Objective To analyze the effects of salmeterol/fluticasone propionate aerosols fluticasone propionate and salmeterol joint tiotropium aerosol on pulmonary function and exercise tolerance in patients with chronic obstructive pulmonary disease (COPD),and to provide a theoretical basis for clinical treatment.Methods 119 COPD patients were selected in this study.They were randomly divided into 65 cases of seretide group and 54 cases of combined treatment group.Before treatment,three months after treatment and six months after treatment,the pulmonary function and 6MWD were measured in all patients.Results After 3 months,6 months of treatment,the FEV1,FEV1/FVC,FVC,6MWD of the combined treatment group had significant differences compared with before treatment (ta =-5.89,tb =-6.88,te =-8.46,tf =-8.86,ti =-10.74,tj =-8.52,tm =-9.37,tn =-13.04,all P ＜0.05).After 3 months,6 months of treatment,the FEV1,FEV1/FVC,FVC,6MWD in the control group had significant differences compared with before treatment (tc =-4.29,td =-7.19,tg =-6.16,th =-11.40,tk =-11.69,tl =-7.43,to =-11.71,tp =-10.53,all P ＜ 0.05).After 3 months of treatment,the differences of FEV1,FEV1/FVC,FVC between two groups were significant (tv =2.69,tq =6.74,tr =2.91,all P ＜ 0.05).In the control group,theFEV1,FEV1/FVC,FVC after 6 months of treatment had significant differences compared with after 3 months of treatment(ts =-2.50,tt =-9.46,tu =-1.65,all P ＜ 0.05).Conclusion Seretide and tiotropium aerosol aerosol can better improve lung function in patients with COPD and exercise tolerance,but the result of using two drugs to improve the patients'lung function was significantly better than seretide alone.

Objective To offer the theoretical evidence for clinical application,we observed the changes of angiographic appearances and local pathological changes before and after embolizing the left gastric artery with mitomycin C gelatin microspheres (MMC-MS).Methods Catheter was delivered into the left gastric arteries via femoral artery and then infused MMC-MS.The angiographic appearances and local pathological changes were observed immediately,and then with follow up of 6～8h,24h,72h,1w,2w and 4w. Results The minute arterioles of tunia mucosa and tela submucosa were mainly embolized inducing edema and focal necrosis.With the degradation of MMC-MS,the damage of gastric tissue was alleviated but turned normal after 4 weeks.The results of DSA showed that no recanalization of the embolized vessels occurred after one week of emboliatdion but revealed one recanalization after two weeks and two in four weeks.Conclusions The damage of tissue induced by embolizing the left gastric artery with MMC-MS can be recovered.The application of the MMC-MS is feasible.

Gouty arthritis is a clinical common joint disease caused by metabolic disorder. TCM therapy has unique advantages, such as good efficacy and few adverse reactions. Professor WEI Zi-xiao advocates differential treatment for this disease. In his opinion, acute gouty arthritis is equivalent to TCM damp-heat arthralgia, and therapy of eliminating dampness and heat should be used. During the intermission, therapy of reinforcing spleen and nourishing kidney is appropriate because of deficiency of them. Deficiency of liver and kidney and phlegm and blood stasis are basic pathogenesis in chronic phase of the disease, therefore, activating blood, reducing phlegm and nourishing liver and kidney should be adopted. In addition, Professor WEI pays attention to pharmacological research achievement of TCM, disease differentiation and life and diet regulating in treatment of the disease.

BACKGROUND:Different embolic materials can be used for bronchial artery embolization in patients with pulmonary tuberculosis hemoptysis. Sodium alginate microspheres and gelatin sponge are two commonly used materials; however, there are relatively few related reports about the comparative analysis on the application effect of these two materials. OBJECTIVE:To investigate the clinical efficacy of sodium alginate microspheres for bronchial artery embolization on pulmonary tuberculosis hemoptysis. METHODS:Totaly 157 patients with pulmonary tuberculosis hemoptysis, including 98 male and 59 female patients, aged 22-75 years, were enroled and subjected to bronchial artery embolization using different embolic materials: sodium alginate microspheres group (n=74) and gelatin sponge group (n=83). During the 12 months of folow-up, the clinical curative effect, recurrence and complications condition of these two groups were observed. RESULTS AND CONCLUSION:The total effective rates of sodium alginate microspheres and gelatin sponge groups were respectively 91.19% and 81.93%, and there was a significant difference between groups (P < 0.05). The recurrence rates of sodium alginate microspheres and gelatin sponge groups were respectively 6.8% and 26.5%, and there was a significant difference between groups (P < 0.05). Additionaly, there was no significant difference in the complications between groups (P > 0.05). These results demonstrate that sodium alginate microspheres for bronchial artery embolization has a better result in the clinical treatment of pulmonary tuberculosis hemoptysis with a high clinicaly effective rate and low recurrence rate.

Object The purpose of this study was to analyze the changes in blood rheology in paitents with hepatocirrhosis accompanied by hemorrhage of upper digestive tract,explore the effect of frequent small bllod transfusion on it,after controlled hemorrhage and its clinical singnificance.Methods Thirty-four patients with hepatocirrhosis accompanied by hemorrhage of upper digestive tract were recruited into this study,10 days after controlled hemorrhage.These patients all underwent blood transfusion(200ml fresh blood or 2-unit concentrated erythrocyte) every month.Blood rheology data were obtained before and after 3 times blood transfusion,regular observed the liver function and further hemorrhage time interval.Results There were significantly elevation of whole blood specific viscosity(SV),blood plasma SV,fibrinogen,and hematocrit after treament,The frequent small blood transfusion led to reduce significantly in erythrocyte sedimentation,ALT,AST,TBiL,and significantly prolonged hemorrhage time interval further.Conclusions Frenquent small blood transfusion to patients with hepatocirrhosis could change the blood reology,remission illness state,prolongating the time interval of hemorrhage next occured.

Objective To investigate the correlation of serum concentrations of interleukin(IL)-6,IL-10 and tumor necrosis factor(TNF)-α and the prognosis of sepsis in children.Methods Fifty-seven septic patients in PICU were enrolled in the study,of whom 44 patients survived(sepsis survival group),13 patients died(sepsis dead group).Another 65 cases of non-sepsis patients served as control(non-sepsis group).The critical illness score,the number of damaged organs,and serum levels of IL-6,IL-10,TNF-α,IL-6/IL-10,TNF-α/IL-10 in each group were compared.Results The critical illness score was decreased and the number of damaged organs was more in sepsis dead group than those in non-sepsis group and sepsis survival group.Compared with non-sepsis group and sepsis survival group,the expression of IL-6 and IL-10 increased,TFN-α/IL-10 ratio significantly decreased in sepsis dead group(P ＜ 0.05),but the difference between the sepsis survival group and non-sepsis group was not statistically significant(P ＞ 0.05).The serum levels of TNF-α and IL-6/IL-10 ratio showed no significant difference among three groups(P ＞ 0.05).Conclusion In sepsis patients,the serum concentrations of IL-6,IL-10 are higher and the TNF-α/IL-10 ratio is smaller,the prognosis is worse.

Aim: To study the therapeutic effects of ZK_(14), a novel nitric oxide donor, on hepatic fibrosis in rats. Methods: Rats were injected intraperitoneally with CCl_4 and induced to hepatic fibrosis, followed by intra-gasrtic administration with high dose of 20 mg/kg and low dose of 10 mg/kg of ZK_(14) for 4 weeks. The effects were evaluated in the content of nitric oxide of serum and nitric oxide synthases of liver, in serum levels of the hepatic functions indices and hepatic fibrotic index and in liver histopathology. Results: The biochemical indices and pathology grade were effectively improved in the group of ZK_(14) 20 mg/kg, and liver function was also effectively protected in this group. Conclusion: ZK_(14), a novel nitric oxide donating biphenyldicarboxylate derivative, showed preferable therapeutic effects on hepatic fibrosis of rats induced with CC14, and it may be of potential value in the treatment of hepatic fibrosis.

Objective To compare the differences in metabolites between newborns with intrauterine growth restriction (IUGR) and appropriate for gestational age (AGA) in order to understand the changes in metabolites of newborns with IUGR and explore the possible metabolic mechanism of tissue and organ damages in patients with IUGR,with the ultimate goal of providing the basis for clinical intervention.Methods A total of 45 newborns with IUGR and 56 AGA newborns who were hospitalized in the Neonatal Intensive Care Unit of Bayi Children's Hospital,the General Hospital of the Chinese People's Liberation Army between July 2009 and June 2015 and who underwent metabolic disease screening were enrolled in this study.The differences in of 21 amino acids and 55 carnitines in peripheral blood,as well as the changes in the ratios of free carnitine and acylcarnitine to total carnitine,were compared.Results (1)According to the comparison of birth weights (＜ 3rd percentile,3rd-＜ 5th percentile,5th-＜ 10th percentile,and 10th-90th percentile),peripheral blood of the IUGR newborns with birth weight ＜ 3rd percentile contained lower concentrations of alanine (F =2.94,P =0.03),homocysteine (F =3.83,P =0.01),methionine (F =2.88,P =0.04),ornithine(F =3.32,P =0.02),serine (F =3.09,P =0.03) and tyrosine (F =4.76,P =0.00) than those of the AGA newborns.In the peripheral blood of the IUGR newborns with birth weight of 3rd-＜ 5th percentile,the diversity of alanine concentrations showed compensatory increase,and their alanine concentrations were higher than those of the AGA newborns.(2) Metabolites also had significant differences in different gestational age groups:the concentrations of alanine (t =2.423,P =0.026),proline (t =2.470,P =0.023),and 14-carbon acylcarnitine (t =-2.870,P =0.010) in premature was higher than those in full-term newborns,but the concentration of 26-carbon acylcarnitine (t =-2.189,P =0.041) was lower than full-term ones;the concentrations of alanine (t =2.354,P =0.022),glutamine (t =2.520,P =0.015),pipecolic acid (t =2.017,P =0.049),proline (t =2.204,P =0.032) in premature AGA newborns were higher than those in full-term ones,but the concentrations of homocysteine (t =-2.624,P =0.011),seven carbon acylcarnitine(t =-2.403,P =0.020),and ten carbon acylcarnitine (t =-5.739,P =0.000) were lower than those of full-term AGA newborns;the concentrations of homocysteine (t =-2.421,P =0.020),decanogl carnitine(t =-2.181,P =0.035),methyl propylene acyl carnitine (t =-2.373,P =0.022),pentyl acyl carnitine (t =-2.165,P =0.036),decyl acyl carnitine (t =-4.148,P =0.000),hydroxyl acetyl carnitine (t =-2.097,P =0.042),hydroxyl cetyl acylcarnitine (t =-2.446,P =0.019) in premature IUGR were higher than those in fullterm IUGR newborns;but the concentrations of arginine (t =2.167,P =0.036),glutamic acid (t =2.469,P =0.018),histidine (t =2.718,P =0.009),leucine/isoleucine (t =3.938,P =0.000),ornithine (t =4.264,P =0.000),serine (t =2.647,P =0.011),threonine (t =2.311,P =0.026),tryptophan (t =4.040,P =0.000),valine (t =2.700,P =0.01),7-carbon acylcarnitine (t =-2.44 1,P =0.019),18-carbon diene carnitine (t =2.449,P =0.018),capric acylcarnitine(t =-4.148,P =0.000) and hydroxyl acetyl carnitine (t =-2.097,P =0.042) were lower than those in full-term IUGR newborns.(3) For AGA newborns,metabolites had no differences between male and female (P ＞ 0.05);however,for newborns with IUGR,metabolites significantly differed between male and female,and the concentrations of aspartic acid(t=2.521,P =0.016),glutamate(t =-2.175,P =0.035) in male IUGR were lower than those in female newborns with IUGR,but the concentration of 26-carbon carnitine (t =2.231,P =0.031) was higher than that in female group.(4) Birth weight had no significant effect on free carnitine concentration or on the ratios of free carnitine and acylcarnitine to total carnitine(all P ＞ 0.05).Conclusions IUGR infants exhibit significant abnormalities in amino acid and acylcarnitine metabolism,especially those with birth weight ＜ 3rd percentile.With the increase of birth weight,amino acids and acylcarnitines showed compensatory increases or decrease,and when birth weight reached the 10th percentile,the newborns with IUGR were close to the AGA newborns.

Objective: To explore the influence of heat and noise exposure on the risk of hypertension in workers,and to provide evidence for prevention of hypertension in occupational population. Methods: Cluster sampling method was used to recruit 2 130 steel workers from four factories（north iron-making,long steel,cold steel and power department）of some steel company. A cross-sectional study was conducted to collect physical examination results,heat and noise exposure. Logistic regression models were used to analyze the effects of noise,heat and their interaction on hypertension. Results: Totally 1 971 valid questionnaires were collected,and the response rate was 92.54%. There were 654 workers suffering from hypertension,with a prevalence rate of 33.18%. There were 1 006 workers exposed to noise,accounting for 51.04%;and 853 workers exposed to heat,accounting for 43.28%. The prevalence rates of hypertension in workers exposed to noise and heat were higher than those in workers without the above exposure（P<0.05）. The prevalence rates of hypertension increased with the increase of age and working years（P<0.05）. The results of multivariate logistic regression analysis showed that noise（OR=1.711,95%CI：1.380-2.121）,heat（OR=1.721,95%CI：1.394-2.125）were risk factors for hypertension;the interaction between noise and heat on hypertension was not statistically significant（P>0.05）,while the interaction between noise and age（OR=1.086,95%CI：1.057-1.115）,between heat and age（OR=1.087,95%CI：1.059-1.115）both increased the risk of hypertension. Conclusion Occupational exposure to heat and noise are risk factors for hypertension. These two occupational hazards also interact with age,which can increase the risk of hypertension in workers.

Objective:To explore the application of endoscopic narrow-band imaging(NBI) in the early diagnosis of throat malignant tumors.Methods:From January 2014 to December 2019, 512 patients with suspected benign or malignant diseases of the throat in the First People's Hospital of Wenling were selected, and all patients were performed white light endoscopy and NBI endoscopy.The biopsies were taken for pathological examination.The histopathological results were seemed as gold standard for diagnosis.Results:NBI endoscopy was superior to white light endoscope in terms of microvascular morphology and lesion outline(χ 2=457.497, 293.209, all P<0.05). The diagnostic coincidence rate, sensitivity and negative coincidence rate of NBI endoscope for malignant tumors were higher than those of white light endoscope(χ 2=10.131, 6.197, 4.084, all P<0.05). The sensitivity of NBI endoscope type Ⅰ-Ⅱ in the diagnosis of benign lesions was 90.65%, and the specificity was 96.88%.The sensitivity and specificity of NBI endoscope type Ⅲ-Ⅳ in the diagnosis of mild-moderate dysplasia were 80.99% and 97.52%, respectively.The sensitivity and specificity of NBI endoscopy type Va in the diagnosis of severe atypical hyperplasia were 15.18% and 98.54%, respectively.The sensitivity and specificity of NBI endoscope Va-c in the diagnosis of invasive cancer were 93.24% and 96.93%, respectively. Conclusion:Compared with white light endoscope, NBI endoscope can more clearly show the outline of lesions and submucosal blood vessels, and can more accurately diagnose malignant tumors in the throat, especially can more recognized the pre-cancerous lesions and early malignant tumors.It has important clinical application value in early diagnosis of malignant tumor in the throat.