Objective To explore the value of tiotropium bromide in the treatment of patients with bronchiectasis accompanied by obstructive ventilation dysfunction.Methods 45 patients with bronchiectasis accompanied by obstructive ventilation dysfunction who were treated in the third people’s hospital of Haikou city from January 2014 to January 2015 were selected, and divided into control group (22 cases) and experimental group (23 cases) with the randomized controlled methods.The control group received routine treatment and experimental group received tiotropium bromide powder inhalation for a 8 week’s consecutive treatment.The pulmonary function, blood gas were compared and analyzed by BORG dyspnea score, six-minutes walk test (6MWT) and St.George’s respiratory questionnaire ( SGRQ).Results After treatment, maximal voluntary ventilation ( MVV) (%) in experimental group was significantly higher than that in control group(P<0.05), but there were no significant differences in forced expiratory volume in one second (FEV1), FEV1 (%), forced vital capacity ( FVC) (%) and FEV1/FVC between two groups.The PaCO2 in experimental group was significantly higher than that in control group ( P <0.05 ), but there was no significant difference in PaO2 between two groups.The 6MWD in experimental group was significantly higher and SGRQ values was lower than those in control group(P<0.05).Conclusion Long-term and regular usage of tiotropium bromide powder inhalation could improve pulmonary ventilation function and improve the quality of life of patients with bronchiectasis accompanied by obstructive ventilation dysfunction.

Objective:Common troubleshooting methods of networking malfunction for central monitoring system were discussed in order to realize its safe application of networking central monitoring system.Methods: Time calibration server and necessary conditions of network for central monitoring system were discussed and analyzed. In addition, practical troubleshooting and maintenance methods were proposed to solve the networking malfunction between a bedside monitor of Mindray iPM-9800 and its central workstation.Results: Smooth operation of networking central monitoring system could simultaneously obtain physiological parameters of several patients, thus largely improving the efficiency of medical staffs.Conclusion: Safe operation of networking central monitoring system could ensure the accuracy of real-time monitoring information of patients and improve hospital’s management level of network and informatization.

A young male patient presented with a rapidly growing mass on the left ear. Histopathologic and immunohistochemical findings were consistent with nodular fasciitis. The disease is rare in the ear, without obvious clinical features. The diagnosis mainly relies on the postoperative pathological findings.
Adult ; Ear, External ; pathology ; Fasciitis ; Humans ; Male

Objective To observe the expression of motilin precursor mRNA and location of motilin in human thyroid and to explore the clinical significance.Methods RT-PCR,Sourthern blot and immuno- fluorescence histochemical techniques were applied to detect the expressions of motilin precursor mRNA and motilin in human thyroid and to compare the difference of motilin peptide and motilin mRNA expression among tissues of normal thyroid,nodular goiter and medullary thyroid carcinoama.Results(1)The results of RT-PCR and Southern blot showed that motilin precursor mRNA was expressed in human thyroid.(2)A large number of cells showing collocation of motilin with calcitonin were observed in human thyroid,suggesting that motilin was expressed in C cells.(3)Both the motilin immunoreactive(MTL-IR)and the motilin mRNA were significantly increased in medullary thyroid carcinoma(P0.05).(4)Western blot results showed that the expression of motilin in thyroid medullary carcinoma was significantly higher than that in normal thyroid. However no difference was observed between thyroid nodular goiter and normal thyroid tissue.Conclusion MTL- IR positive cells and motilin mRNA expression are found in human thyroid.Motilin is located in C cells of thyroid. The expressions of motilin and motilin precursor mRNA are significantly increased in medullary thyroid cancer,no difference between thyroid nodular goiter and normal thyroid tissue.

Objective To investigate the surgical approach for adult patients with presacral cystic teratoma.Methods In this study,16 female patients,aged at 26-45 years,with presacral cystic teratoma underwent surgical resection between March 2007 and August 2012.Tumor was primary in 9 cases and recurrent in 7 cases,Rectal examination revealed retrorectal tough semi-circular poorly movable massess with intact rectal mucosa.MR examination showed cystic or solid mass in the anterior sacral,clear boundary,rectum and or vagina compressed.Tumors were completely removed in all cases.Results All patients were cured by surgery,13 cases were cured by one stage resection and 1 was cured by two stage resection.Two cases suffered from recurrence and was cured by reoperation.There were no injury to rectum,anal sphincter,cauda equina,presacral vein.Pathological diagnosis was cystic teratoma.Conclusions By sacrococcygeal surgical resection of presacral cystic teratoma was safe and effective ; complete resection of the tumor capsule is the key to successful operation.

Objective To investigate the protective effect and it's possible mechanism of Tanshinone ⅡA in radiation-induced pulmonary fibrosis.Methods Having the right hemithorax of female Wistar rats irradiated(30?Gy) in 10 fractions within 14 days by 6 ?MV photons,the radiation-induced pulmonary fibrosis animal model was established.In the treatment group,sodium Tanshinone ⅡA sulfonate(15?mg/kg) was given by intraperitoneal injection 1 hour before each fraction of irradiation.Five months after irradiation,the difference of the histopathological changes,the hydroxyproline content and expression of TGF-?1 between the radiation alone group,tanshinone plus radiation and control group were analyzed by HE stain,Massion stain,immunohistochemical methor and reverse transcriptase polymerase chain reaction(RT-PCR) method.Results The histopathological comparison revealed the protective effect of Tanshinone ⅡA.The content of hydroxyproline was(21.99?3.96),((38.25?)(7.18)),(28.94?4.29)??g/g in the control group,radiation alone group and radiation plus Tanshinone ⅡA.The expression of TGF-?1(mRNA and protein) was reduced by Tanshinone ⅡA.Pathological changes of the pulmonary fibrosis was reduced by Tanshinone ⅡA yet.Conclusions Our study shows that Tanshinone ⅡA can inhibit radiation-induced pulmonary fibrosis,and the possible mechanism of its may be made possible through down-regulating the expression of TGF-?1 in the irritated lung tissue.

Objective To evaluate factors which maintain the stability of the ankle, and discuss indications for trans-syndesmotic fixation. Methods 12 freshly-frozen cadaver legs amputated below the knee were collected and divided into 2 groups. An ankle fracture model of unconstrained pronation-external rotation was then designed. Group A simulated the injury combined with medial malleolus fracture, and Group B the injury combined with deltoid tear. Ligaments were cut off sequentially to simulate the increasing severity of the injury. Fuji super low-pressure sensitive films and displacement transducers were used to measure the contact area of the tibiotalar articular surface and the width of the syndesmosis. The data were analyzed with SPSS to analyze the relationship of ligament injury and ankle stability. Results In Group A, the articular contact area and the syndesmotic width after section of the deltoid were significantly different from those before the section (P

Objective To investigate the early fluid resuscitation of patients with traumatic shock.Method Two hundred and ninty-eight patients with traumatic shock were retrospectively analyzed.Survivors within 24 hours after admission were regarded as survival group and dead patients as dead group.The comparison was made in regard to injury severity score(ISS)and volume of fluid infusion and blood-transfusion between two groups within 24 hours after admission.At the same time,the comparison in respct of mortality between operation group and non-operation group was also made.Results Of the 298 patients,230(77.2%)survived and 68 (22.8%)died within 24 hours after admission.The ISS and the volume of fluid infusion and blood-transfusion in the dead group were significantly higher than those in the surviving group(P

Objective To evaluate results and demonstrate problems of Scandinavian total ankle replacement (STAR) in patients with ankle arthritis and clarify its role as a growing alternatives to ankle fusion.Methods Retrospectively analyzed 43 patients who had total ankle replacement from May 1999 to January 2013.All cases were evaluated with interview focusing on pain,daily activities and clinical and radiologic examinations.The average age of patients was 46 (range,35 to 56) years old.Among these cases,9 patients suffered from posttraumatic arthritis,25 osteoarthritis,5 rheumatoid arthritis and 4 avascular necrosis of the talar body.All patients complained about ankle joint pain and swelling as well as limited ROM of joint.Results Mean follow-up was 6.7 (1.5 to 12 years) years.37 cases had complete follow-up.The average preoperative ankle score was 27.0± 10.5,pain degree score was 16.5± 12.8,joint function score was 10.6±7.4,ROM score was 8.2±5.2.The average preoperative ankle score was 86.5±13.2,pain degree score was 49.5±4.5,joint function score was 19.7±9.5,ROM score was 19.2±3.2.The indicatiors compared with preoperative,postoperative differences have statistical significance.The score of postoperative Kofoed were divided into excellent 35 cases,good 1 case and poor 1 case,excellent and good rate was 97.3％.The American orthopaedic foot and ankle society (AOFAS) scoring system was improved from 40.5 preoperatively to 80.6 postoperatively.No postoperative loosening or migrating of the prosthesis was noted.Conclusion It was demonstrated that the standardized and normalized operative techniques as well as operative tools closely matched to the prosthesis could achieve favorable outcomes according to the clinical and radiographic outcomes and overall acceptable cornplication rates in the present study.STAR was a choice for the patients with advanced osteoarthritis,posttraumatic arthritis,rheumatic arthritis and avascular necrosis of the talar body.

Objective To observe the curative effectiveness of kidney transplantation on uremic patients complicated with Thalassemia.Methods Forty-six cases of uremic patients complicated with Thalassemia(26 cases of alpha-thalassemia,20 cases of beta-thalassemia)subject to kidney transplan- tation were retrospectively studied as the anemia group.Incidence of delayed graft function restoration, rejection(hyperacute rejection,accelerated rejection and acute rejection)and anemia correction were observed.Time needed for renal function restoration was recorded and creatinine value(Cr)was mea- sured in those patients whose kidney function restored after kidney transplantation.Control group in- cluded 131 cases of kidney transplantation performed concurrently that accompanied with different con- tent of anemia other than thalassemia.Results Incidence of DGF was 26.1% and 23.7% in thalasse- mia group and control group,respectively.Six months after transplantation,39 cases in thalassemia group and 109 cases in control group with follow-up were host and kidney alive.In 6 months,rejection ratio was 30.8% in thalassemia group and 32.1% in control group respectively.Cr value was(121?20)?mol/L and(128?33)?mol/L in thalassemia group and control group,respectively.Ratio of anemia correction in thalassmia and control groups was 79.5% and 76.1%,respectively.No indexes above were found to be statically significantly different between these two groups.Conclusion Uremic patients complicated with thalassemia is suitable for kidney transplantation,with clinical effectiveness similar to those without thalassemia.