Objective To explore the clinical application of anticoagulation therapy for patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 55 patients with AECOPD were selected and divided into control group(24 cases) and treatment group(31 cases).Oxygen treatment,anti-infection treatment were applied to the patients of the control group.Treatment group was given anticoagulation treatment with heparin at the base treatment of the control group.The treatment efficacy,pulmonary functions,coagulation functions and inflammatory factors were tested and compared.Results There were no significant differences between two groups of total treatment efficacy(80.65％ vs 79.17％,x2 =1.304,P ＞0.05) ;PaCO2 decreased,pH and PaO2 increased significantly after treatments in the two groups(all P ＜ 0.05),which was more significantly in the treatment group (all P ＜0.05) ;FVC,FEV1 and FEV1/ FVC％ increased significantly after treatments in the two groups(all P ＜ 0.05),more significantly in the treatment group (all P ＜ 0.05) ; APTT,PT were prolonged,the level of DD and PAD decreased significantly after treatments in the two groups(all P ＜ 0.05),which was more significantly in the treatment group(all P ＜ 0.05) ;The level of IL-6,IL-10 and hs-CRP decreased significantly in all patients(all P ＜ 0.05),IL-6and hs-CRP were more significantly in the treatment group (all P ＜ 0.05),but the level of IL-10 of the treatment group was higher than that of the control group (P ＜ 0.05).Conclusion Pulmonary functions,Blood-gas indexes could be improved,inflammatory balance and coagulation status could be maintained by anti-coagulation treatment in patients with AECOPD.

Objective To investigate effects of sevoflurane and propofol on hemodynamic changes in patients undergoing cardiac double valve replacement.Methods Totally 80 patients admitted with rheumatic heart disease were divided into sevoflurane group and propofol groups.The anesthetic drugs on hemodynamics,myocardial function and renal function were compared.Results There were statistically significant in CIL concentration,stroke volume index (SVI)and left ventricular -stroke work index (LVSWI)levels between the two groups at the same time points (F =2.467,2.4783,2.553,P =0.032,0.032,0.021).The levels of MAP,HR,PAWP,CIL,SVI and LVSWITBIL between the two groups were statistically significant at different time points (F =2.597,2.468,2.523,2.589,2.532, 2.556,P =0.032,0.021,0.030,0.021,0.024,0.023),and difference at the same group at different time points (F =2.597,2.468,2.523,2.497,2.479,2.538,P =0.032,0.021,0.030,0.034,0.034,0.038).No obvious liver and renal function damage was found during the surgery in the two groups.Conclusion Anesthesia induction of sevoflurane and propofol for patients undergoing cardiac double valve replacement has similar effects on the hemody-namics and cardiac function,without obvious damage to liver and renal function.

The papers on information ecology theory in foreign and domestic libraries were analyzed and its appli-cation value in book acquisition was studied.The information ecosphere formed by readers, acquisition members and experts was put forward and how to make the information ecosystem reach its new balance by dynamic regula-tion of its main components through information flow.

Sanger sequencing technology is the most commonly used method for genetic analysis in inherited eye disease in the past few decades on account of its long DNA sequencing read length and high accuracy.However,application of this method is limited in genetically heterogeneous diseases because of the high economic and time cost.Next generation sequencing (NGS) technology is a high-throughput,cost-effective,and highly automated method which has been widely used since 2005.Although NGS is especially suitable for studies on genetically heterogeneous inherited eye disease,overdependence on the technique itself and neglect of the assessment of the phenotype may lead to misjudgment of the testing results and higher economic burden for the patients.So far,the most common method on researches of monogenic inherited eye disease is to combine NGS and Sanger sequencing technique.Precise evaluation of the clinical phenotype of patients is very important,as it is related with selection of detection methods and determination of disease-causing mutations.

OBJECTIVE:To evaluate the cost-effectiveness of salmeterol/fluticasone compound(SFC)and budesonide(BUD)in the treatment of asthma.METHODS:A multicenter randomized controlled clinical trial was performed on386asthma cases,who were administered with SFC50/100?g bid or BUD400?g bid,data on which were retrospectively collected and then the cost-effectiveness analysis was conducted,the effectiveness was measured in terms of successfully-treated weeks,symptom-free days and uninvolved days;The direct healthcare cost was adopted as the cost index.RESULTS:The average daily medical cost of the SFC treatment group(RMB:15.6yuan)was a little bit higher than that of the BUD control group(RMB:13.8yuan),but the costs of every successfully-treated week,every symptom-free day and every uninvolved day for SFC group were166.5yuan,33.4yuan and41.2yuan,respectively,which were all lower than those of the BUD group(which were188.6yuan,50.6yuan and66.1yuan,respectively);Incremental cost-effectiveness ratios for every successful?ly-treated week,per symptom-free day and per uninvolved day for the SFC group were88.7yuan,9.4yuan and10.8yuan,respectively vs.the BUD group.CONCLUSION:The results show that the cost-effectiveness of SFC50/100?g bid is supe?rior to BUD400?g bid in the treatment of asthma.

Objective To explore the teaching effect of cooperative learning approach in the training class of basic nursing operation techniques for male students. Methods A total of 82 male nursing students who were admitted into college in 2013 with a 3-year study program were divided into two groups based on mechanical sampling method, 42 students in the experimental group were trained with cooperative learning approach, while 40 students in the control group were trained with traditional teaching method. At the end of the semester, surveys were conducted and the results of students′operative skill were analyzed. Results The result of operative skills evaluation in the experiment group was 88.0 ± 6.9while that in the control group was 79.0 ± 9.2. The comparative difference between the two groups had statistical significance(t = 4.392,P<0.01). The qualified rate in the experiment group was 95.23%(40/42)while that in the control group was 70.00%(28/40).The comparative difference between the two groups had statistical significance(χ2=9.118,P<0.01). Conclusions Cooperative learning approach can improve the teaching effect of nursing operative skills for male nursing students. Thus it is an effective teaching method that deserves promotion and application in the practice teaching of Basic Nursing Techniques.

Objective:To investigate the effects of endoscopic local treatment for colorectal intramucosal carcinoma.Methods:42 patients with colorectal intramucosal carcinoma were treated with endoscopic local through one or few methods such as biopsy forceps resection,looping ligature and high frequency electric coagulation etc.in past five years.Results:(1)18 cases received biopsy forceps resection,3 cases received looping ligature,16cases received high frequency electric coagulatio resection,5 cases received many kinds of methods.(2)3 cases of 5 cases with advanced carcinoma were operated enlarge radical surgery except 1 cases who refused operation and 1 cases who losted operation opportunity.In the rest 37 cases,7cases were operated surgery,malignant remnants were no founded in theses colon specimens.(3)The following-up 33cases(30 cases without surgery)failed to show recurrent cancer for 1 month to 5 years.(4)In the following-up cases,the incidence of neogenesis adenoma was 57.1% in cancer with pilosity adenoma and was 15.8% in early cancer without adenoma during 1 year to 3 years after operation.Conclusions:It can achieve to healing,security and minimum invasive treatment for endoscopic local resection to colorectal intramucosal carcinoma as long as it is suitable to select case.

Objective:To evaluate the influence of health education on knowledge and attitude about drugs and addictive drug abuse prevention among the junior middle school students.Methods:389 junior middle school students were selected in this program.Drugs and addictive drug abuse prevention related knowledge and attitude of the junior middle school students were surveyed by questionnaire anonymously before and after the health education.Results:After education,average score of drugs and addictive drug abuse prevention knowledge among the junior middle school students was significantly increased from 8.8 to 15.7(full score 17),suggesting the significant difference.The junior middle school student's level of knowledge about the danger of smoking and drinking also increased significantly.The correct rate of the answers rose from 4.6%～78.6% to 79.4%～100.0%.After this education,the rate of correct attitude about the drugs and addictive drug abuse prevention was significantly higher than before.Conclusion:The study suggests that health education on drugs and addictive drug abuse prevention among the junior middle school students has the positive impact on increasing the basic knowledge on the drugs and addictive drug abuse prevention for the junior middle school students as well as setting up the correct attitude on it.

Objective:To assess the anatomy of portal vein and hepatic vein with three dimensional 16-MSCT angiography.Methods:A total of 100 healthy subjects underwent upper abdominal MSCT examinations in our department.All subjects were administered 90～120ml of IV contrast material at an injection rate of 3ml/s.The scan delay time was 45～60s and 90～120s for portal venous and hepatic venous phase with automated bolus tracking,respectively.All data sets were reconstructed in 1-mm section and 0.5mm interval,and then were transferred to a workstation for maximum intensity projection(MIP)and volume ren-dering(VR) econstruction.The portal vein anatomy was classified according to Couinaud and Atri’s classification;the hepatic veinanatomy according to Nakamura’s,Marcos’s and Kawasaki’s classification.Results:① Normal portal vein anatomy was seen in 76 cases,type Ⅱin 16,type Ⅲ in 6,type Ⅳ in 2.②Nakamura’s TypeⅠof hepatic vein was presented in 72 cases;type Ⅱ in 22.type Ⅲ in 6.The branching pattern of the middle hepatic vein was type Ⅰin 65 cases,type Ⅱin 19,and type Ⅲ in 16.Segment IVb vein branched from the middle hepatic vein in 42 cases,and from the left hepatic vein in 58.Conclusion:3D 16-MSCTA is a significantly valuable tool which can provide complete and comprehensive information on the anatomy of portal vein and hepatic vein combined with MIP and VR image.

Objective: To study the effects and significances of lipopolysaccharide preconditioning on the activities of NF-?B and the expression of ICAM-1/LFA-1 in rats graft liver ischemia/reperfusion injury. Methods: Male Sprague-Dawley rats were divided into three groups: sham operation group(Sham group),orthotopic liver transplantation group (OLT group) and LPS preconditioning group (LPS group). Only dissecting hepatoduodenal ligament was perfomed in Sham group. Experiments of OLT were performed by two-cuff method in OLT group and LPS group. The activities of NF-?B and the expression of ICAM-1/LFA-1 in hepatic tissue ,the levels of ALT,AST in inferior caval vein blood were detected at 0,60,180 min after dissecting of hepatoduodenal ligament in Sham group and after portal vein reperfusion in OLT group and LPS group. Results: Compared with those in Sham group at the different time points respectively,the activities of NF-?B and the expression of ICAM-1/LFA-1 were higher in OLT group and LPS group(P0.05) at 0 min after reperfusion,they were evidently higher in OLT group than in LPS group (P