Objective To explore the clinical value and significance of the chronic obstructive pulmonary disease (COPD) assessment test (CAT) in patients with acute exacerbation of COPD (AECOPD).Methods A prospective observational study was conducted,AECOPD patients were admitted to the Department of Respiration Medicine in Jiaxing Second Hospital from February 2011 to July 2016 were enrolled,and they all underwent CAT assessment test and lung function examination.The patients were assigned to Ⅱ,Ⅲ and Ⅳ grade groups according to the lung function level,and the difference of forced expiratory end volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC) ratio were compared among the three groups;the patients were also assigned into 2,3 and 4 grade groups according to CAT scores,and the difference of length of stay in the hospital and hospitalization expenses were compared among the three groups.Spearman correlation analysis was used to analyze the correlations between the CAT score and lung function indexes.Results One hundred and thirty-five patients with AECOPD were accepted and all of their clinical data were analyzed in the study.Their mean FEV1 was (0.42±0.16) L,FEV1/FVC was 0.44 ±0.13 and CAT score was 26.64 ± 5.43.The correlation analyses showed:there were significant negative correlations between CAT score and FEV1,FEV1/FVC (r value was-0.691,-0.728,both P ＜ 0.001).With the elevation of lung function grade,FEV1 and FEV1/FVC were decreased gradually (1Ⅱ,Ⅲ,Ⅳ grade groups were 0.62±0.07,0.40±0.06,0.25±0.03 and 0.64±0.01,0.40±0.00,0.33±0.06 respectively),while CAT score raised gradually (20.03 ± 3.36,28.30 ± 3.31,30.18±3.86,all P ＜ 0.01);with the CAT score getting higher and higher,hospitalization expenses (yuan) and the length of stay in hospital (day) of patients with AECOPD were increased significantly (2,3,4 grade groups:expense were 6214.09±1396.16,8339.31±1866.46,9600.97±4339.87,and length of stay in hospital were 7.54± 1.62,9.52±2.21,14.85 ±5.62,respectively,all P ＜ 0.01).Conclusion CAT is a reliable tool to measure the life quality of AECOPD patients and has certain relevance to the severity and prognosis of the disease.

Objective To compare large dose or conventional dose of budesonide/formoterol fumarate powder in treatment of stable chronic obstructive pulmonary disease(COPD).Methods 120 patients with stable COPD from March 2015 to March 2016 in Jiaxing Second hospital were selected,were treated with budesonide/formoterol,and were divided into the conventional dose group and high dose groupaccording to different doses,60 cases in each group.Pulmonary function tests,CAT Chinese version scale assessment and 6 min walking distance(6MWD)test were performed before and after treatment,and adverse reactions and acute attack were observed.Results FEV1/FVC and FEV1％were significantly improved after treatment in the two groups,and those in the high dose group were significantly better than those in the conventional dose group,the difference was statistically significant(P<0.05),CAT score and 6MWD were significantly improved after treatment in the two groups,and those in the high dose group were significantly higher than those in the conventional dose group,the difference was statistically significant(P<0.05),adverse reactions such as palpitations,tachycardiain the high dose group were significantly higher than those in the conventional dose group,while the acute attack rate was significantly lower than that of the conventional dose group,the difference was statistically significant(P<0.05).Conclusion High dose of budesonide/formoterol inhalation in the treatment of patients with stable COPD powder can improve the pulmonary function and health status,but adverse reactions increase.

ObjectiveTo investigate the effects of astragalin on pulmonary edema after acute cervical spinal cord injury in rats.MethodsA total of 200 adult Wistar rats weighing 240-250 g were randomly divided into five groups:astragalin group,low concentration astragalin group,physiological saline group,blank group and sham group,with 40 rats in each group.The rats with cervical spinal cord injury were induced at C7 by modified Allen' s method,with the dropping weight of 10 × 2.5 g · cm.In the sham group,the laminas were removed only,leaving spinal cord at the C7 intact.Each group was further divided into four time points:24 hours,3 days,1 week and 2 weeks after the modeling,with 10 rats in each time point,according to the specimen collection time.Rats were sacrificed at different time points to observe the pathological change of the lung tissue using optical microscope,measure the lung wet/dry weight ratio (W/D) and protein concentrations of the serum and bronchoalveolar lavage fluid and calculate the lung W/D and lung permeability index (LPI).ResultsAt the same instant,the W/D and LPI in the astragalin group and low concentration astragalin group were lower than those in physiological saline group and blank group,with the lowest value in the astragalin group at day 3 after injury ( P ＜0.05 ).ConclusionsRats with acute cervical spinal cord injury may cause pulmonary edema,which can be efficiently alleviated through early use of astragalin.

Prostaglandin E_2(PGE_2)is one of the major metabolic products of arachidonic acid.PGE_2 plays important roles in various important physiological processes by binding to its G protein-coupled receptors designated EP1,EP2,EP3,and EP4,respectively.EP receptors are highly expressed in the kidney and cardiovascular system,and PGE2-mediated activation of EP receptors plays important roles in the regulation of blood pressure.The abnormal expression of EP receptors in the kidney and cardiovascular system is associated with some blood pressure disease such as salt-sensitive hypertension,renal hypertension,and myocardial hypertrophy.

Objective To assess the outcome of vesicoureteral reflux after augmentation cystoplasty in patients with neurogenic bladder.Methods Between January 2008 and January 2014,a total of 25 patients,with a hypocompliant bladder associated with vesicoureteral reflux confirmed by video-urodynamics preoperatively,were recruited in this study.They all had undergone bladder augmentation with a generous detubularized segment of bowel at our institution.No effort had been made to correct existing reflux.Preoperatively assessment included urinalysis,kidney function tests,ultrasonography,video-urodynamic evaluation.All patients had various degrees of vesicoureteral reflux.The status of vesicoureteral reflux and bladder function were studied by video-urodynamic.Results Mean follow-up was 2.2 years (range 0.5 to 5.5 years).The video-urodynamics manifested a significant improvement of bladder capacity,diminution of intravesical pressure and resolution of reflux after bladder augmentation.Of the 25 patients,20 (80％) no longer had reflux,3 (12％) had improvement,2 (8％) had no change.Sixteen of 18 with grades Ⅰ to Ⅲ (89％),all refluxing units with grade Ⅳ to grade Ⅴ (100％) showed complete cessation of reflux.Symptomatic urinary infection was not found after surgery.Conclusions Augmentation enterocystoplasty without ureteral reimplantation is effective and adequate for patients with high pressure and hypocompliant neurogenic bladder.Therefore,ureteral reimplantation is not necessary underwent when augmentation enterocystoplasty is recommended to patients with neurogenic bladder and vesicoureteral reflux.

Objective To investigate the regulations of lymphatic metastasis of rectal carcinoma which can provide help of clinical diagnosis and treatments.Methods A retrospective analysis was performed of 222 patients with rectal carcinoma who underwent surgical resection from November 2006 to January 2012.Summarize the relevance of each factor and lymph node metastasis by logistic regression analysis.Results (1) Gender and lymph node metastasis has no significant correlation (x2 =0.000,P ＞ 0.05).(2) Lymph node metastasis rate reduced with increasing age and the difference was statistically significant (x2 =5.001,P ＜ 0.05).(3) There is no significant difference between tumor location and lymph node metastasis rate (x2 =0.052,P ＞ 0.05),when the distance between anal rectal cancer and the anus was closer,the tendency of lymph node metastasis was higher,and there has the obvious correlation with lymph node metastasis rate of its size,2.5 to 5.5 cm group and more than 5.5 cm lymph node metastasis rate was significantly higher than less than 2.5 cm group with a significant difference (x2 =2.267,P ＜ 0.05).(4) Tumor invasion of the intestinal circumference was closely related with lymph node metastasis rate (x2 =2.323,P ＜0.01).(5) Lymph node metastasis rate was closely related to the depth of invasion,metastasis rate increased with the depth of invasion increasing(x2 =2.277,P ＜0.05).(6) Lymph node metastasis was significantly higher with the decrease of the degree of tumor differentiation (x2 =4.322,P ＜ 0.01).Logistic regression analysis showed that the degree of tumor differentiation,infiltration and invasion of intestinal circumference diameter lymph node metastasis influential,OR (95 ％ CI) was 5.562 (0.105-0.444),2.178 (0.144-0.971),1.563 (0.038-8.613) respectively (P ＜0.01).Conclusion The lymphatic metastasis of rectal carcinoma is related to age,tumor size,intestinal circumference invasion,depth of tumor invasion and the differentiating degree of the tumor,and the differentiating degree is the major factor.

Objective to investigate the role of Pim‐3 and NF‐κB in the development and progression of infiltrating ductal carcinoma of the breast .Methods Here ,we used immunohistochemistry to detect expression of Pim‐3 and NF‐κB in 75 samples of infiltrating ductal breast carcinoma ,21 samples of intraductal breast carcinoma and 30 normal breast tissues .The relationship of their expression ,as well as their correlation with clinicopathological features and patient survival were assessed .Results In con‐trast ,both Pim‐3 and NF‐κB were more commonly detected in infiltrating ductal carcinoma than in intraductal carcinoma and normal tissue .In the infiltrating ductal carcinoma ,the positive expression rate of Pim‐3 was 77 .3% ,and that of NF‐κB was 68 .0% ;in duc‐tal carcinoma of the breast ,the positive expression rate of Pim‐3 was 52 .4% ,and that of NF‐κB was 42 .9% ;in the normal breast tissue ,the positive expression rate of Pim‐3 was 23 .3% ,and that of NF‐κB was 16 .7% ;the positive expression rate of Pim‐3 was correlated with tumor size ,histological grade ,and clinicopathological stage ;and that of NF‐κB was correlated with tumor size ,histo‐logical grade ,lymph node metastasis of breast cancer .Spearman rank correlation analysis revealed a positive correlation between Pim‐3 expression and NF‐κB expression in infiltrating breast cancer (r=0 .243) .Conclusion Our results demonstrate that Pim‐3 and NF‐κB play a role in the initiation and development of breast cancer ,thus ,these proteins may serve as useful diagnostic and prognostic markers of invasive breast cancer .

Objective To analyze the anatomic factors of the central retinal artery occlusion or the ophthalmic artery occlusion after the injection of facial cosmetic surgery.Methods Retrospectively analyzed 3 patients who occurred severely ocular complications just after facial cosmetic injection in last 2 years.The diagnosis of central retinal artery occlusion was confirmed by fundus examination and fundus fluoresce-in angiography.Analysis the blood vessel distribution of the injection site and characteristics of peri-orbit vascular anastomosis.Results All the 3 cases presented no light perception,with eye pain or (and)the eyeball pain.The fundus test and fundus fluorescein angiographies showed central retinal artery obstruction.Facial cosmetic injection pressure significantly exceeded the ophthalmic artery systolic pressure 2 seconds after injection (P <0.05).Dorsal nasal artery and angular artery were anastomotic,and the angular artery was usually anastomotic with lateral nasal branches of the posterior ciliary artery.The filler can enter the ophthalmic artery by the branches of the anastomosis,which can make ophthalmic artery occlusion,central retinal artery occlusion or get occlusion of their branches.Conclusion The injectant may get into the orbital artery and retrograde to the ophthalmic artery,which resulting in ophthalmic artery occlusion,or get into central retinal artery and posterior ciliary artery,which resulting in serious ocular complications.

Basic fibroblast growth factor (bFGF) has been used in wound healing, bone healing, vascular grafting, lens regeneration and limp regeneration. Anti-bFGF antibody is thought to be an major important reagent for bFGF research. This review summarizes the development of anti-bFGF antibody in recent years including preparation, screening, identification and application in order to provide reference to the studies of this field in our country.

Objective To investigate the expression of lung keratinocyte growth factor receptor (KGFR) in rats with acute spinal cord injury (ASCI) in different time points and its role in lung edema.Methods Thirty-two adult Wistar rats weighing 240 g to 260 g were assigned to experimental group (n =16) and control group (n =16) according to the random number table.Each group consisted of time points of 24 hours,3 days,1 week and 2 weeks after the modeling (4 rats per time point).A rat model of ASCI in experimental group was induced at C7 segment by dropping a weight of 10 g from the height of 2.5 cm (Allen' s method).In control group,laminas were removed only,leaving spinal cord at C7 intact.Rats were sacrificed at each time point for measurement of lung wet/dry weight ratio,Western blot analysis of expression of lung KGFR protein and RT-qPCR detection of lung KGFR mRNA expression.Results After ASCI in rats,the expressions of lung KGFR protein and mRNA began to drop at 24 hours (0.23 ±0.06,0,012 1 ±0.002 3),reached the trough at 3 days (0.17 ±0.04,0.008 5 ±0.001 7)and picked up at 1 week.Expression of lung KGFR mRNA in experiment group showed statistically significant difference from that in control group at 24 hours and 3 days (P ＜ 0.05),whereas in each time point the difference of KGFR protein expression between experiment and control groups was statistically significant(P ＜0.05).Variation trend of KGFR expression was in parallel with the severity degree of pulmonary edema.Conclusion Lung KGFR presents significant down-regulation in ASCI rats and this may be associated with the development of pulmonary edema after ASCI.