Objective To investigate the effect of salmeterol and fluticasone propionate on cardiopulmonary function and 6 min walking distance in patients with severe COPD. Methods 100 cases of patients with severe COPD who were treated in the hospital from March 2013 to May 2015 were selected as the study objects and were randomly divided into the observation group and the control group, 50 cases in each group. The control group was treated with theophylline sustained-release tablets and N-acetylcysteine. Based on this, the observation group inhaled salmeterol and fluticasone propionate powder inhalant. All patients were treated for 6 months. Serum inter-leukin 8(IL-8)and tumor necrosis factor-α(TNF-α)were compared before and after treatment between the two groups to evalu-ate the anti-inflammatory effect. The changes of cardiopulmonary function were recorded. Meanwhile,the 6 min walking distance (6MWD) and the incidence of adverse reactions were observed and compared between the two groups before and after treat-ment. Results After treatment,the IL-8 was(133. 5 ± 32. 1)ng/L and TNF-α was(140. 9 ± 21. 3)mg/L in the observation group, which were significantly lower than(156. 8 ± 28. 4)ng/L and(181. 2 ± 25. 4)mg/L in the control group( P < 0. 05);the ANP was (95. 32 ± 2. 73)ng/L in the observation group,which was significantly higher than(82. 15 ± 1. 25)ng/L in the control group;the right ventricular Tei index was (0. 26 ± 0. 09) in the observation group,which was significantly smaller than (0. 30 ± 0. 07) in the control group ( P < 0. 05);the predicted value of FEV1% was (78. 32 ± 3. 04)% ,FEV1/FVC was (80. 03 ± 3. 28)% and 6MWD was (314. 2 ± 6. 9)m in the observation group,which were significantly different from(60. 05 ± 2. 08)%,(73. 56 ± 2. 35)%,(279. 5 ± 4. 8)m in the control group ( P < 0. 05);there was no significant difference in the incidence rate of adverse reactions between the two groups (16. 00% us 12. 00%)( P > 0. 05). Conclusion Salmeterol and fluticasone propionate have certain effect on cardiopulmonary function and 6 min walking distance in patients with severe COPD. It has significant effect on improving right cardiac function,and the safety is better,which is worthy of clinical promotion.

OBJECTIVE To evaluate the clinical value of enhanced magnetic resonance imaging(MRI)in diagnosis of infections after spine surgery so as to improve the accuracy of diagnosis of infections.METHODS From Feb 2013to Jan 2014,totally 37patients with postoperative infections who underwent the spine surgery were enrolled in the study and divided into the unenhanced group with 18cases and the enhanced group with 19cases,then the plain scan group received the plain MIR scan,while the enhanced group received the enhanced MIR scan,the effects of the scans on lesions were observed and compared between the two groups,and the accuracy of diagnosis was compared between the two groups.RESULTS The display rate of discitis was 16.67%in the plain scan group,significantly lower than 36.84%in the enhanced group;the display rate of spine osteomyelitis was 11.11%in the plain scan group,significantly lower than 26.32%in the enhanced group;the display rate of abscess outside the inner membrance was 27.78%in the plain scan group,significantly lower than 15.79%in the enhanced group;the display rate of soft tissue infections was 22.22%in the plain scan group,significantly lower than 10.53%in the enhanced group,the differences were significant(P0.05).The result of the statistical analysis showed that the specificity,sensitivity,and accuracy of the enhanced group were significantly better than those of the plain scan group(P0.05).CONCLUSIONS The enhanced MRI scan can effectively improve the accuracy,sensitivity,and specificity of MRI and overcome the problems in early diagnosis of infections;it has significant clinical value and is worthy to be promoted.

目的：对比320层CT血管造影（CTA）与数字减影血管造影（DSA）在老年下肢动脉闭塞性病变诊断中的应用效果。方法选取2011年5月至2013年5月在该院行下肢动脉CTA及DSA检查的28例老年下肢动脉闭塞性病变患者，将肾动脉水平以下的单侧下肢动脉和腹主动脉分为15个节段，共840个节段，对比320层CTA与DSA的诊断准确率、特异性、敏感性及显示的节段数。结果在全部的840个节段中，320层CTA诊断的准确率、特异性、敏感性分别为99％、98％、99％，DSA诊断的准确率、特异性、敏感性分别为99％、99％、99％。评估腘动脉以下区的动脉节段时320层CTA和DSA诊断的准确率、特异性、敏感性均98％、99％、100％；评估股动脉-腘动脉区节段时320层CTA诊断的准确率、特异性、敏感性分别为98％、98％、99％，DSA诊断分别为99％、98％、98％；评估主动脉-髂动脉区节段时320层 CTA诊断的准确率、特异性、敏感性分别为97％、98％、98％，DSA诊断分别为98％、98％、97％。另有1例腘动脉以下节段在320层CTA显影不清晰，50个节段在 DSA检查中显示不清晰，无法进行评估。结论320层CTA对老年下肢动脉闭塞性病变的诊断具有较高的准确率、特异性、敏感性，与 DSA 基本一致，且较 DSA能够显示出更多的节段。可作为老年下肢动脉闭塞性病变患者制定介入治疗方案的参考依据。

OBJECTIVE To evaluate the value of multi-slice CT angiography (MSCTA) in the diagnosis of super mesenteric artery (SMA) and super mesenteric vein (SMV), and discuss the 3D reconstruction method for detecting mesenteric vessel lesions. METHODS Thirty-three patients suffering from mesenteric vessel diseases were analyzed. There were 14 SMA lesions, including 9 thromboses, 3 dissecting aneurysms, 1 pseudoaneurysm, and 1 malrotation. There were 19 SMV thromboses. The 3D reconstruction included volume rendering (VR), maximum intensity projection (MIP), and multi-planner reformation (MPR). RESULTS The lesions appeared clear by MSCTA in the 33 patients. The SMA thrombosis was shown clear in the MIP in all 9 patients, and only 4 of them were detected in the VR. There was significant difference between MIP andVR in detecting SMA thrombosis (P=0.0294). Three dissecting aneurysms were best shown in the MPR; 1 pseudoaneurysm and 1 malrotation were clearly manifested in the VR. The thrombosis of SMV was clearly shown by both MIP and MPR in all 19 patients. Collateral vessels were clearly shown in the MIP in 12 patients; the collateral vessels were detected by VR only in 5, and the other 7 failed to show the collateral vessels. There was significant difference between the MIP and the VR in showing lateral collateral vessels (P=0.0046). CONCLUSION Both lesions of SMA and SMV can be detected by MSCTA. MIP is an ideal reconstruction method for SMA thrombosis and collateral vessels around the SMV.

[Objective]To investigate the curative effect and surgical techniques of short-segment pedicle screw system (PSs) with posterior lumbar interbody fusion (PLIF) for severe isthmic spondylolisthesis. [Methods]From January 2005 to January 2007, a consecutive series of 51 patients with severe isthmic spondylolistbesis were managed by short-segment PSs and PLIF. The mean age at time of surgery was 41 years (range, from 25 years to 67 years) . According to Meyerding grade, the preoperative percentage of spondylolisthesis was above 33% in all cases, with an average of 42%. All patients were radiculo-pathic. The percentage of spondylolisthesis and disc height were analyzed to determine the effectiveness by measuring the data from the standing anterior-posterior and lateral radiographs, which were taken before surgery, in the postoperative period, and at last follow-up. The Beaujon functional score was assessed for each patient before surgery and at last follow-up. [Results]The average time of follow-up was 2 years and 8 months (range, from 2 years to 3 years and 10 months) . There was a mean improvement of 92% for reduction rate of spondylolisthesis. The disc height improved from 4. 9 mm to 10. 3 mm on the average. All patients got bony fusion of the fixation segments within 4 months. The mean Beaujon functional score increased from 8. 1 be-fore surgery to 17.9 two years after surgery and the rate of excellent and good results was 91%. In the time of follow-up, no significant loss of spondylolisthesis reduction rate and disc height occurred. [Conclusion]Short-segment PSs with PLIF has a good effectiveness in the treatment of severe isthmic spondylolisthesis. It provides short segmental fusion to preserve more lumbar mobile segments.

Objective: To examine the aberrant neurophysiological response during the parametric N-back task in schizophrenia,and investigate the dynamic dysfunction in the WM system of schizophrenia.Methods: 20 schizophrenic patients and 20 matched healthy controls performed a parametric n-back task with increasing working memory(WM) load(0-Back,1-Back and 2-Back),while the EEG was recorded during they performed the task.Results: Schizophrenia performed significant poorly than normal subjects in 1-back and 2-back task(P0.01).For controls,P3 peak amplitude decreased progressively as WM load increased(0-back 1-back 2-back),while schizophrenic subjects showed no significant difference between the amplitude of P3 elicited in 1 and 2-back task(0-back1-back=2-back).Moreover,the patient group showed larger P3 amplitude than that of controls in central region in 0,1,2-back task,and parietal region in 2-back task.The difference wave N450 appeared at the frontal and parietal areas by subtraction of ERP in the lower load task from the higher load task.Schizophrenia demonstrated an enhanced 1-0 difference wave N450 in parietal region compared with controls,but a reduced 2-1 difference wave N450 in the same region(P0.05).Conclusion: Schizophrenia showed significant WM impairment.The short-term storage deficit in schizophrenia might be associated with the physiological inefficiency of parietal lobe and the reduced WM capacity.