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 investiGate the distribution of clinical infectious pathoGens and druG resistance status of common bacteria in the Ninth Peopleˊs Hospital Affiliated to medicine School of ShanGhai Jiao TonG University in 20l2. Methods Clinical isolated bacterial strains were collected from the Ninth Peopleˊs Hospital Affiliated to medicine School of ShanGhai Jiao TonG University durinG 20l2. The identification of bacteria and antimicrobial susceptibility were determined by VITEK 2 COMPACT automatic microbioloGy analyzer. The data were analyzed by WHONET 5. 4 software. Results A total of 3456 pathoGenic strains were collected. Of them,Gram positive cocci,Gram neGative bacilli and funGus accounted for 20. 3%,76. 8% and 2. 9% respectively. Methicillin resistant strains in S. aureus( MRSA ) and coaGulase neGative Staphylococcus ( MRCNS)accounted for averaGe of 44. 4% and 85. 5% respectively. No vancomycin and linezolid resistant strains were found. Extended spectrumβ-lactamases strains accounted for 66. 4% and 30. 6% in Escherichia coli ( E. coli)and Klebsiella spp respectively. Strains of E. coli and Klebsiella spp were still hiGhly susceptible to imipenem. Resistance rates of P. aeruGinosa and A. baumannii sppstrains to imipenem were 8. 3% and 58. 4%respectively. Conclusion The major clinical pathoGenic microorGanisms in the Ninth Peopleˊs Hospital Affiliated to medicine School of ShanGhai Jiao TonG University are still Gram neGative bacilli. Baterial resistance is serious. It is important to strenGthen the detection of resistant bacteria in routine work,which is useful for rational use of antimicrobial aGents.

Objective To analyze the basics and influencing factors for the medical expenditure of poor patients of tumor and end-stage renal diseases in Hubei province,and put forward policy recommendations for the critical illness insurance and health poverty alleviation.Methods 535 patients with tumor and end-stage renal diseases in Wuhan,Xiangyan and Shiyan in Hubei province were selected for a questionnaire survey,with 415 of the questionnaires subject to data analysis.Single factor variance analysis and multiple linear regression were used to analyze the influencing factors for their medical expenditure.Results 83.9% of the patients held their medical costs as too high;84.6% of them complaining significant drop of their annual family income due to their diseases; disposable household income of urban patients higher than their rural counterparts both before and after their disease; types of medical insurance and diseases are significant influencing factors for medical expenditure.Conclusions Poverty rate is high among patients of such patients.To reduce their financial burden,the government is recommended to cover more major diseases,enhance support for those of critical illness and improve the medical assistance system.

Objective To explore the relationship of delivery of parenteral fat emulsion and lipid peroxidation,and to observe the safety and effectiveness of parenteral nutrition(PN)in infants with very low birth weight(VLBWI).Methods Thirty infants with VLBWI were randomly divided into 3 groups:the preterm infants received pareneral nutrition containing amino acids and dextrose and soluvit,while intralipid provided separately,intralipid were light exposed(group A,n=10)or light protected(group B,n=10).In group C(n=10),soluvit and vitlipid were co-administered with intralipid and light protected.All the prematures received PN for 7 days and 10 cases of VLBWI not recei-ving PN were collected as control group.Anti-oxidation level,ascorbate,blood glucose,oxygen saturation,serum biochemistry index and body weight were determined before and after experiment.Results Seven days after PN,the MDA concentrations in the test groups all increased(⊿dA was the most,⊿dB was the next,⊿dC was the least).For superoxidedimutuse(SOD)reduction concentrations,⊿dA decreased sharply,then was ⊿dB,⊿dc decreased little,The blood Vit C increase in group B and C were more than group A.Significant changes of MDA,SOD and Vit C existed among the group B,C and A.In the 3 test groups,bilirubin,albumin,prealbumin concentrations were higher after the experiment,but there were no significant changes compared with control group.No significant changes in blood biochemistry,oxygen saturations were found before and after the observation in every group.Conclusions Multivitamin preparations protect fat emulsion against light-induced formation of lipid hydroperoxides,and administering multivitamins with fat emulsion via dark delivery tubing provide a practical way of preventing peroxidation of the lipid while limiting vitamin loss.Furthermore,it is relatively safe to apply fat emulsion intravenously with suitable dose and infusion rate for a few days to VLBWI from the second day of birth who require partial parenteral nutrition.

Objective To analyze the importance of procalcitonin (PCT) and high-sensitivity Creactive protein (hsCRP) in assessing the severity of pneumonia and sepsis patients as well as prognostic evaluation.Methods A total of 77 patients with pneumonia complicated with sepsis were randomly (random number) selected from May 2013 to May 2016 in our hospital and 50 patients with simple pneumonia were enrolled as control group.The sepsis pneumonia patients were divided into three groups,namely sepsis group,severe sepsis group and septic shock group.The sepsis patient were further divided into survival group and death group according to the death of patient within 2 weeks.Statistics was employed to study the roles of PCT and hsCRP in evaluating the severity of pneumonia and sepsis patients as well as prognostic evaluation.Results Compared with control group,the levels of PCT and hsCRP were higher in patients of sepsis groups (P ＜ 0.05).The levels of PCT and hsCRP were gradually increased as the severity of the patient getting worse (P ＜ 0.05).The levels of PCT and hsCRP in the death group were higher than those in the survival group.The areas under ROC curve of PCT and hsCRP for diagnosis of sepsis and septic shock as the optimal cut-off point at ≥ 2 ng/mL and at ≥ 75 mg/L,had the sensitivity of 62.1％ and 81.2％,respectively,and the specificity of 89.2％ and 68.2％,respectively.Conclution PCT and hs CRP levels have a certain value in assessing the severity of pneumonia and sepsis patients as well as prognostic evaluation.

Objective To explore the methods for coverage of the defect of great toe after the wrap-a- round flap transferand decrease the morbidity of donor site in great toes.Methods Twenty-five patients received three kinds of procedure for immediate resurfacing of donor defect of the great toes during wrap-around flap transferAmong them9 cases received the free flaps for coverage of defect in donor great toes12 cases was repaired by local pedieled dorsal or plamarpedis flapsand the other cases were treated by the nail-flap of second toe.Results All the flaps were survivalTwo patients received the flap thinning procedure in 6 months laterall patients were satisfied with cosmetic and functional outcomeThe appearance and sensory function of donor toe repaired by second toe nail-flap was best among three methods.Conclusion Accord- ing the detect situation of great toesthree kinds of flap were selected for immediate coverage of donor site, which can decrease the complication of donor great toe at the most.

Objective To investigate the pregnancy outcomes of couples with either maternal or paternal balanced translocations.Methods One hundred and ninety-four couples were divided into three groups based on the kind of translocations:135 with reciprocal translocation,52 with nonhomologous Robertsonian translocations,and 7 with homologous Robertsonian translocations.Past reproductive histories were surveyed.For those who wanted to have their own babies by natural conceptions after knowing their karyotypes as well as the risks of abnormal offsprings,subsequent pregnancy outcomes were recorded.Total pregnancy outcomes were compared between three groups.Results(1)503 previous and subsequent pregnancies were recorded in detail.The pregnancy outcomes are as follows:spontaneous abortions 81.7% (411/503);induced terminations because of fetal abnormalities 3.2%(16/503);birth defects 7.2% (36/503);normal/balanced offsprings 8.0%(40/503).In reciprocal translocations,nonhomologous Robertsonian translocations and homologous Robertsonian translocations,the birth defects rates were 5.7% (20/350),10.9%(14/128)and 8.0%(2/25),respectively(P

Objective To investigate the changes of protein kinase C(PKC)activity in peripheral blood T lymphocytes in children with chronic idiopathic thrombocytopenic purpura(CITP)and the relationship between PKC activity,T lymphocytes activation and thrombocytes decrease.Methods Collecting sterile peripheral blood from CITP children(n=30)and healthy children(n=30),T lymphocytes were isolated and purified by the T cell segregation enrichment column,the PKC activity was detected by non-radioactive assay.Soluble interleukin-2 receptor(sIL-2R),which was T cell activated marker,was determined by enzyme-linked immunoabsorbent assay(ELISA),platelet was counted by cell counting meter.Results Compared with healthy children,PKC activity was significantly enhanced in CITP children[(0.94?0.23)mmol/(min?L)vs(0.50?0.17)mmol/(min?L),t= 8.42 P

AIM: To analyze the genotype of the allele distribution of a polymorphic G-954C within the 5 upstream promoter region of the nitric oxide synthetase 2A gene (NOS2A) in samples of diabetic retinopathy in patients with cystoid macular edema in the mainland of China.METHODS: Eighty-nine patients with diabetic retinopathy and cystoid macular edema and 90 healthy controls were enrolled in this study. Nest polymerase chain reaction (PCR)was performed, and restriction endonudease digestion and gene fragments sequence were examined to detect the genotype of NOS24 G-954C.RESULTS: The genotypes of the sample population of 89 cases and 90 healthy controls were all detected as GG.CONCLUSION: The distribution of G-954C of NOS2A polymorphism are at a lower frequency in China, with little relevancy to the frequency of diabetic retinopathy combined with cystoid macular edema.

Objective To study the protective effect of chlorogenic acid(CGA)on the apoptosis of PC12 cells induced byβ-amyloid protein23-35(Aβ25-35)and its mechanism. Methods The cells model of death was estab-lished by Aβ25-35 (20 μmol/L)-induced PC12 cells. The cells were interfered with 5 different concentrations of CGA. CCK-8 assay was used to detect cells viability to determine the 3 concentrations of CGA in future experi-ments. The cells were divided randomly into control group ,model group and interference groups with 3 different concentrations of CGA. Cells apoptosis rates were detected by flow cytometry;colorimetry method was used to detect MDA,SOD and GSH-Px. The mitochondrial membrane potential(MMP)was detected by fluorescent staining and the expression of caspase-3 by western blot. Results Compared with model group,the cells viability of CGA groups were increased but the apoptosis rates were reduced;the activity of SOD and GSH-Px were increased but the level of MDA,MMP and caspase-3 were decreased(P<0.05). Conclusions CGA has a protective effect on Aβ25-35-induced PC12 cells apoptosis and it may be related to the improvement of cellular antioxidation capacity and mitochondrial damage.