Objective To investigate the clinical efifcacy of albuterol sulfate aerosol inhalation and theophylline tablets in emergency senile asthma. Method 112 cases of elderly patients with asthma in our hospital from October 2009 to October 2013 were selected and randomly divided into experimental group and control group. Patients in the control group were treated with albuterol sulfate inhalation aerosol therapy, the experimental group were treated with albuterol sulfate inhalation aerosol therapy and oral theophylline release tablets, the therapeutic effect between two groups were compared after treatment. Results After two months of treatment, asthma symptoms and lung function in both groups were improved , but the degree of improvement in experimental group were signiifcantly better than control group , the difference was signiifcant (P<0.05);the incidence of adverse reactions in experimental group was signiifcantly lower than control group (P<0.05). Conclusion The combination of albuterol sulfate aerosol inhalation and oral theophylline tablets treatment of acute asthma in the elderly better, is the drug of choice for clinical treatment , worthy of clinical application and promotion.

Objective The infiltration and micrometastasis of cancer cells via lymph vessel and blood is the important factors which influence the prognosis of patients with cancer. The present study was to establish the method of cytological examination of circulating gastric cancer cell in the peripheral blood and to explore its clinical significance. Methods The monocytes in blood samples, taken from 24 patients with advanced gastric cancer, were seperated by using Ficoll density gradient centrifugation and magnetic cell sorting system in which the magnetic microbeads were wrapped with cytokeratin 7 and 8. The samples were smeared and observed with HE stain. The expression of CD 34 , CD 45 , CEA and human telomerase reverse transcriptase (hTERT) of the cells were also examined with immunocytochemical and immunofluorescence staining methods. Results Gastric cancer cells were found in 10 out of 24 cases, and the positivity rate was 41.7%, which was significantly different from pathological differentiation of primary focus. Conclusion This method can be used to detect cancer cells from peripheral blood of patients with gastric cancer and therapeutic protocol and prediction of prognosis can be made based on it.

Objective To investigate the diagnostic value of JAK2V617F mutation detection in the diagnosis of polycythemia vera,and screen a more simple method for clinic laboratory to detect the mutation of JAK2V617F.Method DNA was extracted by standard procedures after isolating total leukocytes from peripheral blood mononuclear cells by density gradient centrifugation over Histopaque 1077.DNA samples were amplified,and single-stranded biotinylated PCR products were prepared for sequencing.At the same time,in order to testify the reliability of the allele-specific PCR,two forward primer and one common reverse primers were applied for identifying the mutation.Result In 32 of 38 patients with polycythemia vera,JAK2V617F mutation was determined by conventional DNA sequencing.35 JAK2V617F mutations were detected by the allele-specific PCR.and these mutations were confirmed by DNA sequencing.None mutation was found in secondary polycythemia and normal control.Conclusion JAK2V617F function mutation occuis in nearly all patients with PV,and JAK2V617F mutation should be a molecular marker in the diagnosis of polycythemia vera.Allele-specific PCR is a very sensitive and specific method for detecting JAK2V617F mutation.

Objective: To explore the effects of ginsenosides(GS) on learning,memory and activity of rats during sleep deprivation(SD).Methods: SD was induced in Sprague-Dawlay rats by employing "flower pot" technique.The rats were randomly divided into five groups according to the time of SD(0-96h),and every group was also divided into two subgroups: experimental group(E) and control group(C).Forced feeding of GS to the experimental rats for 5 d before the rats were deprived of sleep.Before and after SD immediately,the behaviors of rats were studied in "Y" maze test,step-down test and open-field test.Results: ①"Y" maze test: As compared with those of the controls,the accuracy of response of experimental groups increased significantly in 24h,48h,72h and 96h(P

Objective To evaluate carotid endarterectomy for patients with atherosclerotic occlusive diseases. Method Surgical experience of endarterectomy in 32 patients with atherosclerotic occlusive diseases was retrospectively analyzed. Internal carotid artery stem pressure was measured during operation. Shunting was used routinely. Patching was used electively. Anti-platelet agents and agents reducing plasma fibrinogen were given perioperatively. Result There was no perioperative mortality, nor ischemic cerebral stroke. Patients were followed-up from 5 months to 20 months with no occurrence of ischemic cerebral stroke during the follow-up. One case presented dysfunction of hypoglossal nerve. Two cases presented dilation of carotid artery on ultrasound scan. There were no restenosis (≥50%) and thrombosis. Conclusion Carotid endarterectomy for patients with atherosclerotic occlusive diseases of carotid artery is effective and safe. Careful performance, shunting, patching and the correct order of clamps removing are the keys of preventing complications.

Objective To explore the diagnosis and management of ruptured abdominal aortic aneurysm(RAAA).Methods Twelve patients with RAAA treated in past 7 years were revienled retrospectively.The main clinical manifestations were abdominal pain and / or back pain,low blood pressure or shock,and pulsating abdominal mass.All cases were accurately diagnosed with CT and 7 were treated by conventional operation,one by EVAR,and the other 4 did not receive surgical treatment.Results Perioperative death occurred in 5 cases(mortality rate was 62.5%) in 8 surgical treated patients,including circulatory failure in 2 cases,renal failure in 1 case,and multiple organ failure in 2 cases.All the 4 patients treated with nonoperative method were dead.Conclusions Surgical operation in RAAA cases still carried a high mortality.Early dignosis,appropriate resuscitation,urgent surgical repair,reduction of operative time,and infrarenal clamping are measures conducive to lowering the mortality rate of RAAA.EVAR has the potential to reduce the mortality rate from RAAA.

To study the effect of the problem-based manifold teaching methods in nursing psychology teaching. The results show that majority of the students believe the problem-based manifold teaching methods can improve their interests in study and ability of self-study, reinforce the relationship between teachers and students and enhance the skill of self- healthcare.

Objective To compare the mental health among students of the Han,Y i,Ham,Dai,Lahu and Wa nationalities in Pu 'er Health school and provide the basis for mental health education of minorities.Methods A total of 2894 students of grade one and two,which are the Han,Yi,Hani,Dai,Lahu and Wa nationalities of Puer health school in Yunnan Provinc,were tested with SCL-90.And then an analysis was carried out by the characteristics among different nationalities on mental health.Results ①The psychological problem's ratio of minorities in Health school students was 40.3％.Detection rate of psychological problems in descending order is Wa 48 (55.8％),Dai 75 (41.4％),Yi 258 (41.0％),Hani,182 (40.2％),Han 557 (39.1％) and Lahu 46 (38.3％).The factor scores in descending order were obsessive-compulsive (38.6％),interpersonal sensitivity (33.2％),phobic anxiety (27.5％),hostility (25.3％),depression (23.6％),anxiety (22.4％),paranoid ideation (21.9％),psychotism (17.4％) and somatization (13.7％).②The ratio of psychological problems among different nationalities had shown significant differences (P＜0.05,P＜0.01) except for hostility factor.③In SCL-90,the scores of minority medical school students were all higher than those in the national youth norm.There existed significant differences among the most factor scores of SCL-90 (P＜0.01,P＜0.05).④The mental health of Wa was the worst.While,the mental health of Yi and Lahu were better than other ethnic groups.Conclusion The mental health of minorities medical school students is not optimistic.Therefore,the mental health education should be strengthened in the minority medical school students.

Objective To study the prognostic value of procalcitonin (PCT) level in the outcome of patients with paraquat poisoning (PQ).Methods The clinical data of 128 patients with acute PQ admitted to emergency department were collected from March 2013 through March 2014.The patients were divided into two groups:the death group and the survival group (survival of 28 days).Poisoning doses,urine concentration of PQ,time elapsed from poisoning to admission,and time elapsed from poisoning to gastrolavage were documented.And on the 1 st day,the 3rd day and the 7th day after poisoning,serum PCT were detected.The level of PCT was used to investigate the prognostic values in patients with acute PQ in the death group and survival group.Results Of 128 cases,72 (56.3％) survived and 56 died in 28 days.Among them,the level of PCT increased to some extent in the first day in 90 cases,and 48 patients died.According to trend analysis,the levels of PCT in death group on the 1st day,the 3rd day and the 7th day after PQ were significantly higher than those in survival group [ld:(0.96 ±0.13) vs.(0.08 ±0.01),3d:(1.12 ±0.14) vs.(0.28 ±0.05),7d:(1.22 ±0.14) vs.(0.20 ±0.03),P ＜0.01].There was a trend of escalating PCT levels in death group,whereas the PCT level reached the peak on the 3st day and decreased gradually in the following days in survival group.The early PCT level was obviously related to poisoning doses,urine concentration,CRP,WBC,ALT,CR (the coefficient of association were 0.794,0.723,0.724,0.332,0.700,0.414,respectively,P＜0.01).Conclusions The serum level of PCT increased in patients with acute PQ was significantly positively correlated with the oral dose and urine concentration of paraquat,and it can be used as an indicator for PQ severity.There is important clinical significance in detecting the change of serum level of PCT for estimating the condition of patients and evaluating the prognosis.

Objective To investigate the incidence,clinical characteristics and risk factors of upper gastrointestinal bleeding (UGIB) in patients with acute coronary syndrome (ACS) who were administrated with aspirin and clopidogrel dual antiplatelet therapy after percutaneous coronary intervention (PCI).Methods ACS patients who had undergone PCI in the cardiovascular institute of Guangdong General Hospital from September 2009 to August 2014 were retrospectively enrolled.The incidence of UGIB and clinical characteristics of ACS patients on dual antiplatelet therapy for 1 year after PCI were analyzed.Risk factors of UGIB were screened in the cohort of patients and sex and age matched controls with ratio 1:3.Results A total of 9 118 ACS patients had undergone PCI and UGIB occurred in 189 patients (2.07％,189/9 118) from September 2009 to August 2014.UGIB patients with history over one year,gastrointestinal tumors or varices or negative endoscopy were excluded.Thus the revised incidence of UGIB occurred was 0.61％ in 56 patients (0.61％,56/9 118) and appeared to decline year by year.Most patients (91.07％,51/56) had melena or stool occult blood positive (OB +),while others had bloody stool or haematemesis.Most UGIB were ulcer-related which was proved by endoscopy,accounting for 67.86％(38/56).There were 24 cases with duodenal ulcer,13 with gastric ulcer and 1 with complex ulcer,while others were gastric erosion,gastritis and duodenitis.The risk factors of UGIB were previous history of peptic ulcer (P ＜ 0.01) and renal impairment (P ＜ 0.01).On the other side,PPI intake was a protective factor (P ＜ 0.05).The incidence of new-onset ACS was 1.44％ (50/3 464) in PPI group,compared with 1.34％(76/5 654) in no PPI group (P ＞ 0.05).PPI use for the prevention of UGIB after PCI didn't increase the recurrence of ACS.Conclusions The incidence of UGIB is 0.61％ in ACS patients on dual antiplatelet therapy (aspirin and clopidogrel) for 1 year after PCI and falls year by year.Administration of PPI after PCI protects patients from UGIB,especially in those with precious history of peptic ulcer and renal impairment.