Objective To study the clinical efficacy of theophylline combined with tiotropium dry powder in the treatment of stably chronic obstructive pulmonary disease (COPD).Methods 140 patients with stable COPD were divided into the study group and control group according to the random number table method,70 patients in each group.The control group was treated with theophylline,while the study group was treated with theophylline combined with tiotropium dry powder.The quality of life was evaluated by quality of life scale(QLC),the exercise tolerance was estimated by 6min walk distance(6MWD),and the forced expiratory volume in one second(FEV1 ),FEV1 /forced vital capacity(FVC),matrix metalloproteinase enzyme -9(MMP -9)and interleukin -8(IL -8)were detected in two groups before and after treatment.The adverse reactions of two groups were compared.Results After treatment, FEV1 ,FEV1 /FVC of the two groups were (1.49 ±0.04)L,(3.21 ±56.02)% and (1.89 ±0.21 )L,(59.98 ± 2.09)% respectively,which were significantly better than before treatment(t =7.98,9.03,8.03,8.32,all P <0.05),and which of the study group after treatment were significantly better than the control group(t =7.21,8.23,all P <0.05).6MWD and QLC after treatment of the two groups were (301.19 ±18.08)m,(67.19 ±2.31)points and (342.89 ±8.07)m,(75.21 ±5.25)points,which were significantly better than before treatment(t =7.98,8.03, 7.28,7.43,all P <0.05),and which of the study group after treatment were significantly better than the control group (t =8.03,8.47,all P <0.05).MMP -9 and IL -8 levels of two groups after treatment were (524.58 ±7.02)ng/mL, (7.23 ±1.04)ng/mL and (419.26 ±6.39)ng/mL,(6.09 ±0.06)ng/mL,which were significantly better than before treatment(t =7.52,8.13,7.23,7.41,all P <0.05 ),and which of the study group after treatment were significantly better than the control group(t =8.45,8.91,all P <0.05).The difference of adverse reactions of two groups was not statistically significant(χ2 =2.13,P >0.05).Conclusion Theophylline combined with tiotropium dry powder has an exact efficacy in the treatment of stable COPD,which can improve the lung function and the quality of life of patients.

Ocular surface is a special interface between the inner ocular tissue and the external environment.It provides effective physical and biological barriers to prevent environmentally harmful substances and pathogenic microbes invading into the eye.This protection is afforded by unique local anatomy and cellular components, especially the resident immune cells such as innate lymphoid cells (ILCs), macrophages, mast cells, Langerhans cells(LCs) and γδ T cells.Recent studies reinforce the importance of LCs and mast cells as inducers of immune tolerance.Most adult tissue macrophage populations are seeded before birth and maintained in the steady state independently of monocytes from blood.However, under inflammatory condition, some transient monocytes enter into tissue and become macrophage compartments.Monocytes are subdivided into two main phenotypically and functionally distinct subsets.The first main subset is dedicated to the surveillance of endothelial integrity.The second main subset compasses classical monocyte functions such as rapid migration to the sites of injury and the replenishment of peripheral dendritic cells and macrophage compartments.In addition, newly identified ILCs are founded in the ocular surface tissues.These cell groups defens the different stimulus from external environment by producing different cytokines and growth factors.Accumulating data highlight some key roles of tissue-resident immune cells in ocular surface homeostasis and pathology.

Ocular surface tissues are vulnerable to various stimuli from the external environment,including microbial invasion,mechanical damage,chemical stimulation,dust,UV light,and allergen stimulation.Conjunctival goblet cells play an important role in maintaining ocular surface self-homeostasis and health.These cells are the only unicellular glands in humans and mammals that are mainly distributed in the epithelium of the digestive tract,respiratory tract,and the ocular surface.Many factors affect goblet cell development and differentiation,especially the newly discovered molecule Spdef,which is a transcription factor found in the ETS family.The main function of conjunctival goblet cells is to secrete mucin to protect and lubricate the ocular surface;however,they also secrete a variety of other bioactive substances.Recent studies have demonstrated that goblet cells are involved in antigen presentation,regulation of dendritic cell phenotype differentiation,and induction of immune tolerance on the mucosa.Many ocular surface diseases,such as dry eye,will alter density and function of conjunctival goblet cells.Therefore,ophthalmologists should be concerned about the biological behavior of conjunctival goblet cells and the relationship between them and ocular surface diseases.

Objective To research the effects of parenteral nutrition(PN)with high branchedchain amino acid(BCAA)content for critically ill patients in general ICU.Methods A total of60 patientsfrom the general ICU were randomly divided into the control group(30 cases)and treatment group(30 cases).The control group was given PN with balanced amino acids,while the treatment group received PNwith high content of BCAA.Therapeutic outcomes and the blood parameters were measured betweengroups.Results Total protein (TP),albumin (ALB),prealbumin (PA),arm muscle circumference(AMC)and arm circumference(MAC)of the treatment group increased significantly(P <0.05).In thecontrol group,the change of TP,ALB and PA after 7 days was statistically significant(P <0.05).Compared to the control group,the improvement of parameters in the treatment group was more obvious.Conclusion For patients in general ICU,parenteral nutrition with high BCAA content is able to provide effective nutritional support without relative sideeffects.

To comparet the role of nitrogly-cerin with nicorandil in relieving myocardial ischemia, a critical stenosis of the left anterior descending coronary artery was produced by an ex-ternal micrometer constrictor in 18 open chest dogs. Intracoronary infusion of nitroglycerin ( 1 ?g ? kg-1 ? min-1) had two effects: decreasing large coronary artery resistance (RL) and small coronary artery resistance (Rs) and increasing coronary blood flow (CBF) in first 5 min so as to relieve myocardial ischemia; then increasing RL, decreasing CBF and increasing whole blood viscosity (?o) and hematocrit (Hct) in coronary vein after 10 min so as to worsen myocardia ischemia. However, intracoronary infusion ofnicorandil(l ?g ? kg-1 ? min-1) increased CBF and decreased Rs and reduced ?o and Hct in coronary vein. The vasodilatory effect of nico-randil was moderate but long-lasting and it improved blood supply to the ischemic region in coronary circulation.

Objective To observe the dynamic changes of adrenomedulin(ADM) and calcitonin-gene-relat-ed peptide(CGRP) at different time before,during and after laparoscopic operation for treating CO2 pneumoperitone-urn. Methods 47 cases undergoing laparoscopic operation in our hospital were selected. Plasma ADM and CGRP levels were determined by RIA before anesthesia(T0),10 min before (T1) and 10 min (T2) ,30 min (T3),60 min (T4),and 30 min (TS) after CO2 pneumoperitoneum was treated. Results There was statistical significance in ADM and CGRP level at the different time points before and after CO2 pneumoperitoneum (F=9.686 and 49.804, P<0.01). There was no significance in ADM and CGRP level at TO and T1 (P>0.05);ADM level would decrease at T2 (P<0.05) but CGRP level decrease slowly with no remarkable change as compared with that before CO2 pneumoperitoneum(P>0.05). With time going on, ADM and CGRP level at T3 and T4 was remarkably lower than that at T1 (P<0.01);ADM and CGRP level at T5 would come to that at T1. Conclusions CO2 pneumoperitoneum during laparoscopic operation is the major factor causing decreased ADM and CGRP level;The decrease of ADM and CGRP level will influence the cardiac endocrine function,so CO2 pneumoperitoneum operation should be taken seri-ously when the patients have heart disease and cryptorrhea.

Oral tolerance describes the phenomenon that orally administered proteins induce systemic hyporesponsiveness to the protein fed. The primary mechanisms by which oral tolerance is mediated include clonal deletion, clonal anergy and active cellular suppression through gut-associated lymphoid tissue(GALT). Low doses favor active suppression mediated by Th2 and Th3 cells, whereas high doses favor deletion and anergy mediated by Th1 and Th2 cells. Oral tolerance is an effective and specific approach without toxicity. In recent years, it has been used successfully to treat autoimmune diseases in model animals and patients. The article discussed the mechanisms and advances of oral tolerance for the purpose of providing new ways of treat autoimmune diseases.

AIM:Recently it was found that loss of anterior chamber-associated immune deviation (ACAID) was associated with normal pregnancy in rabbits. The purpose of this study is to further investigate whether the same events occurred in nonhuman primates. METHODS:Mid-pregnant cynomolgus monkeys were randomly selected. Bovine serum albumin (BSA) or balanced salt solution was inoculated in anterior chamber of eyes of nonpregnant and mid-pregnant monkeys that were subsequently immunized with BSA in adjuvant and then skin was challenged for delayed-type hypersensitivity with BSA. RESULTS: Non-pregnant monkeys of intracameral BSA were able to acquire antigen-specific suppression of delayed-type hypersensitivity. By contrast, inoculation of BSA to anterior chamber of pregnant monkeys abolished the DTH-suppression effect. CONCLUSIONS: This is the first demonstration in primates that loss of anterior chamber-associated immune deviation occurred during normal pregnancy. The fluctuations of systemic hormone levels during normal pregnancy might influence local immunoregulation within the eye.

NOK is a newly identified receptor protein-tyrosine kinase (PRTK) molecule that can promote tumorigenesis and metastasis. Previous data showed that NOK could activate the phosphatidylinositol 3'-kinase (PI3K) pathway in stable BaF3 cells. But how does NOK activate PI3K in cells remains unknown. It was showed that NOK physically interacted with the PI3K downstream effector Akt and enhanced its activation in human embryo kidney 293T (HEK293T) cells. Deletion mapping indicated that protein kinase B (Akt) was able to directly contact with the kinase domain of NOK. Inactivating the Akt kinase domain significantly reduced the intermolecular interaction between NOK and Akt, while constitutively active mutant of Akt apparently had a stronger interaction with NOK. NOK did not have an additive effect on insulin-mediated Akt activation. Overall, the results indicate that NOK might complex with Akt and directly activate PI3K/Akt signaling pathway.

Objective To establish an allogenic intraocular melanoma model and observe its pathological features. Methods Thirty-six kunming mice were devided randomly into 3 groups with 12 ones in each, and allogeneic melanoma cells B16F10(C57BL16) were inoculated into the anterior chamber (AC), vitreous cavity (VC) of right eyes and under the skin (subcutaneous, SC) of the back of right feet of each grup respectively. The incidence of tumor occurance, time of breaking through the eyeball and other general pathologic features of the tumor were observed by slip-lamp biomicroscopy and operating microscopy for continuous 32 days, and the results were statistically analyzed. Pathological examination was given for tumors at last. Results The incidence of tumor occurance in both AC (12/12 eyes) and VC group (11/11 eyes) was higher than that in SC group (2/12 feet)( ? 2 =17.143, P =0.000; ? 2 =16.218, P =0.000) . The time of eyeball diabrosis was 11-13 days in AC group and 13-32 days in VC group, and there was significant difference between these two groups (Log Rank=18.22, P =0.000). The intraocular melanomas could grow progressively, but reduced and fell off when they broke through eyeball and grew in orbit for a period. The average diameter of the tumor after 32 days after inoculation was (2.27?1.97) mm in AC group,(3.82?1.85) mm in VC group and (0.94?2.27) mm in SC group. There was significant difference between VC and SC group ( t =3.322, P =0.003). In pathohistological examination, tumor tissue necrosis could be observed at the center of the subcutaneous melanomas but not in intraocular melanomas. Conclusions Allogeneic intraocular melanoma model is successfully established which is convenient, repeatable, and helpful to studying the mechanism of genesis and development of this tumor.