Objective To investigate the effect of different doses of ambroxol on efficacy and lung function of elderly patients with chronic obstructive pulmonary disease.Methods 200 patients with COPD were selected.They were divided into two groups randomly.The high dose group (102 cases) were given anmbroxol hydrochloride in high doses.The low dose group (98 cases) were given anmbroxol hydrochloride in low doses.The effect of different doses of ambroxol on efficacy and lung function of elderly patients with chronic obstructive pulmonary disease was evaluated by the efficacy,TNF-α,CRP,pulmonary function indexes and adverse reaction during treatment.Results The effective rate was 89.2％ in the high dose group and 75.5％ in the low dose group.The effective rate of high dose group was higher than that of the low dose group (P ＜ 0.05).Before treatment,there were no statistical significance on CRP and TNF-α between two groups.After treatment,the CRP and TNF-α were decreased in two groups and lower in the high dose group (P ＜ 0.05).Before treatment,there were no statistical significance on FVC,FEV1 and FEV1/FVC％ between two groups.After treatment,FVC,FEV1 and FEV1/FVC were increased and higher in the high dose group (P ＜ 0.05).During treatment,there were no statistical significance on adverse reaction between two groups.Conclusion High dose of ambroxol was effective and safe for COPD.It could reduce inflammation and improve pulmonary ventilation with clinical use.

Objective:To explore the relation of the expression among C-erbB-2,p16 and nm23-H 1 protein in tissues of nasopharyngeal carcinoma(NPC)and its clinical significance.Methods:SP TMimmunohistochemical technique was used to detect the positive expression rate of C-erbB-2,p16 and nm23-H 1 protein in NPC tissues.Rusults:①The positive rates of C-erbB-2,p16 and nm23-H 1 in low differentiated squamous cell carcinoma were 58.75%,47.5% and 35%,while in undifferentiated squamous cell carcinoma, they were 86.67%,31.11% and 60% respectively. ②Their expression rate were significantly correlated with the clinical staging(P

Doctors'language can help the patients and hurt them as well just like their bis-toury.Warm words give the patients confidence,hope and energy to beat their disease.When doctors communicate with the patients,their words are not only the important tool but also a kind of art.This article displays five artistic characters of doctors'words such as morality,etiquette,emotion,preciseness and secrecy.

Objective:To investigate the effects of Porhyromonas endodontalis(P.e)liopolysaccharide(LPS)on the expression of IL-23mRNA and protein in mouse osteoblasts MC3T3-E1 and the role of phosphatidylinositol 3-Kinases (PI3K)signaling pathway in this process.Methods:MC3T3-E1 cells were treated with different concentrations of P.e LPS for different hours,or pretreated with LY294002,a special PI3K inhibitor.The IL-23 mRNA and protein expression levels were detected by real-time PCR and Western blot respectively.Results:The level of IL-23 mRNA increased in MC3T3-E1 cells with the increase of concentration and the treatment time of P.e LPS(P <0.05).The IL-23 protein expression was increased by P.e LPS in a time dependent manner(P <0.05).The mRNA and protein of IL-23 decreased(P <0.05)after pretreatment with LY294002.Conclusion:P.e LPS can induce the expression of IL-23 mRNA and protein in MC3T3-E1 cells,and the PI3K signaling pathway may play a part in this process.

Objective To establish z-score model for fetal aorta (Ao) and pulmonary artery (PA) dimensions base on fetal femur length (FL),then to evaluate them in prenatal diagnosis of tetralogy of Fallot (TOF).Methods Three hundred twenty-nine normal fetuses and 43 fetuses with TOF were involved,Ao and PA dimensions were measured for all cases offline after cardio-spatiotemporal image correlation (STIC) volume acquisition,and PA to Ao ratio (PA/Ao) was calculated.Normal Ao and PA dimensions z-score models were constructed by using first standard regression analysis using FL as independent variable.Subsequently,the three parameters between normal and TOF fetuses were compared.Results The models use to calculate z-score for Ao and PA dimensions were constructed,FL had close correlation with fetal Ao and PA dimensions.Compared with normal fetuses,the mean z-scores of Ao,PA and PA/Ao ratio were statistical different in TOF fetuses.All Ao z-scores were ＞ + 2 z-scores and all the PA/Ao ratio were ＜ the 95％ CI in TOF group,however,only 48.84％ (21/43) PA z-scores of TOF cases were ＜-2 z-scores.Conclusions The Ao and PA dimensions z-score can provide quantitative evidence in prenatal diagnosis of TOF.Aortic dilatation and abnormal PA/Ao ratio are the main performances in fetal TOF and would be markers for prenatal diagnosis of TOF.

Objective To investigate antenatal sonographic findings of the fetal isolated callosal hypoplasia and partial agenesis. Methods A retrospective study was performed on the cases of hypoplasia and partial agenesis of the corpus callosum suspected at antenatal sonographic basic examination from 2006 to 2014, all the cases were confirmed by pathology or magnetic resonance imaging(MRI). For the surviving infants, clinical follow-up had been performed to assess the developmental outcome. Results Thirteen fetuses suspected with callosal underdevelopment were identified at a median gestational age of 31 (range, 18~39) weeks. Ten cases were confirmed by autopsy and MRI, including 9 with partial agenesis and 1 with hypoplasia. Among the 10 fetuses confirmed with isolated partial agenesis or with hypoplasia, incidence of the absent cavum septum pellucidum was 20%, the ‘Tear-drop’ lateral ventricles was 40%, the upward displacement of the third ventricle was 80%. Pregnancy was terminated electively in 8 of the cases with partial agenesis or with hypoplasia. Among the 2 surviving infants, apparent normal development was observed in only one case, but we lost the follow-up of this case at two-year-old. Six fetuses received the chromosome identification, almost all of them were normal. Conclusion The basic ultrasonic examination is feasible for the antenatal diagnosis of isolated callosal underdevelopment the. The indirect classical signs of callosal partial agenesis and hypoplasia are different with those of complete agenesis of the corpus callosum. The incidences of the‘Tear-drop’ lateral ventricles and the upward displacement of the third ventricle are higher than the absence of CSP. The chromosome of isolated callosal partial agenesis or hypoplasia is normal, however, the prognosis is uncertain.

Objective To analyze the effects of fertilization methods and sperm sources in intra‐cytoplasmic sperm injection (ICSI) on the developmental capacity of surplus embryos .Methods A retrospective study was carried out to compare the blasto‐cyst rate of the surplus embryos from 2 697 patients .According to the fertilization methods ,the embryos were divided into IVF group and ICSI group .According to sperm sources ,the ICSI group was divided into ejaculated group and testicular sperm group . The rates of blastocyst formation and good quality blastocysts were compared between different fertilization methods and sperm sources .Results There were 8 426 embryo developed in 2 697 patients .The blastocyst formation rate of surplus embryos was high‐er in the IVF group(n=1 048 ,53 .18% ) than that in the ICSI group(n=1 378 ,49 .27% ) ,but with no statistically significant differ‐ent(P> 0 .05) .The rates of blastocyst were not statistically significant different between the IVF group and in the rescue ICSI group(P>0 .05) .The rates of blastocyst were not statistically significant different between the ejaculated group and the testicular sperm group(P>0 .05) .Conclusion There were not statistically significant different of the rate of blastocyst between different fer‐tilization methods and sperm sources in ICSI .

Objective:To explore the feasibility of using Double FLASH coronary CTA (CCTA) to evaluate myocardial blood perfusion based on the original Patlak Plots.Methods:A total of 50 subjects with non-ischemic heart disease were prospectively included in the study who received dynamic myocardial CT perfusion (CTP) and Double FLASH CTA scans in General Hospital of Tianjin Medical University from January 2018 to January 2020 due to coronary heart disease or suspected coronary heart disease. The age of the enrolled patients was at least 18 years old and there was no moderate or above stenosis on CTA. The dynamic CTP images were analyzed by using CTP analysis software on FRONTIER platform to calculate the CTP derived MBF (MBF CTP). While the CTA derived MBF (MBF CTA) was calculated from the CT attenuation values of both aorta and myocardium segments on two scanning time set of Double FLASH CTA which were measured by two independent radiologists. Pearson correlation and Bland-Altman analysis were used to compare the results of MBF CTP and MBF CTA. Results:There was a strong linear correlation between MBF CTP and MBF CTA measurements. In the mid anteroseptal level: MBF CTA=0.936MBF CTP-11.999, r2=0.600, P<0.01. In the mid anterolateral level: MBF CTA=1.010MBF CTP-9.206, r2=0.448, P<0.01. In the apex: MBF CTA=0.822MBF CTP+16.904, r2=0.375, P<0.01. Bland-Altman analysis also showed there were no significant differences between MBF CTP and MBF CTA measurements. Compared with dynamic CTP scan, Double FLASH CTA mode significantly reduced the radiation dose [(4.33±1.89) mSv vs. (1.38±0.19) mSv, t=4.378, P=0.030]. Conclusions:This study validated the feasibility and accuracy of the MBF CTA measurement based on the theory of Patlak Plots only using Double FLASH CTA images. This method might have the potential to expand the clinical application of one-stop CTP examination for simultaneously evaluating coronary artery and myocardial ischemia in the clinic.

Background and objective The expression of long noncoding RNA HOX antisense RNA (HO-TAIR) is abnormal in a variety of tumors. The aim of this study is to explore the serum levels and clinical significance of HOTAIR in patients with non-small cell lung cancer (NSCLC). Methods The serum levels of HOTAIR were detected by real-time quantitative polymerase chain reaction (PCR) in 64 NSCLC patients and 64 normal controls. The rela-tionships between the serum levels of HOTAIR and clinical pathological parameters were analyzed. Results Compared with normal controls, the serum levels of HOTAIR in patients with NSCLC increased significantly (P<0.01). The serum levels of HOTAIR were correlated with tumor size, tumor-node-metastasis (TNM) stage and lymph node me-tastasis (P<0.05), but not with age, gender, smoking, differentiation and histology (P>0.05). Conclusion The serum levels of HOTAIR in patients with NSCLC are significantly higher, and HOTAIR may be involved in the pathogenesis of NSCLC.

Objective To investigate the relationship of relative telomere length in cumulus cells(CCs) with oocytes at different mature stages and the outcome of intracytoplasmic sperm injection and embryo transfer (ICSI-ET). Methods Oocyte-cumulus complex samples were collected from 92 patients undergoing ICSI-ET and patients were divided into group A including 55 women≤35 years and group B 37 women>35 years. The embryonic development ability and the result of clinical pregnancy were recorded in different groups. DNA was extracted from CCs and assessed for telomere length by real-time quantitative PCR. Results In ICSI-ET,the relative telomere length of CCs gradually shortened with the age.There was a significantly longer telomere length of CCs in the preg-nant subgroup than that in the non-pregnant subgroup in the two groups(P < 0.05). Conclusion The telomere length of CCs may be associated with the pregnancy outcome in ICSI-ET.