ion:Objective To study the effect of enteral nutrition on cardio-pulmonary function in elderly patients with chronic obstructive pulmonary disease (COPD) .Methods Fifty-eight elderly COPD patients were randomly divided into treatment group (enteral nutrition group ,n=29) and control group (free diet group ,n=29) .Their nutrition parameters (BMI ,serum total protein ,al-bumin and prealbumin) ,LVEF and pulmonary function (FEV1 ,FVC ,FEV1/FVC) were assayed before and after treatment .Results The BMI ,serum levels of total protein ,albumin and prealbu-min were significantly higher in treatment group after treatment than before treatment ( P<0.05) .However ,no significant difference was observed in these parameters in control group after treatment .The LVEF ,FVC ,FEV1 and FEV1/FVC were significantly higher in treatment group than in control group after treatment (P< 0 .05) .Conclusion Enteral nutrition in combination with conventional treatment can improve the nutrition and cardio-pulmonary function in elderly COPD patients ,thus shortening their hospital stay time .

Objective To evaluate the expression of autoantibodies to cell membrane associated with DNA (mDNA) in systemic lupus erythematosus (SLE).The specificity of these antibodies differs from antibodies to double stranded DNA.Method Using indirect immunofluorescence,serum samples were detected giving a characteristic pattern of peripheral membrane fluorescence on cultured HL60.Results This pattern was observed in 81 of 90 serum samplas of SLE patients,but absent in the serum samples of 35 rheumatoid arthritis,31 ankylosing spondylarthritis and 42 blood donors.In 20 Sjgren syndrome′s patients only one showed a positive test.Conclusion This novel rapid immunofluorescence method may serve as an identification test of SLE patients.Due to the sensitivity (90%) and specificity (98 8%),it is better than the other diagnostic tests such as the detection of antibodies to dsDNA and Sm.

Objective To assess the value of clinical application of CT pulmonary angiography(CTPA) in diagnosing pulmonary damage of Behcet’s syndrome.Methods 17 patients with Behcet’s syndrome underwent MSCT(Light Speed Plus, GE)with conventional CT scan and CTPA. The two kinds of imaging materials were comparatively studied by chi-square test , and diagnosed by comprehensive imaging appearances. Results The major feature of conventional CT included:bilateral or unilateral pulmonary density were nonhomogeneous in all cases,solitary or multiple pulmonary aneurysmal ecctasia in 9 cases,pulmonary artery growed in 12 cases,irregular and constrictive vascular wall in 6 cases and segmental infiltration in 5 cases.The features of CTPA included:irregular and constrictive pulmonary vascular wall in 15 cases,pulmonary aneurysms in 15 cases,pulmonary artery expansion in 16 cases,pulmonary artery thrombosis in 8 cases.There were statistical differences between conventional CT and CTPA in pulmonary aneurysm and arterial wall changes(?_1~2=5.10,P_10.05).Conclusion CTPA can diagnose pulmonary damage of Behcet’s syndrome in combination with clinic and conventional CT.

Objective To analyse imaging appearances of chest in AIDS and to supply the evidence for imaging diagnosis this lesions. Methods 46 cases of AIDS who had chest X-ray films and CT were collected and their imaging appearances were reviewed. Results 20 cases showed bilateral lung diffuse lesions which were network shadow with mottle, punctate, patchy, nodular and opacification. 10 cases showed unilateral lung field lesions,of them,cavity in the left upper lung was presented in one patient. 5 cases showed thickness or turbulence of texture in bilateral lungs. 11 cases were negative on chest film.Conclusion The characteristics of X-ray film or CT of lung can reflect the chest pathological changes in patient with AIDS.

Objective To study the X-ray signs of pulmonary lymphangitis carcinomatosa (PLC).Methods X-ray and HRCT signs of PLC proved by bronchoscopic or pleural or open-lung biopsy in 37 cases were retrospectively analyzed in order to find out some X-ray signs that suggested the PLC.Results The major X-ray features of PLC included:(1)Multiple thickened bronchovascular bundles in the bilateral lung in 37 cases;(2)Irregular thickened kerley A distributed over the bilateral lung in 28 cases;(3)The reticular and inosculating shadows(kerley C) extensively distributed over the bilateral lung in 19 cases;(4)The multiple irregular thickened kerley B distributed over the bilateral lung in 15 cases ;(5)Pulmonary hilar lymph adenopathy in 18 cases ;(6)Pleurae irregularly thickened in 16 cases;(7)Hydrothoraxes in 9 cases.Conclusion HRCT is the most satisfactory method in diagnosing PLC,but the super-quality thoracic plane film can supply some useful signs of PLC.

Objective To assess the efficacy and safety of argon plasma coagulation(APC) in treating patients with Barrett's esophagus.Methods Two reviewers independently searched the Cochrane Library(Issue 2,2008),MEDLINE(January 1948 to November 2008),and CNKI(January 1999 to November 2008),respectively.The quality of the included studies was assessed according to the guidance in the Cochrane Handbook of systematic reviews of interventions.Results Six randomized controlled trials involving 253 patients with Barrett's esophagus met the inclusion criteria and were included.One trial reported that the ablation rate of patients in the APC group was significantly higher than that in the endoscopic surveillance group.Followed up one year,the ablation rate in APC group was 63% compared with 15% in the control group(P

Objective To investigate the effects of octreotide on the apoptosis of human hepatic stellate cells (HSCs) and expression of Bcl-2/Bax in HSCs,and to reveal the mechanism underlying octreotide against hepatic fibrosis. Methods HSCs lines (HSC-LX2) were incubated with different concentrations of octreotide for 24 and 48 hours. Cell apoptosis was evaluated by Fitc-tunel fluorescence staining. Bcl-2 and Bax protein exoression in HSC-LX2 was detected by immunocytochemistry. Meanwhile, Bcl-2 protein of HSC-LX2 were detected by Western blot assay. Results Octreotide could promote the apoptosis of HSC-LX2, and the apoptosis rate was significantly increased with the concentration of octreotide(P < 0.05). The HSC-LX2 were incubated with the same concentration of octreotide for 24 and 48 hours, the cell apoptosis rate of 48-hour octreotide treatment was significantly higher than that of 24-hour octreotide treatment (P < 0.05). The immunocytochemistry result indicated that octreotide could significantly decrease Bcl-2 expression and increase Bax expression in HSC-LX2 (P<0.05); Western blot assay showed that octreotide could also significantly inhibit Bcl-2 expression in HSC-LX2 (P<0.05). Conclusions Octreotide could induce the apoptosis of HSCs in a dose-and time-dependent manner, the mechanism of octreotide inducing HSCs apoptosis might be associated with down-regulation of Bcl-2 and upregulation of Bax in HSC.

Objective To investigate the safety and clinical response of dendritic cells (DC)vaccine loaded with HLA-A2-restricted peptides MAGE-3、 Tyr、 MART-1 and GP-100 against malignant melanoma. Methods Twenty three HLA-A2 positive patients with malignant melanoma were enrolled.Peripheral blood mononuclear cells were separated into adherent cells for induction of DC loaded with four peptides. DC vaccine was administered subcutaneously once a week in inguinal region. The immunological responses and clinical responses were evaluated. Results Dendritic cell vaccination were well tolerated in all patients and there was no toxicity observed. Serum levels of IL-2, IL-12 and IFN-γincreased significantly after first vaccination and fourth vaccination. The positive rate of DTH test was 50% (5/10), and 2 fold increase of CD8+ IFN-γ+ cells were observed in 6 of 10 patients. Stable disease was observed in 11 of 23 patients, one patient had a complete metastasis regression, four patients had 50% regression of metastasis,four patients had a minor response, and disease progressed in three patients. Conclusion DC vaccines loaded with peptides MAGE-3、 Tyr、 MART-1 and GP-100 can elicit non-specific and specific immune responses, leading disease control. DC vaccine is considered one of safe and effective treatments for malignant melanoma.

Objective To study the imaging findings of pulmonary lymphangitic carcinomatosis (PLC) and discuss it′s clinical value. Methods The imaging materials of 40 cases with PLC which were proved by bronchoscopic or pleural or open-lung biopsy were retrospectively analyzed, and the clinical application of imaging diagnosis were investigated. Results The primary tumorous pathological types of PLC included:13 cases peripheral type carcinoma of lung,2 cases central type carcinoma of lung,11 cases mammary cancer,6 cases gastric carcinoma,4 cases pancreatic carcinoma,3 cases renal carcinoma,1 case colon carcinoma. The major imaging features of PLC were showed as pleural nodes, lobular core nodes, intralobular small reticular and nodular shadows, small beaded thickened interlobular septums, beaded thickened bronchovascular bundles, tumescent pulmonary hilar and/or mediastinal lymph nodes. Conclusion PLC possess relative imaging feature, particularly HRCT may accurately reflect pathological feature of PLC. Imaging diagnosis is a satisfactory method in diagnosing pulmonary lymphangial metastasis of malignant tumor.

Objective To explore the effect of temozolomide on apoptosis and molecular mechanism in small cell lung cancer (SCLC) cell H446. Methods The effect of temozolomide on the viability of H446 cell was measured by MTT assay.The effect of temozolomide on cell cycle was detected by flow cytometry.The activation of phosphatidyl inositol 3-kinase (PI3K)/AKT signaling pathway and expression level of downstream target genes (Cyclin B1), cell division cycle 2 (Cdc2), Bax, Bcl-2 and Survivin were detected by western blot.Results Temozolomide (50, 100, 200 μmol/L) could inhibit H446 cell viability, and the inhibitory rate was highest at 48 h.Moreover, temozolomide made H446 cell cycle arrested in G2 phase.Western blott showed the expression of PI3K, Cyclin B1, Cdc2, Bcl-2, Survivin and the phosphorylation of AKT were reduced, but the expression of Bax were increased by temozolomide.Conclusion Temozolomide could induce SCLC cell H446 apoptosis via blocking PI3K/AKT signal pathway.