ObjectiveTo explore the Clinical effect of Tiotropium Bromide combined with seretide in patients with chronic obstructive pulmonary disease at stable period.Methods84 patients with stable COPD from March 2015 to February 2016 in our hospital outpatient respiratory department were randomly divided into control group and treatment group.The control group was treated with Seretide, the treatment group was treated withtiotropium bromide on the basis of control group.Compared the lung function, blood gas analysis, 6-minute walking distance, dyspnea score and quality of life were between the two groups after six months of treatment.ResultsFVC, FEV1and FEV1/ FVC (%) in the treatment group were significantly higher than those in the control group (P<0.05).The score of quality of life and dyspnea in the treatment group were significantly lower than those in the control group (P<0.05).The 6MWD in treatment group was significantly longer than that in control group (P<0.05).PaCO2 was significantly lower in the treatment group than that in the control group, but PaO2 was significantly higher than that in the control group after six months treated(P<0.05).ConclusionThe combination of tiotropium bromide and seretide in patients with chronic obstructive pulmonary disease (COPD) is effective in improving pulmonary function, improving life therapy, and reducing the symptoms of dyspnea.

Objective To study the assessment of airway inflammation in asthma patients with airway remodeling by high resolution spiral CT(HRCT).Methods Retrospective analysis on 60 cases of chronicity-persistent period asthma patients with induced sputum IL-4 test,airway mucosa biopsy,HRCT scan; while 20 patients only used HRCT scan as control group.To compare the difference of sputum IL-4,HRCT test of airway wall thickness(WT),wall area(WA)and airway wall relative area(WA％)in different degrees of asthma paitents.Results WA,WA％and WT were significantly increased in different degrees of asthma patients when compared to control group(P<0.05),there were significant difference among each group(P<0.05).WA％and WT were positively correlated with induced sputum IL-4.Conclusion HRCT can effectively evaluate the airway inflammation in airway remodeling of asthma patients,which can be used to evaluate the severity of asthma,treatment effect and follow-up observation.

Objective To investigate the clinical effect of milrinone injection combined therapy in patients with cor pulmonale complicated with respiratory failure and observe the effect of milrinone on blood gas index, blood viscosity and pulmonary arterial pressure.Methods The clinical data of 100 patients with cor pulmonale complicated with respiratory failure were retrospectively analyzed from April 2014 to April 2016.Among them, 50 cases were treated with conventional oxygen therapy, diuretic, asthma and anti-infection treatment.In the control group, 50 cases were treated with milrinone injection as the treatment group.The clinical curative effect and adverse reaction were analyzed.The blood gas analysis index, blood viscosity and pulmonary arterial pressure were measured before and after the treatment.The sputum normal and cyanosis, cough, wet rales and edema time were recorded in the two groups.Results The total effective rate of the treatment group was 92.0%, which was significantly higher than that of the control group 70.0%(P <0.05).After treatment, the hemorheological indexes and blood gas analysis indexes of the two groups improved significantly, However, the improvement of the indicators of the treatment group were significantly better than the control group (P<0.05).The pulmonary arterial pressure in the treatment group was (18.36 ±7.38) mmHg, which was significantly lower than that in the control group (23.79 ±6.14) mmHg (P<0.05); After treatment, the sputum normal and cyanosis in the treatment group, cough, wet rales, edema time were significantly shorter than the control group ( P <0.05 ) .No significant adverse effects were observed in both groups during the treatment.Conclusion The use of milrinone injection comprehensive treatment of pulmonary heart disease with respiratory failure in patients with significant efficacy and safety , but also can help improve blood viscosity and blood gas analysis indicators, reduce pulmonary artery pressure, better promote the rehabilitation of patients.

Objective:To investigate the clinical efficacy and safety of anlotinib combined with docetaxel for the treatment of advanced non-small cell lung cancer.Methods:A total of 118 patients with advanced non-small cell lung cancer who received treatment in Jinhua Guangfu Cancer Hospital from March 2018 to June 2019 were included in this study. They were randomly assigned to receive treatment with either anlotinib combined with docetaxel (study group, n = 59) or docetaxel alone (control group, n = 59) for two treatment courses. Clinical efficacy, progression-free survival, 1-year survival rate, and adverse drug reactions were compared between the study and control groups. Results:There was no significant difference in the objective remission rate between the two groups (22.03% vs. 32.20%, χ2 = 1.544, P = 0.214). The disease control rate in the study group was significantly higher than that in the control group (88.14% vs. 69.49%, χ2 = 6.141, P = 0.013). Progression-free survival in the study group was significantly longer than that in the control group [6.92 months (95% CI: 3.83-9.54 months) vs. 3.84 months (95% CI: 2.08-6.17 months), χ2 = 5.934, P = 0.019). The 1-year survival rate in the study group was significantly higher than that in the control group [52.47% (31/59) vs. 32.20% (19/59), χ2 = 4.998, P = 0.025]. During the treatment, the proportion of patients having leucopenia, erythropenia, gastrointestinal adverse reactions and abnormal liver and kidney function in the study group was 20.34%, 13.56%, 28.81% and 5.08%, respectively, which was significantly higher than 16.95%, 10.17%, 23.73% and 3.39%, respectively in the control group ( χ2 = 0.211-0.835, P = 0.361-0.646). Conclusion:Arotinib combined with docetaxel can effectively inhibit the progression of non-small cell lung cancer, prolong the progression-free survival, increase the 1-year survival rate, and does not increase adverse drug reactions.

Objective To investigate the effects of a novel standardized training program on the satisfaction and training quality of general practitioners (GPs). Methods 114 GPs trained in Wuxi People's Hospital between 2009 and 2013 were included, 52 GPs and 62 GPs were trained before and after the reform respectively. The measures of teaching reform included improvements in curriculum provision, theory teaching, learning modality and skills training. The evaluation indexes of satisfaction questionnaire and examination were confirmed by literature method and small-group discussion. Self-report satisfaction ques-tionnaire were distributed to graduate GPs and valid questionnaires were collected, while the results of entrance examination and graduation examination of GPs were recorded before and after the teaching reform. The research data were analyzed by chi-square test using SPSS 16.0 software. Results The basic characteristics of GPs and results of entrance examination before and after the teaching reform were compa-rable (P>0.05), however, GPs' satisfaction with curriculum, theoretical education, study form and skill training were increased significantly after teaching reform (P<0.05). Besides that,the results of graduation examination of GPs after the teaching reform, both the theory and skill examination, were improved signifi-cantly (P<0.05). Conclusion The study showed that GPs satisfaction with training modality and the results of graduation examination were improved greatly through our innovative teaching reform.

Objective To understand the willingness to receive human papillomawrus (HPV) vaccination of men who have sex with men (MSM) and the male clients of sexually transmitted disease (STD) clinics and related factors in China.Methods MSM were enrolled from the community through snowball sampling and male clients of STD clinics were enrolled from a sexual health clinic through convenience sampling in Wuxi,China.A questionnaire survey on the subjects' socio-demographic characteristics and the awareness of HPV was conducted.Results A total of 186 MSM and 182 STD clients were recruited.The awareness rates of HPV were 18.4％ and 23.1％,respectively and the awareness rates of HPV vaccination were 10.2％ and 15.4％,respectively.STD clinic clients (70.9％) were more likely to receive HPV vaccination than MSM (34.9％) (x2=47.651,P＜0.01).Only 26.2％ of MSM and 20.2％ of STD clinic clients were willing to receive free HPV vaccination before the age of 20 years.Multivariate logistic regression analysis showed that MSM who had passive anal sex (OR=2.831,95％ CI:1.703-13.526),MSM who never used condom in anal sex in the past 6 months (OR=3.435,95％CI:1.416-20.108),MSM who had been diagnosed with STDs (OR=1.968,95％CI:1.201-8.312) and STD clinic clients who had commercial sex with females in the past 3 months (OR=1.748,95％ CI:1.207-8.539),STD clinic clients who never used condom in commercial sex in the past 3 months (OR=1.926,95％CI:1.343-5.819) and STD clinic clients who had been diagnosed with STDs in past 12 months (OR=2.017,95％CI:1.671-7.264) were more likely to receive free HPV vaccination.Conclusion Sexually active MSM and male clients in STD clinics in China had lower awareness of the HPV related knowledge.Their willing to receive HPV vaccination were influenced by their behavior related factors.It is necessary to strengthen the health education about HPV and improve people's awareness of HPV vaccination.

Objective To understand the willingness on acceptance of a short-message-service (SMS) program provided for HIV/STD testing and the related factors,among male clients at the STD clinics in China.Methods Convenience sampling method was used to select study subjectsat a STD clinic in Wuxi,Jiangsu province.A questionnaire survey was conducted among the subjects to collect the information on socio-demographic characteristics and willingness of acceptance to the SMS.Results A total of 368 SMS subjects were surveyed,in which 75.5％ expressed the willingness of acceptance,while 57.2％ and 38.1％ of them wanted to receive the short message every 3 months or 6 months,respectively.53.8％ of the respondents showed their willingness to share the news with their sexual partners about SMS and 44.8％ of them would do the same to their friends.Data from the Multivariate logistic regression analysis showed that those who had received senior high school or above education (aOR =3.632,95％CI:1.939-6.715),having homosexual behavior (aOR =1.973,95％ CI:1.234-8.358) or those having received AIDS related intervention service in the past year (aOR=9.416,95％CI:4.822-18.309) were more likely to accept the SMS.Conclusion SMS seemed to be acceptable among the male STD clinic clients in Wuxi,suggesting that it is feasible to conduct the SMS as a strategy to improve the HIV/STDs testing program at the STD clinics in the future.Promotion of SMS should be strengthened and the provision of general AIDS intervention service at the STD clinics should be established in order to make more STD clinic clients understand this SMS.

Objective To investigate the prevalence of genital Chlamydia trachomatis (GCT) infection and associated risk factors in male clients attending sexually transmitted disease (STD) clinics in Guangdong and provide integrated intervention strategy for this group.Methods Convenient sampling was used to recruit participants from April to June in 2015 in Guangdong province.The information about their socio-demographic characteristics and sexual behaviors were collected by using a questionnaire,and blood samples were taken from them to test the antibodies against HIV,syphilis and HCV.First pass urine was taken to test GCT and gonorrhea.Results A total of 1 749 participants with the average age of 39.53 years were recruited.The majority of them were married (73.87％,1 292/1 749),residents of Guangdong (92.28％,1 614/1 749) and in Han ethnic group (99.49％,1 740/1 749).The positive rates for GCT,HIV,syphilis,HCV,Neisseria gonorrhea,and WBC in urinalysis were 6.06％ (106/1 749),0.46％ (8/1 749),3.43％ (60/1 749),0.45％ (7/1 550),2.74％ (48/1 749),7.89％ (138/1 749) respectively.Multivariate analysis showed that risk factors for GCT infection include IDUs (OR=13.98,95％CI:3.35-58.38),anal sex with men (OR=3.11,95％ CI:1.45-6.71),Neisseria gonorrhea positive (OR =9.64,95％ CI:5.09-18.24),and WBC positive (OR =1.96,95％ CI:1.08-3.55).Conclusions This study demonstrated the high prevalence of GCT infection in male clients attending STD clinics in Guangdong.Therefore precision intervention should target this population at high-risk.

ObjectiveTo determine the situation and challenges of innovation platforms in China， and to explore the construction strategy of Shanghai Nutrition Innovation Platform， which is suitable for Shanghai and may achieve the research and transformation of nutrition innovation and population health， so as to coordinate， unite and gather the superior resources of all parties and promote nutrition innovation. MethodsConstruction scheme and operational mechanism of Shanghai Nutrition Innovation Platform were explored by literature review， expert consultation and questionnaire. ResultsThere were various forms of innovation platforms in China. However， challenges were identified， such as decentralizing force， resource rearrangement and insufficient sharing effect. Shanghai Nutrition Innovation Platform adopted a modular organizational structure， which was divided into central group， node group， and subject group. Shanghai Center for Disease Control and Prevention， as the central organization， is responsible for the platform operation management. The expert database as an academic committee selected key organizations from nutrition-related universities， research institutes， academic associations， centers for disease control and prevention， hospitals and the industry. Based on the opening of its own innovation resources， the platform made effective use of external innovation resources and formed a closely integrated nutrition innovation network of multiple disciplines. ConclusionThis study promotes the construction of innovation platform model of cooperation， co-construction and resource sharing， and provides reference for the construction of innovation platform in China.