Objective To discuss the value of Visfatin in severity evaluation in patients with severe pneumonia via observation on the variations of the plasma level of Visfatin. Method Seventy subjects including 40 patients with severe pneumonia ( group A) and 30 patients with non-severe pneumonia (group B) admitted to the ICU of emergency department and general wards from June 2009 to June 2010, were enrolled in this prospective study, and another 30 healthy individuals from physical examinees were included as subjects in control group (group C). Patients with severe diseases of heart, brain and kidney, cancers, autoimmune disease, or under special treatment in latest one month were excluded. For the subjects of all three groups, the plasma levels of Visfatin, IL-6, IL-8 and TNF-α were measured by using ELISA, while the level of CRP was assayed by using immunoturbidimetry, and the routine blood test was performed as well. The blood gas analysis and Acute Physiology and Chronic Health Evaluation Ⅱ ( APACHE Ⅱ) were carried out in patients with pneumonia. Comparisons between groups were made by t-tests, ANOVA or nonparametric test. Correlation analysis was carried out by Pearson correlation coefficient or Spearman rank correlation test. Results The plasma level of Visfatin in patients with severe pneumonia (group A) was significantly higher than that in patients with non-severe pneumonia (group B) and in the control subjects (group C) (P < 0. 01) , and the level of Visfatin in pneumonia ( group B) and in control group (group C) , and that in group B was significantly higher than that in the controls (group C) (P <0. 01). In group A, the plasma level of Visfatin was positively correlated with CRP, TNF-α, APACHE Ⅱ and PMN% (rha =0. 653, r = 0.554, r = 0.558, r= 0.484, P <0. 05), while negatively correlated with PaO2 and PaO2/FiO2 ( rha = -0.422, r= -0.543, P <0. 05). Conclusions Visfatin may be involved in the systemic inflammation response in severe pneumonia as a pro-inflammatory cytokine which is valuable in assessing the severity of pneumonia.

Objective To determine the level of adiponectin (APN) in serum and induced sputum of patients with chronic obstructive pulmonary disease both during acute exacerbation (AECOPD) and silent stage, and investigate APN' s role as a marker of inflammation in the pathogenesis of COPD. Method From October 2008 to October 2009,30 male AECOPD patients in the emergency department, 30 male silent COPD patients in the department of respiratory diseases and 30 healthy nonsmoking male volunteers were included. All subjects' serum and induced sputum were collected, and they were all of normal weight(BMI range of 18.5～ 24.9 kg/m2). Patients were excluded if they suffered from severe bronchial asthma, bronchiectasis or autoimmune disease. The number of cells in induced sputum was counted and the cell type was classified. The concentrations of APN, IL-8, IL-6 and TNF-α in both serum and sputum were measured by using ELISA, and their pulmonary function was tested. The different groups were compared among them by using the t -tests, ANOVA analysis or nonparametric analysis, the relation between variables was assessed by using the Pearson or Spearman correlation test. Results The concentrations of APN in both serum and induced sputum of AECOPD patients were significantly higher than those in the silent COPD patients and the control subjects ( P ＜ 0.01 ). The concentrations of APN in the silent COPD patients were significantly higher than those in the control subjects ( P ＜ 0. 01 ). There were significant relationships between the concentrations of APN in serum and induced sputum and the levels of IL-8 and TNF-α in AECOPD patients ( r = 0.739, 0. 734,0.852 and 0. 857, respectively, P ＜ 0. 05) and in silent COPD patients ( r = 0.751,0.659, 0.707 and 0.867, respectively, P ＜0.05). There was significant relation betweenship between APN and neutrophil in induced sputum of AECOPD patients (r = 0.439, P ＜ 0.05). Conclusions APN was involved in the process of systemic and airway inflammation of COPD, and it was related with IL-8 and TNF-α. APN can be used as a new inflammation marker for COPD.

Objective To investigate the efficacy of the hospital intensive treatment by auto-CPAP on elderly patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and to analyse the possible factors related to the effectiveness.Methods Subjects were selected from elderly OSAHS patients over 60 years old.The eligible subjects were divided into intensive treatment group and non-intensive treatment group (non-ITG).Patients in intensive treatment group were intensively treated using auto-CPAP for 3 consecutive days,assisted with targeted health education and guidance,and making proper adjustments to parameters of the auto-CPAP according to treatment outcomes at the previous day.But those in non-intensive treatment group were just treated with auto-CPAP for only 1 day,supplemented by regular health education and guidance.The apnea-hypopnea index (AHI),minimum oxygen saturation (SaO2min),mean oxygen saturation (SaO2mean) and the time spent at SaO2 lower than 90％ (tSaO2＜90％),the occurrence of clinical symptoms and adverse effect,Epworth sleepiness scale(ESS) were compared between both groups.The correlation analyses were also conducted.Results ESS (3.58±3.76 vs.6.84 ± 3.22),AHI [(7.85±6.53) time/h vs.(10.42±7.27) time/h] and tSaO2＜90％[(5.65±15.43) min vs.(15.26±33.14) min] were lower(t=6.902,2.760,2.765,allP＜0.05),while SaO2mean [(96.57±1.53)％ vs.(94.63±1.38)％] and SaO2min [(88.24±4.43)％ vs.(83.28±5.06)％]were higher(t=-9.870,-7.740,both P＜0.05)in intensive treatment group than in non intensive treatment group.The occurrences of clinical symptoms and adverse effect (except for skin allergy) were decreased in intensive treatment group versus non-ITG (all P＜0.05).The AHI after intensive treatment was decreased in females versus males [(7.85±5.19) times /h vs.(11.27±7.78) times/h,t=2.133,P＜0.05].BMI,age,gender and the state of OSAHS were correlated to AHI,SaO2 mean,SaO2 min and tSao2＜90％ after intensive treatment (all P＜0.05).Conclusions The hospital intensive treatment can improve the clinical results and decrease the occurrences of clinical symptoms and adverse effect for elderly OSAHS patients,and is expected to improve therapy compliance,and its curative efficacy is correlated to BMI,age,gender and state of OSAHS before therapy.

Objective To evaluate the value of serum procalcitonin(PCT)on antibiotics use in treatment of acute exacerbations of chronic obstructive pulmonary disease( AECOPD). Method From May 2004 to December 2006, a total of 235 patients requiring hospitalization for AECOPD were randomly assigned into two groups: standard therapy group(group A, n = 117)and PCT-guided group(group B, n = 118) .PCT levels of all patients were measured after hospital admission by an amplified cryptate emission technology assay. On the base of similarly normal treatment, group A received antibiotics according to the attending physicians,and group B were treated with antibiotics according to serum PCT levels:antibiotic treatment was applied with PCT level ≥0.25 ng/ml and was discouraged with PCT level ＜0.25 ng/ml. Length of hospitalization,clinical efficacy,costs of hospitalization and antibiotics, rate of antibiotics use, hospital mortality,rate of exacerbation and rehospitalization within 1 year were observed. Analyses were performed by t test, Mann-Whitney U test or χ2 test. Results Clinical efficacy, hospital mortality, length of hospitalization, rate of exacerbation and rehospitalization within 1 year were similar in two groups (P =0.635,0.768,0.884,0.747,0.727) ;costs of antibiotics and hospitalization,rate of antibiotics use of PCT-guided group were lower than that of standard therapy group( P = 0.029,0.036,0.014). Conclusions PCT could be used in treatment of AECOPD for antibiotic use after hospital admission,which may reduce antibiotic use and lower costs of antibiotic and hospitalization.

Objective To synthesis and characterization nano-composite biomaterials-polyamidoamine dendrimers/nano-hydroxyapatite (PAMAM/n-HAP),which has the properties of both organic and inorganic materials,and then evaluate its role in dentin tubule occlusion. Methods PAMAM/n-HAP was characterized and validated by Fourier transform infrared spectrometry and transmission electron microscopy after its preparation via the Pramanik aqueous-based chemical method. Scanning electron microscope was used to evaluate its role in dentin tublule occlusion. Results The peak absorption bands were found at 1244 cmand 1650 cmin Fourier transform infrared spectroscopy. A relatively low-density coating (about 10 nm) appeared on the n-HAP. The results of Fourier transform infrared spectrometry and transmission electron microscopy confirmed the successful synthesis of PAMAM/n-HAP. The scanning electron microscope showed that PAMAM/n-HAP could effectively reduce the diameter of the dentin tubule and close dentin tubule. Conclusion PAMAM/n-HAP,as a newly synthesized biomaterial,has a good binding capacity with collagen fibers with the help of superficial carboxyl. It can induce effective dentinal tubule occlusion,indicating that PAMAM/n-HAP have great potential in clinical practice for dentin hypersensitivity.