Objective To observe the effects and feasibility of using walking and breathing exercises to help patients with chronic obstructive pulmonary disease in the community.Methods A hundred and one communitydwelling patients with moderate to severe chronic obstructive pulmonary disease were randomized into an experimental group (51 cases) and a control group (50 cases).The control group was given conventional pharmacotherapy,while the experimental group was given quantified walking (i.e.walking for a pre-set number of steps daily) and breathing exercises (15 minutes,3 sessions daily) to do at home for 48 weeks in addition to the conventional pharmacotherapy,.Both groups were evaluated before and after the 48 weeks of treatment using the 6-minute walk test (6MWT),a clinical COPD questionnaire,Medical Research Council (MRC) dyspnea scoring,a general anxiety/depression questionnaire and a pulmonary function test.In addition,days of hospitalization and incidence of acute exacerbation were also recorded and compared between the 2 groups.Results Among the 101 cases,92 (91.1％) completed the study (45 in the experimental group,47 in the control group,a difference which was not statistically significant).After treatment,the average 6MWT distance in the experimental group was significantly increased and significantly greater than that in the control group.No statistically significant intra-group or inter-group differences were observed with regard to the pulmonary function test or the MRC dyspnea scores.Intra-group comparison and inter-group comparison of the clinical COPD questionnaire scores and anxiety/depression scores did,however,reveal statistically significant differences.There was no significant difference in the average number of acute attacks or in the length of hospital stays.Conclusions Quantified walking and breathing exercises are effective and feasible therapy for patients with chronic obstructive pulmonary disease in the community.

Objective To observe the influence of smoking on lower airway bacterial colonization(LABC)in stable phase of chronic obstructive pulmonary disease(COPD).Methods 104 patients with moderate or severe COPD were divided into three groups:42 cases smoking continuously were divided into A group,36 cases quit smoking were B group,34 non-smoker were C group.Induced sputum were analyzed for quantitiative bacteriology and bacterial culture,pulmonary function was evaluated at begining and in two years later.Results Smokers has higher positive rate of LABC than non-smokers;patients in B group has significantly lower positive rate of bacterialculture in quit smoking 2 years late than before,and significantly lower than that in A group;bacterial colonization in A group and B group include Streptococcus pneumoniae,Haemophilus influenzae,Moraxella catarrhalis; patients in B group quit smoking 2 years late and patients in C group has significantly lower positive rate of Pseudomonas aeruginosa,significantly decreased exacerbation frequency and decline of FEV1 than patients in A group.Conclusion Smoking increase positive rate of LABC in patients with moderate or severe COPD.Smoking is an important factor in deterioration of lung function in COPD.there is positive significance to quit smoking in patients with COPD.

Objective To explore the effects of seretide (salmeterol 50 μg and fluticasone propionate 500 μg) on lower airway bacterial colonization (LABC) in the patients with stable moderate-tosevere chronic obstructive pulmonary disease (COPD).Methods A total of 84 patients with moderate-tosevere COPD were divided into 2 groups,i.e.test (n =43) and control (n =41).The control group received basic treatment while the test group seretide 50/500 μg per inhalation twice daily for 2 years plus basic treatment.Induced sputum specimens were analyzed for quantitative bacteriology and bacterial culture.The pulmonary function key parameters and exacerbation frequency were compared between two groups at pre- and post-therapy.Results The test group has significantly a lower positive rate of bacterial culture in the lower respiratory tract than before(16.3％ vs.34.9％,x2 =3.9091,P =0.0480).While in the control group,the positive rate of bacterial culture stayed almost the same as compared with that at pre-therapy (x2 =0.2253,P =0.6350).The test group had significantly decreased exacerbation frequency than the control group (1.9±2.1 vs.2.9 ±2.3,t =2.0364,P =0.0449);FEV1 of the control group decreased by (0.0885 ± 0.0186)L in 2 years and decreased by (0.0807 ± 0.0165)L in the test group.Significant differences existed in two groups (t =2.0355,P =0.0450).Conclusion The treatment of seretide can decrease LABC,slow decreasing trend of lung function and improve clinical symptoms in the patients with stable moderate-to-severe COPD.

Objective To investigate the diagnostic value of B-mode ultrasonography in detecting middle hepatic vein(MHV)in chronic liver disease patients.Methods 80 chronic liver disease patients were divided into 2 groups(chronic hepatitis and liver cirrhosis).Liver biopsies and the inner diameter(ID)of MHV was detected with B-mode ultrasonography.The ID of MHV was compared in the chronic hepatitis and liver cirrhosis groups,different liver fibrosis stages and compensation/non-compensation liver cirrhosis.The ability of ID of MHV in auxiliary diagnosis liver cirrhosis was analyzed with the receiver operating characteristic curve(ROC).Results The size of ID of MHV in liver cirrhosis(3.82±1.84)mm was smaller than that of chronic hepatitis(6.15±1.67)mm(P＜0.01).The size of ID of MHV in non-compensation liver cirrhosis(2.98±1.15)mm was smaller than that of compensation liver cirrhosis(4.42±2 20)mm(P＜0.05).There was midrange negative correlation with liver fibrosis stages and the ID of MHV(rs=-0.465,P＜0.01).The cutoff point of ID of MHV diagnosis liver cirrhosis was 4.7mm.The area under ROC(AUC)achieved 0.813(P＜0.01).The sensitivity(Se),specificity,(Sp),positive predictive value (PPV),negative predictive value(NPV)and Youden index were 67.5%,90.0%,88.0%,73.5% and 57.5%,respectively.Conclusion There is well clinical value with B-mode ultrasonography detecting ID of MHV for the auxiliary diagnosis of chronic liver disease.