Objective To observe the effect of early pulmonary rehabilitation (PR) on patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods AECOPD patients (n=97) were randomly distributed into two groups:control group (n=39) and rehabilitation group (n=58). Patients in both groups were assessed when symptom im?proved from acute phase (baseline, T1). Then patients in control group only received pharmaco-therapy and rehabilitation ed?ucation without PR. When symptom was relieved and stable (T2), they were given 12 weeks PR (T3). On the other hand, pa?tients in rehabilitation group underwent a 12-week PR after T1 directly (T2). The lung function parameters, 6 min walking distance (6MWD), MRC scores and CAT scores were observed and analyzed in two groups. Results Until the end of the 12-weeks observation, the value of lung function showed no statistic differences between two groups(either T1 in control group vs T1 in PR group or T2 in PR group vs T2 and T3 in control group. In control group, the value of 6MWD scores of T3 was bet?ter than that of T1 and T2, in PR group(F6MWD=8.762,FMRC=4.432,FCAT=10.266,P<0.05)while MRC, CAT value in T3 of control group were higher than those in T1 and T2 of PR group. At T1, parameters does not demonstrate significant difference between these two groups. Value of 6MWD was higher while MRC and CAT were lower in T2 of PR group than that in T2 and T3 of control group. Conclusion Early pulmonary rehabilitation could improve the mobility and qulity of life, as well as ameliorate the severity of dyspnea in AECOPD patients.

ObjectiveIn our study, the electrical current intensities of 0.05ms square wavelenth in I/t curve were explored in diagnosing damage degree and predicting prognosis of facial paralysis.MethodsAccording to tested 0.05ms intensity values of fronto-occipital muscle and orbicular muscle of mouth in healthy side of 236 cases with facial paralysis and that values of 30 cases with completely-absent nerve, the standard of diagnosing slight, moderate and severe facial paralysis was made. A follow-up survey for the recovery of 198 cases evaluated by House-Brachmann facial nerve grading system was made for one to three years.ResultsIt is found that there were 113 slight cases and 89% of them recovered in 40 days, 112 cases reached to H-B Ⅰgrade; 82% of 49 moderate cases recovered in 4-5 months; 36 severe cases appeared visible mouth corner movement in 2-5 months after onset, and 92% of them had complications or sequelae.Conclusions Intensities of 0.05ms square wavelenth can help in diagnosing damage degree and predicting prognosis of facial paralysis.

Objective To study the effect of different doses of monocrotaline in combination with isopropylarterenol on the hemodynamic resonse, heart index and right heart hypertrophy index in rats.Methods Sixty-four healthy adult SD rats, male:female=1∶1, body weight 200-250 g, were randomly divided into blank control group (n=16) and three model groups (n=16 in each group).The high dose model group (n=16) received i.p.injection of monocrotaline 80 mg/kg once and epinephrine 10 mg/kg once daily for one week.The moderate dose group received i.p. injection of monocrotaline 55 mg/kg once and epinephrine 8 mg/kg once daily for one week.The low dose group received i. p.injection of monocrotaline 30 mg/kg once and epinephrine 3 mg/kg once daily for one week.The rats were fed for 6 weeks, and then pulmonary artery pressure and right ventricular pressure were tested and heart index and right ventricular hypertrophy index were determined.Results Compared with the control group, the mean pulmonary artery pressure and right ventricular systolic blood pressure in the low dose monocrotaline group were not significantly changed, but significantly changed in the moderate dose monocrotaline group ( P<0.05) .The heart index and right ventricular hypertrophy index in the low dose monocrotaline group were not significantly changed, but in the moderate dose monocrotaline group, the heart index was significantly reduced ( P<0.01 ) and the right ventricular hypertrophy index was significantly increased ( P<0.05 ) .Conclusions The use of a single injection of 55 mg/kg monocrotaline in combination with continuous injection of 8 mg/kg isopropylarterenol once daily for one week can ensure the survival rate of rats, and the successful formation of pulmonary artery hypertension, leading to heart weakness.

In order to investigate the expression levels of Pin1 mRNA and protein in cervical cancer and its association with Ki67 and their clinical significance, amplification of Pin1 gene was examined by RT-PCR, and the expression of both Pin1 and Ki67 protein was detected by immunohistochemistry in cervical cancer tissues. It was shown that the expression levels of Pin1 were higher in cervical cancer than in normal cervical tissues (P < 0.05). The expression of Pin1 protein was increased progressively along with the disease process from normal cervix to CIN and to cervical cancer (P < 0.05). No significant difference in the Pin1 expression was found between disease stages (FIGO), pathological grades or pelvic lymph node metastasis status (P > 0.05). The expression of Pin1 was significantly higher in adenocarcinoma than in squamous carcinoma of the uterine cervix (P < 0.05). In cervical cancer, the overexpression of Pin1 was positively correlated with that of Ki67 (P < 0.05). These results suggested that the overexpression of Pin1 was closely related with cancer cell proliferation or progression of cervical cancer and contributed to oncogenesis. Pin1 may serve as a potential marker for cervical cancer diagnosis.
Cervical Intraepithelial Neoplasia/metabolism ; Ki-67 Antigen/*biosynthesis ; Ki-67 Antigen/genetics ; Peptidylprolyl Isomerase/*biosynthesis ; Peptidylprolyl Isomerase/genetics ; Tumor Markers, Biological ; Uterine Cervical Neoplasms/*metabolism

Objective To explore the change of apoptosis factor Caspase-3 and Bcl-2 in the injured segment of rat with spinal cord injury after inhibiting lentivirus expression of inflammation factor TNF-α. To study the relationship between Caspase-3, Bcl-2, Bax and TNF-α in spinal cord injury. Mthods Spinal cord contusion model was prepared by Allen method. The relation between tumor necrosis factor alpha and Bcl-2, was predicted by the method of GeneMANIA bioinformatics. The RNA which was packaged by lentivirus constructed the RNA interference model of tumour necrosis factor alpha. After interference of tumor necrosis factor alpha, we used the method of QRT-PCR to assays the mRNA expression of Caspase-3 and Bcl-2 in spinal cord and detect of the localization of Caspase-3 and Bcl-2 by immunohistochemistry. Statistical analysis with SPSS17.0. Results SD rats had paraplegia and urinate retentaion because of spinal cord injury. The result of QRT-PCR showed that in the seventh day after SCC, the expression of Caspase-3 reduced significantly (P < 0.05) and Bcl-2 did not change significantly (P > 0.05). Immunohistochemistry experiment results showed that Caspase-3 Bcl-2 and Bax immunoreactive cells were observed in the neurons and glial cells of both white matter and gray matter in the spinal cord. The results were the same with QRT-PCR.. Conclusion TNF-α in rats after SCC can effectively regulate the ratio of Bcl-2 and Bax , and then regulate the expression of Caspase-3 , which may affect the function of apoptosis and function recovery after spinal cord injury.

Objective:To analyze the survival and prognostic factors of adult acute lymphoblastic leukemia (ALL) with different consolidation regimens after complete remission by induction therapy.Methods:A total of 93 adult patients with ALL were enrolled from January 2012 to June 2019 in Peking University Shenzhen Hospital. All the patients achieved complete remission induced by VDLCP regimen, and were divided into the standard group, intensive group and transplantation group according to the consolidation treatment. Thirty-four patients in the standard group received an ALL-like chemotherapy regimen based on VDLCP or Hyper-CVAD consolidation for 4-6 courses. Twenty-nine patients in the intensive group received BFM90/95 consolidation treatment for 2 years. Thirty patients in the transplantation group received allogeneic hematopoietic stem cell transplantation (allo-HSCT) after 2-3 courses of consolidation with the original induction regimen. The median follow-up was 18 (3-96) months, and the main follow-up indicators were overall survival (OS) and disease free survival (DFS). Prognostic factors of adult ALL patients and treatment-related deaths in each group were analyzed.Results:The 3-year OS rates of the standard group, intensive group and transplantation group were 54.0% (95% CI: 35.3%-72.6%), 71.8% (95% CI: 41.0%-94.5%), 62.3% (95% CI: 43.6%-80.9%), with a statistically significant difference ( χ2=6.110, P=0.047). The 3-year DFS rates of the three groups were 31.4% (95% CI: 12.9%-49.8%), 72.1% (95% CI: 52.3%-91.9%), 65.7% (95% CI: 45.3%-86.1%), with a statistically significant difference ( χ2=13.831, P=0.001). There were no significant differences in OS and DFS between the intensive group and the transplantation group ( χ2=0.709, P=0.400; χ2=0.046, P=0.830). OS and DFS of the intensive group were better than those of the standard group ( χ2=5.346, P=0.021; χ2=10.326, P=0.010). Multivariate analysis suggested that bone marrow minimal residual disease (MRD) negative on day 14-21 of chemotherapy was an independent prognostic factor affecting adult ALL ( HR=0.114, 95% CI: 0.015-0.841, P=0.033). The 3-year OS rates of Ph + ALL patients who received and did not receive allo-HSCT were 53.5% (95% CI: 23.1%-83.8%), 52.4% (95% CI: 23.8%-81.0%), the 3-year DFS rates were 77.1% (95% CI: 54.2%-100.0%), 35.0% (95% CI: 4.8%-65.2%), and there were no significant differences between the two groups ( χ2=3.600, P=0.223; χ2=3.824, P=0.050). The treatment-related mortalities of the non-transplantation group (standard group + intensive group) and the transplantation group were 3.2% (2/63) and 20.0% (6/30), and the treatment-related mortality of the non-transplantation group was significantly lower than that of the transplantation group ( χ2=7.318, P=0.007). Conclusion:Adult ALL has a poor prognosis. The 3-year OS rate and 3-year DFS rate of BFM intensive consolidation therapy are better than those of standard consolidation therapy, achieving a similar effect to allo-HSCT, but treatment-related mortality does not increase significantly. Patients with bone marrow MRD negative on the day 14-21 of chemotherapy have the better OS and DFS.

Objective:To explore the application effect of clinical nursing pathway in patients undergoing permanent cardiac pacemaker implantation through axillary vein puncture spiral electrode.Methods:According to the convenience sampling method, a total of 217 patients who underwent permanent cardiac pacemaker implantation through axillary vein puncture spiral electrode in Huzhou Central Hospital from January 2018 to December 2018 were selected as research objects. According to the time of admission, 102 patients who were admitted from January 2018 to June 2018 were set as the control group while 115 patients who were admitted from July 2018 to December 2018 were set as the observation group. The control group was given routine nursing while the observation group was given nursing measures according to the prescribed clinical pathway. The length of hospital stay, hospitalization expenses, mastery of health knowledge and satisfaction degree of patients were compared between the two groups.Results:The length of hospital stay and hospitalization expenses in the observation group were respectively (12.63±2.39) d and (1.62±0.37) ten thousand yuan, both lower than those in the control group, and the differences were statistically significant ( t=4.455, 3.681; P<0.05) . The score of health knowledge in the observation group was (92.37±5.28) , higher than that in the control group ( t=8.886, P<0.05) . The nursing satisfaction degree of patients was 93.04% in the observation group and 81.37% in the control group, and the difference was statistically significant (χ 2=6.759, P<0.05) . Conclusions:The application of clinical pathway nursing in permanent cardiac pacemaker implantation through axillary vein puncture spiral electrode can effectively promote postoperative rehabilitation of patients, reduce medical costs and to improve patients' satisfaction with nursing, which is worthy of clinical promotion and application.

Objective To analyze and study the diagnosis of large granular lymphocyte leukemia(LGLL).Methods To report and discuss six cases weth LGLL we have found. Results 2 of T-LGLL and lof NK-LGLL had indolent process, mainly presenting with anemia and splenomegaly and good response to treatment, while; 1 of T-LGLL and 2 of NK-LGLL had aggressive process, their clinical characters are obviously general symptom, hepatomegaly,splenomegaly,these disease develop quickly and have bad prognosis. The immunophenotype of indolent LGLL is distinct from aggressive cases. Conclusion As a group of heterogeneous disease,its diagnosis should be based on clinical manifestation and immunophenotype and differentiated it carefully.

Objective To investigate the clinical and laboratory diagnosis of adult hemophagocytic syn-drome (HPS) . Methods Clinical data of 24 patients with HPS from 2000 to 2008 were retrospectively analyzed. Results Of the 24 HPS cases, 12 had a malignant associated hemophagocytic syndrome (MHAS), and 10 were fi-nally diagnosed by bone marrow immunohistochemist ;Of 12 cases in non-MAHS group,4 were with virus associated hemophagocytic syndrome (VAHS), and 4 were of the other infections, whereas 4 patients diagnosed of immune associated HS (MAS). There were significant difference in onset age, mortality, serum lactate dehydrogenase (LDH) and serum ferritin(FER) and neutrophilic NAP between non-MAHS group and MAHS group(P <0.01 ,P<0.05). In all cases bone marrow biopsy showed significant differences in cytological and pathological features between MAHS group and non-MAHS group. Conclusion Etiology,immunology,and bone marrow cell biopsy and pathology as well contribute to the diagnosis and typing of HPS and will give a guide to the therapy.

Objective To evaluate the cancer risk among the inhabitants around a certain nuclear facility of Gansu Province after operation for nearly 50 years.Methods Specially developed forms were filled by countryside doctors in the villages 30 km on the leeward or at the lower reaches of Yumen City,Gansu Province where a nuclear facility had operated for nearly 50 years,to register the relevant data of those who died of solid cancer and leukemia during the period from 1 January 2004 to 31 December 2008 based on the relevant data and household survey.A town 90 km away from the nuclear facility with 4181 people were regarded as control area.Results The crude mortality and standardized mortality rate(SMR) of cancer were 95.51×10-5 and 93.56×10-5.respectively.The crude mortality and SMR of leukemia were 2.44×10-05 and 2.22×10-05, respectively.and the crude mortality and SMR of cancer were 106.88×10-05, and 89.31×10-5, respectively.The crude mortality and SMR of leukemia were 2.44×10-05 and 2.22×10-5, respectively in the investigated area,and the crude mortality of leukemia was 3.56×10-5 (only one leukemia cage died)in the control area in the same time.The cancer and leukemia mortality rates of the investigated area were similar to those of control area.Conclusions Nuclear facility does not significantly increase the cancer mortality among the residents living nearby.