Objective To observe the efficacy of inhaled tiotropium bromide combined with budesonide/formoterol on reducing the frequency of acute episodes of symptom exacerbation and improving lung function,health status in chronic obstructive pulmonary disease (COPD). Methods Eighty-six patients with COPD were divided into 3 groups, combination group[29 cases, inhaled budesonide/formoterol (160 μg/4.5 μg, twice one day ) and tiotropium bromide ( 18 μg, once one day)], budesonide/formoterol group( 29 cases, 160 μg/4.5 μg, twice one day) and tiotropium bromide group(28 cases, 18 μg, once one day). The treatment continued for 3 months. Results Lung function, symptoms and health status improved obviously in three groups. The forced expiratory volume in one second (FEV1) of combination group after treatment was (1.24±0.18) L , which was improved by 11.7% compared with before treatment. It was significantly higher than that in budesenide/formoterol group and fiotropium bromide group (P < 0.01 ). The rescue medication consumptions and the times of acute episode of combination group were significantly decreased compared with those in the other groups,and there was significant difference (P <0.01). The SGRQ score of combination group was (35.6±13.9) points which was significantly lower than that of budesonide/formoterol group and tiotropium bromide group,and there was significant difference (P < 0.01 ).There was no statistical difference in the adverse events occurred in three groups (P > 0.05 ). Conclusions Combination treatment produces better control of symptoms and lung function and has no greater risk of sideeffects, compared with the treatment of budesonide/formoterol alone and tiotropium bromide alone. The combination treatment should be considered for patients with COPD.

Objective To investigate the correlation between GSTP1 exon5 A/G polymorphism and clinic phenotype of COPD in the population of the Han nationality from southwest China.Methods Using PCR followed by restriction fragment length polymorphism(PCR-RFLP),genotypes of Ile105Val polymorphism in exon5 of GSTP1 were determined in 91 patients with COPD and 87 healthy control subjects.Results No significant differences were observed in the frequencies of genotypes and alleles of exon5 of GSTP1 between COPD patients and the healthy controls.The frequency of Ile105 in pink puffer patients was much more than that in the blue bloater patients.The CT scores of emphysema in patients with Ile105 was significantly higher than those with Val105.Conclusions The genetic polymorphism of exon5 of GSTP1 may not be associated with the susceptivity of COPD in the populations of the Han nationality from southwest China,but may be correlated with clinical phenotypes and lung parenchyma damage of COPD patients in the present population.

Objective To study the effect of cardiac resynchronization therapy (CRT) on the cardiac function and arrhythmias of patients with chronic heart failure and left ventricular systolic dyssynchrony. Methods Thirty-two cases of patients with chronic heart failure and left ventricular systolic dyssynchrony underwent CRT therapy. And LEVESV, LVEDV, LVEF, LVEDD, MRA, LAA, MRA/LAA were detected by echocardiography while the cardiac function was kept stable. Then the left ventricular systolic 12 segment peak time (Ts) was measurements by tissue doppler in all patients, the poor (Ts-maxD) and standard deviation (Ts-SD) were also calculated. The 24-hour ambulatory 12-lead ECG was took postoperation. All the patients were treated by anti-heart failure drugs after CRT pacemeker implantantion. All these indicators were assessed again at 12 weeks later. Results Compared with the previous CRT pacemaker implantation, LVEF, LV dp/dpsignificantly increased (P < 0.05). LEVESV, Ts-maxD, Ts-SD, MRA, MRA/LAA markedly declined (P < 0.05). But no statistical significance was found between the preoperative and postoperative CRT (P>0.05). Atrial premature beats and paroxysmal atrial tachycardia were significantly reduced in the preoperative CRT (P < 0.05). No significant differences were found in atrial fibrillation, ventricular premature beats and paroxysmal supraventricular tachycardia between the preoperative and postoperative CRT (P > 0.05). Conclusion CRT resynchronization therapy can improve left ventricular systolic function, and reduce the MRA and Ts. The mechanism may be associated with the improvement of left ventricular synchrony, reducing mitral regurgitation, and reducing the occurrence of atrial arrhythmias.

Objective To investigate the correlation between the mierosatellite polymorphism of heme oxygenase-1(HOX-1)gene promoter and susceptibility to chronic obstructive pulmonary disease(COPD)in Han nationality of Southwest China and CT imaging.Method The alleles frequencies with varying number of(GT)n repeatings in the Hox-1 gene in 180 smokers with COPD and in 150 healthy smokers were analyzed.Results Polymorphisms of the(GT)n repeats were grouped into three classes:S(≤25 repeats),M(26-31 repeats),L(≥32repeats).The proportion of genotypic frequencies in the group with class L alleles(L/S,L/M,I/L)was significantly higher in the smokers with COPD than in healthy smokers(29.4%vs18.7%,P=0.023,OR=1.8,95%CI 1.1-3.1).However,there was no relationship between the polymorphism of HOX-1 gene and subtypes of COPD by CT imaging in COPD patients(P＞0.05).Conclusion Genetic polymorphism in Hox-1 is associated with development of COPD in Han nationality of Southwest China.But the polymorphism of HOX-1 gene is not associated with subtypes of COPD by CT imaging.

Objective To study the effect and mechanism of down-regulating Silt2/Robo 1 signaling pathway on rabbit iliac artery after angioplasty restenosis. Methods The 30 male New Zealand white rabbits were divided randomly into 3 groups , namely the blank group , the control group , and the experimental group , 10 rabbits in each group. Hign-fat feeding , the rabbits were produced endothelial denudation of iliac artery stenosis model. Another 4 weeks of feeding , percutaneous balloon angioplasty was performed. Then R5 antibody was injected into the abdominal cavity. After 4 weeks of feeding ,angiography again. The results of angiography was analysied by image workstation. The concentrations of Slit2 and Robo1 was detected by ELISA. The iliac artery tissue examined by HE staining. Results The rabbit iliac artery after angioplasty restenosis animal model was set up successfully. Compared with the control group and the experimental group , the serum concentration of Slit2 and Robo1 were significantly higher (P < 0.01) than the blank group. But in the experimental group, the Slit2 and Robo1 serum concentrations were significantly lower than those in the control group (P < 0.05) after R5 antibody intervention. The area ratio stenosis and diameter stenosis rate of iliac artery were reduced that confirmed by angiography. Conclusion The expression of Slit2/Robo1 was significantly higher in the rabbit model of vascular restenosis. R5 antibody can effectively inhibit the expression of Slit2/Robo1. Down regulation of Slit2/Robo1 signaling pathway in the treatment of restenosis after angioplasty in rabbits.

Objective To study the mechanism and characteristic of traffic injury of front crash. Methods Thirty rabbits were divided randomly into 3 groups according to crash velocity. The initial velocity of GroupⅠ was 30 km/h, group Ⅱ 40 km/h, and group Ⅲ 50 km/h. The rabbits were fixed on the seats in a sitting position and the injury process were started by driving power system with the velocity and acceleration set primarily. The crashing velocity and deceleration were recorded by laser velocity measuring system and high speed camera system. The injury characteristics of rabbits were observed and then the AIS-ISS score was compared. Results During 1 hour after injury, all rabbits survived except one in group Ⅱ and three in group Ⅲ. No organ injury was found in group Ⅰ, but organ injuries in thorax and abdomen were found in group Ⅱ and Ⅲ. The score of AIS (MAIS) and ISS were (2.30?0.65), (14.50?2.10) in group Ⅱand (4.20?0.70), (36.40?4.58) in group Ⅲ respectively. Conclusion The velocity and deceleration of crash have impact on the injury character of animal, and the main injury organs are the thorax and abdomen in traffic injury of front crash in rabbits.

Tuberculous pleurisy is the common disease in pleural disease ,this disease had different degree of lung injury.In recent years,lung function rehabilitation training is a hot spot .This article will elaborate breathing training application and its value in tuberculous pleuritis .

Pulmonary embolism is a clinical and pathophysiological syndrome caused by endogenous or exogenous emboli obstructing the pulmonary artery , and its branches causing acute pulmonary circulatory disturbances .Venous thromboembolism is a complex multifactorial disease that involves the interaction of secondary or hereditary thrombosis and various risk factors such as trauma and surgery .With the characteristics of high incidence , misdiagnosis and high mortality ,this study explored the risk factors for pulmonary thromboembolism .Finding its risk factors is the main method to reduce the incidence of pulmonary embolism and reduce the severity of pulmonary embolism.

OBJECTIVETo assess the feasibility and safety of using the modified active fixation pacing leads model to pace the right ventricular outflow tract septum.

METHODSA total of 136 patients undergoing artificial heart pacemaker implantation with active fixation pacing leads were randomized into two groups to receive conventional right ventricular outflow tract pacing (CRVOTP) or modified right ventricular outflow tract pacing (MRVOTP). The electrode lead wire core was modeled in a double-curved three-dimensional shape in CRVOTP group and in a J-shaped bend in MRVOTP group before fixation at the right ventricular outflow tract septum.

RESULTSRight ventricular outflow tract septum pacing was achieved successfully in all the patients. None of patients experienced serious complications. No significant differences were found between the two groups in the number of times of electrode fixation, pacing thresholds, impedance, R wave height or QRS wave width during the operation, but MRVOTP was associated with a reduced time of X -ray exposure and operation (P<0.05) due to the convenience in electrode modeling and in passing the leads through the tricuspid annulus and the direct access to the right ventricular outflow tract septum. Postoperative follow-up of the patients showed no incidence of active fixation pacing lead dislocation and comparable pacing thresholds of the ventricular electrodes, impedance, R wave height and QRS wave width between the two groups.

CONCLUTIONSUsing the modified active fixation pacing leads model to pace the right ventricular outflow tract septum can reduce the time of X -ray exposure and operation with a low probability of lead damage.

Objective To compare the concentrations of alpha-enolase (ENO1),CYFRA21-1,and CA125 in the patients with malignant pleural effusion ,tuberculous exudative pleural effusion ,or parapneumonia pleural effusion. To explore the clinical value of ENO1 in pleural effusion combined with serum CYFRA21-1 and CA125 in diagnosis of malignant pleural effusion. Methods Enzyme-linked immunosorbent assay(ELISA)was used to detect the concentration of ENO1 in pleural effusions. The concentrations of CA125 and CYFRA21-1 in the blood samples were measured using chemiluminescence and magnetic particle-based chemiluminescence respective-ly. The sensitivity and specificity of ENO1 combined with serum CYFRA21-1 and CA125 detection were calculated. Results The concentration of ENO1 in malignant pleural effusion group was significantly increased(P<0.001);the concentrations of ENO1 did not differ significantly between tuberculous exudative pleural effusion and parapneu-monia pleural effusion(P>0.05). The sensitivity and specificity of ENO1 combined with serum CYFRA21-1 and CA125 detection in malignant pleural effusion were 94％ and 74％,98％ and 98％,respectively. Conclusions ENO1 combined with serum CYFRA21-1 and CA125 detection can improve the sensitivity of diagnosis of malignant pleural effusion and enhance the diagnostic rate of malignant pleural effusion.