Objective To evaluate the clinical effectivity of continuous positive airway pressure in treatment of chronic obstructive pulmonary disease complicated with left heart failure.Methods Totally 103 patients (aged 63-78 years) with chronic obstructive pulmonary disease complicated with left heart failure were randomly divided into two groups:treatment group (received noninvasive ventilation combined with routine medication) and control group (received conventional drug therapy).The patients of two groups were observed in the treatment of 1 hour to one week that blood pressure (SBP),heart rate (HR),arterial blood gas analysis,respiratory rate (RR),brain natriuretic peptide (BNP) and other indicators to improve the situation.Results After treatment,the PaO2 level of patients in treatment group was significantly increased from (56.1 ± 7.8) mm Hg to (91.1 ±11.3)mm Hg,(t=449.94,P＜0.05),PaCO2 decreased from (60.1± 10.9) mm Hg to (42.3± 9.3)mm Hg,(t=4.66,P＜0.05),pH value was improved from (7.26±0.12) to (7.36±0.17) (t=5.88,P＜0.05) and BNP was decreased from (350±181) ng/L to (961±376) ng/L (t=8.07,P＜0.05).In control group,the PaO2 was significantly increased from (55.0±8.1) mm Hg to (89.1±12.0) mm Hg (t=43.17,P＜0.05) after treatment,PaCO2 by decreased from (48.9±10.8) mm Hg,(58.9±10.8) mm Hg to (t=5.13,P＜0.05),pH value by up to (7.27 ±0.08),BNP by decreased from (439 ± 246) ng/L to (947 ±407) ng/L t=9.81,P＜0.05.Compared with the control group,the difference of PaO2 and BNP had no significantly significant.PaCO2 in treatment group was increased more sharply than it in the control group,and pH decreased more (P＜0.05 or P＜0.01).Conclusions The use of continuous positive airway pressure to treatment chronic obstructive pulmonary disease complicated with left heart failure can alleviate fatigue and prevent the respiratory failure.It is remarkable treatment effect and worthy of clinical application.

Objective To observe the value of non-invasive positive pressure ventilation for the overlap syndrome complicated with pulmonary encephalopathyt.Methods Fifty-six patients with the overlap syndrome complicated with pulmonary encephalopathy were divided into the experinental group and the controlled group.The experimental group was treated with non-invasive positive pressure ventilation and conventional clinical therapy (drugs and oxygen).The controlled group was treated with conventional clinical therapy.Results The experimental group was better than tche Controlled group in blood gas analysis (PH、PaCO2) in the second hour and the twentyfourth hour after treatment (P ＜ 0.05).The experimental group was more than the controlled group in the improvement of consciousness disorder (P ＜ 0.05).The experimental group was less than the controlled group in tracheal intubation (P ＜ 0.05).Conclusion Non-invasive positive pressure ventilation could improve consciousness disorder of the overlap syndrome complicated with pulmonary encephalopathy,and reduce tracheal intubation.

Objective To investigate the effects of capsaicin on the invasion ability of human large cell carcinoma NCI-H460 and the expressions of E-cadherin and Snail;To discuss the possible mechanisms of anti-non-small cell lung cancer.Methods NCI-H460 cells were cultured in vitro and treated with capsaicin at various concentrations, and no capsacin-treated group was set as control group. Effects of capsaicin on NCI-H460 apoptosis, its invasion ability, and the changes in protein expressions of E-cadherin and Snail were evaluated by Hoechst33342 nuclear staining assay, Transwell chamber invasion assay, and Western blot respectively. Results Compared with the control group, Hoechst33342 nuclear staining assay showed that capsaicin could induce NCI-H460 cell apoptosis (P<0.05);Transwell invasion in vitro results showed that capsaicin could significantly inhibit invasion of penetrating cells (P<0.05);Western blot analysis showed that E-cadherin expression level was significantly elevated and snail expression level significantly decreased (P<0.05).Conclusion Capsaicin can induce NCI-H460 cell apoptosis. Decrease the Snail expression and stimulate E-cadherin expression so as to inhibit the invasion ability of NCI-H460, which may be one of its mechanisms of anti-non-small cell lung cancer.

BACKGROUND:Sodium butyrate, a histone deacetylase inhibitor, can inhibit cell proliferation, and induce apoptosis and differentiation of various cancer cells. However, the role of sodium butyrate combined with tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) on lung cancer stem cells remains unclear. OBJECTIVE:To explore the effect of sodium butyrate combined with TRAIL on biological behaviors of lung cancer stem cells. METHODS:Magnetic bead separation was used to separate lung cancer stem cells (CD133+) from human lung adenocarcinoma A549 cells. After the lung cancer stem cells were treated with simple DMEM/F12, DMEM/F12 containing sodium butyrate (5 mmol/L), TRAIL (50 μg/L) or sodium butyrate combined with TRAIL, the cell proliferation within 96 hours of culture was determined by MTT assay; the apoptosis within 24 hours of culture was measured by flow cytometry; the cell migration within 48 hours of culture was detected by cell scratch test; the expression levels of pluripotent transcription factors (Oct4, Sox2 and Nanog) within 48 hours of culture were detected using western blot analysis. RESULTS AND CONCLUSION:The CD133+ lung cancer stem cells were successfully enriched from human lung adenocarcinoma A549 cells. MTT assay showed that sodium butyrate and TRAIL significantly inhibited the proliferation of lung cancer stem cells (P< 0.05), and the combination effect was even stronger (P < 0.05). Results from flow cytometry analysis and scratch test showed that sodium butyrate or TRAIL induced apoptosis and inhibited cell migration of lung cancer stem cells (P < 0.05), and the combination of sodium butyrate and TRAIL showed a stronger effect (P < 0.05). In addition, the expression levels of Oct4, Sox2 and Nanog were significantly down-regulated by sodium butyrate (P < 0.05), TRAIL or sodium butyrate combined with TRAIL, and the combination effect was stronger (P < 0.05). In conclusion, sodium butyrate and TRAIL have synergistic effects on lung cancer stem cells, indicating a new way for treatment of lung cancer.

Objectives To analyze the clinical features, diagnosis and treatment of Lemierre syndrome. Methods The clinical data of one case of Lemierre syndrome were retrospectively analyzed. The relevant literatures were reviewed. Results The primary infection of the patient was oral infection, and jugular vein thrombosis and metastatic lung abscess were followed. The blood culture showed that Staphylococcus aureus was positive. Lemierre syndrome was diagnosed. After anticoagulation and anti-infection treatment, the symptoms were improved. Conclusion Lemierre syndrome should be considered in present of jugular vein thrombosis and pulmonary abscess caused by infection.

Objective To investigate the association of red cell distribution width (RDW) with outcome in patients with septic shock.Methods A retrospectively study was performed on a total of 156 cases with septic shock who hospitalized in the Affiliated Hospital of North China University of Science and Technology from January 2012 to December 2014.All cases were divided into two groups according to the outcome:survivor group and non-survivor group.The data of general information,combined disease,RDW,acute physiology and chronic health score(APACHE Ⅱ) were collected and compared between the two groups.All cases were divided into three subgroup in regard of RDW,group A was ≤ 14.0％,group B was 14.1％-15.9％,group C was ＞16.0％.Multiple Logistic regression analysis was performed to analyze the related factor of mortality.ROC analysis was used to test the predictive effect of RDW for the outcome of septic shock.Results Sixty-nine cases died in 156,with a mortality rate of 44.2％(69/156).The RDW in non-survivor group was significantly higher than that of survivor group((15.79±2.64) ％ vs.(12.69±3.09) ％,P＜0.001).Mortality rate in each sub-group were 21.5％ (14/65) in group A,49.0％ (25/51) in group B,75.0％ (30/40) in group C,respectively,and the difference among the three groups was statistically significant (x2 =29.396,P ＜ 0.001).Logistic regression analysis showed RDW was independently associated with mortality of septic shock.In reference with group A,the risk of mortality was 3.504 (95％ CI:1.563-7.858,P =0.002) in group B and 10.924 (95％ CI:4.314 -27.661,P＜0.001) in group C.Conclusion Red cell distribution width is a risk factor of mortality in patients with septic shock.

[ABSTRACT]OBJECTIVETo compare the difference of serum Leptin between obstructive sleep apnea hypopnea syndrome (OSAHS) patients and the control group, to analyze the genotype distribution and allele frequency of Leptin receptor gene Gln223Arg in OSAHS patients. To discuss the relationship between the gene polymorphism and OSAHS susceptibility.METHODSOSAHS group(221 cases) and control group (213 cases) were divided into obese OSAHS group (107 cases), non-obese OSAHS group (114 cases), obese control group (110 patients) and normal control group (103 cases). All participants were tested the level of serum Leptin after monitoring by polysomnography (PSG). The genomic DNA of Leptin receptor gene was extracted and the genotype was analyzed.RESULTSThe level of serum Leptin in non-obese OSAHS patients was 13.59±5.01μg/L and (13.10±1.87)μg/L in obese control patients. They were higher than that in normal control group, but there were no significant difference among them. The level of Leptin in obese OSAHS group was(19.01±3.43)μg/L, that was significantly higher than that in other three groups. Leptin receptor gene Gln223Arg genotype and allele frequency had no significant difference among the 4 groups. But neck circumference of GG genotype patients was greater than that of AA/AG patients.CONCLUSIONThe level of serum Leptin in obese OSAHS patients is significantly higher than that in control group. There is no relations between the gene polymorphism of two sites in Leptin receptor gene Gln223Arg and the onset of OSAHS. But Gln223Arg variation may be involved in regulating the OSAHS patients' neck fat distribution.

Objective To investigate the effects of grape seed proanthocyanidin(GSPE) on mitochondrial injury in hippocampus and learning-memory impairment after obstructive sleep apnea hypoxia in rats.Methods Male SD rats(n=80) were randomly divided into control group,model group,low dose of GSPE treatment group and high dose of GSPE treatment group.Rats in control group were exposed in air,the model group were suffered from intermittent hypoxia conditions (50 ml/L,8-hour-intermittent hypoxia everyday,and the duration of experiment 2 and 6 weeks,respectively).Mitochondrion pathology in hippocampal region was observed using electron microscope;malondialdehyde (MDA) contents and superoxide dismutase activity were detected by colorimetry and apoptotic cells was measured by TUNEL method.The cognitive function of rats in each group was assessed with the Morris water maze (MWM).Results After hypoxia,mitochondrion was significantly injured.The MDA contents were increased(79.86 ± 2.52,88.26 ± 2.86) and SOD level decreased (70.67 ± 6.70,64.26 ± 7.86).The number of neural apoptotic cells was significantly enhanced (9.68 ± 0.79,15.9 ± 2.92).MWM test showed that the escaping latency was prolonged and the frequency of crossing the platform was decreased (P ＜ 0.05).Compared with that in the model group,low dose of GSPE decreased MDA contents (76.38 ± 1.96,82.16 ±2.02),increased SOD level(76.20 ± 6.86,70.58 ± 6.86),and decreased apoptotic cells (6.60 ± 0.69,9.54 ±1.36).MWM test showed that the escaping latency was shortened and the frequency of crossing the platform was increased in GSPE treatment groups(P ＜ 0.05).Compared with low dose of GSPE,high dose of GSPE decreased MDA contents increased SOD level and decreased apoptotic cells.MWM test showed that the escaping latency was shortened and the frequency of crossing the platform was increased (P＜ 0.05).Conclusion GSPE can attenuate mitochondrial injury and improve learning-memory function after obstructive sleep apnea hypoxia.

Objective To assess the efficacy and safety of argon plasma coagulation(APC) in treating patients with Barrett's esophagus.Methods Two reviewers independently searched the Cochrane Library(Issue 2,2008),MEDLINE(January 1948 to November 2008),and CNKI(January 1999 to November 2008),respectively.The quality of the included studies was assessed according to the guidance in the Cochrane Handbook of systematic reviews of interventions.Results Six randomized controlled trials involving 253 patients with Barrett's esophagus met the inclusion criteria and were included.One trial reported that the ablation rate of patients in the APC group was significantly higher than that in the endoscopic surveillance group.Followed up one year,the ablation rate in APC group was 63% compared with 15% in the control group(P

Objective To investigate the risk factors and anticoagulation parameters in patients of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with deep venous thrombosis (DVT). Methods All of 110 AECOPD patients were divided into two groups according to Doppler examination of lower extremities: DVT group and non-DVT group. The risk factors and anticoagulation parameters were compared. Results Twelve cases (10.9%) were in DVT group,of whom 2 cases (1.8%)had pulmonary embolism. The rate of lying in bed > 3 d, smoke, mechanical ventilation, hospital stays and the levels of PaCO2 were significantly higher in DVT group than those in non-DVT group (P < 0.01 or <0.05 ). In DVT group, the activity of antithrombin Ⅲ and the level of protein S decreased (P < 0.05 ), and the level of D-Dimer increased (P < 0.05). Conclusions Long-term bed, smoke and mechanical ventilation requirement are the main risk factors of DVT in patients with AECOPD. Respiratory failure (type Ⅱ ) is easier to combine with DVT. Abnormality of coagulation and fibrinolytic system exists in AECOPD with DVT.