Objective: To explore the effects of pulmonary rehabilitation on exercise tolerance ability. Methods:Fifteen (10 males,5 females)stable COPD patients, entered into 48 weeks of rehabilitation program. The lung function, 6 minutes walk distance(6MWD) were measured at pre, post and first post-maximal exercise training. Results: There was no significiant change in FEV1, FEV1/predict and FEV1/FVC at pre, post and first post-maximal exercise training in COPD patients. 6MWD significantly increased in COPD patients after 48 weeks exercise training program. There was no significant change in baseline and first post-maximal exercise training in COPD patients. Conclusion:There were no significant changes in parameters of lung function before and after training. The exercise tolerance in COPD patients was significantly improved by 48 weeks exercise training.

Objective The aim of this study is to evaluate clinical application of BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index in patients with chronic obstructive pulmonary disease (COPD). Methods Forty patients with stable COPD in Xuanwu Hospital of Beijing during September 2003 to December 2007, were recruited in the study, including 25 men and 15 women, aged 38 to 85 years (with a mean of 62 ± 13 years). BODE index was measured for each patient, one year and three years after recruitment, respectively. Severity of COPD, including number and duration of episodes, length of each hospital stay and times of hospitalization due to acute exacerbation of COPD (AECOPD), were recorded. All data were statistically analyzed with SPSS 13.0 software for windows. Results ①There was a remarkable difference in COPD severity between patients with BODE score equal to or greater than five and these with less than five (P <0.01 ). ①BODE score inversely correlated with forced expired volume at the first second ( FEV1 ) in COPD patients (P < 0.01 for those with BODE score equal to or greater than five and P <0.05 for these with BODE score less than five, respectively). ③BODE score positively correlated with number and duration of acute exacerbation, length of hospital stay and times of hospitalization due to AECOPD (P <0. 01 for those with BODE score equal to or greater than five and P < 0. 05 for those with BODE score less than five, respectively). For patients with COPD, their BODE score in the first year positively correlated with that in the third year ( r = 0.834, P < 0.01 ). Conclusions BODE index is a better indicator to evaluate their condition severity in patients with COPD.

Objective To investigate the efficacy and safety of acute normovolemic hemodilu-tion for pregnant women with total placenta pravia and accreta.Methods Fifty-two pregnant women with placenta praevia and accreta were randomly divided into three groups.Groups A and B received ANH or AHH before the operation while group C received the normal treatment.The total blood loss,transfusion of allogeneic blood and preoperative and postoperative routine blood test were recor-ded;the infants’umblical artery blood samples were taken immediately after birth,and 1 min,5 min Apgar scores and the blood gas was analyzied.Results There were no significant difference in the general condition,operation duration,blood loss among the three groups;the transfusion of allogeneic blood in groups B and C were much more than group A (P <0.05);the postoperative hemoglobin and hematocrit and the count of plateletsin in group A were better than groups B and C (P <0.05),while there were no statistically difference between groups B and C;there were not only seldom difference in the Apgar scores of 1 min and 5 min,but also barely change in the blood gas analysis of umbilical ar-tery in new borns from the three groups.Conclusion ANH could play an important role in the pre-vention of postpartum hemorrhage without doing any harm to the mother and infant.

Objective To observe the protection effect of ischemic preconditioning to small intestines injury after limbs ischemia reperfusion ,and investigate the role of nitrogen monoxidum in the process .Methods 52 male Wistar rats were randomly divided in-to Sham group ,limbs ischemia-reperfusion (IR) group ,IPC + IR group and Nω-nitro-L-arginine methylester (L-NAME) group . The value of diamine oxidase (DAO) and nitrogen monoxidum (NO) in plasma and gut tissue ,the content of fluorescein isothiocya-nate lipopolysaccharide (FITC-LPS) in plasma ,and the value of cyclic guanosine monophosphate (cGMP) and malondialehyde (MDA) in gut tissue were measured ,respectively .The expression of P-selection and Caspase-3 were measured by immunohisto-chemistry .The apoptosis of intestinal cells was detected by terminal deoxynucleotidyl transferase -mediated dUTP nick end labe-ling (TUNEL) and the results were analysed quantitatively by automatic image analytical system .Results Compared with the LIR group ,the values of DAO and FITC-LPS in plasma decreased obviously in the IPC group ,and the level of NO in plasma increased obviously (P<0 .01) .The values of DAO ,NO and cGMP in gut tissue increased obviously ,the level of MDA and the expression of Caspase-3 and the apoptosis index (AI) were significantly decreased in IPC group (P<0 .01) .Compared with the IPC group ,the value of DAO and FITC-LPS were higher and the level of NO was lower in plasma of the L-NAME group (P<0 .01) .The values of DAO ,NO and cGM P in gut tissue obviously decreased ,the level of MDA significantly increased ,and the expression of Caspase-3 and the AI significantly upregulated in L-NAME group than those in IPC group (P<0 .01) .Conclusion IPC can improve the small intestine injury and the apoptosis following hind limbs ischemia reperfusion which may correlated with the increase in the level of NO .

Objective To evaluate the efficacy of dexmedetomidine mixed with ropivacaine for epidural anesthesia in the patients.Methods Forty-six patients, of ASA physical status Ⅰ or Ⅱ , aged 36-58 yr, weighing 48-77 kg, scheduled for elective hysterectomy under epidural anesthesia, were randomly divided into 2 groups (n =23 each) according to the random number table: normal saline + ropivacaine group (R group) and dexmedetomidine + ropivacaine group (DR group).Epidural anesthesia was performed at L2,3interspace.The catheter was inserted into the epidural space.A mixture of 0.75％ ropivacaine 15 ml and dexmedetomidine 1 μg/kg was injected epidurally in DR group.A mixture of 0.75％ ropivacaine 15 ml and normal sline 2 ml was injected epidurally in R group.The onset time of sensory block, maximum level of sensory block, and duration of sensory block were recorded.The modified Bromage scale, Ramsay sedation score and intraoperative traction reaction were assessed.The occurrence of dexmedetomidine-related cardiovascular events and respiratory depression, and epidural anesthesia-related adverse events within 2 h after operation was recorded.Results Compared with R group, the onset time of sensory block was significantly shortened, the duration of sensory block was prolonged, the maximum level of sensory block and Ramsay sedation score were increased, the degree of intraoperative traction reactions was lessened, and the incidence of shivering was decreased in DR group (P ＜ 0.05).No patients developed dexmedetomidine-related adverse events.Conclusion Epidural dexmedetomidine 1 μg/kg significantly optimize the efficacy of ropivacaine when used for epidural anesthesia in the patients.

Objective To establish an HPLC method to determine the content of diosgenin in Paridis Rhizoma; To examine contents of diosgenin in different varieties of Paridis Rhizoma medicinal plants and from different habitats. Methods Shimadzu Inertsil ODS-C18 guard column (150 mm×4.6 mm, 5μm) was used in HPLC system; elution conditions were the mobile phase using 92% acetonitrile and 8% water (isocraticelution) at a flow rate of 1.0 mL/min with 203 nm detection wavelength. The temperature of the column oven was maintained at 30℃.Results Different varieties of Paridis Rhizoma medicinal plants and Paridis Rhizoma medicinal plants from different habitats contained diosgenin. TheParis polyphylla var.pseudothibetica in Yubei district had the highest content (6.813 7 mg/g);Paris polyphylla var.stenophylla in Chengkou County had the middle content (5.758 4 mg/g);Paris yunnanensisFranch in Shizhu county showed the lowest content (1.952 2 mg/g). The results showed that the obvious difference of chemical quality between various cultivated varieties of Paridis Rhizoma medicinal plants, which might be related with origin, variety and the cultivation technology, and so on.Conclusion The diosgenin contents ofParis polyphylla var. pseudothibetica andParis polyphylla var.stenophylla were higher than that of varieties recorded in Chinese Pharmacopeia.Paris polyphylla var.pseudothibetica andParis polyphylla var.stenophylla had important medical value.

Objective To determine the optimum dose of normal saline (NS) for preloading epidural space required to prevent the injury to blood vessel by epidural catheter placement for caesarean section.Methods Two hundred ASA Ⅰ or Ⅱ parturients with a single baby at full term in vertex presentation,aged 24-35 yr,weighing 63-78 kg,scheduled for caesarean section under continuous epidural anesthesia,were randomly divided into4 groups (n-50 each):control group (group Ⅰ),NS2 ml group (group Ⅱ),NS5 ml group (group Ⅲ)and NS 10 ml group (group Ⅳ).The epidural puncture was performed at L2-3 interspace with a Tuohy needle attached to a 5 ml syringe.Loss of resistance was used to identify the epidural space.In group C no fluid was injected into the epidural space before insertion of the catheter,while in groups Ⅱ,Ⅲ and Ⅳ NS 2,5 and 10 ml were injected into the epidural space before the catheter insertion respectively.After a test dose of 3 ml 1.5％ lidocaine,0.75％ ropivacaine 10-20 ml was administered through the epidural catheter.MAP and HR were recorded before epidural puncture (T0),at 10 and 20 min after the end of epidural administration (T1.2),and at the end of surgery (T3).The number of patients in whom blood or blood tinted fluid was withdrawn from the epidural catheter was recorded.The amount of ropivacaine consumed was recorded.The upper level of anesthesia was measured by pin-prick and the degree of motor block was assessed using modified Bromagc scale at T2.Results The hemodynamic parameters were in the normal range in the four groups.MAP was significantly lower at T2,the upper level of anesthesia was significantly higher,and the degree of motor block was significantly smaller in group Ⅳ than in groups Ⅰ,Ⅱ and Ⅲ (P ＜ 0.05).There was no significant difference in MAP among groups Ⅰ,Ⅱ and Ⅲ (P ＞ 0.05).There was no significant difference in HR and the amount of ropivacaine consumed among the four groups (P ＞ 0.05).The number of patients in whom blood or blood tinted fluid was withdrawn fiom epidural catheter was significantly smaller in groups Ⅲ and Ⅳ compared with groups Ⅰ and Ⅱ (P ＜ 0.05).Conclusion Preloading the epidural space with NS 5 ml can prevent the occurrence of injury to blood vessel induced by insertion of epidural catheter with no influence on the efficacy of anesthesia and NS 5 ml is the optimum dose.

ObjectiveTo evaluate the effect of preloading epidural space with 0.9％ sodium chloride on the incidence of the injury to blood vessel by epidural catheter insertion for cesarean section.Methods One hundred uterogestation patients with single birth,ASA class Ⅰ - Ⅱ,underwent caesarean section and requested continuous epidural analgesia were divided into group P and group C with each 50 cases by random digits table.After identification of the epidural space,group C was inserted epidural catheter directly,and 5 ml of 0.9％ sodium chloride was injected into epidural space through the epidural needle in group P,while the syringe plunger was held closed for 20 s to make sure the solution spreaded sufficiently,following insertion the epidural catheter.Between the two groups,mean arterial pressure and heart rate were recorded prior to anesthesia,2 min after turn to the supine horizontal position after succeeded puncture,the time when the fetus were born and when the surgery were over.The cases with bloody fluid in the epidural puncture needle during puncture,or in the epidural catheter during catheter placement,fresh blood in the epidural catheter,and bloody fluid in caudal end of epidural catheter during extubation were recorded.ResultsThe changes of mean arterial pressure and heart rate were all in the normal range,there was no obvious difference between the two groups.The incidence of rates with bloody fluid in the epidural puncture needle during puncture and the bloody fluid in caudal end of epidural catheter during extubation in group P were significantly lower than those in group C [ 10％ (5/50) vs.26％ (13/50),22％ (11/50) vs.48％ (24/50),P ＜ 0.05 or ＜ 0.01 ].ConclusionPreloading epidural space with 5 ml 0.9％ sodium chloride can reduce the incidence of the injury to blood vessel induced by insertion of epidural catheter.

Objective To understand the knowledge of tuberculosis in general hospital patients with respiratory diseases.Methods Face to face questionnaire survey 821 respiratory patients, the main contents include: the tuberculosis awareness, common symptoms of tuberculosis, tuberculosis with or without contagious, persistent cough expectorant willing to go to where the treatment of tuberculosis, national policy, treatment of the course of treatment, tuberculosis prevention measures, and whether the knowledge of tuberculosis drug resistance.Results 92.1% of patients were aware of TB and 98.7% of patients knew TB was contagious, and 99% knew that TB was transmitted by the respiratory tract.Only 4.5% of patients with symptoms appear willing to go to tuberculosis treatment of patients.94.9% of the patients were aware of a specific TB control facility, 85% knew that the basic TB treatment was free, 99% thought to be good treatment of tuberculosis patients, 55% of patients know that tuberculosis treatment for a long time, to regular medication.30% of people know that mycobacterium tuberculosis resistance.90% of patients know to isolate tuberculosis patients, 40% of patients that protect susceptible populations, and 95% believed that BCG could prevent tuberculosis.Conclusion Patients have a certain understanding of tuberculosis, the timely treatment of indifference to the treatment of treatment is probably not impressed, very little knowledge of tuberculosis resistance.

ObjectiveTo study the effects of 9 different drying methods on total saponin content and antioxidant capacity ofParis polyphylla var.yunnanensis.Methods UV-VIS spectrophotometry was used for measuring the total saponin content ofP. polyphylla var.yunnanensis, 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-azino-bis (3-ethylbenzthiozoline-6)-sulphonic acid (ABTS+) radical scavenging methods were used for evaluating the antioxidant capacity ofP. polyphylla var. yunnanensisextracts.ResultsThe total saponin contents ofP. polyphylla var.yunnanensis dried by different methods existed significant difference. The sample dried at 35℃ showed highest total saponin content (17.557 mg/g). The sample dried in the shade naturally showed middle total saponin content (13.740 mg/g). Based on the results of antioxidant capacity detected by two methods, the samples ofP. polyphylla var. yunnanensis dried by 9 different methods all showed good antioxidant capacity and showed a certain concentration dependence.Conclusion The samples dried at 35℃ have the highest antioxidant capacity. Therefore, drying at 35℃ is a better drying method to obtain high quality and high activity ofP. polyphylla var.yunnanensis.