Objective To explore the differences between patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) accompanied with or without community-acquired pneumonia (CAP).Methods We collected 141 patients with COPD who met the admission criteria and had multiple acute exacerbation hospitalization history.Among them,40 patients with AECOPD accompanied with or without acute exacerbation of hospitalization of CAP (group A),38 patients with AECOPD accompanied with acute exacerbation of hospitalization of CAP (group B) and 63 patients with AECOPD but without acute exacerbation of hospitalization of CAP (group C).The demographic differences of age,sex and smoking status were analyzed and compared.The clinical symptoms and blood-related inflammatory indicators of pa tients in group A were analyzed and compared under the acute aggravation of CAP.The number of acute hospitalizations in 12 months before onset and 12 months after discharge were tracked.Results The age,smoking rate,COPD-GOLD classification,dyspnea index,anxiety and depression score in group A were higher than those in group B and C,while the percentage of forced expiratory volume in the first second (FEV1) in predicted value was lower than that in group B and C.The proportion of patients who cooperated or needed long-term home oxygen therapy and drug therapy was higher than that in group B and C,with statistical significance (P ＜ 0.05),but there was no statistical difference in each index between group B and C (P ＞ 0.05).The clinical symptoms of cough,expectoration,fever and other blood-related inflammatory indicators were aggravated in group A when accompanied with CAP.The number of acute hospitalizations in 12 months after discharge of AECOPD without CAP was significantly higher than that of COPD with CAP (P ＜ 0.05),while there was no significant difference in blood gas analysis indicators between the two cases (P ＞ 0.05).The number of hospitalizations in 12 months after discharge,percentage of neutrophils (N)and the level of interleukin (IL)-17 were independent clinical predictors of COPD with CAP.Conclusions Patients with AECOPD accompanied with or without CAP (group A) had poor lung function,worse illness conditions,greater support of home oxygen therapy and drug therapy and poor quality of life.Patients with AECOPD accompanied with CAP had more symptoms and higher levels of inflammatory indicators,but less risk of re-hospitalization in 12 months after cure than AECOPD patients without CAP.The number of hospitalization in 12 month after discharge,the percentage of neutrophils (N),and IL-17 level were helpful in screening the patients with CAP from the AECOPD patients.

A 50-year-old female presented with bilateral cervical arteriosclerosis and right-sided plaque formation,after 25 d of treatment with rosuvastatin calcium tablets(20 mg,po,qn),the patient developed temporomandibular joint dislocation,the adverse reactions occurred again after giving manipulative repositioning.The patients were healthy,had no history of trauma and related diseases in stomatology,no history of drug allergy,patients did not open their mouth loudly at the onset of the disease,no external factors affecting the use of drugs during the combined use of other drugs.It was considered"very likely"that the dislocation of the jaw joint was caused by rosuvastatin calcium tablets.The patients were followed up for 3 months after the treatment of manipulative repositioning and other treatments,did not have any further dislocation of the temporomandibular joint dislocation.It is suggested that when using rosuvastatin calcium in clinical practice,attention should be paid to strengthening drug observation to ensure drug safety.