Chronic obstructive pulmonary disease and asthma are complex inflammatory diseases with airway obstruction as the main characteristics, and have become common respiratory diseases that seriously affect human health. Compared with the clinical use of PDE3 or PDE4 inhibitors alone, dual PDE3/4 inhibitors have synergistic anti-inflammatory and bronchodilator effects, and have attracted widespread attention in recent years. This article reviews the representative research results of dual PDE3/4 inhibitors currently in the preclinical and clinical research stages, summarizing their latest progress and their potential for the treatment of chronic obstructive pulmonary disease and asthma.

The morphologic changes of human hepatocaranoma transplanted in nude mice afler photodynamic therapy (PDT) with sulfonated aluminum phthalocyanine (ALSPQ were studied The cancer cells after PDT with ALSPC showad vacuolar degeneration and separation from each other. The endothelium of blood vessel was damaged and hemorrhage occured Under electron microscope the endoplasmic reticulum enlarged, mitochondria swelled, perinudear space dilated, and chromosome aggregated and condensed. The membrane of nuclei and cells broke off and tumor cells died at last The endothdial cells had the same changes mentioned above. This result suggests that ALSPC has photodynamic effect on the human hepatocellular carcinoma tranaplanted in nude mice. And the membrane system of cells is probably the main target.

Objective To summarize the clinical experience of laparoscopic cholecystectomy (LC) in the treatment of acute cholecystitis. Methods A total of 93 cases of acute cholecystitis treated by LC from May 2003 to May 2005 was retrospectively reviewed, including 15 cases of preoperative endoscopic retrograde cholangiopancreatography (ERCP) combined with endoscopic sphincterotomy (EST) for common bile duct stones and 6 cases of intraoperative cholangiography. The LC was performed within 48 hours after admission. Results The LC was successfully completed in 91 cases (97.8%), whereas a conversion to open surgery was required in 2 cases (2.2%). The operation time was 35~160 min (mean, 65 min). Postoperatively, biliary leakage occurred in 3 cases (3.2%) and residual stones in the common bile duct were found in 3 cases (3.2%), which were all cured by open surgery combined with ERCP, EST, and endoscopic nasobiliary drainage (ENBD). No iatrogenic injuries happened. Conclusions With proper selection of ERCP and EST, LC for the treatment of acute cholecystitis is feasible and safe. But the incidence of conversions and complications may be high.

[Objeetive] To compare the expression level of CD44V6,?-catenin in osteosarcoma cells with controls,and to investigate the correlation with invasion of osteosarcoma cells.[Methods]Expression of CD44V6 and ?-catenin was examined by immunohistochemistry SP method in 35 specimens of human osteosarcoma tissue.The control group was 15 samples of normal bone tissue and 15 samples of osteochondroma.[Results]The expression of CD44V6 and ?-catenin was correlated significantly with clinical stage,neoplasm metastasis(P0.05).In osteosarcoma,CD44V6 was positively correlated with the expression of ?-catenin(u=3.77,P

Objective To evaluate the effect of infiltration anesthesia at Calot's triangle on postoperative analgesia in the patients undergoing laparoscopic cholecystectomy.Methods One hundred and forty patients,aged 18-64 yr,with 18 kg/m2 ≤ body mass index ≤ 31 kg/m2,of ASA physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic cholecystectomy,were randomly divided into 2 groups (n =70 each):control group (group A) and infiltration anesthesia at Calot's triangle group (group B).In group B,1％ ropivacaine 10 ml was injected into Calot's triangle before dissection of the gallbladder,while the equal volume of normal saline was injected into Calot's triangle in group A.The patients in both groups received patient-controlled intravenous analgesia (PCIA) for 48 h starting from 10 min before the end of surgery.The VAS score was maintained below 4 during PCIA.When VAS score ≥ 4,lasting for more than 30 min,tramadol 1.5 mg/kg was injected intravenously.The consumption of physic liquor for PCIA,and requirement for tramadol were recorded.The incidence of puncture-related damage to Calot's triangle and local anesthetic intoxication and adverse effects such as nausea and vomiting within 48 h after surgery were also recorded.The first postoperative flatus time was recorded.Results Compared with group A,the consumption of physic liquor for PCIA,requirement for tramadol,and consumption of tramadol were significantly reduced,and no significant change was found in the incidence of nausea and vomiting and the first postoperative flatus time in group B.No puncture-related damage to Calot's triangle occurred in A and B groups.There was no local anesthetic intoxication in group B.Conclusion Infiltration anesthesia at Calot's triangle can optimize postoperative analgesia in the patients undergoing laparoscopic cholecystectomy.

Objective Differentiation of breast fibroadenoma from breast cancer is of great importance. The purpose of the ar-ticle was to evaluate the diagnostic efficacy of magnetic resonance imaging(MRI) in the differentiation of breast fibroadenoma from breast cancer in DCE-TIC ( dynamic contrast enchancement-time intensity curve) platform type ( typeⅡ) . Methods Between March 2014 and May 2016, 64 patients were included in our study, 19 patients with breast fibroadenoma and 45 patients with breast cancer. All the patients underwent DCE-MRI ( dynamic contrast-enhanced magnetic resonance imaging) examination before operation. Morpho-logic characteristics, hemodynamic characteristics, EER ( early enhancement rate) and ADC ( apparent diffusion coefficient) values were calculated and statistically compared. Results Among 19 cases of breast fibroadenoma, 9 cases were round or ovoid, 8 cases are lobulated, 2 cases were irregular, 15 cases with clear boundary, 14 cases in mammary gland vascular enlargement, 2 cases of slowinflows, 4 cases of moderate inflows, 13 cases of rapid inflows, and the average ADC value was ( 1. 47 ± 0. 38) × 10-3 mm2/s. Low signal separation present in 11 lesions of fibroadenoma. Among the 45 cases of breast cancer, 17 cases were round or ovoid, 7 cases were lobulat-ed, 21 cases were irregular, 11 cases with clear boundary, 38 cases of mammary gland vascular enlargement, 1 case of slow inflows, 5 ca-ses of moderate inflows, 39 cases of rapid inflows, and the averageADC values was (0.98±0.40)×10-3mm2/s. The shape, (χ2=9.176), margin (χ2=16.452), EER(χ2=18.489) and ADC between breast fibroadenoma and breast cancer were of significantly difference. No significant difference was found in the increased and enlarged blood vessels. The success of ADC values in differentation of breast fibroadenoma from breast cancer was statistically significant( P<0.001), and the area under the curve(AUC)of the ROC, sensitivity and specificity of VE were 94.7% and 71.1%. Conclusion Breast fibroadenoma are in fast inflows in the early phase on the DCE-MRI, and there are differences in morphologic characteristics and mass enhancement ways between patients with breast fibroadenoma and breast cancer. Morphologic characteristics combined with inter-nal low signal separation contribute to the differentiation of breast fibroadenoma from breast cancer.

Objective To evaluate the differential diagnostic value of dynamic contrast enhanced magnetic resonance imaging(DCE-MRI) and diffusion weighted imaging(DWI) in adenosis of the breast and breast cancer.Methods 30 cases of adenosis and 45 cases of breast cancer with pathological verification were scanned with DCE-MRI and DWI.The MRI features of the lesions were analyzed, including shape,margin,T2WI singal, features of enhancement, time intensity curve(TIC) type, early enhancement rate(EER),peak time, background enhancement and ADC value.Results The irregular margin with or without spiculation and the heterogeneous enhancement were mostly seen in breast cancer (P=0.002,P=0.009, respectively).The TIC type Ⅲ, EER larger than 100% and peak time within 2 minutes were mostly seen in breast cancer(P<0.001).The ADC of breast cancer and adenosis were (1.03±0.24)×10-3mm2/s and (1.34±0.30)×10-3mm2/s respectively(P<0.001).The features of shape,T2WI singal and background enhancement had no statistical significance between adenosis and cancer(P>0.05).Conclusion DCE-MRI combined with DWI will be helpful to the diagnosis of breast lesions.

Aged ; China ; Confusion ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Medicine in Literature

Objective To explore the differences of curative effect and short-term prognosis to severe traumatic brain injury patients with three different early postoperative nutritional supports.Methods A retrospective study was performed on 60 severe traumatic brain injury patients received in Neurosurgical Intensive Care Unit of Northern Jiangsu People's Hospital from July 2014 to July 2016.A total of 60 cases were randomly divided into the early enteral nutrition support therapy group,the early parenteral nutrition group,and the early compound nutrition group.The clinical indicators such as basic clinical characteristics before treatment,the nutrition data in two weeks,the length of stay in the Neurosurgical Intensive Care Unit,complications and GCS scores between the three groups were observed and analyzed.Results The indicators of early compound nutrition group were fasting blood-glucose (5.74 ± 0.64) mmol/L,prealbumin(203.80 ± 10.45) mg/L,total serum protein(61.99 ± 1.34) g/L,blood hemoglobin (114.53 ± 2.69) g/L,C-reactive protein(0.37 ± 0.06) mg/dl.The length of stay in Neurosurgical Intensive Care Unit was (11.6 ± 0.42) days in the compound nutrition group while those in the early enteral nutrition group was (13.20 ±0.42) days and those in the early parenteral nutrition group was(14.65 ± 0.42) days.The postoperative complications of the compound nutrition group were significantly lower than other two groups.The GCS scores of early compound nutrition group was(11.40 ± 1.60),which was the best in three groups.The differences were statistically significant (P ＜ 0.05).Conclusions Early compound nutrition support has an exact curative effect on postoperative severe traumatic brain injury patients in Neurosurgical Intensive Care Unit.It can obviously improve the nutrition status of patients with less complications,shorter length of stay in Neurosurgical Intensive Care Unit,higher safety and lower degree of coma,worth clinical promotion.

Objective To investigate the actuality of self-compassion and perceived social support among probationer nursing students, and to analyze the relationship between them. Methods 552 probationer nursing students from three tertiary hospitals in Suzhou were investigated by means of the Self-Compassion Scale (SCS) and Perceived Social Support Scale (PSSS). Results The probationer nursing students′ self-compassion and perceived social support was (3.20 ± 0.61) points and (5.81 ± 1.13) points, respectively. Scores of the total scale and the factors of self-compassion and perceived social support were positively correlated (r=0.485, P<0.01). Hierarchical regression analysis showed that perceived social support (family support and friend support) could be used to forecast the self-compassion of probationer nursing students and independently explain the variation of their self-compassion of 21.5%(△R2=0.215, P<0.01). Conclusions Self-compassion among probationer nursing students is in medium level, and perceived social support an important factor affecting their self-compassion.