Objective To investigate the parameters of nutrition status in the patients with COPD and study the difference nutrition status among COPD GOLD classification including A, B,C and D.Methods According to the global initiative for chronic obstructive lung disease ( GOLD) criteria, we classified the COPD outpatients into A, B, C, D group, with 10 cases in each group, 20 cases healthy people as control group as well as 20 patients with chronic bronchitis.Body mass index ( BMI) , triceps skin-fold thickness( TSF) ,ser-um albumin ( ALB ) were measured in each person.Results BMI was significantly lower in COPD group than health control group (21.3 ±4.0kg/m2 vs 24.7 ±3.7kg/m2, P<0.01) ; TSF was significantly reduced in COPD group than the control group (10.3 ± 4.4mm vs 13.0 ±4.4mm, P<0.05);ALB in COPD group was significant decreased than the control group (34.4 ±5.3g/L vs 39.5 ± 6.7g/L, P<0.01).Moreover, there were significantly differences in the nutrition status among COPD groups.BMI in the group of(C+D) was significantly lower compared with the group of (A+B) (19.9 ±4.3kg/m2 vs 22.1 ±3.5kg/m2, P<0.05).TSF was significant-ly decreased in the group of (C+D) than the group of (A+B)(7.7 ±2.4mm vs 12.9 ±4.4mm, P<0.01).Compared with the group of (A+B), ALB was also significantly reduced in the group of (C+D)(32.3 ±4.5g/L vs 36.5 ±5.4g/L, P<0.01).Conclusion The parameters of BMI, TSF, ALB are significantly reduced in the patients with COPD.Severe COPD easily develops malnutrition.Ac-cording to COPD GOLD classification, the nutrition status is worse in the group of ( C+D) than in the group of ( A+B) .It is worthy to pay attention to the nutrition status of COPD patients, and give appreciate therapy for patients with COPD.

Objective To study the expression of ILD patients and health men during exercise,furthermore provide the reference of application of exercise test in ILD.Methods Cycle exercise test was used in 36 patients with ILD and 20 normal subjects,The oxygen uptake per minute(VO2),Borg Scale(BS),SpO2,and other index of exercise test were detected.Results Compared with normal subjects,The VO2max in ILD patients was decrease markedly;The BS was increased,SpO2 decreased markedly during exercise.Conclusions The results indicate that the hypoxemia and dyspnea are the limited factors of exercise in the patients with ILD;The capacity of exercise in ILD decrease compare with normal subjects.

Objective To study the expression of dyspnea and SpO2 with the patients with COPD and silicosis during exercise, further more to provide the reference in clinic treatment.Methods Cycle exercise test was used in 20 patients with COPD and 20 silicosis patients , The oxygen uptake per minute (VO2) ,Borg Scale (BS), SpO2, and other index of exercise test were detected. Results Dyspnea index as Borg scale was closely correlated with oxygen uptake (VO2) during exercise in all the patients. Borg scale slope (BSS) for quantitative evaluation of dyspnea could be derived from the linear regression line,and the BSS in COPD patients was higher than BSS in silicosis patients[(10.9?3.8)BS/(L?min) vs (7.2 ?1.9)BS/(L?min),P

Objective Esophageal spindle cell carcinoma is a rare type of esophageal squamous cell carcinoma , which was usually named esophageal carcinosarcoma .This article was to discuss the clinical characteristics , treatment and prognostic factors of e-sophageal spindle cell carcinoma . Methods The clinical and pathological data of 28 cases of esophageal spindle cell carcinoma were retrospectively analyzed .The prognostic factors was analyzed for various factors including gender , age, smoking history , tumor loca-tion, tumor size, lymph node metastasis, histological type, pathological staging and adjuvant treatment regimen .Kaplan-Meier method was applied to calculate the survival rate , log rank method for single prognostic factor analysis and Cox proportional hazard regression model for multivariate analysis of prognosis . Results One-year, three-year, and five-year survival rates were 89.3%(25/28), 67.1%(19/28), 38.5%(10/28)respectively.Single factor analysis showed that the pathological type , N stage, T stage, pTNM stage were the factors influencing the prognosis(P﹤0.05), while gender, age, smoking and drinking history, tumor location, tumor size, operation incision selection , adjuvant treatment regimen were not .Multivariate analysis showed pTNM stage were the independent fac-tors affecting the prognosis of esophageal spindle cell carcinoma (χ2 =13.104, P=0.000). Conclusion Esophageal spindle cell carcinoma is a rare kind of esophageal squamous cell carcinoma with less invasiveness , low rate of lymph node metastasis and good progno-sis.Radical operation is the preferred treatment .

Objective To monitor right heart hemodynamic changes of patients with lung cancer during and after the procedures of pneumonectomy and discuss the effect of pneumonectomy on right heart function and risk of postoperation morbidities. Method 16 patients with lung cancer were randomly selected and the clinical database was queried and Swan-Ganz catheter was applied awake from jugular vein to pulmonary artery ,measuring mean arterial pressure(MAP) ,heart rate(HR) ,central venous pressure(CVP) ,mean pulmonary artery pressure (MPAP),mean pulmonary capllary wedge pressure(MPCWP) ,and eardiaoc output(CO) and calculating cardiac index (CI),left ventricular-stroke work index (LVSWI), right ventricular stroke work index (RVSWI) , and stroke volume index(SVI) instantaneously before anaesthesia, after anaesthesia with single lung ventilation, after pulmonary artery and pulmonary vein occlusion and supine chest dosed during the procedure of pneumonectomy. Pre-and post-operative complications were recored. Results Cardiovascular complications occurred in 6 patients(37.5%) postoperatively. There were no operative or perioperative deaths. MPAP increased significantly after the procedure of pneumonectomy compared with that of preoperation, and MPAP > 26 mm Hg was in 4 patients who got cardiovascular complications postoperatively with morbidity of 100% ,which was "significantly higher than the morbidity of 16.7% (2/12) when MPAP < 25 mm Hg. Conclusion Pneumonectomy has significant effects on right heart hemodynemic changes and as MPAP increases postoperatively, the risk of cardiovascular complications becomes higher.

Objective To evaluate the effects of exogenous hydrogen sulfide on inflammatory responses during acute myocardial ischemia in rats.Methods Twenty-four adult male Sprague-Dawley rats,weighing 250-290 g,were randomly divided into 3 groups (n =8 each):sham operation group,acute myocardial ischemia group,and sodium hydrosulfide (NaHS) group.The animals were anesthetized with intraperitoneal chloral hydrate.The model of acute myocardial ischemia was established by ligating the left anterior descending branch of coronary artery.Normal saline 2 ml/kg and NaHS 3.12 mg/kg were intraperitoneally injected at 3 h of ischemia in AMI and NaHS groups,respectively.The rats were sacrificed at 6 h after ligation and hearts were removed for determination of interleukin-1β (IL-1β),IL-6 and tumor necrosis factor-α (TNF-α) contents (by ELISA) and intercellular adhesion molecule-1 (ICAM-1) mRNA expression (by semi-quantitative PCR) in myocardial tissues and for examination of myocardial ultrastructure with transmission electron microscope.Results Compared with S group,IL-1β,IL-6 and TNF-α conte.nts and ICAM-1 mRNA expression in myocardial tissues were significantly increased in AMI group (P ＜ 0.05).Compared with AMI group,IL-1β,IL-6 and TNF-α contents and ICAM-1 mRNA expression in myocardial tissues were significantly decreased in NaHS group (P ＜ 0.05).The damage to myocardial ultrastructure was significantly alleviated in NaHS group when compared with AMI group.Conclusion The mechanism by which exogenous H2S alleviates the acute myocardial ischemia injury is related to inhibition of the inflammatory responses in rats.

Objective To investigate effects of H2 S on myocardial ischemia injury in rats and explore the possible mechanism from oxidative stress.Methods Fourty-eight male SD rats were randomly divided into 6 groups:sham operation group,ischemia group,ischemia + NaHS low,middle and high dose groups and ischemia + PPG group.The acute myocardial ischemia model was established by ligating the left anterior descending coronary artery(LAD) of the rats.Saline was intraperitoneally administrated in ischemia group.LADs were not ligated but only threaded in sham operation group in rats.In ischemia + NaHS low,middle and high dose groups or ischemia + PPG group,sodium hydrosulfide(NaHS) or DL-propargylglycine(PPG) was intraperitoneally injected respectively at 3 hours after ischemia.All rats were killed at 6 hours after the operation.The content of malondialdehyde (M DA),and the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in myocardial tissue were respectively measured.The pathological changes of myocardial tissue were observed with electron microscope.Results Compared with those of sham operation group,the myocardial structural damage was increased,the content of MDA was significantly increased,and the activities of SOD and GSH-Px were significantly decreased in ischemia group in rats ((P ＜ 0.01).Compared with those of ischemia group,the myocardial structural damage was alleviated,the content of MDA was significantly decreased,and the activity of SOD was significantly increased in ischemia + NaHS low,middle and high dose groups ; the activity of GSH-Px was significantly increased in ischemia + NaHS middle and high dose groups in rats (P ＜ 0.05).Compared with those of ischemia group,the myocardial structural damage was increased,the content of MDA was increased,the activities of SOD and GSH-Px were decreased in ischemia + PPG group in rats (P ＜ 0.05).Conclusion The administration of H2S could significantly alleviate the myocardial injury by increasing the activities of SOD and GSH-Px,and decreasing the MDA synthesis in acute myocardial ischemia.

Objective To evaluate the efficacy of administration of ampicillin/sulbactam and imipenem/cilastatin in treatment of aspiration pneumonia in aged patients. Methods 26 aged patients was treated with aspira-tion pneumonia (2.25～3.00 g) through vessel injection twice perday,and another 26 patients was treated with imi-penem/cilastatin (0.5 g) through vessile injection every 6～8 hours. We evaluated the efficacy through assessing the temperature,the chest radiography,WBC and CRP,incidence of side effects,the time to cure and the clearance of bacteria. Results The cure rate was 84.6% (22/26) and 92.3% (24/26),respectively (χ2=0.19,P=0.66). The time to cure was 8.2±2.8 days and 7.5±1.6 days for the groups (t=1.107,P=0.274). Gastrointestinal side effects were observed in the group of ampicillin/sulbactarn;slight abnormality of liver function occurred in the group of imipenem/cilastatin ;all above adverse effects in two groups were rapidly and completely disappeared after therapy stopped. Conclusion Both ampicillin/sulbactam and imipenem/cilastatin are effective antibiotics to treat aspiration pneumonia in aged patients.

Background Ex-PRESS glaucoma drainage device implantations have been clinically applied worldwide.In China,50 type and 200 type of Ex-PRESS glaucoma drainage devices are used for different types of open angle glaucoma.However,whether the clinical outcomes are similar between 50 type and 200 type of Ex-PRESS glaucoma drainage devices are not elucidated.Objective This study was to compare the therapeutic efficacy and security of Ex-PRESS implantation between PS0 type and P200 type of Ex-PRESS glaucoma drainage devices for open angle glaucoma Methods A randomized,parallel-group trial was designed,and written informed consent was obtained from each patient prior to entering in the cohort.Eighty eyes of 69 patients with various types of open angle glaucoma were included from March 2012 to April 2013 in Wuhan General Hospital of Guangzhou Military Command.The patients were randomized into 2 groups according to randomized digital table.The P50 type Ex-PRESS glaucoma drainage device was implanted in 40 eyes of 35 patients in the P50 group,and P200 type was implanted in 40 eyes of 34 patients in the patients of the P200 group.The disease composition,best corrected visual acuity (BCVA) recovery time,theoretical hospitalization days,lowing intraocular pressure (IOP) range and postoperative complications were compared between the two groups.Results The average lowing-IOP ranges of the P50 type group and P200 type group were (21.19±11.22) and (24.35±12.27) mmHg,respectively,with an insignificant difference between them (t =-1.201,P＞0.05).The theoretical hospitalization days and BCVA recovery time in the of P50 type group were (3.65±0.92) days and (2.85±0.95)days,and those in the P200 type group were (4.90±0.81) days and (3.40± 0.96) days,showing significant decreases in the P50 type group (t =-6.444,P＜0.01 ;t =-2.584,P＜ 0.05).The incidence of postoperative complications were 6.06％ and 25.00％ in P50 type group and P200 type group,respectively,with a significant difference between the two groups (.x2 =9.800,P＜0.05).Conclusions Although P50 and P200 Ex-PRESS implantation provide a similar effect in lowing IOP,P50 type Ex-PRESS implantation can restore BCVA more rapidly and lessen complications in comparison with P200 type Ex-PRESS implantation in the early postoperative stage.

Objective To investigate the influence of respiratory motion on target dose distribution in three-dimensional conformal radiation therapy(3DCRT) and intensity modulated radiation therapy(IM-RT). Methods A 2D air vented ionization chamber array MatriXX system,a platform which can mimic the clip motion of lung tumor, and a home-made solid water(RW3) phantom were used to measure the 2D dose distribution of static and moving targets irradiated by 3DCRT and IMRT beams using multiple gantry an-gles. The period of the moving platform was set to 3.5 s and the amplitude was ± 1 cm. Then the differences of dose distribution between the static phantom and moving phantom were compared and analyzed with the MatriXX system software. Results Compared with the static phantom in 3DCRT, the penumbra of dose distribution of the periodic moving phantom along the moving directions was increased by 6-9 mm, the high dose area was shrinked by about 5 ram,and the low dose area was extended by 5 mm,but the area of 50% i-sodose and the dose center area changed very little. When a single segment beam of IMRT was delivered and measured and the maximum dose of measuring plane was normalized to 100% ,the average difference of dose distribution between the static and dynamic phantoms was ±27% (from -56.4% to 56.1%) ;When all of the segment beams of IMRT were dehvered and the integrated dose distribution was measured ,the dose differ-ences were less than ±3% ,and the maximum difference of dose distribution was about ±15% which mainly appeared at the field margin and were similar to 3DCRT. Conclusions The dose distribution of most cen-ter areas of the periodic moving target using multi-fraction 3DCRT/IMRT beams is similar to that of the static target, while the high dose area of the former is shrinked and the low dose area is extended.