Objective To investigate the effect of respiratory muscle training on quality of life and pulmonary function of patients with chronic obstructive pulmonary disease during remission stage.Methods 110 patients with chronic obstructive pulmonary disease in remission stage were chosen.They were instructed by the specialist nurses for training of respiratory muscle function.The respiratory rate,heart rate,FEV1％,FEV1/FVC,vital capacity,maximum voluntary ventilation,time ventilation and partial pressure of oxygen before and after exercise were recorded.The quality of life rating scale was completed by the medical staff and patients.Results By the respiratory muscle training,the patient′s breathing rate and heart rate had declined compared with before exercise.The respiratory function had got effective improvement.The quality of life improved significantly.There were significant differences before and after the training.Conclusions Respiratory muscle training can improve the quality of life and lung function in patients with chronic obstructive pulmonary disease in remission stage,which is worthy of wide promotion.

Objective To invesitgate the relationship between 8-iseprostane (8-iso-PG) level in exhaled breath condensates (EBCs) and severity of asthma and explore the role of 8-iso-PG in asthma evaluation and monitoring.Methods Fifty-nine patients with asthma were enrolled.In which 15 eases were acute exacerbation, 13 eases were mild intermittent, 15 eases were mild persistent, and 16 eases were mederate-to-severe persistent.Thirteen healthy volunteers were recruited as control.EBCs were collected using EeoSereen system.The 8-iso-PG levels in EBCs were measured by a specific enzyme immunoassay.The patients with mild intermittent asthma were treated with inhaled corticosteroid (ICS) for one month and their EBCs were recollected for 8-iso-PG measurement.Results Exhaled 8-iso-PG levels were obviously increased in the patients with acute asthma compared with those chronic asthmatics [(47.2±6.8) pg/mL vs (24.5±12.0) pg/mL, P < 0.01].In the chronic persistent asthma, the levels were significantly higher in patients with mild persistent and moderate-to-severe asthma [(17.9±1.2) pg/mL and (39.7±4.0) pg/mL, P <0.01].While 8-iso-PG level did not differ significantly in intermittent asthma [(13.5±1.1) pg/mL] compared with the control subjects (P > 0.05).After one-month ICS treatment the 8-iso-PG level in the patients with mild intermittent asthma did not change significantly although the ACT score improved.Conclusions 8-iso-PG levels in EBC are associated with the severity of asthma,implicating 8-iso-PG may be useful in monitoring airway oxidative stress in asthma.ICS treatment is incapable of decreasing the 8-iso-PG,suggesting the ICS has minor impact on oxidative stress.

Objective To systematically evaluate the effects of lidocaine on female patients during urinary catheterization.Methods A literature search was conducted in following databases as the Cochrane Library,EMbase,PubMed,CBM,CNKI,VIP,and Wanfang data.All included RCTs were screened and assessed according to the standard of Cochrane systematic review.The data were analyzed by RevMan 5.0 software.Results A total of 11 RCTs were included,involving 737 patients in the experimental group,666 patients in the control group.The results of Meta-analysis showed that there were significant differences between the two groups in the pain caused by intubation,one-time success rate of intubation,and agitation rate in anesthesia recovery period.Conclusions Using lidocaine for female patients before catheterization may reduce the pain,increase the one-time success rate of intubation,and reduce agitation rate in anesthesia recovery period.The results still need to be confirmed by more high-quality and large-sample RCTs.

Objective To measure the dynamic and static frictional resistances between different self-ligating orthodontic brackets and different combination of tandem archwires.Methods On standard model the upper right quadrant Damon Q self-ligating brackets was pasted as team A,3M Smart clip self-ligating brackets as team B and Forestadent Quick 3.0 self-ligating brackets as team C respectively.Nickel-titanium archwires of 0.012 inch and 0.016 inch and two nickel-titanium archwires of 0.014 inch were applied to simulate sliding in the brackets and measure the friction changes in brackets and archwires,so as to explore the frictional resistance between different combination of the tandem archwires and different self-ligating brackets.Results When using the combination of two 0.014-inch nickel-titanium tandem archwires,the static frictional resistances was significantly different (P＜ 0.05):team A ＜team B ＜team C while the kinetic frictional resistance was also significantly different (P＜0.05):team A ＜team B ＜team C,When using the combination of 0.012-inch and 0.016-inch nickel-titanium tandem archwires,the static frictional resistances was significantly different (P＜0.05):team A＜team B＜team C,while the kinetic frictional resistance was also significantly different (P＜0.05):team A＜team B＜team C.Gonclusion There are different frictional resistance in different kind of self-ligating brackets and different combination of the tandem archwires.The combination of two 0.014-inch nickel-titanium tandem archwire applied to Forestadent Quick 3.0 self-ligating brackets has the biggest frictional resistance while the combination of 0.012-inch and 0.016-inch nickel-titanium tandem archwire applied to the Damon Q self-ligating brackets has the lowest frictional resistance,which enables the teeth to move at the fastest speed and facilitates the following use of the edgewires.

Objective To evaluate the expression of human vascular endothelial cell growth factors 165 (hVEGF165) gene transfected into fibroblasts by recombinant adenovirus and study the repairing effect of this cells on radiated skin ulcer in rats.Methods The recombinant adenovirus with hVEGF165 was established and transfected to rat primary fibroblasts, and its expression of hVEGF165 in fibroblasts was identified with real-time PCR, immunocytochemistry and Western blot.Twenty four clean grade SD rats of were irradiated locally with 50 Gy γ rays to generate an animal model of radiation skin injury.The hVEGF165-transfected cells were injected to the irradiated site under rat skin 7 d post-irradiation.The therapeutic effects on the irradiated skin wound were evaluated through general observation as well as histological staining of HE.The expression of hVEGF in the irradiated skin tissue with fibroblasts injection was analyzed by Real-time PCR.Results The hVEGF165 gene was overexpressed in the transfected cells and approached to 88 373-fold bigger compared to controls transfected with blank vectors, and an extensive expression of VEGF in the cytoplasm of transfected cells was observed by immunohistochemistry.VEGF protein with the relative molecular mass of 23 000 was also detected in cell lysate by Western blot.The local skin ulcers in rats occurred about two weeks after irradiation.In the hVEGF165-transfected group, the average area of radiation-injured skin was 40.2 mm2, about 57％ less than that of the control group transfected with blank vectors so that the healing time was shorten by 6 days.The relative concentration of hVEGF mRNA in the skin tissue of rats injected with hVEGF165-transfected cells were 5.15-fold and 4.15-fold bigger compared to that of controls (t =3.385,3.220, P ＜ 0.05) at 3 and 7 d after administration.Conclusions The primary fibroblasts transfected with hVEGF165 gene could efficiently release VEGF to the irradiated skin tissue and promote the recovery of irradiation skin ulcers by shortening the healing time and thus enhanced the therapeutic effect on skin wounds.

Objective To investigate the association between polymorphisms of thyroid-stimulating hormone receptor(TSHR)gene intron 1(rs179247, rs12101261)and Graves′ disease(GD)in the China Han population from Xuzhou city, Jiangsu Province. Methods Total 1 066 GD patients and 1 107 control subjects were recruited for genotyping by Taqman probe technique on Fluidigm EP1 platform. Meanwhile, serum concentrations of thyroid hormone and TSH receptor antibodies(TRAb)were determined. Results The rs179247_A, rs12101261_T were significantly associated with GD risk(OR=1.35, 95%CI 1.19-1.54, P=5.92×10-6; OR=1.32, 95%CI 1.16-1.50, P=2.22×10-5). Logistic regression identified that rs179247 was an independent susceptibility locus of GD. Serum TRAb concentration showed a significant difference(P=0.015)among rs179247_AA, AG, and GG genotypes. Conclusion rs179247 and rs12101261 in TSHR intron 1 are both associated with GD, and rs179247 may contribute risk to GD independently. The polymorphism is associated with TRAb, but not with serum concentration of thyroid hormones, age of onset, diffused thyroid goiter, ophthalmic signs, and relapse.

Objective To compare endovenous laser therapy (EVLT) with endovenous microwave coagulation (EMC) in the treatment of varicose vein in the lower extremities. Methods Sixty-five (male 30, female 35) patients with 70 lower extremities (35 legs in each treatment group) were pair matched according to age, gender and CEAP classification to receive endovenous laser therapy (EVLT) or endovenous microwave coagulation (EMC). The same surgeon performed all procedures. Patients were monitored on 72 hours, 4 weeks and 6 months after the procedure (by procedural site scored for bruising, skin burn, painful induration or trabes as well as a pain score), the cured extremities were examined via Duplex uhrasonography to evaluate the effects of the procedure. Results All these 65 patients (mean age, 47.52 years) completed treatment and were followed-up. The mean operation time of EMC group was less than that of EVLT (71±25 vs. 59±15, P=0.01). At 72 hour after the procedure, bruising scores and skin buring were significantly different (P<0.05): patients in the EMC group showed less bruising (17.14% vs. 54.29%) but more burn (48.57% vs. 20%) on the procedure site than the patients in the EVLT group. At 4 weeks and 6 months after the procedure, no significant differences were found between patient outcomes, physical conditions, and symptoms and or possible adverse events. In 20/28 patients the pigmentation faded away, Edema were relieved in all the 25 extremities. 4 patients with ankle ulcer were healed. No major complications were found. Conclusions Both EMC and EVLT were effective in treating lower extremities varicose veins, with no major complications.

Objective To explore the relationship between the clinical features,serological markers and European League Against Rheumatism SS Disease Activity Index (ESSDAI) scores of primary Sj(o)gren's syndrome (SS).Methods We enrolled 106 patients,who fulfilled the 2002 classification criteria for primary SS from December 2008 to January 2015,to evaluate the relationship among the clinical characteristics,laboratory features,serological variables and ESSDAI scores.According to serological variables,the prognosis was subdivided into three distinct groups:favourable (no serological markers),intermediate (one serological marker) and poor (two or more serological markers).These data were analyzed by Chi-square test and variance analysis.Results The mean ESSDAI score of 106 pSS patients was (11±7).ESSDAI score was categorized according to the EULAR-SS recommendations as low activity,moderate activity and high activity (scores of 0-4,5-13 and ≥14,respectively),and the positive rate of antinuclear antibody (ANA) 1:100 (6 cases,37.5％;37 cases,66.1％;32 cases,94.1％) in three different ESSDAI levels was statistically different (x2＝18.110,P＜0.01).Those with positive ANA 1:100[positive (13±7) and negative (7±4)],anti-SSA antibody postive (12±7) and negative (9±7),anti-RNP antibody (positive 16±9 and negative 10±6) had higher ESSDAI scores than those with negative ones (F=8.812,P=0.0001;F=3.862,P=0.024;F=5.786,P=0.004).No statistical difference in ESSDAI means were found between patients with positive anti-SSB antibody,rheumatoid factor (RF),FS level,dry mouth,Raynoud's phenomenon and psychosomatic diseases.The ESSDAI scores of favourable group,intermediate group and poor group were significantly different (8±5,10±7,14±7,F=8.715,P=0.000 1).In comparison with the other two groups,the poor pSS patients had a higher frequency of positive ANA 1:100 (15 cases,55.6％;20 cases,57.1％;40 cases,90.9％),anti-SSA antibody(11 cases,0.7％;23 cases,41.1％;36 cases,81.8％),anti-SSB antibody (6 cases,2 2.2％;13 cases,37.1％;23 cases,52.3％),anti-RNP antibody (0 case,0;2 cases,5.7％;9 cases,20.5％) (x2=17.408,P=0.002;x2=14.306,P=0.006;x2=12.330,P=0.015;x2=1 1.482,P=0.022).Conclusion Patients with two or more serological markers may have higher ESSDAI score,and which in turn may associate with poor prognosis.

BACKGROUND:It is important to prepare a mal eable putty to repair irregular bone defects because the preformed bone substitute material cannot suit to bone defects.
OBJECTIVE:To prepare mal eable demineralized bone matrix/hyaluronic acid putty and to screen out the optimal composite ratio, as wel as to evaluate its cellcompatibility.
METHODS:Demineralized bone matrix was prepared from the cortical bone of healthy donors. The hyaluronic acid was dissolved at concentrations of 0.75%, 1.5%, 3%, 4.5%, and the viscosity of them was measured. Then 450 mg demineralized bone matrix was compounded with 1 mL hyaluronic acid solution to prepare the demineralized bone matrix/hyaluronic acid putty, and the optimal ratio of demineralized bone matrix/hyaluronic acid was screened by the disintegrated time of the putty at 37 ℃. L-929 mouse fibroblasts were cultured in the leaching liquor of demineralized bone matrix/hyaluronic acid, and the cytotoxicity was tested by cellcount kit-8 assay at days 1, 4 and 7.
RESULTS AND CONCLUSION:With the increase of hyaluronic acid concentration, the viscosity of hyaluronic acid solution was increased;the demineralized bone matrix/hyaluronic acid putty was strengthened and the disintegrated time was prolonged gradual y. When the ratio of demineralized bone matrix/hyaluronic acid was 15/1, demineralized bone matrix/hyaluronic acid was molded easily, and the disintegrated time was 8 hours in 7 ℃ PBS. The results of cytotoxicity showed that cellproliferation rates were 93.72%, 101.65%and 97.68%at days 1, 4 and 7 respectively, while the cytotoxicity was in grade 0 or 1. These findings indicate that demineralized bone matrix/hyaluronic acid putty at a compound ratio of 15:1 can be molded easily and difficult to disintegrate, with low cytotoxicity.

Objective To evaluate the visual improvement of therapeutic plasma exchange (TPE) for refractory optic neuritis (ON) patients in acute phase.Methods Seventy-five affected eyes from 44 refractory ON patients with severe visual defect or resistance to high-dose intravenous methylprednisolone (IVMP) therapy,who were admitted to The Chinese PLA General Hospital between January 2015 and August 2016,were recruited and received TPE therapy.Among these patients,11 were male and 33 were female;the average age was 39.1 ± 13.9;31 patients had two affected eyes,13 patients had one affected eye.The course of the disease on the group of patients were more than 2 weeks,and the visual acuity worsened for more than 10 days and continued to deteriorate.TPE treatment was performed on all of the patients.BCVA was recorded before and 24 h after treatment,and the visual function was scored using visual outcome scale (VOS).At the same time,the adverse reactions of TPE treatment were observed.The paired t-test was used to compare the VOS before and after treatment.The correlation between VOS before and after treatment was analyzed by Linear-by-Linear correlation analysis.Results Among 75 affected eyes,the post-therapy VOS 3.89 ±2.13 was significantly improved from pre-therapy VOS 5.56± 1.69 (t=6.77,P＜0.001).Forty-eight of 75 eyes were improved at lease 1 score of VOS,the overall rate of visual improvement was 64.0％.Especially among the eyes with initial vision of light perception,an improved rate of 82.4％ was presented.75.0％ in those eyes with initial vision of count fingers and 67.7％ in no light perception.Linear-by-Linear correlation analysis showed a significant linear correlation between the scores of VOS before and after TPE treatment (r=0.398,P=0.01).During the course of TPE treatment,5 patients had mild adverse reactions such as low calcium reaction and allergic reaction and were well controlled after treatment.Conclusion Using TPE to treat refractory ON in acute phased can improve the visual function of patients.