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 investigate the effect of small dose of dexmedetornidine on venous continuous infusion combined with oxycodone or fentanyl during brachial plexus blockade.Methods Sixty thyroid patients (ASA Ⅰ or Ⅱ) undergone brachial plexus anesthesia for cutting or cutting thyroid tumor patients were randomly and double-blindly into three groups (n =20 in each group).Group A:single brachial plexus anesthesia;group B:dexmedetornidine combined with fentanyl;group C:dexmedetornidine combined with oxycodone.Blood pressure (Bp),heart rate (HR),the determination of plasma norepinephrine (NE),cortisol (Cor),the concentration of blood glucose (Glu),VAS,Ramsay calm score,local anesthetics dosage and side effect formation rate at the beginning operation (To),skin incision (T1),separation of the glands (T2),gland excision (T3),and the end of the surgery (T4) were recorded.Results Compared to group A,the mean arterial pressure (MAP),HR,NE,Cor,and Glu were much lower at each time point (P ＜ 0.05) in groups B and C;Ramsay calm score and VAS score were significantly better at each time point (P ＜ 0.05);the incidence of chills and lidocaine additional quantity were significantly lower (P ＜0.01).However,compared to groups A and C,choking cough response rates were much higher in group B (P ＜ 0.01).Conclusions Small dose of dexmedetornidine on venous continuous infusion combined with oxycodone during brachial plexus blockade for thyroid patients both can eliminate the preoperative patients nervous anxiety,and effectively restrain perioperative stress response,maintain hemodynamics stable,implementation of intraoperative awaken to reduce complications.It is the new choice of anesthetic adjuvant.

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.

Objective To observe the effects of herbal compound in reinforcing the kidney for activating blood and arousing consciousness(HCRAA) on the ABR threshold and the expression of neurotrophic factor 3(NT-3) of the cochlea of gentamicin (GM)-induced ototoxic mice.Methods 40 mice were randomly divided into normal group,model group,and high,middle and low concentration HCRAA groups.Normal group received no treatment.The model group and the HCRAA groups were intraperitoneally injected with GM 100mg/kg per day for consecutive 15 days.At the same time,the model group and the HCRAA groups respectively receiveded normal saline and high,middle and low concentration Chinese medical formula decoction at the same dosage by garage for consecutive 20 days.After the experiment,the mice were tested ABR.The expression of NT-3 of the cochlea in mice was detected by western blot.Results HCRAA at high and middle concentration reduced the GM elevated ABR threshold(P＜0.01),and increased the expression of NT-3 in the cochlea(P＜0.01).Conclusion HCRAA may effectively reduce the elevated ABR threshold induced by gentamycin by protecting GM damaged cochlear hair cell and neurons and increasing the expression of NT-3 in the cochlea.

Objective:To modify the pulsatile bioreactor we constructed previously for simulating the high-flow, high-pressure hemodynamics of heart valve in vivo, and to experimentally cultivate the tissue-engineered heart valves (TEHV) in the modified bioreactor. Methods: T-PLS system (NewheartBio Co., Ltd Korea) was used to generate pulsatile flow in the modified bioreactor and we designed a new air-exchange pathway to avoid contamination. The TEHV were made by seeding human bone mesenchymal stem cells (BMSCs) on de-cellularized porcine heart valve. After cultured under static condition for 4 d, the TEHVs were moved to the modified bioreactor and exposed to low-flow (0-600 ml/min) or high-flow(0-4 800 ml/min) pulsatile hydrodynamics for 7d, then the cells on TEHVs were evaluated. Results: After modification, the flow range expanded from (0-1 200) ml/min to (0-6 000) ml/min and the pressure range expanded from (0-40) mmHg to (0-180) mmHg. In culture experiments, 26.3% of the seeded cells remained under low-flow environment and cells were completely lost under the high-flow dynamics. Conclusion: The modified bioreactor can basically simulate the dynamics of heart valve in vivo and can be used in TEHV cultivation research. However, the current TEHV can not tolerate the high-flow pulsatile hydrodynamics.

Objective To investigate nutrition status and dyspnea in the patients with chronic obstructive pulmonary disease (COPD) between GOLD Ⅱ and GoLD Ⅲ, and test the evaluative validity of disease status by GOLD classification of COPD. Methods Thirty patients with clinically stable COPD were recruited, including 15 patients of GOLD Ⅱ of COPD and 15 patients of GOLD Ⅲ of COPD. Body mass index (BMI), triceps skin-fold thickness (TSF), serum albumin (Alb), and partial pressure of oxygen in arterial blood (PaO2) were measured in each patient. Dyspnea was assessed by the Borg Scale (BS). Exercise stress test was taken by incremental exercise test. Results BMI was significantly lower in the patients of GOLD Ⅲ than that in the patients of GOLD Ⅱ[(19±5 ) kg/m2 vs (23±3) kg/m2,p < 0.05]. TSF was significantly reduced in the patients of GOLD Ⅲ than that in the patients of GOLD Ⅱ[ (8±3) mm vs(13±5) mm, P < 0.01]. Alia in the patients of GOLD Ⅲ was significantly decreased than that in the patients of GOLD Ⅱ [(32±7) g/L vs (36±6) g/L, P <0.05]. The difference of PaO2 between the patients of GOLD Ⅲ and the patients of GOLD Ⅱ was significant [(72±9) nun Hg (1 mm Hg = 0.133 kPa ) vs (78±8) nun Hg, P < 0.01], and the significant difference of BS was found between the patients of GOLD Ⅲ and the patients of GOLD Ⅱ( 5.0±2.0) grades vs (3.0±1.0) grades, P <0.05 ]. In addition, 12 patients in the patients of GOLD Ⅱ took the exercise stress test and 8 patients were found anaerobic threshold (AT), 5 patients in the patients of GOLD Ⅲ took the exercise stress teat and no AT was found. Conclusions The parameters of BMI, TSF, Alb and PaO2 are significantly reduced in the patients of GOLD Ⅲ than those in the patients of GOLD Ⅱ. In the patients of GOLD Ⅲ, BS is higher than that in the patients of GOLD Ⅱ and AT is difficult to obtain, suggesting more severe in degree of impairment. GOLD classification of COPD reflects the disease stares and prognosis in the patients with COPD, as a valuable parameter in clinical practice.

Objective To compare the accuracy, image quality and radiation dose between prospective ECG?gated sequential and high?pitch acquisition on 128?slice dual?source CT (DSCT) angiography in infants and children with congenital heart disease (CHD). Methods Ninety?two children with CHD from October 2011 to February 2013 were prospectively enrolled and assigned into two groups according to random number table. Forty?six patients underwent DSCT angiography with sequential mode, and the other 46 patients were examined with high?pitch mode. With surgical and/or DSA results as the standard, the diagnostic accuracy and sensitivity of the two groups for the intracardiac structures, extracadiac and coronary artery anomalies were evaluated, and the comparison was analyzed by Fisher exact test. A 5?grade scoring system was used to interpret the image quality of intracardiac structures, great vessels and the proximal and middle segments of coronary arteries. Interobserver agreement on grades of image quality was assessed by Kappa statistics. The image quality scores were compared using the Mann?Whitney U test. The Student t test or the Mann?Whitney U test was used to analyze the differences between the two groups regarding to patients' age, weight , heat rate, CT attenuation, image noise and SNR in the ascending aorta and the pulmonary trunk as well as radiation dose. Results All 92 patients successfully underwent DSCT angiography. The diagnostic accuracies of intracardiac anomalies by high?pitch group and sequential group were 95.65%(88/92) and 99.28%(274/276), showed significant difference between the two groups (P<0.05), but no significant difference in the sensitivity of intracardiac anomalies (P>0.05) .There was no significant difference in the diagnostic accuracy and sensitivity of extracadiac anomalies between the two groups (P>0.05). The diagnostic accuracies of coronary artery anomalies by high?pitch group and sequential group were 93.48%(43/46) and 100.00%(46/46), showed no significant difference between the two groups (P>0.05), but there was significant difference in the sensitivity of coronary artery anomalies (50.00%(3/6) , 100.00% (11/11)) (P<0.05). There was excellent agreement for image quality scoring of the intracardiac structures, great vessels and the proximal and middle coronary arteries between the two observers (Kappa=0.81, 0.85, 0.85, P<0.05). The median image quality scores of extracardiac great vessels were both 5.00 in high?pitch group and sequential group, and there was no significant difference between the two groups (U=981.000, P>0.05). The median image quality scores of intracardiac structures and proximal and middle segments of coronary arteries respectively by high?pitch group were 4.00 and 3.00, and 5.00 and 4.00 respectively by sequential group. The image quality of intracardiac structures (U=594.500, P<0.05) and proximal and middle segments of coronary arteries (U=397.500, P<0.05) was significantly better in the sequential group than that in the high?pitch group. There was no significant difference between the two groups in CT attenuation, noise and SNR of the ascending aorta and pulmonary trunk. The mean effective doses of the high?pitch group and the sequential group were(0.27±0.11)and(0.39±0.17)mSv, and showed significant difference between the two groups (t=4.316, P<0.05). Conclusions Both sequential and high?pitch mode of 128?slice DSCT angiography provide high accuracy for the assessment of CHD in infants and children, while the high?pitch mode, though with some image quality declined, shows further significantly lower radiation dose.

Objective Rheumatoid arthritis (RA) is a systemic autoimmune disease, which mainly involves joints across the body, resulting in joint stiffness and loss of daily activity. Recent evidence suggests that numerous self-reacting T cells, including Th1 and Th17, infiltrate the synovium in RA patients, accompanied by functionally-compromised Treg. Iguratimod, a new small molecule with anti-inflammatory and immunomodulatory effects, has shown curative effects in animal models of arthritis. In this study, we aimed to test the clinical effects of Iguratimodˊs on RA patients and its role in immunoregulation. Methods We examined the clinical effects of iguratimod on RA patients in a random controlled clinical trials and analyzed its effects on Th1, Th17 and Treg as well as their associated cytokines and transcription factors by flow cytometry and real-time polymerase chain reaction (PCR). Then t-test, chi-square test and rank sum test were used to conduct statistical analysis. Results Our results revealed that iguratimod therapy provided significantly greater clinical benefit [ACR20, ACR50, ACR70 reached 50%, 20%, 15% respectively in iguratimod treatment group, Z=-2.216,P=0.027] than placebo group with the reduction of Th1 and Th17 but increment of Treg after iguratimod treatment [Th1: week 0 (26.5 ±8.0)%, week 24 (14.2 ±7.3)%, P<0.01; Th17:week 0 (1.7±0.7)%, week 24 (1.3±0.4)%, P<0.05;Treg:week 0 (6.8±1.6)%, week 24 (8.9±2.9)%, P<0.05], which was statistically significant. Conclusion Our results provide theoretical and clinical based evidence for the impact of iguratimod on immunomodulation of RA.

Objective To study regulatory mechanism of osteopontin (OPN) in rheumatoid arthritis (RA). Methods The expression of OPN in peripheral blood mononuclear cells (PBMC), synovial fluid cells (SFMC) and synovium tissue (ST) and T cell subsets from RA patients were detected by real time PCR. The concentration and relative rate of inflammatory factors in the synovial fluid from RA patients were analyzed by ELISA. Results The mRNA expression of OPN in synovial fluid and tissue was higher than that of PBMC in the same RA patient. The OPN expression was found mainly on CD4+T. The OPN concentration was higher in the synovial fluid than that of in the same patient′s serum. Meanwhile, the concentration of IL-10, IFN-? and TNF-? was higher than that of in the serum from same patient. Also, the concentration of IL-18 and IL-12 were higher than that of normal individual serum. Conclusion OPN may control secretion of inflammatory factors of synovium tissue and synovial fluid and induce the inflammatory response.

Objective To analyze the application of intraoperative neurophysiological monitoring combined with neuronavigation multi-modal fusion technology in the brainstem glioma resection. Methods One hundred twenty patients with brainstem glioma were divided into observation group and control group. The control group was treated by traditional operation, while the observation group was treated by intraoperative nerve electrophysiological monitoring combined with neuronavigation multimodal fusion technology. The general condition, clinical efficacy, KPS score, complications and survival rate of the two groups were compared. Results The effect was significantly better in the observation group(76.66%)than in control group(53.33%)( x2=11.962,P=0.001).KPS scores were significantly higher in the observation group (27.91 ±1.98) than in the control group (12.11 ±2.13)(t=32.669, P<0.001). Conclusions Intraoperative nerve electrophysiological monitoring plus neuronavigation multimodality fusion technology can improve clinical efficacy and quality of life in patients with brainstem glioma.