ABSTRACT
@#【Objective】To explore the effect of pulmonary rehabilitation on patients with severe and extremely severe chronic obstructive pulmonary disease（COPD）. 【Methods】68 patients with chronic obstructive pulmonary disease admitted to Chaozhou people′s hospital from January 2014 to January 2016 were enrolled in the study，including 51 males and 17 females ，aged（64±8） years old. All patients were divided into treatment group（34 cases） and control group（34 cases）by random number. All patients received routine medication and life style guidance，while pulmonary rehabilitation was added to the treatment group. Follow up for 12 months ，and the data of lung function ，6 minute walking test（6MWT），COPD assessment test（CAT）scores and hospital anxiety and depression scale（HADs）scores were collected regularly.【Results】No statistically significant difference was found between the two groups in forced expiratory volume in one second/prediction（FEV1/Pre），FEV1/FVC，6MWT and HADs score after six months′ follow-up（P > 0.05），while the CAT scores of treatment group was superior to the control group（P < 0.05）. No statistically difference was found between the two groups in FEV1/Pre and HADs scores after 12 months′ follow-up（P > 0.05），while FEV1/FVC，6MWT and CAT scores of treatment group were superior to control group（P < 0.05，P < 0.05，P < 0.01，respectively）. The 6MWT and CAT scores of treatment group were superior to pretreatment after 6 months′ follow-up（P < 0.01，P < 0.001）and 12 months′ follow-up（P < 0.001，P < 0.001）.【Conclusion】Pulmonary rehabilitation for patients with severe and extremely severe COPD can effectively improve their symptoms，lung function，quality of life and exercise endurance.
ABSTRACT
<p><b>OBJECTIVE</b>To analyze the changes in the cardiac function after St. Jude Regent mechanical valve replacement and assess the prosthesis-patient matching.</p><p><b>METHODS</b>From October 2007 to March 2009, 44 patients received implantation of 17 mm St. Jude aortic prostheses in our hospital. The patients were followed up for clinical symptoms, signs, electrocardiogram (ECG), echocardiogram and cardiac functions, and the results were compared with those of randomly selected 44 patients receiving 21 mm St. Jude aortic prostheses.</p><p><b>RESULTS</b>In 17 mm St Jude Medica Regent valve group, 8 patients presented with ECG ST segment changes, 3 complained of chest tightness, 3 had occasional chest pain and discomfort, and 8 had grade II and 4 grade III cardiac function. In 21 mm St Jude Medical Regent valve group, 6 patients had ECG ST segment changes, 2 complained of chest tightness, 2 reported occasional chest pain and discomfort, 11 had grade II and 2 grade III cardiac function. No significant differences were found in these indices between the two groups (P=0.32). Compared with those before operation, the two groups showed significant improvements in the left ventricular end-diastolic diameter, left ventricular posterior wall thickness, left ventricular mass index, and aortic pressure gradient (P<0.05). A significant increase in the left ventricular ejection fraction occurred 6-12 months after operation, but without statistical difference between the two groups (P>0.05).</p><p><b>CONCLUSION</b>For underweight patients (<60 kg) and those with small body surface area (<1.6 cm(2)), 17 mm St. Jude Medical Regent valve prosthesis may produce good therapeutic effect, and some indices are even close to those after placement of 21 mm St. Jude Medical Regent valve prosthesis. No obvious prosthesis-patient mismatch occurs after the placement of the 17 mm valve prosthesis and aortic valve ring expansion is not necessary.</p>