OBJECTIVE:To investigate the effects of aerosol inhalation of budesonide combined with Compound ipratropium bromide on therapeutic efficacy and safety of patients with pneumoconiosis during perioperative period of massive whole-lung la-vage (WLL). METHODS:One hundred and fifty male patients with pneumoconiosis receiving WLL under general anesthesia se-lected from our hospital during Dec. 2014-May 2016 were divided into treatment group and control group in accordance with ran-dom number table,with 75 cases in each group. Both groups received WLL under general anesthesia as well as pure-oxygen manu-al positive pressure ventilation alternating with negative pressure drainage keeping interval and respiratory rate of ventilator synchro-nization. Treatment group was given Budesonide suspension 2 mL,bid+ Compound ipratropium bromide solution 2.5 mL,tid,by aerosol inhalation from 3 d before surgery to 3 d after surgery. The levels of arterial blood gas indexes(pH,PaO2,PaCO2,BE)at different lavage stages,lung function indexes (FVC,MVV,FEV1/FVC),blood gas indexes and clinical symptom score 3 d be-fore surgery and 7 d after surgery were observed in 2 groups,and the occurrence of ADR was recorded. RESULTS:After two-lung ventilation for 20 min following unilateral/bilateral lung lavage,PaO2 of 2 groups were all increased significantly compared to be-fore surgery,with statistical significance (P<0.05);but there was no statistical significance between 2 groups (P>0.05). three days after surgery,FVC,MVV,FEV1/FVC and PaO2 of 2 groups were all increased significantly,PaCO2 and clinical symptom score were all decreased significantly. FVC,FEV1/FVC,PaO2 and clinical symptom score of treatment group were significantly bet-ter than those of control group,with statistical significance(P<0.05). The incidence of airway spasm,hypoxemia and airway pres-sure increasing in treatment group were significantly lower than in control group,with statistical significance(P<0.05). CONCLU-SIONS:During perioperative period of WLL,the aerosol inhalation of budesonide combined with Compound ipratropium bromide for patients with pneumoconiosis can improve clinical efficacy of WLL and reduce the occurrence of ADR during surgery.

0. 05) , mid-upper arm circumference and serum prealbumin (PA) were clearly improved (P

Objective To investigate the clinical manifestation and outcome of severe acute respiratory syndrome (SARS).Methods The clinical data of 233 patients with SARS admitted to China-Japan Friendship Hospital from April 2003 to June 2003 were analyzed,including clinical manifestations,laboratory findings,chest radiograph,outcome and mortality of SARS.Results There were 115 male and 118 female patients in this cohort,aged 13-86 (mean 42 8?18 5yr);43 3%of the patients had one or two kinds of underlying diseases;73 0% of the patients had a history of SARS close contact. Incubation period was 1-21 days (mean 4 9?4 1d).The initial symptoms were fever in 86 3% of the patients.The respiratory symptoms were found after the onset of 1-2 weeks.The laboratory abnormalities were decreased in WBC (56 7%) and lymphocytes (78 5%).Corticosteriod was used in 69 5% of the patients.There were 10 deaths (4 3%).The elder age,underlying diseases,continued high fever, thrombocytopenia,leucocytosis and bilateral lung involvement were the risk factors.Conclusion SARS is a new and strongly contagious disease,which mainly affects youth and people in their prime life.It has its own characteristic clinical manifestations.There is high mortality in severe cases.The prognosis is poor in patients complicated with diabetes,leucocytosis,lymphocytopenia,thrombocytopenia and elevated serum LDH and CPK.

BACKGROUND:Clinical studies have shown that early use of methylprednisolone can promote neurological functional recovery, reasonable initial dose, interval time and treatment duration are the key to the methylprednisolone treatment of acute spinal cord injury. OBJECTIVE:To observe the differential protein expression profile in spinal cord tissue after intrathecal injection of high-dose methylprednisolone was given in rat model of acute spinal cord injury. METHODS:Eight Sprague-Dawley rats were included in this study to establish acute spinal cord injury model and the models were randomly divided into two groups, receiving intrathecal injection of methylprednisolone 7.5 mg/kg at 0 and 8 hours after modeling. The injured spinal cord tissue was harvested after 24 hours of injection. The differentialy expressed proteins and nerve regeneration-related differential proteins in two groups were analyzed using isotope labeling and quantitative technical analysis. RESULTS AND CONCLUSION: Totaly 87 differentialy expressed proteins were identified in this study. Compared with 0 hour group, there were 43 up-regulated differential proteins and 44 down-regulated differential proteins in the 8-hour group. Eighteen differential proteins were related to neural regeneration, including 8 up-regulation proteins and 10 down-regulation proteins. OMgp as a potential neural axon growth inhibitory factor specificaly bound with NgR/P75/TROY/Lingo-1 to form receptor complexes and activated RhoA through the second messenger cAMP, thus inhibiting the colapse of axon growth cone. Folowing intrathecal injection of methylprednisolone for treatment of acute spinal cord injury in rats, differential proteins and nerve regeneration-related factors in spinal cord are identified and analyzed for protein database retrieval and protein function analysis, their expression may serve as the indicator of monitoring nerve regeneration after acute spinal cord injury.

Objective To observe the expression changes of matrix metalloproteinase 9(MMP-9),vascular endothelial growth factor(VEGF)in the esophageal squamous cell carcinomas,and to study the chinical significance. Methods The expression of MMP-9 and VEGF in 60 patients with esophageal carcinoma and 20 cases with adjacent normal mucosa were tested with immunohistochemical SP method. Results The positive rate of MMP-9,VEGF in the esophageal squamous cell carcinomas were 70%(42/60)and 80%(48/60),the positive rate of adjacent normal mucosa were 10%(2/20)and 20%(4/20).The positive rates of the two groups were compared,all the differences had statistical significance(P＜0.05); expressions of MMP-9,VEGF in the esophageal squamous cell carcinomas related to invasive depth of carcinoma and lymph node metastasis(P＜0.05).There were positive correlation(r=2.330,P＜0.05). Conclusion The higher expression of MMP-9 and VEGF in the esophageal squamous cell carcinomas played an important role in invasion and metastasis of esophagus squamous cancer.

Central pancreatectomy is an ideal surgical procedure for the treatment of benign or low-grade malignant tumors in the pancreatic neck or the proximal body of the pancreas,and it can preserve more normal pancreatic tissue in order to reduce the incidence of endocrine and exocrine insufficiency after surgery.Although some clinical studies have demonstrated the feasibility and safety of this procedure,laparoscopic central pancreatectomy was technically challenging with a few number of cases.This article reviews the current status of laparoscopic central pancreatectomy and introduces our clinical experience of laparoscopic central pancreatectomy and pancreaticojejunostomy.

Objective To summarize some problems about the management of acute pancreatic pseuclocyst(PPC) by CT guided percutaneous drainage(PCD).Methods The recent domestic and foreign literatures were reviewed in order to explore the research advancement,such as indication,applied time,technique skill,complication and curative effect by CT guided PCD.Results This operation could be early performed in patients with acute PPC,preventing and decreasing the incidence of possible complications resulted from the traditional long-term observation and waiting.The technique skill of operation was easy with low incidence of complications and the effect was good.Combined use of somatostatin might shorten the treatment time.Some patients could be postoperatively managed in out-patient,thus the expense could be cut down.Conclusions CT guided PCD is a minimally invasive operation and is easy to perform with high effective rate and low incidence of complications and low cost.Reasonable selection of the indications and improvement of equipments and operation techniques may be helpful to improve the curative effect.The extended application of this operation is advised.

Object To study the chemical constituents of Schizonepeta tenuifolia (Benth.) Briq.. Methods The monoterpenoid constituents of S. tenuifolia were separated on silica gel column and their structures were elucidated by spectral. Results Two new compounds and three known compounds were obtained. Conclusion The new compounds were identified as 3-hydroxy-4(8)-ene-p-menthane-3(9)-lactone and 1, 2-dihydroxy-8(9)-ene-p-menthane.

Objective To learn the degree of the asthmatic patients'understanding of the disease, and to provide references for formulating the plan of the asthma patient's education and management infuture.Methods One hundred and one outpatients were surveyed by questionnaire face to face.Results Among 101 patients,the percentages of mild intermittent,mild persistent,moderate persistent and severepersistent asthma assessed by current symptom were 23%,29%,30%,18%.Among these patients thosewho understanding the inflammatory nature of asthma account occupied 70.3%,those who realizing the importance of inhaled corticosteroids(ICS)and taking ICS as the first-line medicine for asthma occupied67.3%,those who knowing the indication about rational use of short-acting beta-2-agonists(SABA)occupied 88.1%,those who realizing the goal of asthmatic therapy occupied 71.3%.All these results were significantly better than both the reporter in the asthma insights and reality in Asia-Pacific and the realizing degree to asthma of the respiratory professionals in Beijing's urban district hospitals in 1997.Conclusion After long term systematic education and management,asthmatic patient's understanding of the disease has been improved greatly.

Objective To evaluate the efficacy of intramuscular parecoxib for postoperative analgesia in patients undergoing total knee arthroplasty.Methods Fifty-four ASA Ⅰ-Ⅲ patients,aged 65-75 yr,scheduled for unilateral total knee arthroplasty,were randomly divided into 2 groups (n =27 each)∶ tramadol group (group T) and parecoxib group (group P).Total intravenous anesthesia was used in both groups.Group P received intramuscular injection of parecoxib 40 mg at 12 h before operation and 12,24,36,48,60 and 72 h after operation,and group T received tramadol 100 mg at the same time points.When VAS score was more than 3 after operation,intramuscular parecoxib 50 mg was given as rescue analgesic.The ineffective analgesia at rest and during activity was recorded.The time for knee range of motion to reach 90° and cardiovascular events were recorded.The ultrasonic inspection was performed on veins of the bilateral lower extremities at 7 and 14 days after operation for detection of vein thrombosis.Results Compared with T group,the rate of ineffective analgesia at rest and during activity was significantly decreased,the time for knee range of motion to reach 90° was shortened,and the incidence of deep vein thrombosis was significantly decreased (P ＜ 0.05 or 0.01),and no significant change was found in the incidences of cardiovascular events and intramuscular venous thrombosis in group P (P ＞ 0.05).Conclusion Parecoxib 40 mg injected intramuscularly before and after operation can significantly relieve postoperative pain,is helpful for the hip function rehabilitation and can reduce the occurrence of deep vein thrombosis in patients undergoing total knee arthroplasty.