Objective To evaluate effects of different starting dose methylprednisolone on acute exacerbations of chronic obstructive pulmonary disease(AECOPD).Methods 40 patients with AECOPD were allocated two groups in random,including group A(n=20,120mg methylprednisolone)and groups B(n=20,80mg methylprednisolone),with duration of treatment was 7 days respectively.Clinical sign and symptom,dyspnea score and arterial blood gases were measured and observed at 0-hour,72-hour,day 7.Results The group A was surperior to the group B in clinical efficacy.The differences of dyspnea score and arterial blood gases at 72-hour are significant between the two groups(P

Objective To explore the effect and its clinical significance of different dose of glucocorticoids on inflammation mediators in patients with acute exacerbation of chronic obstructive pulmonary diseases.Methods 45 patients admitted to our hospitals from March 2007 to March 2011 were randomly divided into 3 groups:methylprednisolone 40 mg group (methylprednisolone 40mg,iv,qd),methylprednisolone 80 mg group (methylprednisolone 80mg,iv,bid),and control group (without any glucocorticoids).The changes of dyspnea scores,arterial blood gas analysis,clinical symptom scores and serum IL-6,IL-8 and tumor necrosis factor (TNF) levels were detected in patients of each group before and at the 7th day after treatment.The related adverse drug reactions were recorded.Results The improvements in clinical symptom scores,Borg scores,PaCO2,PaO2 after treatment were higher in methylprednisolone 40 mg group and methylprednisolone 80 mg group than in control group (F=3.6747.162 and 42.88,respectively,P＜0.01 or 0.001),and the above improvements was better in methylprednisolone 80 mg group than in methylprednisolone 40 mg group (all P＜0.05).The decreases in levels of serum IL-8,TNF-α,IL-6,C-RP after the treatment were more significant in methylprednisolone 40 mg group and methylprednisolone 80 mg group than in control group (F=12.65,16.17,30.99,respectively,all P＜0.001),and the decrements were more significant in methylprednisolone 80 mg group than in methylprednisolone 40 mg group(all P＜0.05).NO serious adverse drug reactions happened during the course of treatment in the three groups.Conelusions Short-term and moderate dose of glucocorticoid treatment is effective and safe in treating the patients with acute exacerbation of chronic obstructive pulmonary diseases.Methylprednisolone 80 mg injection daily can more obviously improve AECOPD symptoms,and reduce the levels of inflammatory factors better.

Objective To evaluate the role of transbrochial needle aspiration (TBNA) in the diagnosis of patients with enlarged mediastinal and/or hilar lymph node. Methods Patients with mediastinal and/or hilar lymphoadenopathy proven by CT scan were eligible for TBNA as reported. All specimens were directly and instantly smeared for pathological examination. Results From June 1 2004 to December 31 2007, 164 patients were examined: including 80 lung cancers, 69 lung bengin diseases, 2 other malignancy tumor, and 13 without definite diagnosis. Total 260 lymph nodes were punctured. TBNA procedures were successfully carried out in 445/463(96.1%). Sensitivity of TBNA was 82. 5 % (66/80) in patients who had been proven to suffer from bronchogenic carcinoma. There were 25 patients that diagnosis of lung cancer was pathologically determined by TBNA only. A total of 122 lymph nodes in the 80 lung cancer patients were aspirated by TBNA with a positive rate of 65. 6% (80/122). Severe complications were rare except small amount of bleeding at the TBNA site (100/164, 61.0%). From June 1 2006 to December 31 2007, lymph node tissues able to make histology diagnosis were yield in 73.5% (64/87) patients. Through histology pathology, the sensitivities of TBNA were 53. 3% (8/15) for sarcoidosis and 78.6% (33/42) for lung cancer. Conclusion TBNA is quite safe and helpful in diagnosis and staging of bronchogenic carcinoma, and in diagnosis of benign lung diseases.

Objective To evaluate the appearance of CT in patients with severe acute respiratory syndrome (SARS) in the recovery phase, and to study the correlation of CT findings with pulmonary function.Methods From June to August in 2003, 100 patient with confirmed SARS accepted examination in our hospital. Among them, 91 patients (39 men, 52 women, mean age 36.4 years, age range 19- 66 years) received CT examination and pulmonary function test on the same day. The interval between SARS onset and the examination ranged from 52 to 125 days (mean 87.4 days). CT appearances of pulmonary parenchymal abnormalities including distribution and extent of involvement were quantitatively analyzed, and four levels on CT scan including the aortic arch, the tracheal carina, the pulmonary venous confluence, and the dome of right diaphragm were selected to score the lesions. The correlation of CT scores with the results of pulmonary function tests was studied.Results Of the 91 cases, 47 patients had normal CT appearance in the recovery phase, whereas the other 44 patients still had parenchymal abnormalities, including residual ground-glass opacification and reticular shadow. CT visual score had correlation with DLco% ( r =-0.618, P