Objective To investigate the effect of bronchodilators on dyspnea and pulmonary function in patients with chronic obstruction pulmonary disease (COPD) at different degrees.Methods 50 patients with COPD from January 2014 to January 2015 in pneumology department of Tongchuan City People's Hospital were selected.According to the standard of Global initiative for chronic obstructive lung disease (GOLD), the patients were divided into mild degree of 14 cases, moderate degree of 18 cases and severe degree of 18 case.The changes of Borg score of dyspnea, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and inspiratory capacity (IC) after received tiotropium bromide inhalation in each group.Results FEV1, FVC, PEF and IC values significant improved in mild, moderate and severe degree groups after received tiotropium bromide inhalation and the values of improvement rate changed significantly with degrees of disease ( P <0.05 ).The improvement rates of FEV1, FVC and IC were highest in patients at severe degree, improvement rate of PEF was highest in patients at mild degree (P<0.05).After received tiotropium bromide inhalation, the Borg score improved significantly compared with that of pre-treatment in mild, moderate and severe degree groups (P<0.05), the improvement rate of Borg score was highest in severe degree group(P<0.05).There were significantly positive correlations between Borg score and FEV1(r=0.372),FVC(r=0.296),PEF(r=0.284),IC(r=0.704)(all P<0.05).Conclusion Bronchodilator could significantly improve dyspnea and lung function in patients with COPD, and the improvement rate of FEV1, FVC and IC is highest in patients with COPD at server degree, PEF is highest at mild degree and Borg score is highest at server degree, which need the comprehensive analysis of each indicators for reversibility of airflow obstruction.

Objective To observe the efficacy of self-made Arnebiae oil by our hospital on phaseⅠandⅡpressure ulcers. Methods A total of 324 pressure wounds of 283 cases collected from March 2014 to August 2015 were randomly divided into the observation group (145 cases) and the control group (138 cases). The control group received Kangfuxin solution in conjunction with conventional pressure ulcer care treatment, the observation group were treated with Arnebiae oil and conventional pressure ulcer care treatment. The therapeutic effect and healing time of both groups were compared. Results Arnebiae oil was effective in 96.97% (160/165) of the pressure ulcer patients and cured 84.85% (140/165) patients in the observation group. Nearly 84.91%(135/159) patients were effective and 50.94%(81/159) patients were cured in the control group. There was statistical significance (χ2=42.93, 14.46, P<0.01). The healing time was (8.78±4.27) d in the observation group and (10.46±3.99) d in the control group with significance(t=2.88, P< 0.05). The healing rates of Arnebiae oil sacrococcygeal region, hips, legs and other parts were 87.96%(95/108), 9/10, 12/16, 9/9, significantly higher than those of the control group, 46.43%(39/84), 6/12, 3/9, 9/15, the difference had statistical significance (χ2=4.02-44.35, P<0.05). Conclusion Arnebiae oil com-bined with the overall care can improve the rate of wound healing in aged pressure ulcer, which is suitable for clinical application.

Objective To explore the clinical efficacy of lymph node involved-field irradiation (IFI) and elective nodal irradiation (ENI) for treatment of esophageal cancer among Asian populations. Methods The randomized controlled trials and retrospective analyses of Asian esophageal cancer patients treated by IFI and ENI were retrieved by computer in Cochrane Library, PubMed, Embase, CNKI, and Wanfang database. The last retrieval time was May 2018. According to the inclusion and exclusion criteria, the clinical efficacy, adverse reactions and failure modes were selected in each study. A Meta-analysis was performed by using Review Manager 5.3 software to compare the advantages and disadvantages of IFI group and ENI group in treatment of Asian esophageal cancer patients. Results Eventually, a total of 18 domestic and foreign literature that meet the standards (6 randomized controlled trials, 12 retrospective analyses) were included, with a total of 2220 patients. There were no significant differences in the overall survival rate, the local control rate, the local/regional failure rate, the distant metastasis rate, the intra-field recurrence rate, and the field recurrence rate between the IFI group and the ENI group (all P>0.05). The overall failure rate of ENI group was slightly lower than that of IFI group (P= 0.05). The incidence of radiation pneumonitis in ENI group was higher than that in IFI group (P= 0.004), and the incidence of radiation esophagitis was higher than that in IFI group (P< 0.01). Conclusion For Asian patients with esophageal cancer, ENI has no obvious advantage compared with IFI, including the increase of adverse reactions.

The incidence of brain metastases in patients with non-small cell lung cancer (NSCLC) has increased as a result of improved local control rate and survival rate. Prophylactic cranial irradiation (PCI) has been proven to reduce the incidence of brain metastases and improve survival rate in patients with NSCLC. However, the value of PCI for NSCLC is still controversial. This paper reviews the progress of the efficacy and adverse reactions after PCI treatment for patients with NSCLC.

Objective: To describe the clinical features, causal agent and transmission mode of a fever outbreak in a school in Shanghai. Methods: Field epidemiological approaches including case definition development, searching for contacts, distribution of diseases description, environmental sampling and laboratory testing. Results: A total of 16 influenza like cases were included, all concentrated in the one class of grade two, including 15 students and 1 teacher. Among student cases, the incidence rate was 36.59% (15/41), the average age was 7.4 years, the incidence rate was 36.84%(7/19) for boys, 36.36%(8/22) for girls. The clinical course was 5-15 days, with the median of 9 days, and 18.75%(3/16) of the cases stayed studying while sick. The nasopharyngeal swab specimens in 16 cases all tested positive for influenza B, of which 11 tested positive for mycoplasma pneumoniae and 1 case also tested positive for coronavirus OC43. Body temperature, number of mononuclear cells, and treatment time of patients infected with Influenza B and mycoplasma pneumoniae were higher than those of patients infected with influenza B alone( P <0.05). The outbreak lasted for 12 days, all sick students were treated and discharged from hospital, with no severe cases or death, and the outbreak was effectively controlled. Conclusion This campus cluster outbreak caused by influenza B and mycoplasma pneumoniae. Patients with influenza B with mycoplasma pneumoniae have severe symptoms and a long course of illness, suggesting the importance of early management of the epidemic.

Objective To investigate the clinical manifestations and gene mutation of a pedigree with retinal lattice degeneration and granular corneal dystrophy (GCD) type 2.Methods Ten members in 3 generations of a pedigree with retinal lattice degeneration and GCD2 were included in the study, including 6 patients (3 males and 3 females) and 4 healthy family members. All members underwent visual acuity, slit lamp microscope, three-mirror lens, fundus color photography, optical coherence tomography, and corneal endothelial cells counting. Genomic DNA was extracted from peripheral venous blood (2 ml) from all the subjects and their spouses, who had no related inherited diseases. The next generation sequencing method was used to detect the mutation sites of transforming growth factor β (TGFBI), and all results underwent Sanger verification.Results Among the 12 eyes of 6 patients, the visual acuity was FC/20 cm-1.0. In the superficial central corneal stroma, snowflake-like deposits were observed in three cases (6 eyes), and a small amount of granular deposits were observed in three cases (6 eyes). Corneal endothelial cell counts were normal. Retinal lattice degeneration were observed in 3 cases, 6 eyes (including 3 cases of rhegmatogenous retinal detachment in 4 eyes); retinal thinning without obvious lattice degeneration in 4 eyes of 2 patients. Nystagmus in 1 patient and fundus examination showed no significant abnormalities. DNA sequencing results showed that the proband and 4 patients had missense mutation of TGFBI gene in exon 4 c.371G> A, the mutation site corresponding to the amino acid change encoded by TGFBI gene No. 124 Amino acids, from arginine to histidine (p.R124H). Patients with this mutation have varying degrees of clinical phenotype.Conclusions The mutation of c.701G> A (p.R124H) in TGFBI gene is the causative gene of GCD in this pedigree. The patients with this mutation have different clinical phenotypes.

Sleep disorders are abnormalities in sleep duration or quality caused by factors that range from insomnia,circadian rhythm sleep disorders to abnormal behavioral disorders during sleep.Long-term sleep disorders may affect the emotions and physical strength of soldiers,impair their learning and cognitive ability,and even increase the prevalence of physical and mental diseases,which may be detrimental to their physical and mental health and combat effectiveness.This article is intended to review the current research progress in sleep disorders in military personal at home and abroad.

BACKGROUND: There are few multi-city studies on the association between temperature and mortality in basin climates. This study was based on the Sichuan Basin in southwest China to assess the association of basin temperature with non-accidental mortality in the population and with the temperature-related mortality burden. METHODS: Daily mortality data, meteorological and air pollution data were collected for four cities in the Sichuan Basin of southwest China. We used a two-stage time-series analysis to quantify the association between temperature and non-accidental mortality in each city, and a multivariate meta-analysis was performed to obtain the overall cumulative risk. The attributable fractions (AFs) were calculated to access the mortality burden attributable to non-optimal temperature. Additionally, we performed a stratified analyses by gender, age group, education level, and marital status. RESULTS: A total of 751,930 non-accidental deaths were collected in our study. Overall, 10.16% of non-accidental deaths could be attributed to non-optimal temperatures. A majority of temperature-related non-accidental deaths were caused by low temperature, accounting for 9.10% (95% eCI: 5.50%, 12.19%), and heat effects accounted for only 1.06% (95% eCI: 0.76%, 1.33%). The mortality burden attributable to non-optimal temperatures was higher among those under 65 years old, females, those with a low education level, and those with an alternative marriage status. CONCLUSIONS Our study suggested that a significant association between non-optimal temperature and non-accidental mortality. Those under 65 years old, females, and those with a low educational level or alternative marriage status had the highest attributable burden.
Female ; Humans ; China/epidemiology* ; Cities ; Cold Temperature ; Hot Temperature ; Mortality ; Temperature ; Time Factors ; Middle Aged ; Male

Hypoxia inducible factor 1-α(HIF-1α) is a transcription factor induced by hypoxia, and it regulates the transcription of hypoxia-related genes for cells, especially for tumor cells to adapt to the hypoxic environment. HIF-1 α has been widely studied concerning breast cancer, liver cancer and other solid tumors. High expression level of HIF-1 α was related to tumor angiogenesis, metastasis, and chemotherapy-drug resistance. Recent studies showed that HIF-1α was closely related to the pathogenesis and the progress of hematological malignancies such as leukemias, and the expression of HIF-1 α was related to the prognosis of these patients. This paper reviews the research progress of HIF-1α in hematologic malignancies.

Chloroquine (CQ) phosphate has been suggested to be clinically effective in the treatment of coronavirus disease 2019 (COVID-19). To develop a physiologically-based pharmacokinetic (PBPK) model for predicting tissue distribution of CQ and apply it to optimize dosage regimens, a PBPK model, with parameterization of drug distribution extrapolated from animal data, was developed to predict human tissue distribution of CQ. The physiological characteristics of time-dependent accumulation was mimicked through an active transport mechanism. Several dosing regimens were proposed based on PBPK simulation combined with known clinical exposure-response relationships. The model was also validated by clinical data from Chinese patients with COVID-19. The novel PBPK model allows in-depth description of the pharmacokinetics of CQ in several key organs (lung, heart, liver, and kidney), and was applied to design dosing strategies in patients with acute COVID-19 (Day 1: 750 mg BID, Days 2-5: 500 mg BID, CQ phosphate), patients with moderate COVID-19 (Day 1: 750 mg and 500 mg, Days 2-3: 500 mg BID, Days 4-5: 250 mg BID, CQ phosphate), and other vulnerable populations (.., renal and hepatic impairment and elderly patients, Days 1-5: 250 mg BID, CQ phosphate). A PBPK model of CQ was successfully developed to optimize dosage regimens for patients with COVID-19.