Granulomatosis with polyangiitis (GPA) is a systemic inflammatory disease characterized by necrotizing granulomatous inflammation and small vessel vasculitis. Upper and/or lower respiratory tract and kidneys are involved mainly. GPA is a rare disease with complicated clinical manifestations, which causes difficulty in making correct diagnosis. GPA is a serious disease, with a nearly always fatal outcome in the absence of treatment. The combination of immunosuppressant drugs and corticosteroids is a standardized treatment for GPA. Treatment is based on two phases known as the induction phase and the maintenance phase. Here, the diagnosis and treatment of GPA are reviewed.

Objective To investigate the application effects of noninvasive ventilation combined with bron-choalveolar lavage in patients with AECOPD with respiratory failure.Methods 70 patients with AECOPD and respir-atory failure were chosen,and they were divided into control group and observation group,both two groups were treated with routine treatment,the control group combined with noninvasive ventilation,the observation group combined with bronchoalveolar lavage on the basis of the control group.Blood gas index,intubation rate,hospital stay and time of invasive ventilation between the two group were compared.Results After treatment,PaO2 and PaCO2 in the control group were (61.20 ±11.23)mmHg,(56.27 ±15.42)mmHg,which in the observation group were (73.04 ± 8.58)mmHg,(47.25 ±11.18)mmHg.PaO2 and PaCO2 of the two groups were improved compared with before treat-ment,which of the observation group were better than the control group,the differences were statistically significant (t =4.956,2.802,all P <0.05).Intubation rate of the observation group was 5.71%,which was 22.85% in the control group,the difference between the two groups was statistically significant(χ2 =4.200,P <0.05).Total intuba-tion rate had no significant difference between the two groups(P >0.05).Invasive ventilation time,hospital stay in the control group were (8.19 ±3.92)d,(10.43 ±4.11)d,which were higher than (6.21 ±1.43)d,(8.30 ±1.68)d in the observation group,the differences were statistically significant(t =2.807,2.838,all P <0.05 ).Conclusion Noninvasive ventilation combined with bronchoalveolar lavage could effectively improve the serum index and early intubation rate,and with short invasive ventilation time and hospital stay,it is worth promoting.

Setting up and improving the system of medical liability insurance is the primary direction in and the chief means of dispersing medical risks and settling medical disputes. However, the system currently in use in China is confronted with a number of problems, including, on the theoretical plane, insufficient effective demand by medical institutions, varied understanding of the insurance-covered services by the parties involved, different expected values with regard to the final results of the insurance, and on an operational plane, the legal positioning of the disposition of medical disputes, the relationship between the rights and obligations of the parties involved during dispositions or lawsuits, the comprehension and explanation of certain provisions of the insurance and so on. In order to solve these problems, it is necessary to take such measures as setting up a mechanism for negotiations in the trial period of medical liability insurance, opening up insurance market, implementing the separation of medical administrative liabilities and civil compensation liabilities, and encouraging patients to buy medical risk insurance while developing medical liability insurance The goal is to improve the system of medical liability insurance, harmonize the relation between doctors and patients, and thus build a harmonious society.

This paper introduced the framework designs of digitalized hospitals,and developed the wireless doctor-nurse management system on such a framework.It described the overall structure of this wireless system,and probed into key technologies in overall construction of the system;mobile computing and EDA technologies,wireless LAN technology,mid-ware technology and RFID technologies.All these aimed at providing references for digitalized hospitals.Even more important,this paper has introduced the concept of overall system and key technologies.

Legal philosophy redefines medieal technology as follows:Medical technology is a deficient technology offered to patients for their benefits in emergency,which however may victimize the patients somehow in the end.Its beneficiary and victim tend to be the same,and its deficiency tends tO amplify and accumulate in the course of development.In spite of the significant capabilities and effectiveness development of medical technology,the security of itself is weakening instead.This,however,is a cost humans have to pay to keep off health threats.

Objective:To study the bioequivalence and pharmacokinetics of two kinds of loratadine tablets in 20 healthy volunteers.Methods:An oral dose of 20mg of test or reference loratadine tablets was given according to a randomized 2-way cross-over design,blood samples were withdrawn up to 12 hours past administration,and plasma concentration of loratadine was determined by HPLC method.Results:The peak plasma levels (C max ) of loratadine test drug and reference drug were 8.59?6.70 or 9.59?8.22ng/ml respectively. The peak time (T max ) were 1.08?0.41 or 1.21?0.28h respectively,and AUC 0-t were 27.29?25.54 or 27.12?20.64ng?h/ml respectively.Conclusion:The result of statistic analysis and tow one-sided test suggest that the domestic loratadine talbet is bioequivalent to the imported tablet.The relative bioavailability of domestic loratadine tablets is 100.63%?14.27%.

Objective:To investigate preliminarily the expression of P-glycoprotein(pGp),a multi-drug resistance gene-1 product,in patients with nasopharyngeal squamous carcinoma(NPSC) before and after radiotherapy.Methods:pGp was detected by immunohistochemistry with one monoclonal antibody JSB-1 before and after radiotherapy in fourty-eight patients with NPSC.None of them had received neoadjuvant chemotherapy or radiotherapy.Results:The positive rate of pGp expression in the patients with NPSC before radiotherapy was 18.75%(9/48).But the positive expression rate of pGp after radiotherapy was 75.00%(36/48).pGp expression rate after radiotherapy was significantly higher than that before radiotherapy( P

Objective:To explore the effects of hypertonic saline and pentoxifylline resuscitation on pulmonary inflammation following hemorrhagic shock in rats. Methods:Controlled hemorrhagic shock was induced by blood withdrawal (MAP,40 mmHg)and maintained for 60 min. Animals were randomly divided into 3 groups:① Sham animals(n=8)underwent cannulation without shock or resuscitation and served as negative controls;②RL-resuscitated animals (n=8)received 32 ml/kg RL;③HSPTX group received 4 ml/kg of 7.5% NaCl+25 mg/kg of PTX. PaO2,pH,PaCO2,wet/dry lung weight ratio(W/D),and lung penetrating index were determined. The percentages of neutrophil in bronchoalveolar lavage fluid,the levels of malonadialdehyde (MDA)and superoxide dismutase (SOD)were measured. The tumor necrosis factor-?(TNF-?)and interleukin 1?(IL-1?)in the supernatant of bronchoalveolor lavage fluid were determined by ELISA method,and the expression of NF-?B in the lung tissues was quantified by Western blot. Results:PaO2 and pH were increased whereas PaCO2 was decreased in HSPTX group when compared with that in RL group (P

Objective To study the clinical efficacy and safety of nitroglycerin combined with atenolol in the treatment of coronary heart disease.Methods From February 2014 to November 2016, 114 cases of coronary heart disease patients treated in Zhongshan hospital were selected, all patients were randomly divided into experimental group and control group, the patients in experimental group were treated with nitroglycerin combined with atenolol, and the patients in control group were treated with nitroglycerin, the therapeutic effects of two groups were observed, the adverse reactions of the two groups were compared.Results After treatment, the total effective rate of the treatment group was 93% higher than that of the control group(78.9%), the difference was statistically significant(P< 0.05);The total effective rate of ECG in the experimental group was 89.5% higher than that in the control group(73.7%), the difference was statistically significant(P<0.05);There were 2 cases(3.5%)of adverse reactions in the experimental group and there were 11 cases(19.3%)of adverse reactions in the control group, which was significantly lower in the experimental group than that in the control group, the difference was statistically significant(P<0.05).Conclusion Phenyl bromide Malone and colchicine had good clinical curative effect in the treatment of chronic gout.

OBJECTIVE:To study the efficacy of the compound preparation of Yangshen and Chuanxiong in the treatment of cardiovascular diseases. METHODS: The effect of the compound preparation of Yangshen and Chuanxiong on blood pressure of spontaneous hypertensive rats was observed. The myocardial ischemia model was established in rats by ligating coronary artery for the observation of the effect of the compound preparation on serum creatine phosphoric acid activating enzyme (CK), lactic dehydrogenase (LDH), malonaldehyde (MDA), and hyperoxide mutase (SOD). The ischemic cerebral edema model was established in rats by carotid ligation for the observation of the effect of the compound preparation on brain water content. The experimental thrombus model was established in rats by extracorporeal circulation for the observation of the effect of the compound on thrombus weight. The model of blood stasis was established in rats by injecting them with adrenalin hydrochloride for the investigation of the effect of the compound on whole blood viscosity. RESULTS: The compound preparation of Yangshen and Chuanxiong brought down the blood pressure in model rats significantly, increased serum levels of SOD and MDA as well as brain water content, inhibited the empirical thrombogenesis, and reduced the whole blood viscosities in rats with acute myocardial ischemia. CONCLUSION: The compound preparation of Yangshen and Chuanxiong has remarkable efficacy in anti-thrombosis, improving the cerebral circulation disturbance and cerebral oxygen supply, eliminating cerebral edema and promoting blood circulation to remove blood stasis.