Objective To evaluate the clinical effectivity of continuous positive airway pressure in treatment of chronic obstructive pulmonary disease complicated with left heart failure.Methods Totally 103 patients (aged 63-78 years) with chronic obstructive pulmonary disease complicated with left heart failure were randomly divided into two groups:treatment group (received noninvasive ventilation combined with routine medication) and control group (received conventional drug therapy).The patients of two groups were observed in the treatment of 1 hour to one week that blood pressure (SBP),heart rate (HR),arterial blood gas analysis,respiratory rate (RR),brain natriuretic peptide (BNP) and other indicators to improve the situation.Results After treatment,the PaO2 level of patients in treatment group was significantly increased from (56.1 ± 7.8) mm Hg to (91.1 ±11.3)mm Hg,(t=449.94,P＜0.05),PaCO2 decreased from (60.1± 10.9) mm Hg to (42.3± 9.3)mm Hg,(t=4.66,P＜0.05),pH value was improved from (7.26±0.12) to (7.36±0.17) (t=5.88,P＜0.05) and BNP was decreased from (350±181) ng/L to (961±376) ng/L (t=8.07,P＜0.05).In control group,the PaO2 was significantly increased from (55.0±8.1) mm Hg to (89.1±12.0) mm Hg (t=43.17,P＜0.05) after treatment,PaCO2 by decreased from (48.9±10.8) mm Hg,(58.9±10.8) mm Hg to (t=5.13,P＜0.05),pH value by up to (7.27 ±0.08),BNP by decreased from (439 ± 246) ng/L to (947 ±407) ng/L t=9.81,P＜0.05.Compared with the control group,the difference of PaO2 and BNP had no significantly significant.PaCO2 in treatment group was increased more sharply than it in the control group,and pH decreased more (P＜0.05 or P＜0.01).Conclusions The use of continuous positive airway pressure to treatment chronic obstructive pulmonary disease complicated with left heart failure can alleviate fatigue and prevent the respiratory failure.It is remarkable treatment effect and worthy of clinical application.

Objective To investigate outcomes of transanal endoscopic microsurgery(TEM) for the treatment of rectal villous adenoma and early-stage rectal carcinoma.Methods A series of 31 patients with rectal tumors underwent TEM from November 1995 to December 2003.The operation was performed under general anesthesia.The patients were placed in a dependent position dictated by the location of the tumor.A special rectoscope was inserted into the anus with CO_2 insufflation to keep the rectum open.Under the stereoscope and laparoscopic-type instruments,the tumor was completely resected(submucosal or full-thickness excision) using a needle diathermy or a 5-mm ultrasonic dissector.The operative wound was closed with intra-lumen continuous sutures.Results The rectal tumor was completely removed with negative resection margins in all the 31 patients.The operating time was 45~220 min(mean,95 min) and the intraoperative blood loss was 0~180 ml(mean,40 ml).Complications included temporary flatus incontinence in 2 patients,acute retention of urine in 1 patient,exacerbation of chronic obstructive airway disease in 1,and secondary hemorrhage following Aspirin taking in 1.The postoperative pathological stages were pT_0 in 16 patients,pT_(is) in 2 patients,pT_1 in 7,pT_2 in 3,and pT_3 in 3.Follow-up checkups in the 31 patients for 2~92 months(mean,23 months) revealed no local recurrence.Conclusions TEM is a safe and effective minimally invasive surgical technique for the treatment of rectal villous adenoma and early rectal carcinoma.

Objective To explore whether or not the use of prophylactic antibiotics is required before inguinal hernia repair in metabolic syndrome (MS) patients.Methods According to the randomized double blind,prospective study,from 2010 July to 2012 December,186 MS patients underwent inguinal hernia repair operation were selected as the study objects.The control group(n =93) was given a one-time cefazolin 1.5g plus 0.9％ sodium chloride injection 20ml intravenous injection 30min before operation,the observation group(n =93) was given 0.9％ sodium chloride injection 20ml intravenous injection.Results The control group had 5 cases of infection,the observation group had 6 cases.There were no statistically significant differences in the normal body temperature of operation site infection,occurred between the two groups after operation (all P ＞ 0.05).But in the two groups,the probability of infection occurs of the patients with body mass index(WBI) more than 30 was higher that of the patients with 25 ≤WBI ≤ 30(17.24％ vs 1.56％,12.90％ vs 1.61％,x2 =4.69,4.87,all P ＜0.05),the probability of infection occurs of fasting blood glucose(FPG) more than 12.0mmol/L was higher than that of the patients with 6.1mmol/L≤FPG≤ 12.0mtol/L(15.30％ vs 1.64％,13.33％ vs 1.59％,x2 =4.81,5.13,all P＜0.05).Conclusion MS patients underwent tension-free repair of inguinal hernia don't need the use of antibiotics to prevent postoperative surgical site infection(SSI).But for the severe obesity,high blood sugar (FPG ＞ 12.0mmol/L) patients,the preoperation prophylactic antibiotics is necessary,and it can reduce the incidence of postoperative SSI.

The clinical values of acetoacetate ( AcAA ) and β hydroxybutyrate ( βHBA ) determination in classification of type 1 and2 diabetes were explored. 102 normal control subjects,33 cases of type 1 diabetes, and 104cases of type 2 diabetes were enrolled. Serum AcAA, βHBA, fasting plasma glucose ( FPG), C-peptide, and insulin levels were measured. The results showed that serum AcAA, βHBA, total ketone tody (TKB) levels in the diabetic groups were significantly higher than those of the normal group( P＜0. 01 ). AcAA, βHBA, TKB levels in type 1diabetes were higher as compared with those of type 2 diabetes( P＜0.01 ). The AcAA, βHBA, and TKB levels were negatively related with C-peptide and insulin in diabetic patients( P＜0. 01 ). All the type 1 diabetic patient were found to have TKB and lower C-peptide levels. TKB positive and lower C-peptide in type 2 diabetes were found in 47% and 26% respectively. Receiver operating characteristic (ROC) curve suggested that the area under the ROC curve of type 1 and type 2 diabetes was 0.926. The optimal operating point of the total ketone body was 0. 532 mmol/L with higher sensitivity and specificity. Enzymatic determination of acetoacetate and β hydroxybutyrate seems to have important clinical values for classification of type 1 and 2 diabetes.

The development of health-related quality of life (HRQL) instrument in traditional Chinese medicine (TCM) is increasing rapidly in China, but few studies focus on their necessity. This study explores the necessity of the development of TCM instruments from both theoretical and practice perspectives, and aims to explain whether the adoption of the cross-medical style is valid. Through theoretical analysis, both TCM and Western medicine instruments show the same objectives, whereas TCM instruments are more suitable for the Chinese social behavior, customs and expectations. In practical analysis, 47 TCM instruments were identified, among which 17 had 18 corresponding Western medical instruments. In the domains layer, except for physiological, psychological and social factors, TCM instruments focus more on the harmony between body and spirit, humanity and nature or human and society and the constitution, etc. In the facts layer, TCM instruments focus on the emotions, initiative social intercourse, TCM symptoms, diet, sleep, taste, feces and urine, etc. In addition, significant differences existed in the methods of information selection. There is no need to modify cross-medical style research except when TCM characteristic terms exist, but attention must be paid to the influence of culture in different areas. Therefore, the TCM instruments can resolve the limitations of the application of Western medical instruments to the Chinese setting, while also having remarkable abilities of information coverage and detection. Both forms of instruments have the capacity and requirement to inter-communicate with each other in order to serve the whole Chinese cultural system. Generally speaking, there is no need to modify the instruments in cross-medical style research. But this point requires further demonstration in the rigorous designed clinical trials.

Aim To investigate the effects of Zhiling capsule (ZLJN) on the proliferation inhibition and apoptosis induction in K562 cell line.Methods According to the different components of ZLJN,K562 cells were treated respectively with tradtional Chinese medicine,Western medicine and ZLJN compound groups.The cell viability and colony formation were observed by MTT assay and colony formation assay respectively.Apoptotic cells were detected by Annexin V-FITC/PI staining and DNA fragmentation assay.Caspase-3 activity was detected by flow cytometry,and pro-caspase-3 was detected by Western blot.Results Treated with drug,K562 cell growth and cell colony formation were significantly inhibited.Apoptosis occurring in the early stage was identified by Annexin V-FITC/PI staining.Typical DNA ladder was seen from gel electrophoresis and apparent apoptotic peaks were observed by flow cytometer.The level of caspase-3 activity increased after the treatment,while the level of pro-caspase-3 decreased.Conclusion ZLJN can efficiently inhibit proliferation and induce apoptosis in K562 cells,which may be related with the up-regulation of caspase-3 activity.

Aim To explore the mechanisms of the apoptosis induction and the effects of adhesion suppression of Zhiling capsule (ZLJN) in small cell lung cancer cell line NCI-H446.Methods According to the different components of ZLJN,NCI-H446 cells were treated with traditional Chinese medicine,western medicine and ZLJN composite groups.Apoptotic cells were tested by light microscopy,Hochest33258 staining method.The mRNA and protein expressions of bcl-2,bax and hTERT were analyzed by RT-PCR and Western blot respectively.The expressions of CD44 were detected by flow cytometry.Results After NCI-H446 cells were treated with different drug groups,The morphological changes of apoptotic cells were found by light microscopy and Hochest33258 staining method.The mRNA and protein expressions of bcl-2 were down-regulated while the expressions of bax were up-regulated compared to the control groups(P

Objective To sutdy the anti-inflammatory action and pharmacodynamics of Liushen Cataplasm (LC). Methods The anti-inflammatory action of LC was observed on mice models of xylene-induced ear swelling and on the rat models of carrageenan-induced pedal swelling. With the decrease of pedal swelling as the parameter,the pharmacodynamics of LC was studied. The apparent parameters of pharmacodynamics were estimated based on the time-effect curve. Results LC showed a potent anti-inflammatory effect. The effect-time curve can be described by the one-compartment model. The main pharmacodynamic parameters were as follows:t1/2(Ka)=2.11727h,t1/2(Ke)=3.13464h,AUC=3.33131 mg?kg?h-1,respectively. Conclusion Liushen Cataplasm shows a potent anti-inflammatory effect. The effect-time curve can be described by the one-compartment model.

Objective To explore the pathway of continuous rehabilitation intervention in community stroke patients and to evaluate its effect. Methods Stroke patients (64 cases) were selected from Yuetan community as the rehabilitation group by objective sampling based on inclusive and exclusive standard and 64 stroke patients wre selected from other community in Xicheng district as the control group. At the same time, 16 doctors and nurses from 10 clinics of Yuetan community health service center were trained and they gave reha-bilitative intervention to the rehabilitation group. After intervention for 6 months, the effect of rehabilitative in-tervention was evaluated compared with the control group who did not receive rehabilitative intervention. Re-suits The Fugl-Meyer score of the rehabilitation group was (76.14±12.48), the score of the control group was (19.36±14.32),which had significant difference compared with the rehabilitation group, P < 0.05. The Batthel index of the rehabilitation group was (72.25±10.22), the index of the control group was (22.62±9.71),which was significantly different from that of the rehabilitation group, P < 0.05.Besidcs, the rate of knowing health knowledge and healthy exercise in the rehabilitation group was higher than that of the control group, P < 0.05. Condusions The rehabilitation information net and systemic community rehabilitation intervention can im-prove the motor ability and the ability of daily activity for patients with stroke.

Objective The effect of different doses of ethylnitrosourea(ENU)and cyclophosphamide(CP)on the loss rate of CD59 on peripheral blood erythrocytes was explored to optimize the detection method of Pig-a gene mutation. Methods According to the weight and loss rate of CD59 on peripheral blood erythrocytes,rats were divided into 4 groups:the control group,CP 40 mg/kg group,ENU 10 mg/kg group and ENU 40 mg/kg group(n=6). The control group was injected i.p. with PBS,other groups were injected i.p. with corresponding solutions. The body weight of rats on days 0,7,14,21, 28, 42 and 56 were recorded. At the same time, blood samples were collected and incubated with antibodies,and the loss rate of RBCCD59-was detected by flow cytometry. Results Compared with the control group, at different time points, the body weight and weight gain of ENU 10 mg/kg group and ENU 40 mg/kg group had no statistically significant difference(P > 0.05),while those in the CP 40 mg/kg group were significantly decreased(P <0.05). The loss rate of RBCCD59-was significantly increased in the CP 40 mg/kg group at 28,42 and 56 days, ENU 10 mg/kg group at 42 and 56 days,and ENU 40 mg/kg group at 7,14,21,28,42 and 56 days,(P < 0.05). The results showed a dose-response relationship. Conclusions Under the conditions of this Pig-a mutation detection method,ENU is superior to CP on raising loss rate of RBCCD59-,ENU 40 mg/kg is better than 10 mg/kg,and 28 days is suitable as the test period.