Objective To investigate the apoptosis of alveolar macrophage and its significance in patients with chronic obstructive pulmonary disease (COPD). Methods A total of 11 patients with COPD and 10 healthy controls were enrolled in the study. Alveolar macrophages (AM) were harvested from the BALF (bronchoalveolar lavage fluid). The positive rate of myeloperoxidase (MPO) staining of alveolar macrophages by MPO staining was observed so as to indirectly reflect neutrophil apoptosis and the phagocytosis of apoptotic neutrophils by alveolar macrophages. Apoptosis were detected by the transferase-mediated dUTP nick end labeling (TUNEL) technique. Results The positive rate of alveolar macrophages by MPO staining was lower in COPD group than the control group (P

Objective To study the clinical and imaging features of chlamydial pneumonia in newborns.Methods Medical records,chest X-Ray and CT findings of 17 neonates with chlamydia pneumonia were reviewed.The age was ranged from 9.0 to 28.0 days with mean of ( 16.8 ± 5.8 ) days.There were 11males and 6 females.Sixteen were full term infants and one was born post term.All babies were examined with chest X-ray film,and 13 patients also underwent chest CT scan.Serologic test using immunofluorescence method for Chlamydia IgG and IgM antibodies were performed in all patients.Results All newborns presented with cough but without fever.Positive results of the serologic tests were demonstrated.Chest films showed bilateral hyperventilation in 10 patients,diffuse reticular nodules in 10 patients including nodules mimicking military tuberculosis in 7 patients,and accompanying consolidation in 9 patients.CT features included interstitial reticular nodules in 13 patients with size,density,and distribution varied.Subpleurul nodules ( 11patients) and fusion of nodules ( 10 patients ) predominated.Bilateral hyperinflation was found in 10 patients,which combined with infiltration in 12 patients,thickening of bronchovascular bundles in 10 patients,and ground glass sign in 5 patients.No pleural effusion and lymphadenopathy was detected in any patient.Conclusions Bilateral hyperinflation and diffuse interstitial reticular nodules were the most common imaging features of neonatal chlamydial pneumonia.The main clinical characteristic of neonatal chlamydial pneumonia is respiratory symptoms without fever,which is helpful to its diagnosis.

BACKGROUND: Neurasthenia is commonly believed attributing to the complex influence of psychological, social and biological factors.OBJECTIVE: To probe the correlation of neurasthenia with personality,life events and the positive rate of serum Epstein-Barr (EB) virus.DESIGN: Case-controlled observation and prospective paired analysis.SETTING: Mental Health Institute of Second Xiangya Hospital Affiliated to Central South University.PARTICIPANTS: From May to October 2000, patients with neurasthenia,selected from the Clinical Ward of Mental Health Institute of Second Xiangya Hospital Affiliated to Central South University for medical treatment,19 males and 11 females, with mean age of (27±8), the course of disease ranged from 0.5 to 20 years with the average of 4.0 years, enrolled in this study. According to 1:1 paired principle, 30 matched volenteers, their relatives, or students of Xiangya Hospital were randomly selected as controls.Two groups were matched in age, sex and education, patients with psychological and physical disease were excluded. All participants were given written informed consent.METHODS: The level of serum EB virus IgG and IgM of two groups were determined by using ELISA methods. Blood samples were colleted before and after treatment in experimental group, while blood samples were only collected once in control group. Patients in experimental group were given routine medication and integrative psychotherapy according to their state of illness, and Eysenck personality questionnaire (EPQ) were filled in before and after treatment (including four dimensionalities: neuroticism, psychoticism, extroversion/introvision and lie, amongst which higher scores for extroversion/introvision dimensionality represented extroversion and lower dimensionality represented introvision; higher scores of neuroticism dimensionality suggested anxiety and worry. Higher scores for psychoticism suggested solitude and inadaptability to the outer environment), life events scale (including the total score for life events, positive events value and negative events value), and symptom checklist 90 (SCL-90) (consists of 10 factors scored of 0-4, representing non-symptom to severer symptom) were used to assess the clinical symptom. EPQ and SCL-90 were adopted on patients at four months after treatment for self-comparison. EPQ and life events scale were taken on healthy controls, the scores compared with that of experimental group before treatment.for EPQ, the total scores for SCL-90 and positive rate of EB virus in patients with neurasthenia before and after treatment.RESULTS: Totally 27 patients were followed up at 4 months after treatment, and 3 cases lost due to long distance from hospital, thereby 27 cases in experimental group and 30 cases in control group were remained in the roticism in neurasthenia group was significantly higher than that of control group (57.59±10.79, 40.58±8.68, t=6.536, P ＜ 0.01), scores of extroversion/introvision were obviously lower than that of control group (46.31 ±10.79, 53.50±11.28, t=3.203, P ＜ 0.01). In neurasthenic group, scores for neuroticism was obviously decreased after treatment in contrast to before events scale: The total scores and negative scores in neurasthenia group was significantly higher than that of control group (19.73±17.25, 18.93 tal scores for SCL-90: The total scores for SCL-90 was obviously declined after treatment comparing to that of before treatment in neurasthenia of EB virus IgG and IgM: The positive rate in neurasthenia group was significantly higher than that of control group (76.67% vs 26.67% );and positive rate of serum EB virus were proved to be two important pathogenic factors for neurasthenic patients.CONCLUSION: Patients with neurasthenia possess susceptible personality, such as neuroticism and introvision, and commonly experienced negative life events before illness. Moreover the positive rate of EB virus in neurasthenic patients is higher, which might be associated with the higher glucocorticoidinduced EB virus activation under stress state.

BACKGROUND: Chronic obstructive pulmonary disease(COPD) is characterized of chronic inflammation in airway, pulmonary parenchyma and pulmonary vessels. The mechanism of the increment and activity changes of these inflammatory cells is unclear at present.OBJECTIVE: To study the apoptotic character of peripheral blood polymorphonuclear neutrophils(PMNs) and its relationship with COPD to provide a reference for early intervention and function surveillance for COPD patients.DESIGN: An observatory comparative study based on COPD patients and healthy population as controls.SETTING: Department of pulmonary medicine in a military medical university of Chinese PLA affiliated hospital.PARTICIPANTS: Totally 98 COPD patients were admitted by the Department of Pulmonary Medicine, Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA between February 2003 and December 2003 due to COPD acute attack. Eighteen patients including 12 males and 6 females aged between 48 and 70 years old [mean of(56 ± 7) years old]were randomly selected into COPD group according to random number table.Totally 14 healthy adults including 10 males and 4 females aged between 50 and 70 years old [mean of (59 ± 8) years old] who were individuals came for physical check up in our hospital were selected in control group.METHODS: PMNs were separated from peripheral blood by density gradient centrifugation. The dynamic changes of PMNs apoptosis in peripheral blood was observed by flow cytometer and TUNEL method.MAIN OUTCOME MEASURES: Comparison of PMNs apoptotic rate in peripheral blood among groupsRESULTS: As indicated by flow cytometric analysis, PMNs apoptotic rate at early apoptotic phase in COPD patients at paracmasis was(8.5 ± 1.3)%,which was significantly lower than(12.5 ± 1.8)% of normal control group( t=6.25, P ＜ 0. 01); PMNs apoptotic rate was(5.1 ±0.6)% at acute aggravation stage, which was significantly lower than that of paracmasis group ( t =5.66, P ＜001). As indicated by TUNEL analysis, PMNs apoptotic rate at paracmasis was(12.42 ±2.7)% , which was significantly lower than (21.5±4.8)% of normal control group(t=5.76, P ＜ 0.01); PMNs apoptotic rate was(4. 9 ±0.4)% at acute aggravation stage, which was significantly lower than that of paracmasis group( t = 6. 12, P ＜ 0. 01 ) . PMNs changes at the late phase of apoptosis/necrosis had a contrary tendency, i. e.,PMNs rate at late apoptotic phase/necrosis was(2. 8 ± 0.5)% in COPD patients at paracmasis, which was significantly higher than(1. 3 ±0.4)% of normal control group ( t= 6. 37, P ＜ 0. 01 ); PMNs rate was (3.7 ± 0. 3) % at acute aggravation stage, which was significantly higher than that of paracmasis group(t=5.81, P ＜0.01).CONCLUSION: PMNs abnormal apoptosis might be an important reason that induces PMNs aggregation in airway and lung tissues in COPD. This process might have an important significance in the generation and development of chronic airway inflammation, which provides an etiologic basis for the primary rehabilitative intervention of COPD.

Objective To explore the distribution of Acinetobacter baumannii and its drug resistance to 17 antimicro-bial agents to provide basis for clinical treatment.Methods The data of 689 strains of A.baumannii from Jan.2010 to Dec. 2012 were collected and reviewed for bacterial identification and drug sensitive test and then analyzed using WHONET 5.4. Results 689 strains of A.baumannii isolates were broadly distributed in sputum (75.5%), most primarily isolated from the ICU (36.9%).The antimicrobial susceptibility testing showed that the drug resistance rate of Ab was the highest to Bactrim (36.3%), followed by gentamicin (29.0%), and the lowest to cefperazone-sulbactam (8.0%).The drug resistance rate of Ab to cefperazone-sulbactam was the lowest (8.5%) in 2012.In the three years, the drug resistance rate of Ab to imipenem was the biggest rise (14.5%);while to gatifloxacin and levofloxacin declined.The drug resistance rate of Ab to gatifloxacin dropped by 13.1%, which was bigger than that to levofloxacin (9.5%).The drug resistance rates of Ab to the rest antimi-crobial agents fluctuated insignificantly, but were all in an increasing trend.Conclusion Acinetobacter baummannii mainly distribute in sputum of patients in the ICU and department of respiratory diseases, and its detection rate and drug resistance rate are increasing year by year.

BACKGROUND:Recently,some overseas in vitro researches and animal models confirmed that donor leukomonocyte cultured by fludarabine can significantly reduce acute graft-versus-host disease,but the mechanism of action is not clear.OBJECTIVE:To explore immunophenotype changes of donor leukomonocyte cultured with fludarabine in vitro.DESIGN,TIME AND SETTING:The observational cytology experiment was performed at the Department of Hematology,First People's Hospital from July 2007 to January 2008.MATERIALS:Leukomonocytes were collected from four hour healthy persons as donors of allogenic peripheral blood hematopoietic stem cell transplantation.Fludarabine was offered by Schering AG,Germany.METHODS:Peripheral blood hematopoietic stem cells collected by COBO SPECTRA were washed with RPMI1640 twice.These cells were cultured in RPMI1640 containing 0.10 volume fraction of fetal bovine serum till cell density of 2?109 L-1.1 mL of hematopoietic stem cells were washed with phosphate-buffered saline,and added CD3,CD4,CD8,CD44mAb 10 ?L,and added Mouse Ig-G1-FITC/PE as control group.These cells were attenuated with phosphate-buffered saline after incubated for 30 minutes at a low temperature,then detected by flow cytometry.Other cells were put in 24-well cultivate plate,added 8 mmol /L fludarabine as a final concentration for 24 hours(5% CO2,37 ℃).MAIN OUTCOME MEASURES:Studying immunophenotypic changes of donor leukomonocytes by flow cytometry.RESULTS:There was no significant change in the ratio of CD4+CD44+T cells before or after donor leukomonocytes cultured with fludarabine for 24 hours,and proportion of CD8+CD44+T cells declined significantly(P

Objective To study the expression of Gq protein in bronchopulmonary tissues of rats of chronic obstructive pulmonary disease (COPD) model and the roles of inflammation in airway of COPD rats. Methods A total of 44 Wistar rats were divided randomly into 4 groups: nonsmoking control group, 1 month smoking group, 2 month smoking group, and intervention group (dexamethasone + smoking for 2 months). The pathological changes of lung tissues and the total and differential count of white blood cells in bronchoalveolar lavage fluid (BALF) in all groups were observed. The expression of Gq in bronchopulmonary tissues was detected by immunohistochemical method and Western blot analysis. Results More significant increases in total number of leukocytes and neutrophils in BALF were found in the model group than those in the control group. Gq was mainly expressed in airway epithelial cells, inflammatory cells, and pulmonary capillary endothelia. Weak expression of Gq was found in bronchopulmonary tissues in the control group, but overexpression of Gq in the model group. The ratios of Gq positive cells in bronchopulmonary tissues were significantly correlated with the number of white blood cells and neutrophils in BALF. The levels of expression of Gq were significantly higher in the model groups and intervention group than those in the control group. More significant decrease in Gq expression was found in the intervention group as compared with that in 3 month smoking group. Conclusion Gq may be involved in the process of airway inflammation in COPD. Inhibition of the Gq overexpression might be a new approach to the treatment of COPD. Corticosteroid might have some effects on the inhibition of the airway inflammation.

Objective To investigate molecular cytogenetic abnormalities in chronic lymphocytic leukemia and clinic prognostic significance. Methods Conventional cytogenetics (CC) examination was performed in 17 cases with CLL by I-FISH with five probes [DI3S25(13q14.3), ATM(11q22.3), RB1(13q14), p53(17p13.1) and CSP12(12p11.1-12q11.1)]to detect molecular cytogenetic abnormalities in CLL. Results Among 17 cases of CLL, by CC examination, only 18.75 % patient were found to have chromosomal abnormalities;whereas on I-FISH, 70.6 % patient were found to have molecular cytogenetic abnormalities including 13q-(47.1%) del(RB1) (23.5 %), del(13q13.4)(29.4 %), trisomy 12 (29.4%), del(17p13.1)(11.8 %), del (ATM)(5.6 %), the frequency of complex abnormalities were 11.8 %. No correlation of molecular cytogenetic abnormalities with sex, age, Binet stage, LDH and β_2-MG were found. Conclusion I-FISH is a more rapid, accurate and sensitive technique for detection of molecular cytogenetic abnormalities in CLL than CC, There was no statistically significant difference between molecular cytogenetic abnormalities and clinic characteristics, but its prognostic significance in CLL needs to be further investigated.

Objective To study the physical characteristics of the OPEN stereotactic body radiotherapy system for the clinical application. Methods The 0. 125cc ioniztion chamber, 160 mm polystyrene sphere model,Gafchromic EBT2 films and IBA film analysis software were used to evaluated the focus position tolerance,dose rate,repeatability,linear relation,penumbra and composite error of the OPEN stereotactic body gamma knife. We used the DTA method to verify the accuracy of dose distribution between the plans and measured value. Resualts The focus error was 0. 36 mm,max dose rate tolerance 3%,linear relation error 2%,repeatability error 0. 3%,composited error 2. 5 mm. There was 90% pass rate when the distance away from test point was less than 2 mm and the dose error was set less than 5 % . Conclusions Parts of the test resualts were similar to the head gamma knife national protocal of OPEN stereotatic body gamma knife. The deliver dose distribution can meet the clinic need.