Objective To observe effect of aerobic exercise combined with inhalation of tiotropium on patients with stable chronic obstructive pulmonary disease (COPD) complicated with pulmonary hypertension.Methods A total of 98 patients with stable COPD and grade Ⅱ or Ⅲ pulmonary function complicated with pulmonary hypertension were recruited.They were divided into an observation group (n =31) and two control groups (n =30 and 37).Patients in control group 1 inhaled shahmette and fluticasone powder,and antibiotics as well as apophlegmatisant were also used in accordance with the demands of the patient's condition.Patients of in control group 2 inhaled tiotropium dry powder and accepted other therapeutic measures equivalent to those of control group1.The patients in the observation group were given aerobic exercise in addition to other therapeutic measures equivalent to those of control group 2.Six-minute walk test distances,pulmonary arterial systolic pressure and chronic obstructive pulmonary disease assessment test scores were compared after 6 months of treatment,among the groups and against the baseline values before treatment.Results After 6 months of treatment the average 6-minute walk distance,chronic obstructive pulmonary disease assessment score and pulmonary arterial systolic pressure of the observation group were all significantly better than for either of the control groups.Conclusions Inhaling tiotropium dry powder combined with aerobic exercise can reduce pulmonary artery systolic pressure and improve the symptoms as well as the quality of life for patients with stable COPD complicated by pulmonary hypertension.

Objective To evaluate the effect of self-management education on gastroesophageal reflux asthma .Methods 71 gastroesophageal reflux asthma patients were divided into two groups , the management group (n=35) and the control group (n=36).The control group received routine drug therapy and routine outpatient guidance, while the management group was given routine drug treatment and systematic outpatient self -management education.The self-management lasted for 6 months.The symptoms of gastroesophageal reflux , control level of asthma and the pulmonary ventilation function were compared between the two groups .Results After the intervention, the score of symptoms of gastroesophageal reflux in the management group was (5.1 ±1.2), which was significantly lower than (6.8 ±1.6) in the control group (t=5.07,P<0.01).The score of asthma control in the management group was (23.5 ±0.6), which was significantly lower than (22.7 ±0.9) in the control group (t=4.41,P<0.01).On the aspects of pulmonary ventilation function , the 1 second forced vital capacity of the expected percentage , the 1 second forced expiratory rate and peek expiratory flow rate were (87.4 ± 3.9)%,(86.7 ±3.1)%and (8.8 ±1.8) L/s in the management group , which were significantly higher than (83.4 ±4.6)%,(84.3 ±4.2)% and (7.7 ±1.2) L/s in the control group (t =3.96,2.74,3.05, respectively;P<0.01).Conclusions The systematic outpatient self-management education can improve the ability of self care , decrease patients'symptoms and improve patients pulmonary ventilation function .