Objective To investigate the effect of target -oriented fluid therapy on the tissue perfusion of patients with hemorrhagic shock during ectopic pregnancy .Methods From December 2015 to June 2017 ,80 patients with ectopic pregnancy hemorrhagic shock in Laiyang Central Hospital of Yantai were enrolled in this study .They were divided into two groups according to the random number method ,with 40 cases in each group .The control group was given routine fluid supplementation .The observation group was given target -oriented fluid therapy .The average arterial pressure,central venous pressure and urine output in two groups were compared .The vasoactive drug use and use time were analyzed in the two groups .Results The mean arterial pressure in the observation group was (115.6 ±10.3)mmHg,which was higher than that in the control group [(86.9 ±5.6)mmHg](t=15.482,P<0.05).The central venous pressure in the observation group was (7.1 ±0.5)cmH2O,which was higher than that in the control group [(5.9 ±0.2)cmH2O](t =14.093,P<0.05).The urine output in the observation group was (256.8 ±15.9)mL,which was more than (53.1 ±5.0)mL in the control group(t=77.294,P<0.05).The use rate of vasoactive drug in the observation group was 7.5％,which was lower than 37.5％in the control group(t=8.674, P<0.05).The duration of vasoactive drug use in the observation group was (35.0 ±0.1)min,which was shorter than (49.6 ±1.8)min in the control group(t=13.707,P<0.05).Conclusion Target-oriented fluid therapy for ectopic pregnancy hemorrhagic patients is more effective for fluid resuscitation and less usage of vasoactive drugs .

Objective To investigate the current status of prevalence, prevention and management of chronic obstructive pulmonary disease(COPD) in rural area in China. Methods A cross-sectional survey of COPD was conducted in Beijing city, Shanghai city, Guangdong province, Liaoning province,Tianjin city, Chongqing province and Shanxi province. A population-based cluster sample was randomly selected from each rural area. In the selected community,all residents at least 40 years old were recruited,and interviewed with a modified standardized questionnaire from the international burden of obstructive lung diseases (BOLD) study. All participants were tested with spirometry. Those with airflow limitation were performed on post-bronchedilator spirometry. The post-bronchedilator a ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) less than 70% was defined as the diagnostic criteria of COPD. Results (1) Data of 9434 participants was valid for analysis, with a valid response rate of 83. 6% ;the prevalence of COPD in rural was 8. 8% (830/9434), 12. 8% in male and 5.4% in female. (2)The percentage of smoking and the exposure to biomass smoke in rural was 43. 0% (4059/9434) and 83. 1% (7835/9434) respectively; cigarettes cessation rate was 17.5% ; only 12. 4% ( 502/4059 ) of smokers had received advice to quit smoking. (3) Among COPD patients, only 30. 0% (249/830) had ever been diagnosed as COPD, bronchitis, emphysema, or asthma, 2. 4% (20/830) had ever received spirometric tests, and 74. 5% were current smokers; only 7.9% (50/634)COPD patients in stage two or over had received regular drug treatment. Conclusion There was high prevalence and poor prevention and management for COPD in rural areas. Therefore, an enforced prevention and management for COPD are urgent.