Objective To investigate the effect of bronchodilators on dyspnea and pulmonary function in patients with chronic obstruction pulmonary disease (COPD) at different degrees.Methods 50 patients with COPD from January 2014 to January 2015 in pneumology department of Tongchuan City People's Hospital were selected.According to the standard of Global initiative for chronic obstructive lung disease (GOLD), the patients were divided into mild degree of 14 cases, moderate degree of 18 cases and severe degree of 18 case.The changes of Borg score of dyspnea, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and inspiratory capacity (IC) after received tiotropium bromide inhalation in each group.Results FEV1, FVC, PEF and IC values significant improved in mild, moderate and severe degree groups after received tiotropium bromide inhalation and the values of improvement rate changed significantly with degrees of disease ( P <0.05 ).The improvement rates of FEV1, FVC and IC were highest in patients at severe degree, improvement rate of PEF was highest in patients at mild degree (P<0.05).After received tiotropium bromide inhalation, the Borg score improved significantly compared with that of pre-treatment in mild, moderate and severe degree groups (P<0.05), the improvement rate of Borg score was highest in severe degree group(P<0.05).There were significantly positive correlations between Borg score and FEV1(r=0.372),FVC(r=0.296),PEF(r=0.284),IC(r=0.704)(all P<0.05).Conclusion Bronchodilator could significantly improve dyspnea and lung function in patients with COPD, and the improvement rate of FEV1, FVC and IC is highest in patients with COPD at server degree, PEF is highest at mild degree and Borg score is highest at server degree, which need the comprehensive analysis of each indicators for reversibility of airflow obstruction.

AIM: To investigate the quality of life in adults with strabismus and evaluate the improvement in quality of life after treatment.
METHODS: In this prospective study, forty-five adults with a diagnosis of strabismus conform to the inclusion and exclusion standard were selected in our hospital from October 2013 to May 2014, as experimental group and 45 normal adults were enrolled as control group. A Chinese Adult Strabismus-20 questionnaire was used to evaluate the differences of quality of life between patients with strabismus and normal adults, and to evaluate the differences of quality of life in patients with strabismus preoperative and 6mo postoperative.
RESULTS:The scores of quality of life in adult patients with strabismus preoperative and 6mo postoperative were statistically significant lower than those of normal adults (P< 0. 01). In 6mo postoperative, the scores of quality of life statistically significant increased than preoperative ( P<0. 01).
CONCLUSION: Strabismus can decrease the quality of life in psychosocial and visual functional for adults and the surgical treatment can improve quality of life in patients with strabismus.

Objective To observe the effects of Yiqi Huoxue Tongluo Jiedu fang (YHTJF) on pneumocyte apoptosis after lung ischemia/reperfusion (I/R) injury (LIRI) in mice and to investigate whether c-Jun N-terminal protein kinase (JNK) is involved in the mechanism of apoptosis.Methods Seventy C57BL/6J male mice were randomly divided into seven groups:normal control group (C group),carboxyl methyl cellulose-Na+normal control group (CMC-Na+C group),CMC-Na+sham group (CMC-Na+S group),CMC-Na+I/R group (CMC-Na+I/R group) and CMC-Na+YHTJF-low,-middle,-high dose groups (CMC-Na+YL,CMC-Na+YM,CMC-Na+YH groups).C group did not undergo any processing;in CMC-Na+S group,only was chest opened without clipping the lung hilum;in the rest of the four groups,they all underwent opening of the chest and clipping the lung hilum for 30 minutes,then the clipping of artery was relieved and left lung reperfusion was carried out for 3 hours.After operation,the mice were sacrificed,the lung tissues were harvested.Under light and electron microscopes,the lung morphological and ultra-structural changes were observed,and the changes of index of quantitative evaluation for alveolar damage (IQA) were determined.The terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) was applied to evaluate the apoptosis index (AI) of the lung tissues.The protein and mRNA expressions of JNK and glucose regulating protein 78 (GRP78) in lung tissues were detected by Western Blot and reverse transcription-polymerase chain reaction (RT-PCR);the correlations between lung AI and the expressions of mRNA and protein of JNK and GRP78,IQA were analyzed.Results Compared with CMC-Na+S group,IQA,AI and mRNA and the protein expressions of JNK and GRP78 in CMC-Na+I/R group were obviously higher [IQA:(74.00 ± 7.31)％ vs.(7.00 ± 1.23)％,AI:(64.40 ± 11.97)％ vs.(5.60 ± 1.14)％,JNK mRNA (gray value):1.143 ± 0.284 vs.0.152 ± 0.128,GRP78 mRNA (gray value):0.897 ± 0.129 vs.0.284 ± 0.044,JNK protein (A value):0.428 ± 0.074 vs.0.073 ± 0.052,GRP78 protein (A value):1.075 ± 0.145 vs.0.589 ± 0.060].Compared with CMC-Na+I/R group,the IQA,AI,protein and mRNA expressions of JNK and GRP78 in CMC-Na+YL,CMC-Na+YM,CMC-Na+YH groups were all lower,and the degree of reduction in group CMC-Na+YM was the most remarkable,greater than that in CMC-Na+YL or CMC-Na+YH group [IQA:(26.20 ± 3.35)％ vs.(34.00±5.34)％,(41.20±9.18)％,AI:(29.40±3.05)％ vs.(48.20±3.83)％,(39.20±6.14)％,JNK mRNA (gray value):0.681 ± 0.130 vs.0.804 ± 0.153,0.938 ± 0.11,GRP78 mRNA (gray value):0.450 ± 0.105 vs.0.747 ± 0.231,0.566 ± 0.115,JNK protein (A value):0.188 ± 0.049 vs.0.261 ± 0.065,0.209 ± 0.063,all P ＜ 0.01],compared with the CMC-Na+I/R group,the expression of GRP78 protein was obviously higher in CMC-Na+YH,CMC-Na+YL,CMC-Na+YM groups and the most remarkably high was in CMC-Na+YH group (A value:1.429 ±0.226 vs.1.130±0.169,1.128 ±0.177,all P ＜ 0.01).The apoptosis of each group was mainly in the pulmonary vascular endothelial cells and alveolar epithelial cells,and brown particles were positive cells under light microscope.Under transmission electron microscope:nuclear pyknosis and margination under the nuclear membrane,cytoplasm condensed,lamellar bodies decreased and emptying increased,cell membrane microvilli decreased or disappeared,mitochondria swelling,inflammatory cells increased in alveolar septum and adhering onto the capillary walls could be seen in CMC-Na+I/R group.Compared with CMC-Na+I/R group,the lung tissue ultrastructural damage alleviated,ultrastructure of alveoli clearly seen,nuclear chromatin relatively uniform,cytoplasm increased,type Ⅱ alveolar epithelial cell surface microvilli relatively plenty,lamellar corpuscle number increased,mitochondria swelling ameliorated in CMC-Na+YH,CMC-Na+YL,CMC-Na+YM groups and the most remarkable one was CMC-Na+YM group.AI was significantly positive correlated with the mRNA and protein expressions of JNK,GRP78 and IQA (r =0.907,0.928,0.880,0.712,0.911,all P ＜ 0.01).Conclusions YHTJF may effectively alleviate the cell apoptosis in mice LIRI,and its mechanism may be related to the inhibition of JNK pathway.

Objective To study the activation of TLRs/NF-κB signal pathway and production of different functional cytokines during invasive pulmonary aspergillosis( IPA) , in order to probe the pathogene-sis of IPA. Methods Mouse were randomly divided into normal, normal + inoculated with Aspergillus fumigatus( normal inoculation group), and immune suppression + inoculation with Aspergillus fumigatus (IPAmodel group) , the mouse were killed at different time points after inhaling Aspergillus fumigatus spores by nose. Removing the lung tissue in a sterile manner and making pathological section respectively, counting Aspergillus fumigatus colony, dynamiclly detecting the expression of TLR2, TLR4 mRNA, variation of NF-κB p65 protein, pro-inflammatory cytokines TNF-α, IL-1β and anti-inflammatory cytokines IL-10 levels in the lung tissue by RT-PCR and Western blot method during Aspergillus fumigatus infection in mouse. Results (1) When it's 72 h after inhaling Aspergillus fumigatus by nose, IPA model emerged severe lung tissue inflammation, and generated a large number of hyphae, meanwhile, burthen of Aspergillus fumigatus was higher than normal inoculation group at each time point. (2)Compared with the normal inoculation group, IPA group whose TLR2 mRNA was low expression at early stage of infection (24 h), and emerged high expression at late stage of infection (120 h, 144 h); and TLR4 mRNA has been at a state of low expression in the infection process; NF-κB p65 suddenly increased at early stage of infection(24 h) and then continued to decline. (3) After infected by Aspergillus fumigatus in normal mouse, proinflammatory cytokine TNF-α, IL-1β in lung exhibited high expression at the early stages of infection, and the highest expression levels appeared at 48 h or 72 h, then decreased and recovered to normal level. And the expression level of anti-inflammatory cytokine IL-10 rised at late stage of infection; The IP A mouse released a lot of anti-inflammatory cytokine IL-10 at early stage of infection, which significantly reduced at late stage, and released pro-inflammatory cyto-kines TNF-α, IL-1β at slow and low level. Conclusion The abnormal activation of TLRs/NF-β signaling pathway caused the loss of dynamic balance between pro-inflammatory cytokines and anti-inflammatory cytokines, leading to the occurrence and development of IPA.

The design space of the high shear wet granulation process was established and validated within the framework of quality by design (QbD). The system of microcrystalline cellulose-de-ioned water was used in this study. The median granule size and bulk density of granules were identified as critical quality attributes. Plackeet-Burmann experimental design was used to screen these factors as follows: dry mixing time, the impeller and chopper speed of dry mixing, water amount, water addition time, wet massing time, the impeller and chopper speed of wet massing and drying time. And the optimization was implemented with the central composite experimental design based on screened critical process parameters. The design space of the high shear wet granulation process was established based on the quadratic polynomial regression model. Since the P-values of both models were less than 0.05 and values of lack of fit were more than 0.1, the relationship between critical quality attributes and critical process parameters could be well described by the two models. The reliability of design space, illustrated by overlay plot, was improved with the addition of 95% confidence interval. For those granules whose process parameters were in the design space, the granule size could be controlled within 250 to 355 μm, and the bulk density could be controlled within a range of 0.4 to 0.6 g x cm(-3). The robustness and flexibility of the high shear wet granulation process have been enhanced via the establishment of the design space based on the QbD concept.
Cellulose ; chemistry ; Reproducibility of Results ; Technology, Pharmaceutical ; methods ; Water

Background: With the increase of troops entering the plateau for a variety of missions, the occurrence of de-adaptation increased significantly when the army returned to the plains, however, until now, there has been no effective treatment for de-adaptation to high altitude. Objective: To observe the interventional effects of compound Chinese herbal preparations (Sankang Capsule, Rhodiola Rosea Capsule and Shenqi Pollen Capsule) on de-adaptation to high altitude, and provide scientific evidence for appropriate treatment methods in the army health care for future missions. Design, setting, participants and interventions: A randomized, single-blind, placebo-controlled trial design was used. Soldiers of a returning army unit who exhibited de-adaptation response symptoms were selected for observation after participating in earthquake relief at high altitude. A total of 543 soldiers were divided into a Sankang Capsule group, a Rhodiola Rosea Capsule group, a Shenqi Pollen Capsule group and a placebo group for drug intervention and administered with corresponding drugs. The course of treatment was 15 days. A self-evaluation scale for de-adaptation to high altitude was used to measure the signs and symptoms exhibited by the soldiers. Main outcome measures: Effective rate of signs and symptoms of de-adaptation to high altitude was analyzed after a 15-day treatment and the differences of improvement rate of symptoms between groups were compared to evaluate the efficacy of the drugs. Results: All three drugs improved the symptoms of de-adaptation to high altitude. Compared with the placebo group, symptoms of de-adaptation to high altitude in the drug-treated groups were remitted (P<0.05). Compared with placebo, Sankang Capsule mainly had well-marked effects on dizziness, fatigue, palpitations, cough, sputum and sore throat (P<0.05); Rhodiola Rosea Capsule significantly reduced the symptoms of fatigue, drowsiness, chest tightness, palpitations, vertigo, lack of attention and memory loss (P<0.05); Shenqi Pollen Capsule significantly reduced the symptoms of dizziness, fatigue, weakness, chest tightness, palpitations, cough, sputum, sore throat, memory loss, unresponsiveness and limb numbness (P<0.05). The symptom improvement rate of Shenqi Pollen Capsule was significantly higher than those of the other two drugs. Conclusion: All the three drugs played an evident role in ameliorating symptoms of de-adaptation, and the use of Shenqi Pollen Capsule was more effective than Rhodiola Rosea Capsule and Sankang Capsule.

Background and purpose: Triple negative breast cancer (TNBC) is a high risk breast cancer characterized by the negative expression of estrogen receptor(ER), progesterone receptor (PR) and Her-2 that have no specific therapy. This study was to analyze clinical pathological characteristics, survival, and prognostic factors of patients with TNBC. Methods: Clinical and pathological as well as follow-up data of TNBC, treated at the Cancer Centre of Sun Yat-sen University from Jan. 2000 to Dec. 2003, were collected and analyzed. Results: A total number of 128 women were identified as having triple negative breast cancer. The median age of these patients was 46 years, and 60.9% of them had stage Ⅰ or Ⅱ disease. The majority of pathological types were invasive ductal carcinomas, and 78.1% of tumors were staged T1 or T2. And 48.4% of these patients were involved in lymph node. Event-free survival, local replase-free survival, distant metastasis-free survival and overall survival at five years were 71.1%, 84.3%, 75.8% and 83.6% respectively. Though lymph node metastasis, tumor masses, stage and lymph-vascular invasion were all found to be related to overall survival, however, only lymph node metastasis and tumor masses affected the overall survival as revealed by the Cox proportional hazard model analysis. Conclusion: Triple negative breast cancer has distinct clinical and pathological characteristics. The patients are usually young, with large masses, lymph node metastasis, family history of breast cancer and poor prognosis; lymph node metastasis and tumor mass are important prognostic factors.

Objective: To analyze the long-term prognosis of re-operation in patients with functional tricuspid regurgitation (FTR) after left sided valve replacement (LSVR) and hence evaluate the optimal timing of mentioned re-operation. Methods: A total of 59 FTR patients who had re-operation after their prior LSVR in our hospital from 1999-01 to 2013-01 were analyzed. The clinical information and post-operative follow-up results were recorded in all patients. Results: There were 5/59 (8.5%) patients died in peri-operative period and the overall post-operative mortality was 11.9% (7/59). The follow-up data of 54 survivors were available for the mean time of 51.1 (21-188) months. There were 19/54 (35.2%) patients suffered from MACE and 30 (55.6%) were beneifted by improved cardiac function. Uni-variable analysis indicated that pre-operative NYHA class IV (P=0.008), pre-operative right ventricular (RV) dysfunction (P=0.037), concomitant left-sided redo-operation (P=0.017) and TVR operation (P=0.002) were associated with all cause mortality of tricuspid re-operation. Multi-variable Cox regression analysis showed that pre-operative RV dysfunction was the only independent risk factor of long term MACE-free accumulating survival rate (HR=3.0, 95% CI 1.11-8.2,P=0.031); while TVR operation (HR=12.8, 95% CI 1.53-107.02,P=0.019) and pre-operative NYHA class IV (HR=5.3, 95% CI 1.20-24.51,P=0.032) were the independent risk factors for long-term mortality in patients after tricuspid re-operation. Conclusion: Patients with compensatory RV function showed better long term prognosis after secondary tricuspid operation. Aggressive re-operation before the occurrence of right ventricular dysfunction could be beneficial for relevant patients.

The degradation of nitrobenzene(NB) using a combination of Fe0 and anaerobic microorganism was studied. Nitrobenzene could be degraded effectively and the synergistic effect between Fe0 and anaerobic microorganism was apparent,and the nitrobenzene removal efficiency increased with the increasing of Fe0;the optimum pH was 5.0～6.0;as cometabolizing substrate,glucose could promote the degradation of nitrobenzene;In case of high concentration of Fe2+ and Fe3+,the anaerobic biodegradation activity of nitrobenzene were inhibited in a certain degree;0.5 mg/L Fe2+ and Fe3+ were the optimum to accelerate biodegradation rate of nitrobenzene; the degradation kinetics of nitrobenzene were followed by first-order reaction, reaction rate constant reduced along with the concentration of nitrobenzene increased.

Objective To investigate the effects of the overexpression of HO-1 induced by CoPP in the donor on the survival of transplanted allogeneic islets of rats and the mechanism.Methods (1) Brown Norway rats were randomly divided into control group, and CoPP-induced group receiving intraperitoneal injection of CoPP (2.5 mg/kg) at 3rd and 1st day prior to islet isolation.By using the cytoimmunofluorescenee and Western blot, the expression of HO-1 in isolated islets was detected.The insulin level in the supernatant of the cultured islets stimulated with glucose was determined by ELISA.(2) Lewis male rat diabetic models were established by a single intravenous injection of alloxan, and then randomly divided into CoPP group and control group.Islets were transplanted under the left kidney capsule of each diabetic recipient.The survival time after transplantation, and pathological changes following rejection of the islet grafts were analyzed.Results The HO-1 was highly expressed in the islets isolated from CoPP-treated rats by cytoimmunofluorescence and Western blot.After stimulation with 16.7 mmol/L glucose, the insulin concentration in Copp-treated and Copp-untreated groups was (46.60± 1.13) and (19.01 ± 1.49) mIU/L respectively (P<0.05).The insulin concentration in Copp-treated and Copp-untreated groups in islets stimulated with 5.6 mmol/L glucose was (15.65 ± 0.89) and (12.28 ± 0.89) mU/L respectively (P>0.05).The stimulated index in Copp-treated and Copp-untreated groups was (2.98 ± 0.10) and 1.55 + 0.01 respectively (P< 0.05).The survival time of islets allograft in Copp-treated and Copp-untreated groups was separately (12.20±5.67) and (5.60± 1.14) days respectively (P<0.05).Histological analysis revealed the presence of more islands of insulin-positive cells and considerably fewer lymphocytes or inflammatory infiltration than the controls.Conclusions CoPP could induce the HO-1 expression of islets, and improve their function.Over-expression of HO-1 in islets could prolong survival time of islets allograft.