Objective To investigate the availability and safety of pulmonary rehabilitation for hospitalized patients with acute exacerba-tion of chronic obstructive pulmonary disease (COPD). Methods Seventy-two hospitalized patients with acute exacerbation of COPD were randomly included into test group (n=36) and control group (n=36) from June, 2015 to June, 2016. All the patients accepted management of anti-infection, phlegm elimination, antiasthma, etc., as well as the guidance of expectoration and health education; while the test group ac-cepted pulmonary rehabilitation from the third day of admission to discharge. Their strength of hand grip, 1-minute sit-to-stand test (STST), the days of hospitalization, lung function parameters, modified Medical Research Council (mMRC) scores and COPD Assessment Test (CAT) scores were measured before and after treatment. Results Compared with the control group, the strength of hand grip (t=2.985, P<0.01) and number of STST (t=2.024, P<0.05) increased, while the scores of CAT (t=3.222, P<0.01) and mMRC (t=2.212, P<0.05) de-creased in the test group. The hospital stay seemed to be shorter in the test group than in the control group, but there was no significant dif-ference (t=1.433, P>0.05). There was no significant difference in lung function after treatment in both groups (Z<1.031, P>0.05). Conclu-sion Pulmonary rehabilitation is effective on hospitalized patients with acute exacerbation of COPD in muscle strength, capability of activi-ties, and relieve the symptoms.

Objective To assess the comparative efficacy of different methods for difficult biliary cannulation in endoscopic retrograde cholangio-pancreatography(ERCP)through a network meta-analysis.Methods Randomized controlled trials(RCTs)that compared the efficacy of different adjunctive methods(early or late needle-knife technique,pancreatic guidewire-assisted technique,pancreatic stent-assisted technique,transpancreatic sphincterotomy,persistent standard cannulation technique)for difficult biliary cannulation with each other were identified.The success rate of biliary cannulation and the incidence of post-ERCP pancreatitis(PEP)were the outcomes of interest.Pairwise and network meta-analysis and ranking according to surface under the cumulative ranking curve(SUCRA)for all methods were performed.Results Eighteen RCTs were identified according to selection criteria,and 2 033 patients were enrolled.The use of transpancreatic sphincterotomy over persistent standard cannulation technique(RR=1.34,95%CI:1.02-1.77)and over pancreatic guidewire-assisted technique(RR=1.26,95%CI:1.00-1.60)significantly increased the success rate of biliary cannulation.Based on SUCRA ranking,transpancreatic sphincterotomy followed by early needle-knife techniques were ranked highest in terms of increasing the success rate of biliary cannulation.Only early needle-knife technique significantly decreased PEP rate when compared with persistent standard cannulation technique(RR=0.53,95%CI:0.30-0.94),whereas both early needle-knife techniques and transpancreatic sphincterotomy led to lower PEP rates as compared with pancreatic guidewire-assisted technique(RR=0.41,95%CI:0.17-0.99;RR=0.49,95%CI:0.25-0.96;respectively).Based on SUCRA ranking,early needle-knife technique followed by transpancreatic sphincterotomy were ranked highest for decreasing the PEP rate of biliary cannulation.Conclusions Transpancreatic sphincterotomy increases the success rate of difficult biliary cannulation in ERCP;early needle-knife technique and transpancreatic sphincterotomy are superior to other interventions in decreasing PEP rates and should be considered as a choice of difficult biliary cannulation.

Photothermal therapy has been intensively investigated for treating cancer in recent years. However, the long-term therapeutic outcome remains unsatisfying due to the frequently occurred metastasis and recurrence. To address this challenge, immunotherapy has been combined with photothermal therapy to activate anti-tumor immunity and relieve the immunosuppressive microenvironment within tumor sites. Here, we engineered silica-based core‒shell nanoparticles (JQ-1@PSNs-R), in which silica cores were coated with the photothermal agent polydopamine, and a bromodomain-containing protein 4 (BRD4) inhibitor JQ-1 was loaded in the polydopamine layer to combine photothermal and immune therapy for tumor elimination. Importantly, to improve the therapeutic effect, we increased the surface roughness of the nanoparticles by hydrofluoric acid (HF) etching during the fabrication process, and found that the internalization of JQ-1@PSNs-R was significantly improved, leading to a strengthened photothermal killing effect as well as the increased intracellular delivery of JQ-1. In the animal studies, the multifunctional nanoparticles with rough surfaces effectively eradicated melanoma via photothermal therapy, successfully activated tumor-specific immune responses against residual tumor cells, and further prevented tumor metastasis and recurrence. Our results indicated that JQ-1@PSNs-R could serve as an innovative and effective strategy for combined cancer therapy.