Objective:To explore the application value of continuous positive airway pressure ( CPAP) in the treatment of obstruc-tive sleep apnea hypopnea syndrome (OSAHS ) complicated with coronary heart disease (CHD).Methods:Totally 50 patients with OSAHS complicated with CHD from June 2012 to June 2014 in our hospital were randomly divided into the control group and CPAP group with 25 ones in each .The patients in the control group were treated with the conventional drug therapy for coronary heart disease , while those in CPAP group were treated with CPAP additionally .After 6-month treatment, PSG index, clinical symptoms, arrhythmia and ischemia electrocardiogram changes of the patients in the two groups were compared .Results:After the 6-month treatment , AHI and oxygen desaturation index in CPAP group were significantly decreased when compared with those before the treatment , and the min-imum value of SaO2 and the average value of SaO 2 were higher than those before the treatment (P<0.01), and the above indices were better than those in the control group (P<0.01).The incidence rate of chest pain and chest tightness , arrhythmia, times of myocardi-al ischemia in a day and time of myocardial ischemia in a day were decreased after the treatment (P<0.01), and the decrease in CPAP group was more notable than that in the control group (P<0.01).Conclusion: CPAP combined with the conventional drug therapy for coronary heart disease can improve the oxygen concentration and reduce the incidence of arrhythmia and myocardial ischemia in the patients with OSAHS with CHD , which can be widely used in clinics .

Objective:To observe the efficacy of Chuankezhi injection combined with budesonide and formoterol fumarate powder for inhalation in the treatment of chronic obstructive pulmonary disease ( COPD) . Methods:Totally 120 patients with COPD were ran-domly divided into two groups:the observation group inhaled budesonide and formoterol fumarate powder for inhalation combined with intramuscular injection of Chuankezhi injection, and the control group inhaled budesonide and formoterol fumarate powder for inhala-tion. The treatment course was 28 days. The pulmonary function indices [ FEV1% expected value, FEV1 /FVC, 6 min walking dis-tance (6MWD)], the times of acute exacerbation and the adverse drug reactions during the treatment were observed and compared be-tween the two groups. Results:After the treatment, the lung function and 6MWD were improved in the two groups, and the improve-ment of FEV1% expected value in the treatment group was more obvious than that in the control group [(59. 7+12. 1)% vs (49. 8+11. 3)%, P<0. 05]. The number of patients with at least once of acute exacerbation was significantly reduced in the treatment group when compared with that in the control group (35% vs 62%, P<0. 01). The incidence of adverse drug reactions in the two groups showed no significant difference. Conclusion:Chuankezhi injection combined with budesonide and formoterol fumarate powder for in-halation can notably improve the lung function in the patients with COPD and reduce the times of acute exacerbation without effect on the incidence of adverse drug reactions.

In the clinical skill evaluation,SP and the new technology OSCE for medical educational evaluation brought by SP can offer a vivid and complete exam atmosphere for the medical students,which have been widely applied by medical colleges and schools at home and abroad,with real,effective,reliable characteristics and broader development prospect. To induce the technology into TCM clinical evaluation is in accordance with the requirements of TCM educational development,which can make students better grasp clinical various basic skills within limited studying periods.

Objective:To investigate the influence of compound glycyrrhizin on expression of HMB45,TNF-? and IL-6 in lesion of compound. using vitiligo guinea pig model induced by chemical decolorized compound.Methods:Two Guinea pig model groups were respectively treated with compound glycyrrhizin in 27.8 mg/kg and 55.6 mg/kg dosage. Immunohistochemical studies were performed to study the expression of HMB45,TNF-? and IL-6 in compound glycyrrhizin treated group,vitiligo model group and normal control group.Results:The expression of HMB45 in lesion of vitiligo model group was lower than the normal control group.The expression of HMB45 in lesion of compound treated group was higher than the vitiligo model group and the expression of HMB45 increased accompany by the increase of dosage.The expression of TNF-? and IL-6 in vitiligo model group was significantly higher than the normal control group (P

BACKGROUND:The Specification of Quality Management for Medical Device Production (for Trial Implementation) issued by the China Food and Drug Administration (CFDA) on December 16, 2009 was demanded to be initially implemented in medical device manufacturers with a higher risk in sterility and implant before January 1, 2011. The revised version was published on December 29, 2014 and came into effect on March 1, 2015. OBJECTIVE:To put forward specific suggestions through analyzing the status of 31 sterile implantable medical device manufacturers in Sichuan Province and the corresponding implementation situation of the specification for trial implementation. METHODS:The relevant data of these 31 manufacturers were collected through the quality management system assessment, supervision and inspection, flight inspection and questionnaire survey. And the data were analyzed statistically. RESULTS AND CONCLUSION:The overall size of medical device manufacturers in Sichuan Province is small. There are still some other problems, such as no advanced equipment, low quality of employees, lack of funds and inappropriate management, in these manufacturers. Considering these, we have given some guiding recommendations from the aspects of production and supervision.

Objective To examine whether ethanol modulates the intracellular processes involved in the secretion of IL-1α,and then exert a protective effect against coronary heart disease. Methods THP-1 cells in human were cultured for 2-3 generations , and put in PMF for 72 h to induce THP-1 into macrophage. ELISA was applied to detect effects for secretion of IL-1α by LPS, cholesterol and ethanol. In the light of ELISA re-sults, western blot was applied to detect the effects of ethanol on caspase-1 and NLRP3. Results Compared with the control group, the secretion of IL-1α in LPS group and LPS + CHOL group increased. Compared withLPS + CHOL group, the concentration of IL -1α in LPS + CHOL + etha group significantly decrease(P < 0.01). The results of western blot showed that ethanol significantly inhibited caspase-1 and NLRP3 activation. Conclu-sion Ethanol can inhibit the NLRP3 inflammasome activation in macrophages , which may represent a biological pathway underlying the protective effect of moderate alcohol consumption on coronary heart disease.

Objective To investigate the clinical manifestation,pathological characteristics,neurological imaging,indications,operative approach and microsurgieal technique of surgery for brain stem tumor.Methods 17 cases of brain stem tumor treated by applying microsurgical skills were retrospectively analyzed from Jan.2002 to Dec.2007.Ten cases were operated via the suboccipito-retromastoid approach,among which 5 situated in pons,3 in medulla oblongata and 2 invoved both pens and medulla oblongata;4 cases were performed via the posteromedian-suboccipital approach,among which 2 located in pens,1 in medulla oblongata and 1 involved both midbrain and pens;3 lesions situated in varying sites of mesencephalon were operated by the suboceipito-supratentorial,infratemporal approach and pterional approach respectively.Results In the series of the patients,lesion was totally excised in 6 cases,subtotally in one,without surgical mortality.All patients were followed up for years ranging from 5 months to 4 years.During the follow-up period,seven patients resumed work and normal life;4 patients could perform physical labor;3 patients obtained self care capability;2 patients needed to be taken care of,1 patient died from pneumonia after discharge.Conclusion Fine therapeutic efficacy and low disability rate could be obtained while applying microsurgical techniques to resect brain stem tumors with correct indication,appropriate approach and elaborate microneurosurgical skills.

Objective To investigate effect of tuberosity reduction and fixation during humeral head replacement for treatment of complex proximal humeral fractures on functional recovery of the shoul-der ioint and on decrease and prevention of complieaitons. Methods From January 2004 to August 2007,42 elderly patients(at average age of 78.5 years)with three-or four-part fractures and dislocations of proximal humerus received humeral head replacement.Cable-needle interual implant cerclage T-shape compression fixation was done in 14 patients.classic Dacron needle fixation in 13 and classic Dacron nee-die fixation plus metal band extemal implant cerclage fixation in 15.Postoperative exercises were carried out according to Neer's rehabilitation principles. Results All patients were reviewed with the Ameri-can Shoulder and Elbew Surgeons(ASES)score at the mean follow.up of 8 months postoperatively.Sta-tisticaI difierence of ASES score was found between the postoperative iniured shoulder and the preoperative ipsilateral side as well as the uninjured side.Tuberosity complication was found postoperatively at X-P in ll patients including 5 with absorption of tuberosity.4 with lateral displacement(2 posterior-lateral posi-tion and 2 anterior lateral position)and 2 with supra.subluxation of the head of prosthesis. Conclu-sions Cable-needle internaI implant cerclage T-shape compression fixation during humeral head replace-ment is better than other two methods and brings about earlier postoperative rehabilitation.which is help-ful for functional recovery of the shoulder as soon as possible.prevention of tuberosity complications and improvement of shoulder funotion rehabilitation level.

Objective To comprehensively analyze the effect of low-dose radiation on the lens of the eye of radiation workers.Methods The papers dealing with the relationship between occupational radiation exposure and the lens of the eye were collected by retrieving documents of the domestic and foreign medical information databases with references to other papers.There were 28 papers finalized with 17 608 workers included in the Meta-analysis.Stata12.0 was used for Meta-analysis,Q-test and I2 statistic for heterogeneity test,and funnel regression method,Begg's rank method and Egger's regression method for publication bias.Results The pooling odds ratio (OR) opacity in radiation workers were 2.51 (2.01,3.13),4.03 (2.77,5.85),respectively.Conclusions Low-dose radiation may lead to negative impact on ocular lens under the current occupational protection conditions.The proportion of posterior subcapsular opacity in radiation-related cataract is higher than that in age-related cataract.It is important to strengthen radiation protection of ocular lens.

Objective This study aimed to study the effect of intra-brachial nitroglycerin administration via the angiography catheter on radial artery spasm in transradial percutaneous coronary intervention. Methods From patients undergoing transradial percutaneous coronary intervention (TRI) and succeeding in coronary angiography (CAG), 810 patients who needed percutaneous coronary intervention (PCI) (including Percutaneous Transluminal Coronary Angioplasty and/or stent implantation) were erolled, including 413 patients in the study group and 397 patients in the control group. When coronary angiography completed, positioned the angiography catheter over brachial artery and patients in the group received an administration of 400μg nitroglycerin via the angiography catheter. The control group received an administration of 400μg nitroglycerin via the sheath. The incidence of RAS were recored and compared. Resultes Baseline characteristics were similar between two groups. In the study group, the incidence of RAS was signiifcatively lower (18 vs. 33, P=0.021). Conclusions Intra-brachial nitroglycerin administration via the angiography catheter can prevent RAS during the insertion of guiding catheter in TRI.