Objective To investigate the effect of bronchodilators on dyspnea and pulmonary function in patients with chronic obstruction pulmonary disease (COPD) at different degrees.Methods 50 patients with COPD from January 2014 to January 2015 in pneumology department of Tongchuan City People's Hospital were selected.According to the standard of Global initiative for chronic obstructive lung disease (GOLD), the patients were divided into mild degree of 14 cases, moderate degree of 18 cases and severe degree of 18 case.The changes of Borg score of dyspnea, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and inspiratory capacity (IC) after received tiotropium bromide inhalation in each group.Results FEV1, FVC, PEF and IC values significant improved in mild, moderate and severe degree groups after received tiotropium bromide inhalation and the values of improvement rate changed significantly with degrees of disease ( P <0.05 ).The improvement rates of FEV1, FVC and IC were highest in patients at severe degree, improvement rate of PEF was highest in patients at mild degree (P<0.05).After received tiotropium bromide inhalation, the Borg score improved significantly compared with that of pre-treatment in mild, moderate and severe degree groups (P<0.05), the improvement rate of Borg score was highest in severe degree group(P<0.05).There were significantly positive correlations between Borg score and FEV1(r=0.372),FVC(r=0.296),PEF(r=0.284),IC(r=0.704)(all P<0.05).Conclusion Bronchodilator could significantly improve dyspnea and lung function in patients with COPD, and the improvement rate of FEV1, FVC and IC is highest in patients with COPD at server degree, PEF is highest at mild degree and Borg score is highest at server degree, which need the comprehensive analysis of each indicators for reversibility of airflow obstruction.

Objective To study the efficiency of the first time platelet transfusion in patients with blood diseases.Methods Investigate the effect of platelet transfusion in 87 patients with blood diseases.All the patients were transfused 10U platelet (platelet≥2.5×1011 ).Observe CCI after platelet transfusion and analyse the influence factors to the efficiency of the first time platelet transfusion such as the kind of diseases,splenomegaly,fever,age and sex.Results After platelet transfusion,66 patients (75.9 ％) were effective.The efficancy rates were 80.0 ％,78.1％,65.2 ％,82.3 ％ in AA,ITP,AL,MDS (x2=2.88,P＞0.05).In 31 patients with a fever and infaction the efficancy rate was 58.1％,but it was 85.7％ in 56 patients without a fever and infaction (x2=8.3308,P＜0.01).The efficancy rate in 59 patients with non-splenomegaly was 86.4 ％.It was higher than that in 28 patients with splenomegaly which was 53.6％(x2=11.2033,P＜0.01).The efficancy rate was 76.0％ in male patients and it was 75.7 ％ in female patients (x2=- 0.0012,P＞0.05).The efficancy rate was 74.5 ％ in young group (＜60 years old)and 77.8 ％ in old group (≥60 years old)(x2=0.1231,P＞0.05).Conclusion Fever and splenomegaly are the influence factors to the efficiency of the first time platelet transfusion.

Objective To understand the iodine deficiency disorders in Xunhua county Qinghai province, and to provide reference values for setting up prevention and control strategy. Methods According to historical data of Xunhua county, 1 township center elementary school and 1 village elementary school were sampled in Qingshui, Baizhuang, Hongqi, Jiezi and Galeng townships. A total of 9 elementary schools were investigated (Caleng has only 1 elementary school). Fourty children aged 8-10 years were checked thyroid size by palpation in every school. Twenty children were chosen to assay their urinary iodine and edible salt iodine in every school. Thirty 5-grade students were surveyed by questionnaire on health education in every school. Ten housewives were inquired prevention knowledge on iodine deficiency disorders and salt iodine level was tested in every village. Results Goiter rate was 7.9%(30/378) in children aged 8-10 years, with Baizhuang and Galeng the highest (11.9%,5/42), and Qingshui the lowest (2.4%, 1/42). The median was 196.5 μg/L in children aged 8-10 years, and urinary iodine level lower than 50 μg/L was accounted for 5.3% (11/208), but that value was 25.0% (5/20)in Galeng. The average qualified rate of using edible salt was 91.4%(159/174), and that rates were 79.0%(15/19), 83.3%(15/18) and 89.5%(17/19) in Chajia, Tuanjie and Minzhu villages, respectively. The average score were 2.8, 2.1 in health education survey of the 5-grade students and housewives. Conclusions After years effort in prevention and control of iodine deficiency disorders, remarkable progress has been made in Xunhua County. The monitoring of iodized salt and the knowledge spreading are still need to be strengthened.

Objective To analyze the clinical,radiological and pathological features of primary leiomyosarcoma of bone and to im-prove the diagnostic level.Methods Totally 6 cases of PLB proved by pathology were collected in our study.The clinical,radiologi-cal and pathological findings were retrospectively analyzed,and combined with the relevant literature to have a comprehensive analy-sis.Results The lesions of 6 patients were solitary,located in femoral (1 case),distal femur (1 case),proximal tibia (2 cases),is-chium (1 case)and humerus (1 case).There was no periosteal reaction in all 6 cases but they all had soft tissue mass,sometimes there may have some mineralization within the tumor.Ill-defined osteolytic bone destruction was detected in 5 patients,while expan-sion of cystic bone destruction was found in the other 1 patients.3 cases had hardened edge,2 cases with adjacent bone cortical thickening.The MR imaging in 5 patients showed iso-intensity signal on T1 WI,a slightly inhomogeneously higher signal on T2 WI and a significant heterogeneously enhancement after injected of Gd-DTPA.Another 1 patient showed a double ring sign,the central area onT1 WI and T2 WI expressed heterogeneous slightly higher signal,the peripheral annular zone was iso-intensity on T1 WI and slightly higher on T2 WI,after injected contrast medium,it was inhomogeneous enhancement.In immunohistochemically,all tumors reacted positively with SMA,3 patients with Desmin and Vimentin positive,2 patients with Ki-67 positive,and there had some scat-tered cells with CD68 positive,but the S-100 were all negative.Conclusion The clinical,radiological and conventional histological manifestations of PLB are not specific.Immunohistochemical and/or ultrastructural analysis who displayed smooth muscle differenti-ation can confirm the diagnosis.

Objective To study the relation of matrix metalloproteinase-9 in serum and tumor necrosis fac- tor-?in serum and amniotic fluid in predicting ehorioamnhionitis in patients with premature rupture of membranes (PROM).Methods The levels of MMP-9 in serum and TNF-?in serum and amniotie fluid were measured by ra- dioimmunoassay and ELISA in 67 cases with premature rupture of membranes as study group and 40 cases normal full-termed pregnant women as controls group.Results(1)The levels of TNF-?in amniotie fluid and MMP-9 in serum in study group were significantly higher than those in controls group(P0.05).(2)In study group,the levels of MMP-9 of serum in0.05).Conclusions The levels of TNF-?in amniotic fluid and MMP-9 in serum were valuable clinical indices for identification of chorioamnionitis in patients with PROM.The levels of MMP-9 in serum also could assess the time of rupture of membranes and the degree of ehorioamnionitis.

OBJECTIVETo investigate the relationship between mRNA expression of inducible nitric oxide synthase (iNOS) and organ injury, and the effect of Salviae Miltiorrhizae on iNOS mRNA in severe acute pancreas (SAP) rats.

METHODSForty-five Wistar rats were randomly divided into 3 groups, the model group (MG), the Salviae Miltiorrhizae group (SMG), and the control group (CG), with 15 rats in each group. Rats in MG and SMG were established to SAP model by intraductal injection with 5% sodium taurocholate in a dose of 1.0 ml/kg, while rats in CG were merely performed sham-operation. Immediately after modeling, rats in SMG were injected with Salviae Miltiorrhizae injection (SMI) 2 ml/kg every 6 h for 4 times in total, but to rats in other two groups same volume of normal saline were administered. The level of serum amylase (AMY), nitric oxide (NO) and the volume of ascites of rats were determined 24h after modeling, and intensity of iNOS mRNA expression in pancreas, lung and kidney were detected in the same time using in situ hybridization and image analysis. The pathologic change was observed as well.

RESULTSThe volume of ascites and serum levels of AMY and NO in MG were significantly higher then those in SMG and CG (P < 0.05 and P <0.01). The expression of iNOS mRNA in pancreas, lung and kidney increased in MG and SMG, it was significantly higher in MG than that in SMG. And the pathological change of pancreas, lung and kidney in SMG was milder than that in MG.

CONCLUSIONSOver-expression of iNOS mRNA could cause excessive synthesis of NO, and lead to injury of pancreas, lung and kidney in SAP. Salviae Miltiorrhizae in early stage of the disease can inhibit the over-expression of iNOS mRNA to ameliorate the injury of the pancreas, lung and kidney.

Animals ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Kidney ; pathology ; Lung ; pathology ; Male ; Nitric Oxide Synthase Type II ; biosynthesis ; genetics ; Pancreas ; pathology ; Pancreatitis, Acute Necrotizing ; drug therapy ; enzymology ; pathology ; Phytotherapy ; RNA, Messenger ; biosynthesis ; genetics ; Random Allocation ; Rats ; Rats, Wistar ; Salvia miltiorrhiza

Objective To investigate the feasibility of ultrasmall superparamagnetic iron oxide- enhanced(USPIO)-enhanced MR imaging for monitoring synovitis of antigen-induced arthritis in rabbit model and explore the optimal MR imaging sequences.Methods Nine female white rabbits with antigen(0.5 ml mBSA,2 mg/ml)induced arthritis of the right knees were used in the study.The left knees of these rabbits and both knees of another 3 rabbits served as the control.Nine to 28 days(mean 21.3 d)after successful model induction,all knees were imaged before and 24 h after intravenously injection of USPIO (0.3 ml/kg),among which 2 rabbits were also imaged at 48 and 72 h after administration of USPIO respectively.The MR protocol included spin-echo(SE) T_1WI,fast spin-echo(FSE)T_2WI,gradient echo (GRE)T_2~* WI and short tau inversion recovery(STIR).Images were analyzed quantitatively and qualitatively based on signal characteristics and patterns of the synovium.Paired t-test was used for the analysis of the signal intensity of inflammatory synovial membrane before and 24 h after injection of USPIO. MR findings were correlated with histopathology.Results Arthritis was successfully induced in all 9 right knees with intraarticular injection of mBSA.Pathological examination revealed hyperplasia of synovium with infiltration of USPIO-loaded-macrophages.MR depicted synovial thickening(thickness 2.07?0.97 mm) and joint effusion.Synovium and joint fluid appeared as slightly hypo- or iso-intense on T_1 WI and hyper- intense on T_2 WI or T_2~* WI.Twenty four hours after USPIO injection,significant T_1 enhancement(ASNR 41.91%?27.94%),negative T_2 and T_2~* enhancement(△SNR -34.92%?11.77% and -57.24%? 16.05%)were demonstrated in the region of synovial inflammation respectively.The signal at 48 h and 72 h changed less than that at hour 24.No signs of arthritis occurred in all left knees and in all knees of the artificial model group.Conclusion Iron oxide phagocytized into macrophages can be a root cause resulted in signal change on USPIO-enhanced MR images.The gradient echo sequence should be the optimal sequence to be used in USPIO-enhanced MR imaging in antigen-induced arthritis.

Objective To compare the effect of right ventricular outflow tract (RVOT) and right ventricular apex (RVA) pacing on ventricular systolic synchrony using gated blood pool SPECT (GBPS).Methods A total of 50 patients implanted with pacemaker due to high degree or complete atria-ventricular block were enrolled in the study. Twenty-three patients were RVOT paced ( Group A, n = 23) and 27 were RVA paced (Group B, n=27). Twenty-four patients with malignancy, normal echocardiographic findings and no history of cardiac diseases were scheduled for pre-chemotherapy evaluation of cardiac structure and function and were enrolled as control group ( Group C, n = 24). All patients underwent GBPS imaging and the values of phase angle (PS), mean phase of each wall, standard deviation (SD) of mean phase of each wall, lateral-septal motion delay of left ventricle ( LV Sep-Lat Delay), septal-right ventricular (RV) delay of LV ( LV Sep-RV Delay) and LV-RV Delay were acquired. The parameters of ventricular systolic synchrony among the three groups were compared using one-way ANOVA. Results The mean phase of LV lateral wall in Groups A and B were significantly higher than that in Group C: Group A (120.50 ±40.58) ms; Group B (103.23±28.34) ms; Group C (84.63 ±22.38) ms (F=7.72, P ＜0.05). There was no significant difference between Groups A and B ( t = 1.30, P ＞ 0.05 ). The mean phase of RV in Group A was significantly larger than those in Groups B and C: Group A ( 137.05 ± 39.27) ms, Group B ( 100.85 ± 23.79) ms,Group C (59. 13 ±30.52) ms (F=35.55, P＜0.05). PS, SD and LV Sep-Lat Delay in Groups A and B were significantly higher than those in Group C: (85.73 ± 12.00)°vs (89.85 ± 15.61 )°vs (58.95 ±9.87)°, (27.68±10.66) ms vs (26.15 ±13.02) ms vs (15.63 ±8.35) ms, (25.06±34.23) ms vs (2. 62 ± 60. 31 ) ms vs ( - 23.66 ± 31.39) ms, F = 41.54,8.55,6.81, all P ＜ 0.01 ), however, there was no significant difference between Groups A and B ( t = 0. 68, 0.68, 1.30, all P ＞ 0.05 ). LV Sep-RV Delay and LV-RV Delay were significantly different among the three groups ( LV Sep-RV Delay: Group A (57.60 ±56.77) ms, Group B (6.36 ±61.88) ms, Group C ( -41.89 ±35.78) ms; LV-RV Delay:Group A (47.36 ±42.59) ms, Group B ( 3.08 ± 38.81 ) ms Group C ( - 26.50 ± 20.99 ) ms, F = 20. 32,25.38, both P ＜ 0.01 ). Conclusion Both RVA and RVOT pacing increase the segmental phases detected by GBPS, causing inter- and intra- ventricular asynchrony compared with patients without pacemakers.

OBJECTIVETo summarize the 23-year experience of laparoscopic biliary surgery in General Hospital of PLA and evaluate the application of laparoscopic surgery in the treatment of biliary diseases.

METHODSWe retrospectively analyzed the clinical data of 11 419 consecutive patients with biliary diseases undergoing laparoscopic surgery from April, 1992 and December, 2014. The disease spectrum was compared between patients treated before December 31, 2003 and those treated after the time point.

RESULTSThe 11419 patients receiving laparoscopic surgery accounted for 56.3% of the total patients undergoing biliary surgeries during the 23 years, including 4701 male and 6718 female patients with a mean age of 50.9∓13.2 years (6-93 years). Most (80.83%) of the patients received laparoscopic surgery for gallbladder stones, and 12.53% patients had the operation for gallbladder polyps. The laparoscopic operation rate was 84.81% in patients with gallbladder stones and 34.91% in patients with extrahepatic bile duct stones, but remained low in patients with biliary carcinoma. In laparoscopic operations, laparoscopic cholecystectomy was the most frequent (96.18%) followed by operations for extrahepatic bile duct stones, in which primary suture accounted for 1.38%, traditional T tube drainage for 0.90% and laparoscopic transcystic duct exploration for 0.72%. For malignant tumors, laparoscopic technique was used mainly for the purpose of exploration (0.34%). The application of laparoscopic technique in biliary surgery tended to increase after the year 2004, especially for benign gallbladder diseases and extrahepatic bile duct stones (P<0.05).

CONCLUSIONLaparoscopic technique in biliary surgery is gradually replacing the traditional open operation and becomes the gold standard for the treatment of benign biliary diseases.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms ; surgery ; Bile Ducts, Extrahepatic ; Child ; Cholecystectomy, Laparoscopic ; Drainage ; Female ; Gallbladder Diseases ; surgery ; Gallstones ; surgery ; Humans ; Laparoscopy ; trends ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

This study was purposed to investigate the correlation of absolute lymphocyte count (ALC) in peripheral blood of de novo multiple myeloma (MM) patients with clinical characteristics, therapeutic efficacy and prognosis. The clinical data of 34 de novo patients with MM in our hospital from January 2002 to August 2011 were analysed retrospectively. According to ALC, patients were divided into ALC < 1.3×10(9)/L (n = 15) group and ALC ≥ 1.3×10(9)/L (n = 19) group. The correlation of incipient ALC levels of de novo MM patients with clinical data such as sex, age, type of MM, bone destruction, clinical staging and grouping, levels of LDH, β(2)-MG, creatinine and albumin, as well as therapeutic efficacy was analysed. The results showed that ALC was (0.4 - 2.9)×10(9)/L (median ALC was 1.3×10(9)/L) in untreated patients. The effective rate of therapy was 20% in ALC < 1.3×10(9)/L group while it was 57.9% in ALC ≥ 1.3×10(9)/L group. There was statistical difference in effective rate between two groups (χ(2) = 4.9696, P < 0.05). Compared with the ALC ≥ 1.3×10(9)/L group, the percentage of the CD4 and CD4/CD8 ratio were reduced and the percentage of the CD8 increased (P < 0.05). But no significant differences were found in sex, age, type of MM, bone destruction, clinical staging and grouping, levels of LDH, β(2)-MG, creatinine and albumin in those patients (P > 0.05). It is concluded that ALC in de novo patients with MM may be used as the important indication for analysing therapy effect and prognosis.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymphocyte Count ; Male ; Middle Aged ; Multiple Myeloma ; blood ; diagnosis ; pathology ; Prognosis ; Retrospective Studies ; T-Lymphocyte Subsets