Objective To study the significance of changes in the blood C-reactive protein(CRP)concentration in patients with chronic obstructive pulmonary disease(COPD)at different stages and different classification and further analyze the relationship between the degree of impairment of pulmonary function and CRP concentrations.Methods Fouty-two cases of COPD patients were enrolled,forced expiratory volume in one second(FEV1),the forced expiratory volume in one second/forced vital capacity(FEV1/FVC),a second rate were tested in these patients at admission and discharged from hospital after recovery.Arterial blood gas including PaO2,PaCO2 were analyzed.The CRP level was measured by ELISA from venous blood collected in the early morning.At the same time,10 healthy people were selected as control group.Results The CRP level in COPD group was significantly higher than that of the control group(P ＜ 0.05).It displayed highest in the Ⅳ grade of COPD patients,but there was no statistically significant differences among the levels(P ＞ 0.05).The CRP level in COPD patients at acute exacerbations was significantly higher than that in COPD patients at remission and differences was statistically significant([6.283 ± 3.168]mg/L vs[4.104 ± 1.013]mg/L,P ＜0.05).The changes of serum CRP levels was correlated negatively with FEV1(r =-0.618,P ＜ 0.05),with FEV1/FVC(r =-0.629,P ＜ 0.05)and with PaO2(r =-0.605,P ＜ 0.05).The changes of serum CRP levels was correlated positively with PaCO2(r =0.613,P ＜ 0.05).Conclusion The increase of CRP level may be associated with the damage of lung function and the degree of dyspnea in COPD patients.But CRP as a independent predictor of COPD outcomes and prognosis remains to be further studied.

Objective The study aimed to analyze the clinical data of patients with pulmonary embolism and summarize the clinical characteristics of pulmonary embolism,in order to improve the correct diagnostic rate and the prognosis. Methods Data of 178 patients who were cured in our hospital from January 2011 to December 2014 were analyzed retrospectively,including relative risk factors,clinical behaviors,examination data,misdiagnosis and prognosis. Results Patients with pulmonary embolism had related basic diseases and risk factors. Their clinical symptoms,signs and ordinary detection methods indicated pneumatorexis and cardiovascular injury,but lacked of specificity. The misdiagnosis rate of the first diagnosis was 48.88%,including 22 cases of the misdiagnosis to COPD, 18 cases to pneumonia and 16 cases to coronary heart disease. The misdiagnosis rate of elderly patients was 56.36%, while that of the young and middle-aged patients was 36.80%,the difference was statistically significant,P < 0.05. Computed tomography pulmonary angiography(CTPA)could accurately observe the pathological changes of pulmonary embolism,and all the patients were diagnosed by CTPA in the research. 11 cases(10%)of elderly patients died,while 2 cases(2.9%)happened in young and middle-aged patients. There was no statistical significant difference(P > 0.05). Conclusion Although the related risk factors of pulmonary embolism in patients existed,the misdiagnosed rate of the disease was high and prognosis was poor due to many confusing basic diseases. And the symptoms,signs and ordinary inspection of the patients lacked specificity. CTPA,being utilized to diagnose pulmonary embolism reliably,should be promoted.

Objective To compare the difference of IL-8 and MMP-9 levels in the serum and sputum before and after treatment in patients with acute exacerbations of COPD,and to analyze the correlation between IL-8 and MMP-9 levels and lung function.Method A total of 20 cases of AECOPD patients were randomly selected in the observation group and 15 cases of healthy people were selected in the control group.Pulmonary function was measured and the specimens of sputum and blood were collected during the admission and discharge for AECOPD patients.FEV1 and FEV1/FVC％ were recorded,and the concentration of IL-8 and MMP-9 in the sputum supernatant and serum were tested with double antibody sandwich enzyme linked immunosorbent assay before and after treatment.All the data and correlation were analyzed with t test and SPSS software.Results (1) Before the treatment,serum IL-8 concentration in COPD patients was 28.30 ± 14.39 pg/mL,higher than that in the control group [17.46 ± 3.48) pg/mL,P=0.008].After treatment,the serum IL-8 concentration was significantly decreased [(13.30 ± 6.31) pg/mL,P=0.000].IL-8 concentration of sputum significantly decreased after treatment [(501.60 ± 508.61) pg/mL,P=0.042] than one before treatment (639.40 ± 703.12) pg/mL.(2) Before treatment,serum MMP-9 concentration in patients with AECOPD was 1.12 ± 0.36 ng/mL,lower than control group [(17.89 ± 11.00) ng/mL,P=0.000)].After treatment,the serum MMP-9 concentration was significantly decreased [(0.87 ± 0.31) ng/mL,P=0.000].MMP-9 concentration of sputum before treatment (12.04 ± 12.22) ng/mL decreased significantly after treatment [(8.02 ± 7.13) ng/mL,P=0.005].(3) Before treatment,no correlation was seen between the concentration of serum IL-8 and FEV1,FEV1/FVC.Negative correlation was observed between the sputum IL-8 concentration and FEV1/FVC and no correlation was found with FEV1.After treatment,we found that no correlation showed between the concentration of IL-8 and FEV1,FEV1/FVC,and negative correlation was seen between the IL-8 concentration in sputum and FEV1,FEV1/FVC.(4) Before treatment,no correlation between the concentration of serum MMP-9 and FEV1,FEV1/FVC was observed and no correlation between the sputum MMP-9 concentration with FEV1 was seen.Negatively correlation was found between the sputum MMP-9 level wtih FEV1/FVC.After treatment,we observed no correlation between the serum concentration of MMP-9 and FEV1,FEV1/FVC,and negative correlation between the concentration of MMP-9 in sputum and FEV1,FEV1/FVC.Conclusion The concentration of IL-8 and MMP-9 in serum and sputum in patients with acute exacerbation of COPD is higher than those in the stable phase.IL-8 and MMP-9 levels in serum show no correlation with lung function.Negative correlation was observed between IL-8 and MMP-9 levels in sputum and lung function.We can test the levels of IL-8 and MMP-9 in sputum to evaluate the severity of the disease.

To study the variety of sIL-2R, Il-8, immunoglo bulin, T-lymphycyte subgroup in patients with COPD． 30 cases with COPD and the control group of 30 cases were d etected sIL-2R, IL-8 with ELISA; IgG, IgA with rate nephelometry; CD+3，CD+1， Cd+ 3，with immunoflu orescence． Results: Patients with CO-PD sIL-2R, Il-8, CD 8 increase and IgG, IgA, CD+3, CD+4，CD+4/CD+8　 decrease ． The difference is very significant． Conclusion: The immuni faction of patients with COPD reduce．

Objective:To investigate possible correlation between nutritional status and forced expiratory volume in 1 second expressed as percent predicted (FEV1%) and serum levels of complement components C3 and C4 in patients with chronic obstructive pulmonary disease (COPD).Method:Body weight,FEV1% and serum levels of C3 and C4 in 27 healthy subjects and 40 stable COPD patients were determined and studied the correlation between them.Results:Body weight and C4 serum level in COPD group were much lower than that health group,while C3 serum level was no significant.A significant and positive correlation was present between FEV1% and decrease of body weight and C4 level(γ=0.517 9,0.527 3,respectively).Morever,there was significant correlation between body weight and C4 level (γ=0.487 3) in patients with COPD.Conclusion:In patents with stable COPD,pulmonary funciton was associated with the decrease of nutritional depletion (ND) and serum level of complement components C4,which was an indicator of showing the severe degree of COPD and prognosis.These results suggest that nutritional supplementation and immunological supporting treatment directly influence the curative effect of COPD.

Objective To explore the impact of heat shock factor 2 (HSF2) on the development of lung cancer by promoting interleukin (IL)-10 expression.Methods 50 lung cancer tissues and adjacent normal tissues selected from 50 patients,the expression level of mRNA and protein of HSF2 and IL-10 were respectively detected by RT-PCR,Western blot and Immunohistochemistry;To interfere with expression of HSF2 in A549 cells by siRNA,the expression level of IL-10 was detected by Western blot.Results Compared with the adjacent normal tissues,HSF2 of 76％ (38 of 50) cases were up-regulated (P＜0.01),IL-10 of 80％ (40 of 50) eases were up-regulated (P＜0.01),protein level consistent with mRNA level.The up-regulation expression of IL-10 in lung cancer tissues and HSF2 positively correlated (R2 =0.921 6).The expression of IL-10 in A549 cells was weakened through interference with HSF2 by siRNA.Conclusion HSF2 may contribute to the development of lung cancer by facilitating the expression of IL-10.