Objective To study correlation between oxygen uptaking efficiency and exercise endurance of patients with stable chronic obstructive pulmonary disease (COPD).Methods From January 2013 to December 2014,50 patients with COPD plateau were selected as the research subjects,and according to the severity,28 cases of gradeⅠ -Ⅱ,22 cases of grade Ⅲ -Ⅳ.50 COPD patients with acute phase of disease were selected as disease control group.50 healthy people were selected as healthy control group.The forced vital capacity (FVC),forced expiratory volume in first second (FEV1 ),FEV1 /FVC,peak oxygen uptake (peak VO2 ),peak oxygen uptake of expected value (peak VO2% Mr Pred),oxygen uptake efficiency slope (OUES),oxygen uptake efficiency platform (OUEP),when the anaerobic threshold (OUE @ AT)such as index,and the oxygen uptake efficiency and movement endurance were detected and analyzed.Results FVC,FEV1 ,FEV1 /FVC index values of COPD group were less than those of the control group,the differences were statistically significant (all P <0.05),and COPD patients with acute phase of FVC(2.86 ±0.36)L,FEV1 (1.25 ±0.36)L,FEV1 /FVC(50.16 ±5.37)% index values were less than COPD stabilization [(3.12 ±0.46)L,(1.51 ±0.38)L,(60.16 ±6.16)%)],the differences were statistically significant (all P <0.05).The peak VO2 ,peak VO2% Mr Pred,OUES,OUEP,OUE @ AT index values of COPD group were less than those of the control group,the differences were statistically significant (all P <0.05),and COPD patients with acute phase of peak VO2 (1 072.35 ±271.21)mL/min,peak VO2%pred(62.79 ±6.31),OUES(1.59 ±0.29),OUEP (25.72 ±3.42),OUE@AT(26.75 ±3.12)index values were less than patients with COPD stabilization[(1190.67 ± 286.21)mL/min,(70.76 ±6.27),(1.89 ±0.31 ),(31.46 ±4.05 ),(31.62 ±3.16)],the differences were statistically significant (all P <0.05).As the stabilization of disease severity in patients with COPD was aggravated, peak,VO2 peak VO2% Mr Pred,OUES,OUEP,OUE @ AT declined (1 089.62 ±221.68)mL/min vs.(1236.75 ± 235.37)mL/min,(67.28 ±5.03)vs.(75.81 ±5.39),(1.62 ±0.18)vs.(2.04 ±0.25),(30.67 ±6.47)vs. (34.17 ±4.40),(30.31 ±3.42)vs.(36.59 ±3.63)(F =16.92,12.71,4.27,8.75,7.59,P <0.05).Patients with COPD stabilization OUES,OUEP,OUE @ AT peak oxygen uptake efficiency indexes and movement endurance targets were positively correlated with VO2% Mr Pred (r =0.451,0.462,0.451,P =0.019,0.012,0.26),there was a positive correlation with peak VO2 (r =0.446,0.452,0.446,P =0.023,0.011,0.29).Conclusion COPD patients oxygen uptake efficiency and movement endurance than healthy people,patients with COPD oxygen uptake efficiency and movement endurance is associated with illness and severity of COPD,and COPD patients exercise endurance on the oxygen uptake efficiency also has a certain degree of influence.

BACKGROUND: Severe acute respiratory syndrome (SARS) is a kind of very strong infective respiratory system diseases. Due to rapid development of disease course, severe symptoms, forced isolation, being away the supports from relatives and friends, many patients with SARS presented extremely anxiety and panic, even depression and despair, and they are in the crisis state and need mental support and help.OBJECTIVE: To evaluate the therapeutic effect of mental crisis intervention in patients with SARS.DESIGN: Controlled observation.SETTING: Xiaotangshan Hospital of Chinese PLA.PARTICIPANTS: Totally 680 patients with SARS who received the mental intervention in the Psychological Counseling Center, Xiaotangshan Hospital of Chinese PLA in May 2003. The patients, 379 male (55.74%)and 301 female (44.26%), were aged (35±7) years. Degree of education:34.5% of patients received education below junior high school, 31.5% senior high school and 34.0% college. 100% of the patients had family member or colleague-infected life events, and 14.4% of the patients lost their family members. Degree of disease: 6.9% of patients were in the severe period, 67.5% in the stable period and 25.6% in the rehabilitation period.METHODS: ① Totally 489 patients who received telephone counseling,and attended telephone mutual-help group, group debugging, individual counseling and group counseling were chosen, serving as intervention group, and the other 191 patients served as control group. ②The mental health state of patients in the 2 groups was evaluated at admission with symptom checklist 90 (SCL-90), which consisted of somatization, obsessive compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism 9 factors. The grading scoring was used. The higher grades, the more severe symptoms. ③ The patients of intervention group were given comprehensive mental intervention, which included handing out materials(self-debugging propagandist manual), care from staff, mental counseling by telephone, group debugging, individual counseling, guidance by mental doctor, etc. Patients in the control group only received handed materials (self-debugging propagandist manual) and the care from staff. SCL-90 was used to re-evaluate the patients of intervention group and control group before discharge. ④Intervention therapeutic effect of patients in 2 groups were evaluated with comprehensive mental intervention questionnaires, which were mainly about self and social cognition, feeling and emotion, life behavior styles, physiological and body symptoms 4 dimensions. Grading scoring was used. The higher points, the better intervention effect. Self-rating and rating by others were used in each question. If the results in self-rating are the same as those in rating by others, questionnaire is valid, otherwise, it is invalid). ⑤ The scoring of all the patients at admission was compared with that of Beijing norm by using SCL-90.The mental health of patients of 2 groups after intervention was measured, evaluated and compared with SCL-90.MAIN OUTCOME MEASURES: Difference in scoring of SCL-90 between all the patients and Beijing norm; Changes in the scoring of SCL-90 between intervention group and control group at admission and after intervention.RESULTS: Totally 680 comprehensive mental intervention questionnaires were handed out, and 669 of them were retrieved, among which 483 from intervention group and 186 from control group. Altogether 669 patients participated in the result analysis. ① Points of each factor in SCL-90 of patients at admission were significantly higher than norm, especially in anxiety and phobic anxiety. 45.5% and 50.1% of the investigated patients had more than 3 points in anxiety and phobic anxiety respectively. 86.5% of the investigated patients had mental problems to different degrees. ②There was no significant difference in the points of various factors in SCL-90 at admission between intervention group and control group (P＞0.05).In the various factors of SCL-90, no significant difference in the points of various factors in SCL-90 at admission between intervention group and control group (P＞0.05).In the various factors of SCL-90,no significant difference exists in phobic anxiety and paranoid ideation and psychoticism between two groups (P＞0.05),but the points of the other factors of intervention group were significantly lower than those of control group (P＜0.05-0.01).CONCLUSION: Mental crisis intervention can remarkably lighten the somatization, obsessive-compulsive, anxiety and depression, lower interpersonal sensitivity and improve hostility.

Objective To improve the diagnosis of germinomas in basal ganglia area by analysing the imaging manifestations.Methods Clinic,pathologic and medical imaging data of 8 cases of germinomas in basal ganglia area confirmed pathologically were analyzed retrospectively.Results 8 cases were all men,the age ranged from 5~13 years old with mean age of 10.5 years.All cases had change of muscle strength on one side of extremity,and one case accompanied by intracranial hypertension,this case was showed the effect of space occupying of the tumor obviously and hydrocephalus on CT and MRI.The findings of CT and MRI showed cystic degeneration in 4 cases,slight edema around the tumor in 2 cases,cortex atrophy of the same side of tumor in 2 cases and calcification in the tumor in 2 cases.All cases were enhanced greatly.The pathologic specimen with rich supply of blood was gray-red,and cystic degeneration was seen in 4 cases.Conclusion CT and MRI features of germinomas in basal ganglia area are quite characteristic,the improvement of diagnosis can be achieved in combination with clinical manifestation.

Objective To realize the utilization of antibacterial drugs in pediatric inpatients in Children's Hospital for clinical reference of rational use of drugs. Methods By a retrospective study, 180 cases in pediatric inpatients were randomly sampled in Children's Hospital from July to December 2012, and were analyzed in utility rate, antibiotics varieties, administrational frequency,single dose,combination use,prophylaxis time,courses of drug use,etc. Results The use of antibacterial drugs in pediatric inpatients was 110 cases (61.1%) and used in combination was 55 cases (50%) . Leading the list in terms of DDDs was cephalosporins,followed byβ-lactam and its enzyme inhibitor complex preparations. The improper medications frequency was 12 cases (10.9%), irrational single dose was 7 cases (6.4%), and irrational course of treatment was 9 cases (8.2%) . Conclusion The utilization of antibacterial drugs in Children's Hospital is basically rational, but there still exist some irrational drug uses,such as antibiotics varieties,no indication, irrational dosage,long duration and irrational combination. So, it is necessary to enhance the administration of antibiotics use and improve the level of clinical reasonable application of antibiotics.

Objective To evaluate surgical complications and outcomes based on prostate size in patients with benign prostatic hyperplasia (BPH) treated with plasmakinetic enucleation of prostate (PKEP).Methods A retrospective review was conducted of PKEP performed in 326 patients with BPH.According to the prostate size on preoperative transrectal ultrasonography measurement,patients were divided into three groups:groupl:＜40ml (n =92),group2:40～80ml (n =155),and group3:＞80ml (n =79).Intraoperative and perioperative parameters were evaluated.Patient perioperative data and postoperative outcomes were compared.Patients were followed up at 1,3,6 and 12 months after surgery.Early and late complications were recorded.Results There were significant differences among three groups regarding the mean operative time (P ＜ 0.01) and the mean resected tissue weight (P ＜ 0.01).However,enucleation efficiency (P ＜ 0.01) in gm tissue per minute increased significantly as prostate size increased.Mean hemoglobin decrease (P ＞0.05),mean serum sodium decrease (P ＞0.05),mean postoperative irrigation time (P ＞ 0.05),mean catheter time (P ＞ 0.05) and mean hospital stay (P ＞0.05) did not differ significantly among three groups.Three groups had a similar and significant postoperative improvement in international prostate symptom score (IPSS),quality of life (QOL),maximum urine rate (Qmax),and post-void residual urine volume(PVR) independent of prostate size (P ＜ 0.01),but no significant difference was found among three groups during 1,3,6 and 12-month follow-up (P ＞ 0.05).Perioperative and postoperative complications did not depend on prostate size (P ＞ 0.05).Conchsions Although patients with a larger BPH required significantly longer operation time in PKEP,prostate size did not affect perioperative and postoperative complications or micturition improvement.

Objective To observe the effect of electromyographic biofeedback combined with swallowing training on dysphagia after stroke.Methods Ninety-five patients with difficulty in swallowing after stroke were randomly divided into a treatment group (48 eases) and a control group (47 cases).The patients in the treatment group were provided electromyographic biofeedback and swallowing training; the patients in the control group received swallowing training only.The therapeutic effect was assessed with Kubota's drinking water test before treatment and 30d after treatment.Results Swallowing in both groups improved after treatment.The total recovery rate in the treatment group was 87.5％,and in the control group it was 68.0％,a significant difference.Conclusion Electromyographic biofeedback can improve the effectiveness of swallowing training after stroke.

Objective To study the influence of survivin mutant-T34A ( survivinT34A) and survivin deletant-N-terminal 8 amino acids residues ( survivinN-8AA ) on the cell cycle distribution and chemosensitivity in human ovarian cancer HO-8910 cells for explorating the roles of modified survivin-mediated apoptosis induced by chemotherapeutic agents and possible signaling pathways involved. Methods pcDNA3.1 plasmid contained wild-type, survivinT34A and survivinN-8AA genes were transfected into HO-8910 cells,respectively, the control groups were HO-8910 cells transfected with pcDNA3. 1 plasmids. The expression of mRNA was examined by reverse transcription(RT) PCR and identified by DNA sequencing; the cell cycles were determined by flow cytometer analysis ( FCM ); the growth inhibitions rate of cisplatin ( DDP),paclitaxel (PTX) and LY294002 on the transfected cells were determined using methyl thiazolyl tetrazolium (MTT) assay. Results (1) The RT-PCR procedures and genome sequences showed that the survivin mRNA were expressed stable in the transfected HO-8910 cells. (2) There was lower percent of G0/G1 phase cells in SN-HO-8910 cells than that in PC-HO-8910 cells (44. 72% vs. 49.64%, P ＜0. 05) ;while higher percentage of G2/M phase and S phase cells( 1.06% and 54. 22% vs. 0. 56% and 49. 80%, P ＜ 0. 05 ).There was lower the G2/M phase and S phase cells in M-HO-8910 cells 0. 16% and 36. 33%, than that in PC-HO-8910 cells( P ＜ 0. 05 ); while higher percentage of G0/G1 phase cells(63. 51% ,P ＜ 0. 05 ). G0/G1 ,G2/M and S phase cells in Sur-HO-8910 cells were 54. 46%, 0. 62% and 44. 92%, and there were not significantly difference ( P ＞ 0. 05 ), compared to those in PC-HO-8910 cells. ( 3 ) The inhibitory concentration ( IC50 ) of DDP and PTX were higher in Sur-HO-8910 cells than those in control cells [(20. 4 ±6. 1)vs. (14.4 ±3.9)μmol/L,(36.7 ±4.0) vs. (28.6 ±3.6) μmol/L;all P＜0.05]. The IC50 of DDP and LY294002 in SN-HO-8910 cells were lower than those in control cells[(7. 6 ± 1.0) vs. ( 14. 4 ± 3.9)μmol/L, ( 13.2 ± 4. 0) vs. (41.0 ± 7. 9 ) μmol/L; all P ＜ 0. 01]. The IC50 of PTX [( 37. 9 ± 4. 8 ) μmol/L]in SN-HO-8910 cells were higher than that in control cells(P ＜0. 05). The IC50 of DDP in M-HO-8910 cells [(9.9 ± 1.2) μmol/L] were lower than that in control cells(P ＜0. 05) ,and the IC50 of LY294002 in M-HO-8910 cells [(66. 9 ± 4. 8) μ mol/L] higher than that in control cells ( P ＜ 0. 01 ). Conclusions The changes of cells cycle distribution caused by survivinT34A or survivinN-8AA enhanced the G2/M cell cycle-dependent chemosensitivity of PTX. Compared to survivinT34A, survivinN-8AA preferentially to mediate the cytotoxicity of DDP and LY294002, suggesting that it may be related to the cell cycle-dependence of survivin function and to blockage of the formation of its active dimer.

Objective To explore the reliability of Chinese simplified diagnostic method for acute drug‐induced liver injury (DILI) in diagnosis of acute DILI .Methods From 2008 to 2013 ,a total of 320 patients diagnosed with acute DILI were enrolled .The clinical data of them were collected .International recognized Roussel Uclaf causality assessment method (RUCAM ) was taken as control and then simplified diagnostic method for DILI in China was evaluated . Variance analysis was performed for statistical analysis .Gamma value of two diagnostic methods was calculated and the correlation was analyzed .Results Among the 320 patients with acute DILI ,according to RUCAM ,there were 39 cases (12 .19% ) with quite high probability ,193 with high probability (60 .31% ) ,74 with possibility (23 .12% ) ,11 with less possibility (3 .44% ) and three with no probability (0 .94% ) .According to simplified diagnostic method for acute DILI ,194 cases were diagnosed (60 .62% ) ,103 were suspicious (32 .19% ) and 23 were excluded (7 .19% ) .The RUCAM score of diagnosed group (7 .5 ± 1 .2) was higher than that of suspicious group (5 .3 ± 1 .3) and excluded group (2 .1 ± 1 .1) ,and the difference was statistically significant (F =239 .545 ,P< 0 .01) .The correlation analysis between these two diagnostic methods indicated that Gamma value was 0 .955 (P < 0 .01) .Conclusions The simplified diagnostic method for acute DILI in China is simple ,practical and consistent with RUCAM .It can be used as one of the clinical methods for screening acute DILI .

ObjectiveTo observe the effect of transcutaneous electric nerve stimulation (TENS) and physical therapy on shoulder pain after stroke. Methods60 patients of shoulder pain after stroke were randomly divided into treatment group (30 cases) and control group(30 cases). The patients in the treatment group were treated with TENS and physical therapy. The cases in the control group were treated with TENS only. All patients were evaluated with visual analogous score of pain (VAS) and Fugl-Meyer measure (FM) before and after treatment. ResultsThe scores of VAS and FM improved more significantly in treatment group than in control group(P<0.01).ConclusionTranscutaneous electric nerve stimulation combined with physical therapy showed more effective on shoulder pain after stroke.