Objective To discuss Si tactic of breathing exercises on the rehabilitation of lung function, dyspnea, distance of 6-minute walk distance (6MWD), respiratory muscle endurance and quality of life in stable patients with chronic obstructive pulmonary disease (COPD). Methods 63 patients with COPD were divided into experimental group with 31 cases and control group with 32 cases according to random digital table method. The experimental group were given routine treatment and nursing care, take Si tactic of breathing exercises. The control group were given routine treatment and nursing care only. Both groups were given treatment for 4 months. The indexes of lung function (FEV1, FEV1%, FEV1/FVC), scores of the Modified Medical Research Council Scale (MMRC), 6MWD, scores of Saint-George′s Respiratory Questionnaire (SGRQ), maximal voluntary ventilation (MVV) changes before and after the therapy were measured. Results After intervention, the lung function as measured by FEV1, MVV, 6MWD showed a significant improvement in the experimental group, and was higher than that in the control group[(1.42±0.43) L vs.(1.22±0.32) L and(1.21±0.45) L,(52.39±14.21) L vs.(47.20±14.59) L and (43.65±11.89) L, (288.36±71.70) m vs.(244.42±71.50) m and (250.56 ±79.25) m, P<0.05]; MMRC scores, SGRQ scores, activities and daily life part score were lower after intervention and was lower than that in the control group [(2.63 ±1.00) points vs. (3.21 ±0.92) points and (3.14±1.12) points, (44.38±5.23) points vs. (54.74±5.73) points and (52.87±5.49) points, (41.25± 6.03) pints vs.(66.48±6.38) points and (64.13±5.34) points, (28.00±7.34) points vs. (44.87±4.86) points and (42.31 ±9.12) points, P<0.05]. Conclusions For COPD patients in stable stage, Si tactic of breathing exercises can improve the pulmonary function and alleviate dyspnea, enhance exercise endurance and respiratory endurance, thereby improve the quality of life of patients, so this is one of the method for comprehensive pulmonary rehabilitation in the future.

Objective To explore the clinical efficacy of anterior superior malleolus flap and second toe transplantation for thumb reconstruction and soft tissue defect repair or first web reconstruction.Methods A total of 13 cases were underwent anterior superior malleolus flap and second toe transplantation for thumb reconstruction and soft tissue defect repair from June,2008 to January,2016.There were 9 males and 4 females.The average age was 25 years old,ranging from 18 to 52.There were 3 cases of Ⅲ-degree thumb defect with soft tissue defect of hand,6 cases of Ⅳ-degree thumb defect with soft tissue defect of hand,3 cases of single Ⅴ-degree thumb defect and 1 Ⅴ-degree thumb defect with soft tissue defect.There were 5 patients accompanied with injury of other fingers of the affected hand.And the thenar muscles were also damaged to a varied degree.There were 10 patients with soft tissue defect before surgery,with the wound surface ranging from 3 cm × 5 cm-6 cm × 13 cm.And the wound of other 3 cases was closed.After the surgery,follow-up visit was conducted on the appearance,sensation,function,daily life and working condition of reconstructed thumb,the appearance and function condition of donor site.Results The reconstructed thumbs and anterior superior malleolus flaps in 13 cases survived and healed primarily.The average post-operative followed-up time was 5.5 years,ranging from 2.5 to 10.0 years.The appearance of reconstructed thumb was satisfactory,and the temperature sensation,pain sensation and touch sensation were recovered.The two-points discrimination was 8-18 mm.Moreover,the flexion and extension function,opposing function and finger-to-thumb function was recovered,which could meet the demand of daily life and work.The appearance of donor site was satisfactory,without claudication,pain or dysfunction.The survival of transplanted skin area in the calf was good,with no ulcer noticed.According to the Trial Standard for Thumb and Finger Reconstitution Functional Assessment of Hand Surgery Society of Chinese Medical Association,there were 10 cases excellent results,2 good and 1 fair.Conclusion Application of anterior superior malleolus flap and second toe transplantation for first-stage thumb reconstruction and soft tissue defect repair or thenar muscles and first web reconstruction is an effective therapeutic approach.

Hepatocellular carcinoma (HCC) is an aggressive human cancer with increasing incidence worldwide. Multiple efforts have been made to explore pharmaceutical therapies to treat HCC, such as targeted tyrosine kinase inhibitors, immune based therapies and combination of chemotherapy. However, limitations exist in current strategies including chemoresistance for instance. Tumor initiation and progression is driven by reprogramming of metabolism, in particular during HCC development. Recently, metabolic associated fatty liver disease (MAFLD), a reappraisal of new nomenclature for non-alcoholic fatty liver disease (NAFLD), indicates growing appreciation of metabolism in the pathogenesis of liver disease, including HCC, thereby suggesting new strategies by targeting abnormal metabolism for HCC treatment. In this review, we introduce directions by highlighting the metabolic targets in glucose, fatty acid, amino acid and glutamine metabolism, which are suitable for HCC pharmaceutical intervention. We also summarize and discuss current pharmaceutical agents and studies targeting deregulated metabolism during HCC treatment. Furthermore, opportunities and challenges in the discovery and development of HCC therapy targeting metabolism are discussed.