Airway Remodeling ; drug effects ; Cholinergic Antagonists ; therapeutic use ; Humans ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; immunology ; metabolism ; Scopolamine Derivatives ; therapeutic use ; Tiotropium Bromide

BACKGROUND: The rare earth elements (Res) have multiple bio-activities and some extent neurotoxicity, Because of their distinct physical and chemical properties. The studies on neuromuscular junction and sympathet ic ganglia have shown that some Res, such as lanthanum(La), gadolinium (Gd),etc, exert considerable effects on synaptic transmission, but the effects and mechanism of Samarium on synaptic transmission are still unknown.OBJECTIVE: To investigate the effects and impossible mechanism of Samarium Chloride (SmCl3) on the nicotinic transmission in the isolated sympathetic ganglia, superior cervical ganglion (SCG) of rats.DESIGN: Controlled experimental study based on cells.SETTING: Department of Pharmacology, Guangxi Medical University. MATERIALS: Totally 40 adult Wistar rats (weighing 250-300 g) of either sex, provided by the Experimental Animal Center of Guangxi Medical University, were used in this study. SmCl3 was made by the chlorination of Samarium Oxide with purity 99.5% and relative molecule mass 348.7, presented by Professor Liu Da-yuan, Guangxi Medical University. Acetylcholine chloride (Ach) and carbachol (Carb) were purchased from Sigma.METHODS: The experiment was completed at the neuropharmacology lab of the experimental center of Guangxi Medical University from September 2001 to December 2002. After sacrificing animals by acute exsanguination,SCG together with their preganglionic nerve trunks were isolated rapidly,then transferred to the recording chamber, the preganglionic nerve trunk was drawn into a suction electrode for orthodromic stimulation. The ganglia were superfused continuously with a Krebs solution, saturated with 950 mL/L 02 and 5mL/L CO2, pH 7.4±0.05, (34±0.5) ℃.The fiber containing glass microelectrodes filled with 3 mol/L KC1 (30-60 MΩ tip resistance) were used to impaled cells and do intracellular recording. The fast excitatory postsynaptic potentials (FEPSPs) were evoked in SCG neurons by single pulse stimulations (0.2-0.5 Hz, 0.5-1.0 ms, 2-10 V)on preganglionic nerve trunk. The remarkable membrane depolarization would be recorded in SCG neurons by superfusing ganglia with exogenous Ach (0.1 mmol/L) or Carb(0.1 mmol/L) for 30-60 s. The effects of 1×(10-7-10-4) mol/L SmCl3 on FEPSPs, membrane potentials, membrane resistance, exogenous Ach and Carb-induced membrane depolarization of SCG neurons were investigated in this experiment.The effects of SmCl3 on the facilitation of high Ca2+ (10 mmol/L ) on FEPSPs were also be observed, namely, first superfusing the ganglia with high Ca2+ (10 mmol/L)to facilitate FEPSPs, then superfusing the ganglia with Ca2+(10 mmol/L)contained SmCl3. All the drugs were solved in Krebs solution or improved Krebs solution and applied to ganglia by superfusion in known concentration.The bioelectricity difference before and after the drug superfusion were analyzed by paired Student's t test.MAIN OUTCOME MESURES: ①Effects of SmCl3 on FEPSPs.②Effects of SmCl3 on membrane potentials and membrane resistances. ③Effects of SmCl3 on exogenous Ach and Carb-induced membrane depolarization. ④Effects of SmCl3 on the facilitation of high Ca2+ (10 mmol/L ) on FEPSPs.RESULTS: ① 1 ×(10-7-10-4)mol/L SmCl3 could reversibly depressed the FEPSPs of rats SCG neurons [the amplitude inhibitory percentage of FEPSPs of l×10-4, 1×10-5, 1×10-6, 1×107 mol/L SmCl3 was (49.78±13.85)%(n=20),(39.05±4.05)%(n=10),(29.83±9.73)%(n=10)and (16.30±2.16)%(n=10)respectively (P ＜ 0.05-0.01)].1×10-4 mol/L SmCl3 could chang Aps into FEPSPs (n=5).②The membrane depolarization induced by Ach (n=5) and Carb (n=7) were not significantly changed by 1×10-4 mol/L SmCl3(P ＞ 0.05).③The membrane potential and membrane resistance were not significantly altered by 1×(10-7-10-4)mol/L SmCl3(n=67), P ＞ 0.05. ④1×10-4 mol/L SmCl3 could antagonized the facilitation of high Ca2+ (10 mmol/L ) on FEPSPs (n=5), P ＜ 0.01.CONCLUSION: SmCl3 can depresses nicotinic transmission in rats sympathetic ganglia by presynaptic mechanisms, perhaps due to its inhibition on Ca2+ influx.

Objective To study the clinical and MRI features of central pontine myelinolysis(CPM).Methods The MRI findings of 11 cases with central pontine myelinolysis verified by clinic and imagings were analyzed.Results There were history of drink wine long term in 7 cases,undernourishment in 4 cases,low-blood-sodium in 10 cases.Long T 1 and T 2 signal intensity was showed on MR in central pontine,focus presented under cortex cerebri and in nucleus basalis area in 4 cases.3 cases enhanced around focus,2 cases enhanced in center and 4 cases no enhanced on postcontrast MRI.Conclusion There are characteristic MRI features in central pontine myelinolysis,it is not difficult to diagnoses CPM in early stage if its clinical manifestations and testing treatment with hormone is associated with MRI features.

Adult ; Diagnostic Errors ; Humans ; Leprosy, Lepromatous ; diagnosis ; Male ; Sinusitis ; diagnosis

Objective To evaluate the clinical efficacy, impacts on lung function and cytokines, and safety of azithromycin on the treatment for asthma. Methods Forty patients with asthma were randomized equally to receive azithromycin combined with inhaled cortisteroid (ICS) plus long-acting β_2-agonists (LABA), or only ICS plus LABA for 12 weeks. We evaluated the clinical efficacy including asthma control test scores and lung function, cytokines in induced-sputum including interleukin-4, interleukin-5 and interferon-γ, and the safety of azithromycin. Results After 12 weeks, asthma control test (ACT) scores and lung function were improved obviously, and concentrations of IL-4, IL-5 and IFN-γ in induced-sputum were reduced significantly in both groups. Comparing with the control group, the decline of cytokines in induced-sputum was much more significant in patients treated with azithromycin. No severe adverse events were found in both groups. Conclusions Azithromycin combined with ICS plus LABA is an effective and safe treatment for asthma, which could significantly reduce the level of cytokines elaborated from Th2-type cells in the airways.

Objective To evaluate the clinical application value of a new type of Bard Max-Core coaxial biopsy system and com-pare the effectiveness and safety of different diameter biopsy guns.Methods This retrospective study included 286 patients who re-ceived CT-guided percutaneous lung biopsy using Bard MC disposable biopsy system.We divided patients into three groups:1 6G, 18G,and 20G group.Then,we evaluated the biopsy effectiveness,histological diagnosis rate and complication incidence of this new type of Bard Max-Core coaxial biopsy system.Results All lung biopsy specimens were successfully obtained.The total histological diagnosis rate was 80.8%.Patients with malignant lesions had higher histological diagnosis rate than patients with benign lesions. The histological diagnosis rate in 1 6G group was the highest among three groups.There was no significant difference among three groups regarding to the rate of diagnosis of malignant lesions.Group with 1 6G had the highest histological diagnosis rate among three groups in diagnosing begin lesions.The incidences of pneumothorax in three groups had no significant difference.The incidence of bleeding in 1 6G group was the highest among three groups.Conclusion The new Bard MC disposable coaxial biopsy system is a safe and effective instrument for lung biopsy.We should select the biopsy needles with appropriate diameter according to the fully as-sessment of patients'preoperative conditions.

Objective To analyze the MR signs of primary subdural extramedullary tumors so as to improve the correct diagnostic rate.Methods MR signs of 40 cases with primary neoplasms of extramedullary were studied retrospectively.All cases were verified by surgery. Results Neurinoma,neurofibroma,meningioma,lipoma and teratoman had specific MR features in location,size,shape,edge,signal and enhancement change. Conclusion Primary subdural extramedullary tumors can be correctly diagnosised.

Objective To analyse MRI findings of multicentric craniopharyngioma and improve knowledge to it. Methods MRI and Gd-DTPA enhanced SE T 1WI scaning were performed in 4 cases of multicentric craniopharyngioma proved by surgery and pathology before operation, PDWI scaning were performed in 2 cases.Results MRI manifestations of multicentric Craniopharyngioma is the tumors of Parenchymal -predominant mixed in the sella turcica region or Suprasellar region as the center focus in 4 cases, and different cystic focus were also found in the di-temporal lobe,the basis of anterior cranium fossa,the anterior part of third ventricle,the pontine cistern, the caudate nucleus.Cystic-Parenchymal focus has low-iso mixed signal on T 1WI and high-low mixed signal on T 2WI;cystic focus of the tumors had different signal,signal ranges form low up to high on T 1WI,while high signal on T 2WI and from iso-signal to high on PDWI. After Gd-DTPA enhanced,annular wall enhancement were seen on cystic focus,Parenchymal focus appeared as uniform enhancement.Conclusion The multicentric craniopharyngioma growth performance is multi-origination growth with the sella turcica region or suprasellar region center, the MRI signal specialty of craniopharyngioma is related to ratio of cystic-consolidated and the contents of the cystic fluid.

Objective To study the CT and MRI features of meningiomas at special locations.Methods CT and MRI findings of meningiomas at special locations (lateral ventricle,diaphragma sellae,frontal sinus) in 11 cases confirmed by pathology were analyzed retrospectively.8 patients were evaluated with MRI,3 patients were evaluated with CT.Results 11 cases were all singular lesion.The lesions were at lateral ventricle in 4, at diaphragma sellae in 4,at frontal sinus in 3.Of total 11 cases,8 cases showed isointensity or slight hypointensity signal on T 1WI ,tumors had isointensity or slight hyperintensity signal or slight hypointensity signal on T 2WI,homogeneous or inhomogeneous enhancement were found on Gd-DTPA enhanced MRI scanning.3 cases were showed homogeneous density or slight highly density on plain CT scanning.Pathological diagnosis was as follows:fibroblastic type in 4,angioblastic type in 3,syncytial type in 1,psammomatous type in 3.There were 9 cases were misdiagnosed before operation.Conclusion It is a fact that improving the imaging correct diagnostic rate of meningioma at special locations will play an important role in deciding correct operative route of entry and increasing cure rate.

Objective: To compare the difference of self-concept between children of complete and divorced family. Methods: 42 subjects in divorced family and 45 controls were tested by Piers-Harris Self-concept Scale for Children. Rusults: The students in divorced family reported significantly lower scores on self-concept than the controls on behavior,anxiety, gregariousness, satisfaction and total score. Conclusion: The self-concept of divorced family students is lower than that of the control group.