OBJECTIVE:To observe the clinical efficacy and safety of noninvasive mechanical ventilation combined with aero-sol inhalation drug in the treatment of AECOPD complicating with respiratory failure. METHODS:90 patients diagnosed as AECO-PD complicating with respiratory failure were selected and randomly divided into observation group and control group,with 45 cas-es in each group. Both groups received routine treatment as oxygen supply at low flow rate,anti-infection,relieving asthma,venti-lation,cardiotonic,spasmolysis and nutritional support. Control group received noninvasive mechanical ventilation;observation group was additionally given aerosol inhalation of Budesonide atomized liquid+terbutaline+ipratropium bromide,bid. Both groups received 7 d of treatment. Clinical efficacy of 2 groups were compared as well as pH value,PaCO2,PaO2,HR,RR and PEF lev-els before and after treatment. The occurrence of ADR was observed. RESULTS:Total effective rate of observation group was 93.3%,which was significantly higher than 73.3% of control group,with statistical significance(P<0.05). There was no statisti-cal significance in blood gas analysis indexes,HR,RR and REF between 2 groups before treatment (P>0.05). pH value,PaO2 and PEF of 2 groups increased after treatment,while PaO2,HR and RR decreased;the observation group was better than the con-trol group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Noninvasive me-chanical ventilation combined with aerosol inhalation drug is effective in the treatment of AECOPD complicating with respiratory failure,and can effectively improve blood gas indexes,HR,RR and PEF with good safety.

Objective To explore the effect of laparoscopy and laparotomy surgery on immune function related indicators in ovarian benign tumor patients. Methods From January 2015 to January 2016, 86 cases of ovarian benign tumor patients were set as study objects. All the patients were randomly divided into control group and observation group, 43 cases in each. Patients in control group were given traditional laparotomy surgery, while patients in observation group were given laparoscopic surgery. The changes of immune function related indexes before and after operation were recorded, before operation, day 1 and day 3 postoperative, number of peripheral white blood cells (WBC), neutrophil ratio (NGR), immunoglobulin (IgA, IgG, IgM) levels, C reactive protein (CRP) content and the distribution of T lymphocyte subsets (CD3+, CD4+ and CD3+/CD4+ ratio) distribution were respectively determined, and the incidence of postoperative complications was recorded, and were further statistical analyzed. Results There was no significant difference in immunoglobulin IgA, IgG and IgM between the twogroups before operation (P > 0.05). Postoperative, only the IgG content of the two groups was significantly lower than that before the operation (P < 0.05 ); The levels of WBC, NGR and CRP in the control group patients in the昀rst day and the third day after surgery were significantly increased compared with preoperative period, while CRP in the observation group was higher than that before the operation, there was significant difference between the two groups (P < 0.05). There was no significant difference in CD3+, CD4+ and CD3+/CD4+ ratios between the two groups before operation (P > 0.05), the difference between the two groups was significant (P < 0.05). The complication rate of the observation group after operation was 6.98%, the control group was 16.28%. Conclusion Clinical use of laparoscopic treatment of benign ovarian tumors relative to the traditional laparotomy can effectively reduce the immune system of patients with immune function, with high safety, contribute to the recovery of patients, it is worthy of clinical promoting.

Objective:To explore the effective treatment to the depression after silent cerebral infarction(SCI).Methods:Seventy-three patients suffering from depression after SCI were treated for three moths with a mono-blind experiment.Results:There was significant difference between the effect of antidepressant and the effect of nonantideressant( P

AIM: To investigate the changes of serum angiogenic factors including vascular endothelial growth factor (VEGF) and basic fibroblast growth factor ( bFGF) in Mongolia patients with diabetic retinopathy ( DR) and to explore their roles in the progress of DR.
METHODS: Eighty - three patients with diabetes were divided into three groups according to the retinopathy, no DR group ( NDR, 25 cases), background DR ( NPDR, 31 cases) and proliferative DR group (PDR, 27 cases), and 36 age - matched healthy people ( control group) were selected. Serum concentrations of VEGF and bFGF were measured using ELISA method.
RESULTS: In Mongolia patients with diabetes, the serum concentrations of VEGF and bFGF were higher than those in control group; the serum concentrations of VEGF and bFGF in PDR group was higher than those of NDR and NPDR group (P< 0. 05); the concentrations of VEGF and bFGF in NPDR group was higher than that of NDR group (P<0. 05).
CONCLUSION: High level of VEGF and bFGF may be the important pathogenic factors for DR in Mongolia patients.

Objective To determine the clinical features of Klebsiella pneumoniae pneumonia and antimicrobial resistance of Klebsiella pneumoniae, providing the basis for rational use of antibiotics. Methods Eighty-six strains of Klebsiella pneumoniae were isolated from the sputum specimen which collected from the inpatients in our hospital from Dec 2008 to Dec 2010,which were identified with Bio Merieum Vitek 2. A total of 86 children were enrolled in the study, which were divided into hospital infection/colonization group (n = 68) and community infection group (n = 18). Clinical information were recorded. Extended spectum β-lactamase (ESBLs) and antibiotic susceptibility of Klebsiella pneumoniae were determined. Results Klebsiella pneumoniae pneumonia in children mainly occured in infants, especially in infants with basic diseases.Clinical manifestations of Klebsiella pneumoniae pneumonia had no much difference from common pneumonia. The detection rate of ESBLs was high(76. 7%). ESBLs were found in 64 strains of the hospital infection/colonization group (94. 1% ,64/68) ,while in 2 strains of the community infection group (11. 1% ,2/18).There was a significant difference between the two groups (P ＜0. 01). The drug resistance of hospital infection/colonization group was significantly higher than that of community infection group. The strains of hospital infection/colonization group were sensitive with cefotan, piperacillin/tazobactam, carberpenem, amikacin and ciprofioxacin only, while were highly resistant to penicillins, cephalosporins and monoamine antibiotics.The average hospital stay of the hospital infection/colonization group was (15.0 ± 7. 1) d, while the other was (8. 2 ± 3. 8) d. There was a very significant difference between the two groups in average length of stay (P＜0.01). Conclusion Klebsieila pneumoniae pneumonia in children mainly occurs in infants with basic diseases. The symptoms are untypical. Klebsiella pneurmoniae multi-drug resistance is a serious problem,which must be paid attention to. We should make a difference between the two groups when antibiotics were prescribed.

Objective To observe the clinical efficacy and adverse reactions of docetaxel and carboplatin 21 day regimen (TC)as second -or third -line in treatment of patients with advanced triple -negative breast cancer (ATNBC).Methods 37 ATNBC patients with anthracyclines resistance were given docetaxel 70mg/m2 ,the first day of intravenous drip,carboplatin AUC =5,through intravenous drip on the first day,21 days for a course of treatment, until disease progression or not tolerated or most received six cycles of chemotherapy.Results 147 cycles of chemo-therapy were completed in 37 patients,and the median chemotherapy cycle was 4 cycles.The efficacy and adverse reactions could be evaluated in all patients.Among them,complete remission (CR)in 0 patient,partial remission (PR)in 12 patients (32.43%),stable (SD)in 11 patients (29.73%),and progression (PD)in 14 patients (41.18%).The effective rate(CR +PR)was 32.43%.The disease control rate (CR +PR +SD)was 62.15%,median TTP was 3.9 months (95%CI:4 -8months),and median OS was 10 months.Until the end of follow -up,there were 3 patients with no progress.The main adverse reactions were hematological toxicity (51.53%)and gastrointestinal reaction (56.76%).Conclusion TC regimen is effective and safe in the treatment of patients with ATNBC.

OBJECTIVETo summarize laws of acupoint selection of prescriptions for treatment of cervicogenic headache by acupuncture in modern literature.

METHODSRandomized controlled trials (RCTs) involving acupuncture and moxibustion for treatment of cervicogenic headache were recruited from CBM (1978-2012), VIP (1989-2012), Wanfang Database (1998-2012), CNKI (1979-2012), PubMed (1966-2012), EMbase (1980-2012), and Cochrane Library (Volume 4, 2012). Hand recruitment was also auxiliarily used. The frequency and percentage of common acupoints, the distribution of acupoints along 14 meridians and across each part of the body, the application of specific acupoints, and features of using prescriptions for specific acupoints were statistically described.

RESULTSTotally 37 recruited papers included 42 acupoints and 159 times. Common acupoints covered Fengchi (GB20, 28 times), Jingjiaji (EX-B2, 21 times), Baihui (DU 20, 12 times), Tianzhu (BL9, 1 times), and Ashi point (11 times). Meridians along which acupoints were used mainly covered Foot-shaoyang Gallbladder Meridian, Foot-taiyang Bladder Meridian,and DU meridian. Acupoints were mainly needled from head, neck, and upper limbs. Eight confluence points and luo-connecting point were commonest used as specific acupoints. Acupuncture prescriptions were mostly composed of multiple acupoints. Filliform needle was mainly used in acupuncture methods, followed by electro-acupuncture needle.

CONCLUSIONSModern acupuncture treatment of cervicogenic headache focuses on local specific points and acupoints along meridians. Acupoints were mostly selected from head, neck, and upper limbs by syndrome typing of Chinese medicine.

Acupuncture Points ; Acupuncture Therapy ; methods ; Humans ; Post-Traumatic Headache ; therapy ; Randomized Controlled Trials as Topic

Adolescent ; Chronic Disease ; Helicobacter Infections ; complications ; drug therapy ; Humans ; Male ; Purpura, Schoenlein-Henoch ; drug therapy ; etiology ; Syndrome

OBJECTIVETo compare the efficacy differences in the treatment of somatoform pain disorder between resuscitation and tranquilization acupuncture technique and oral administration of deanxit.

METHODSForty cases of somatoform pain disorder (complicated with mild and moderate depression) were randomized into an acupuncture group and a western medication group, 20 cases in each one. In the acupuncture group. acupuncture was applied to Shenting (GV 24). Shuigou (V 26). Sishencong (EX HN I) to Baihui ((V 20) (penetrating technique). Feng-chi (GB 20). etc. The treatment was given once every day. 6 times a week. In the western medication group. the anti depression drug. deanxit was prescribed for oral administration, 1 tablet in every morning and lunchtime each day. In 8 weeks of continuous treatment, the visual analogue scale (VAS) and Hamilton depression scale 17 items (HAMD) were used to evaluate the efficacy in the patients of the two groups, the adverse reactions were observed and the recurrence rate was followed up in 3 months.

RESULTSAfter treatment. VAS and HIIAMD scores were all apparently reduced as compared with those before treatment in the patients of the two groups (all P<0.05). The reducing amplitude of VAS score in the acupuncture group was greater than that in the western medication group (P<0.05) and that of HAM) score was not different significantly as compared with that in the western mnedica tion group (P > 0.05). There was no adverse reaction in the acupuncture group and were 3 cases as dizziness, trembling. dry mouth and constipation in the western medication group. The curative and remarkably effective rate was 50.0 (10(20)) in the acupuncture group, better than 15.0% (3/20) in the western medication group (P<0.05). The recurrence rate was 10.0 (2/20) in the acupuncture group. lower than 35.0% (7/20) in the western medication group (P<0.05).

CONCLUSIONThe resuscitation and tranquilization acupuncture technique achieves the definite efficacy on somatoform pain disorder, relieves depression symptoms of patients, especially pain and reduces adverse reactions and recurrence rate. The effects of this therapy are advanced as compared with deanxit.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Resuscitation ; Somatoform Disorders ; therapy ; Treatment Outcome

Objective To evaluate the therapeutic effectiveness of postoperative hemorrhage of cholejejunal or pancreato - jejunal anastomotic stoma after pancreato - duodenectomy by the way of fibercholedochoscopy. Meth- ods The drainge tube was extracted out of choledochojejunal anastomotic stoma. And fibercholedochoscopy was in- serted in fistula to affirm hemorrhagic position of choledochojejunal or pancreato - jejunal anastomotic stoma. And then local coagulation and microwave solidifying was proceeded with. Local spray of Galla - chineses compound solution was performed for hemostasis. Results We succeeded in hemorrhage of four choledochojejunal and six pancreato - jejunal anastomotic stoma One failed for frequent hemorrhage in pancreato - jejunal anastomotic stoma. Conclu- sion Fibercholedochoscopy is the first selective and effective method in the diagnosis and treatment of postoperative hemorrhoge of pancreato - jejunal or choledochojejunal anastomotic stoma after whipple operation.