Objective To explore the association between Q-1 and T1 locus polymorphism in ADAM33 gene and chronic obstructive pulmonary disease in Han population in northern Guizhou by detecting Q-1 and T1 locus polymorphism in ADAM33 gene in patients with COPD in the distribution of frequency ,provide a theoretical basis for the prevention and treatment of COPD. Methods Polymerase chain reaction and DNA sequencing tech-nology,electrophoresis separation method were applied to detect Q-1 and T1 locus polymorphism in ADAM33 gene. Results The genotype distribution of Q-1 and T1 locus in the case group and the control group of ADAM33 gene were in accordance with the Hardy-Weinberg equilibrium law and ADAM33 gene Q-1,T1 locus were C and T alleles. There was no significant difference in genotype and allele frequency distribution between the case group with control group,and COPD complicated with chronic respiratory failure(COPD)and hypoxemia(P > 0.05). T1(83 bp,112 bp)at a high probability of two heterozygous in the same samples(18/19),and is located in the encoding region. Conclusion No association was found between Q-1,T1 locus polymorphism in ADAM33 gene and chronic obstructive pulmonary disease in Han population in northern Guizhou.

Objective To investigate the effect of indoor coal PM2.5 on the airway inflammation and the pathological morphology alterations of lung tissue in asthmatic rats induced by ovalbumin(OVA). Methods Forty six?week?old male SD rats were randomly divided into four groups(Control,OVA,PM2.5,PM2.5+OVA). Normal saline,OVA(15μg/mL)and(or)PM2.5(2.5 mg/mL)were given to rats in the four groups through intratracheal instillation for four times (two weeks one time),respectively. Twenty?four hours after the last intratracheal instillation ,bronchoalveolar irrigation lavage fluid (BALF) was collected for determinations of serum interleukin 4(IL?4),interferon gamma (IFN?γ). The lung tissue was collected for HE staining and electron microscopy detection. Results HE staining showed less inflammatory cell infiltration was observed in the control group;In PM2.5 group and OVA group,there was medium quantity of inflammatory cell infiltration,In PM2.5+OVA group, severe inflammatory cell infiltration was observed. Electron microscopy showed no abnormal lung tissue in the control group,but organelles were gradually destroyed,endothelial cell edama,alveolar interval with a large number of fibersin were observed in PM2.5 group. The exfoliated cells,local typeⅡ cells with visible damage were found in OVA group. A large number of fibers were existed among the lung tissues and organelles were destroyed,thickness of basement membrane was non?uniform,and blood air barrier structure was not clear in PM2.5 + OVA group. Compared with PM2.5+OVA group,concentration of IL?4 in PM2.5,OVA and the control group was siganificantly different(P < 0.05). A negative correlation between IL?4 and IFN?γ was observed (r =-0.358,P < 0.05). Conclusion Indoor coal PM2.5 exacerbates the airway inflammatory cell infiltration and airway remodeling in OVA?induced asthmatic rats.

Purpose:Taking tuberculosis as an example, this paper aims at to analyzing the level of reimburse-ment for infectious diseases care, and clarifying the government responsibility. Methods:In order to achieve the ob-jective of this research, UHC framework was used to analyze the security level. Result:The findings of this research reveal that TB in-patients' Compensation Ratio of the New Cooperative Medical Scheme ( NCMS) was lower than aver-age level of all the NCMS patients, the out-patients' was even lower. The categories of anti-tuberculotic for free was limited, the utilization was not as expected. Medical assistance covered few people in spite of its high level of reim-bursement. Conclusion:Based on the findings of this review, it has been revealed that the medical insurance didn't make a big difference in financial protection for patients with infectious diseases. As the treatment for of infectious diseases is a quasi-public good, the government has to shoulder the responsibility of improving the compensation ratio of the patients.

Objective:To study the effect of cardiac rehabilitation program on recovery of patients after small incision aortic valve replacement.Methods:600 patients who underwent small incision aortic valve replacement in our hospital from January 2015 to January 2020 were retrospectively collected and divided into Cardiac rehabilitation group(CR) and control group by propensity matching analysis. Clinical data of CR group and control group were collected 6 months and 12 months after the beginning of Cardiac rehabilitation program. The primary outcome measures were the peak oxygen uptake(VO 2 Peak) of cardiopulmonary function test and the number of patients attending cardiovascular specialty in tertiary hospitals after the rehabilitation program began. The secondary outcome measures were 6-minute Walk test(6-MWT), psychological evaluation, and assessment of cardiovascular disease risk factors. Results:After 6 months and 12 months of cardiac rehabilitation program, the VO2 peak in CR group was statistically significant compared with the control group, and the 6-MWT index after 12 months was statistically significant.The cardiovascular specialist visits in tertiary hospitals in the two groups were statistically significant. The comparison of psychological self-rating scale and cardiovascular disease risk factors between the two groups was statistically significant after propensity matching analysis.Conclusion:Cardiac rehabilitation has a positive effect on postoperative recovery after small incision aortic valve replacement, and can improve patients’ motor ability.

Objective:To explore the characteristics of brain structure in patients with long-term withdrawal of methamphetamine-dependence.Methods:A total of 44 patients with withdrawal of methamphetamine-dependent for more than 14 months were recruited,who met the diagnostic criteria for substance dependence in the fifth edition of the American Mental Disorders Diagnostic and Statistical Manual (DSM-Ⅴ),and 40 healthy subjects were used as the control.In addition to the general scale of drug-relevant survey,the subjects received the 3.0T magnetic resonance high-resolution scan.The voxel-based morphometric measurements for the subject's brain gray volume were conducted.Results:There was no significant difference in age,education,smoking and alcohol consumption between the methamphetamine-dependent withdrawal group and the control group (P＞0.05).The volumes for the bilateral cerebellum,the left side of temporal gyrus and the right side of the lingual gyrus in the methamphetamine-dependent withdrawal group were increased than those in the control group.The volumes for the bilateral lingual gyrus and bilateral cuneus in the methamphetamine-dependent withdrawal group were decreased than those in the control group.The volumes of left of cuneus and cerebellum were positively correlated with the duration of abstinence.Conclusion:After long-term abstinence,although the patients still show abnormal brain structure,their behavior and cognitive function is improved.The cerebral nerve structural is recovered from long-term abstinence.

Objective:To investigate the effect of remote ischemic preconditioning combined with postconditioning (RIPC+ RIPostC) on postoperative delirium (POD) in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB).Methods:Eighty patients aged 44-64 years old and scheduled to elective heart valve replacement under CPB in the operating room of our hospital were recruited and divided into control group (group C) and group R according to random number table method, with 40 cases in each group. Patients in group R underwent RIPC 30 minutes before the start of CPB and RIPostC 30 minutes before the end of CPB. The specific treatment measures were as follows: tie an inflatable cuff on the patient' s lower limb, inflate and pressurize until the pressure to 200 mmHg, hold for 5 minutes, and then completely deflate the cuff until the pressure to 0; after 5 minutes, inflate and pressurize again, and repeat for 3 cycles. The cuff was tied to the patient' s lower limb, but no inflation and deflation were performed in group C. Peripheral venous blood was drawn 1 day before operation and 1 day and 3 days after operation, and blood routine was determined. POD was assessed by the intensive care unit (ICU) consciousness disturbance assessment method (CAM-ICU) within 3 days after the operation. Neurocognitive testing was performed preoperatively, at discharge, and 3 months postoperatively, and postoperative cognitive dysfunction (POCD) and dementia (AD) were assessed using the Mini-Mental State Examination Scale (MMSE), with exclusion of preoperative patients with <24 points. Intraoperative and postoperative adverse events including sinus bradycardia or hypotension/hypertension, postoperative infection, etc. were recorded. The length of hospital stay and 90-day mortality were recorded. After 3 months, data related to sleep, quality of life, anxiety and pain were collected using questionnaires.Results:The white blood cell count, neutrophil count and percentage of neutrophils in the two groups at 1 day and 3 days after operation were all higher than those at 1 day before operation, but the indexes in group R was significantly lower than those in group C ( P<0.05). A total of 13 patients (32.5%) in group C developed POD within 3 days after surgery, while 27 patients (67.5%) did not develop POD, and there was a significant difference between the groups ( P<0.05). A total of 5 patients (12.5%) in group R developed POD within 3 days after surgery, and 35 patients (87.5%) did not develop POD. At the 90-day follow-up, there was no difference in the MMSE score compared with the baseline ( P>0.05). A total of 4 patients (10%) developed neurocognitive dysfunction after surgery. There was no difference in the incidence of POCD between the two groups ( P>0.05). The incidence of adverse events such as bradykinesia, hypotension/hypertension, and postoperative infection were similar between the two groups, and there was no significant difference ( P>0.05). During the 90-day follow-up period after surgery, no patient died in either group. There was no significant difference in postoperative hospital stay between the two groups ( P>0.05). Using the EQ-5D questionnaire to evaluate the quality of life of the two groups of patients, the results showed that there was no statistically significant difference between the two groups ( P>0.05). At 3 months after operation, there was no significant difference in sleep quality between the two groups ( P>0.05). Conclusion:RIPC+ RIPostC can reduce the inflammatory response, reduce the incidence of POD and improve the quality of life after operation in patients with heart valve replacement under CPB.