Objective To evaluate the efficacy of 9 μ g tiotropium inhalation once daily in patients with moderate to severe chronic obstructive pulmonary disease(COPD).Methods One hundred seventy-one patients with moderate to severe COPD were divided into two groups by random digits table methods:86 patients in test group who used 9 μ g tiotropium powder inhaler once daily,and 85 patients in control group who used the recommended dose 18 μ g once daily,both for 6 months.Patients' pulmonary function and 6-minute walk test were measured before treatment,3 months after treatment and 6 months after treatment.Results Two groups were compared 6 months after treatment.The level of forced expiratory volume in first second(FEV1) in the control group increased an average of (0.21 ± 0.12) L,and the rising rate was (19.31 ± 10.61)％.The level of FEV1 in test group increased (0.22 ±0.13) L,and the rising rate was (19.25 ± 11.52)％.The level of forced vital capacity (FVC) in control group increased an average of (0.22 ±0.10) L,and the rising rate was (11.63 ±5.31)％.The level of FVC in test group increased (0.23 ± 0.15) L,and the rising rate was (11.62 ± 6.45)％.The distance of 6-minute walk test in control group increased an average of (29.24 ± 11.92) m after treatment for 6 months,and the rising rate was (18.30 ± 3.77)％.The distance of 6-minute walk test in test group increased an average of (29.14 ± 11.89) m,and the rising rate was (18.20 ± 3.85)％.The number of acute exacerbations and rehospitalizations in two groups at these period had no significant difference (P ＞ 0.05).As for the test group,though the number of acute exacerbations and rehospitalizations decreased,there were no significant differences (P ＞ 0.05).Conclusions The effect of inhalation therapy of 9 μ g tiotropium once daily is more or less the same with that of 18 μ g once daily.

ObjectiveTo evaluate the effectiveness of treating tuberculous pleurisy with hydrogen peroxide solution washing and povidone iodine solution perfusing topically.MethodsAfter fixing position with B ultrasound or 64 rows spiral computed tomography,the thoracic cavity was firstly inspected with thoracoscope,the effusion was exhausted and the conglutionations was cut with thoracoscope or high frequency electrome,then the thoracic cavity was washed with 200 ml 3％ hydrogen peroxide solution,and lastly it was perfused continually with 0.5％ povidone iodine solution to control the intracavity infection quickly and to promote cicatrization.After routine antitubercular therapy for one year,the time of pleural effusion disappearing and the state of pleura hypertrophy was observed.ResultsThere were 86 cases in all.After antitubercular therapy and extracting pleural effusion at the same time in 48 cases.Twenty-two cases'effusion didn't increase basically after 4 weeks.They stopped extracting effusion and went on with antitubercular therapy (the first group).The rest 26 patients continued to accept the therapy of hydrogen peroxide solution washing and povidone iodine solution perfusing topically(the second group),and 23cases achieved remedial goal in a week with the effective rate of 88.46％ (23/26).The third group had 38 cases who didn't accept thoracocentesis but accepted the therapy of hydrogen peroxide solution washing and povidone iodine solution perfusing directly,and there were 36 cases that achieved remedial goal in a week with effective rate of 94.74％ (36/38).The time of pleural effusion disappearing in the third group was obviously shorter than that in the first group (1 week vs.4 weeks )(P ＜ 0.05 ),and there was no significant difference in the efftective rate between the second group and the third group (P ＞ 0.05 ).Half a year after therapy,the thickness of pleura was measured and it was found that in the first group was thickest and in the third group thinnest and even some without hypertrophy.It was the same effect after one year.Conclusions The effectiveness of the method treating tuberculous pleurisy with hydrogen peroxide solution washing and povidone iodine solution perfusing topically is defimite,and the method can shorten the time of pleural effusion disappearing and alleviate the pleural hypertrophy.