Humans ; Medicine, Chinese Traditional ; Psoriasis ; classification ; therapy ; Syndrome

Objective To explore the influence of salmeterol fluticasone plus tiotropium bromide on right cardiac and thyroid functions of patients of chronic obstructive pulmonary disease ( COPD) with chronic cor pulmonale .Methods A total of 92 cases of COPD patients with chronic cor pulmonale at our hospital from July to December 2012 were recruited as subjects and divided randomly into 2 groups of treatment ( n=47) and control (n=45).The control group received diuretics and vasodilative drugs while the treatment group had additional therapies of salmeterol fluticasone ( 50/500 μg ) twice daily plus tiotropium bromide once per day once daily for 6 months.Measure and compare two groups of patients′FEV1%, forced expiratory volume in one second(FEV1), status of vigor, brain natriuretic peptide(BNP), left ventricular ejection fraction ( LVEF ) , ultrasonic cardiogram ( right ventricular outflow tract , right ventricular internal diameter, right pulmonary artery trunk ) and value of thyroid function before and after treatment .Results Before treatment, the treatment group′s FEV1 (%) (36 ±10)%, FEV1 (1 036 ±410) ml, BNP (357 ± 101) ng/L, LVEF (46.2 ±10.4)%, internal diameter of right ventricular outflow tract (36.0 ±5.4) mm, right ventricular internal diameter (38.1 ±6.7) mm, right pulmonary artery trunk (24.0 ±3.6) mm, TT3 (1.47 ±0.38) nmol/L, TT4 (114.56 ±21.39) nmol/L, FT3 (4.47 ±1.42) pmol/L, FT4 (15.6 ± 2.5) pmol/L and TSH (2.50 ±0.91) mU/L showed no marked difference from those of control group (P>0.05).After treatment, the treatment group′s FEV1(%)(58 ±1)%, FEV1(1 706 ±456)ml, BNP(225 ± 52) ng/L, LVEF (57.1 ±11.5)%, internal diameter of right ventricular outflow tract (30.1 ±4.2) mm, right ventricular internal diameter ( 32.0 ±3.9 ) mm and right pulmonary artery trunk ( 20.2 ±2.3 ) mm greatly improved ( P <0.01 ) while its TT3 ( 1.46 ±0.42 ) nmol/L, TT4 ( 113 ±22 ) nmol/L, FT3 (4.46 ±1.38) pmol/L, FT4 (15.4 ±2.5) pmol/L and TSH (2.51 ±0.82) mU/L showed no marked difference from those of control group ( P>0.05 ) .However , no obvious difference existed in the control group′s BNP, LVEF, internal diameter of right ventricular outflow tract , right ventricular internal diameter , right pulmonary artery trunk and value of thyroid function before and after treatment ( P >0.05 ) . Conclusion Salmeterol fluticasone plus tiotropium bromide can effectively improve right cardiac functions of patients of COPD with chronic cor pulmonale , without marked suppression of thyroid function .

Objective To investigate the relationship between the posterior vitreous detachment (PVD) and the diabetic macular edema (DME). Methods A total of 169 eyes with DME which were diagnosed by funduscopy,fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) were retrospectively analysed. PVD and partial PVD were detected by OCT and biomicroscopy. The characterizations of OCT images of DME were analysed. Results In 169 eyes, 156 (92.3%) had no PVD with the average thickness of fovea of 297 ?m; 11 (6.5%) had complete PVD with the average thickness of fovea of 229 ?m; 2 (1.2%) had partial PVD with the average thickness of fovea of 347 ?m. Conclusions Only a few PVD were found in DME eyes, so traction of PVD may not be the main cause of DME.

Objective To investigate the course of the idiopathic macular hole (IMH) clinically diagnosed as at stage Ⅰ-Ⅳ by optical coherence tomography (OCT), and analyze the relationship between the posterior vitreous detachment (PVD) and the course of IMH. Methods Hadn′t undergone any operation, periodical OCT were performed on 72 eyes of 58 patients with IMH at stage Ⅰ-Ⅳ confirmed by Gass standard and the features of OCT images. Results The longest follow-up period was 43 months (average 13.4 months), and the examine times of OCT on each eye were between twice to 10 times (average 4.7 times). During the follow-up period, 23 eyes were in stage I in which 9 (39.1%) developed to stage II and 2 had recovered normal curve of fovea after PVD; 19 were in stage II in which 13 (68.4%) developed to Ⅲ-Ⅳ and 1 had closed hole after PVD; 11 were in stage III in which 5 (45.5%) developed to stage IV and 1 had partly closed hole 12 months later. The images of OCT showed that the process of macular hole was consistent with the course that vitreous depart from retina from the circumference of fovea till entire posterior detachment.Fifteen affected eyes in this series of patients had undcrygong surgical treatment due to serious progression of IMH in follow-up period. Conclusions There is a close relationship between the formation and development of macular hole and the occurrence of PVD. OCT can show the progress of the macular hole directly and offer an important technique in diagnosis, classification and surgical treatment of IMH.

Purpose: To evaluate the therapeutic effect of the jejunal interposition reconstruction SS and P type after total gastrectomy in patients with gastric carcinoma. Methods: 31 cases with gastric carcinoma operated on from June, 1990 - Octuber, 2000 were retrospectively analyzed. After total gastrectomy 16 patients were operated by jejunal interposition reconstruction SS type and 15 a jejunal interposition reconstruction P type. The clinic materials of the two types of jejunal interposition reconstruction were assessed by 6 months -5 years follow-up. Results: 30 -60 minutes and 80 - 120 minutes Ba emptying time of SS and P type were 62. 5%, 66. 7% and 37. 5%, 33. 3% respectively ; BLA were 73. 6 + 1. 1% and 74. 4 + 1. 3% , respectively; HB were 15 +1.3 and 15 +1.5; The Visick scoring of the 87. 7% patients with S type and the 86. 7% patients with P type was Ⅰ - Ⅱ grades. Reflux oesophagitis of the patients with S type was 12. 5%. Conclusions: The jejunal interposition reconstruction SS and P type after total gastrectomy are effective means to improve quality of life and to reduce complications after gastrectomy and to maintain the canal of the chyme through the duodenal tract.

Objective To evaluate the therapeutic effect of the jejunal interposition reconstruction type Ⅰ and Ⅱ after total gastrectomy in patients with gastric carcinoma.Methods 31 cases of gastric carcinoma operated were retrospectively analyzed, 16 patients after total gastrectomy were reconstructed to have a jejunal interposition type Ⅰ and 15 a jejunal interposition reconstruction type Ⅱ. The clinic data of the two types jejunal interposition reconstruction were assessed during 6 months ～5 years follow-up. Results 30- 60 minutes and 80-120 minutes barium agent emptying time of type I and II were 62.5%,66.7% and 37.5%,33.3% respectively;normal diet regimen(4～6 meals/d)was recovered,plasma total protein 56～75g/L accounted for 74 2%(23/31),46～56g/L accounted for 25 8%(8/31).Hemoglobin 110～160g/L accounted for 38 7%(12/31) 96～105g/L accounted for 61 3%(19/31).Mean body weight was decreased by 3～5kg in all groups.9 cases recovered eight physical strength labor.The visick scoring of the 87 7% patients with type I and the 86 7% patients with type II was I-II grades. Reflux oesophagitis of the patients with type I was 12 5%. Conclusions The jejunal interposition reconstruction type Ⅰ and Ⅱ is suitable reconstruction after total gastrectomy to improve quality of life and to reduce complications and to maintain the canal of the chyme through the duodenal tract.

Objective To investigate the technique of drain air, cryotherapy, and explant (DACE) of operation for superior bullous retinal detachment (SBRD). Methods In the DACE procedure, drainage and air or balanced salt soultion (BSS) injection were carried out first, with the intention of flattening the retina before localization of retinal hole, cryotherapy out of choroid and scleral buckling. Results In 42 SBRD eyes, 40 underwent the operation with DACE technique. In 23 eyes injected with BSS instead of air, 5 should be injected air due to no avail for flattening deeply retinal detachment, and 1 needed scleral buckling due to new retinal tear after DACE procedure two weeks. During the follow up, all retinae attached. Conclusions The DACE technique is very useful and effective in upper ballooned retinal detachment due to single hole or breaks localized in small area between the 10 and 2 o′clock meridiant. BSS instead of air injection can eliminate the difficulty of observation of retinal breaks from the presence of air in some cases.

Objective To investigate the progression of idiopathic epiretinal macular membrane(IEMM) and compare the correlation factors of contrast sensitivity function (CSF) such as visual acuity(VA) and central macular thickness. Design Prospective, case-controlled study. Participants 80 normal people (80 eyes) were divided into three groups: old-aged group (60-80 years old, of 26 eyes), middle-aged group (40-59 years old, of 30 eyes) and young-aged group (

AIM: To investigate the possibility of simultaneously ex vivo generating cytomegalovirus (CMV) pp65 and Epstein - Barr virus (EBV) - specific cytotoxic T lymphocytes (CTL) from human umbilical cord blood (CB). METHODS: Mononuclear cell derived from CB (CBMC) was used to construct EBV - transformed B-lym- phoblastoid cell lines (BLCL). Then BLCL were transduced with a recombinant retrovirus encoding pp65, the immunodominant CMV polypeptide. CBMC from the same CB donor were stimulated with pp65 - expressing BLCL (BLCLpp65) weekly for 5 - 6 weeks. Chromium release assays (CRA) were performed to detect the specific cytotoxicity of the CTL against EBV and CMV. RESULTS: Western blot analysis and immunocytochemistry confirmed that BLCLpp65 could simultaneously express CMVpp65 and EBV antigen. CRA results showed that the generated CTL possessed specific cytotoxic against EBV and CMV, and the cytotoxicity was mediated by CD8+ CTL. CONCLUSION: BLCLpp65 can be used as antigen - presenting cells to stimulate expansion of EBV and CMV specific CTL simultaneously from the predominantly native T cell population in CB.

Objective To investigate the relationship between dendritic cell (DC)and intestinal endotoxemia in patients with chronic hepatitis B (CHB).Methods Peripheral blood were collected from CHB patients (n = 80)and healthy controls (n = 21 ).Plasma endotoxin (ET)levels,liver function (alanine transaminase,total bilirubin)were detected.According to plasma ET concentration,all CHB patients were divided into two groups:ET positive and ET negative.The peripheral blood mononuclear cells (PBMCs)were isolated and then cultured with recombinant human granulocyte-macrophage colony-stimulating factor ( rhGM-CSF),recombinant human interleukin-4 ( rhIL-4 ),FMS-related tyrosine kinase 3 ligand (Flt3L)and tumor necrosis factor-alpha (TNF-α)to derive DC.The phenotypic patterns were characterized by flow cytometry.The proliferation of T lymphocytes was evaluated with mixed leukocytes reaction (MLR)and the levels of IL-12 and interferon-γ (IFN-γ)produced by DC were analyzed with enzyme-linked immunosorbent assay (ELISA).Comparisons among the two groups and healthy control group were done by single factor analysis of variance.Results Compared to healthy controls,the expressions of CD83,CD80,CD86,human leucocyte antigen (HLA)-DR and the proliferation of allogeneic T lymphocytes by DC were all significantly reduced in CHB patient groups.The expressions of CD83,CD80,CD86,HLA-DR and the activation of proliferation in ET positive subjects were lower than those in ET negative subjects [CD83 (8.25±3.63)% vs(11.39±4.35)% ,CD80 (10.63±4.52)% vs (13.56±5.13)%,CD86 (36.61±16.16)% vs (45.90±15.35)%,HLA-DR (61.65±14.33)% vs (70.35±18.89)%,the activation of proliferation0.812±0.311 vs 1.153±0.324; F=5.123,4.213,3.714,3.323 and 3.125,respectively; all P＜0.05].After cultured for 9 days,the secretions of IL-12 and IFN-γ by DC were significantly lower in CHB patients than in healthy controls [IL-12 (16.99± 6.74)pg/mL vs (44.51±14.56)pg/mL,IFN-γ (10.52±4.19)pg/mL vs (17.94±5.86)pg/mL].The level of IL-12 in the ET positive group was significantly lower than that ET negative group [( 13.14 ±5.71)pg/mL vs (20.98 ± 9.03)pg/mL; F= 3.225,P = 0.016].The level of IFN-γ was not different between two groups [(9.46 ± 3.24)pg/mL vs (11.54 ± 5.20)pg/mL; F = 2.003,P =0.076].Conclusion The intestinal endotoxemia may play a role in DC dysfunction in CHB patients.