Objective To evaluate the clinical efficacy of salmeterol /fluticasone propionate in the treatment of chronic obstructive pulmonary disease .Methods 107 patients with chronic obstructive pulmonary disease from June 2012 to June 2014 were randomly divided into control group and observation group .Patients in control group re-ceived routine therapy, yet patients in observation group received salmeterol /fluticasone propionate on the basis of routine therapy.The st.George respiratory questionnaire (SGRQ) mark, 6 -minwalktest (6MWT),pulmonary func-tion indexes and drug adverse reactions before treatment and after treatment were observed respectively .Results Af-ter treatment, the lung function index recovery , the SGRQ total score,6MWT of observation group was obviously bet -ter than that of the control group , and the difference had statistical significance (p <0.05).There were no serious adverse reactions occurred in the two groups , and with no statistically significant difference (p >0.05).Conclusion On top of conventional therapy ,salmeterol /fluticasone propionate has good clinical curative effect and high safety for treating COPD,and so it is suitable for long -term and sustained treatment .

Objective Comparison of the modified Weaver-Dunn method with AO clavicular hook plate for acromioclavicular joint dislocation efficacy.Methods Surgical treatment of Rockwood Ⅲ to the V Type acromioelavicular joint dislocation 35 cases,depending on the surgical approach,were divided into 2 groups of the modified Weaver-Dunn method and AO clavicular hook plate.Operation time,blood loss,hospitalization costs,postoperative Xray film results,the clinical efficacy results and complications were compared between two groups.Results Modified Weaver-Dunn method Section of the longer operative time,mean intraoperative blood loss more.Shoulder pain,the incidence of postoperative modified Weaver-Dunn method group is significantly lower than the AO clavicular hook plate group,abduction activity was better than AO clavicular hook plate group.AO clavicular hook plate group prone to shoulder mobility and shoulder pain.Postoperative Karlsson assessment standard,modified Weaver-Dunn method were excellent in 10,good in 4 cases and poor in 1,excellent rate was 93％ ;AO clavicular hook plate group were excellent in 8 cases,good in 7 cases and poor in 5 cases,excellent rate of 75 ％.Conclusion Modified Weaver-Dunn method is used to treat complete acromioclavicular joint dislocation.Postoperative shoulder pain and shoulder mobility are in low incidence of shoulder function recovery effect.

Objective To explore the main points of early diagnosis,the principles and the efficacy of surgical treatment of Lisfranc injury.Methods The clinical data and follow-up results of 23 cases of patients with Lisfranc injury treated from April 2004 to February 2011 (17 males,6 females,aged from 19 to 57 years old) were collected and analyzed.All patients underwent open reduction and internal fixation,among them,13cases with Kirschner wire fixation and 10 cases with screws fixation.Efficacy was evaluated in accordance with Maryland foot score.Results Twenty-one patients were followed up for 6 - 46 months with an average of (28.5 ± 2.6) months.In the last follow-up no patients has internal fixation fracture,loss of reduction and other complications.The score was 56 - 97 points with an average score of ( 86 ± 8 ) points.The results showed excellent in 6 cases,good in 10 cases and fair in 3 cases,good rate was 76.2％.Conclusion Lisfranc injury can be diagnosed by early signs and symptoms,and can be confirmed by combining with radiographic examination.Lisfranc injury should be treated with open reduction and internal fixation with Kirschner wire or screw,both of the two fixation methods can achieve good results.

Objective To evaluate surgical results an d choice of various procedures for hypospadias repair in boys.323 cases of hypospa dias were treated from 1995-2002,and of these,205 boys whose average age was 5.1 years had underwent different surgical procedure for hypospadias. M ethods 205 boys with hypospadias were retrospectively analysed.MAGPA (5 cases),Mathieu(7),Onlay island flap(9) were given to boys of hypospadias wit hout chordee.Duckett procedure (127),Modified Denis-Browne (16),Bladder mucosa graft technique (16),Duckett plus Duplay techniques(25) were adopted for hypospa dias with chordee. Results There were 19 cases with uret hra fistula and 1 case with external orifice stricture of urethra.The success ra te for all cases was 90.2%,and morbidity of all complications was 9.8%.The compl ication for Duckett techniques was 7.8%(10/127),Modified Denis-Browne 12.5%(2/1 6),Mathieu 28.6%(2/7),Duplay plus Duckett 16.0%(4/25),Bladder mucosa graft techn ique 6.3%(1/16) and Onlay 11.2%(1/9). Conclusions It is suggested that a complete mastery of applications for different surgical approac h and a proper selection of various surgical methods according to individual pat ient’s condition can reduce complication of operation.

Objective To investigate the possible relationship between the changes in the serum level of hepatocyte growth factor (HGF) and the tumor c-Met expression in postoperative patients with small primary hepatocellular carcinoma (SHCC) and the recurrence of the cancer. Methods We examinated the HGF concentration in serum by ELISA within 1 day before and 3 days after operative removal of the tumor, and also determined the expression of c-Met protein in the tumor and non-tumor tissue by Western and Northern blotting in situ. Results The serum HGF concentration 1-day before or 3-days after operation was 0.64?0.15ng/ml and 1.41?0.28ng/ml, respectively. There was statistically significant difference between them (P

Objective To establish a method for in vitro induction and amplification of immature dendritic cells(DCs) with maturation resistance from human peripheral blood. Methods Mononuclear cells separated from peripheral blood were cultured with rhGM-CSF and rhIL-4 for 9 days, and rhIL-10 was added into medium at the 7th day. The suspending cells were examined with scanning electronic microscope and flow cytometry, and their ability for stimulating non-sensitized T lymphocyte proliferation was observed by mixed lymphocyte reaction(MLR). Cultured cells were stimulated with LPS and TNF-? for additional 2 days, respectively, and MLR was performed again. Results rhGM-CSF+rhIL-4-induced and IL-10-treated peripheral blood mononuclear cells(PBMC) exhibited typical morphological characteristics and immunological phenotype of DCs with high expression of CD1a and no expression of CD 83 on the cellular surface. Costimulating molecules CD 40 and CD 86 expressions were down-regulated.The capability of cultured cells for stimulating the proliferation of non-sensitized T lymphocyte was weak, and the same result was observed in cultured cells stimulated with LPS or TNF-?. Conclusion Immature dendritic cells with maturation resistance were obtained by culturing with IL-10,which might be a useful in the induction of immune tolerance of allogenic skin grafting for the major burn patients with deep burn wounds.

In recent years,the abnormal expression of microRNA-21 (miR-21) in head and neck carcinoma have been found in many studies,which may be closely related to the genesis and development of thyroid carcinoma,nasopharyngeal carcinoma,laryngocarcinoma and oral carcinoma,etc.MiR-21 may also be valuable for the clinical diagnosis,treatment and prognosis of head and neck carcinoma.

Objective The aim of the study was to examine the influence of clonidine and ketorolac pretreatment on cytokine response to abdominal surgery. Methods Twenty patients scheduled for upper-abdominal surgery were randomly allocated to two equal groups: (1) pre-emptive analgesia group: patients received oral clonidine 4?g/kg and ketorolac 10mg 1h before surgery and (2) control group: patients received placebo. Blood samples were taken 24h before surgery , 20min after induction of anesthesia (before surgery), 90min after induction (during surgery), and 0,1,2,4,6 and 24h after surgery for determination of serum tumor necrosis factor-? (TNF-?), interleukin-1?(IL-1?),interleukin-6(IL-6) and interleukin-10 (IL-10) concentrations.Results (1) In the control group, serum IL-6 concentration increased significantly during surgery and peaked at 2h after skin closure. In contrast serum IL-6 concentration in pre-emptive analgesia group increased significantly when the skin was closed and peaked at 4h after skin closure. IL-6 production in the pre-emptive analgesia group was less than that in control group at 0,1 and 2h after surgery(P

0.05),but the duration of the peaking period, the time for improving one grade, the time for reaching 2 grade, and the hospitalization was significantly shorter in patients treated with steroid than without steroid(P0.05). (3) The major side effects included Cushing's reaction and the infection of the upper respiratory tract.Conclusion Steroids can quicken the recovery of GBS, and shortened average hospitalization in patients with GBS, but steroid doesn't alter the incidence rate of the sequel and the severity of the disability at 1 year in the course.It has no side reaction to use steroid reasonably.

The connotation and position of learning and examination resources center in library were elaborated. How to perfect the service system for readers was proposed by introducing the IC ideas and model into library con-struction.The characteristic, cooperative, sharing and developmental principles were pointed out, which should be followed in construction of the learning and examination resources center.The new model for learning together and innovative service should be established by integrating the characteristic databases ,constructing communication plat-forms,strengthening librarian literacy,and bringing the functions of library resources,spaces and manpower into full play.