pulmonary diseases, evaluation of respiratory function and exercise therapy were discussed in this study.

Exercise is effective in preventing and treating diseases of heart ,brain and lung . It plays a define role in treating the risk factors of these diseases such as hypctronsion , hyperlipemia , diabetes and obesity . This study discussed the development of domestic reha-bilition medicine and the diffence with developed countries . We also considered how to improve exercise therapy.

A study on 48 middle-aged and elderly joggers through exercise echocardio-graphy and measurements during systolic time intervals (STI) showed that whencompared with a control group of 26 sedentary persons, their stroke volume was44.2% and cardiac output 25.1% greater at rest, 34.3% and 15.8% greater duringequivalent load exercise, and 35.1% and 33.1% grater during equivalent heart rateexercise. In addition, their left ventricular end-diastolic diameter (LVEDd) andleft auricule diameter were also longer and the closing velocity of the mitral valveduring the early diastolic stage was greater, although their ejection fraction, AD%and STI showed no significant difference. This proves that jogging can improvecardiac pumping function by enlarging LVEDd and increasing pre-load of heart.

Objective To study the effects of isotonic and resistance exercises on renal hormones in plasma. Methods Eight healthy men were instructed to performed isotonic and resistance exercises, respectively, with the same target heart rate and the same exercise duration, in which both exercises-induced changes of plasma renin activity (PRA), aldosterone (ALDO) and antidiuretic hormone (ADH) were observed. Results Plasma levels of PRA, ALDO and ADH increased significantly after both isotonic exercise and resistance exercises. Plasma levels of ADH and PRA were higher after resistance exercise than those after isotonic exercise. Conclusion The increases of PRA, ALDO and ADH in plasma caused by exercise might be an adaptive response to maintain balances of water and electrolyte in the status of physical stresses. The tendency of increase of ADH and PRA after resistance exercise suggested that the exercise intensity rather than type of exercise correlated with on the changes of renal hormones.

To resolve the problem of methodology of exercise echocardiography andthe criterion and value for evaluating left ventricular (LV) pumping func-tion, 68 healthy persons (age 54.8?8.9 years) and 48 patients with coronary artery disease (age 57.6?5.7 years) were studied by echocardiography bothat rest and during bicycle ergometer exercise in the supine position. Mostsubjects (76.8%) having clear echocardiograms at rest also acquired cleartracing during exercise. Fifty percent of patients had abnormal responsesto exercise. There were no increase in ejection fraction (EF%), percentchanges of diameter (△D%) and stroke volume index (SVI). All these weresensitive indices for determining LV pumping function reserve. Six indicesincluding △D%, PEP/LVET, mVcf at rest, exercise, increment of EF%, △D%and SVI were used as comprehensive assessing criterion of LV pumpingfunction. Compared with the indices of the rest state, the abnormal ratioof LV pumping dysfunction found in patients were raised from 21% to 37%by the indices of the exercise increment and further to 56% by the compre-hensive assessing criterion. This was not in the case of healthy persons.It showed that exercise echocardiography and comprehensive assessing cri-terion might enhance the sensitivity of evaluating LV pumping functionwithout affecting its specificity. It is suggested that they might be adaptedin the research works in rehabilitation medicine and sports medicine.

BACKGROUND:Schatzker V, VI fracture often causes the injuries to cruciate ligament, col ateral ligaments and meniscus. Moreover, the col apse and shifting were severe. The locking plate on one side cannot support the weight or obtain satisfactory reduction. OBJECTIVE:To compare the effects and stability of the dual-incision double-plate fixation and knee midline incision locking plate fixation in the treatment of Schatzker V, VI tibial plateau fracture. METHODS:A total of 76 patients with Schatzker V, VI tibial plateau fracture were respectively treated with locking plate fixation (n=38) and dual-incision double-plate fixation (n=38). Fracture reduction and healing were assessed using anteroposterior and lateral radiographs. Varus angle and medial caster angle of tibial plateau received biomechanical measurement. RESULTS AND CONCLUSION:Hospital stay and postoperative load time were significantly less in the dual-incision double-plate fixation group than in the locking plate fixation group (P<0.05). No significant difference in healing time was detected between locking plate fixation and dual-incision double-plate fixation groups (P>0.05). The number of complications, such as ankylosis, fracture delayed union, pin tract infection, delayed union, varus deformity, was significantly fewer in the dual-incision double-plate fixation group than in the locking plate fixation group (P<0.05). There were no significant differences in the fracture of loosening, knee instability, wound infection, skin necrosis, bone necrosis and nonunion between the dual-incision double-plate fixation and locking plate fixation groups (P>0.05). Postoperative Rasmussen classification was significantly better in the dual-incision double-plate fixation group than in the locking plate fixation group (P<0.05). Experimental results indicated that the clinical efficacy of the dual-incision double-plate fixation is superior to that of the anterior cruciate midline incision locking plate fixation in the treatment of Schatzker V, VI type tibial plateau fractures. The dual-incision double-plate fixation has more biomechanical stability.

Objective To evaluate the clinical effects of intra-lamellar orbicularis dissecting micro-traumatic double eyelid surgery for the treatment of adolescent upper eyelid trichiasis. Methods Three cutaneous micro-incisions following intra- and sub-lamellar orbicularis dissections were performed and the deep orbieularis and suborbicularis fat pad between the intended eyelid crease and 1 mm above the eyelid margin were resected. The subcutaneous orbicularis was fixed to the exposed levator aponeurosis at the medial, center and lateral regions. For the quantitative analysis, the entire eyelid margins' eyelashes were equally divided into three sections and the eyelashes lift-up angle (LA), the body curl-up angle (BC) and the end curl-up angle (EC) were compared before and after surgery in each section, respectively. Results One hundred and fourteen eyes of 57 cases were followed up during 24-30 months. Compared to the LA before surgery and 2 years after surgery, it was changed from (26.37±9.67)° to (55.42± 10.03)° in section Ⅰ , and from (22.03±11.64)° to (50.03±10.02)° in section Ⅱ , and from (25.31±8.01)° to (64.05±8.33)° in section Ⅲ. There were no significant changes of BC and EC during following-up. Con-clusions For the adolescent upper eyelid trichiasis, the intra-lamellar orbicularis dissecting micro-trau-matic double eyelid surgery could acquire satisfactory aesthetic appearance and stable eyelashes'position at the same time.

Objective To investigate the percentage of CD4 + C125 +Tregs in peripheral blood of patients with sepsis and its effect on cell immunity so as to unravel the effect of immunomodulatory therapy on it. Method Fourty patients with sepsis in ICU were randomly (random number) divided into experimental group and control group . The patients of experimental group were treated with Ulinastatin and immunoregulation agent (Thymosin αl) as well. The blood specimens were collected just before treatment, 3 days and 8 days after treatment. The percentages of CD4 + CD25 + Tregs and lymphocyte subsets were detected by using FCM (flow cytometry), and TNF-α, IL-6 and IL-10 assayed by using ELISA, and APACHE Ⅱ scores were calculated. Results Before treatment, the percentage of CD4 + CD25 + Tregs increased, and the number of lymphocytes and the percentage of T lymphocytes decreased, especially the CD4 + T lymphocytes and CD4+/CD8+ decreased more markedly, and the levels of IL-6 and TNF-α increased. After treatment,the percentage of CD4+ CD25 + Tregs was decreased, the number of lymphocytes and CD4 +/CD8 + increased, and the levels of APACHE Ⅱ score, IL-6 and TNF-α decreased especially in the experimental group decreased more significantly (P ＜ 0. 05). Conclusions The percentage of CD4 + CD25+ Tregs in peripheral blood can reflect the immune status of patients with sepsis and become a novel indicator to estimate the progress of sepsis, and the immunity and prognosis of patients. Treating the patients with Thymosin αl and Ulinastatin can raise their immunity, decrease the levels of IL-6, TNF-α and APACHE Ⅱ score and improve their prognosis.

Objective To observe the clinical effects of a new method:non-optic nerve transecring evisceration combined with first stage hydroxyapatite orbital implantation.Methods One hundred and twenty two eyes (122 cases) were randomly divided into group A and group B,evisceration was first undertaken,the scleral wall was superior-temporally to inferior-nasally dissected and double scleral petals were placed before the implanted hydroxyapatite artificial eyeball.The difference between group A and group B was:in group A,the optic nerve was transected behind the eyeball,but in group B,a 2 mm outside the optic nerve scleral circle cutting was taken.Hemostasis time before implantation,tensile force during conjunctival suture,pain during surgery,palpebral fissure height after eye speculum wearing,operation time consuming,pain after surgery,conjunctival edema and congestion,and ocular prosthesis wearing time were compared between the two groups.Results In groups A and B,the intra-operative hemostasis time were (23.46 ± 6.96)mins and (5.49 ± 1.72)mins,the tensile force score during conjunctiva suture were 3.39±0.74 and 0.45±0.59,the score of pain in the first day were 2.8 ±0.68 and 1.47 ± 0.67,the ocular prosthesis wearing time after surgery were (6.27±2.73) and (3.07 ± 2.11)weeks,respectively.The differences of all the parameters above were with statistical significance between groups A and B (P＜0.01).During 2 years follow-up,no complications such as orbital implant exposure or infection happened.Conclusions Compared to traditional methods,the non-optic nerve transecting evisceration method has merits of less impairment,short time-consuming,less pain,and quicker postoperative recovery.

Objective To explore the effects of continuous renal replacement therapy (CRRT) on the changes of the respiration and blood circulation as well as peripheral blood cytokines levels in patients with severe acute pancreatitis(SAP) complicated with acute respiratory distress syndrome.Methods 48 SAP patients complicated with acute respiratory distress syndrome were divided into control group and CRRT treatment group according to the parallel control design principle.The control group was treated with routine way,and the CRRT treatment group was treated with CRRT on the basis of routine way.The clinical data and the levels of IL-6,IL-1β,TNF-α were compared between the two groups.Results The levels of IL-6,TNF-α were significantly lower in the CRRT treatment group than those in the control group in 12h [(147.72 ± 22.06) ng/L vs.(132.27 ± 18.03) ng/L,t =2.315,P＜0.05;(236.08 ±41.29) ng/L vs.(208.79±39.25)ng/L,t =2.406,P ＜0.05].The levels of IL-6,IL-1β,TNF-α were significantly lower in the CRRT treatment group than those in the control group in 24h [(136.57 ± 30.74) ng/L vs.(109.98 ± 35.83) ng/L,t =2.184,P ＜ 0.05;(35.76 ± 8.57) ng/L vs.(28.96 ±3,95) ng/L,t =2.237,P ＜0.05;(219.81 ±36.06) ng/L vs.(173.48 ±48.19) ng/L,t =2.206,P ＜0.05].The level of PaO2/FiO2 was significantly higher in the CRRT treatment group than that in the control group in 24h[(139.89 ±35,61) vs.(173.12 ±21.84),t =2.913,P ＜0.01].The levels of Ppeak,IL-1β were significantly lower in the CRRT treatment group than those in the control group in 48h [(28.96 ± 4.14) cmH2 O vs.(24.73 ± 8.52) cmH2 O,t =2.518,P ＜0.05;(29.87 ±5.12) ng/L vs.(23.57 ±3.91) ng/L,t =2.427,P ＜0.05].The levels of IL-6,TNF-αwere significantly lower in the CRRT treatment group than those in the control group in 48h [(117.60 ± 23.46) ng/L vs.(88.56 ± 13.02) ng/L,t =3.062,P ＜ 0.01;(205.25 ± 46.14) ng/L vs.(141.63 ± 33.80) ng/L,t =3.174,P ＜0.01].The level of PaO2/FiO2 was significantly higher in the CRRT treatment group than that in the control group in 48h [(148.07 ± 25.64) vs.(193.23 ± 29.60),t =2.983,P ＜ 0.01].There were no significant differences between the control group and CRRT treatment group in PaO2/FiO2,Ppeak,IL-6,IL-1β,TNF-α before treatment [(103.68±29.65) vs.(107.07 ±25.13),t =0.359,P ＞0.05;(34.62 ±7.36)cmH2O vs.(35.18 ±4.04)cmH2O,t =0.416,P ＞0.05;(152.61 ±31.53)ng/L vs (150.74 ±30.26) ng/L,t =0.668,P ＞0.05;(40.06 ±5.15) ng/L vs.(38.09 ±10.13) ng/L,t =0.819,P ＞0.05;(226.85 ±37.62) ng/L vs.(225.47 ±39.02) ng/L,t =0,702,P＞0.05].Conclusion CRRT can effectively reduce the plasma levels of IL-6,IL-1β,TNF-α in SAP patients complicated with acute respiratory distress syndrome,it has therapeutic effect on the respiration through changing the cytokines of SAP patients complicated with acute respiratory distress syndrome.