The effect of short-term pulmonary rehabilitation on the exercise ability and life quality of male patients with acute exacerbations of chronic obstructive pulmonary disease / 中华物理医学与康复杂志

Objective:To investigate the effects of short-term pulmonary rehabilitation on the exercise ability and life quality of men with acute exacerbations of chronic obstructive pulmonary disease (COPD).Methods:Thirty-eight male COPD patients with acute exacerbation were selected and randomly divided into a rehabilitation group ( n=20) and a control group ( n=18). Both groups were given routine health education and medication, while the rehabilitation group was additionally provided with a 7-day, three-stage rehabilitation intervention, including the respiratory training, resistance training using a resistance band and gradual low-intensity walking training, all under remote electrocardiographic monitoring. Before and after the intervention, both groups′ exercise ability was evaluated using the 30-second chair sitting test (30-STS) and a 30-second forearm load flexion test (30-ACT). Each subject′s quality of life and ability in the activities of daily living were evaluated by two qualified rehabilitation therapists. The subjects′ level of daily physical activity was assessed 2 months after discharge. Results:After the intervention the average 30-STS and 30-ACT results of the rehabilitation group had improved significantly. The 30-ACT results of the control group were also significantly improved. After the intervention the average 30-STS and 30-ACT results of the rehabilitation group were significantly better than the control group′s averages. The average CAT and MBI scores of both groups were significantly better after the intervention, with the rehabilitation group′s averages significantly better than those of the control group. Two months after discharge, the number of patients with at least moderate daily physical activity increased from 6 to 19 in the rehabilitation group and from 4 to in the control group, a significant difference between the two groups.Conclusion:The three-stage pulmonary rehabilitation program is helpful for improving the exercise ability and quality of life of COPD sufferers, and their ability in the activities of daily living. Their level of daily physical activity is higher 2 months after discharge.

Effects of aerobic exercise combined with resistance training on the cardiorespiratory fitness and exercise capacity of patients with stable coronary artery disease / 中华心血管病杂志

Objective@#To observe the effects of aerobic exercise combined with resistance training on the cardiorespiratory fitness and exercise capacity of patients with stable coronary artery disease (CAD) .@*Methods@#From June 2014 to December 2015, 73 patients with stable CAD in our department were recruited and randomly assigned to two groups: the control group (n=38) and the exercise group (n=35) . Patients in both groups received conventional medical treatment for CAD and related cardiac health education. While for patients in exercise group, a twelve-week aerobic exercise combined with resistance training program were applied on top of conventional treatment and health education. Cardiorespiratory fitness and exercise capacity were evaluated by cardiopulmonary exercise testing.@*Results@#(1) The exercise capacity was significantly increased in the exercise group after 12 weeks training as compared to baseline level: peak oxygen uptake per kilogram ( (26.25±5.14) ml·kg-1·min-1 vs. (20.88±4.59) ml·kg-1·min-1) , anaerobic threshold ( (15.24±2.75) ml·kg-1·min-1 vs. (13.52±2.92) ml·kg-1·min-1], peak oxygen pulse ( (11.91±2.89) ml/beat vs. (9.77±2.49) ml/beat) , peak Watts ( (113.2±34.0) W vs. (103.7±27.9) W) , peak metabolic equivalent ( (7.57±1.46) METs vs. (6.00±1.32) METs) (all P<0.05 vs. baseline) . (2) The degree of improvement of peak oxygen uptake per kilogram ( (26.25±5.14) ml·kg-1·min-1 vs. (22.32±4.00) ml·kg-1·min-1) , anaerobic threshold ( (15.24±2.75) ml·kg-1·min-1 vs. (13.76±2.51) ml·kg-1·min-1) , peak oxygen pulse ( (11.91±2.89) ml/beat vs. (9.99±2.15) ml/beat) and peak metabolic equivalent ( (7.57±1.46) METs vs. (6.47±1.17) METs) were significantly higher in exercise group than in control group (all P<0.05) .@*Conclusion@#Aerobic training at an aerobic threshold level combined with Thera-band resistance training is safe for patients with stable coronary artery disease. This combined exercise program can significantly improve the cardiorespiratory fitness and exercise capacity of patients with stable coronary artery disease.

Autonomic Nerve Functional Changing and the Impact of Comprehensive Exercise in Patients With Cardiovascular Neurosis / 中国循环杂志

Objective: To observe the autonomic nerve functional changing and the impact of comprehensive exercise in patients with cardiovascular neurosis (CN). Methods: Our research included in 2 groups: CN group, n=48 and Control group, n=30 normal subjects. Resting heart rate (RHR) and heart rate at the first recovery minute (HRR1) were measured by cardiopulmonary exercise testing (CPET) for comparison between 2 groups. In CN group, 30 patients were chosen and randomly assigned into 2 subgroups: Medication subgroup, patients received β-receptor blocker, n=14 and Comprehensive exercise subgroup, patients received the same medication plus aerobic and Thera-band resistance training, n=16; both subgroups were intervened for 3 months. Symptom checklist 90 (SCL-90) was used to evaluate relevant parameters before and after intervention, the changes of RHR and HRR1 were also compared between 2 subgroups. Results: ① Compared with Control group, CN group had the higher RHR and lower HRR1, all P<0.01. ② Compared with pre-intervention, both subgroups had improved RHR, HRR1 and SCL-90 scores at post-intervention, all P<0.05; compared with Medication subgroup, Comprehensive exercise subgroup showed improved SCL-90 scores and HRR1, all P<0.05. Conclusion: Comprehensive exercise including aerobic and Thera-band resistance training could effectively improve the clinical symptoms in CN patients, which might be related to changing the autonomic nerve function in relevant patients.

Discussion on Application Practice and Improvement Program of Outpatient Pharmacy Automation System in Our Hospital / 中国药房

OBJECTIVE:To improve automatic outpatient pharmacy drug delivery system in our hospital,and to promote the efficiency of automatic drug delivery. METHODS:The outpatient pharmacy automation system of our hospital was introduced in terms of main structure,working process and application. The work efficiency,safety and error were compared between automatic drug delivery mode and manual drug delivery mode. Drug delivery machine was improved to increase the rate of drug delivery. RE-SULTS:The outpatient pharmacy automation system of our hospital included 2 boxed drug delivery machine and 1 drug dispensing machine,etc. Compared with manual drug delivery mode,automatic drug delivery mode improved drug delivery efficiency,health security and use security,and reduced drug delivery error. Through adjusting the time setting and step of drug delivery of gearing in drug delivery machine,idle time of transmission equipment was utilized effectively,and the quantity of delivered prescriptions was increased,increasing from 220 to 320 each hour. CONCLUSIONS:The reasonable improvement of outpatient pharmacy auto-mation system makes outpatient pharmacy automation system play a bigger role,and further optimize resources.

Empirically analysis on outpatients/emergency visits and price elasticity of the medical prices reform at Nanjing Children's Hospital / 中华医院管理杂志

Objective To identify the changes of outpatients/emergency visits at Nanjing Children′s Hospital since introduction of the general pricing reform at public hospitals.Methods Fluctuations of outpatients/emergency visits at Nanjing Children′s Hospital before and after the reform in 2015 were compared,and an empirical analysis was made in view of the overall structural changes,demand price elasticity and cross-price elasticity of various outpatients/emergency visits.Results The change of total outpatients/emergency visits was minimal,yet the composition registered significant changes.Monthly average of common outpatients totaled 7 072 visits,a growth of 12.6%;that of senior specialists totaled 3 035 visits,a growth of 48.4%.The price elasticity was<1,while the demand for various outpatients/emergency visits services and cross-price elasticity appeared inelastic.Conclusions The one year reform has witnessed the hospital in smooth operations as yet.Given the sizable rise of examination prices for both outpatients/emergency visits,patient volume remains stable instead of drastic decrease,evidencing the strong demand for children′s medical services.

Potassium sodium dehydroandroan drographolide succinate combined with routine therapy for rotavirusenteritis in children / 国际中医中药杂志

Objective To evaluate the efficacy of potassium sodium dehydroandroan drographolide succinate (PSDS) combined with routine therapy for rotavirus enteritis in children.MethodsA total of 148 children with rotavirus enteritis were included and divided into an observation group and a control group by random number table method, 74 in each group. The children in the observation group were treated with intravenous PSDS combined with routine therapy, and those in the control group with intravenous ribavirin combined with routine therapy. Serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were determined by enzyme-linked immunosorbent assay, and plasma lactate dehydrogenase (LDH), creatine kinase (CK), and creatine kinase-MB (CK-MB) were determined using standard clinical laboratory procedures. The clinical efficacy was evaluated. Results The total efficacy rate in the observation group was significantly higher than that in the control group (91.9%vs. 78.4%;χ2=2.314,P<0.05). After the treatment, the serum levels of IL-6 (18.24 ± 3.62 ng/mlvs. 25.36 ± 5.25 ng/ml; t=2.425,P<0.05) and TNF-α (20.86 ± 4.28 ng/mlvs. 31.22 ± 7.15 ng/ml;t=2.503,P<0.05), and the plasma levels of LDH (104.25 ± 22.06 U/Lvs. 150.26 ± 37.22 U/L;t=2.316,P<0.05), CK (84.25 ± 13.57 U/Lvs. 107.88 ± 16.28 U/L;t=2.327,P<0.05) and CK-MB (22.30 ± 4.24 U/Lvs. 32.26 ± 7.14 U/L;t=2.426,P<0.05) in the observation group was significantly lower than those in the control group. The time to diarrhea resolution (2.42 ± 0.53 dvs.3.56 ± 0.78 d;t=2.316,P<0.05) and the time to fever resolution(2.11 ± 0.32 dvs.2.63 ± 0.43 d;t=2.472,P<0.05) in the observation group were significantly delayed than those in the control group, and the hospital length of stay longer (6.23 ± 1.42 dvs. 4.35 ± 0.96 d;t=2.413,P<0.05).Conclusions PSDS combined with routine therapy may reduce inflammatory response, protect from myocardial injury, and promote recovery in children with RVE.

Effect of low dose midazolam on maternal cognition function after cesarean section / 中国基层医药

Objective To explore the effect of low dose midazolam on maternal cognition function after cesarean section.Methods According to the digital table,60 women with cesarean section operation,who graded Ⅰ to Ⅱ according to America anesthesiologists (ASA),were randomly divided into the control group and observation group,30.cases in each group.The control group was given intravenous injection of 0.9％ sodium chloride injection 5mL after the fetal removed,and the observation group was given small dose of midazolam intravenous injection (0.03mg/kg,diluted to 5mL).The bad memories of the maternal operation process of the two groups were observed after the operaion.Results In the control group,0 case was completely forgotten,the completely forgetting rate was 0.0％ ;29 cases in the observation group were completely forgotten,the completely forgetting rate was 96.7％.The completely forgetting rate of the two groups had significant difference(x2 =19.73,P ＜ 0.01).Conclusion The small dose of midazolam can effectively eliminate the mothers during anesthesia and operation in the bad memories.

Effects of exercises on the lipid metabolism and expression of PPAR-α mRNA in skeletal muscles of ApoE knockout mice / 中华物理医学与康复杂志

Objective To observe the influence of exercises on the mRNA expression of peroxisome proliferator-activated receptor (PPAR-α) and its target genes of acyl-CoA oxidase (ACO),Enoyl-CoA-hydratase and 3-hydroxyacyl-CoA-dehydrogenase (EHHADH) in the skeletal muscles in insulin-resistance mice to develop a way to improve the lipid metabolism.Methods Twenty male ApoE knockout mice were randomly divided into two groups,the high-fat diet group (group HFD) and the exercise training group (group Ex).The HFD group were fed with highfat diet,while the Ex group were fed in the same way,with additionally swimming training.And ten healthy male C57BL/6j mice were chosen as the control group(group ND).After 12 weeks of intervention,the serum lipid,blood glucose and insulin levels were determined,and homeostasis model assessment insulin resistance index (Homa-IRI) was calculated.The bilateral gastrocnemiuses were cut to be observed under a transmission electron microscope,and the mRNA expression of PPAR-α,ACO and EHHADH in skeletal muscle were measured using reverse transcription polymerase chain reaction(RT-PCR).Results The transmission electron microscope showed that the sarcolemma edema,mitochondrial swelling,as well as focal myocytolysis and edema within myofibrils were observed in the HFD group.The total cholesterol,low-density lipoprotein cholesterol,free fatty acid,fasting glucose,insulin and HomaIRI of the HFD group were significantly higher than the control group (P ＜ 0.05),while the mRNA expression of PPAR-α,ACO and EHHADH was significantly deceased than the latter(P ＜ 0.05).After swimming,the abovementioned pathological changes disappeared.The serum lipid of the Ex group were significantly lower (P ＜ 0.05),while HDL was significantly higher (P ＜ 0.05).And fasting insulin,glucose and HOMA-IR of the Ex group were significantly lower (P ＜ 0.05),while the mRNA expression of the above in the Ex group were significantly increased (P ＜0.05).Conclusion Swimming training could improve insulin resistance and metabolic disorder of lipid of ApoE knockout mice.The possible mechanisms may be through up-regulating the expression of PPAR-α,which in turn stimulates the expression of ACO and EHHADH mRNA to strengthen fatty acid β-oxidation.

Effect of chinese traditional herb Epimedium grandiflorum C.Morren and its extract Icariin on osteoarthritis via suppressing NF-kB pathway.

Osteoarthritis (OA), which is also called degenerative arthritis, is the leading cause of disabilities in the old people. The Chinese traditional herb Epimedium grandiflorum had long been found to attenuate osteoarthritis process, but the detailed mechanism was not clear. To study the mechanisms of E. grandiflorum in the treatment of osteoarthritis, rabbit osteoarthritis model combined with D-galactose was used. After different treatments for 10 weeks, cartilage sections were analyzed by immunohistochemistry for uPA, uPAR and PAI expression level. E. grandiflorum could significantly attenuate OA condition and decrease uPA, uPAR and PAI expression. The extract of E. grandiflorum, icariin also had a similar effect when compared with E. grandiflorum treatment alone. Rabbit chondrocytes were further isolated to be stimulated by TNFα combined with different reagents treatment. Here, icariin treatment significantly reduced nuclear factor kappa B NF-B (P65) activity, decreased uPA expression level and increased IBα protein level. The results indicated that E. grandiflorum and its extract icariin could attenuate OA condition, reduce the expression of uPA and uPAR and increase PAI in experimental rabbit model and this effect may be conducted by suppressing NF-kB activity by increasing IkBα level.

Efficacies of sleeve gastrectomy and Roux-en-Y gastric bypass for the treatment of type 2 diabetes mellitus: a Meta-analysis / 中华消化外科杂志

Objective To review the efficacies of sleeve gastrectomy and Roux-en-Y gastric bypass for the treatment of type 2 diabetes mellitus.Methods The Cochrane library,PubMed,China Journal Full Text Database,Chinese Scientific Journal Full Text Database,Chinese Biomedical Literature Database and Wanfang Database were searched with key words including“减重手术”,“胃切除术”,“胃绕道术”,“胃旁路手术”,“胃转流术”,“胃袖状切除术”,“糖尿病”,“bariatric surgery”,“gastric bypass”,“sleeve gastrectomy”,“diabetes,T2DM and et al.Literatures published between the time of database establishment and December 2012 were searched.Literatures focused on the comparison of the efficacies of sleeve gastrectomy and Roux-en-Y gastric bypass for the treatment of type 2 diabetes mellitus were retrieved.Data extraction and quality evaluation of the literatures were done by 2 researchers independently.Meta analysis was performed by RevMan 5.1.2 software.The count data were presented by risk ratio (RR) or odds ratio (OR),and the measurement data were presented by mean difference (MD) or standard mean difference (SMD).The heterogeneity of the literatures was analyzed by I2.Results Five literatures were retrieved,including 164 patients in the sleeve gastrectomy group and 184 patients in the Roux-en-Y gastric bypass group.The results of Meta analysis showed that Roux-en-Y gastric bypass could significantly increase the remission rate of type 2 diabetes (OR =0.48,95 ％ confidence interval:0.26-0.91,P ＜ 0.05),increase the percentage of patients without drugs during follow up (OR =0.37,95 ％ confidence interval:0.16-0.84,P ＜0.05),decrease the levels of HbA1c and body weight (MD =0.28,-0.44,95％ confidence interval:0.14-0.43,-0.76--0.13,P ＜ 0.05) when compared with sleeve gastrectomy.There was no significant difference in the incidence of complications between the 2 groups (OR =1.81,95％ confidence interval:0.20-16.73,P ＞ 0.05).Conclusion Roux-en-Y gastric bypass is superior to sleeve gastrectomy for patients with type 2 diabetes.

Study of molecular mechanisms of fuyuan capsule, icariin and arasaponin R1 in treatment of osteoarthritis / 中国中药杂志

<p><b>OBJECTIVE</b>To study the molecular mechanisms of Fuyuan capsule serum containing, icariin and arasaponin R1 in the treatment of osteoarthritis from the urokinase-type plasminogen activator (uPA) system.</p><p><b>METHOD</b>Chondrocytes were isolated, cultured and identified using type II collagens immunostaining. After stimulating with TNF-alpha 10 microg x L(-1), 1 h, then the chondrocytes were treatment with glucosamine hydrochloride 25 g x L(-1), 20% Fuyuan capsule serum containing, icariin 12.5 mg x L(-1), arasaponin R1 125 mg x L(-1), icariin 12.5 mg x L(-1) + arasaponin R1 125 mg x L(-1). After 2 h, expression of uPA and nuclear factor kappa B (NF-kappaB P65) mRNA was detected by reverse transcription polymerase chain reaction (RT-PCR), the activities of NF-kappaB(P65) combine DNA were determined by electrophoretic mobility shift assays (EMSA), 1kappaBalpha were detected by Western blotting.</p><p><b>RESULT</b>Fuyuan capsule, icariin and arasaponin R1 could significantly reduce NF-kappaB (P65) activities and uPA mRNA expression, and increase expression of IkappaBalpha (P < 0.01), but no significant difference between all treatment groups.</p><p><b>CONCLUSION</b>Fuyuan capsule and its two main active ingredients, icariin and arasaponin R1, could protect chondrocytes from damage through reducing the NF-kappaB (P65) activities, increasing the express of IkappaBalpha and then reducing uPA of chondrocytes.</p>

Effects of Erbie San on Walker-256 liver cancer and adjustment to unbalance of VEGF/endostatin in rats / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the anticancer effects of Erbie San on the rats bearing Walker-256 liver cancer and the potential mechanism of its angiogenesis effects.</p><p><b>METHOD</b>Wistar rats bearing Walker-256 liver cancer were used in this study. The experimental groups were treated with Erbie San 1.25, 2.5, 5 g x kg(-1) x d(-1), and 5-Fluorouracil injection 75 mg x kg(-1), respectively. The tumor's weight, the expression of VEGF, Endostatin and the ratio of VEGF/endostatin in serum of each groups were observed.</p><p><b>RESULT</b>Compared to the model group, Erbie San 2.5, 5 g x kg(-1) x d (-1) and 5-Fluorouracil injection groups can reduce the tumor's weight significantly (P<0.05 or P<0.01). The expression of VEGF was reduced, while endostatin was increased, and the ratio of VEGF/endostatin was reduced (P<0.05 or P<0.01).</p><p><b>CONCLUSION</b>Erbie San can effectively inhibit the growth of Walker-256 liver cancer of rats and can inhibit the expression of VEGF but increase the expression of endostatin, which suggest that Erbie San has the inhibition of angiogenesis which is responsible for its anticancer effects.</p>

Advanced development of blood-gas exchanger / 生物医学工程学杂志

In order to simplify the technique of extracorporeal membrane oxygenation (ECMO) and apply extracorporeal life support ( ECLS) broadly for assisting the treatment of severe respiratory failure patients, we have developed a blood-gas exchanger (BGE) with the characteristics of small volume and simple structure. The exchange between blood and gas of BGE adopts cross-flowing model; blood flows along the outer hollow fiber and gas flows in the inner hollow fiber with the reverse direction of blood flowing. The interface of blood flow in and out was designed as the internal spiral, and the caliber of BGE is matched with the blood interface of dialysis. Thus it may successfully make single-use spiral connectors link up mutually in the extracorporeal blood circulation of dialysis, may help clinical operations become safe, convenient and easily-controlled, and may simplify the technique of EGMO.

Expressions of survivin and caspase-9 in human primary hepatocellular carcinoma tissues and their significances / 吉林大学学报(医学版)

Objective To study the expressions of survivin and caspase-9 in human primary hepatocellular carcinoma(HCC) tissues and their relationship with apoptosis.Methods Immunohistochemical staining was uesed to detect the expressions of survivin and caspase-9 in paraffin sections of 96 cases including 42 HCC tissues,42 paired adjacent noncancerous tissues and 12 normal liver tissues. Apoptosis was detected by TUNEL.Results No immunoreactivity of survivin was seen in normal liver tissues.The positive rates of survivin in HCC and paired adjacent noncancerous tissues were 73.81% and 4.76%,respectively,there was significant difference between two groups(P0.05).The expressions of survivin and caspase-9 in HCC tissues were not associated with age,sex and the size of tumor,but they were directly associated with tumor histological grade and metastasis.Conclusion High expression of survivin in HCC may inhibit apoptosis through depressing the expression of caspase-9,and it is an indicator of independent poor prognosis.