Objectives To investigate the incidence rate of asthma and chronic obstructive pulmonary disease (COPD) overlap syndrome(ACOS)in elderly male patients with stable COPD by following-up,and to explore the characteristics and clinical significance of pulmonary function for ACOS.Methods According to GOLD and Spain's guidelines for the diagnosis and treatment of COPD,we screened ACOS patients in 299 elderly male patients with stable COPD by following up in Beijing Hospital between 2003 and 2014.All patients were divided into 2 groups of 51 ACOS patients and 248 non-ACOS patients with COPD.All patients underwent pulmonary function tests and bronchial dilation test in the stable condition.The differences in pulmonary functions were compared between stable ACOS patients and non-ACOS patients with COPD.Results Among 299 elderly male patients with stable COPD,ACOS patients accounted for 17.1 ％ (51/299).Compared with nonACOS patients with stable COPD,ACOS patients had significantly lower baseline values in forced expiratory volume in 1 seconds(FEV1) [(61.0 ± 14.5) ％ pred vs.(74.4 ± 20.0) ％ pred],in forced expiratory volume in 3 seconds(FEV3) [(71.6± 14.3)％ pred vs.(82.7± 19.6)％ pred]and in forced vital capacity(FVC) [(84.6 ± 16.4)％ pred vs.(93.8 ± 20.6)％ pred],and also had significantly higher values in residual volume(RV)[(139.4±55.8)％ pred vs.(118.8±46.6)％ pred]and in RV/total lung capacity(TLC) [(52.7±10.7)％ pred vs.(48.1±10.9)％ pred],all P＜0.05.After bronchodilation test,there was no significant difference in FEV1,FEV3 and FVC between the two groups(all P＞0.05).Patients with stable ACOS had lower value in forced expiratory flow rat (FEF25％±75％)than those with non-ACOS in baseline [FEF25％-75％ ％ pred(26.8± 11.5) ％ vs.(36.1 ±17.5) ％ (P＜0.05)],and the improvement of small airway function was significantly better in ACOS patients than in non-ACOS patients after bronchodilation test (P＜0.05).Conclusions ACOS is very common in the elderly patients with COPD,stable ACOS patients have lower time vital capacity as compared with non-ACOS patients with stable COPD.But after bronchodilation test,the two groups have similar ventilation function,and the small airway function in ACOS patients improves more significantly.The ACOS patients have unique characteristics of pulmonary functions and suitable treatment may improve the prognosis.

Objective To observe the clinical efficacy of ZHU Lian's acupuncture activating method with type 1 manipulations in treating hypotonic cerebral palsy.Method Sixty patients with hypotonic cerebral palsy, aged 9-59 months, were randomized into a treatment group and a control group, 30 cases in each group. The treatment group was intervened by ZHU Lian's acupuncture activating method with type 1 manipulations, while the control group was intervened by acupoint injection of vitamin B1 and B12. The two groups were treated once a day, 5 sessions as a treatment course. The Gross Motor Function Measure-88 (GMFM-88) was evaluated before the treatment and after 10 treatment courses.Result The GMFM-88 score was significantly changed after the treatment in both groups (P<0.05). After the intervention, the GMFM-88 score in the treatment group was significantly different from that in the control group (P<0.05).Conclusion ZHU Lian's acupuncture activating method is an effective approach in treating hypotonic cerebral palsy.

Objective To evaluate the feasibility of intra-utero fetal lamb surgical repair. Methods Six twin lambs underwent surgery intra-utero at 112 days of gestation (term 140～160 days). After maternal laparotomy and Hysterotomy, fetal lamb′s toe was excised or its cleft lip was repaired in one of twin. Results At 30 to 32 days post operation,five lambs were spontamcously delivered and the other was cesarean delivery to full term gestation. Fetal wounds healed without inflammation and scar formation. Conclusions The methods of fetal lamb intro utero surgical repair is feasible.

Objective To analyze the effects of fetal anoxia, respiratory and metabolic acidosis on the activity of antioxidation in fetal distress Methods Blood samples were taken from umbilical artery in 386 neonates for blood gas analysis and detection of the concentration of superoxide dismutase (SOD) Normal situation, anoxia, acidosis, respiratory acidosis, metabolic acidosis and mixed acidosis were diagnosed in all neonates according to the results of blood gas values, and the neonate asphyxia was diagnosed according to the Apgar scores (one minute) The effect of anoxia and acidosis to SOD were analyzed with multiple factor analysis of variation Results (1) Among the all 386 cases, 317 were normal, 31 with anoxia, 17 with acidosis, and 21 with both anoxia and acidosis Among the total cases of acidosis, 8 respiratory, 21 metabolic, and 9 mixed acidosis (2) The plasma levels of SOD of umbilical artery blood in anoxia, acidosis, both anoxia and acidosis, and normal sitution were (118 5?7 1) mmol/L, (122 0?11 4) mmol/L,(140 0?7 0)mmol/L, and (98 5? 2 6) mmol/L,respectively The results of unvariate analysis of variance showed that anoxia: F =4 999 ( P 0 05) (3) The plasma levels of SOD with respiratory acidosis, metabolic acidosis and mixed acidosis were (127 3?18 4) mmol/L, (126 0?8 1) mmol/L, (150 0?10 4) mmol/L The results of univariate analysis of variance showed that respiratory acidosis: F =4 404 ( P 0 05) Conclusion The superoxidation and antioxidation can be effected by factors like anoxia and acidosis, respiratory acidosis and metabolic acidosis However, the mechanisms of these effects are different. There is additive, but not synergistic effects among them

Objective To explore the characteristics of clinical features,diagnosis,treatment and prognosis in acute fibrinous and organizing pneumonia (AFOP) patients.Methods We described an 80-year-old woman who was diagnosed with AFOP and got better after treatment with glucocorticoids.Clinical data of 51 patients which have been published in literatures in China and abroad were retrospectively analyzed.The differences in characteristics of clinical features were compared between the elderly and non-elderly patients.Results The case reported herein,who was a 80-year-old female with latent autoimmune diabetes in adults (LADA),presented with fever,dry cough and progressive dyspnea.Chest CT scan showed bilateral multiple patchy consolidation.CT-guided needle aspiration was performed and the pathological examination finding was consistent with AFOP.The patient was treated with oral methylprednisolone and experienced a significant improvement in symptoms and imaging manifestations.But she presented with deterioration with relapsing clinical symptoms when she discontinued corticosteroid treatment by herself,and the clinical symptoms were improved by retreatment.Clinical data of 51 reported cases with AFOP including 27 males and 24 females aged 38 d to 80 years were enrolled and analyzed in the study.Patients aged 60 years and over accounted for 47.1％ (24 cases).No risk or predisposing factor was found in most of cases.Autoimmune diseases were the most common combined diseases in AFOP patients.The top three symptoms were dyspnea (80.4％,41 cases),cough (64.7％,33 cases) and fever (52.9％,27 cases).The incidence of dyspnea was lower in elderly patients than in non-elderly patients [66.7％ (16/24) vs.92.6％ (25/27),P＜0.05],and ground glass opacity in the chest image was also less in elderly patients than in non-elderly patients (P＜0.05).15 patients (29.4％) got definitive diagnosis by minimally invasive procedures including percutaneous lung puncture biopsy or transbronchial lung biopsy.Corticosteroids were the main drug treatment,and 39 cases (76.5 ％) received antibacterial drugs.The mortality rate of AFOP was 37.3％ (15 cases).The average time from symptom onset to final diagnosis was shorter in dead cases than in recovered patients (19 days vs.40 days,P＜0.05).The rate of using mechanical ventilation was higher in dead cases than in recovered patients [57.9 ％ (11/19) vs.9.4％ (3/32),P＜0.05].Conclusions There are no specific clinical and imaging features in AFOP,which is easily misdiagnosed as infectious diseases.AFOP is more common in elderly patients.Dyspnea and other symptoms can easily be ignored,and minimally invasive biopsy and pathological examination findings is helpful for diagnosis.The mortality rate of AFOP is high,and insufficient course of therapy is associated with the increased risk of AFOP relapse.Rapid progression of disease and the invasive mechanical ventilation predispose poor outcomes.

Objective To investigate the effect of Cordyceps sinensis on renal fibrosis and its possible mechanism.Methods Thirty Sprague-Dawley rats were randomly divided into three groups:Sham operation group (Sham,n =10),5/6 subtotal uephrectomy group (SNx,n =10),and 5/6subtotal nephrectomy treated with Cordyceps sinensis group (CS,n =10).Body weights were assessed and 24-hour urine excretion was collected before and every four weeks after surgery.Rats were sacrificed at 12 weeks after surgery.Blood samples were taken for biochemical study,and kidney tissues were used for HE and Masson stains to assess histological changes.Immunohistochemical staining was used to detect the expression of transforming growth factor β1 (TGF-β1) and its receptors of type Ⅰ (TβR Ⅰ),type Ⅱ (TβR Ⅱ).Immunofluorescence was used to detect E-cadherin and α-SMA.The relative protein level of TGF-β1,TβR Ⅰ,TβR Ⅱ,p-Smad2/3,Smad7,E-cadherin,α-SMA were examined by Western blotting.Results CS group had higher body weights and lower urinary protein,BUN and Scr level compared with SNx group.Glomerulosclerosis index and tubulointerstitial injury score were significantly reduced in CS group compared with those in SNx group (all P ＜ 0.05).The protein expressions of TGF-β1,TβR Ⅰ,TβR Ⅱ,p-Smad2/3 were decreased in CS group compared with those in SNx group (all P ＜ 0.05).CS treatment up-regulated the expression of E-cadherin,Smad7 and down-regulated the expression of α-SMA compared with that in SNx group (all P ＜ 0.05).Conclusion Cordyceps sinensis has inhibitory effect on renal fibrosis in 5/6 subtotal nephrectomy rat model,which might be related with the suppression of TGF-β 1 signal pathway.

Objective:To illuminate the influence of InsB15-23 H-2Kd dtSCT to the morbidity of type 1 diabetes mellitus in NOD mice.Methods:An eukaryotic plasmid encoded membrane-expressed InsB15-23 H-2Kd dtSCT was inoculated into 3 weeks old female NOD mice subcutaneously and the blood sugar and morbidity of type 1 diabetes mellitus were monitored once a week.To illuminate the cellular mechanism of immunologic intervention of membrane-expressed InsB15-23 H-2Kd dtSCT to the course of type 1 diabetes mellitus in NOD mice,the mononuclear cell infiltration of islets was detected by tissue slice and the frequency of IGRP206 2-14 specific CTLs in PBMC was analyzed by FACs.Results: As compared with pcDNA3.1 (-) control ( 60%) and untreated NOD mice ( 80%) , mice immunized with InsB15-23 H-2Kd dtSCT exhibited low level of islet infiltration and low morbidity in 30 weeks old ( 9%) .But the frequency of IGRP206-214 specific CTLs in PBMC of 16 and 40 weeks old mice showed no difference.Conclusion:Membrane-expressed InsB15-23 H-2Kd dtSCT can protect NOD mice from type 1 diabetes mellitus in IGRP206-214 independent pattern.

ObjectiveTo quantitative evaluate the alterations of cardiac morphology and function in gestational impaired glucose tolerance(GIGT) fetuses.MethodsFetal echocardiograms were performed on 68 GIGT fetuses with gestation age between 21 ～ 40 weeks for evaluation of cardiac morphology and function.Fetal cardiac morphology,systolic and diastolic functions of 68 GIGT fetuses were compared with 81 control group fetuses using conventional two-dimensional,M-mode,pulsed Doppler echocardiography and myocardial tissue Doppler imaging.ResultsComprehensive fetal echocardiography data analysis showed no significant differences in cardiac morphology and function between two groups (P＞0.05).Conclusions The alterations of cardiac morphology and function in GIGT fetuses can be accurately and objectively evaluated using quantitative evaluation in fetal echocardiography and will help to offer consultation.

Objective Metabonomics method based gas chromatography-mass spectrometry (GC/MS)were used to analyze the urine samples of patients with hyperlipidemic pancreatitis (HLP) to describe the characteristics of metabolism changes of HLP,identify potential biomarkers,and investigate the role of metabonomics study in the management of AP.Methods 24 patients of HLP and 40 age,sex matched volunteers were enrolled and their urine samples were collected.The urine samples underwent preparation,derivation and GC/MS analysis,Orthogonal-Projection to Latent Structures-Discriminant Analysis (OPLS-DA)were performed to detect the metabolic profile difference between the HLP and control group.Results HLP patients can be precisely distinguished from healthy controls.21 metabolites (credibility ＞ 700 ) were identified using the reference compounds available in the libraries of NIST and Wiley.It was identified that levels of nicotinic acid,aconitie acid,citric acid,hippurie acid,hydroxyphenylacetic acid,hydroxyphenylpropionicacid were decreased,while the levels of tryptophan,tyrosine,tyramine,16-hexadecanoic acid,18octadecanoie acid were increased.It was also suggested that there was change in tricarboxylic acid cycle and gut bacterial flora,as well as fat metabolism and metabolism of amino acid.Conclusions There are differences between healthy controls and HLP patients in the term of GC/MS metabolic profiling,and the biomarkers in the metabolites could be found through metabonomics analysis,and the mechanisms of the metabolic changes could be explored.It was noted that the research of metabolites in the urine samples may be a useful tool to help diagnose and understand the pathogenesis of HLP.Metabonomics analysis is a promising research method.

Objective To find an ideal animal model of acute respiratory distress syndrome (ARDS) through investigating the characteristics of three two-hit animal models of ARDS.Methods Forty-eight SD rats were randomly divided into 4 groups: Control group [2.5 mL/kg normal saline (NS) i.v.given at 0 min and 30 min];OA+OA group [0.5 mL/kg oleic acid (OA) i.v.given at 0 min and 30 min];LPS+LPS group [2.5 mg/kg lipopolysaccharide (LPS) i.v.given at 0 min and 30 min];and OA+LPS group [0.5 mL/kg OA i.v.given at 0 min and 2.5 mg/kg LPS,i.v.given at 30 min].The samples were collected at 5 h after the second drug injection.White blood cells count (WBC),polymorphonuclear leukocyte ratio (PMN%),total protein concentration,tumor necrosis factor α (TNF-α) level in bronchoalveolar lavage fluid (BALF),arterial blood gas analysis and lung wet-dry weight ratio (W/D) were measured,respectively.Pathological changes in the lung tissues were observed and histological scores were evaluated.Results Compared with those in the control group,PaCO2,WBC,PMN%,total protein concentration and TNF-α levels in BALF were significantly increased,while PaO2 was dramatically decreased (P<0.01) in the OA+OA,LPS+LPS and OA+LPS groups.The levels of protein concentration in BALF and lung W/D ratio in the OA+LPS group were significantly higher than these in the LPS+LPS group (P<0.05 for all),but had no statistically significant difference compared with these in the OA+OA group.The levels of WBC,PMN% and TNF-α in BALF in the OA+LPS group were significantly higher than those in the OA+OA group (P<0.05),but not significantly different from those in the LPS+LPS group.The most typical pathological changes and the highest pathological scores were found in the OA+LPS group.Conclusions All the three different methods including OA+OA,LPS+LPS,and OA+LPS can be used to establish “two-hit” animal models of acute respiratory distress syndrome.The “two-hit” animal model of acute respiratory distress syndrome induced by OA+LPS is more closer to clinical ARDS and is useful for studies on the pathophysiology of ARDS,and is an ideal “two-hit” animal model of ARDS.