Meta-analysis of the Effectiveness of Inhaled Corticosteroids Combined with Tiotropium Bromide versus Inhaled Corticosteroids Alone in the Treatment of Asthmatic-COPD Overlap Syndrome / 中国药房

OBJECTIVE：To systematically e valuate the effectiveness of inhaled corticosteroids combined with tiotropium bromide versus inhaled corticosteroids alone in the treatment of asthmatic-COPD overlap syndrome ，and to provide evidence-based reference for clinical use. METHODS ：Retrieved from PubMed ，Web of Science ，Embase，Cochrane Library ，CBM，CNKI， VIP，Wanfang database ，during the establishment of the database to Nov. 2019，randomized controlled trials （RCT）about inhaled corticosteroids combined with tiotropium bromide （trial group ）versus inhaled corticosteroids alone （control group ）in the treatment of asthmatic-COPD overlap syndrome were collected. After data extraction of included literatures met inclusion criteria ，quality evaluation with modified Jadad scale ，Meta-analysis was performed for response rate ，forced expiratory volume in the first second （FEV1），forced vital capacity （FVC），FEV1/FVC，inspiratory fraction （IC/TLC），residual to total ratio （RV/TLC），asthma symptom（ACT）score，chronic obstructive pulmonary symptom （CAT）score，the times of acute exacerbations by Rev Man 5.3.0 software. RESULTS ：A total of 25 RCTs were included ，involving 2 828 patients. The results of Meta-analysis showed that the response rate [RR ＝1.16，95％CI（1.10，1.22），P＜0.001]，FEV1[MD＝0.44，95％CI（0.35，0.54），P＜0.001]，FVC [MD ＝0.70， 95％CI（0.46，0.95），P＜0.001]，FEV1/FVC [MD= 8.79，95％CI（6.22，11.37），P＜0.001]，IC/TLC [MD ＝4.93，95％CI（3.01， 6.85），P＜0.001]，RV/TLC [MD ＝－9.22，95％CI（－9.79，－8.66），P＜0.001]，ACT score [MD ＝5.38，95％CI（4.30，6.47）， P＜0.001]，CAT score [MD ＝－3.67，95％CI（－4.89，－2.45），P＜0.001] and the times of acute exacerbations [MD ＝－1.49， 95％CI（－2.82，－0.17），P＝0.03] in trial group were significantly higher than control group ，with statistical significance. CONCLUSIONS：Compared with inhaled corticosteroids alone ，inhaled hormone combined with tiotropium bromide can improve the response rate and pulmonary function ，but increase the times of acute exacerbation of patients with asthmatic-COPD overlap syndrome.

The efficacy and safety of vidldagliptin combined with acarbose in treating type 2 diabetes / 实用医学杂志

Objective To observe the efficacy and safety of vildagliptin combined with acarbose in treating type 2 diabetes. Methods 78 patients with type 2 diabetes were divided into two groups to have additional vildagliptin combined with acarbose or acarbose combined with placebo. The clinical efficacy and adverse reactions after 12 weeks were investigated. Results In the treatment group, FBG, 2 h PG and HbA1C declined after treatment (P 0.05). There were either liver and kidney damage (P > 0.05), nor hypoglycemia. Conclusion Vildagliptin combined with acarbose is superior to Acarbose combined with placebo , and it produced no more untoward effect.

Professor Wang Xinghua’s Experience for the Treatment of Cough / 浙江中医药大学学报

Objective] To study Professor Wang Xinghua's experience in the treatment of cough. [Methods] Typical cases of cough treated by Wang Xinghua are selected for the analysis of causes, pathogenesis, treatment methods and detailed prescription. [Results] Six exogenous climatic evils, internal injury caused by excess of seven emotions, improper diet and overwork all can damage lung Qi, inducing cough. Delayed or improper treatment can lead to sub-acute types of cough, while weak constitution and deficiency of vital Qi consumed by prolonged diseases result in chronic cough. External induced acute cough mainly is excess type, while internal damage induced chronic cough is more prone to have deficient type. Syndrome differentiation based on external and internal factors, cold and heat, deficiency and excess is recommended for the treatment of cough. Those frequently used methods include dissipating wind-cold, expelling wind-heat, clearing away phlegm-heat, reinforcing earth to generate metal, removing dampness to reduce phlegm, warming Yang for resolving fluid retention, nourishing Yin to moisten dryness. Exogenic cough should be treated with expelling pathogens, assisted with tonifying vital Qi. Chronic cough resulting from disordered visceral function should be treated with tonification and conditioning, combined with expelling pathogen. [Conclusion] Professor Wang Xinghua's experience for treating cough is worth spreading for the comprehensive understanding of the pathogenesis of the disease, accurate syndrome differentiation, unique medicine application and significant treating effect.

Simple and effective method for monitoring ambulatory electrocardio-gram in toads / 中国病理生理杂志

[ ABSTRACT] AIM:To screen out a suitable lead for monitoring the ambulatory electrocardiogram ( ECG) in un-restrained toad, and to investigate its practicability.METHODS:After subcutaneously implanting the electrodes in toads under anaesthesia, the ambulatory ECG of 5 leads were monitored with BL-420S data acquisition and analysis system, and the leads which could well express the waveform in ECG were screened out.The recovery process of the toads from the arti-ficial hibernation within 6 h, the day-to-day stability of the heart rate ( HR) and the heart rate variability ( HRV) in 5 suc-cessive days of hibernation, and the HR and HRV after freeze-thawing process were monitored to determine its practicabili-ty.RESULTS:Two out of 5 leads showed better ECG waveforms.Compared with 6 h post hibernation, lowered HR at 0 h and 1 h was observed, and the standard deviation of normal R-R intervals ( SDNN) was significantly increased ( P<0.05 or P<0.01), but the HR and SDNN from 2 to 5 h showed no significant difference, suggesting that the cardiac function reached the steady state after 2 h recovery.The HR at 2 h and 4 h on day 4 and day 5 decreased significantly compared with that on day 1 (P<0.05 or P<0.01), followed with a significant increase in SDNN (P<0.05 or P<0.01), sugges-ting that the ECG remained stable within 3 d.The HR increased, while SDNN decreased significantly at 1 h and 12 h post-thawing compared with that at pre-freeze (P<0.05), indicating the damaged cardiac function after freeze-thawing process. CONCLUSION:The method of subcutaneously implanting electrodes is suitable for effectively monitoring the ambulatory ECG in toads.

Case analysis and literature review of low-grade fibromyxoid sarcoma / 中华全科医师杂志

To explore the originating sites,clinical manifestations,imaging features,pathologic findings,treatments and prognosis of low-grade fibromyxoid sarcoma.Among 54 cases,6 came from our hospital and the other 48 cases were reported in literatures from 1998 to 2012 in China Knowledge Resource Integrated Database (CNKI).Their data were reviewed for analysis.The usual presentation was a slowly growing,painless mass commonly located in extremities.The optimal treatment of extended resection could significantly reduce recurrence and improve survival.And a long-term follow-up was necessary.

Clinical analysis of cellular schwannoma in the gastric wall misdiagnosed as gastric stromal tumor / 中华消化外科杂志

Cellular schwannoma is a rare benign tumor of the peripheral nerves.The tumor is consist of spindle cells which arranged in interwoven bundles,and lacking the mesh district and palisading structure.The tumor cells are abundant,with coarse chromatin,deeply stained nuclei and in multiforms.So the tumor may easily be misdiagnosed as various types of spindle cell sarcoma.Intraperitoneal cellular schwannoma may also be mistaken as gastrointestinal stromal tumors.In this article,the clinical characteristics,diagnosis and treatment of cellular schwannoma were analyzed based on the clinical data of a patient with cellular schwannoma in the gastric wall misdiagnosed as gastric stromal tumor.

Treatment of open injury of foot and ankle in children / 中华骨科杂志

Objective To investigate the clinical characteristics,treatment methods,and clinical outcomes of open injury of foot and ankle in children.Methods From February 2004 to June 2010,35 children with open injury of foot and ankle were treated,including 22 males and 13 females,aged from 3 years to 14 years (average,8.4 years).Twenty-eight cases resulted from traffic accidents; 7 cases occurred from sharp instruments and machine-related crush injuries.Thirty cases were associated with bone fractures,and according to the Gustilo classification of open fractures,five cases were Type Ⅰ injuries,eight cases were Type Ⅱ injuries and 22 cases were Type Ⅲ.Twenty three cases (type Ⅰ,type Ⅱ and type Ⅲ) underwent surgical debridement and/or internal fixation with skin flap grafting.Twelve type Ⅲ cases underwent debridement,temporary Kirschner wire or plaster fixation and VSD in the first stage of treatment.In the second stage of treatment,fracture reduction and internal fixation (with or without bone graft) + skin flap grafting was performed in all 12 cases.Results Thirty patients (85.7％) were followed-up for an average of 38.7months (range,6-89 months).Skin grafting was performed in two Type Ⅱ cases that developed necrosis in parts of the wound.Wound healing time was an average of 8.3 weeks (range,3-15 weeks).One Type Ⅲ case suffered chronic osteomyelitis with the formation of a sinus tract.Two cases suffered from club foot ab normalities 3 years postoperatively.All three patients above mentioned healed after treatment.In 12 type Ⅲpatients with staged treatment,the flap survived,and its color and elasticity were good.Healing time ranged from 3 to 8 weeks (average,6.8 weeks).According to the Maryland standard,17 cases were excellent,9good,3 fair,and 1 bad; the excellent and good rate was 86.7％.Conclusion Traffic accidents are the major causes of open foot and ankle trauma in children.A good surgical outcome can be achieved when patients receive staged treatment that is appropriate to injury severity.

Relationship between anti-oncogene mutation and microsatelite instability in gastrointestinal stromal tumor / 国际外科学杂志

By now,the mutations of C-KIT gene and PDGFRA have been regarded as the most important primary incidences.The latest results have revealed the fact that the abnormal expressions of p53,p16,p21 WAF-1,p27 and E-cadherin(cDH1) which were labeled as anti-oncogenes in most of human tumors,existed in the progression of gastrointestinal stromal tumor.Therefore,we put forward the theory that gene mutaion may lead to the instability of DNA that further promotes mutation of short tandem repeat in anti-oncogene coding region,on basis of which,that finally lead to the malignant progession of gastrointestinal stromal tumor by anti-oncogene mutation.

Outcome and prognosis of avascular necrosis after talus fracture / 中华创伤杂志

Objective To study the incidence and prognosis of avascular necrosis after talus fracture. Methods A retrospective survey was performed in 12 patients ( 13 feet) with talus fractures admitted into hospital from July 2004 to November 2009 to analyze necrosis rate, ankle function recovery and disability rate. According to Hawkin' s classification system, there were two patients with type Ⅰ feet, four with type Ⅱ feet, five with type Ⅲ feet and two with type Ⅳ feet. Results All patients were followed up for average period of 19.6 months (range 11-52 months). Avascular necrosis was detected in eight feet, of which one foot was treated with ankle fusion, one with subtalar arthrodesis and one with bone implantation. The other five feet had good ankle and subtalar function, with no collapse or osteoarthritis. According to Maryland foot score, the result was excellent in eight patients, good in two, fair in one and failure in two, with excellence rate of 77%. Conclusion The incidence of avascular necrosis after talus fracture is related to the location and energy of trauma. However, the function prognosis of the talus shows no correlation with necrosis.

Multicenter clinical study on patients with inflammatory bowel disease in Kunming city / 中华消化杂志

Objective To retrospectively investigate the characteristics of patients with inflammatory bowel disease (IBD)in last 10 years in Kunming city. Methods Four hundred and thirty consecutive patients with IBD, who had hospitalized in 7 hospitals between January 1998 to March 2007, were investigated. Among them, 379 patinets had ulcerative colitis (UC) and 51 had Crohn's disease (CD). The patients who received coloscopy, histopathological and bariam enema examination accunted for 98.2%, 56.2% and 2.6% in UC group,respectively, and 72.5%,78.4% and 31.4% in CD group,respectively. The gender, age, occupation and the clinical manifestation of the patients, and the results of the colonoscopy and pathological examination were analyzed. Results Most of the UC patients were aged 30 to 39 years and 50 to 59 years with average age of (46.9±15.8) years, whereas CD patients were aged 20 to 29 years with average age of (41.6±17.2)years. The male and urban patients were predominat in both UC and CD groups. Mental workers were common in UC group. The symptoms of diarrhea (302,79.7%), abdominal pain (285,75.2%) and bloody stools (290,76.5%) were major events in UC patients, and those of abdominal pain (44,86.3%), diarrhea (28,54.9%) and weight loss (28,54.9%) were major events in CD patients. The coincidence ratio among colonoseopy, histopathology and bariam enema examinations was 88.4 % ( 329/372 ), 24.4 % ( 52/213 ) and 4/10 in UC patients, respectively, and 86.5%(32/37), 27.5%(11/40) and 75%(12/16) in CD patients, respectively. All of the UC patients were in active stage of disease,including 38.3 % in mild,42.2% in moderate and 19.5% in severe. In CD group, 7.8% was in relief stage and 92.2% in active stage,including 15.7% in mild,43.1% in morderate and 41.2% in severe.Conclusion The understanding of prevalence and clinical characteristics of IBD in last 10 years in Kunming city will be helpful in diagnosis and treatment of the disease.

Application of Multilayer Spiral CT Scanning and Reconstruction Technology in Rhinoplasty / 医疗卫生装备

Objective To discuss the application of spiral computed tomography and reconstruction technology for patients of depressed nasal bone. Methods The patients of transsection location were backlying on the scan bed and continuously scanning in spiral, and baseline was acou-infraorbital line. The reconstructed image with 2mm layer thickness and 1.5mm overlap can be selected SSD liminal value as bone -wide and surface threshold. Results SSD image can be clearly demonstrated than general nasal bone cross-section profile in the shape, location, size and suitability of filled composite. Conclusion The surface shadow display can be shown nasal bone structure realistically, the three-dimensional anatomic structure images of vessels and the effect of bionics. The bone of volume, distance and angle can be measured exactly by clinical physician, and made the best treatment plan based on the images.

The computer-assistant study of the relationship between orthodontic treatment and temporomandibular joint disorders / 实用口腔医学杂志

Objective: To study the relationship between orthodonti c treatment and temporomandibular joint disorders(TMD). Methods: The survey tables and their corresponding database were designed with the aid of computer. The questionnaire and clinical examination were administered t o 173 cases who had received orthodontic treatment (orthodontic group), 95 case s with morphologic malocclusion and without having orthodontic treatment ( maloc clusion group) and 32 cases with normal occlusion (normal group).Symptoms and s igns of TMD were collected,the data were analyzed with the databases. Results: The survey tables and their corresponding database were se t up. There were statistically significant differences between the orthodontic g roup and malocclusion group in the distribution of anamnestic, clinical dysfunct ion and occlusion indices (P

Blood glucose,insulin,C-peptide response and relative safety after orally taking different doses of fructose in type 2 diabetes / 肠外与肠内营养

Objective: To study the glucose,insulin,Cpeptide response and relative safety after orally taking different doses of fructose in type 2 diabetes.Methods: 10 patients with type 2 diabetes,were given 50 g glucose,10 g fructose+40 g glucose,30 g fructose+20 g glucose,40 g fructose+10 g glucose,50 g fructose respectively,the serum glucose,insulin,C-peptide,lactic acid,uric acid,heart ratio and blood pressure were measured at 0 min,15 min,30 min,60 min,120 min and relative safety was observed at the same time.Results: The serum glucose,insulin,C-peptide were significantly lower than 50 g glucose group,the insulin,C-peptide decreased 14.30%,23.73%,40.42%,58.48% and 4.62%,14.32%,7.62%,29.33% in 10F+40G group,30F+ 20G group,40F+10G group and 50F group when compared with 50G group,which showed dose-response relationship.The glycemic index was 91.8,62.4,43.6,37.5 in 10F+40G group,30F+ 20G group,40F+ 10G group and 50F group.No adverse effect was observed during the test.Conclusion: It is beneficial to the protection ? cells of pancreas to orally take different doses of fructose.Fructose taken orally may influence the serum lactic acid.

Imaging characteristics of thoracic LDRD and artifacts analysis / 医疗卫生装备

Objective To analyze the imaging characteristics of thoracic LDRD(Low-dose directly Digital Radiographic Device) and its artifacts.Methods 188 patients were performed with LDRD and common thoracic X-ray film respectively in our hospital during two weeks.Results Among the 188 cases,1.60%(3/188) showed thoracic motion artifacts.46.8%(88/188) appeared as tentorial prominence along left heart edge and 2.6%(5/188) along the right one.1 artifact was in aorta-pulmonary artery window(0.53%).Conclusion(1)Less than 0.5 should be taken as reference in podoid enlargement diagnosis.(2)Pseudomorph from heart motion may result from cardio-phase,cardiac contraction,heart rate,arrhythmia,local abnormal pulse of left heart edge,different enlarged velocity of cardiac cavity during heart beat,etc.(3)The motion artifacts in thoracic LDRD has no important influence in clinical diagnosis and therapy.