of acute attack of bronchial asthma has better effect, could significantly reduce the symptoms of asthma patients and shorten the treatment time with synergistic effect, and improve the pulmonary ventilation function of the patients.

OBJECTIVE: To investigate the mechanism of in situ intestinal absorption of mangiferin in rats.METHODS: The in situ intestinal perfusion model was employed.HPLC/UV was developed to determine the concentration of mangiferin in intestinal circulated fluid.The effects of mangiferin concentration,bile and absorption site on the absorption parameters were studied.RESULTS:The mangiferin at a concentration from 5.0 to 25.0 ?g?mL-1 had no influence on the intestinal absorption kinetics(Ka) but it did at a concentration below 12.5 ?g?mL-1 in biliary duct-ligated rats.The absorption rate constants(Ka) in descending order were 0.164 h-1(ileum),0.132 h-1(jejunum),0.125 h-1(colon) and 0.107 h-1(duodenum),respectively.CONCLUSION: The absorption of mangiferin is in line with first-order kinetics with passive diffusion absorption mechanism.Mangiferin is well absorbed at all segments of intestine in rats,and bile is conducive to the increase of the permeability coefficient of Mangiferin in intestine.

China ; Diagnosis, Differential ; Humans ; Medicine, Chinese Traditional ; Meridians ; Phytotherapy ; Taiwan ; Yin-Yang

Objective To evaluate the current knowledge and practice of evidence-based nursing for preventing ventilator-associated pneumonia (VAP) and its influencing factors in ICU nurses. Methods Selfadministered structured questionnaire was used in 101 ICU nurses working in one grade three A hospital of Jiangsu province by convenient sampling method. The results underwent statistical description and variance analysis. Results The mean score of knowledge about evidence-based nursing to prevent VAP was (4.75±1.42) (total score=10),the mean score of practice was (3.32±0.32) (total score=4). The influencing factors of knowledge in ICU nurses were different divisions and ICU working years. Different ICU working years resulted in different behavior of nurses. Most nurses considered that nursing work was too busy due to serious condition of patients, which was the principal interfering factor in practice of evidence-based nursing for preventing VAP. Conclusions Further expertise of ventilator-associated pneumonia training and evidence-based nursing education are urgently required. The best-practice guidelines for preventing VAP are more often consummated. Whilst encouraging the reasonable personnel disposition and the essential facilities are priority. Effective fulfillmere in evidence-based practice to prevent VAP may be achieved by broader adjustment of the medical system and the medical cost structure, so that evidence-based nursing for preventing VAP can be put into effect.

Objective To investigate the epidemiological features of out-of-hospital cardiac arrest (OHCA) patients who are return of spontaneous circulation (ROSC) on scene. Methods According to Utstein style,we collected the clinical data of OHCA patients who are ROSC on scene from the pre-hospital on the call of 120 of Henan Provincial People ' s Hospital from January 2012 to December 2016. We analyzed the data by SPSS 20.0 software. Results Among a total of 29 patients were enrolled,9(31.03%)were ROSC ≥ 6h,and 20 (68.97%)were ROSC < 6 h. There were no significant difference in the two groups in patients' age,sex,arrest location,witnessed by bystander,bystander CPR,initial arrest rhythm,etiology,the use of epinephrine. None of patients were survival in the group of ROSC≥6 h. The average length of hospital stay was(44.15 ± 34.16)hours, while the shortest length of hospital stay was 12.08 hours and the longest length of hospital stay was 125.75 hours. The ratio of emergency response time to the return to hospital time were 4.55 min ± 2.46 min vs 6.45 min ± 3.60 min,P=0.014 in all patients. The emergency response time consumes more time. Conclusion The hospitalized survival rate of ROSC patients is low. The occurrence of OHCA needs early prevention. The short-term survival(6 h)is not affected by the patients' basic situation and the first-aid situation.

Objective To obtain panorama X-ray images of the lower extremity with a simple method,eliminate the mosai-cing error,and apply this manual stitching technique for digital radiography to the measurement of the force line in total knee arthroplasty.Methods The track of X-ray tube was preset,and Dicom format data were collected by using digital X-ray ima-ging.Then,the data were imported to photoshop CS4 for manual image registration and image fusion.The reliability of the film was tested by comparing the vertical length of the body symbols proj ection in the coronal plane with that on the panorama X-ray (AutoCAD 2010)images.Moreover,the hip-knee-ankle angle was compared before and after operation.Results The matching sample t-test showed there were no significant differences in the length(4 groups of data)between the greater trochanter femur and the fibular head,and between the fibular head and the lateral malleolus between before and after operation(P>0.05 for all) .The hip-knee-ankles angle was much greater after operation than that before operation.Conclusion This manual stitching technique for digital radiography can produce seamless and precise panorama X-ray images,which can be used to reflect the length and angle of the lower extremity before and after operation.

There has been great interest in NiTi alloy in medical domain si nc e Buehler found its memory effect in 1963. In the recent 30 years, a lot of basi c and clinical researches of the alloy have been reported in the world. From the biomechanical viewpoint, the ossification and resorption of bone are related to the stress. Different stresses are required in the different kinds of fracture healing. Many measurements have been used to test the biomechanical properties o f the Nitinol orthopedic instruments. The clinical applications of the instrumen ts in hand surgery started in China in 1980's and resulted in satisfactory outco mes. This article summarizes the progress made in the basic researches of the ni tinol orthopedic instruments and their clinical applications in hand surgery.

Objective To report the method and effect of treating cholepathia under laparoscopy and endoscopy. Methods Laparoscopy, duodenoscopy and choledochoscopy in combination were used in treating 1 990 cases of cholepathy and the results were analyzed. Results Laparoscopy and duodenoscopy in combination were used in 1 350 cases of cholecystolilhiasis and choledocholith with cure rate ( 93. 6% ) ; laparoscopy and choledochoscopy in combination were used in 332 cases of choledocholith with cure rate (100% ) ; laparoscopy, duodenoscopy and choledochoscopy in combination were used in 258 cases of choledocholith (29 cases with pancreatitis) and 24 cases of Mirizzi syndrome with cure rate( 100% ). There was no serious complications happened. Followed up 1 051 patients from 3 months to 12 years (average 7.8 years) , 10 cases have recurrence of stones. There was no long-term complication such as stenosis of bile duct, etc occurred. Conclusion The procedure had minor trauma, mild suffering, and less operative complications compared with the traditional laparotomy.

With the development of society and medical science,the medical arena should develop with the times,transform medical ethics idea, construct new medical ethics view to unceasingly promote the medical ethics progress and the comprehensive,coordinated, and sustainable development of medical industry.This article discussed the principle,significance and several related problems of new medical ethics view in order to make direct instruction for the constnuction of new medical ethics view.

Six cases of T-cell lyrnphoma associated with reactive histiocytic hyperplasia with hemophagocytosis (HHH) localized primarily to the skin and subcutaneous fat were described. Initial biopsy findings may he misinterpreted as benign panniculitis. Four of which were progressive, recurrent, even fatal (follow-up for 8-36 months). Histologically the lesions of all cases were composed of a mixture of small and medium sized atypical lymphoid cells and benign hemophagocytes infiltrated with neutrophils and eosinophils between fat cells. The mechanism and differential diagnosis of the disease were discussed.