OBJECTIVE:To observe the clinical effect of tiotropium bromide combined with salmeterol xinafoate and fluticasone propionate in the treatment of medium and severe COPD. METHODS:119 patients with medium and severe COPD were divided into control group(54 cases)and observation group(65 cases)according to admission order. Control group was treated with Salmeterol xi-nafoate and fluticasone propionate powder for inhalation 50 μg,bid;observation group was additionally given Tiotropium bromide powder for inhalation 18μg,qn. Both groups received 1 month of treatment. Lung function indexes as FEV1,FVC and IC,blood gas indexes as SaO2,PaCO2 and PaO2 and inflammatory factors as IL-8 and TNF-α,COPD assessment test(CAT)score were observed in 2 groups,and the occurrence of ADR was also observed. RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups(P>0.05). After treatment,FEV1,EVC,IC of observation group were increased significantly,SaO2 and PaO2 of observation group were increased significantly,while PaCO2,IL-8 and TNF-αlevels was decreased significantly;those index-es of observation group were significantly better than those of control group,with statistical significance(P<0.05). CAT score of 2 groups were decreased significantly compared to before treatment,and the observation group was significantly lower than control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Tiotropium bromide com-bined with salmeterol xinafoate and fluticasone propionate shows good clinical efficacy and safety in the treatment of medium and se-vere COPD.

Objective To investigate the changes of psychological state and family environment of the patients with neurosis (including depression and anxiety) in the process of treatment. Methods The Hamilton depression scale (HAMD), Hamilton anxiety scale(HAMA), self-rating depression scale(SDS), self-rating anxiety scale(SAS), family environment scale(FES), and family adaptability and cohesion scale(FACESⅡ-CV) were used to evaluate the changes of psychological state and family relationship in the process of treatment among patients with depression and anxiety hospitalized in general hospitals (n=45) and their family members (n=45). Results Before intervention, values of HAMD, HAMA, SDS and SAS in patients were higher than normal ones, and were in line with the corresponding diagnostic criteria. After psychological intervention and medication for 2 to 3 months, symptoms such as depression and anxiety were improved significantly, and values of the above scales were within normal ranges. Besides, there was also significant improvement in FES and FACESⅡ-CV after intervention among the patients. All the values of the family members were in the normal ranges before intervention, however, significantly positive changes were observed after intervention. Conclusion With the improvement in depression and anxiety after intervention among patients, the psychological pressure of family members is released, and family relationship is partially restored. The rehabilitation of patients plays an important role in the restoration of family function.

Fifty cases of mild - moderate cerebrovascular dementia selected by referring to the diagnositic criterion DSM- I -R for cerebrovascular dementia (VaD) established by America Society of Psychoneurology issued by WHO were randomly divided into Shen Tong Capsule treatment group (30 cases) and hydergine treatment group (20 cases). Modified Mental State Examination (MMSE) and Blessed Behavior Scale (BBS) were used to calculate changes of marks before and after treatment for assessment of therapeutic effects. Results show that Shen Tong Capsule has therapeutic effect on key symptoms and clinical behaviour of mild - moderate disturbance of intelligence, with the total effective rate of 86. 67%. Differences of accumulated marks in both MMSE and BBS before and after treatment in the treatment group are superior to those of the control group respectively.

Objective To investigate the subjective life quality of hospitalized children and analyze its influencing factors for improving their life quality.Methods 48 hospitalized children who were admitted between May to August 2011 were investigated in convenience using inventory of subjective life quality (ISLQ).Results Patients investigated had a higher score than the national norm on Family Life Dimension.The satisfaction level of 20％ ～ 30％ children were below the average on Family Life and other eight dimensions,the cognitive components of 16 cases (33.3％) and emotional component of 11 cases (22.9％) were below the average.15 cases (31.3％) were not satisfied with their subjective quality of life.Female patients had higher scores than male patients on peer exchanges,body feelings and subjective quality of life satisfaction; the satisfaction level of experience depression for rural children was lower than urban children.Conclusions The subjective life quality of vast majority of hospitalized children is about the general level,but some patients still experience serious anxiety,depression and other negative psychological emotion.Nurses should guide the patients positively and specially,considering the influence of their gender and living places while providing caring.Based on the health education of patients and their family,we promote them to face the disease.

Objective To patients with neonatal dacryocystitis underwent left Ofloxacin Gel, Tobramycin and Dexamethasone Ophthalmic Ointment and lacrimal surgery combined with treatment effects were observed.MethodsIn Ningxia Hui Autonomous Region Qingtongxia City People's Hospital during December 2015 to December 2016 for dacryocystitis in 130 cases according to the data analysis, using different treatment schemes were divided into two groups, 65 cases underwent lacrimal surgery as control group, 65 cases and left Ofloxacin Gel, Tobramycin and Dexamethasone Ophthalmic Ointment combined treatment as the observation group, blocking characters and comparison of complications two groups of clinical curative effect, lacrimal duct.ResultsIn the observation group, the total effective probability of 96.92% higher than the control group of 80.00%(P<0.05), and the nasal deformity, nasolacrimal duct, lacrimal bone deformity multiple adhesions or obstruction and lower incidence of membranous obstruction of lacrimal duct is lower than that of control group (P<0.05);the total complication rate in the observation group(3.08%) than the control group(21.54%)low (P<0.05).ConclusionNeonatal dacryocystitis underwent left Ofloxacin Gel, Tobramycin and Dexamethasone Ophthalmic Ointment and lacrimal surgery combined therapy can improve the clinical symptoms and characteristics of lacrimal duct obstruction, and reduce postoperative complications, which may be of clinical promotion and application.

0.05). Chuansu Jiuxin Capsule could improve haemorheology (mainly act on blood viscosity, plasma viscosity and HCT), degrade platelet function (increase TXB2 level and decrease 6-keto-PGF1? level) and protect endothelia (increase ET and decrease NO level). Conclusions Chuansu Jiuxin Capsule was effective and safe for the treatment on AP patients with syndrome of blood stasis in collateral of heart.

Objective In this study,we aim to investigate and evaluate the application of peer education on the teaching of medical graduate students and to evaluate the teaching effect,in order to provide the basis for subsequent practice reform.Methods 49 graduate students majoring Internal Medicine-Pulmonology were randomly divided into traditional teaching(24) and peer education groups (25).We chose the primary culture technology of rat distal pulmonary arterial smooth muscle cells to be the teaching contents.For the traditional teaching group,we used the mode of class lecture giving and experimental skills learning under the assistance of the teachers; while in the peer education group,students benefited from the combination of class lecture given by the teacher and the seniors fixed teaching in which seniors help younger students.We selected the experimental operating time,cell purity and the practicing time to reach a standard culture as the evaluation indexes by filling a follow up questionnaire.The SPSS 13.0 was applied to the related data forx2 or t test.Results In the traditional teaching group,the average time to reach three times of standard culture was(3.2 ± 0.5) hour,which was(2.3 ± 0.4) hour in the peer education group.The cell purity was 80.1 ± 3.6％ in the traditional teaching group,while(85.4 ± 5.9)％ in the peer education group.The average practicing time was(6.3 ± 1.0) in the traditional teaching group,while(4.9 ± 0.6) in the peer education group.The peer education group master the teaching content better than the traditional teaching group (P=0.00).95.8％(23/24)of the students in the peer-education group considered the teaching contents simple,which was statistically higher(P=0.00) than traditional group (62.5％,15/24).Meanwhile,95.8％ (23/24)of the students in the peer-education group considered the teaching methods easy to accept,which was also statistically higher(P=0.02) than traditional group(70.8％,17/24).The difference was statistically significant (P=0.02).Conclusion The application effect of peer education is good and there is high degree of acceptance among the students.Besides,peer education accords with the medical postgraduate experiment teaching rules,and can cultivate medical graduate students' spirit of cooperation and communication ability in the process of implementation.

AIM: To investigate the role of nitric oxide synthase (NOS), soluble guanylyl cyclase (sGC) and protein kinase C (PKC) signaling in tumor necrosis factor-? (TNF-?)-induced cardioprotection against hypoxia/reoxygenation (H/R) injury. METHODS: Neonatal rat ventricular myocytes were pretreated with TNF-? or sodium nitroprusside (SNP) or L-arginine (L-Arg), respectively, for 12 h and then subjected to continuous hypoxia for 12 h, followed by reoxygenation for 6 h. The manganese superoxide dismutase (Mn-SOD) activity of the cells was measured after H/R. Myocyte injury was determined by the release of lactic dehydrogenase (LDH). RESULTS: TNF-? (10~5 (U/L)) significantly increased the Mn-SOD activity and decreased release of LDH from ventricular myocytes. The cardioprotection against H/R injury was induced by the pretreatment with SNP (5 ?mol/L) or L-Arg (5 mmol/L), which was blocked by ODQ (10 ?mol/L), the specific sGC inhibitor, and Chel (5 ?mol/L), the specific PKC inhibitor. Pretreatment with L-NAME (100 ?mol/L), ODQ, Chel, antoxidant 2-MPG (400 ?mol/L) or tyrosine kinase inhibitor genistein (50 ?mol/L) attenuated the increased Mn-SOD activity and reduced LDH level induced by TNF-?. CONCLUSION: The results suggest that NO may play a role in TNF-?-induced cardioprotection, which is mediated by sGC and PKC. [

Objective To explore the factors affecting the prognosis of pancreatic cancer patients,using COX risk model to carry on the statistical analysis of 154 cases of pancreatic carcinoma.Methods Retrospectively analyzed 154 pancreatic cancer cases' history date treated in April 2001-April 2008 of Fujian Medical University Union Hospital.Survival rate was caculated by Kaplan-Meier estimation while survival cruve was analysed by Log-rank test.Prognostic factors were studied by multivariate analysis with COX proportional hazards survival model.Results In this group,survival time was from 1 to 106 months and the median survival time was 8 months.Overall survival rates at 6 months,12 months,18 months,36 months were 58.4％,29.2％,16.3％ and 3.7％ respectively.Multivariate revealed that independent prognostic factors were follows:TNM tumor staging,operation mode and synthetic therapy.Conclusions The prognosis of patients with pancreatic carcinoma is determined by multiple factors.Patients of advanced TNM staging have a poorer prognosis.Radical resection and comprehensive treatment of patients prognosis is better.

BACKGROUND:Manual reduction for external fixation of distal radius fractures can achieve good outcomes.
OBJECTIVE:To carry out the bibliometric analysis on manual reduction for external fixation of distal radius fractures.
METHODS:Literatures concerning reduction for external fixation of distal radius fractures were retrieved in CNKI database from 2003 to 2012. The keywords were“external fixation;distal radius fractures”. Duplicate and irrelevant articles were eliminated, and a total of 408 articles were retrieved. A bibliometric analysis of these 408 articles was performed in terms of publishing time and number, subject categories, source journals, research institutions, times cited and download frequency.
RESULTS AND CONCLUSION:Literatures concerning manual reduction for external fixation of distal radius fractures exhibit an upward trend in number. In 2012, there were 85 relevant articles. In the past 10 years, 18 relevant articles have been published in Chinese Journal of Traditional Medical Traumatology&Orthopedics, which is the most. There are not many relevant studies in various research units, only 1-7 articles published per unit, and five articles are funded.