Objective To improve the method of bedside blind placement of bengmark nasointestinal tube, and evaluate its application effect in severe acute pancreatitis (SAP) patients. Methods Combined with clinical practice experience, the "four-point testing method" "four-point auscultation method" and "gently shaking method" were applied to the traditional blind placement, so as to form a standard, operative and highly-qualified blind placement method of the blind placement of the bengmark nasointestinal tube. A total of 50 SAP patients hospitalized in the Gastroenterology Department of Xinqiao Hospital Affiliated to Army Medical University from November 1st, 2016 to March 31st, 2018 were recruited to evaluate the catheterization success rate of the new catheterization method, time-consuming of catheterization, vital signs, catheter-related complications, patient satisfaction, and other indicators. Results The success rate of bedside blind placement of bengmark nasointestinal tube in 50 patients with SAP was 96% (48/50). The median catheterization time was 22.8 (minimum 10 to longest 60) min. There was no statistical significance in the differences of blood pressure, heart rate, respiration, and oxyhemoglobin saturation before and after catheterization (P＞ 0.05). No arrhythmia, bleeding, perforation, misplaced airways, and other related complications occurred. The satisfaction degree of catheterization was 100% (50/50). Conclusions The improved bedside blind placement of bengmark nasointestinal tube has the advantages of strong operability, easy to learn and use, and at the same time has good results in the preliminary application of SAP patients. It can be used in further randomized controlled trials with higher intensity of demonstration and can be used in severe patients.

Objective:To investigate the risk factors, severity of symptoms, acute exacerbations, and pulmonary function in women with chronic obstructive pulmonary disease (COPD).Methods:A total of 4 204 COPD patients, including 533 female COPD patients and 3 671 male COPD patients, were investigated from January 2017 to December 2019 in Second Xiangya Hospital of Central South University, Hunan Prevention and Treatment Institute for Occupational Disease, affiliated Hospital of Guilin Medical College and Guilin Second People's hospital. The risk factors, severity of symptoms, risk of acute exacerbation and clinical characteristics of pulmonary function in patients with COPD were comprehensively analyzed.Results:There was no statistical difference in age between male and female COPD patients ( P>0.05). There were statistically significant differences in smoking history, occupational exposure history and biofuel exposure history ( P<0.001), among which smoking history and occupational exposure history were significantly higher in males than in females ( P<0.001), and exposure history of biofuels was significantly higher in females than in males ( P<0.001). The COPD assessment test (CAT) score of male and female patients was statistically different ( P<0.05), and the mean CAT score of female patients was higher than that of male patients. The modified medical research council dyspnea scale (mMRC) grading results of male and female patients were statistically different ( P<0.05), and the mMRC grading of female patients was higher than that of male patients. There was no statistical difference in the risk of acute exacerbation between male and female patients ( P>0.05). There were statistically significant differences between male and female patients in first second exertional volume as a percentage of predicted value (FEV 1%) and forced expiratory volume in one second/forced vital capacity (FEV 1/FVC) mean value ( P<0.001), and FEV 1% predicted value and FEV 1/FVC of female patients were better than that of male patients. Conclusions:The risk factors, symptom severity and pulmonary function of female patients with COPD are different from those of male patients, providing reference for the individualized treatment of female patients with COPD.

Objective:To observe the clinical characteristics and guideline compliance of chronic obstructive pulmonary disease (COPD) patients with initial triple therapy in real-life world.Methods:This study is a cross-sectional study. The subjects of the study were COPD patients admitted to 13 hospitals in Hunan Province and Guangxi Zhuang Autonomous Region from December 2016 to December 2021. The initial treatment was triple inhaled drugs. The data collected included gender, age, diagnosis, body mass index (BMI), history of acute exacerbation (AE) in the past year, pulmonary function, COPD Assessment Test (CAT) score, modified British Medical Research Council Dyspnea Questionnaire (mMRC), inhaled drugs and other indicators. The characteristics and differences of COPD patients before and after 2020 were analyzed.Results:7 184 patients with COPD were enrolled in this study, including 2 409 COPD patients treated with initial triple therapy, accounting for 33.5%(2 409/7 184). Taking January 1st, 2020 as the cut-off point, 1 825 COPD patients (75.8%) received initial treatment with triple inhaled drugs before 2020 and 584 patients (24.2%) after 2020 were included in this study. Compared with COPD patients before 2020, the COPD patients after 2020 had higher FEV 1% [(40.9±15.5 )% vs (39.3±15.5)%, P=0.040], lower CAT [(15.8±6.5)point vs (17.5±6.2)point, P<0.001], less AE in the past year [1(0, 2)times vs 1(0, 2)times, P=0.001] and higher rate of non-AE [255(43.7%) vs 581(37.1%), P=0.006]. In addition, before 2020, patients with COPD were mainly treated with open triple drugs (1 825/1 825, 100%); after 2020, 306 patients (52.4%) received open triple inhaled drugs, and 278 patients (47.6%) received closed triple inhaled drugs. Conclusions:In real-life world, most of patients with COPD treated with triple therapy have severe lung function, obvious symptoms and high risk of acute exacerbation. The real-world prescribing of triple therapy in patients with COPD does not always reflect recommendations in guidelines and strategies, and overtreatment is common. After 2020, prescribing triple therapy for COPD patients is more positive and worse consistency with guideline.