Objective To investigate the efficacy and adverse effects of methotrexate(MTX) in the treatment of steroid-dependent asthma.Methods By a randomized, double-blind scheme,50 patients with steroid dependent asthma were divided into two group:MTX group and placebo group:MTX(15mg?week -1 ) and placebo agent were given respectively for 12 weeks.The dose of oral steroid daily,symptom scores, peak flow rates, spirometry, ?-agonist frequency were monitored before and after treatment. During the treatment,frequency of asthma attack,adverse events of MTX were noted,and blood routine examination,liver function test,kidney function test were performed.Results 45 subjects completed the study. Compared with before treatment,the MTX significantly decreased daily steroid dosage(14 38?4 90mg?d -1 versus 10 63?5 77mg?d -1 ,P0 05).No serious adverse effects of MTX were found during the study.Conclusion We consider that low-dose MTX may be beneficial for steroid-dependent asthma and that this therapy is well tolerated by patients.

Objective To determine the effect of tea polyphenols on oxidative damage and (apoptosis) in human bronchial epithelial cells induced by low-dose cigarette smoke condensate (CSC).Methods We prepared CSC. 3-(4,5-dimethyl thiazoly) 2,5-diphenyl-tetrazoliun bromide (MTT) assay was used to determine the growth of cultured human bronchial epithelial cells (HBE135-E6E7). Fluorescent-chemiluminescent analyzer was used to measure cell reactive oxygen species (ROS) level. DNA ladder method was used to detect HBE135-E6E7 apoptosis. Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect Bcl-2 and Bax mRNA expression.Results Concentration of intracellular ROS in the CSC group and CSC + TP group was significantly higher than that in the control group (P＜0.01); concentration of intracellular ROS in the CSC + TP group was significantly lower than that in the CSC group (P＜0.01). Apparent DNA breakage of the tail belt appeared in the CSC Group,while only a small amount of DNA breakage of the tail belt appeared in the CSC + TP group. Compared with the control group, Bcl-2 mRNA expression was reduced and Bax mRNA expression was increased in the CSC group (all P＜0.01). Compared with the CSC group, Bcl-2 mRNA expression was increased and Bax mRNA expression was reduced in the CSC+TP group (all P＜0.01). Ratio of Bcl-2 mRNA/ Bax mRNA in the CSC group and CSC+TP group was significantly lower than that in the control group (all P＜0.01).Conclusion TP can antagonize CSC-induced airway epithelial cell apoptosis through the effective removal of ROS, promoting Bcl-2 mRNA expression and inhibiting the expression of Bax mRNA.

Objective To determine the effect of combination of chest physiotherapy (CPT) and intermittent non-invasive ventilation for chronic obstructive pulmonary disease (COPD) patients with respiratory failure. Methods Ninety COPD patients with intermittent bi-level positive airway pressure (BiPAP) ventilation were randomly divided into 2 groups : control group (n=45) received BiPAP treatment after conventional anti-infection, phlegm treatment and support treatment; CPT group (n=45) received CPT before BiPAP treatment. Clinical symptoms, chest signs, chest X-ray, time of BiPAP therapy, PaO2, and PaCO2 after the treatment were evaluated. Results Compared with with the control group, patients in the CPT group significantly improved in clinical symptoms, chest signs, chest X-ray absorption as well as shorter BiPAP therapy time, PaO2 increase and PaCO2 decrease(P<0.05). Conclusion For COPD patients who need intermittent non-invasive BiPAP ventilation, receiving CPT can effectively improve the therapeutic effect. CPT and intermittent non in-vasive BiPAP ventilation cooperate in the treatment of COPD patients with respirstory failure.

Objective To observe the change of peripheral blood Th17 cells and relationship between the severity and Th17 cells in patients with acute asthma.Methods We recruited patients with mild acute asthma(n=10) and severe acute asthma(n=10), and healthy volunteers(n=10). T-lymphocytes were collected from the peripheral blood mononuclear cells (PBMC). Flow cytometer (FCM) was used to detect the expression of peripheral blood Th17 cells. IL-17 levels in the peripheral blood were measured by enzyme-linked immunosorbentassay (ELISA).Results The rate of positive Th17 cells of peripheral blood in the severe acute asthma group was higher than that in the mild acute asthma group(P＜0.05) and the rate of positive Th17 cells of peripheral blood in healthy volunteer group were the lowest among all groups (P＜0.05, respectively). The level of IL-17 in the peripheral blood of patients with severe acute asthma increased significantly compared with that in patients with mild acute asthma and healthy volunteers (P＜0.05). The positive Th17 cells of peripheral blood in patients with acute asthma were positively correlated with the severity of acute asthma(r=0.869, P＜0.05).Conclusion The positive rate of Th17 cells in the peripheral blood increases in patients with acute asthma and has positive correlation with the severity of acute asthma.

Objective:To explore the effect of calcium release-activated calcium channel modulator 1 (ORAI1) on the migration and invasion of colon cancer cell line SW480 and its mechanism. Methods:The SW480 cells were infected with ORAI interference lentivirus. The expression of ORAI1 mRNA and protein was confirmed by quantitative real-time polymerase chain reaction and Western blot. Transwell chamber, adhesion, angiogenesis, and vasculogenic mimicry experiments were conducted to detect the ability of cell invasion, migration, and angiogenesis and the intercellular adhesion of homogeneous and heterogeneous cells among each group. Confocal microscopy was employed to detect the difference of store-operated Ca2+entry (SOCE) in each group. Western blott was used to detect the expression of ERK1/2, p-ERK1/2, MMP-2, VEGF, and E-cadherin protein. Results:After the infection of SW480 with the ORAI1 interference lentivirus for 72 h, significant fluorescence expression was observed. Compared with the empty vector group and control group, the expression of ORAI1 was lower in the interference group (P<0.01). Invasion and migration ability decreased (P<0.01); the intercellular adhesion ability of homogeneous cells increased (P<0.05); the intercellular adhesion ability of heterogeneous cells decreased (P<0.05);the angiogenesi and vasculogenic mimicry were enhanced (P<0.01);the internal flow peak of SOCE was low (P<0.05); the expression of p-ERK1/2, MMP-2, and VEGF proteins decreased (P<0.01); and the expression of E-cadherin protein increased (P<0.01). Conclusion:ORAI1 may promote the migration and invasion of SW480. This mechanism may be associated with the increase of SOCE.

Objective:To investigate the changes of plasma ghrelin levels and insulin(INS) sensitivity of full-term infants small for gestational age (SGA) and the effects of breast feeding on it.Methods:Full-term SGA hospitalised in the Department of Neonatology, Wuhan Children′s Hospital from October 2014 to April 2019 were re-cruited as the SGA group (120 cases), with full-term infants appropriate for gestational age (AGA) born in the same period as the AGA group (96 cases) in this study with recorded birth weight and length.The levels of fasting blood glucose (FG), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), INS and ghrelin were measured 7 days after birth.Homeostasis model assessment-insulin resistance (HOMA-IR) was calculated.The SGA group was subdivided into breast feeding group and formula feeding group.The above indexes were tracked and mea-sured in the 3 rd and 6 th month, respectively, and their growth parameters were recorded. Results:There were no diffe-rences in serum FG, TG, LDL and HDL levels between the SGA and the AGA group (all P>0.05). Compared with the AGA group, the serum INS[(4.21±0.83) mIU/L vs.(3.54±1.10) mIU/L], ghrelin levels[(0.80±0.23) μg/L vs.(0.69±0.19) μg/L] and HOMA-IR (0.85±0.25 vs.0.72±0.25) increased in the SGA group, the differences were statistically significant (all P<0.05). Serum INS, HOMA-IR and ghrelin levels changed with the duration of breast feeding, the differences were statistically significant( F=12.394, 9.810, 5.531, all P<0.05). Conclusions:The serum ghrelin levels of SGA infants increased and INS sensitivity decreased.Breastfeeding can decrease levels of serum INS, HOMA-IR and ghrelin, and can improve INS sensitivity of SGA infants.

Objective To investigate the diagnosis of value 99mTc-MIBI SPECT and CT fusion imaging in the differential solitary pulmonary nodule ( SPN). Methods Thirty-nine patients with SPN underwent 99mTc-MIBI-SPECT and positioning CT fusion imaging, and the imaging results carried on the qualitative and semi-quantitative analysis. The diagnostic value of the imaging method for SPN was judged according to the results of the final diagnosis. Results Of 39 cases with SPN, 13 cases were malignant and 26 cases were benign. The diagnostic sensitivity, specificity, accuracy, negative predictive value and positive predictive value of 99mTc-MIBI-SPECT positioning CT fusion imaging qualitative analysis in benign and malignant SPN was 92.31%(12/13),88.46%(23/26),89.74%(35/39),80% (12/15) and 95.83% (23/24),respectively. Receiver operating characteristic (ROC) curve analysis showed:using 99mTc-MIBI early uptake ratio (EUR) ≥1.474 as the critical value for identification the benign and malignant SPN, the sensitivity and specificity was 100% and 76.90%, respectively;using 99mTc-MIBI delayed uptake ratio (DUR) ≥ 1.38 as the critical value, the sensitivity and specificity was 100%and 76.90%. Conclusion The method of 99mTc-MIBI-SPECT and positioning CT fusion imaging has a high clinical value in the differential diagnosis of SPN.

Objective To investigate the feasibility of a rat carotid atherosclerosis model induced by artery clamping with high-cholesterol diet and vitamin D3.Methods Twenty Wista rats were randomly divided into either a general diet group (n =5) or a high cholesterol diet group (n =15).After clamping the right common carotid arteries of the rats in the high cholesterol diet group,they were fed with high fat diet,and vitamin D3 (600 000 IU/kg) was injected intraperitoneally.The lipid levels of the general diet group and the high cholesterol diet group were detected at 6 and 12 weeks respectively.The bilateral cormmon carotid arteries were selected for preparing paraffin sections and were stained with HE staining.The pathological changes in blood vessels were observed.Results The levels of serum total cholesterol at 12 weeks (2.803 ± 1.307 mmol/L vs.1.513 ±0.281 mmol/L; P=0.017) and low-density lipoprotein cholesterol (0.660± 0.260 mmol/L vs.0.311 ±0.078 mmol/L; P =0.003) in the high-cholesterol diet group were significantly higher than those at 6 weeks.The histopathological examination showed that the common carotid artery intimas on the clamping sides were incomplete,the foam cell deposition was observed under intima,the atherosclerotic plaques or fibrous plaques were observed on the surface of cavity,inside the plaques contained necrotic tissue,and thrombosis was observed in the cavity.The common carotid artery intima-media thickness in the general diet group (n =5) at 12 weeks was 8.3 ± 1.1 μm.The sham-operated sides (n =20) and clamping sides (n =20) were 8.8 ± 0.7 μm and 97.4 ±25.7 μm,respectively.There were significant differences among the three groups (F =116.313,P=0.000).The clamping sides in the high-cholesterol diet group were significantly higher than the shamoperated sides in the high-cholesterol diet group (P=0.000) and the general diet group (P =0.000).Conclusions Common carotid artery clamping with high-cholesterol diet and vitamin D3 is a simple and feasible method for inducing a rat carotid atherosclerosis model.

Objective To investigate the correlation between ATP-binding cassette transporter A1 (ABCA1) R219K polymorphism and ischemic stroke in Chinese populations.Methods The case control studies of the correlation between Chinese ABCA1 R219K polymorphism and ischemic stroke published before May 2013 were collected using comprehensive literature search.The Stata 11.0 software was used to conduct metaanalysis.Odds ratio (OR) and its 95％ confidence interval (CI) was used to evaluate the strength of association between the gene polymorphism and ischemic stroke.Results A total of 10 studies met the criteria and were included in the analysis,including 1 619 patients in the patient group and 1907 in the control group.The selected literature had no obvious bias.Meta-analysis showed that the risk of ischemic stroke in patients carrying RK + KK genotype significantly decreased 8％ (OR 0.92,95％ CI 0.88-0.96; P =0.000)compared to those carrying RR genotype.The risk of ischemic stroke in patients carrying KK genotype significantly decreased 36％ compared to those carrying RR genotype (OR 0.64,95％ CI 0.44-0.94; P =0.02).The risk of ischemic stroke in patients carrying RK genotype significantly decreased 19％ compared to those carrying RR genotype (OR 0.81,95％ CI 0.69-0.95; P =0.009).The risk of ischemic stroke in patients carrying K allele significantly decreased 17％ compared to those carrying R allele (0R 0.83,95％ CI 0.69-0.99; P =0.036).Conclusions ABCA1 R219K polymorphism is associated with the susceptibility of ischemic stroke in Chinese.K allele may be a genetic protective factor for ischemic stroke in Chinese populations.

Objective To observe the clinical efficacy and adverse reactions between pemetrexed plus cisplatin and paclitaxel plus cisplatin in the treatment of advanced non-small cell lung cancer (NSCLC).Methods Forty-two cases with non-small cell lung cancer in our hospital from June 2013 to June 2015 were selected.Patients were randomly divided into observation group and control group with 21 cases in each group.The observation group was treated with pemetrexed plus cisplatin and the control group was treated with paclitaxel plus cisplatin.The clinical efficacy and adverse reactions were observed after two courses (21 days of a course) and the statistical analysis was performed.Results In the observation group and control group,response rate and clinical benefit rate were33.33％ (7/21),28.57％ (6/21) and76.19％ (16/21),71.43％ (15/21) respectively.No statistical significance were seen between the two groups (P＞0.05).The rate of hair loss (23.81％) (5/21) and the total number of adverse reactions (18.37％) (27/147) in the observation group were significantly lower than the rate of hair loss (47.62％) (10/21) and the total number of adverse reactions (25.17％) (37/147) in the control group (P＜0.05) No statistical significance was found in the incidence rate of leukopenia,neutropenia,erythropenia,thrombocytopenia,nausea and vomiting and phlebitis between the two groups (P ＞0.05) Conclusion Pemetrexed plus cisplatin is as effective as paclitaxel plus cisplatin in the treatment of advanced NSCLC with less adverse reactions and is much safer than paclitaxel plus cisplatin.Pemetrexed plus cisplatin is more valuable in the clinical treatment of advanced NSCLC.