Objective To explore the clinical effect of budesonide inhalation combined with psychological intervention in the treatment of chronic obstructive pulmonary disease (COPD).MethodsSelected in Zhuji city center hospital from July 2012 to April 2017 year to receive treatment in patients with chronic obstructive pulmonary disease in 80 cases as the research object, after the patient related clinical data, all patients were randomly divided into treatment group and control group two groups, each group of 40 cases of patients in the study group of patients with a doctor inhaled budesonide combined with psychological intervention treatment, inhalation therapy on the comparison group of patients treated with budesonide, observe the changes of two groups, serum blood gas index change and remodeling index sputum viscous indicators clinical statistics.ResultsAfter treatment the corresponding treatment after the intervention, the study group of serum basic fibroblast growth factor Xian (b-FGF), nerve growth factor (NGF) and tissue inhibitor of metalloproteinase-1 (TIMP-1), sputum interleukin-8, tumor necrosis factor alpha and PaO2, PaCO2 and other aspects of the statistical index is obviously better than the contrast group;the study group of patients treatment effect is much higher than that of contrast group patients.ConclusionBudesonide inhalation combined with psychological intervention in the treatment of chronic obstructive pulmonary disease is more effective than conventional treatment, which is worthy of popularization and application in clinical medicine.

[Objective]To discuss the method and effectiveness of arthroscopically assisted mini-incision arthrolysis for the stiff knee.[Method]A small lateral suprapatellar incision was made in all 26 patients suffered from stiff knee,and the scissors were introduced the joint to release the adhesive tissues of patellofemoral joint.All adhesive tissues between the medial,lateral retinaculum and the femur,and the between vastus intermedius and femur were released subsequently.After the release of the adherence between the fat pad and femoral condyle,the lateral retinaculum was dissected 1 cm lateral to the patellae,and the dissection of medial retinaculum was applied at the insertion of the vastus medialis.Eventually,arthroscopic debridement and hemostasis combined with manipulative release was applied to remove all remanent adhesive bundles and scar tissues.[Result]Follow-ups were maintained for an average of 19 months(range,from 8-32 months).An increase in the average range of motion of the knee was attained from 32 degrees preoperatively to 113 degrees postoperatively.No complications such as skin necrosis,wound dehiscence,tendon rupture and fracture had occurred during the follow-up period.[Conclusion]The advantages of arthroscopically assisted mini-incision arthrolysis for the stiff knee include simple procedure,minimal trauma,and quick rehabilitation.Otherwise,reservation of the insertion of vastus medialis is of great importance not only for the maintenance of extensive strength and stability of the knee,but also for the functional recovery and the reduction of complications.

[Objective]To investigate the clinical results and significance and mechanism of early dislocation rate after total hip arthroplasty following the posterolateral approach with posterior capsulotendinous repaired.[Method]The incidence of early dislocation and the prosthetic range of rotation motion among 212 consecutive primary THAs with the posterior capsule and the short external rotators which had been sutured to the medius tendon was reviewed retrospectively,and was compared to the results of 486 consecutive unilateral primary THAs with a complete posterior capsulectomy.[Result]During a 6 months to 5 years(3.7 years in average)following-up,there were significant differences between two groups.In patients with posterior capsulotendinous repair,two of 224 primary total hip arthroplasty(0.9%) had an early posterior dislocation.In patients with a complete posterior capsulectomy,27 of 486 primary total hip arthroplasty(5.6%) had an early dislocation.The difference was statistically significant(x~2=8.51,P

Objective To study the effect of adaptive support ventilation (ASV) in treatment of severe asthma.Methods Forty-nine cases of severe asthma were divided into ASV group (25 cases) and control group (24 cases,tradition mechanical ventilation).The arterial blood gas,respiratory dynamics,mechanical ventilation time,hospital stay and thorax barotrauma was compared between two groups.Results The arterial blood gas and respiratory dynamics was improved after mechanical ventilation compared with that before mechanical ventilation in two groups,and there was significant difference (P ＜ 0.05 or ＜ 0.01).The airway peak voltage,lung dynamic compliance and platform pressure after mechanical ventilation of 2,12 and 24 h in ASV group was better than that in control group[2 h:(33 ± 12) cm H2O(1 cm H2O =0.098kPa) vs.(37 ± 11) cm H2O,(16 ± 9) ml/cm H2O vs.(17 ± 10) ml/cm H2O,(27 ± 6) cm H2O vs.(30 ±12) cm H2O; 12 h:(23 ± 12) cm H2O vs.(25 ± 11) cm H2O,(28 ± 6) ml/cm H2O vs.(23 ± 10) ml/cm H2O,(20 ±6) cm H2O vs.(25 ±4) cm H2O; 24 h:(18 ± 12) cm H2O vs.(20 ± 11) cm H2O,(32 ±9)ml/cm H2O vs.(28 ± 10) ml/cm H2O,(12 ±7) cm H2O vs.(16 ±7) cm H2O],and there was significant difference(P＜ 0.05 or ＜ 0.01).The mechanical ventilation time and hospital stay in ASV group was shorter than that in control group [(46 ± 8) h vs.(56 ± 6) h,(7 ± 2) d vs.(10 ± 3) d],and there was significant difference (P＜ 0.01).The thorax barotrauma was not observed in ASV group; 3 cases showed subcutaneous emphysema and 2 cases showed pneumothorax in control group.Conclusions ASV mode could decrease airway peak voltage and platform pressure,improve arterial blood gas and lung dynamic compliance,shorten mechanical ventilation time and hospital stay.It is safe and effective for patients with severe asthma.

Objective To determine the surgical procedures and effects of ultra-distal tibial intramedullary nails combined with blocking screws in treatment of distal tibial fractures.Methods From April 2008 to September 2012,21 cases of distal tibial fractures were treated with ultra-distal tibial intramedullary nails combined blocking screws.All fractures were statically locked and closed using undreamed technique.For relatively simple fracture,blocking screws were considered when the reduction and stability was not satisfied after the insertion of intramedullary nails; for severe comminuted fractures,blocking screws were inserted directly under C-arm fluoroscopy.Partial weight-bearing was permitted 3 weeks after surgery.Quality of reduction,fracture union,and function assessment were measured at follow-up.Results No skin necrosis and soft tissue and bone infections occurred after a mean follow-up of 17.5 months (range,12-22 months).All fractures were healed with an average healing time of 12 months (range,8-26 months).X-ray findings revealed the fracture of ＜ 5° angulation on coronal and sagittal planes.There was no deformation or breakage of blocking screws and intramedullary nails.According to the criteria of Tormetta,the results were excellent in 19 cases and good in 2.Conclusion Blocking screws assists reduction and improve the fixation stability by narrowing the canal in treatment of distal tibial fractures and expands the application of intramedullary nails.

Objective To investigate the changes of coagulation function and blood rheology in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and effects of depside salt from salvia miltiorrhiza.Methods The patients with AECOPD were randomly divided into depside salt from salvia miltiorrhiza anticoagulation group (45 patients) and conventional treatment group (45 patients).At the same time 50 normal were choosed as control group (50 patients).On the 14th day after treatment,4 indexes of coagulation,D-dimer and of blood rheology in depside salt from salvia miltiorrhiza anticoagulation group and conventional treatment group were determine and compared with those of normal control group.Results The levels of Fbg (4.6 ± 0.7) g/L and D-dimer (1.58 ± 1.13) mg/L were significantly different between depside salt from salvia miltiorrhiza anticoagulation group and normal controls.After depside salt from salvia miltiorrhiza anticoagulation,The levels of FbgFbg (3.3 ± 1.2) g/L and D-dimer (0.48 ± 0.36)mg/L were decreased significantly (P ＜ 0.01).The 1 evels of Fbg (3.3 ± 1.2) g/L and D-dimer (0.48 ± 0.36)mg/L were decreased significantly in depside salt from salvia miltiorrhiza anticoagulation group compared with those in Conventional treatment group (P ＜ 0.01).But PT,APTT and TT level were not significantly different in three groups (P ＜0.05).After treatment,hemodynamic indexes:whole blood high shearing viscosity (4.76 ± 1.35)mPa.S,low shearing viscosity (8.69 ± 2.36) mPa.S plasma viscosity (2.32 ± 0.26) mPa.S and hematocrit (40.3 ± 2.38)％ in depside salt from salvia miltiorrhiza anticoagulation group indicated significant differences compared to those in Conventional treatment group[(5.50.3 ± 1.34) mPa.S,(12.30 ± 2.30) mPa.S,(2.32 ± 0.26) mPa.S,(47.89 ± 3.13)％)] (P ＜ 0.01).Conclusion Patients with in AECOPD have hypercoagulable state.depside salt from salvia miltiorrhiza could improved hypercoagulable state in acute exacerbation of chronic obstructive pulmonary disease and decrease blood viscosity.

Objective To explore the safety and clinical effect of combined laparoscopic-colonoscopy resection of colorectal tumor.Methods A total of 26 patients with early colorectal tumor was treated by combined laparoscopic-colonoscopy resection.To observe the postoperative complications,the mean operative time,mean intraoperative blood loss,mean time of gastrointestinal function recovery,and mean postoperative hospital stay were analyzed.Results All the 26 cases were operated successfully.The mean operative time was 60 ～ 162 (93.7 ± 22.5)min.The mean intraoperative blood loss was 15 ～ 120 (35.9 ± 24.2) ml.The mean time of gastrointestinal function recovery was 48 ～ 120(73.2 ± 14.5)h.The mean postoperative hospital stay was 5 ～ 13 (7.4 ± 1.8) d.No postoperative complications occurred,such as stomach leak,enterobrosis and intestinal obstruction.Follow up 6 ～ 12 months,there were no tumor residue and recurrence.Conclusions The combined laparoscopic-colonoscopy resection was located exactly,reasonable excision scope,minimally invasive,quick recovery and other advantages.It was worth of clinical application.

protrusion measured by ultrasound for diagnosing bladder outlet obstruction.Methods A literature search of medline (1966.1-2011.6),embase(1984.1-2011.6),CNKI (1994.1-2011.6) and WEIPU Data (1989.1-2011.6) from 1999 to 2009 was performed by two reviewers independently.QUADAS items was applicated to assess trial quality.Golden standard was BOOI measured by urodynamics (BOOI more than 40 indicates bladder outlet obstruction).Heterogenous studies and meta-analysis were conducted by Meta-Disc 1.4 software.Results Totally 6 studies was included at last,involving 682 subjects.No threshold effect was found,but there was heterogeneity due to other factors.The meta-analysis showed that the sensitivity was 70.8 ％,specificity was 87.6 ％,positive LR was 5.132,negative LR was 0.303,the diagnostic OR was 22.18,the area under SROC curve was 0.8723 and Q index was 0.8028.Conclusions Intravesical prostatic protrusion measured by ultrasound is a good index for diagnosing bladder outlet obstruction in patients with benign prostate hyperplasia when intravesical prostatic protrusion is equal or more than 10mm.

Objective To study the optimum combination of orientation parameter of total hip prosthesis and acetabular safe zone on condition that the range of motion for activities of daily living (ADL) is fulfilled.Methods A three-dimensional generic parametric and visually kinematic simulation module of THA was developed.Range of motion ( ROM ) of hip flexion ≥ 110°,internal-rotation ≥30° at 90° flexion,extension ≥30° and external rotation ≥40° were defined as the normal criteria for ADL.ROM of hip flexion ≥ 120°,internal-rotation ≥45° at 90° flexion,extension ≥30° and external rotation ≥40° were as the severe criteria.The ranges of changes in general ratios (GRs) of head-neck,femoral neck antevemion ( FNA ),operative inclination (OI) and anteversion (OA) of acetabulur components were 2.0-2.92,0°-30°,10°-60°,and 0°-70° respectively.Within the limits of the upper two activity criteria,the synchronous OA of acetabulur components was calculated with every 5°change in OI of the cup,and the collodiaphyseal angle ( CDD ) was set as 135°.The safe-zone of combination of acetabulur operative anteversion (OA) and inclination (OI) was defined as the area that fulfilled the two mentioned criteria of ROM without cup-neck impingement.All parameters were analyzed by using SAS 6.12 software.Results The safe zone of acetabdar angle rose with the increase of GRs of head-neck and the safe zone of severe criteria was smaller than that of normal criteria.When the CDD angle was 135°,the sum of average aeetabular OA and acetahular OI plus 0.816 times of the FNA equaled to 84.76° innormal criteria; and the sum of average acetabular OA and acetabular OI plus 0.873 times of the FNA equaled to 92.04° in severe criteria.Conclusions A high GR of head-neck greatly increases the size of safe-zone of acetabular angle.The higher demand of ROM of hip joint requires the smaller safe zone of acetabular angle,as can be corrected by increasing the GR of head-neck.The optimum combination between the sum of average acetabular OA and acetabular OI ( Y) plus FA (X)in the normal criteria and severe criteria can be estimated by using the following formulae:Y1 =-0.816X1 + 84.76 (R2 =0.993 ),Y2 =-0.873X2 + 92.04( R2 =0.999) respectively.

Objective To explore the application value of Golgi protein-73 (GP73)and AFP in single and combining form in the diagnosis of primary hepatocelluar carcinoma (PHC).Methods Eighty PHC,65 liver cirrhosis,54 chronic hepatitis patients and 50 controls were selected in the First Afiliated Hospital in Xinjiang Medical University from May to September in 2011,GP73 was detected by ELISA and AFP was measured by clinical chemiluminescence.The sensitivity and specificity of each parameter in single and combining form were evaluated.Results Serum GP73 in PHC group 282.0(163.6-366.7) μg/L,liver cirrhosis group 211.8(107.5-295.7) μg/L,chronic hepatitis group 100.3(61.8-191.3) μg/L and control group 58.3(43.4-83.6) μg/L was tested by Kruskal-Wallis(H =106.6,P ＜0.01).GP73 in PHC group was further compared with liver cirrhosis group,chronic hepatitis group and control group using MannWhitney test,significance was found,(U was 1796.0,826.5,154.0,respectively,all P ＜0.01).In the single form,the sensitivity of GP73 [82.5％ (66/80)] was higher than AFP [66.3％ (53/80),x2 =4.65,P ＜0.05],but the specificity of GP73 [63.3％ (107/169)] was lower than AFP [88.7％ (150/169),x2 =28.91,P ＜0.05].There were 27 AFP negative cases in PHC group,but 22 of them were GP73 positive,making the positive rate of GP73 [81.5％ (22/27)] in PHC patients with AFP negative.There were 14 GP73 negative cases of in PHC group,but 9 of them were AFP positive,making the positive rate of AFP [64.3％ (9/14)] in PHC patients with GP73 negative.In series diagnostic test,the specificity of combining form [95.9％ (162/169)] was higher than AFP [88.7 ％ (150/169),x2 =6.00,P ＜ 0.05] ; in parallel diagnostic test,the sensitivity of combining form [93.8％ (75/80)] was higher than GP73 [82.5％(66/80),x2 =4.84,P ＜0.05].In PHC group,52 patients with HBV infection,10 patients with HCV infection and 18 patients without virus infection,GP73 was 309.5 (170.5-370.5) μg/L,351.0 (274.7-397.9) μg/L and 210.1 (156.8-306.7) μg/L,respectively,no significance was found (H =4.0,P ＞0.05).Conclusion GP73 and AFP have a complementary feature of sensitivity and specificity in the early diagnosis of PHC,some PHC cases with AFP negative can be avoided missing efficiently by parallel diagnostic test.