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.

nal surface coil,and it can be a promising method to diagnose interphalangeal joints lesions.

Objective:To verify the reliability, accuracy and stability of the machine performance check (MPC) system of Varian′s TrueBeam series accelerator.Methods:After the installation was completed, the acceptance data were compared with the results of the first MPC operation to verify the reliability of the MPC results; the accuracy of the MPC results in the image-guided radiotherapy (IGRT) application was verified by the method of artificially introducing errors. The mechanical performance results of 60 groups of MPC from March 2019 to March 2020 were collected to calculate the mean value and standard deviation and compare the stability differences of each index.Results:The equipment error parameters obtained by MPC were all lower than those obtained by acceptance. The maximum difference between two sets of data was only 2mm and the threshold ratio was less than 20%. MPC had a high sensing accuracy for radiation and imaging position shift, and the r values were more than 90%. The vertical direction of the couch had a poor sense of displacement accuracy, and the r value was less than 73.7%. For this verification project, the angle of the treatment bed was the most stable, and the standard deviation did not exceed 0.01. The stability of other indexes did not significantly differ.Conclusions:MPC can be used as a verification tool for routine quality assurance of IGRT. The verification accuracy of radiation and imaging centers are better than the mechanical accuracy of gantry, collimator and couch.