Objective To investigate the clinical effects of salmeterol and fluticasone propionate combined with tiotropium in treatment of chronic obstructive pulmonary disease (COPD).Methods 78 patients with COPD were randomly divided into two groups according to hospitalized order ,the control group(n=39)was given salmeterol and fluticasone propionate on the basis of the conventional treatment while the observation group ( n=39 ) was given tiotropium on the basis of the control group .The clinical efficacy and adverse events were compared between the two groups.Results After treatment,FVC,FEV1 and FEV1/FVC of the observation group were (1.90 ±0.19) L, (2.26 ±0.25)L and(68.41 ±5.65)%,which were significantly higher than those before treatment (t2 =9.92, 11.62,9.72;t1=9.70,8.76,9.41,all P<0.05)and of the control group(t=8.37,7.72,7.52,all P<0.05);the incidenceof adverse reactions had no statistically significant between the two groups (χ2 =2.207, P >0.05 ). Conclusion Salmeterol and fluticasone propionate combination of tiotropium in the treatment of COPD has significant effect,and it can effectively alleviate clinical symptoms and improve lung function ,so it is safe and reliable,which should be widely applied in clinical .

Objective To explore the clinical efficacy of methylprednisolone injection and magnesium sulfate injection in the treatment of severe bronchial asthma and the impact on inflammatory cytokines.Methods 87 cases of severe bronchial asthma were selected for the study,and they were divided into two groups according to the order of admission,the control group (43 cases ) was given methylprednisolone treatment,while the observation group (44 cases)was given methylprednisolone injection and magnesium sulfate treatment.The clinical treatment and inflammatory cytokine levels before and after treatment were compared between the two groups.Results The effective rate of the observation group was 93.18%,which was higher than 74.42% of the control group,the difference was significant(χ2 =10.33,P <0.05 ).After treatment,pulmonary functions of the observation group [FVC (3.72 ± 0.42)L,FEV1 (2.72 ±0.32)L and PEF(3.48 ±0.49)L/s]were increased significantly than before treatment(t =7.87,7.81,8.41,all P <0.05),and had significant differences compared with the control group(t =6.93,7.44, 7.20,all P <0.05).After treatment,inflammatory cytokines indicators of the observation group[IL -6 (67.44 ± 0.43)μg/L,TNF -α(80.32 ±7.34)ng/L,hs -CRP(3.32 ±0.89)mg/L]were significantly increased than before treatment(t =6.85,7.41,7.33,all P <0.05),compared with the control group,the differences were significant(t =6.55,7.04,6.45,all P <0.05).Conclusion The methylprednisolone combination with magnesium sulfate in treat-ment of severe bronchial asthma had significant effect,and it can effectively improve the airway inflammation,promote lung function in patients'recovery,and it has great clinical value.

Objective To study the etiology of functional dyspepsia (FD) and compare the clincial responses of medical treatment and psychological intervention.Methods Psychological intervention (psychologic support),advices for daily life (eating habits) and medical treatment were administered to the 346 FD patients;and the therapeutic effects were compared.Results Complete remission:225 cases (65%);partial remission:52 cases (15%);no effect:69 cases (20%).The overall effective rate was 80%.Conclusion FD is a clinical syndrome focusing in upper abdomen,but without local or systematic evidence Psychological treatment is stressed.

Objective To investigate the correlation between the measurement methods of carotidcerebral pulse wave velocity (ccPWV) and the traditional method of brachial-ankle pulse wave velocity (baPWV).Methods A total of 136 healthy volunteers were divided into a youth group (20-39 years),a middleaged group (40-59 years),and an elderly group (more than 60 years) according to their ages.While detecting baPWV,transcranial Doppler ultrasound was used to simultaneously monitor the ipsilateral common carotid artery and the terminal segment of internal carotid artery.The time differences of the beating points of their cardiac cycles and the distanceses of the skin surfaces between the 2 probes were measured and ccPWV was calculated.Results The systolic blood pressure,pulse pressure and mean arterial pressure in the elderly group were signifificantly higher than those in the middle-aged group and the young group.The ccPWVs in the youth,middle-aged and elderly groups were 418 ± 52 cm/s,489 ±54 cm/s,and 599 ± 58 cm/s,respectively.The elderly group was significantly faster than the middle-aged group (t =7.308,P ＜0.001),and the middle-aged group was significantly faster than the youth group (t=6.758,P＜0.001).A Pearson correlation analysis showed that ccPWV was significantly positively associated with the age (r=0.847,P＜0.001) and baPWV (r =0.548,P ＜0.001).The multiple linear regression analysis showed that ccPWV was significantly positively associated with the age and diastolic blood pressure (partial correlation coefficients were 0.742 and 0.293respectively,P ＜0.001 and ＜0.010 respectively).Conchlusions ccPWV is a new measurement method for cerebrovascular stiffneas,and it has a good correlation with the traditional measurement method.

Objective: To determine whether intrauterine infection with hepatitis B virus (HBV) occurs in early pregnancy and to characterize associated virulence factors. Methods: Villi tissues and blood samples of 45 HBV surface antigen (HBsAg)-positive pregnant women were collected during the first trimester and HBV DNA loads were quantified by quantitative reverse transcription polymerase chain reaction (qRT-PCR). The expression of GCM1, HBsAg and hepatitis B core antigen (HBcAg) in villi tissues were detected by immunohistochemical method. Results: Data from qRT-PCR showed that HBV DNA was detected in 14 of 45 villi tissues (positive rate of 31.11%), and 24 of 45 blood samples (positive rate of 53.33%), further statistical analysis showed that the positive rates of HBV DNA between blood samples and villi tissues were not significantly different (χ²=4.555, P=0.054). Among them, 12 samples were consistently positive between the villi and blood specimens, and HBsAg, HBeAg, HBeAb, HBV DNA from peripheral blood in these pregnant women were significantly higher than those of the other women (P value was 0.007, 0.004, 0.000, and 0.000 respectively). The multivariate logistic regression analysis showed that blood HBV DNA greater than 106 IU/ml was independently associated with HBV DNA positive in villi, and the HBsAg, HBeAg, villi tissues HBV DNA positive rates of these pregnant women were significantly higher than those of the other pregnant women (all P value were 0.000). Immunohistochemistry results showed that all 45 cases were positive for GCM1 expression in the cell nucleus. Nine cases also had HBsAg expression in the cytoplasm. Only one case was found to express HBV core antigen (HBcAg) in the nucleus. Conclusions HBV DNA and HBsAg can be detected from villi tissues harvested during the first trimester in HBsAg-positive pregnant women, and the results suggest an early occurrence of intrauterine infection of fetuses with high HBV levels.