Objective To investigate the diagnostic value of serum amyloid A(SAA)in diagnosing acute exacerbations of chronic obstructive pulmonary disease(AECOPD).Methods A total of 86 patients with AECOPD and 46 patients with stable COPD were recruited.SAA determined with ELISA was compared between AECOPD patients and stable COPD patients.The changes of SAA,WBC,the percentage of neutrophils and C-reactive protein (CRP) of AECOPD patients Was compared before and immediately after the last treatment procedure.Results The SAA levels in AECOPD patients were higher than those in stable COPD patients [(182.33±50.12)mg/L vs (6.24±3.05)mg/L,P<0.05].The change of SAA was more evident than that of serum WBC and the percentage of neutrophils before and after the treatment procedure. SAA was more sensitive than CRP in diagnosing lung function severity of AECOPD patients.Conclusion SAA has great diagnostic value in AECOPD diagnosis and evaluation of lung function severity.

We reported 2 cases of descending neerotizing mediastinitis (DNM) and reviewed the related literatures. The etiology, clinical manifestations, imaging manifestations, diagnostic criteria and therapeutic strategies of DNM were discussed. It is concluded that descending necrotizing mediastinitis is a life-threatening disease with high mortality and is prone to be misdiagnosed. Early diagnosis, prompt application of sensitive broad-spectrum antibiotics and abscess drainage with proper surgical medality may improve the prognosis of DNM.

Objective To investigate the role of the pulmonary function, arterial blood gas analysis, the St George respiratory questionnaire (SGRQ) score and nutritional status in evaluating the development of chronic obstructive pulmonary disease (COPD). Method Changes of the above-mentioned parameters were analyzed in hospitalized patients suffered from moderate to severe COPD and compared with parameters of those who had acute exacerbations when admitted to hospital. Results The forced expiratory volume in one second (FEV1)% pred and oxygenation index of the patients declined significantly with the development of the disease after one, two, three, four times in hospital [(68.43 ± 3.09)%, (61.27 ± 3.38 )%, (42.05 ± 4.16)%, (33.64 ± 3.34)% and 435.55 ± 10.23, 404.35 ± 11.56, 358.38 ± 13.21, 321.29 ± 11.78] (P < 0.05), while the level of PaCO2 increased significantly in moderate COPD [(36.23 ± 3.62), (45.44 ± 4.67), (57.82 ± 4.12), (78.28 ± 5.21 )mm Hg (1 mm Hg = 0.133 kPa) ] (P<0.05). The oxygenation index was declined significantly in severe COPD. The scores of SGRQ score declined significantly in all patients while the level of hemoglobin, albumin and body mass index did not change significantly. Conclusions Acute ex-acerbation attributes to the deterioration of pulmonary function and life quality of COPD patients. Monitoring the changes of pulmonary function, arterial blood gas analysis and SGRQ score may be useful in the evaluation of the development of COPD.

Objective To determine whether the extent of airflow obstruction is associated with left ventricular function in mild-to-moderate chronic obstructive pulmonary disease (COPD) patients.Methods Left ventricle end diastolic volume ( LVEDV ),left ventricle end systolic volume ( LVESV ),left ventricle stroke volume( LVSV),left ventricle ejection fraction( LVEF),heart rate ( HR),cardiac output ( CO) and cardiac index (CI) were measured by ultrasonic cardiogram.Thirty-one patients with chronic bronchitis,42 mild-to-moderate COPD patients and 16 controls with normal lung function were recruited.The relations between the extent of airflow obstruction and the impairment of left ventricular function were analyzed.Results There were no significant differences of LVEDV,LVESV,LVSV,HR,CO or CI between the control and chronic bronchitis groups.LVEDV,LVESV,LVSV,CO and CI of chronic bronchitis group were significantly higher than those of mild-to-moderate COPD group while HR was lower.LVEDV,LVESV,LVSV,CO and CI had a positive correlation with forced expiratory volume in 1 second ( FEV1 ),forced vital capacity (FVC) and FEV1/FVC ratio.And HR had a negative correlation with FEV1 and FEV1/FVC.LVEF was positively correlated with FVC,but not with FEV1 and FEV1/FVC.LVEDV,LVESV,LVSV,HR,CO and CI were linearly related with FEV1.Conclusions Left ventricular function is maintained in chronic bronchitis patients. Left ventricular function,especially left ventricular end diastolic filling,deteriorates among the mild-to-moderate COPD patients.The extent of airflow obstruction may reflect the impairment of left ventricular function in COPD patients.

Objective To identify the correlated factors of chronic hypercapnia in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods The study cohort consisted 56 patients with OSAHS.They were taken arterial blood gas analysis and pulmonary function tests.They were divided into two groups,hypercapnic(PaCO_2≥45 mm Hg)and normocapnic(PaCO_2

Objective To investigate the clinical significance of serum sICAM-1 level in patients with NSCLC.Methods Sera from 51 cases with different TNM stages of NSCLC were collected and analyzed for concentration of sICAM-1 with Sandwich ELISA method.Results Serum levels of sICAM-1 were significantly higher in NSCLC group than in healthy controls and correlated with the clinical stage of NSCLC cases.Conclusions sICAM-1 could be an important factor which underlies tumor invasion and metastasis and may have a prognostic value in lung cancer.

Objective Clinical strains of Shigella dysenteriae isolated from eastern parts of India in 1988, 1995 and 2002 were examined for the presence of class 1, 2 and 3 integrons which closely related with drug resistance and the distribution of resistance gene cassette in order to clarify the influence of integron system on drug resistance of Shigella dysenteriae. Methods Susceptibility to antimicrobial agents was tested by the disk agar diffusion method. Class 1, 2 and 3 integron genes (intI) were screened by polymerase chain reaction (PCR) in 16 clinical strains with drug resistance.The variable regions of gene cassette of positive strains were sequenced. Results All 16 isolates were resistant to at least 4 agents including β-lactams, aminoglycosides, tetracyclines, sulfonamides,chloramphenicols and quinolones. Class 1 integron gene was detected in 13 strains and all isolates carried class 2 integron which indicated that strains with two integron structures were detected simultaneously and class 3 integron was not detected. Class 1 integron inserted gene cassette was mainly blaara30 -aadA 1 family, conferring resistance to β-lactamase, spectinomycin and streptomycins isolates carried class 2 integron were mainly dfrAl-satl genes cassettes conferring resistance to methoxybenzyl aminopyrimidine and streptothricin, while dfrA\-sat\-aadA\ genes were present only in 4 isolates. Conclusions These data indicate that class 2 integrons are widespread in Shigella dysenteriae strains, and closely associated with multidrug resistance of Shigella.

Objective To analyze the characteristics and influencing factors of sleep disorders and nocturnal hypoxemia of patients with different degrees of obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Four hundred and twenty-five patients with snoring were scored by Epworth Sleepiness Scale ( ESS), and monitored by polysomnography (PSG). The possible correlations between sleep structure, hypoxia parameters, ESS and clinical features were analyzed and compared in those patients. Results Four hundred and twenty-five patients were divided into 4 groups according to the apnea-hypopnea index (AHI). There were 65 primary snoring patients (15.3%) and 360 OSAHS patients (84. 7% ) including 187 patients (44. 0% ) in severe OSAHS group. ESS was increased as aggravation of OSAHS. There were significant statistical differences in ESS among each group. Compared with primary snoring group, sleep efficiency, NREM1 + 2, oxygen desaturation index ( ODI), time with pulse oxygen saturation below 90% (T(SpO2 <90% ) ) were significantly higher in the OSAHS groups, and NREM3 +4, lowest pulse oxygen saturation level ( LSpO2 ) were lower. ESS was correlated positively with AHI (r= 0. 474,P <0. 01 ). They were both correlated positively with ODI, T (SpO2 <90% ) and NREM1 + 2( ESSr =0. 392, 0. 356,0. 194;AHI r = 0. 714, O. 682, 0. 365, all P < 0. 01 ), and correlated negatively with LSpO2, NREM3 + 4 ( ESS r = - 0. 414, - 0. 196; AHI r = - 0. 740, - 0. 385, both P < 0. 01 ). LSpO2, ODI and T (SpO2 < 90% ) were the primary influencing factors. Common clinical presentations and subjective symptoms were presented including daytime sleepiness, impaired memory, fatigue, dry mouth, oppressive wake and morning headache, etc. Percentage of individuals with daytime sleepiness in the severe OSAHS group was 73. 3% (137/187). These had serious impact on the patients' quality of life, leading to difficulty concentrating, poor memory and cognitive impairment. Conclusions Sleep disorders are found in the patients with different degrees of OSAHS. The excessive daytime sleepiness interrelated partly with the structure of sleep, and totally with hypoxia parameters. The more severity the patients have, the more nocturnal hypoxia, sleep disorders and higher ESS are found.

Objective To screen and identify the differential expression genes on peripheral blood cells of mice based on the experimental animal model of radon exposure. Methods BALB/c mice were exposed in a type HD-3 multifunctional radon-room, with the accumulative doses of radon-exposure group at 105 WLM and control group at 1 WLM. Total RNA was extracted from peripheral blood cells and the methods of SMART for dscDNA synthesis and SSH for gene screening was applied. With the construction of the cDNA library enriched with differentially expressed genes, the pMD 18-T plasmid containing LacZ operator at the multiple cloning site was used to allow a blue-white screening. The TA clones were amplified by nested PCR and the reverse Northern blot was used to identify up and down regulation of the clones. The differently expressed cDNA was then sequenced and analyzed. Results The subtracted cDNA libraries were successfully constructed. A total of 390 recombinant white colonies were randomly selected. Among the 312 cDNA monoelones selected from bath forward- and reverse-subtracted libraries,41 clones were chosen to sequence for their differential expressions based on reverse Northern blot. Among the 41 sequenced clones, 10 clones with known function/annotation and 3 new ESTs with the GenBank accession numbers were obtained. Most of the known function/annotation genes were revealed to be related with cell proliferation, metabolism, cellular apoptosis and carcinogenesis. Conclusions The animal model of radon exposure was established and the cDNA library of peripheral blood cells was suceessfully constructed. Radon exposure could up- and down-regulate a series of genes. Differentially expressed genes could be identified by using SSH technique and the results may help exploring mechanisms of random exposure.

Objective To explore the significance and the change of miRNAs expression profile in different period of HBV infection.Methods Establish the detection method of microRNA(miRNA) by RNA DNA probe liquid chip (flexible multi-analyte profiling,xMap) and estimate the specificity,repeatability and accuracy of this method.From October 2010 to October 2011,collect HBV infected patients' periphcral blood of the First affiliated hospital of SooChow University,including acute hepatitis B,chronic hepatitis B,hepatits B liver cirrhosis,liver cancer patients and health control,each group contains 40 cases.The levels of miR-191,-223,-222,-145,-21,-31,-126,-20a,-372 of peripheral blood mononuclear cell were detected by xMap liquid chiptechnology.The level of miR-103 was taken as reference.The ratio of (the mean fluorescence intensity of target miRNAs-corresponding backgroud mean fluorescence intensity)/( the mean fluorescence intensity of miR-103-corresponding backgroud mean fluorescence intensity) as a valid data and analysis the characteristics of miRNAs expression.The SPSS 17.0 was used as statistical software.The single factor analysis of variance was used as the method to analysis group comparison,and make multiple comparison by the LSD-t method if the result with a significant difference.Results The specificity of Xmap liquid chip method to detect miRNAs was 100％ ;The repeated experiment proved that the CV value was less than 5％ in the high value reference miRNA test,less than 10％ in the low value reference miRNAs test;the accruracy experiment proved that the recovery rate was ( 100 ± 5)％ in the nine miRNAs.There were no statistically differences with miR-222 ( F =1.32,P ＞ 0.05),-191 ( F =1.98,P ＞ 0.05),-145 ( F =0.78,P＞0.05),-21(F=0.64,P ＞0.05),-31 (F =0.83,P ＞0.05),-372(F =1.75,P ＞0.05)in different groups; There was statistically significant differences in miR-223 ( F =14.56,P ＜ 0.05) among different groups,with the highest expression level in actue hepatitis B group (15.37 ± 4.01),and the lowest expression level in liver cancer group (6.91 ±3.18) ; There was statistically significant differences in miR126 (F =17.43,P ＜ 0.05)among different groups,with the highest expression level in health control group (6.33 ±2.75) and the lowest expression level in liver cancer group (2.38 ± 1.07).There were statistically significant differences in miR-20a ( F =19.484,P ＜ 0.05) among different groups,with the highest expression level in health control group (0.33 ±0.18) and the lowest expression level in liver cancer group (0.81 ±0.24).Conclusion The detection method of miRNA by Xmap liquid chip has strong specificity,high accuracy and good repeatability,suitable for large throughput clinical testing.The study for miRNA in HBV infected diseases provides a new clue to the research of chronic progress mechanism.