Objective To investigate the clinical efifcacy of Tiotropium Bromide inhaler on patients with stable chronic obstructive pulmonary disease(COPD). Methods 134 cases with stable COPD were equally randomized into three groups. The conventional treatment group(n=46) were 40 male and 6 femal, aged (63.20±9.3)years old and treated with sustained-release theophylline 0.1 g orally. Observation group with 18μg Tiotropium Bromide(n=45) were 40 male and 5 femal, aged (63.4±85)years old, and given inhaled Tiotropium Bromide 18μg. Observation group with 32μg Tiotropium Bromide(n=43) were 39 male and 4 femal, aged (63.2±9.0)years old, and given inhaled Tiotropium Bromide 32 μg. All patients received same routine therapy, and lasted for 4 weeks. improvement Pre-and post-treatment Lung function and quality of life were compared among those groups. Results In observation group, the results of St George respiratory questionnaire decreased signiifcantly after treatment, which was signiifcantly lower than those of the routine-treatment group (P<0.05). FEV 1/FVC, FEV 1/Pred, FEV 1 were signiifcantly higher than those before treatment (P<0.05). However, the control group showed no signiifcant difference. Conclusion Inhaled Tiotropium Bromide can improve lung function and life quality of paitents with stable COPD, the dose with 32μg per day, which was signiifcantly lower than 18μg per day.

ObjectiveTo study the efficacy of immunosuppressant IL-1RA on the rat model of penetrating keratoplasty.MethodsCorneal transplantation were performed orthotopically from Lou rats to F344 rat's recipients.Animals were randomly assigned to the following groups:1.Control.2.CsA(3mg/kg/2d,subconjunctival injection).3.IL-1RA(0.5mg/kg/2d,subconjunctival injection).Treatment began at the 1st day postoperatively and continued until the 14th day postoperatively.Mean survival times and rejection index were determined.ResultsThe mean survival time of the control group was 12.235±1.674 days,but the mean survival time for CsA and IL-1RA were 17.676±1.528 days and 19.250±1.456 days,respectively,which was statistically significant compared with the control group(P<0.01).Vascularization index in IL-RA group was markedly lower when compared with the control and CsA groups(P<0.01).ConclusionIL-1RA can markedly prolong the survival time of corneal allografts by inhibiting graft rejection,and prevent vascular growth of corneal allografts

Objective To study the effect and nursing of Mayinglong musk hemorrhoids ointment on anus periderm skin damage of fecal incontinence patients. Methods Thirty-one patients with fecal incontinence-induced anus periderm skin damage from March 2012 to February 2013 in the hospital were set as the control group and another 32 patients with the same disease from March 2013 to January 2014 as the observation group. The anus periderm skin damage of the observation group was treated with Mayinglong musk hemorrhoids ointment 3 to 4 times a day. The anus periderm skin damage of the control group were treated with zinc oxide ointment, 3 to 4 times a day. Both groups used ostomy. The two groups were compared in terms of total effective rate in a month. Result The total effective rate of the observation group was 93.8% and the control group was 71.0%, with significant difference between the groups (P<0.05). Conclusions Mayinglong musk hemorrhoids ointment can be more effective in the treatment of fecal incontinence caused by anus periderm skin damage than zinc oxide ointment. It can improve the effect of treatment and reduce local wound pain. It is convenient to use, cheap and thus worthy of clinical popularization and application.

Objective To retrospectively analyze the data of patients with T3N0-1M0 nasopharyngeal carcinoma (NPC) who underwent radiotherapy (RT) alone or concurrent chemoradiotherapy (CCRT), and to investigate the relationship between therapeutic modality and prognosis. Methods From January 2004 to December 2004, 781 patients with biopsy-proven newly diagnosed non-metastatic NPC were analyzed in Sun Yat-Sen University Cancer Center, who had MRI data of nasopharynx and neck. With restaged based on the Chinese 2008 staging system, 82 cases of T3N0-1M0 patients who were treated by RT alone or CCRT were enrolled. They were divided into group A (46 cases, RT) and group B (36 cases, CCRT). Results The clinical data was comparable between the two groups. The 5-year overall survival rate (OS) was 93.5 % (group A) and 100 % (group B)(P =0.046), while the 5-year disease-free survival rate (DFS) was 85.2 % (group A) and 91.7 % (group B) (P =0.498). N-Staging was the factor affecting the DFS. Stratified analysis showed that the 5-year OS of T3N0M0 patients was 94.7 % (group A) and 100 % (group B) (P =0.432), those of T3N1M0 patients were 92.6 %(group A) and 100 %(group B) (P =0.066), while the 5-year DFS was 73.7 % (group A) and 89.3 % (group B) (P =0.244). Multifactor analysis showed that CCRT was not the independent factor affecting the OS(HR =0.019; 95 % CI, 0 to 21.793), and N-stage was not the independent factor affecting the DFS (HR = 0.203; 95 % CI, 0.135 to 1.231×104). Conclusion For T3N0M0, NPC patients, CCRT is not superior to RT alone. Whether CCRT can improve survival of T3N1M0 NPC patients needs further study.

Objective To assess the efficacy and feasibility of neoadjuvant therapy of TPF regimen including docetaxel (TAX), cisplatin (DDP) and 5-fluorouracil (5-Fu) combined with concurrent DDP and radiotherapy (RT) in patients with local advanced nasopharyngeal carcinoma (NPC). Methods From April 2008 to May 2009, 40 patients with newly diagnosed UICC stage Ⅲ orⅣ local advanced NPC were enrolled. Patients were randomly assigned to group A(DDP every 3 weeks) and group B(DDP every week). Two cycles of induction chemotherapy with TAX 60 mg/m2 dl, DDP 60 mg/m3 dl and 5-Fu 600 mg/m2 dl-5 were given on a 3-weekly cycle, followed by RT and chemotherapy(group A: DDP 80 mg/m2 every 3 weeks for 2 times; group B: DDP 30 mg/m2 weekly for 6 times). Two-dimension conformal RT technique with 68-72 Gy/(34-36) fractions for 7 weeks was administered to the nasopharynx and 60-66 Gy/(30-33) fractions for 6-6.5 weeks to the node-positive area. Results 38 patients (78 Cycles) were evaluable for efficacy and toxicity. One patient in each group was excluded due to toxicity. 17 (17/19) patients of group A finished 2 cycles of planed DDP chemotherapy, while only 10 (10/19) patients of group B completed 6 weeks of planed DDP chemotherapy, 4 completed 5 weeks, 4 completed 4 weeks and 1 completed 2 weeks. Response to neoadjuvant TPF was as follows: 4 patients (10.5 %) achieved complete response(CR), 27(71.1%) achieved partial response(PR) and 7 (18.4 %) achieved stable disease (SD), so the overall response (CR+PR) rate was 81.6 %. After RT, 32 patients (84.2 %) achieved CR, 5 (13.2 %) PR and 1 (2.6 %) SD, so the overall response rate was 97.4 %. Conclusion TPF induction chemotherapy followed by concurrent DDP and RT is an effective regimen in the treatment of advanced NPC. Concurrent DDP chemotherapy on a 3-weekly cycle is recommended. Further study should be made to investigate how to increase the dose intensity of chemotherapy.

Objective To investigate the primary repair methods and efficacy of island pedicled pectoralis major muscle flap in soft tissue defect after the operation of head and neck malignant tumors .Methods From April 2011 to September 2012 ,27 patients from this hospital who underwent primary repair using island pedicled pectoralis major muscle flap after a head and neck extensive soft tissue defect were investigated ,including 11 cases of tongue cancer defect ,2 cases of parotid gland defect ,3 cases of gum cancer defect ,2 cases of oropharyngeal cancer defect ,9 cases of floor of the mouth cancer defect .Results 27 patients were safety in periop-erative ,27 cases of island pectoralis major muscle flap survived ,patients were satisfied with both the appearance and function .There was postoperative neck hematoma in 1 patient ,it was eliminated through timely remove the hematoma and hemostasis completely ;There was 1 case of removing the epidermal necrolysis skin as flap necrosis ,while it was acceptable efficacy as the muscle flap sur-vival and surface granulation repaired .Conclusion Island pectoralis major muscle flap obtains unique advantages in repairing a large area of soft tissue defect in head and neck cancer patients after operation ,such as abundant of tissue ,a constant arterial anatomy of thoracoacromial ,easy to operate ,rich blood supply ,strong resistance to infection ,high survival rate and so on .A fine surgery opera-tion is the key of island pectoralis major muscle flap survival .

Objective To discuss the prevention and management method for chylous fistula after neck lymph node dissec‐tion .Methods Totally 1 793 cases of neck lymph node dissection in this department from January 2005 to September 2014 were retrospectively analyzed .The clinical data in the cases of chylous fistula occurred after operation were summarized .Results Twenty one cases of chylous fistula occurred ,accounting for 1 .17% ,in which 13 cases were cured by the local compressed bandaging and continuous negative pressure drainage;5 cases adopted the conventional method for 2-3 d ,but under the ineffective condition ,then they were treated by combining with somatostatin pumping (somatostatin 6 mg+0 .9% normal saline 48 mL ,2 mL/h ,lasting for 24 h ,for successive 2-3 d) and finally cured;3 cases were cured after reoperation .Conclusion Prevention is the best treatment for chylous fistulas ,local compression bandage plus continuous negative pressure drainage is the main method for treatment of chylous fistulas after neck dissection .The combined therapy with somatostatin can increase the close rate of chylous fistulas;for the patients with long persistent time ,large drainage volume and invalid conservative therapy should adopt the remedial measure of operation .

Objective To apply the optical coherence tomography(OCT) to detect the characteristics of coronary artery plaque and to investigate its correlation with levels of serum matrix metalloproteinase 7(MMP 7),MMP9 and MMP12.Methods The patients undergoing coronary arterial angiography for diagnosing coronary arterial lesions in the cardiology department of our hospital from October 2014 to March 2016 were collected and included into the research subjects.The subjects were divided into the stable plaque group and unstable plaque group based on the results of OCT scanning.The neovascularization characteristics such as the fibrous cap thickness of plaque,angle of lipid pool,macrophage infiltration and plaque cracks were detected by using OCT.ELISA was used to measure serum MMP7,MMP9 and MMP12 levels.Results (1) The fibrous cap thickness in the stable plaque group was more than that in the unstable plaque group(P＜0.01);the lipid pool angle,microphage infiltration,intima erosion and plaque cracks in the unstable plaque group were more than those in the stable plaque group(P＜0.05).(2) The MMP7 and MMP9 levels in the unstable plaque group were higher than those in the stable plaque group and control group(P＜0.05).(3) The fibrous cap thickness had significantly negative correlation with serum MMP9 level(r=-0.336,P=0.034);the MMP7 and MMP9 levels in the microphage infiltration group were higher than those in the non-microphage infiltration group(P＜0.05);the MMP9 level in the intima erosion group was higher than that in the non-intima erosion group(P＜0.01).Conclusion OCT can detect and find unstable plaque and the serum levels of MMP7 and MMP9 are significantly elevated in the patients with unstable plaque,which can be used as an important basis for predicting unstable plaque and guiding the treatment decisions.

Aim To investigate the pharmacokinetic characteristics of silibinin in Chinese healthy volunteers.Methods Nine Chinese male healthy volunteers were divided into receiving orally a single dose of silibinin capsule corresponded 70,140 and 280 mg of silibinin,respectively,in Latin square design study.After administration of silibinin capsule,the plasma concentrations were determined by HPLC with UV detection.The pharmacokinetic parameters were analyzed by Topfit 2.0 program.Results The linearity of this method was found to be from 3.125 to 10 000 μg·L~(-1) with a lower limit of quantitation(LLOQ) of 3.125 μg·L~(-1) for silibinin.The pharmacokinetic parameters were calculated as the follows:at the three different dosages(70,140 and 280 mg),T_(1/2) was 2.44,2.38 and 2.47 h;C_(max) was 1135.6,2841.1 and 3946.9 μg·L~(-1);T_(max) was 1.35,1.26 and 1.39 h;AUC_(0-11 h) was 1287.2,3337.8 and 5398.5 μg·h·L~(-1);AUC_(0-∞)was 1300.7,3377.1 and 5453.9 μg·h·L~(-1);CL/F was 1062.1,824.7 and 943.2 ml·min~(-1);And V_d was 219.9,167.1 and 212.0 L,respectively.Conclusions The developed method is shown to be sensitive,accurate and simple,and can satisfy the requirement of pharmacokinetic study of silibinin in human.The C_(max),AUC_(0-11 h) and AUC_(0-∞) of silibinin in Chinese healthy volunteers(in ranges of 40～120 mg)are fitted with non-linear kinetic model,while there are no significant differences in T_(1/2) at the three different dosages.

Objective To compare the short-term therapeutic effect, adverse reaction and influence on immune function between chrono-chemotherapy and routine-chemotherapy with docetaxel +cisplatin(DP)combined with concurrent chemoradiotherapy with cisplatin(DDP)in locally advanced(Ⅲ,Ⅳa stage)nasopharyngeal carcinoma(NPC).Methods 70 cases of newly diagnosed locally advanced NPC were randomly divided into group A and group B,35 cases in each group.Two groups of patients were treated with two cycles of neoadjuvant chemotherapy with DP combined with concurrent chemoradiotherapy with DDP.Both nereoadjuvant chemotherapy and concurrent chemotherapy of patients in group A were administrated with chrono-chemotherapy.Both nereoadjuvant chemotherapy and concurrent chemotherapy of patients in group B were administrated with routine-chemotherapy.Therapeutic effect,adverse reactions and other indicators were observed in both groups.Results After 3 months,there was no sifnificant difference of short term total efficacy between two groups in nasopharyngeal primary tumor(35 cases vs.34 cases),cervical lymph node(32 cases vs.31 cases).The incidence of adverse reactions of marrow toxicity(WBC,Hb,PLT)in group A was lower than group B(P<0.05),the incidence of digestive tract(nausea and vomiting,diarrhea)in group A was lower than group B(P<0.05),while there was no significant difference in oral mucositis between two groups(P<0.05).The high creatinine incidence in group A was lower than group B(P<0.05).There was no significant difference in high blood urea nitrogen and high transaminase incidences between two groups.After treatment, the T lymphocytes ( CD3 +, CD4 +, CD8 +, CD4 +/CD8 +) had no change in group A,the T lymphocytes(CD3 +,CD4 +)in group B decreased significantly compared with pre-treatment(P<0.05),and were lower than group A(P<0.05).Conclusion Adverse reactions and the degree of decline in cellular immune function of chrono-chemotherapy are lower than routine-chemotherapy in locally advanced NPC.