Objective To study the effect improvation of lung function and prognosis of singulair and seretide for moderate to severe AECOPD . Methods 78 patients associated with moderate to severe AECOPD from January 2014 to June 2016 in our hospital were researched.They were divided randomly into observation and control groups according to the order of admission, 39 cases in each group.In the control group, they were treated by conventional anti-infective, expectorant, oxygen, suction seretide.In the observation group, using singulair on the basis of the control group.Clinical data, clinical efficacy, clinical symptoms begin to improve time, hospitalization time, blood gas analysis (PaO2, PaCO2) after five days and pulmonary function after treatment forced expiratory volume in one second ( FEV1 ) , call gas peak velocity ( PEF) , forced expiratory volume in one second than the forced vital capacity (FEV1/FVC), maximum mid-expiratory flow rate (MMEF) were compared with each other.Results Their clinical data of patients and other general information and basic condition had no significant difference between each other.The effective rate of observation group and control group were 97.44%and 87.18%, clinical effecicy of observation group was better than the control group, the difference was statistically significant (u=2.2805, P<0.05).Postoperative hospital stay, time of symptoms began to improve of the observation group were shorter than the control group, the difference was statistically significant (P<0.05), PaO2 of 5-day post-treatment of observation group was higher, and PaCO2 was lower, the difference was statistically significant (P<0.05).Lung function of two groups of patients had no significant difference before treatment, after treatment, pulmonary function in the observation group (including FEV1, PEF, FEV1/FVC, MMEF) was better than the control group, the difference was statistically significant (P<0.05).Conclusion Seretide combined with singulair to treat severe AECOPD has a good effect, it can significantly improve the therapeutic effect and improve the patient's lung function.

0.05) . Tube re-adhesion rate was 10.7% and 17.9% (P

BACKGROUND: With the development of China, quality of life (QOL) is getting more and more attention, however, there are few studies on QOL, especially in Mainland China.OBJECTIVE: To observe the situation of combinative application of Functional Independence Measure (FIM) and QOL assessment in rehabilitation clinical practice.DESIGN: Case analysis.SETTING: Zhongshan Hospital of Fudan University.PARTICIPANTS: Totally 83 rehabilitation patients selected from Shanghai Zhongshan Hospital from January to December 2003,consenting to take part in the study, were divided into 4 groups: bone & joint rehabilitation(n=42), stroke rehabilitation (n=17), internal medicine (n=15), and cancer rehabilitation (n=9).METHODS: Every patient carried out functional independence assessment and quality of life measurement within 24 hours of admission. FIM was adopted for functional independence assessment which included 13 items of motor (ranged from 13 to 91 points) and 5 items of cognition (ranged from 5to 35 points), and FAQ for quality of life included making telephone call,self-care economy, shopping, using vehicle, housework, jobs, entertainment,etc. with 100 in total. The author performed all the assessment.MAIN OUTCOME MEASURES: Every patient carried out FIM and FAQ assessment after admission and discharge.RESULTS: All data of totally 83 patients entered the final analysis. [1]The average age and length of hospital stay in stroke group were higher than those in other groups (P ＜ 0.01). [2] FIM motor and cognitive scores in stroke group were higher at discharge than those at admission (5.276,3.624;6.200,5.941,P ＜ 0.01), but scores of functional activity were lower at discharge than those at admission (1.253, 1.547, P ＜ 0.01). [3]In bone joint group, the FIM cognitive scores were coincidence in general, while motor scores were higher at discharge than those at admission (6.220,5.388, P ＜ 0.01), but scores of functional activity were lower at discharge than those at admission (0.610, 0.912, P ＜ 0.01). [4] Only scores of functional activity in tumor group were lower at discharge than those at admission (0.722, 0.989, P ＜ 0.05). [5] All items in internal medicine group were coincidence in general (P ＞ 0.05).CONCLUSION: FAQ is more sensitive than FIM in rehabilitation practice, but cannot replace FIM, and should be used with FIM.

Aim To explore the effect of N-acetyl-L-cysteine ( NAC ) on β amyloid peptide 25 - 35 ( Aβ25-35 )-induced the increase of calpain activity and its possible mechanism. Methods The activity of cal-pain was induced by 20μmol·L-1 Aβ 25-35 in primary cortical neuron. Neurons were incubated in the absent or present Aβ25-35 , or pre-incubated NAC ( 10 mmol ·L-1 ) , then co-incubated with Aβ25-35 . The meas-urement of calpain activity, H2 O2 level and mitochon-drial membrane potential was performed on a micro-plate fluorometer. The ATP level was detected using a luciferin/luciferase based ATP assay kit. Results In Aβ25-35 treated group, the activity of calpain and H2 O2 was obviously higher than that in control group. How-ever, in neurons pre-incubated in NAC and then co-in-cubated in Aβ25-35 , the calpain activity and H2 O2 level were significantly decreased compared with that in Aβ25-35 group. Upon Aβ25-35 exposure for 12 h, corti-cal neurons showed a significant decrease in mitochon-drial membrane potential and ATP level when com-pared to the control group. Pre-treatment with NAC showed an increase in mitochondrial membrane poten-tial and ATP level as compared to neurons treated with Aβ25-35 alone for 12h. Conclusion This result sug-gests that NAC can attenuate calpain activity induced by Aβ25-35 through protecting mitochondria.

Objective To investigate the features of the memory function disturbance in patients of generalized seizures and the correlation between the memory function and proton magnetic resonance spectroscopy(1H-MRS).Methods The clinical memory scale of 45 general seizures and 20 normal age and sex-matched controls wss measured and a1 H-MRs was performed in the bilateral hippoeampal.The levels of NAA.Cho.Cr and the ratios of NAA/Cr+Cho were compared between these two groups.Meanwhile,tHe correlation coefficients was calculated and the results of clinical memory scale scoreB and the level of NAA,Cho.Cr and the ratios of NAA/Cr+Cho in groups were compared.Results As compared with the controls.the scores of pointing memory(17.19±5.86),associational learning(20.00±6.77),image free memory(18.44±6.62),association memory of portrait(13.19±6.62)and memory quotient (MQ,79.07±20.20)excepts insignificant figure recognition wcrc significandy decreased in patients of seizures(t=4.794-10.224,all P<0.01);The scores of scale and MQ of both the group of patients who wok antiepileptic drugs(AEDs)and the group of patients whose frequency exceeded 3 per month were significantly lower than the group who didn't take AEDs and the group whose frequency was lower than 3 per month(t=3.267-6.537,all P<0.01).The volumes of hippocampal formations(2.45 ±0.25 on left and 2.56 ±0.31 on right),the level of NAA(12.93 ±1.73 on left and 11.88 ±1.69 on right),Cho(15.02 ±0.86 on left and 14.94 ±0.96 on right),Cr(11.86 ±0.71 on left and 10.71 ±0.42 on right)and the ratios of NAA/Cr+Cho(0.48 ±0.08 on left and 0.39 ±0.07 on riht)in the group of pailents of generalized seizures were significantly difference than those in the controls(t=4.103-5.768,all P<0.01).Patients with seizures showed significant correlation between tlle scores of all items.MQ in clinical memory scale and NAA,NAA/Cr+Cho ratio(r=0.489-0.727,all P<0.01),and inverse correlation between the scores and MQ and Cho of in the bilateral hippocampal(r=-0.604-0.484,all P<0.01).However,there was no correlation between the scores and MQ and Cr of in the bilateral hippocampal.Condusions The patients of the general seizures do have the problem of the disturbance of short-term memory including acoustic memory and some visual memory.Both the high frequency of seizure and AEDs could affect the short-term memory function.The correlation between the scores of all the items and MQ in clinical memory scale proved that lack of nerve cell and hyperplasia of gliocyte was one of the reasons of the short-term memory disorder in epileptic.

Objective To assess health-related quality of life and the mood disorder in adults with epilepsy,and to evaluate factors contributing to the quality of life.Methods Quality of life was measured by the Quality of Life in Epilepsy Inventory(QOLIE-31)and the World Health Organization Quality of Life Assessment-Bref(WHOQOL-BREF).Psychotic conditions were evaluated by Self-rating Depressive Scale (SDS)and Self-rating Anxious Seale(SAS).The multivariate analysis was used to assess the determinant factors.Results The study included 141 epilepsy patients in the teat group and 59 sex,age,and education matched normal controls. WHOQOL-BREF scores in the physical and psychological aspects were significantly lower in epilepsy patients(12.7 ±1.8 and 12.4±1.9,respectively)than those in the normal controls(15.1 ±2.3 and 13.9 ±1.9,respectively,t value were 11.75 and 8.625.both P<0.05).The survey reported that 57.4 % of the epilepsy patients suffered with depression.and 39.7 % anxiety.The patients with both anxiety and depression scored lower in all aspects in QOLIE survey except medical effect.Multivariate analysis showed that factors that effect the overall quality of life in order were anxiety.depression and disease duration.Conclusion Our results support that complications of anxiety and depression and long disease duration are key factors affecting the quality of life in epilepsy patients.

Aim To explore the possible protective effect of ginsenoside Rg1 on oligomeric Aβ1-42 induced apoptosis and its possible mechanism. Methods The damage was induced by oligomeric Aβ1-42 in primary cortical neurons. Cells were incubated in the absence or presence of Aβ, or co-incubated in sp600125 with Aβ, or pre-incubated in ginsenoside Rg1 then co-incu-bated in Aβ. The p-JNK, JNK, caspase-3 activity and TUNEL-positive cells were detected. Results In Aβ1-42 treated group, the ratio of p-JNK/JNK level was increased more than that in non-treated group for 15 min. However, in neurons preincubated with (2. 5, 5, 10 μmol·L-1 ) ginsenoside Rg1 and then co-incuba-ted with 5 μmol·L-1 oligomeric Aβ1-42 , the p-JNK/JNK ratio, caspase-3 activity and TUNEL positive neu-rons were significantly decreased compared with those of Aβ1-42 treated group. Conclusion Ginsenoside Rg1 can attenuate the oligomeric Aβ1-42-induced apop-tosis by JNK pathway.

Objeetive To explore the situation of rotavirus infection and extraintestinal organe damage in children in Yueqing city.Methods Two hundred and eighty-seven cases with acute rotavirus gastroenteritis in our hospital were analyzed for prospective study from October 2011 to January 2013 by stool tests.Results Rotavirus infection was found to be more common in autumn and winter.There were 223 cases (17.7％) got extraintestinal organe damage,175 cases (60.80％) got myocardial lesion,and 78 cases (27.18％) got respiratory infection.At the same time,there were 51 cases (17.77％) and 21 cases (7.31％) got liver function lesion and convulsion respectively.Among the metabolic acidosis(48 cases),39 cases were combined with myocardial lesion.While non metabolic acidosis were 239 cases (81.25％),and 136 cases were combined with myocardial lesion.Therefore,the myocardial lesion was significant correlation with metabolic acidosis (P ＜ 0.01).Iron deficiency anemia was 123 cases and combined with 15 cases (12.19％) convulsion,while the convulsion prevalence rates of non iron deficiency anemia was 6 cases (3.65 ％).There was a statistically significant difference between the convulsion prevalence rates of iron deficiency anemia and that of non iron deficiency anemia (P ＜ 0.01).Conclusion Rotavirus diarrhea can lead to extraintestinal organe damage,and the clinical doctors should pay attention to them.

Objective To evaluate the therapeutic efficacy of hook plate and fascia lata graft in management of chronic acromioclavicular joint dislocation.Methods From May 2012 to March 2014,a total of 16 cases of chronic acromioclavicular joint dislocation (Rockwood type Ⅲ) were treated with hook plate and fascia lata graft.They were 10 men and 6 women,from 19 to 57 years of age (mean,34.7 years).Seven cases were at the left side and 9 at the right side.All injuries resulted from direct violence.The time from injury to surgery ranged from 8 to 54 weeks (mean,12.4 weeks).At the final follow-ups,the shoulder function was assessed using the Quick Version of the Disabilities of the Arm,Shoulder and Hand Score (DASH) and visual analogue scale (VAS),and the efficacy using Karlsson's evaluation system.Results All surgical wounds primarily healed.The dislocation of acromioclavicular joint was corrected,without any vascular or neural damage.The patients were followed up for an average of 12 months (from 6 to 18 months).No plate breakage,screw loosening or redislocation was observed.The DASH and VAS scores of the shoulder at the final follow-ups (25.42 ± 8.34 and 2.22 ± 1.70,respectively) were significantly improved,compared with the preoperative ones (43.72 ± 12.35 and 6.33 ± 1.37,respectively) (P ＜ 0.05).According to the Karlsson's criteria,10 cases were excellent,4 good and 2 moderate.Conclusion In management of Rockwood type Ⅲ chronic acromioclavicular joint dislocation,hook plate and fascia lata graft can restore dynamic balance and stability of the acromioclavicular joint,resulting in solid fixation,early joint motion and limited complications.

Objective To investigate the roles of RU486 inhibiting 3T3-L1 pre-adipocytes differentiation and regulating NF-κB activation. Methods Cells were treated with RU486 with concentrations of 0.1 ~ 10μmol/L for 48 h , then the relative contents of triglyceride were analyzed by Oil-Red O staining assay on 9 th day during adipogenesis. The mRNA expressions of PPARγ2,C/EBPa, LPL and FAS were further measured by Real-time PCR. IκBα protein level was detected by Western bolt and nuclear translocation of NF-κB was observed by immunofluorescence assay. Results The relative contents of triglyceride decreased with the increasing of RU486 concentration. Compared with the control, the relative contents of triglyceride in RU486-treatment groups from 0.5 μmol/L were significantly decreased (P < 0.05 or P < 0.01). Compared with the control, PPARγ2, C/EBPa, LPL and FAS mRNA expression and IκBα protein level were significantly decreased (P < 0.01) and NF-κB nuclear translocated from cytoplasm to nucleus in Group 5 mmol/L RU486. Conclusions RU486 could down regulate IκBα protein level , activate NF-κB nuclear translocation , then down regulate PPARγ2 , C/EBPa , LPL and FAS mRNA expression and inhibit adipocytes differentiation.