Objective To evaluate the clinical effect of salmeterol xinafoate and fluticasone propionate powder for inhalation combined ipratropium bromide aerosol in patients with stable chronic obstructive pulmonary disease (COPD).Methods One hundred and twenty patients with stable COPD was randomly divided into control group and observation group with 60 patients each.The control group was received ipratropium bromide aerosol inhalation,and the observation group was given salmeterol xinafoate and fluticasone propionate powder for inhalation and ipratropium bromide aerosol for 6 months.BODE index,SGRQ scores,plasma cortisol and bone mineral density were compared between two groups before and after treatment.Results BODE index scores had no significant difference between two groups before treatment (P＞0.05).After treatment,BODE index scores,dyspnea scale,FEV1％,6MWD and BODE index total scores in observation group were superior to those in control group [ (1.9 ± 0.5) grades vs. (2.3 ± 0.5)grades,(58.5 ± 7.3)％ vs.(50.4 ± 6.2)％,(411.1 ± 56.8) m vs.(347.5 ± 60.4) m,(3.3 ± 1.0) scores vs.(3.8 ± 1.3 ) scores ],there were significant differences (P＜0.05 ).SGRQ scores had no significant difference between two groups before treatment (P＞0.05 ).After treatment and in SGRQ scores,respiration symptom,limitation of activity,disease influence scores in observation group were significantly lower than those in control group [ (20.7 ± 10.3 ) scores vs.(37.9 ± 14.4) scores,(20.7 ± 9.5 ) scores vs.(34.8 ± 13.0) scores,(16.3 ± 6.7) scores vs.(27.2 ± 11.8) scores,(17.5 ± 7.0) scores vs. (34.6 ± 12.3) scores],there were signiticant differences (P＜0.01 ).There were no significant difference of plasma cortisol and bone mineral density between two groups (P＞0.05).Conclusions Salmeterol xinafoate and fluticasone propionate powder for inhalation and ipratropium bromide aerosol in patients with stable COPD can greatly improve the lung function and life quality and with less adverse reaction.

OBJECTIVE To study the preventing methods through analyzing risk factors of nosocomial infection about intubating central vein after liver transplantation.METHODS From Oct 1995 to Oct 2003,1093 patients intubated central vein were retrospectively analyzed through routine germs and fungi culture in our department.From them 59 cases underwent liver transplantation,1034 cases underwent other operations.RESULTS Twenty nine cases with other operations were found nosocomial infection,the positive rate was 2.8%.Four cases with liver transplantation were found nosocomial infection,the positive rate was 6.8%.CONCLUSIONS Nosocomial infection rate in patients underwent intubating central vein after liver transplantation is evidently higher than others.

Objective: To investigate the mechanism of improvement effect of electro-acupuncture at acupoint Neiguan (PC 6) on acute myocardial ischemia (AMI). Methods: Ninety-six rats were randomly divided into sham-operation group, myocardial ischemia model group and myocardial ischemia model plus electro-acupuncture group, the rat model of AMI was established by occlusion of the anterior descending branch of the left coronary artery, then electro-acupuncture therapy was performed at bilateral acupoint Neiguan (PC 6). The myocardial enzyme activities in plasma was detected with biochemical method, and the myocardial c-fos gene expression was detected with reverse transcription polymerase chain reaction(RT-PCR) method. Results: The myocardial enzyme activities in plasma and the myocardial c-fos gene expression in myocardial ischemia model group were obviously higher than those in sham group(P＜ 0.05), after electro-acupuncture treatment, the myocardial enzyme activities in plasma and the myocardial c-fos gene expression were decreased,there was a significant difference (P＜ 0.05). Conclusion: The mechanism of improvement effect of electro-acupuncture at acupoint Neiguan (PC 6) on AMI is related to down-regulation of the myocardial c-fos mRNA expression.

Objective To investigate the influence of early rehabilitation on the recovery of patients who have undergone the low rectal cancer resection. Methods 130 patients with low rectal cancer resection were divided into the rehabilitation group and the control group randomly, there were 65 cases in each group. The control group were accepted the routine nursing care, and the rehabilitation group were accepted the early recovery intervention. Compared the time of anus exhaust, the time of stomach extubation, the incidence rate of postoperative complication, the time of bed rest and the quality of postoperative life in these two groups. Results All the indexes which have compared between these two groups were significant better in the rehabilitation group than those of in the control group, P

Objective To explore the plasma ghrelin levels in children and adolescents with short stature and the role of ghrelin in growth hormone-releasing hormone-growth hormone(GHRH-GH) axis.Methods One hundred and fifty-seven children(115 male,42 female) with short stature were selected.Fasting plasma sample was extracted from 10 mL vemous blood of the children with short stature.Insulin tolerance test and arginine stimulation test was performed initially to differential diagnosis.And blood samples was divided into 3 ca-tegories:37 cases of complete growth hormone deficiency (CGHD),52 cases of partial growth hormone deficiency(PGHD) and 68 cases of idiopathic short stature(ISS) during these two growth hormone(GH)provocative tests.Controls consisted of age and gender-match 20 health children.Plasma ghrelin levels were measured by radioimmunoassay.Serum GH was detected by chemiluminescence method,and serum insulin-like growth factor-1 (IGF-1) was measured by using enzyme linked immunosorbent assay.Fasting glucose,insulin,testosterone,estra-diol,luteinizing hormone,follicle-stimulating hormone were measured.Statistical analysis were conducted by using SPSS 11.5 software.Results The fasting ghrelin levels of CGHD group were significantly lower than that of ISS group and control group(Pa0.05).The ghrelin levels were positive correlated with the stimulated GH peak(r=0.176 P0.05).Conclusion Ghrelin has an important role on GH secretion and abnormal secretion of ghrelin might be a reason of growth hormone deficiency which due to hypothalamic abnormality.

Child, Preschool ; Coronary Aneurysm ; etiology ; pathology ; Coronary Vessels ; pathology ; Female ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; pathology

Objective To investigate the effects of anxiety and depression on the quality of life (QOL) in patients with irritable bowel syndrome with diarrhea (IBS‐D) and the difference in gender .Methods IBS‐D patients met the Rome Ⅲ diagnostic and subtyping criteria were consecutively enrolled .The intestinal symptoms , psychological status , and QOL of patients were evaluated using IBS‐specific symptom questionnaires , the Hamilton anxiety scale (HAMA) ,the Hamilton depression scale (HAMD) ,and the Chinese Version of IBS‐QOL instrument .The data were analyzed by chi‐square test variance analysis ,t test or Spearman rank correlation analysis .Results A total of 155 IBS‐D patients were enrolled .Among them ,115 were complicated with anxiety and/or depression .The number of male and female with comorbid psychological disorders was 69 cases(71 .13% ) and 46 cases(79 .31% ) ,respectively ,and the difference was not statistically significant (χ2 = 1 .267 ,P= 0 .26) . Compared with 40 patients without anxiety or depression ,there was no statistically significant difference (F=1 .143 ,P> 0 .05) in the scores of intestinal symptoms in 59 patients with comorbid anxiety alone and 56 patients with anxiety and/or depression (20 .85 ± 5 .84 vs .21 .71 ± 7 .47 vs .22 .87 ± 6 .09) .The total IBS‐QOL score of the 155 patients was 71 .61 ± 19 .22 .There was negative correlation between IBS‐QOL score and HAMA , HAMD scores(r= -0 .262 and -0 .268 ,both P= 0 .001) .The total IBS‐QOL score of patients with comorbid anxiety and depression or depression were lower than that of patients without anxiety or depression (66 .05 ± 22 .88 vs 77 .22 ± 15 .35 , F = 4 .412 , P = 0 .005) .Except health worrying and sexual ,the scores in six dimensions(including dysphoria ,interference with activity ,body image ,food avoidance and social reaction) were all significantly decreased (F= 3 .309 ,3 .279 ,4 .177 ,3 .765 ,6 .041 and 3 .830 , P= 0 .013 ,0 .012 ,0 .013 , 0 .007 ,0 .001 and 0 .010) .In male patients ,the total score of IBS‐QOL and the scores of dysphoria ,body image and social reaction of patients with anxiety and depression or depression were lower than those of patients without anxiety and depression (t = 2 .143 ,2 .110 ,2 .279 ,3 .061 ; P = 0 .036 ,0 .039 ,0 .027 ,0 .003) .In female patients ,the score of food avoidance domain significantly decreased (t= 2 .812 ,P= 0 .008) .The scores of IBS‐QOL and six dimensions (including dysphoria ,interference with activity ,body image ,food avoidance and social reaction) of patients with history of severe mental disorders and being abused were even lower than those patients without such histories (t= 3 .241 ,3 .433 ,2 .499 ,2 .296 ,2 .514 ,3 .413 and 2 .601 ;P= 0 .001 ,0 .001 ,0 .014 , 0 .023 ,0 .013 ,0 .001 and 0 .010) .Conclusions The QOL of patients with IBS‐D was significantly affected by psychological factors with gender differences .The approaches to improve the psychological status of IBS patients were helpful to enhance the efficacy of comprehensive therapy .

·AIM: To determine the effect of amniotic membrane transplantation(AMT) on the disorders of ocular surface. ·METHODS: From May 2002 to July 2007, twenty patients (20 eyes), who had an previous experienced methods of sorts, including contact lens or tarsorrhaphy, underwent AMT. ·RESULTS: The disorders were healed after the first AMT in 10 eyes (50%) within an average of 20 days after surgery and recurred in 1 eye (10%).·CONCLUSION: AMT is helpful in the treatment of the disorders of ocular surface.

Objective To investigate the feasibility of evaluating the pancreatic fat deposition with ultrasound,and analyze the relationship of pancreatic fat deposition with the risk factors for diabetes.Methods Two hundred and ninety-four subjects were recruited in the diabetes epidemic survey of Shanghai Sixth Peoples' Hospital,Shanghai Jiaotong University from Oct 2015 to Jan 2016,including 111 diabetes mellitus (DM) cases,54 sugar metabolic abnormalities (IGR) cases,and 129 healthy cases as control group.The general data were collected.Biochemical indicators including ALT,AST and insulin in fasting blood samples were detected,and insulin resistance index (HOMA2-IR) and insulin secretion index (HOMA-IS) were calculated.The pancreatic fat deposition was evaluated by the ultrasound,and pancreas echoes were divided into three levels (1,2,3),by comparing with the echo of the rectus.The Chi-square test was used to analyze the pancreatic fat deposition rate,while the Logistic regression was used to figure out the diabetes high-risk factors influencing the pancreatic fat deposition.Results Forty-two subjects were found to have the pancreatic fat deposition in the healthy group (33.3％),of whom 19 cases,16 cases and 8 cases were categorized into level 1,2 and 3,respectively.Thirty subjects were found to have the pancreatic fat deposition in the IGR group (55.6％),of whom 14 cases,11 cases and 5 cases were categorized into level 1,2 and 3,respectively.Sixty-seven subjects were found to have the pancreatic fat deposition in the DM group (60.4％),of whom 37 cases,18 cases and 12 cases,were categorized into level 1,2,3,respectively.The pancreatic fat deposition rates of the 3 groups were statistically significantly different (P＜0.01).Multivariate Logistic regression analysis showed that body mass index (BMI),HOMA2-IR,high triglycerides (TG),and total cholesterol (TC) may be the-risk factors for the pancreatic fat deposition in IGR and T2DM patients.Conclusions The ultrasound evaluation on pancreatic fat deposition was feasible,and the pancreatic fat deposition was related to multiple high-risk factors for diabetes.

Objective To investigate the correlation between plasma homocysteine (Hcy) level and cerebral microbleeds (CMBs) band leukoaraiosis (LA) in patients with acute stroke.Methods The clinical and imaging data of patients with acute stroke were analyzed retrospectively.The numbers of CMBs were counted and the severity of LA was graded according to the results of MRI.Fasting venous samples were obtained and the plasma Hey concentration was measured the next day after admission.Results A total of 139 patients with acute stroke were enrolled,67 of them were females and 72 were males (mean age 70.1 ± 10.2 years); 24 had hemorrhagic stroke and 115 had ischemic stroke.The age (76.23 ± 8.74 years vs.64.58 ± 7.42 years;t =4.621,P =0.012) hypertension ratio (89.13％ vs.67.74％ ;x2 =8.324,P =0.0 370) and plasma Hey level (14.53 ± 4.31 mmol/L vs.11.31 ±3.16 mmol/L;t =6.538,P=0.008| in a severe LA group (n=46) were significantly higher than those in a non-severe LA group (n =93).Spearman correlation analysis showed that there was significant correlation between the plasma Hcy level and the severity of LA (rs =0.365,P =0.002).Multivariate logistic regression analysis showed that the increased Hey level (odds ratio [ OR ],1.366,95％confidence interval [ CI] 1.141 - 1.526; P =0.010) and age (OR 1.093,95％ CI 1.031 - 1.162; P =0.016)were the independent risk factors for severe LA.The age (74.37 ± 6.35 years vs.67.56 ± 8.52 years; t =6.628,P =0.038) and hypertension ratio (94.74％ vs.62.20％;x2 =8.773,P =0.002) in a CBM group were significantly higher than those in a non-CMB group (n =82).Spearman correlation analysis showed that there was no significant correlation between the plasma Hcy level and the numbers of CBMs (rs =0.038,P =0.813).Multivariate logistic regression analysis showed that hypertension was an independent risk factor for CBMs.Conclusions The elevated plasma Hcy level was associated with LA,but it was not associated with CBMs.