Objective To evaluate the clinical effect of salmeterol xinafoate and fluticasone propionate powder for inhalation combined ipratropium bromide aerosol in patients with stable chronic obstructive pulmonary disease (COPD).Methods One hundred and twenty patients with stable COPD was randomly divided into control group and observation group with 60 patients each.The control group was received ipratropium bromide aerosol inhalation,and the observation group was given salmeterol xinafoate and fluticasone propionate powder for inhalation and ipratropium bromide aerosol for 6 months.BODE index,SGRQ scores,plasma cortisol and bone mineral density were compared between two groups before and after treatment.Results BODE index scores had no significant difference between two groups before treatment (P＞0.05).After treatment,BODE index scores,dyspnea scale,FEV1％,6MWD and BODE index total scores in observation group were superior to those in control group [ (1.9 ± 0.5) grades vs. (2.3 ± 0.5)grades,(58.5 ± 7.3)％ vs.(50.4 ± 6.2)％,(411.1 ± 56.8) m vs.(347.5 ± 60.4) m,(3.3 ± 1.0) scores vs.(3.8 ± 1.3 ) scores ],there were significant differences (P＜0.05 ).SGRQ scores had no significant difference between two groups before treatment (P＞0.05 ).After treatment and in SGRQ scores,respiration symptom,limitation of activity,disease influence scores in observation group were significantly lower than those in control group [ (20.7 ± 10.3 ) scores vs.(37.9 ± 14.4) scores,(20.7 ± 9.5 ) scores vs.(34.8 ± 13.0) scores,(16.3 ± 6.7) scores vs.(27.2 ± 11.8) scores,(17.5 ± 7.0) scores vs. (34.6 ± 12.3) scores],there were signiticant differences (P＜0.01 ).There were no significant difference of plasma cortisol and bone mineral density between two groups (P＞0.05).Conclusions Salmeterol xinafoate and fluticasone propionate powder for inhalation and ipratropium bromide aerosol in patients with stable COPD can greatly improve the lung function and life quality and with less adverse reaction.

Objective To evaluate the role of fibroblast growth faetor-2 (FGF-2) in neuropathic pain (NP) in rats.Methods One hundred male Sprague-Dawley rats,aged 7 weeks,weighing 200-250 g,were randomly divided into 4 groups (n=25 each): sham operation group (group S),group NP,phosphate buffer solution (PBS) group and FGF-2 antibody group (group Ab).FGF-2 antibody 18 μg (40 μl) was injected intrathecally at 1,6,9,13,16 and 20 days after operation in group Ab,while the equal volume of PBS was injected intrathecally in group PBS.Spinal nerve injury was produced by exposing the sciatic nerve and its branches and ligation and transection of tibial nerve and common fibular nerve.Pain behavior was assessed at 1 day before operation and at 1,4,7,14 and 21 days after operation.The paw withdrawal mechanical threshold (PWMT) was measured.The animals were then sacrificed and the lumbar segment (L4-6) of the spinal cord was obtained for determination of the contents of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in the spinal cord.Results Compared with group S,the PWMT was significantly decreased and the contents of TNF-α and IL-6 in the spinal cord was significantly increased in groups NP,PBS and Ab (P ＜ 0.05).The PWMT was significantly higher and the contents of TNF-α and IL-6 in the spinal cord were significantly lower in group Ab than in groups NP and PBS (P ＜ 0.05).Conclusion FGF-2 is involved in the occurrence and development of NP and induction of the inflammatory response in the rat spinal cord in involved in the mechanism.

Objective To evaluate the effectiveness of clinical rotation training in pain department for general practitioner.Methods Totally 31 general practitioners of 3 years program in the First Affiliated Hospital of Chongqing Medical University were involved in clinical rotation training in pain department form August 2008 to December 2011.Training lasted for one month.Clinical rotation training in pain department was conducted for general practitioners by studying rules and regulations,treatment methods,imaging data and clinical practice.Evaluation was made according to the treatment,theoretical knowledge,interpersonal skill and professional competency of general practitioners.Measurement data were expressed as mean ± standard deviation ((-x) ± s) while enumeration data were expressed as rate.Descriptive analysis of the data was used.Results Average total number of patients managed by 31 general practitioners was (15 ± 2),average total number of disease species was (5 ±2),average number of case discussion and small lecture participated was 1 ～2,average number of nerve block participated as assistant was (40 ± 5) and average number of minimally invasive surgery visited and studied was (2 ± 2).Residency duties were skillfully completed and assessment score was (85 ± 4.50).Conclusions Through clinical rotation training,general practitioners can understand common disease diagnosis and treatment category; familiarize clinical evaluation methods and master standards of diagnosis and treatment in pain department.Meanwhile,they would learn doctor-patient communication to establish a good therapeutic relationship with patients.

Objective To observe the clinical effect of lithium carbonate on hyperthyroidism.Methods Forty-seven cases of hyperthyroidism with abnormal hepatic function and/or leucopenia were recruited from January 2010 to January 2012.Thyroid function,adverse reactions,and clinical outcome of patients treated with lithium carbonate were observed and recorded before and after treatment.Results Thyroid function,liver function,and leucopenia in all patients were improved markedly after treatment.Among the treated patients,9 cases resulted in complete remission and had the drug discontinued,11 cases received radioactive iodine therapy afterwards,6 cases underwent surgical treatment,16 cases continued to use the same drug,and 5 cases were lost during follow-up.No obvious adverse reaction appeared during the treatment.Conclusions Lithium carbonate can be effectively used in patients with hyperthyroidism complicated by leukopenia or liver damage.It is also indicated during preparation for radioactive iodine or surgical treatment in patients with thyrotoxicosis.

Aim To construct a subtracted cDNA library o f differentially expressed genes in human gastric carcinoma induced by diallyl dis ulfide(DADS). Methods Differentially expressed cDNA species induc ed by DADS in MGC 803 human gastric carcinoma cell line was determined by using suppression subtractive hybridization (SSH). Then these cDNA species were direct ly inserted into T/A cloning vector to set up the subtractive library. Amplification of th e library was carried out with transformation of E.coli by high voltage electrop erforation. One hundred positive bacteria clones were randomly picked and identi fied using PCR method. Results The amplified library contained more than 1,000 positive bacteria clones. Random analysis of 100 clones with PCR m ethod showed that all clones contained 100～600 bp inserts.Conclusions A subtracted cDNA library of differentially expressed genes in MGC 803 hum an gastric carcinoma cell line induced by DADS is constructed successfully with SSH and T/A cloning techniques. The library is efficient and lays solid foundati on for screening and cloning new and specific tumor correlative genes of human g astric carcinoma, and provides a new idea for further exploring the mechanism of DADS effects on carcinoma cells.

Objective To investigate the impact of maternal health education on the mode of delivery and pregnancy outcome. Methods All 385 pregnant women had been chosen, were randomly divided into observation group of 194 cases and control group of 191 cases,of which 24 cases exit off observation group,27 cases exit off the control group,included the observation group of 170 cases and the control group of 164 cases, the observation group used stages of maternal health education, control group used conventional health education. Results The evaluation of health knowl-edge scores in observation group were significantly higher, the number of prenatal significantly more than the control group,complete check-rate rate were significantly higher(P<0.05).The vaginal delivery rate in observation group were significantly higher than control group,cesarean section own volition choose the ratio in observation group were signifi-cantly lower than the control group(P<0.05). The incidence of adverse pregnancy outcomes between groups were signifi-cantly different(χ2=4.242,P<0.05),in which the observation group gestational diabetes,preterm birth were significantly higher incidence of postpartum hemorrhage, lactation period were significantly less than the control group, nursing satisfaction were significantly higher(P<0.05). Conclusion Maternal health education helps to improve maternal health and prenatal knowledge of the number of times to reduce the cesarean section rate, reduce the incidence of adverse pregnancy outcomes.

OBJECTIVETo observe the temporal changes of basic fibroblast growth factor (FGF-2) expression in the spinal cord of a rat model of spared nerve injury (SNI) of the sciatic nerve.

METHODSA total of 100 male SD rats were randomly divided into sham-operated group and SNI group. The paw withdrawal threshold to mechanical stimulation was recorded at 1 day before and at 1, 4, 7, 14 and 28 days after the operation. The expressions of FGF-2, tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in the L4-6 spinal cord segments of the rats were measured at the specified time points.

RESULTSThe paw withdrawal threshold began to decline at 1 day after SNI, reached the lowest level at 7 days, and maintained a low level till 28 days (P<0.05). The expression of FGF-2 began to increase significantly on postoperative day 4, reached the peak level on day 14 and maintained the high level till day 28 (P<0.05). The rats with SNI showed significantly higher expressions of TNF-α and IL-6A in the spinal cord than those in the sham-operated group at each time point of measurement (P<0.05).

CONCLUSIONSSNI of the sciatic nerve can induce neuropathic tactile allodynia and causes up-regulation of FGF-2 and inflammatory cytokines in the spinal cord.

Animals ; Disease Models, Animal ; Fibroblast Growth Factor 2 ; metabolism ; Hyperalgesia ; Interleukin-6 ; metabolism ; Male ; Pain Threshold ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve ; injuries ; metabolism ; Sciatica ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

Background and purpose:Primary adrenal intravascular large B-cell lymphoma(IVLBCL)is rare and highly aggressive.Unfortunately,comprehensive and sufficient understanding of the disease is lacking.This study investigated the clinicopathological and molecular genetic characteristics of adrenal IVLBCL.Methods:Adrenal IVLBCL cases diagnosed from 2012 to 2023 were collected from Department of Pathology,Fudan University Shanghai Cancer Center.The clinical and histopathological features,immunophenotype,treatment and prognosis were analyzed.The molecular genetic characteristics were detected using next-generation sequencing(NGS).This study was approved by the Ethics Committee of Fudan University Shanghai Cancer Center(Ethics number:050432-4-2307E).Results:All of the 5 patients were male,with median age 52 years(ranged 50-82 years).Two cases had low-grade fever,1 case had abdominal pain,1 case was found by physical examination,and the information of the remaining one was unknown.Peripheral blood test showed elevated serum lactate dehydrogenase in 2 cases and adrenal dysfunction in 2 cases.On initial diagnosis,imaging tests displayed adrenal enlargement or masses with increased fluorodeoxyglucose(FDG)uptake.Bilateral adrenal glands were involved in 4 cases and only the right adrenal gland was involved in the other case.Morphologically,large atypical lymphocytes were confined to blood vessels,and fibrinous necrosis was observed in some cases.Immunohistochemical study revealed that CD20 was positive in all cases.Ki-67 proliferation index was high,all above 80%.80%(4/5)of the cases were of non-germinal-center B-cell-like(non-GCB)phenotype,100%(4/4)of the cases had MYC/BCL2 double expression.Endothelial cell markers staining indicated that most of the tumor cells were confined within the blood vessels in all cases.Follow-up data were available in 3 patients.One patient who underwent only surgical resection died 5 months after diagnosis,one achieved complete remission after surgery plus R-CHOP,and the other diagnosed by biopsy achieved a partial remission after R-CHOP.The 1-year overall survival rate was 66.7%,and overall survival was 5-87 months.NGS testing in 1 case showed missense mutations in MYD88 V217F,TP53,CDH1,ARID1B,MSH3,MLH3,PTPRK,CD22 and FLCN.Conclusion:Adrenal IVLBCL is rare and tends to occur in the middle-aged and elderly male.The majority of our patients were non-GCB phenotype,often accompanied by MYC/BCL2 double expression,and MYD88 non-L265P mutation was detected.Early diagnosis of adrenal IVLBCL is difficult due to its diverse clinical symptoms and lack of specificity.It is of great importance to accumulate more cases and further understand the clinicopathological and molecular genetic characteristics of this rare disease,which might not only help with early diagnosis,timely treatment and improvement of prognosis,but also provide a theoretical basis for further understanding the pathogenesis and development of the disease and exploring therapeutic targets.

BackgroundThe depressive episode is one of the most prevalent mental illnesses worldwide. Relaxation therapy as a psychotherapy for depressive disorder has shown itself to be a viable tool， yet the existing research on relaxation therapy combined with sertraline in the treatment of depressive episodes in children and adolescents is severely limited. ObjectiveTo discuss the effect of relaxation therapy combined with sertraline on the new-onset depressive episodes in children and adolescents， and to provide references for the treatment of depressive episodes in children and adolescents. MethodsFrom January 1， 2019 to December 31， 2020， a sample of 422 children and adolescents with depressive episodes attending the Child Mental Health Department of Sichuan Mental Health Center and fulfilling the International Classification of Diseases， tenth edition （ICD-10） diagnostic criteria were enrolled， and they were classified into study group （n=208） and control group （n=214） using random number table method. All participants were offered sertraline， based on this， study group was assigned to relaxation therapy for 25~30 min per day， five days per week for a period of two weeks. Hamilton Depression Scale 24-item （HAMD-24） and Hamilton Anxiety Scale （HAMA） were applied at the enrollment， the end of 2 weeks of treatment and the end of the 2^nd week after discharge. ResultsA total of 369 patients completed the study， including 185 in study group and 184 in control group. Analysis on HAMD-24 scores revealed a significant time effect， group effect and time×group interaction effect （F=813.279， 17.625， 8 994.905， P<0.01）. Significant time effect， group effect， and time×group interaction effect were noted on HAMA scores （F=635.041， 10.716， 13 945.986， P<0.01）. A reduction in HAMD-24 and HAMA scores was reported in study group at end of 2 weeks of treatment and end of the 2^nd week after discharge compared with baseline （t=0.924， 0.359， P<0.01）. At the end of the 2^nd week after discharge， study group scored lower on HAMD-24 and HAMA compared to control group （t=0.210， 0.720， P<0.05）. At the end of 2 weeks of treatment， study group resulted in greater improvements in depressive symptoms and anxiety symptoms than those of control group （95.14% vs. 66.30%， 89.18% vs. 71.74%， χ²=78.942， 22.526， P<0.05）. The overall efficacy rate yielded no statistical difference between two groups at end of the 2^nd week after discharge （P>0.05）， and no statistical difference was found in the adverse reactions between the two groups （P>0.05）. ConclusionCompared with sertraline alone， its combination with relaxation therapy may achieve a better short-term efficacy in the treatment of depressive episode in children and adolescents. ［Funded by Sichuan Medical Scientific Research Project （number， S18020）］