Objective To explore the effects of Seretide(50/250 μg)in the treatment of patients with stable moderate COPD.Methods Sixty-four patients in the stable period of moderate COPD were randomized into 2 groups,the test group and control group.The control group received routine treatment.The test group received the Seretide(50/250 μg)inhalation in addition to the routine treatment.During the 2-year observation,the pulmonary functions before and 12 and 24 months after treatment were recorded.The clinical symptoms,physical signs,the frequency of acute exacerbation of COPD and hospitaliztion duration were also graded.Results The difference of the parameters before and after the treatment was significant in the treatment group(P ＜0.01)but not in control group(P ＞0.05).The scores of symptoms and signs([2.1 ±0.4]vs.[4.4 ± 0.3],t =2.365),the frequency of acute exacerbation of COPD(29％ vs.47％,x2 =3.547)and hospitalization period ([5.0 ± 1.2]d vs.[10.0 ± 1.6]d,t =2.149)in the treatment group were significantly improved compared with control group after 24 months' treatment(all P ＜ 0.01).Conclusion Seretide(50/250 μg)is able to improve the lung function of the patients with stable moderate COPD and reduce the frequency of acute exacerbation,showing certain value in clinical practice.

Objective To investigate the correlation between bronchial provocation tests and the onset of the disease.Methods One hundred and seven patients who hospitalized in General Hospital of China Aviation from 2013-2014 were selected as our subjects.They all were with unexplained symptoms such as cough and asthma suppress.All the patients were performed bronchial provocation tests.In accordance with the onset time,patients were divided into acute (＜ 3 weeks),subacute (3-8 weeks) and chronic (＞ 8 weeks) groups.The positive rates of bronchial provocation test of three groups were compared.Results Of all 107 patients,36 patients were positive and 71 were negative in terms of bronchial provocation test.The cases with acute,subacute and chronic disease history were 16,36 and 55 respectively.The positive rate of bronchial provocation tests in different onset were 56.3％ (9/16),36.1％ (13/36),23.6％ (13/55) respectively,and there was statistics significant difference(x2 =6.275,P ＜ 0.05).The positive rate of bronchial provocation tests in acute group was higher than that in chronic group (x2 =6.165,P ＜ 0.05).There was positive correlation between the positive rate of bronchial provocation tests and the onset,and the correlation coefficient Pearson was 0.239 (P ＜0.05).Conclusion There is a correlation between the positive rate of bronchial provocation tests and the onset.We should strengthen the monitoring in patients with acute onset and follow-up.

When petiole segment,blade and cotyledon slice of Trichosanihes kililhai were cultured on MS medium with different growth regulators,callus and adventitious root were induced easily but with difficulty for adventitious bud. Yet adventitious bud can be induced when whole small blade,large blade segment and adventitious root tip were cultivated on MS medium with 0. 5mg/L of 6~13 A and propagated extensively whentransplanted on new media for successive transfer culture. When adventitious root bud was cultivated on MS medium wth 0. 5mg/L of NAA and 0. 5mg/L of 6~ 13A,shoot appeared,which can be grown into plantlet though the survival rate was not very satisfactory when further transplanted. Effect of blade segment size and its slicing technique,on the differentiation of adventitious bud was discussed.

Objective:To analyze the clinical characteristics of patients with eosinophilic granulo-matosis with polyangiitis (EGPA) and improve the understanding of the disease.Methods:EGPA patients who fulfilled the 1990 American College of Rheumatology (ACR) classification criteria were recruited from Sun Yat-sen Memorial Hospital Sun Yat-sen University between December 2003 and April 2020. Their demographic characteristics, clinical manifestations, laboratory and auxiliary examinations were analyzed retrospectively. Mann-whitney U test and χ2 test were used for statistical analysis. Results:Among 52 EGPA patients, 34 (65.4%) were males and the median age at disease onset was 47(38-55) years. The median time from disease onset to diagnosis was 30(4-96) months. The most common initial symptoms were respiratory (61.5%) and nose/paranasal sinus (21.2%) involvement. The most common department for the first visit was respiratory medicine (53.8%), followed by rheumatology (11.5%). 44.2% EGPA patients were diagnosed by rheumatologists. The most common clinical manifestations were asthma (88.5%), nose/paranasal sinusitis (84.6%), pulmonary (76.9%) and nervous system (61.5%) in volvement. Eight(15.4%) patients were positive for antineutrophil cytoplasmic antibodies (ANCA). Patients with positive ANCA had lower incidence of asthma, but higher incidence of general symptoms especially arthralgia and renal involvement, elevated eosinophil count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Birmingham vasculitis activity score and vasculitis damage index than patients with negative ANCA (all P<0.05). 21.2%-34.6% EGPA patients had poor prognostic factors. Conclusion:Early diagnosis of EGPA is important. EGPA patients with positive ANCA may be more severe than patients with negative ANCA. The management should be a multi-disciplinary collaboration between rheumatologists and pulmonologists.

Objective To investigate the conversion rate of subtypes of amnestic mild cognitive impairment (aMCI) to Alzheimer' s disease (AD) and assess the contribution of neuropsychological disturbance in progression from MCI to AD over 2 years. Method Subjects from memory clinic of Huashan hospital including 130 of who met the operational criteria for Mayo Clinic defined aMCI by neuropsychological tests covering global cognitive function, executive function, memory function, language function and visual spatial skills. They underwent multidimensional assessment and a neuropsychological battery at baseline and at follow-up, after about 2 years. Diagnosis for dementia was based on National Institute of Neurological and Communicative Disorders and Stroke; Alzheimer' s Disease and Related Disorders Association (NINCDS-ADRDA) criteria. Results Forty-four cases of 130 (33. 8% ) elder people with aMCI converted to probable AD with 17 aMCI-s and 27 aMCI-m subjects within an average 23.8 (6. 8 ) months. There was significant difference between the reversion rate of aMCI-s and aMCI-m (26. 2% vs 42. 9%, x2 = 3.957,P = 0. 047). Moreover, as the disease progressing,the two groups declined similarly in memory and executive function while in the aMCI-s group, the function of spatial structure relatively reserved in aMCI-s but function of language and attention diminished faster, and in the aMCI-m group, the ability of spatial structure declined even more significantly. Conclusion The aMCI-m is more likely to progress to AD than aMCI-s and it' s necessary to divide aMCI into aMCI-s and aMCI-m to help determine prognosis.

Objective To investigate the criteria for assessing the clinical therapeutic effect of chronic urticaria in China.Methods The application of criteria for assessing the clinical therapeutic effect of chronic urticaria in China and their applicable scope were analyzed by frequency analysis and K-means clustering analysis, respectively.Results The criteria for assessing symptoms and therapeutic effect were different in the 857 papers included in this study. SSRI was used in 549 (64.17) out of the 857 papers included in this study.K-means clustering analysis showed that the applicable scope of SSRI with curative rate ( 100%≥SSRI>90%) , improvement rate ( 90%≥SSR<60%) , Significant effect rate (60%≥SSRI>20%) , and no response rate (20%≥SSR≥0%) as its criteria was wider than that of frequency analysis.Conclusion The criteria for the clinical assessment of chronic urticaria and its drug treatment effect should be unified and standardized.

Objective To study the effect of story inquiry in the care to patients undergoing laparoscopic cholecystectomy. Methods Toally 39 patients to undergo laparoscopic cholecystectomy during January to April 2017 were set as control group and another 39 patients to to undergo laparoscopic cholecystectomy during May to August 2017 were set as treatment group. The former received routine nursing care and the latter was treated with the story inquiry including five stages of preparation,story sharing,dialogue inquiry,situational association and comfort making,apart from routine nursing care.The two groups were compared in terms of anxiety, depression and sleep quality. Result The scores of depression and anxiety and sleep quality after laparoscopic cholecystectomy in the experimental group were significantly lower than those in the control group (P＜0.001). Conclusion The effect of emotional comfort and sleep quality improvement can be improved by using the method of story inquiry for the patients undergoing laparoscopic cholecystectomy.

ObjectivesTo examine the validity of high-frequency Doppler ultrasound in identifying knees synovitis in patients with rheumatoid arthritis(RA).MethodsNinety-five consecutive patients with active RA were examined withhigh-frequency Doppler ultrasound to examine synovitis signals in knees.Synovial tissue samples of 51 patients were obtained by closed needle biopsy from knees after ultrasound examination.Serial synovial tissue sections were stained with H&E and immunohistochemical staining,and the histopathological synovitis scores were evaluated.The relationship among clinical, histopathological and ultrasound synovitis indexes was analyzed by Spearman's rank order correlation test and receiver operating characteristic curve analysis.ResultsAmong 95 RA patients,the median thickness of synovial membrane in ultrasound was 2.8 mm,the median depth of effusion was 2.7 mm; Doppler signals of synovial blood flow were detected in 82％(78/95 ) of patients and the median semiquantitive grading of synovial blood flow was 1.0.The thickness of synovial membrane and synovial blood flow at Doppler ultrasound correlated positively with histological synovitis score,hyperplasia of the lining layer,and inflammatory infiltration in sublining area (the thickness of synovial membrane:r=0.438,0.424,0.368,respectively; synovial blood flow:r=0.357,0.377,0.347,respectively; all P＜0.05).Although there was no significant difference in clinical synovitis indexes between patients with histologically low-grade and high-grade synovitis,the thickness of synovial membrane and synovial blood flow in ultrasound in patients with histologically high-grade synovitis was significantly higher than those with low-grade synovitis(P=0.001,0.036,respectively).When the thickness of synovial membrane in ultrasound was ≥ 3.9 mm,the specificity of diagnosing the high-grade synovitis was 96.7％ and the sensitivity was 61.9％.ConclusionSynovitis signals at high-frequency Doppler ultrasound correlate with histopathological synovitis,and it might be helpful in evaluating the severity of histopathological synovitis.

Objective:To explore the application of endoscopic narrow-band imaging(NBI) in the early diagnosis of throat malignant tumors.Methods:From January 2014 to December 2019, 512 patients with suspected benign or malignant diseases of the throat in the First People's Hospital of Wenling were selected, and all patients were performed white light endoscopy and NBI endoscopy.The biopsies were taken for pathological examination.The histopathological results were seemed as gold standard for diagnosis.Results:NBI endoscopy was superior to white light endoscope in terms of microvascular morphology and lesion outline(χ 2=457.497, 293.209, all P<0.05). The diagnostic coincidence rate, sensitivity and negative coincidence rate of NBI endoscope for malignant tumors were higher than those of white light endoscope(χ 2=10.131, 6.197, 4.084, all P<0.05). The sensitivity of NBI endoscope type Ⅰ-Ⅱ in the diagnosis of benign lesions was 90.65%, and the specificity was 96.88%.The sensitivity and specificity of NBI endoscope type Ⅲ-Ⅳ in the diagnosis of mild-moderate dysplasia were 80.99% and 97.52%, respectively.The sensitivity and specificity of NBI endoscopy type Va in the diagnosis of severe atypical hyperplasia were 15.18% and 98.54%, respectively.The sensitivity and specificity of NBI endoscope Va-c in the diagnosis of invasive cancer were 93.24% and 96.93%, respectively. Conclusion:Compared with white light endoscope, NBI endoscope can more clearly show the outline of lesions and submucosal blood vessels, and can more accurately diagnose malignant tumors in the throat, especially can more recognized the pre-cancerous lesions and early malignant tumors.It has important clinical application value in early diagnosis of malignant tumor in the throat.

Objective To investigate clinical characteristics and renal uric acid excretion in early-onset gout patients.Methods Consecutive inpatients with primary gout were recruited between 2013 and 2017.The patients with gout onset younger than 30 were defined as early-onset group while the others were enrolled as control group.Clinical characteristics and uric acid (UA) indicators were compared between two groups.Results Among 202 recruited patients,the early-onset group included 36 patients (17.8％).Compared with control group,the early-onset group presented more patients with obesity [13 patients (36.1％) vs.22 patients (13.3％),P＜0.05],significantly higher serum UA level [(634± 124)μmol/L vs.(527± 169).μmol/L] and glomerular load of UA[(7.2±2.8)mg· min-1 · 1.73m-2 vs.(4.4±2.2)mg· min-1 · 1.73m-2] and estimated glomerular filtration rate (GFR) [(83±21)ml· min-1 · 1.73m-2 vs.(67±21)ml· min-1 · 1.73m-2] (all P＜ 0.05),lower fractional excretion of UA [4.4％ (3.4％,6.1％) vs.7.2％ (5.2％,9.6％),P＜0.05],whereas 24h urinary UA excretion was comparable [(2 788±882)l,μmol/1.73m2 vs.(2 645±1 140)μmol/1.73m2,P=0.274].Subgroup analysis of patients without chronic kidney disease showed significantly lower fractional excretion of UA in the early-onset group [4.5％(3.3％,6.1％) vs.6.7％ (5.1％,8.7％),P＜0.05].Logistic regression analysis showed that obesity (OR=3.25) and fractional excretion of UA less than 7％ (OR=9.01,all P＜0.05) were risk factors of gout early onset.Conclusion The gout patients with early-onset younger than 30 present high serum and glomerular load of uric acid which might be due to obesity and relative under-excretion of renal uric acid.