Objective To evaluate the effects of inhaled bronchodilators on dynamic PEEPi in COPD patients.Methods Twenty moderate to severe COPD subjects were divided into three groups.Lung functions,PEEPi,dyn and Borg score were measured at baseline and 30 min after inhaled placebo,and after inhalation of salbutamol 400 ?g(or ipratropium 80 ?g),ipratropium 80 ?g(or salbutamol 400 ?g)in sequence at interval as specified in different groups.Results In comparison with placebo,PEEPi,dyn decreased after inhalied bronchodilators(P

Objective To investigate the methods of recording EMGscm and its significance in monitoring of central drive.Methods Three methods of collecting EMGscm were compared.The subjects were asked to re-breath until the highest PCO2-ET was reached and the EMGscm,Flow,VT(tidal volume),Ttot(Total time of respiratory cycle),and PCO2-ET were measured during the re-breathe.Results (1)The EMGscm did not appeared until the PCO2-ET reached the value of(48.2?2.6)mm Hg.The value of PCO2-EThighest was(81.2?6.6)mm Hg.(2)As the PETCO2 increased,the Ttot became shorter and shorter,from(2.91?0.85)s to(1.92?0.39)s,while the VT became higher and higher,from(0.68?0.27)L to(2.21?0.37)L.There was a statistical relationship between the Ttot(or VT)and the PCO2-ET,and their correlative coefficient was respectively(0.86?0.12)and(0.89?0.13)(both P

Objective: To study La accumulation and microstructure change of leg bones of rats fed with La(NO 3) 3 in low dosage for a long term. Methods: After the rats were fed by La(NO 3) 3 in dosage of 2 mg?kg -1 ?d -1 for 6 months, the contents of La and Ca,P in the leg bones were determined by ICP MS and spectrophotometry; the microstructure changes of the leg bones were investigated by electron microscopy and X ray powder diffraction. Results: In the leg bones of tested rats, the contents of La and P increased greatly, and those of Ca did not change obviously, so that Ca/P ratio values decreased in comparison with the control group. Conclusion: La was accumulatied in the rat leg bones and the change of bone microstructure induced after the rats were fed with La(NO 3) 3 in low dosage for a long term.

OBJECTIVE: To explore clinical characteristics of sinonasal malignant melanoma and curative effect of the combined modality therapy. METHOD: Clinical data of 6 cases with sinonasal malignant melanoma was retrospectively analyzed. All patients received surgery and postoperative radiotherapy. In addition, 3 cases received postoperative chemotherapy which scheme was CDBT and bioimmunotherapy consisted of INF-α and IL-2 after surgery, of which, 2 cases received one cycle of preoperative chemotherapy. RESULT: Six cases were followed up. The survival time ranged from 15 months to 98 months. The average survival time was 62.7 months. Analyzed by direct method, the 1-year, 3-year and 5-year survival rates were 100%, 83% and 67% respectively. Three cases which received the combined modality therapy, of whch, 2 cases received preoperative chemotherapy have survived by now. CONCLUSION The combined modality therapy should be adopted in case of sinonasal malignant melanoma with operation indication. For the patients who can not be operated recently Postbiopsy, it was beneficial to improve the efficacy of therapy that one cycle of preoperative chemotherapy and bioimmunotherapy should be implemented.
Combined Modality Therapy ; Humans ; Interferon-alpha ; therapeutic use ; Interleukin-2 ; therapeutic use ; Melanoma ; pathology ; therapy ; Paranasal Sinus Neoplasms ; pathology ; therapy ; Retrospective Studies ; Skin Neoplasms ; Survival Rate

Objective To investigate the feasibility and efficiency of monitoring noninvasive respiratory effort and respiratory load-capacity ratio in patients undergoing weaning from mechanical ventilation by mean inspiratory pressure(Pi) which were calculated on the basis of the formula, Pi = 5 × P 0.1 × Ti, as well as the noninvasire tension index calculated from Pi(TTIi). Method Totally 12 patients undergoing weaning from mechanical ventilation were enrolled in the study and their underlying diseases included COPD( n = 9), ARDS( n = 2) and status asthmaticus(n = 1) respectively. Esophageal pressure(PesoM) was monitored via the insertion of esophageal balloon and corrected esophageal pressure(Peso) was acquired by subtracting elastic pressure of chest wall from PesoM. P 0.1, Maximal inspiratory pressure on esophageal pressure curve(MIPeso) and on airway pressure curve(MIPaw) was measured with conventional technique. Pi was calculated on Pi = 5 × P 0.1 × Ti. Pi and MIPaw were used to calculate the noninvasive tension-time index TTIi, whereas Peso and MIPeso were used to calculate the invasive counterpart TTIeso. Comparisons, Correlation and Bland-Altman agreement analysis were made between P0.1 and Peso as well as between TIIi and TTIeso. Results There were no significant differences between Pi and Peso as well as between TTIi and TTIeso(P > 0.05) ,and the correlation coefficients were 0.974 and 0.957 respectively. In the agreement analysis, the mean difference between Pi and Peso, and between TTIi and TTIeso were lower than the minimal values of(Peso + PiSB )/2 and of(TIIi + TTIeso)/2, respectively. Conclusions There is a good correlation between Pi and Peso as well as between TTIi and TTIeso, in which Pi is calculated calculated from P 0.1 and in turn the TTIi is calculated from Pi. The noninvasive indices including Pi and TTIi can be used to monitor respiratory effort and respiratory load-capacity in patients undergoing weaning from mechanical ventilation.

Objective To investigate the association between famine exposure in different life cycles and the risk of central obesity. Methods A total of 2234 spermanent residents were recruited to participate in the China Multi-Ethnic Cohort (CMEC) Study ,they were grouped into four birth cohorts of fetal-exposed (born between January 1,1959, and December 31,1961,95 cases), childhood-exposed (born between January 11,949, and December 31,1958,533 cases), adolescence/adult-exposed (born between January 1,1931, and December 31,1948,256 cases),unexposed cohorts（born after January 1, 1975，871 cases).we used logistic regression model to assess the effect of famine exposure on central obesity in adulthood. Results After adjusting for confounding factors, females in the fetal/infant exposure group（OR=3.283,95%CI：1.472～7.321,P＜0.001）、childhood- exposed group (OR=3.557,95%CI：2.374～5.313,P＜0.001) and adolescence/adult-exposed group (OR=5.785，95%CI：3.536～9.492，P＜0.001) had a higher risk of adult central obesity than the control group.After excluding the subjects with coronary heart disease、cancer、diabetes、stroke or obesity, sensitivity analysis was carried out. The risk of central obesity increased in the female / fetal、childhood、adolescent / adult exposure group,which was unfound in males. Conclusion Severe famine exposure in fetal/infant、childhood and adolescence/adulthood can increase the risk of central obesity in adulthood in females. Therefore, the prevention and control of central obesity in female should start from the early life.

AIM: To investigate the application of phrenic nerve conduction time(PNCT) in the recovery of general anaesthesia. METHODS: Pdi (t) and PNCT were measured by cervical magnetic stimulation of phrenic nerves in 8 patients before and after the administration of muscle relaxant. RESULTS: Pdi (t) was reduced from (23.7?2.4) cmH 2O to (11.5?3.4) cmH 2O (reduction rate: 51.5%, P

Objective To evaluate effects of interleukin-36α (IL-36α) on psoriasiform skin lesions and C-C motif chemokine ligand 20 (CCL20) expression in mice.Methods Totally,30 BALB/c female mice were randomly and equally divided into 3 groups:control group treated with topical vaseline cream on the shaved back and intracutaneous injection with phosphate buffer saline (PBS),model group treated with topical imiquimod cream on the shaved back and intracutaneous injection with PBS,experimental group treated with topical imiquimod cream on the shaved back and intracutaneous injection with IL-36α solution.Psoriasis area severity index (PASI) was used to evaluate changes of psoriasiform skin lesions in mice,and light microscopy to observe morphological changes of skin lesions and to measure the thickness of the epidermis.Real-time fluorescence-based quantitative PCR (qRT-PCR) and Western blot analysis were performed to determine the expression of IL-36α in skin lesions in the control group and model group,and qRT-PCR,Western blot analysis and immunohistochemical study to evaluate changes of CCL20 levels in skin lesions.Results The model group showed significantly increased mRNA (△ Ct value:0.0195 ± 0.0059) and protein expression (3.922 ± 0.248) of IL-36α compared with the control group (mRNA:0.0012 ± 0.0004,P ＜ 0.05;protein:0.690 ± 0.025,P ＜ 0.05).The mRNA and protein expression of CCL20 were significantly higher in the experimental group than those in the model group (mRNA:2.152 ± 0.793 vs.0.999 ± 0.178;protein:0.397 ± 0.033 vs.0.145 ± 0.030;both P ＜ 0.05),and higher in the model group than those in the control group (mRNA:0.378 ± 0.075;protein:0.025 ± 0.009;both P ＜ 0.05).Immunohistochemical study showed that the expression intensity of CCL20 in skin lesions significantly increased in the experimental group compared with that in the model group (Z =2.294,P ＜ 0.05).Conclusion IL-36α may aggravate psoriasiform skin inflammation in mice by promoting CCL20 expression.

Objective To analyze the feasibility of body surface electrodes instead of multipair esophageal electrodes for the evaluation of neural respiratory drive in patients with COPD. Methods Diaphragm electromyo-gram(EMG)from body surface electrodes and multipair esophageal electrodes,was recorded in 29 patients with stable COPD recruited from outpatient clinic. Changes of neural respiratory drive of two kinds of electrodes during resting and maximal isocapnic ventilation (MIV) were observed before and after inhalation of bronchodilators. Results Ventilation significantly improved ,RMS-sur and RMS-eso significantly decreased after the inhalation of bronchodilators during resting and MIV. RMS-sur and RMS-eso were significantly correlated(r=0.660,P<0.01). Conclusion EMG from the surface electrodes may be a useful and noninvasive technique to evaluate neural respi-ratory drive in patients with COPD.

Objective To explore the efficacy of noninvasive positive pressure ventilation technology com-bined with respiratory stimulant in the treatment of pulmonary encephalopathy in patients with COPD.Methods For-ty -eight COPD patients with early pulmonary encephalopathy were included.They were randomly divided into the treatment group and control group.The treatment group was treated by not only regular treatment and noninvasive posi-tive pressure ventilation technology,but also respiratory stimulant.The control group was only treated by regular treat-ment and noninvasive positive pressure ventilation technology.The indexes were recorded,including tracheal intubation rate,clinical recovery rate,mortality,Glasgow coma score,arterial blood gas analysis and adverse reactions.Results Compared with the control group,the arterial blood gas analysis of treatment group on the 2h,24h and 72h were statis-tically significant different(P <0.05).The GCS score on the 24h and 72h were also statistically significant different [24h,(13.4 ±1.6)vs.(11.8 ±2.1),P <0.05;72h,(14.6 ±1.5)vs.(12.4 ±2.4),P <0.05].The treatment group had lower tracheal intubation rate(12% vs.56.5%,P =0.001),shorter consciousness recovery time[(3.0 ± 0.5)h vs.(5.6 ±0.7)h,P =0.023],shorter hospitalization time in ICU[(12.6 ±1.5)d vs.(19.2 ±1.8)d,P =0.004]and better clinical recovery(22 /25 vs.10 /23,P =0.001)than the control group.But the mortality rate had no significant difference between the two groups(1 /25 vs.4 /23,P =0.129).Conclusion NIPPV combined with respiratory stimulant is an effective,safe and simple method for treatment of COPD complicated with pulmonary encephalopathy.It can significantly improve the clinical symptoms and the index of arterial blood gas analysis,and it can shorten consciousness recovery time and decrease tracheal intubation rate.But close observation must be carried out,and the invasive mechanical ventilation should be promptly executed in case of emergency or exacerbation.