Objective To study the relationship between malnutrition and respiratory muscle strengthas well as the effect of diet supplement on respiratory muscle strength in elderlypatients with chronic cor pulmonale in high altitude areas(HAECCP). Methods 46 patients with HAECCP not in exacerbation were divided into two groups, namely, diet supplement group (23 cases) and control group (23 cases). The caloric intake was increased by 45%-50% in the diet supplement group. Ten parameters with regard to body weight, muscle strength and respiratory function were measured in all the patients. These parameters included percentage of ideal body weight (%IBW), triceps skinfold thickness(TSF), midarm muscle circumference (MAMC), maximal inspiratory pressure(PImax), maximal expiratory pressure (PEmax),maximal transdiaphragmatic pressure(Pdimax),forced expiratory volume in 1 second (FEV_1) ,expressed as percentage predicted (FEV_1%), ratio of FEV_1 to forced vital capacity (FEV_1/FVC), partial pressure of arterial O_2 (PaO_2) and partial pressure of alveolar CO_2(PaCO_2). All the parameters were measured again after 4 weeks. Results There was no significant differece between the parameters in the two groups before the treatment. After 4 weeks of treatment, there was significant improvement in %IBW, serum albumin (Alb), TSF, MAMC, PImax,PEmax,Pdimax in the diet supplement group, indicating the effect of increased nutrition on body weight and respiratory muscle strength. However, no significant difference was found in the parameters of pulmonary function and blood gas analysis after diet supplement. NO change was observed in the parameters of the controls after 4 weeks. Conclusions In stable patients with HAECCP not in exacerbation, the strength of respiratory muscle decreased as a result of malnutrition. After diet supplement, the strength of respiratory muscle increased with accompanying improvement in nutritional status.

Objective To investigate the changes and clinical significance of the plasma cytokines and endothelium function in patients with chronic pulmonary heart failure disease at high altitude area.Methods Plasma levels of tumor necrosisfactor-alpha(TNF-?),interleukin-6(IL-6),endothelin-1(ET-1) were measured in 278 chronic pulmonary heart patients with various degrees of heart failure and in 48 healthy controls.Left ventricular ejection fraction(LVEF),Right ventricular ejection fraction(RVEF) and Pulmonary(PASP) were examined with echocardiography.Results Plasma levels of TNF-?,IL-6,ET-1 were elevated in patients of functional classes Ⅱto Ⅳ as compared with age-matched control subjects and were progressively elvated with the decreasing functional status of the patients.The levels of TNF-?,IL-6,ET-1 respectively were positively correlated with PASP but negtively correlated with LVEF and RVEF(P

Objective:To explore the diagnostic value of hand tenosynovitis in rheumatoid arthritis (RA).Methods:Seventy-six RA patients were enrolled for hands ultrasound examination. Forty-five RA patients with synovitis and tenosynovitis were selected as the study group, clinical characteristics, laboratory test results, disease activity score for 28 joint counts (DAS28), were evaluated and assessed, and the health assessment questionnaire (HAQ) was filled out, and semi-quantitative classification the ultrasonic indicators (synovial hyperplasia, synovitis, tenosynovitis, bone erosion) were also assessed. Forty-two non-RA patients with hand tenosynovitis were selected as the control group. Mann-whitney U test, Spearman correlation and paired U test were used for statistical analysis. Results:① In the RA group, synovial hyperplasia [7.50(3.00, 17.50)], synovitis [6.00(2.00, 14.00)], tenosynovitis [6.00(2.00, 12.00)], bone erosion [0.50(0.00, 4.00)] were statisticantly different when compared with in non-RA group in hyperplasia [5.00(3.00, 6.00)], synovitis [3.00(2.00, 4.30)], tenosynovitis [2.00(1.00, 3.00)], bone erosion [0.00(0.00, 1.00)] ( Z=2.143, P=0.032; Z=2.756, P=0.006; Z=5.560, P<0.01; Z=2.550, P=0.011). ② In the RA group, synovial hyperplasia and synovitis were positively correlated with swollen joint counts (SJC), tender joint counts (TJC), platelet (PLT), C-reactive pro-tein (CRP) and DAS28 [synovial hyperplasia ( r=0.806, P<0.01; r=0.486, P<0.01; r=0.326, P<0.05; r=0.450, P<0.01; r=0.413, P<0.01); and synovitis ( r=0.819, P<0.01; r=0.446, P<0.01; r=0.351, P<0.05; r=0.481, P<0.01; r=0.412, P<0.01)]. Tenosynovitis was positively correlated with SJC, CRP and DAS28 ( r=0.436, P<0.01; r=0.496, P<0.05; r=0.359, P<0.05) , bone erosion was positively correlated with disease course and anti-cyclic citrullinated peptide (CCP) antibody ( r=0.418, P<0.01; r=0.338, P<0.05) . ③ The sensitivity of synovial hyperplasia, synovitis, tenosynovitis, bone erosion and synovitis combined with tenosynovitis for the diagnosis of RA was 0.41, 0.61, 0.57, 0.48, 0.61 and the specificity was 0.95, 0.76, 1, 0.83, 0.93, respectively. ④ The largest area under the ROC curve was tenosynovitis [area under the curve (AUC)=0.841], the area under the curve of tenosynovitis and synovitis combined with tenosynovitis was significantly different from synovitis hyperplasia, synovitis and bone erosion [tenosynovitis( Z=3.291, P=0.001; Z=2.651, P=0.008; Z=3.032, P=0.002); synovitis combined with tenosynovitis( Z=4.346, P=0.001; Z=3.753, P=0.001; Z=2.547, P=0.012)]. Conclusion:Synovitis has a high sensitivity for the diagnosis of RA, and tenosynovitis has a high specificity for the diagnosis of RA, synovitis combined with tenosynovitis can improve the specificity for the diagnosis of RA.

Objective:Cholangiocarcinoma (CCA) is a malignant tumor derived from bile duct epithelial cells with extremely poor prognosis. The Hippo-Yes-associated protein (YAP)/transcription activator with PDZ binding motif (TAZ) signaling plays a critical role in cancer stem cell biology. Previous studies have shown that the positive expression of YAP/TAZ in CCA predicts larger tumor size and unfavorable clinical outcomes. We aim to evaluate the prognostic value of YAP/TAZ detection in CCA patients.Methods:CCA patients who underwent radical resection were retrospectively analyzed at our institution from January 2011 to June 2016. Postoperative pathological specimens were scored by YAP/TAZ immunohistochemical staining. The prognostic value of YAP/TAZ was analyzed by multivariate Cox-proportional hazards model.Results:A total of 91 CCA patients were enrolled. During a median follow-up time of 11.0 months, 69.2% patients relapsed and 45.1% died. The median OS and DFS were 10.7 months and 8.8 months respectively. The YAP/TAZ dual positive patients owned a worse TNM stage ( P=0.015), poorer tissue differentiation ( P=0.007), and a higher CA199 than those in negative patients. Multivariate Cox analysis identified that YAP/TAZ dual positivity as a significant factor predicted poorer OS ( P=0.010) and DFS ( P=0.028) in CCA patients after radical resection. In subgroup analysis, YAP/TAZ combination also significantly predicted OS ( P=0.044) and DFS ( P=0.043) in CCA patients with positive lymphatic metastasis and/or surgical margin who required adjuvant therapy. Conclusions:YAP/TAZ positivity is an independent predictive factor for survival in CCA patients after radical resectiony.