Objective:To investigate the therapeutic effect of inhaled corticosteroid combined with long-acting β2 agonists on stable chronic obstructive pulmonary disease (COPD).Methods:A total of 90 patients with stable COPD treated in the Second People’s Hospital of Henan Province from January 2020 to January 2022 were selected. And they were divided into control group and observation group by the two-sphere method, with 45 cases in each group. Both groups were treated by conventional treatment, in addition, the control group was treated with long-acting β2 agonist inhalation, and the observation group was treated with corticosteroid combined with long-acting β2 agonist. The pulmonary function indexes including forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and peak expiratory flow (PEF), blood gas analysis indexes including arterial partial pressure of oxygen (PaO 2) and arterial partial pressure of carbon dioxide (PaCO 2), and incidence of adverse reactions were compared between the two groups. Results:Before treatment, there was no significant difference in pulmonary function indexes or blood gas analysis indexes between the two groups ( P>0.05). After treatment, compared with the control group, the observation group had higher FEV1, FVC, PEF and PaO 2, but lower PaO 2 ( P<0.05). There was no significant difference in the incidence of adverse reactions between the observation group (4.44%, 2/45) and the control group (8.89%, 4/42), P>0.05. Conclusions:The inhaled corticosteroid combined with long-acting β2 agonist in the treatment of stable COPD has a good curative effect, and it can better improve blood gas analysis indexes and pulmonary function.

目的 探讨呼吸衰竭患者医院感染病原菌分布,并对常见病原菌耐药性进行分析,为临床降低医院感染提供参考依据.方法 选取医院2013年1月-2015年1月收治的呼吸衰竭住院患者230例为研究对象,观察患者住院期间医院感染率,对病原菌进行培养,观察其分布,并对常见病原菌进行耐药性分析,观察其特征;采用SPSS17.0软件进行统计分析.结果 230例呼吸衰竭患者发生医院感染16例,感染率为6.96％;共分离出病原菌23株,其中革兰阴性菌17株占73.91％,革兰阳性菌4株占17.39％,真菌2株占8.70％;革兰阴性菌对阿米卡星、亚胺培南、美罗培南的敏感率为100.00％;革兰阳性菌对青霉素、氨苄西林、头孢唑林以及左氧氟沙星的耐药率均达100.00％,对呋喃妥因、替考拉宁以及万古霉素的敏感性较高.结论 呼吸衰竭患者目前医院感染率较高,其常见病原菌以革兰阴性菌为主,且对喹诺酮类抗菌药物敏感性较高,临床医师需做好病原菌的检测及耐药性的检查,避免抗菌药物的滥用.

OBJECTIVE To investigate the clinical treatment effect of continuous renal replacement therapy (CRRT ) for acute kidney injury caused by severe infections ,as well as its effect on plasma inflammatory mediators ,so as to provide the basis for clinical treatment of acute kidney injury caused by severe infections .METHODS A total of 66 cases of patients with acute kidney injury caused by severe infections in our hospital from Dec .2013 to Dec .2015 were selected ,who were divided randomly into two groups ,each group with 33 cases .The control group received conventional treatment ,and observation group received CRRT treatment .The clinical indexes were compared after treatment between two groups ,and data were analyzed by SPSS 17 .0 .RESULTS The 90 days mortality rate and dependent rate of CRRT treatment in observation group were 21 .21% and 6 .06% ,respectively ,the control group 39 .39% and 15 .15% ,and the differences between two groups were significant (P<0 .05) .The plasma TNF‐a , IL‐4 ,IL‐6 ,IL‐10 levels in observation group were significantly reduced after treatment ,the difference compared with before was significant(P< 0 .05) ,but those data were similar in the control group without significance . CONCLUSION CRRT has a significant clinical effect on the acute kidney injury caused by severe infections ,which could also remove inflammatory mediators in patients to have homeostasis of body in vivo environment .

Objective: The purpose of this meta-analysis was to assess the clinical efficacy and side effects of Aidi injection combined with radiation in the treatment of non-small cell lung cancer (NSCLC). Materials and Methods: By searching PubMed, the Cochrane central register of controlled trials, EMBSE and CNKI databases, the efficacy and side effect data of Aidi injection combined with radiation in the treatment of NSCLC from the published clinical studies were collected. The data were pooled using Stata version 11.0 software (http://www.stata.com; Stata Corporation, College Station, TX). Results: Ten clinical studies with1084 subjects were included in this meta-analysis. The combined data showed the clinical efficacy in experiment group was higher than that of control group (risk ratio [RR] = 1.72, 95% confidence interval [CI]: 1.52-1.96, P = 0.00); four articles reported the life quality improvement. The pooled data showed that the use of Aidi can significantly improve the quality of life in the procedure of radiation (RR = 2.29, 95% CI: 1.76-2.98, P = 0.00); six studies reported the radiation toxicities. The pooled data showed that Aidi injection can significant decrease the radiation pneumonia (OR = 0.46, 95% CI: 0. 34-0.63), radiation esophagitis (OR = 0.53, 95% CI: 0.40-0.71), and marrow suppression (OR = 0.50, 95% CI: 0.42-0.59). Conclusion: Aidi injection can improve the clinical efficacy, quality of life, and decrease the radiation-related toxicities in NSCLC patients who received radiation.

目的 探讨舒利迭联合羧甲司坦在慢性阻塞性肺部疾病(COPD)中的治疗效果.方法 将河南大学淮河医院2012年12月-2013年9月收治的100例COPD患者随机分为观察组和对照组,对照组采用常规治疗+舒利迭治疗,观察组在对照组的基础上采用羧甲司坦治疗,比较两组的治疗效果、肺功能变化、6 min步行距离、生活质量的变化以及1年内的复发率.结果 观察组中显效28例,有效20例,总有效率为96.0％高于对照组的82.0％,差异有统计学意义(P＜0.05).两组治疗前的肺功能、6 min步行距离、生活质量差异无统计学意义(P＞0.05).治疗后,观察组1FEV1、1s FEV1/FVC均高于对照组,6min步行距离长于对照组,在呼吸症状、活动受限、疾病影响等方面的生活质量高于对照组,差异有统计学意义(P＜0.05).观察组的1年复发率低于对照组,差异有统计学意义(P＜0.05).结论 舒利迭联合羧甲司坦能够显著提高COPD的治疗效果,改善患者的肺功能和生活质量,减少复发率.

目的：探讨不同剂量糖皮质激素对慢性阻塞性肺病急性加重期（ AECOPD）患者炎性因子水平的影响。方法选取2012年1月至2013年12月在该院呼吸科治疗的AECOPD的患者150例，将患者随机分成三组，低剂量组给予甲泼尼龙40 mg静脉注射1次／d；高剂量组给予甲泼尼龙40 mg静脉注射2次／d；对照组为空白对照，不使用任何糖皮质激素。观察三组患者治疗前及治疗后1 w的呼吸困难评分、动脉血气分析、临床症状评分和血清白介素（ IL）－6、IL－8、肿瘤坏死因子（ TNF）－α和C－反应蛋白（ CRP）的变化，并记录相关的药物不良反应。结果治疗后1 w三组患者中高剂量组和低剂量组的临床症状评分、Borg评分、动脉血二氧化碳分压（ PaCO2）、动脉血氧分压（ PaO2）改善均优于对照组（ F＝4．23、8．16、26．35、42．37，均P＜0．05），而低剂量组优于高剂量组（均 P＜0．05）；治疗后高剂量组和低剂量组血清 IL－6、IL－8、TNF－α、CRP 水平对照组明显下降（F＝29．51、13．29、21．73、33．51，均P＜0．05），而低剂量组较高剂量组下降更明显（均 P＜0．05）。在治疗过程中，三组患者均未出现严重药物不良反应。结论短期、适量糖皮质激素对AECOPD患者的治疗是有效、安全的。

目的：探讨烟草雾吸入诱导的慢性阻塞性肺疾病（COPD）大鼠气道Clara细胞及其分泌蛋白（CC10）表达的变化。方法采用自制的染毒箱，使大鼠吸入烟草雾制作COPD模型，对Clara细胞进行电镜及免疫组化观察，并测定大鼠气道阻力及呼吸系统总顺应性。结果 COPD大鼠终末及呼吸性细支气管Clara细胞数量减少，胞质内滑面内质网扩张；终末及呼吸性细支气管上皮细胞CC10表达减少；呼吸功能检查显示气道阻力增加、呼吸系统总顺应性下降；气道上皮细胞CC10阳性细胞百分率与气道阻力呈负相关。 COPD大鼠终末及呼吸性细支气管上皮细胞 Clara细胞数量减少，气道上皮细胞CC10表达减少，CC10阳性细胞百分率与气道阻力呈负相关、与动态顺应性呈正相关。结论 Clara细胞及 CC10表达减少，这可能与大鼠气道阻力增加及呼吸系统总顺应性下降有关。

目的：分析肺炎合并脓毒症患者的血清降钙素原与超敏C反应蛋白的变化情况,并探究其对于肺炎合并脓毒症的临床意义。方法将本院近年来收治的80例肺炎合例并脓毒症患者完整资料作为探究依据,据患者病情的不同将其分为严重脓毒症组(n=24)、轻微脓毒症组(n=30)、脓毒性休克组(n=26),另选取同期入院治疗的35例单纯性肺炎患者资料作为对比分析依据(对照组)。比较各组患者间的PCT、hs-CRP、Apache-II变化差异,并以ROC曲线评估PCT、hs-CRP、Apache-II评分对于肺炎合并脓毒症的临床诊断价值。结果对照组、轻微脓毒症、严重脓毒症、脓毒症休克者间的PCT、Apache-II得分呈递增升高的态势,各类脓毒症患者的hs-CRP水平均高于对照组(P<0.05),但轻微脓毒症组、严重脓毒症组、脓毒症休克组间的hs-CRP比较差异无统计学意义(P>0.05)；PCT、hs-CRP、Apache-II均对肺炎合并脓毒症具有一定的诊断价值；PCT的特异性优于hs-CRP,而敏感度则低于hs-CRP。结论肺炎合并脓毒血症患者的血清降钙素原与超敏C反应蛋白均呈升高状态,其中血清降钙素原可作为评估肺炎合并脓毒血症患者病情程度与预后的重要指标。

目的通过检测非小细胞肺癌(NSCLC)中埃兹蛋白(Ezrin)、血管内皮生长因子(VEGF)的表达情况,探讨二者的表达与NSCLC临床及病理特征之间的关系。方法该研究采用免疫组织化学的方法检测在80例非小细胞肺癌组织的2种蛋白Ezrin蛋白、VEGF蛋白的表达的概况,并对其在临床分期、病理类型、分化程度和淋巴结转移这几个方面的表达情况进行对比分析。结果肺癌组Ezrin的表达明显高于良性病变肺组织。Ezrin蛋白的表达与淋巴结转移之间有显著的相关性。肺癌组VEGF的表达明显高于良性病变肺组织。结论非小细胞肺癌组织中,Ezrin蛋白、VEGF蛋白都有高表达。Ezrin蛋白与VEGF蛋白的表达共同作用,对肺癌的转移起到了促进作用。可以通过同时检测这2个指标,用来评价肺癌转移的潜能和评价肺癌的预后。

Objective To determine the intervention effects of Bailing capsule on TNF-αin chronic obstrucive pulmonary disease.Methods One-hundred patients were randomly divided into control and treatment group.The control group was treated baseline regimen while the treatment group was administered baseline regimen with additional Bailing capsule.The indicators of pulmonary function and serum TNF-α was measured after 3 months treatment.Results Pulmonary function in the treatment group improved significantly compared with control group(P<0.05).Magnitude of decrease for serum TNF-α was remarkable in the treatment group with increase of FEV1,FEV1% predicted and FEV1/FVC.Conclusion Bailing capsule can improve pulmonary function and has anti-inflammatory effect.

Objective:To investigate the clinical effects Xuefuzhuyu capsule combined with hormone in patients with IPF,to provide new ideas and diagnosis methods in treatment for IPF.Methods:44 patients with IPF were randomly divided into Xuefuzhuyu capsule combined hormone therapy group (18 cases),and hormone therapy group (26 cases),were administered for 24 weeks,Patients in the hormone therapy group were given prednisone in the dose0.5～1mg/(kg·日),on this basis,the Xuefuzhuyu capsule combined hormone therapy group combined Xuefuzhuyu capsule.Before and after treatment,Imaging physiology,and clinical indicators of changes were observed.Results:CRP score,clinical scores (C) and physiological (P) scores after Xuefuzhuyu capsule combined with hormone therapy and the hormone therapy were significantly lower than before(P<0.05),except of imaging (R) scores.CRP scores in Xuefuzhuyu capsule combined hormone therapy group were lower than hormone therapy group(P<0.05).Conclusion:The Xuefuzhuyu capsule combined with hormone can effectively improve the condition of patients with IPF,is an effective treatment method.

Objective:To determine the economical effective treatment modalities on pulmonary fungal infection.Methods:In the present case-control study,32 cases with invasive pulmonary aspergillosis were randomly allotted to treatment(18 cases) and control group(14 cases),which received amphotericin B nebulization plus lavage(more than 40kg),and oral administration of voriconazole 2 times daily respectively.The time for clinical observation was 4～6 weeks.Results:Either amphotericin B nebulization plus lavage,or oral administration of voriconazole showed similar efficiency against pulmonary fungal infection.Conclusion:Amphotericin B nebulization plus lavage is an efficient treatment modality with low cost in clinical practice.

Objective:To investigate the relationship between interleukin-18 and pulmonary function of stable chronic obstructive pulmonary disease.Methods:Forty outpatients and inpatients with stable COPD and 20 healthy volunteers were randomly studied,The deep qualified sputum samples were obtained from all the subjects throμgh sputum induction,The sputum and serum of 40 COPD in the period of alleviation and 20 health controls were collected.The level of IL-18 were tested using ELISA.Simultaneously a11 of which accepted pulmonary function examination,blood routine examination and chest X-ray.Results:The level of IL-18 in sputum and serum of stable COPD group were higher than that in in the control group(P<0.05);The productions of IL-18 in sputum of the patients with FEV1%pred<50%group were higher than those patients with FEV1%pred≥50%group(P<0.01);The level of IL-18 in serum of the stable stage was inversely correlated with FEV1.0%Pred、FEV1.0%/FVC;The level of IL-18 in sputum of COPD was inversely correlated with FEV1.0%Pred,FEV1.0%/FVC.Conclusions:There is airway inflammation of the patients with stable COPD,IL-18 participates in the procedure of airway inflammation,which relates to the great decline of pulmonary function in the patients with stable COPD.

Objective: To analysize the changes in T-Lymphocyte Subsets in peripheral blood of the mice,and investigate the cellular and molecular mechanism of immune system injury induced by irradiation.Methods: The peripheral blood was collected from different radiotherapy dose of the mice.The changes of T-lymphocyte subsets CD3+,CD4+,CD8+ and CD4+CD25highregulatory T cells were analyzed by flow cytometry.Results: TheT lymphocyte subsets CD3+,CD4+,CD8+ have distinctly reduced after irradiation(P0.05);CD4+CD25highregulatory T cells shows marked increase compared with that the control group(P0.05).Conclusion: The radiotherapy can inhibit T lymphocyte subsets in mice which can be a useful index for monitoring the immunity function.

目的:观察斯普林联合多西他赛加顺铂方案化疗治疗复发小细胞肺癌的疗效.方法:57例复发小细胞肺癌患者给予多西他赛加顺铂方案化疗2～6个周期.观察组较对照组加用斯普林静脉滴注,化疗至少2周期评定疗效.结果:全组57例患者均按计划完成化疗,观察组总有效率60.0%(18/30).对照组总有效率48.1%(13/27),无显著差异(x2=0.28,P=0.14).对照组临床受益率为63.0%(17/27),观察组临床受益率为86.7%(26/30),有显著差异(x2=4.31,P=0.03);不良反应主要有骨髓抑制及胃肠道反应,观察组不良反应少于对照组.结论:斯普林联合多西他赛加顺铂方案化疗治疗复发小细胞肺癌的毒副反应轻,有较高的局控率.

Ojbective:To study the effects of erythromycin treatment to endotoxin-induced ALI(acute lung injury) in rat model.Methods: The rat model of ALI was made by injecting lipopolysaccharide(LPS) with a dose of 4mg/kg into vena caudalis.54 male SD rats were randomly divided into three groups: control group(NC),experiment group(LPS) and treatment group(EY),18 rats every group.In control group physiologic saline was injected,in experiment group LPS was injected,in treatment group LPS was injected as time as erythromycin injectable powder intraperitoneal injection(50 mg/kg).Measured the levels of IL-1β,IL-6,TNF-α,IL-8,IL-10 in serum and alveolar wash liquid of 54 rats by enzyme-linked immunosorbent assay(ELISA).Results:Compare treatment group with experiment group,PaO2 and pH stepped up,PaCO2 stepped down,lung coefficient was(0.62±0.07 vs 0.96±0.13,P0.05),lung water content(85.76±0.56 vs 82.88±0.47,P0.05),lung permeability index(7.41±0.61 vs 12.26±0.58,P0.05),all decreased significantly,IL-1β,IL-6,IL-8 and TNF-α in serum and alveolar wash liquid stepped down,however,IL-10 stepped up significantly.The lesion of lung tissue in treatment group was lighter than that in experiment group through pathology observing.Conclusion: Erythromycin can

骨关节炎(osteoarthritiS,OA),是一种关节软骨进行性消失,骨质过度增生,临床出现慢性关节疼痛、僵硬、肥大及活动受限的常见风湿病.本病好发于50岁以上的中老年人.膝OA可见膝关节疼痛、僵硬、膝关节肿胀、痛、骨摩擦音.本人运用中药薰蒸治疗膝OA 78例,效果满意,现报道如下.

AIM: To observe the alterations of all kinds of pathophysiological and biochemical markers in rat model with endotoxin-induced acute lung injury (ALI) after pentoxifylline (PTX)treatment so as to approach the intervention effect of PTX treatment on ALI. METHODS: The rat model of ALI was made by injecting lipopolysacharide (LPS) at a dose of 4 mg/kg into vena caudalis. Seventy-two male SD rats with matched month age and weight were randomly divided into 3 groups: control group (NS), experimental group (LPS) and PTX treatment group, 24 rats each group. In control group physiologic saline was injected into vena caudalis; in experimental group 4 mg/kg LPS was injected into vena caudalis; in treatment group 0.036 mol/L PTX (10 mg/kg) was intraperitoneally (ip) injected 1 h before LPS injection into vena caudalis. Instantly after ALI rat modes were established successfully in erperimental group, 10 mg/kg PTX was injected ip, totally for 5 times, at an interval of 1 h; in the other 2 groups, same-volume physiologic saline was given in the same way. We determined PaO2, pH, PaCO2, lung coefficient, lung water content, lung permeability index, and detected the percentages of neutrocyte and macrophage in bronchoalveolar lavage fluid, the levels of malondialdehyde(MDA), superoxide dismutase(SOD), nitric oxide(NO) and inducible nitric oxide synthase(iNOS), and observed the pathomorphology of lung tissue. RESULTS: In treatment group compared with experimental group, PaO2 and pH stepped up, PaCO2 stepped down, lung coefficient (0.59±0.17 vs 0.92±0.11, P<0.05), lung water content(84.46±0.39 vs 80.22±0.37, P<0.05), lung permeability index(7.28±0.54 vs 12.32±0.28, P<0.05) were all decreased significantly, the percentage of neutrocyte in bronchoalveolar lavage fluid was reduced, NO and iNOS were depressed significantly, and SOD was improved significantly(P<0.05). The lesion of lung tissue in treatment group was lighter than that in experiment group through pathological observation. CONCLUSION: PTX can improve energy metabolism and reduce the cytotoxicity in LPS-induced ALI rats. PTX plays a role in intervening and preventing the development of ALI.

慢性阻塞性肺病(COPD)是临床上常见的呼吸系统疾病,可必特为新一代复方支气管扩张剂 ,含有异丙托溴铵和沙丁胺醇,我院自2005年9月至2006年1月观察有随访条件的42例患者,疗效良好.