OBJECTIVE: To evaluate the efficacy and safety of a short course of nebulized budesonide via transnasal inhalation in chronic rhinosinusitis with nasal polyps. METHOD: Fifty patients with severe eosinophilic nasal polyps were randomized devided into study group (n = 25) and control group (n = 25). The study group received budesonide inhalation suspension (1 mg twice daily) via transnasal nebulization for one week and the control group received oral prednisone (24 mg QD). Visual analogue scales (VAS) of nasal symptoms, endoscopic polyp scores (kennedy scores) and morning serum cortisol concentrations were assessed in both groups pre- and post-treatment. Operation time and surgical field bleeding were evaluated. RESULT: Four subjects dropped out in control group. Budesonide transnasal nebulization caused a significant improvement in all nasal symptoms especially nasal obstruction (baseline: 8.25 ± 0.53; after treatment: 4.97 ± 0.97, P < 0.01) and reduced polyp size significantly (baseline: 4.64 ± 0.63; after treatment: 3.40 ± 0.76, P < 0.01) compared to pre-treatment. The patients treated with oral prednisone, however, showed more obvious improvement in nasal symptoms and polyp size, shorter operation time and better surgical field than budesonide group. Additionally, the morning serum cortisol concentration was mildly decreased after one week treatment in budesonide group [baseline (17.18 ± 2.83) μg/dl, after treatment (16.24 ± 2.93) μg/dl, P > 0.05], but all values were still located in normal range (normal range: 5-25 μg/dl). Conversely, the morning serum cortisol concentration in oral prednisone group was lower than normal limit [baseline (18.19 ± 2.81) μg/dl, after treatment (2.26 ± 0.70) μg/dl, P < 0.01]. CONCLUSION Twice daily budesonide transnasal nebulization is an effective and safe treatment as evidenced by significant improvements in nasal symptoms and reduction in polyp size, coupled with an absence of hypothalamic-pituitary-adrenal axis suppression, which is safer than the systemic corticosteroids. Budesonide transnasal nebulization offers a viable treatment option for CRSwNP before operation.
Administration, Inhalation ; Budesonide ; administration & dosage ; therapeutic use ; Chronic Disease ; Humans ; Hydrocortisone ; blood ; Hypothalamo-Hypophyseal System ; Nasal Obstruction ; Nasal Polyps ; complications ; drug therapy ; Pituitary-Adrenal System ; Prednisone ; therapeutic use ; Rhinitis ; complications ; drug therapy ; Sinusitis ; complications ; drug therapy ; Suspensions

Objective To analyze the relative factors for the prognosis in elderly patients with stroke,and provide theoretical basis for improving prognosis.Methods 188 elderly patients with stroke were treated in our department from Jan.2011 to Nov.2013,and clinical data was analyzed.The prognosis and relative risk factors for stroke were statistically analyzed.Results 99 cases had good prognosis,89 cases had poor prognosis,and the recovery rate were 52.7％ (99/188) and 47.3％ (89/188) respectively.The age was older in group of good prognosis than in group of poor proghosis (t=1.7930,P＜0.05).Univariate analysis showed that the age,position of cerebral infarction,size of lesions,hypertension,diabetes,drinking and smoking were associated with the prognosis of stroke (t=1.7930,x2 =8.6473,15.046,13.1334,4.1536,5.7004,5.9043,respectively,all P＜0.05),while the prognosis was not associated with gender,a family history of stroke,hyperlipidemia and heart disease.Multivariate logistic regression analyses revealed the prognosis of stroke was related with risk factors of age (OR=1.072),size of the lesion (OR=3.481),hypertension (OR=2.034),diabetes (OR=1.631) and smoking (OR=3.144).Conclusions It is beneficial to the prognosis of patients with stroke to stop bad habits and to treat hypertension and diabetes actively.

Objective:To investigate the role of miR-581 overexpression on the proliferation of human colorectal cancer cell line SW620. Methods:The expression group,colorectal cancer SW620 cells were transfected with recombinant lentivirus vector ( LV-miR-581) and miR-581 mimics(miR-581),the negative control group were transfected with negative control lentiviral vector (LV-GFP) and negative control mimics (vector). The mRNA expression of miR-581 was identified by qRT-PCR. Proliferation of the cells were detected by CCK8 assary and colony forming assary. Results:The expression of miR-581 at mRNA significantly increased in LV-miR-581 group compared with control groups were detected by qRT-PCR ( P<0. 05 ) . Up-regulation of miR-581 markedly enhanced human colorectal cancer SW620 cells proliferation than those in the cells transfected with control vector ( P<0. 05 ) . Conclusion: Forced expression of miR-581 accelerates the proliferation of colorectal cancer SW620 cells.

Objective To investigate the effect of HbA1c meeting the standard or not on microalbuminuria,blood lipids and liver enzymes in patients with type 2 diabetes.Methods A retrospective analysis was performed on 457 subjects who had type 2 diabetes.They were divided into substandard group and standard group according to HbA1c result.The general information and relevant laboratory indicators of patients were.collected and compared between two groups.Results The microalbuminuria,serum triglyceride and liver enzymes (glutamyl transpeptidase,alkaline phosphatase,aspertate aminotransferase) were significantly different between two groups [ (189.8 ± 235.3) mg/dl vs (38.9 ± 85.5) mg/dl,(2.64 ± 2.99) mmol/L vs (2.02 ± 1.50)mmol/L,(41.7 ±52.9)U/L vs (29.7 ±24.9)U/L,(83.6 ±28.6) U/L vs (74.3 ±25.8)U/L,(26.7 ±19.1)U/L vs (22.0 ±10.5) U/L,P ＜0.05].HbA1c level was positively correlated with microalbuminuria,glutamyl transpeptidase and alkaline phosphatase (r =0.209,0.115,0.11,P ＜0.01).The microalbuminuria was an independent risk factor of affecting HbA1c to reach the standard (OR = 1.009,P ＜0.05).Conclusions HbA1c meeting the standard or not can influence many factors except blood glucose.

Objective To investigate the molecular mechanisms of PLCεin regulating the invasion and migration of human bladder cancer cells in vitro.Methods After cells treated with recombinant adenovirus , the migratory/in-vasive abilities of T24 cells were explored by wound healing and Transwell chamber cell migration and invasion as -say;RT-PCR was used to detect the mRNA levels of PLCε;The protein levels of PLCε,PKCα,PKCβ, TBX3 and E-cadherin were determined by Western blot;QRT-PCR was used to detect the mRNA levels of TBX3 and E-cad-herin.Results It was confirmed by digesting and sequencing that the recombinant adenovirus had been constructed successfully .The expression of PLCε mRNA and PLCε protein were both decreased after the infection of Ad-shPLCε.Wound healing and Transwell chamber cell migration/invasion assay showed that Ad-shPLCε treatment could inhibit the migratory and invasive activity of bladder cancer cells(P<0.05).The results of Western blot indicated that the expression of PKCα/βin membrane decreased ( P<0.05 ) , and phosphorylation level of PKCαand PKCβwas reduced .QRT-PCR and Western blot analysis demonstrated that the expression level of TBX 3 de-creased , but the expression level of E-cadherin increased .Conclusions PLCε shRNA can inhibit migratory and invasive ability of bladder cancer cells through PKCα/β/TBX3/E-cadherin pathway .

Fed with high-fat diet and assessed by hyperinsulinemia-euglycemia clamp technique, rat models with insulin resistance were successfully induced. Compared with normal chow group ( NC ), serum concentrations of free-fatty acids(FFAs) and baseline insulin in high-fat diet group(HF) was higher( P＜0.05 ), the average glucose infusion rate from 60 to 120 min( GIR60-120 ) was lower( P＜0.01 ), and the expression of p-IRE-lα in the liver was higher( P＜0.05 ). Furthermore, the expression of p-IRE-1α in the liver was positvely correlated with the serum concentration of FFAs. All these data indicate that high-fat diet may induce endoplasmic reticulum stress in the liver by elevating serum concentration of FFAs, and may participate in the genesis of insulin resistance via p-IRE-1α.

OBJECTIVE To evaluate the clinical outcome of submucosal inferior turbinectomy and outfracture surgery of inferior turbinates. METHODS All patients receiving two different operations were measured by acoustic rhinometry and questionnaire of QOL at preoperative 1 week and postoperative 12 months, seperately. RESULTS Forty-seven patients with inferior turbinate hypertrophy were enrolled in this study. Evaluation of SNOT-20 discovered both surgeries could improve patients' QOL with similar outcome. Preoperative '5 important items' in patients with inferior turbinate hypertrophy were 'lack of a good night's sleep', 'need to blow nose', 'thick nasal discharge', 'fatigue' and 'dizziness'. Postperative '5 important items' were 'postnasal discharge', 'runny nose', 'sneezing', 'reduced concentration' and 'reduced productivity'. Both surgeries could make acoustic rhinometry parameters change obviously, such as minimal cross-sectional area, 0-5 cm nasal volume(NV) and 2-5 cm NV. Furthermore, submucosal inferior turbinectomy produced more volume in nasal cavity than outfacture surgery, (7.28±2.01)cm3 vs (6.01±1.22)cm3, (5.99±1.87)cm3 vs (4.23±1.08)cm3(P<0.05), seperately. There was no correlation between the data of SNOT-20 and acoustic rhinometry. CONCLUSION We recommend outfracture surgery of inferior turbinate as the preferred surgical choice for patients with mild inferior turbinate hypertrophy.

Objective To evaluate the effect of preoperative anxiety on the dosage of opioid drugs in perioperative period.Methods Fourty female patients who aged 18-65 years,ASA Ⅰ or Ⅱ, undergoing laparoscopic hysterectomy were enrolled during November 2014 to August 2015.Demo-graphic characteristics of the patients were recorded.The patients were separated into two groups ac-cording to their state anxiety inventory (SAI).The patients with SAI>37 score were included in the high-anxious patients group (group H,n=22)while the other patients with SAI≤37 were enrolled in the low-anxious patients group (group L,n=18).All patients received the SAI test at the day be-fore surgery.The anesthesia time,intraoperative remifentanil consumption,duration of the first time giving analgesia after surgery,consumption of sufentanil at 1(T1 ),2(T2 ),4(T3 ),6(T4 ),24(T5 ) and 48 hours(T6 )after operation were recorded.Visual analogue scale (VAS)scores,the times of pressing PCIA and the side effects of opioid 48 h after the surgery were recorded.Results In group H, the time for first dose of opioid after surgery was significantly shorter than group L (P <0.05).The con-sumption of sufentanil in group H was significantly more than group L at T1-T6 (P <0.05).The times of pressing PCIA at the T5 time point after operation in group H was more than group L (P<0.05).No sta-tistically difference was found in the incidence of nausea or vomit between the two groups.There were no re-spiratory depression, pruritus or urinary retention in all patients.Conclusion Patients with high preoperative anxiety level perceive needed more opioids in postoperative pain control.

Objective:To study the expression and regulation of TLR2/4 in mycobacterium tuberculosis heat shock proteins 16. 3 (mycobacterium tuberculosis heat shock proteins 16. 3,MTB Hsp16. 3) effect on mouse bone marrow-derived macrophages in vitro. Methods:Bone marrow cells were isolated from tibia and femurs of BALB/c mice and incubated with GM-CSF,then detected the expression of CD11b and F4/80 with flow cytometry and observed morphology. The M0 macrophages were stimulated with MTB Hsp16. 3 for 0 h,12 h,24 h,36 h,48 h and 72 h. Real-time PCR detected the expression of TLR2/4 in intracellular at different time point. Silencing macrophages cell surface TLR2/4 molecules by siRNA technology which stimulated with MTB Hsp16. 3 for 0 h,12 h,24 h,36 h,48 h and 72 h. Real-time PCR detected the expression of TLR2/4,Ym-1,Fizz1,IL-10,TNF-α,iNOS and TGF-βin intracellular at different time point. Results:Morphology analysis showed that MTB Hsp16. 3 stimulated macrophages were round cells stretching out pseudopodia,whereas MTB Hsp16. 3 stimulated silencing TLR2/4 macrophages had elongated fibroblastoid. Real time PCR detected the expression of TLR2/4 were upregulated after MTB Hsp16. 3 stimulated M0 macrophages. MTB Hsp16. 3 stimulated silencing TLR2/4 macrophages the expression of IL-6, TNF-α, iNOS were upregulated, whereas IL-10, TGF-β, Ym-1 and Fizz1 were downregulated. Conclusion:MTB Hsp16. 3 may stimulated M0 macrophages to M2 macrophages and suppress M1 macrophages through binding with TLR2/4 receptor,which may be involved the progresss of MTB evaded macrophage phagocytosis.

OBJECTIVE: To evaluate the efficacy and safety of a short course of nebulized budesonide via transnasal inhalation in chronic rhinosinusitis with nasal polyps. METHOD: Thirty patients with severe eosinophilic nasal polyps were randomized into experimental group (n=15) and control group (n=15). The experimental group received nebulised budesonide suspension (1 mg twice daily) via transnasal inhalation for one week and control group-received budesonide nasal spray (256 microg twice daily). Visual analogue scales (VAS)of nasal symptoms (including nasal obstruction, nasal discharge, loss of smell, and headache/facial pain) and endoscopic polyp scores (Kennedy scores) and morning serum cortisol concentration were performed to both groups before and after the treatment. RESULT: Nebulized budesonide inhalation caused a significant improvement in all nasal symptoms especially nasal obstruction (baseline: 8.4 +/- 0.7; after treatment: 4.0 +/- 0.8, P<0.01) and reduced polyp size compared with before treatment. Additionally, the patients treated with nebulized budesonide showed more obvious improvement in nasal symptoms and polyp size than control group. The morning serum cortisol concentration was mild decreased after one week treatment in nebulized steroid group [baseline: (17.6 +/- 2.4) microg/dl, after treatment: (14.8 +/- 2.6) microg/dl, P<0.01], but all values still were located in normal range (normal range: 5-25 microg/dl). CONCLUSION A short course of nebulized budesonide transnasal inhalation can rapidly improve nasal symptoms, reduce polyp size, and does not cause obvious HPA axis suppression. Based on these, it is recommend that transnasal inhalation with nebulized budesonide suspension should be performed as a pre-operative routine in patients with nasal polyp.
Administration, Inhalation ; Adult ; Budesonide ; administration & dosage ; adverse effects ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Nasal Polyps ; complications ; drug therapy ; Nebulizers and Vaporizers ; Sinusitis ; complications ; drug therapy ; Suspensions ; Treatment Outcome ; Young Adult