Objective To discuss relative risk factors and prognosis factors of chronic obstructive pulmonary disease (COPD) combined with respiratory failure.Methods Retrospective investigation was carried out to analyze the clinical data of 110 patients with COPD from March 2005 to February 2008.These patients were divided into two groups according to the condition of respiratory failure,respiratory failure group(40 cases) and non-respiratory failure group(70 cases).Results There were significant differences in the frequency of exacerbation,uric acid,total protein,albumin,bady-mass index between two groups [(5.54 ± 1.16) times/year vs (2.75 ±0.78) times/year,(283.75 ±72.49) mmol/L vs (359.87 ±41.50)mmol/L,(58.77 ± 1.54) g/Lvs(63.95 ±2.04) g/L,(36.15 ± 1.08) g/L vs(36.96 ± 1.48) g/L,(20.33 ±0.99)kg/m2 vs (21.16 ± 1.36) kg/m2](P < 0.01).There were significant differences in COPD stage,nosocomial infection,acid-base disturbance between two groups(P< 0.05 or < 0.01).There was no statistical significance of partial pressure of oxygen in artery between the respiratory failure survival patients and dead patients (P >0.05).There were statistical significances in pH,partial pressure of carbon dioxide in artery,blood Na+,blood Cl-between the respiratory failure survival patients and dead patients (P< 0.01).Conclusion There are many relative risk factors of COPD combined with respiratory failure.

OBJECTIVE:To evaluate the therapeutic efficacy of oxygen-driven aerosol inhalation of Ventolin plus Atrovent and Budesonide suspension for acute episode of intermediate or severe degree of bronchial asthma. METHODS:A total of 48 patients with bronchial asthma were divided into two groups randomly:26 cases in the treatment group received normal saline (1 mL) +Ventolin (2 mL) + Atrovent (2 mL) and Budesonide suspension(4 mL) q6 h in addition to the routinetherapy by high-flow oxygen driven in addition to the routine therapy; 22 cases in the control group received Ventolin inhaler(200 ?g) q 6 h. The improvement of clinical symptoms in the two groups after treatment for 3 days,the forced expiratory volume in one second (FEV1),forced vital capacity (FVC),peak expiratory flow (PEF) at 3 h and 5 days,respectively,the blood sugar level,arterial blood gas index as well as duration of systemic use of hormone and the hospital days were compared between two groups. RESULTS:After treatment for 3 days,the effective rate in the treatment group(24/26) was significantly higher than in the control group (14/22),showing significant differences between two groups. At 3 h,there were significant differences between the treatment group and the control group in FEV1 and PEF but not in FVC; at 5 days,there were significant differences between the treatment group and the control group in FEV1,FVC and PEF. On day 5,there were significant differences between two groups in PaO2,PaCO2 and blood sugar level as well as in the duration of systemic use of hormone and the hospital days. CONCLUSION:Aerosol inhalation of Ventolin plus Atrovent and Budesonide suspension shows remarkable therapeutic efficacy for acute episode of intermediate or severe degree of bronchial asthma.

Objective To investigate the neuroprotective effect of vagus nerve stimulation ( VNS) on a model rat of focal cerebral ischemia. Methods A total of 42 adult male Sprague-Dawle ( SD) rats were randomly divided into a sham operation group (n=10),a model group (n=16),and a VNS-treated group ( n = 16 ) . Each group was randomly redivided into 2 subgroups:left VNS subgroup and right VNS subgroup. A model of focal cerebral ischemia (2 h) in rats was induced by the intraluminal suture method. At 30 minutes after modeling, the VNS-treated group received cervical VNS, the stimulation intensity was 0. 5 mA,the interval was 0. 5 ms,and the frequency was 20 Hz. Stimulation was once every 5 min within 1 h and each lasted for 30 s. The model group did not give any stimulation. Neither blood vessels were embolized nor were the nerves stimulated in the sham operation group. The changes of somatosensory evoked potentials ( SEP) on the lesion sides during operation were monitored. At 24 h after modeling,the neurobehavioral scores were performed. The rats were sacrificed,and their brain infarct volume was measured. Results (1) During the stimulation of left VNS in rats,the neurobehavioral scores of the sham operation group,model group and VNS-treated group were 0. 4 ± 0. 2,9. 5 ± 0. 4,6. 4 ± 0. 3,respectively;during the stimulation of right VNS in rats,the neurobehavioral scores of the 3 groups were 0. 6 ± 0. 2,9. 3 ± 0. 4,and 6. 9 ± 0. 4,respectively. There were significant differences between the scores of the model group and those of the other 2 groups (P<0. 05). (2) Compared with the model group,the brain infarct volume of the VNS-treated group was reduced ( stimulating the left VNS of the 2 groups was 120 ± 7 and 56 ± 7 mm3 respectively;stimulating the right VNS was 115 ± 10 and 54 ± 8 mm3 respectively ) . There were significant differences ( P <0. 05). (3) Compared with the sham operation group and the VNS-treated group,the SEP N1 amplitude of the model group was decreased significantly and the P1 latency was prolonged significantly. There was significant difference (P<0. 05). (4) There were no significant differences in the stimulation of the left or right VNS in the VNS-treated group among the infarct volume, neurobehavioral scores, SEP amplitude,and latency (P>0. 05). Conclusion No matter whether to stimulate the left or right vagus nerves, they both have neuroprotective effects on ischemic brain injury, and there was no significant difference on the action effects.

Objective:To implement an intervention with community-dwelling middle-aged and elderly people through a new science promotion approach, and to evaluate changes in the level of bone health awareness.Methods:From April 2017 to June 2017, 200 community-dwelling middle-aged and elderly people aged 50 years and over were randomly included.They were divided into the intervention group receiving a new science promotion intervention(n=100, with 50 males and 50 females)and the control group(n=100, with 50 males and 50 females). Baseline and follow-up assessments of bone health awareness were performed before and after the one-year intervention.A questionnaire survey on preferences for different types of science promotion articles in WeChat accounts was conducted.Differences in scores for intervention effects before and after intervention were compared between the two groups.Potential influencing factors for the scale score were examined by a multi-factor analysis.Results:After one year of intervention, scores for intervention effects were higher in the intervention group than in the control group( P<0.001). In the intervention group, scores were higher after intervention than before intervention( P<0.001). In the control group, scores after follow-up were slightly higher than those at baseline(29.4±11.4 vs.27.9±10.1, P<0.001). The increase in scores before and after intervention was greater in the intervention group than in the control group( P<0.001). Baseline score, group designation, history of drinking and diabetes impacted the scores in middle-aged and elderly women, while other factors did not.Most middle-aged and older people preferred texts illustrated with pictures, and older people were more receptive to videos. Conclusions:The new science promotion method is beneficial to bone health management, can improve bone health awareness in middle-aged and elderly people.

Objective To develop a simple and patient-reported scoring system for evaluating the efficacy of functional reconstruction of adult hip diseases.Methods A candidate indicators list to evaluate hip function was established through literatures review and panel discussion.Using two rounds of Delphi method,experts were invited to judge and score the importance of screening indicators including pain,daily living ability,activity level,labor ability and self-assessment score of the overall hip status,with explanation of the degree of similarity and the basis for determination.In the second round of consultation,the content of integrity and rationality of the scale were added for evaluation.The final indexes of the scale were determined according to the boundary value of the indexes (average value,full frequency,coefficient of variation).The positive coefficient,authoritative coefficient,and coordination coefficient of the two rounds were calculated,and then the weights of each index was identified to form the final rating scale.Results Two rounds of Delphi reclaimed 25 and 24 experts' responses,which from 28 and 25 questionnaires,and the positive coefficients of the two rounds experts were 89.3％ and 96％,respectively.The authoritative coefficient of the first and second level indicators were generally above 0.85;and both of the expert coordination coefficient with the index importance (so called as Kendall coefficient) were above 0.3,and the second round of the coefficient was higher than the first one,and it indicated the final one was better at the consistency.The candidate index of "by bus" in the mobility was rejected in accordance with the threshold of the boundary value on the importance.Finally,it was determined that the hip scoring system (Shanghai Sixth People's Hospital,SSPH) consisted of two parts:the first part had ten indicators out of four dimensions such as pain,daily living ability,activity level,and labor ability;and the weight scores of these four aspects were 45,25,21,9,respectively.The second part was the patient's self-evaluation score for the overall status of the hip (VAS,out of 100 points);the total score was the sum of the two parts,and the final weights accounted for 85％ and 15％ between the two parts respectively.Conclusion The SSPH hip score based on patient-reported outcomes formed by the Delphi is simple and feasible,and it can be used as a reference for evaluating the clinical efficacy of hip functional reconstruction.

OBJECTIVE: To describe the disease characteristics of osteonecrosis of the femoral head (ONFH) in patients with systemic lupus erythematosus (SLE) who experiencing prolonged glucocorticoid (GC) exposure. METHODS: Between January 2016 and June 2019, 449 SLE patients meeting the criteria were recruited from multiple centers. Hip MRI examinations were performed during screening and regular follow-up to determine the occurrence of ONFH. The cohort was divided into ONFH and non-ONFH groups, and the differences in demographic baseline characteristics, general clinical characteristics, GC medication information, combined medication, and hip clinical features were compared and comprehensively described. RESULTS: The age at SLE diagnosis was 29.8 (23.2, 40.9) years, with 93.1% (418 cases) being female. The duration of GC exposure was 5.3 (2.0, 10.5) years, and the cumulative incidence of SLE-ONFH was 9.1%. Significant differences ( P<0.05) between ONFH and non-ONFH groups were observed in the following clinical characteristics: ① Demographic baseline characteristics: ONFH group had a higher proportion of patients with body mass index (BMI)<20 kg/m ² compared to non-ONFH group. ② General clinical characteristics: ONFH group showed a higher proportion of patients with cutaneous and renal manifestations, positive antiphospholipid antibodies (aPLs) and anticardiolipin antibodies, severe SLE patients [baseline SLE Disease Activity Index 2000 (SLEDAI-2K) score ≥15], and secondary hypertension. Fasting blood glucose in ONFH group was also higher. ③ GC medication information: ONFH group had higher initial intravenous GC exposure rates, duration, cumulative doses, higher cumulative GC doses in the first month and the first 3 months, higher average daily doses in the first 3 months, and higher proportions of average daily doses ≥15.0 mg/d and ≥30.0 mg/d, as well as higher full-course average daily doses and proportion of full-course daily doses ≥30.0 mg/d compared to non-ONFH group. ④ Combined medications: ONFH group had a significantly higher rate of antiplatelet drug use than non-ONFH group. ⑤ Hip clinical features: ONFH group had a higher proportion of hip discomfort or pain and a higher incidence of hip joint effusion before MRI screening than non-ONFH group. CONCLUSION The incidence of ONFH after GC exposure in China's SLE population remains high (9.1%), with short-term (first 3 months), medium-to-high dose (average daily dose ≥15 mg/d) GC being closely associated with ONFH. Severe SLE, low BMI, certain clinical phenotypes, positive aPLs, and secondary hypertension may also be related to ONFH.
Female ; Male ; Humans ; Glucocorticoids/adverse effects* ; Incidence ; Femur Head ; Prospective Studies ; Femur Head Necrosis/epidemiology* ; Lupus Erythematosus, Systemic/chemically induced* ; Hypertension/drug therapy*

【Objective】 To investigate the frequency of platelet antibodies in voluntary blood donors and patients in Zhongshan, Guangdong Province, and to study the specificity and cross-matching of platelet antibodies. 【Methods】 Platelet antibodies of blood donors and patients were screened by solid-phase immunoadsorption (SPIA), rechecked by flow cytometry (FCM), and antibody specificity was identified by PakPlus enzyme immunoassay, and platelet cross-matching was simulated by SPIA. 【Results】 A total of 1 049 blood donor samples and 598 patient samples were tested, with 6 (0.57%) and 49 (8.19%) samples positive for SPIA,respectively(P<0.05); In SPIA positive samples, the positive concordance rate of FCM in blood donors and patients was 100% vs 95%, and that of enzyme immunoassay was 100% vs 88%. Among the initial screening positive samples of blood donors, 5 were anti-HLA Ⅰ antibodies, accounting for 83%, and 1 was anti CD36 antibody, accounting for 17%, with an incidence rate of 0.10%. Among the 14 samples of enzyme immunoassay positive patients, 2 were anti-GP Ⅱb/Ⅲa, 1 was anti-GP Ⅱa/Ⅱa, 8 were anti HLA Ⅰ, and 3 were mixed antibodies (HLA Ⅰ, GP Ⅱb/Ⅲa, GP Ⅰa/Ⅱa). According to the types of antibodies, HLA Ⅰ antibodies were the most common, accounting for 65% (11/17), followed by HPA related anti GP, accounting for 35% (6/17). The majority of patients had a platelet antibody positive typing rate below 30%, accounting for 71.4% (10/14). 【Conclusions】 The positive rate of platelet antibody of patients in Zhongshan area is significantly higher than that of voluntary blood donors, and most of them are anti-HLA Ⅰ and anti-GP, and the incidence of anti-CD36 is extremely low. Therefore, it is necessary to establish a known platelet antigen donor bank, and at the same time, carry out platelet antibody testing and matching of patients, which is helpful to solve the issue of platelet transfusion refractoriness.