OBJECTIVE:To systematically review the effects of long-term oral low-dose of azithromycin on pulmonary func-tion and clinical signs of patients with stable COPD. METHODS:Retrieved from PubMed,Medline,CJFD,VIP and Wanfang da-tabase,randomized controlled trials(RCTs)about long-term oral low-doses of azithromycin for stable COPD were collected. After quality evaluation according to modified Jadad scale,Meta-analysis was conducted by Rev Man 5.2 statistical software. RESULTS:A total of 13 RCTs were included,involving 1207 patients. Meta-analysis showed that,long-term oral low-doses of azithromycin could significantly improve FEV1[SMD=0.78,95%CI(0.62,0.93),P<0.001],FEV1%[SMD=0.81,95%CI(0.61,1.00),P<0.001],FEV1/FVC [SMD=3.91,95%CI(2.58,5.24),P<0.001] and 6MWD[SMD=23.74,95%CI(21.20,26.18),P<0.001] in sta-ble COPD patients,meanwhile significantly reduce dyspnea score [SMD=-1.15,95%CI(-1.60,-0.71),P<0.001],quality of life score [SMD=-1.82,95%CI(-2.74,-0.90),P<0.001] and 24 h sputum volume[SMD=-18.68,95%CI(-24.79,-12.56), P<0.001],with statistical significance. CONCLUSIONS:Long-term oral low-doses of azithromycin can improve pulmonary func-tion,dyspnea,activity tolerance and quality of life in acute exacerbation of COPD patients.

Objective To clinically verify the rationality of evaluation standard of oropharynx involvement in the Chinese 2008 staging system for nasopharyngeal carcinoma (NPC).Methods 333 consecutive patients with newly diagnosed,untreated,and nonmetastatic NPC were included.All patients had an MRI examnation of the nasopharynx and neck.The status of oropharynx involvement were evaluated.Results Of the 333 patients with NPC,26 (7.8 ％) patients presented with oropharynx involvement.Tumor invasion into oropharynx was highly related to tumor invasion into nasal cavity,parapharyngeal space,skull base,medial pterygoid muscle,paranasal sinuses,intracalvarium and masticator space excluding medial pterygoid muscle (P ＜ 0.050).The oropharynx involvement was associated with poorer 5-year overall survival (OS) and distant failure-free survival (DFFS) (38.1％ vs 72.6 ％,P＜ 0.001 and 49.1％ vs 84.5 ％,P＜ 0.001,respectively).By multivariate analyze,it was observed that oropharynx involvement was a significant predictive factor for OS and DFFS (P ＜ 0.001,P ＜ 0.001).Significant differences were observed in the 5-year OS (38.1％ vs 80.9 ％,P ＜ 0.001) and DFFS rates (49.1％ vs 89.3 ％,P ＜ 0.001) between the patients with oropharynx involvement and stage T2 patients.Conclusions MRI-evidenced oropharynx involvement had a negative impact on OS and DFFS in NPC patients.The oropharynx involvement is associated with poorer 5-year OS and DFFS compared with stage T2.The evaluation standard of oropharynx involvement for NPC in the Chinese 2008 staging system could be revised.

Objective To investigate the disease types incurring poverty, patient population layout, and cost burden by poor households due to illness. Methods During the time August 17-24,2017, App questionnaires were used onsite for data survey at 2 824 poor hourseholds in Nanyang city of Henan province, in order to learn the impacts of the poverty-causing diseases on the labor capacity of the patients and the cost burdens. Such methods as descriptive analysis, rank sum test and correlation analysis were used for data analysis. Results The survey found that 61.79 percent(1 745 households) of the poor households turned poor by illness, most of them aged 40 to 60 years old. The ten disease categories, namely cerebrovascular diseases, malignant tumor, ischemic heart diseases and mental diseases, constitute top disease causes of poverty. These diseases significantly damage their labor capacity, up to 37.67% of them totally disabled. The self-paid expenses of the patients per year accounted for 57.22% of the total annual expenses. Conclusions Medical insurance policies need to elevate the scope and efforts of medical compensation;public health services need to improve health promotion and health education; government supervision needs to be enhanced to keep minimizing patients′disease burdens.

Aim To observe the protective effects of probiotics on alcoholic liver injury in rats .Methods Male Wistar rats were randomly divided into the follow-ing three groups: control group , normal diet with nor-mal (5 ×108 CFU· kg -1· d -1) treatment group.Ex-cluding the rats in the normal control group , the other animals were initially received intragastric administra-tion with 56%( V/V) ethanol 5.5~11.0 mL· kg -1 · day -1 for 8 weeks.Then the rats’ faeces were collect-ed, and the liver and the small intestine were obtained for pathologic and ultrastructural observation .Serum ALT, AST and ALP was measured by method of bio-chemistry .Serum DAO and D-LA was measured by en-zyme linked immunosorbent assay .The expression of FOXO4 in small intestine was detected by immunohis-tochemistry .The intestinal flora genome DNA was ex-tracted from faeces and the sequence of 16 S rDNA was analyzed by high-throughput sequencing technologies . Results Hepatic steatosis was obviously improved in probiotics treatment groups compared with ethanol-trea-ted group , and the ultrastructural such as mitochondri-al and rough endoplasmic reticulum pathological chan-ges was significantly alleviated . The ultrastructural changes in intestinal were better in probiotics treatment group than in the ethanol-treated group .And ethanol-induced rats ’ serum ALT, AST, ALP, D-LA and DAO levels showed a significant reduction in the probi-otics treatment groups compared with the ethanol-trea-ted group ( P<0.05 ) .The FOXO4 expression was in-creased obviously in the probiotics treatment groups compared with the ethanol-treated group ( P <0.05 ) . And the intestinal flora diversity was impacted after feeding alcohol , and probiotics had a certain regulative action in helping the intestinal flora back to normal state; At phylum level , the Firmicutes quantity was lower and the Bacteroidetes quantity was higher in eth-anol-treated group than those in the control group ( P<0.05 ) , and the conditions were improved after supple-menting probiotics .At genus level , the percent of ge-nus abundance was similar to normal control group in the probiotics treatment groups compared with the etha-nol-treated group .Conclusion Probiotics can relieve liver injury induced by alcohol in rats , and the mecha-nism may be related to the modulation of probiotics on the intestinal flora distribution and intestinal barrier .

Building a better performance evaluation system for public hospitals is key to the ongoing health reform. To this end, Beijing Municipal Administration of Hospitals reformed the performance evaluation system of public hospitals in Beijing based on its experiences during 2012 to 2014. This reform integrates the target tasks,day-to-day performance,personalized performance,Party and people management performance,and mandatory plan performance as one evaluation integrity,forming a new public hospitals’performance evaluation system of multi-dimension and multi-level.This approach can effectively integrate diversified performance management objectives and overcome key difficulties in performance management,assisting further promotion of the approach,facilitating government objectives in managing the medical sector,promoting healthy development of hospitals,and exploring how to deepen the public hospital reform in terms of separating ownership from operations.

Abstract: Objective To investigate the differences in epidemiological and clinical characteristics of patients with spotted fever (SF) and severe fever with thrombocytopenia syndrome (SFTS). Methods A total of 86 patients with SF and 113 patients with SFTS who were laboratory-confirmed in the second-level and above hospitals in Lu'an City from January 2017 to January 2022 were selected. The basic data, epidemiological history, clinical data and laboratory test results of the two diseases were retrospectively analyzed for comparison. Results The proportion of male in SF group was 32.56% (28/86), and the proportion of male in SFTS group was 53.98% (61/113), the difference was statistically significant (χ2=9.067, P<0.01). The proportions of abdominal pain and diarrhea in the SF group were (3.49%, 3/83) and (21.24%, 24/113), which were significantly lower than corresponding (6.98%, 6/86) and (46.90%, 53/113) in the SFTS group (χ2=13.121, 37.322, P<0.01). The incidences of rash and eschar in SF group were 95.35% (82/86) and 20.93% (18/86), which were significantly higher than corresponding 1.77% (2/113) and 0.88% (1/113) in SFTS group (χ2=175.311, 22.721, P<0.01). The levels of leukocytes, platelets and C-reactive protein in the SF group were significantly higher than those in the SFTS group, and the levels of transaminase, lactate dehydrogenase and D-dimer were significantly lower than those in the SFTS group, and the differences were statistically significant (all P<0.05). Conclusions The rash and inflammatory reaction are more obvious in SF patients, while the liver function, myocardial function and coagulation function are significantly impaired in SFTS patients.

Female ; Heart Atria ; diagnostic imaging ; surgery ; Heart Neoplasms ; diagnostic imaging ; surgery ; Humans ; Leiomyomatosis ; diagnostic imaging ; surgery ; Magnetic Resonance Imaging ; Middle Aged ; Ultrasonography

OBJECTIVE: To observe the effect of anti-osteoporosis drugs on the curative effect of femoral head replacement in the elderly patients with proximal humerus fracture. METHODS: From November 2012 to June 2016, 38 patients with proximal humeral fractures received humeral head replacement were divided into the treatment group and the control group according to whether the anti-osteoporosis drugs were used after the operation. The treatment group included 19 cases, of which 11 cases were three part fractures, 18 cases were four part fractures, and bone density was(0.58±0.14) g/cm²; the control group involved 19 cases, of which 10 cases were the three part fractures, 9 cases were four part fractures, and bone density was(0.58±0.11) g/cm². Periprosthetic bone mineral density(BMD) was measured at 4, 8, 12, 24 and 48 weeks after operation, and visual analogue scale(VAS) was used to evaluate the pain and Neer score was used to evaluate the function of the shoulder joint. RESULTS: The incisions of all patients were healed with grade A and no complications occurred. Thirty-five patients were followed up for 1 year. The bone density around the prosthesis of treatment group was higher than that of control group, the difference was statistically significant(<0.05);VAS in two groups had no statistical significance(>0.05). The total score and functional score of Neer in the treatment group were better than those in the control group, the difference was statistically significant(<0.05), and there was no significant difference in pain and activity score between the two groups(>0.05). According to the Neer score, the results of treatment group was excellent in 10 cases, good in 5 cases, fair in 3 cases;in the control group, 3 cases were excellent, 9 cases were good, and 5 cases were fair;the difference between the two groups was statistically significant(<0.05). CONCLUSIONS Artificial humeral head replacement combined with anti-osteoporosis drugs in the treatment of proximal humeral fractures in elderly patients can effectively improve the bone density around the prosthesis and restore shoulder function. The early clinical effect is satisfactory.
Aged ; Calcitonin ; therapeutic use ; Fracture Fixation, Internal ; Humans ; Humeral Head ; Postoperative Period ; Shoulder Fractures ; prevention & control ; Shoulder Joint ; Treatment Outcome

ObjectiveTo investigate the features of hepatic myelopathy (HM) after transjugular intrahepatic portosystemic shunt (TIPS). MethodsA retrospective analysis was performed for a consecutive cohort of patients with cirrhotic portal hypertension who were successfully treated with TIPS in Department of Liver Disease and Digestive Interventional Radiology in Xijing Hospital of Digestive Diseases, Fourth Military Medical University, from 2005 to 2014 and then developed HM. Routine follow-up was performed for all patients at 1, 3, and 6 months after TIPS and every half a year subsequently. The time to disease progression was used to summarize the natural course of HM, the comparison of continuous data was made by independent samples t-test, the comparison of categorical date was made by chi-square test. The Kaplan-Meier method was used for survival analysis, and the Cox proportional hazards regression model was used to determine prognostic factors. Relief of symptoms in the lower limbs was analyzed to investigate the therapeutic effect. ResultsThe time to HM progression from grade 1 to grades 2, 3, and 4 was 40 months (range, 1-36 months), 8.5 months (range, 1-44 months), and 18.8 months (range, 54-48.6 months), respectively. In HM patients, the 1-, 3-, and 5-year cumulative survival rates were 84.19%, 5186%, and 4521%, respectively. Age of HM onset (HR=1.034, 95% CI: 1.003-1.065) and recurrent ascites (HR=3.869, 95% Cl: 1623-9225) were independent prognostic factors in patients with HM. The patients who underwent liver transplantation had a significantly higher proportion of patients with relief of symptoms than those who did not undergo liver transplantation (χ2=13.5, P=0.003), while the effects of stent flow limitation and occlusion showed no significant differences (P＞0.05). ConclusionThe course of HM consists of rapid progression stage and plateau stage, and HM patients after TIPS show good survival. At present, liver transplantation is an effective method to treat HM.

The 2017 China (Lianyungang) International Medical Technology Conference was held in Lianyungang,Jiangsu Province during November 15-17,2017.During this conference,the Division for Traditional Chinese Medicine and Natural Products Pharmacology of Chinese Pharmacological Society (CNPHARS) and Jiangsu Kanion Pharmaceutical Co. Ltd.jointly held the Forum on R&D and Interna-tionalization of New Drugs and Health Products of Traditional Chinese Medicine.The forum was co-chaired by Professor ZHANG Yong-xiang, President of CNPHARS, Chair of Division for Traditional Chinese Medicine and Natural Products Pharmacology of CNPHARS,and Chair of the Natural Product Section of Inter-national Union of Basic&Clinical Pharmacology(IUPHAR), Professor DU Guan-hua,former President of CNPHARS and Vice-Chair of Division for Traditional Chinese Medicine and Natural Products Pharmacology of CNPHARS,and Dr.XIAO Wei,Chairman of the Board of Jiangsu Kanion Pharmaceutical Co. Ltd. And Vice-Chair of Division for Traditional Chinese Medicine and Natural Products Pharmacology of CNPHARS. More than 70 scholars attended the forum, including four foreign experts [Michael SPEDDING, Secretary-General of IUPHAR; Professor Valérie B. SCHINI-KERTH, Vice-Chair of the Natural Product Section of IUPHAR; Professor Cherry WAINWRGHT, Director of Centre for Natural Product Drugs of Robert Gordon University; Professor InKyeom KIM, Director of the Korean Society of Pharmacology], members of the Division for Traditional Chinese Medicine and Natural Products Pharmacology of CNPHARS and leading researchers at Jiangsu Kanion Pharmaceutical Co.,Ltd.GU Jin-hui,Director of the Division of National Science and Technology Major Project for Drug Innovation,Department of Health Science,Technology and Education,National Health and Family Planning Commission of the People's Republic of China was also invited to attend the forum. Representatives discussed the R&D and internationalization of new drugs and health products of traditional Chinese medicine.The summary of views and advice of some experts was published here for the purpose of promoting domestic and overseas academic exchange, and playing an active role in improving the level of R&D and internationalization of new drugs and health products of traditional Chinese medicine in China.