Objective To investigate the clinical effect of Tiotropium Bromide Powder for Inhalation combined with mental intervention in the treatment of chronic obstructive pulmonary disease in stable period. Methods 80 patients with stable chronic obstructive pulmonary disease treated in our hospital from January 2015 to January 2017were divided into two groups according to the different treatment methods.The control group was treated with conventional methods, the observation group was treated with routine + Tiotropium Bromide Powder for Inhalation + psychological intervention therapy.The clinical curative effect and the improvement of clinical symptoms were recorded and analyzed. Results The clinicalcurative effect of the observation group was better than that of the control group, the improvement of clinical symptoms was better than that of the control group,the difference was statistically significant (P<0.05). Conclusion The effect of chronic obstructive pulmonary disease patients choose conventional treatment+Tiotropium Bromide Powder for Inhalation + psychological intervention mode is significant, can improve clinical symptoms, improve the therapeutic effect and prognosis in the near future and far, worthy of clinical widely used In the treatment of patients with chronic obstructive pulmonary disease in stable phase.

Objective To observe the clinical efficacy of She medicine in treating lumbar intervertebral disc herniation (LIDH) in acute pain stage, and to explore its action mechanism.Method Sixty patients with LIDH in acute pain stage were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by She medicine, while the control group was by oral administration of Loxoprofen tablets. Visual Analogue Scale (VAS) was observed before and after intervention, and the clinical efficacies were compared.Result The excellence rate was 83.3% in the treatment group versus 60.0% in the control group, and the difference was statistically significant (P<0.05). The VAS score changed significantly after intervention in both groups (P<0.01). After intervention, there was a significant difference in comparing the VAS score between the two groups (P<0.05).Conclusion She medicine is an effective approach in treating LIDH in acute pain stage, and it can significantly reduce pain.

Objective To understand the working stress source of nurse anesthetists and its coping measures. Methods The semi-structured in-depth interview was conducted in 11 nurse anesthetists from 4 hospitals. The collected data were analyzed and concluded by using Colaizzi’s seven step method of phenomenological analysis. Results Four themes were extracted and a series of sub-themes, including work environment, work characteristics and nature, confusion of career prospects and coping styles. Conclusions Managers should pay close attention to anesthesia care. The laws and policy of the qualifications standards for nurse anesthetists should be made, which can reduce the stress of nurse anesthetists including healthy and harmonious working environment, a professional training system of nurse anesthetists and career planning. So that we can improve the professionalism of nurse anesthetists.

Objective To explore the expression of ankyrin-repeat SOCS box containing protein 2 (ASB2)and Janus kinase 3 (Jak3)mRNA in bone marrow plasma mononuclear cells of patients with acute lymphoblastic leukemia (ALL)and discuss the correlation of them.Methods Bone marrow plasma was collected from 48 patients of newly diagnosed ALL (37 cases B-ALL and 11 cases T-ALL)and 34 non leukemia patients (control group),respectively.Expression levels of ASB2 and Jak3 mRNA were detected by real-time quantitative PCR.Results The expression of ASB2 mRNA in B-ALL and T-ALL were significantly different compared to control group (t =14.2,P <0.01;t =15.2,P <0.01),which were 68.5,32.7 folded more than control group,respectively.Moreover,the expression level of Jak3 mRNA in B-ALL group and T-ALL group were 2 336.1 and 7 131.5 folded more than control group (t =37.3,P <0.01;t =37.6,P <0.01). At last,the expression of ASB2 and Jak3 gene was positive correlation (r =0.523,P <0.001).Conclusion ASB2 and Jak3 are expressed abnormally in ALL patients and the correlation of them is positive.ASB2 and Jak3 may be related to the proliferation and differentiation in leukemia cells.

Objective To discuss the value of contrast-enhanced ultrasound and color Doppler in diagnosing esoph-ageal varices( EV) among patients suffering from portal hypertension. Methods The control group consisted of twenty nine patients without EV. Sixty patients with EV diagnosed by endoscopy were divided into two groups equal in number according to grade of EV. One being mild,the other was moderate to severe. All patients underwent color Doppler flow imaging and contrast-enhanced ultrasound, and the dynamic angiography data were collected. Time-in-tensity curves were drawn by software. The quantitative parameters including arrival time of hepatic artery ( HAAT) ,hepatic vein ( HVAT) and portal vein ( PVAT) ,damping index ( DI) of hepatic vein and portal vein ve-locity( PVV) were compared. Results The difference of PV-HV, PV-HA, PVV, DI showed statistically signifi-cant among the three groups(F=72.63,14.97,6.71,13.74,P<0.01). A comparison of the control and moderate to severe group among the above four parameters was statistically significant (P<0.01). PV-HV, PV-HA, DI in moderate to severe group showed statistically significant compared with mild group (P<0.01),however there exis-ted no significant difference grouping PVV between the two groups. Mild group contrasted to the control group,the differences of PV-HA were statistically significant (P<0.01), whereas PV-HV, DI, PVV displayed no significant difference. Conclusion Contrast-enhanced ultrasound and color Doppler are helpful in diagnosing EV,which is ex-pected to become a new noninvasive method.

The article reviewed the progress of traditional Chinese medicine in treating fibromyalgia syndrome and summarized the status and feature of different therapies in recent years in order to provide idea for the further researches. In addition, the article also discussed the problems and solutions of the researches.

Objective To study the clinical characteristics, treatment methods and prognosis of primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL). Methods The clinical data of 40 patients with PGI- DLBCL were retrospectively analyzed. All the cases had received surgery treatment. Results In 40 patients with PGI-DLBCL, the major clinical presentation included abdominal pain in 15 cases (37.5%), abdominal mass in 6 cases (15.0%), abdominal discomfort in 5 cases (12.5%), abdominal distension in 5 cases (12.5%), and hematemesis in 5 cases (12.5%). Fifteen cases were misdiagnosed as gastric cancer, 5 cases as colon cancer, and 4 cases as digestive tract ulcer. The misdiagnosis rate was 60.0% (24/40). The survival rates of 1- , 2- and 3- year were 62.3%, 57.5% and 52.6%. The univariate analyses result showed that the clinical stage, international prognosis index (IPI) and treatment method were associated with survival rate (P<0.01), but the gender, age and disease distribution were not associated with survival rate (P > 0.05). The 3-year survival rate of clinical stage Ⅰ - Ⅱ was significantly higher than clinical stageⅢ-Ⅳ(68.0%vs. 13.3%), the 3-year survival rate of IPI 0-2 scores was significantly higher than 3 - 5 scores (66.7% vs. 7.6%), and the 3- year survival rate of surgery combined with postoperative chemotherapy was significantly higher than simple surgery (75.0%vs. 20.0%), there were statistical differences (P<0.01). Conclusions The patients with PGI- DLBCL have no obvious clinical manifestions and a higher misdiagnosed rate. Modified IPI, clinical stage and surgery combined with postoperative chemotherapy are the influencing factors of prognosis.

Objective To observe the effect of edaravone pretreatment on the lung injury during one lung ventilation of patients undergoing thoracoscopic surgery.Methods Forty male patients diagnosed of lung cancer (aged 47-65 years,height 165-183 cm,weight 64-85 kg,BMI<30 kg/m2 ,ASA gradeⅠorⅡ)who were scheduled for thoracoscopic pulmonary resection surgery were randomly divided into two groups(n =20 each):control group (group C)and edaravone group (group E).In group E edaravone 30mg(dissolution in normal saline 100 ml)was administered within 30 min before surgery.In group C nor-mal saline 100 ml was administered within the same time.PET CO2 and peak airway pressure (Pmax)were recorded during operation,venous blood samples were taken before skin incision and at the end of operation for detection of the concentration of IL-8,IL-10,TNF-α and SP-A.Results There were no significant difference in PET CO2 and Pmax between the two groups..Compared with T1 ,concentration of IL-8,IL-10, TNF-αand SP-A all increased significantly in both groups on T6 (P <0.05).Compared with group C,IL-8, TNF-αand SP-A levels of T6 in group E were lower significantly (P < 0.05 ).There was no significant differences in the levels of IL-10 between the two groups.Conclusion Edaravone can inhibit oxidative stress and inflammatory reaction during one lung ventilation in patients underwent thoracoscopic surgery.

Objective To observe the clinical efficacy of Sha-petechia releasing therapy based on She medicine in treating occipital neuralgia, for proving its effectiveness and advantage. Method Eighty patients were randomized into a treatment group and a control group, 40 cases in each group. The treatment group was intervened by Sha-petechia releasing therapy based on She medicine, while the control group was by Western medications, 10 d as a treatment course, totally for 2 courses. The clinical efficacy and change of Visual Analogue Scale (VAS) score after intervention were observed. Result The total effective rate was 92.5% in the treatment group versus 82.5% in the control group, and the difference was statistically significant (P<0.05). Conclusion Sha-petechia releasing therapy based on She medicine is an effective approach in treating occipital neuralgia.

Objective To evaluate the application of liver ultrasound hemodynamic parameters in diagnosing moderate to severe esophageal varices(EV) among patients suffering from portal hypertension.Methods The control group consisted of twenty nine patients without EV.Sixty patients with EV diagnosed by endoscopy were divided into two groups equal in number according to grade of EV.One being mild,the other was moderate to severe.All patients underwent color Doppler flow imaging and contrastenhanced ultrasound,and the dynamic angiography data were collected.Time intensity curves were drawn by software to acquire the arrive time of hepatic artery (HAAT),hepatic vein (HVAT) and portal vein (PVAT).Then HV-HA interval time,PV HA interval time and PV-HV interval time were calculated.The quantitative parameters including HV-HA,PV-HA,PV-HV,damping index (DI) of hepatic vein and portal vein velocity(PVV) were compared.ROC curve was used to assess the value of the parameters above in predicting moderate to severe esophageal varices.Results The difference of PV-HV,PV HA,HV-HA,PVV,DI between the control and the moderate to severe group were statistically significant (P =0.000).PV-HV,PV-HA,HV-HA,DI in moderate to severe group showed statistically significant compared with mild group (P =0.000,P =0.002,P =0.000,P =0.002),however,PVV had no significant (P ＞0.05) difference between the two groups.Mild group contrasted to the control group,the differences of PV-HA and HV-HA were statistically significant (P =0.000),whereas PV-HV,DI,PVV displayed no significant (P ＞0.05) difference.The areas under ROC curve of PV-HV,PV-HA,HV-HA,PVV,DI were 0.952,0.775,0.847,0.699,0.808 respectively.The best cutoff value of PV-HV for diagnosing moderate to severe EV was 0.5 second,with sensitivity and specificity of 86.2％ and 94.8％ respectively.Conclusions The liver ultrasound hemodynamic parameters is helpful in the diagnosis and evaluation of moderate to severe esophageal varices,which is expected to become a new noninvasive method.