Objective To investigate the effect of ipratropium bromide combined with budesonide /formoterol fumarate inhalation powder on serum FeNO and lung function of bronchial asthma patients.Methods 102 cases with clear bronchial asthma during Jan 2013 and Mar.2015 from the affiliated Qianfo Hill Hospital of Shandong University were randomly divided into three groups, control group A (34 cases) were treated with ipratropium bromide, control group B (34 cases) were treated with budesonide/formoterol fumarate powder, experiment group (34 cases) were given ipratropium bromide combined with budesonide/formoterol fumarate powder, all groups were treated for 6 months.Pulmonary function, serum FeNO and IgE levels, clinical efficacy were compared after treatment.Results The effective rate of control group A, B (70.59%, 67.65%) were significantly lower than experiment group (91.18%), the difference were significant (P<0.05).FEV1, FVC, FEV1%pre of experiment group were significantly higher than control group A and B after the treatment.Serum IgE and FeNO concentration were significantly lower than control group A, B, the difference were significant ( P<0.05 ) .Conclusion Ipratropium bromide combined with budesonide/formoterol fumarate powder for inhalation in bronchial asthma patients can effectively reduce FeNO concentration, improve lung function.

Objective To observe the efficacy and toxicity of S -1 monotherapy in elderly patients with advanced non -small lung cancer (NSCLC).Methods Fifty-six patients aged 70 or over with stage IIIb-IV NSCLC were enrolled.S-1 was given orally twice a day according to body surface area on days 1 to 14 for 21-day cycle, the evaluation of efficacy and toxicity were performed on all patients after 2 cycles.Results For all 56 patients, CR 0, PR 15, SD 29 and PD 23 were observed.The objective response rate (ORR) and the disease control rate (DCR) were 26.8% and 78.6%,respectively.The 1-year survival rate was 30.9%, with a medi-an survival of 10.0 months.The myelotoxicity and gastrointestinal toxicity were major side effects .The major toxicity could be tolerated by the patients.Conclusions S-1 monotherapy is an effective chemotherapy for advanced NSCLC in elderly patients with moderate side effects and safety in clinical practice .

Objective To explore the use of gastroscopy and CT for staging and clinical guiding to the surgical therapy of advanced gastric cancer.Methods The preoperative gastroscopic and CT classification and the results of operative classfication of 182 cases of advanced gastric carcinoma were compared.Results The resection rate for low and undifferentiated adenocarcinoma and mucinous carcinoma on gastroscopic biopsy was low(64.1%),and the rate for diffuse infiltrative gastric carcinoma(6.7%)was significantly lower than that of mass tumor type(66.7%)and ulcerative type(61.8%).The total accuracy rate of CT staging was 91.21%.Sensitivity rate of CT diagnosis of perigastric invasion and/or metastasis was 72.22%.For lymph node staging the accuracy rate of CT was 74.2%,sensitivity rate was 74.1% and specificity rate was 74.3%.CT diagnosis of lymph node groups was blur.Conclusions Gastroscopy has an unreplaceable role in the final diagnosis of advanced gastric cancer and has significance for gross tumor grading,histologic biopsy diagnosis can be as a guide to dicide the treatment modality of advanced gastric cancer.CT has high degree of value for accuracy of clinical staging,and diagnosis of invasion of adjacent organs and lymph node metastasis.CT is superior to gastroscopy for judgement of resectability.Therefore,preoperative CT is a valuable guide for surgical treatment of advanced gastric cancer.

Objective To analyze the relationship of 76 primary,nephrotic syndrome's clinic and pathology of the miner hospital of huaibei.so as to study the role of renal pathology to diagnosis and therapy.Methods Review analyze the symptoms,renal pathology and therapy of the 76 primary nephrotic syndrome cases of the miner hospital of huaibei.Re- sults In the 76 primary nephrotic syndrome cases,there are 42 males,34 females,who are average 13～65(30.7? 13)years old.The renal pathology types are 25(33%)Mesangial prolifeative glomerulonephfitis(MsPGN),12 (15.8%)Membranous glomerulonephritis(MN),10(13.2%)IgA nephropathy(IgAN),9(11.8%)Focal seg- mental glomerular sclerosis(FSGS),8(10.5%)Minimal change disease(MCD),7(9.2%)Sclerosing glomeru- lonephritis(SGN),5(6.5%)Mesangiocapillary glomerulonephfitis(MPGN).Meanwhile,the light MsPGN and MCD which lead to much urine protein would be good response for therapy; On the contrary,the heavy MsPGN,FSGS, SGN and MPGN would not.Conclusion Primary nephrotic syndromes are almost present in young males in huaibei mine district,meanwhile,the MsPGN's number are bigger than other renal pathology types.The renal biopsy is very important to diagnosis,to therapy,to prognosis.

Objective To analyse the distribution of pathogenic isolates and their durg resistance from inpatient in department of orthopedics from Jan.2008 to Dec.2012 and promote rational use of antibiotics.Methods All the clinical isolates were analyzed ret-rospectivily.Results of 1044 isolates,Gram-negative bacteria accounted for 54.12% (151/279 ),the most common pathogens of which were Escherichia coli,Enterobacter cloacae,and Pseudomonas aeruginosa.Gram-postive bacteria accounted for 41.58%(116/279),Staphylococcus aureus were the most common type.Fungi isolates accounted for 3.94%.The drug sensitive test showed that the resistance of different bacteria to the same antibiotic was different.The same kind of bacteria showed different drug resistance to different antibiotics.The most effective drugs for Enterobactericaeae infection treatment was Imipenem.Pseudomonas aeruginosa was sensitive to all the antibiotics exept for ciprofloxacin,to which the drug resistance was was 80%.The drug-resistance rate of Staphylococcus aureus to erythromycin,SMZ-TMP and clindanmycin were all higher than 50%,while to the rest antibiotic was low.Conclusion The bacteria that caused the infection in patients were widely distributed in the department of orthopedics,antibi-otics should be properly chosen according to the results of microbial culture and antimicrobial susceptibility test.

Objective To study formation of ammonion-magnesium phosphate crystals in urine with bacteria growing and provide guidance for cilinical prevention of urinary calculi.Methods Bacterial culturefluid of Escherichia coli,Proteus mirabilis,Pseudomonas aeruginosa,Klevsiella pneumoniae,Enterococcus in urine was examined directly under the ultrahigh sensitive microscpcope system for ammonion-magnesium phosphate crystasl.The number of ammonion-magnesium phosphate crystasl was measured when the 24th and the 48th hour.Results Ammonion-magnesium phosphate crystasl were observed from the culture fluid without ammonion magnesium phosphate crystasl.The rate of male formation was higher than that of female.Ammonion-magnesium phosphate crystals in culture fluid of Proteus mirabilis was the highest,Pseudomonasaeruginosa was the second,the third was Klebsiella pneumoniae,and there was formed 1 case in 2 ml culturefluid of enterococcus,and 2 cases of formation in 5 ml culturefluid of Escherichia coli.The crystals formed were the most unformed feather crystals,followed by cubic and square cylinders,an d the envelope like crystals were the least.Conclusion Bacteria with urease play a significant role in ammonion-magnesium phosphate crystasl formed,Proteus mirabilis is the main pathlogen.

A total of 59 untreated asthmatics and 47 healthy control subjects were recruited from Qianfoshan Hospital of Shandong Province from May 2011 to April 2012.Compared with healthy control subjects,the levels of IL-25 in induced sputum and eosinophils,IgE,interleukin-4 (IL-4) and interleukin25 (IL-25) in serum samples of asthmatics were significantly higher while the level of interferon-gamma (IFN-γ) were much lower.However,after inhaled glucocorticoid treatment,the levels of eosinophils,IL-4 and IL-25 decreased and IFN-γ significantly increased,while the level of IgE showed no significant changes.It was also found the expression of IL-25 was markedly positively correlated with the levels of eosinophils and IL-4 in serum and markedly negatively correlated with the levels of IFN-γ and had no relatio.

Objective To investigate the expression of Wnt7b, β -catenin, and c-Myc in asthmatic mice and the intervention of the leukotriene receptor antagonist montelukast on airway remodeling. Methods The asthma model was established by ovalbumin (OVA) induction. HE staining was used to observe the pathological changes in lung tissue. Serum OVA-sIgE levels were determined by ELISA. The level of Wnt7b, β -catenin, and c-Myc protein and mRNA in the lung tissue of mice was analyzed by Western blotting and real-time PCR. The basement membrane perimeter (PBM), wall area of bronchial tube (WAt), wall area of bronchial smooth muscle (WAm), and the number of smooth muscle cells were measured using medical image analysis software and standardized based on the PBM. Results The amount of OVA-slgE in the asthma group was significantly higher than in the control and montelukast groups (P ＜ 0. 05). Western blotting and real-time PCR showed that the expression of Wnt7b, β -catenin, and c-Myc in the asthma group was higher than the expression in the control and montelukast groups (P ＜ 0. 05). Image analysis showed that the WAt/PBM and WAm/PBM ratios in the montelukast group were significantly lower than those in the asthma group (P ＜ 0. 05). Conclusion The Wnt/ β -catenin signaling pathway may be an important factor in the pathogenesis of asthma; montelukast may attenuate airway remodeling in asthmatic patients by decreasing the expression of Wnt7b, β -catenin, and c-Myc.

Objective To understand the epidemiological characteristics of children with positive IgM of mycoplasma pneumoniae (MP) in Wuhan, and to provide a scientific theoretical basis for the diagnosis, prevention and effective control of mycoplasma pneumoniae infection. Methods Patients with respiratory diseases such as fever, cough and runny nose from January 2014 to December 2018 in the Pediatric Outpatient Department and Inpatient Department of Wuhan University People's Hospital were included in the study. Results From 2014 to 2018, a total of 46,790 samples were collected, and the MP-IgM positive rate was 44.08%. The male MP-IgM positive rate was 39.62%, while the female MP-IgM positive rate was 51.00%. The MP-IgM positive rate in males was lower than that in females (χ²=586.15, P<0.0001). There were significant differences in the positive rate among different age groups, and the infection rate in infants aged 3 months was the lowest (χ²=4195.30, P<0.0001). The MP-IgM positive rate in the first and second seasons of infancy within 1 year of age was higher than those in the third and fourth seasons, and the difference was statistically significant (χ²_{1 days =25.05, χ²3 months=26.59, χ²6 months=26.18, P<0.0001). The MP-IgM positive rate of children aged 1-16 in the second and third seasons was higher than that in the first and fourth seasons, and the difference was statistically significant (χ²1-3 years=17.59, χ²4-6 years=28.92, χ²7-16 years =11.43, P<0.05). Conclusion MP-IgM positive rate was related to age, gender and season.}

The atherosclerotic cardiovascular continuum or the conventional cardiovascular continuum(CCC)was first described by Dzau in 2006, describing a series of steps cardiovascular disease undergoes, from risk factors at the beginning to end-stage heart disease(characterized by ventricular dilation, heart failure, and death). The essential features of CCC are myocardial ischemia and myocardial infarction due to coronary artery stenosis, which originates from coronary atherosclerosis.O'Rourke proposed the aging cardiovascular continuum(ACC)in 2010 to explained the role of aging, especially vascular aging, in the development of cardiovascular disease.The continuum encompasses progressive deterioration of the proximal aorta properties with increasing arterial stiffness and dilation, resulting in adverse effects on important organs such as the heart, brain, and kidneys.The two continuums are both distinct and related, complement each other and fully illustrate the occurrence and progression of the cardiovascular continuum.