Objective To investigate the safety and efficacy of long-term low doses of Azithromycin combined with Budesonide/Fomoterol in the treatment of stable Ⅲ to Ⅳ COPD patients. Methods Collect the confirmed COPD patients of our hospital, they were randomly divided into two groups: the control group (160μg/ 4.5 μg, Bid), the joint group (160 μg/ 4.5 μg/ Bid + azithromycin 250 mg qd). Then Observe the PEF, FEV1, FEV1/FVC, mMRC, 6 MWT, AECOPD of the two groups after treatment for 3 months and 6 months. Results the index of PEF, FEV1, FEV1/FVC of joint group improved more significantly (P < 0.05) than control group after 6 months; the mMRC, 6 MWT, AECOPD, of the two groups improve the similar degree in terms of 3 months (P > 0.05), joint group improved more significantly than control group after 6 months (P < 0.05). Conclusion the therapy of Long-term low doses of azithromycin combined with Budesonide/Fomoterol can more significantly improve lung function index , as the treatment time extended , it can significantly improve clinical symptoms ,reduce the number of exacerbations than single inhaled Budesonide/Fomoterol .

Objective To study the prevalence of chronic kidney disease (CKD) among patients with bronchial asthma in Zhengzhou.Methods A total of 655 patients (older than 14years) were interviewed and received physical,uria and blood examination.Bronchial asthma and CKD were diagnosed according to related definition.Results The prevalence of albuminuria,hematuria,reduced eGFR and CKD was 9.41%,10.37%,3.03% and 17.38% respectively in the above special patients,which was higher than that of the general population.Women had higher prevalence of CKD than men (21.47% vs 13.99%,χ2=6.060,P=0.014).Prevalence of 1 to 5 stage of CKD was 8.61%,5.10%,3.03%,0.48% and 0.16% respectively.In the acute phase of asthma,prevalence of CKD (24.42%) was significantly higher than that in chronic duration and clinical remission period (χ2=12.445,P=0.002) and the same significant differences were found in albuminuria and reduced eGFR (χ2=19.619,P＜0.01 and χ2=9.305,P=0.010).Conclusion The bronchial asthma patients have higher incidence of renal damage and should be estimated,especially in the acute phase.

BACKGROUNDTo explore the perioperative changes of T subsets and NK cell and analyze the related factors in patients with lung cancer.

METHODSThe T subsets and NK cell from peripheral blood of 60 patients with lung cancer, 15 patients with lung benign tumor and 15 healthy people were detected by immunofluorescence. These indexes of the patients with lung cancer were detected also at postoperative 2nd, 7th, 14th and 28th days.

RESULTS1.There were significant differences in the indexes between the lung cancer group and the groups of lung benign tumor and normal people except for CD8+ (P < 0.05). 2.At postoperative 2nd day CD3+, CD4+, CD4+/CD8+ and NK cell of the patients with lung cancer were decreased and CD8+ was increased significantly than those before operation (P < 0.05). During postoperative 1 to 2 weeks, all indexes had recovered basically to the preoperative level. At postoperative 28th day, CD3+, CD4+ , CD4+/CD8+ and NK cell were increased and CD8+ was decreased than those before operation (P < 0.05). 3. There was significant difference in the indexes among preoperative stage IIIA, IIIB and IB, and between preoperative N2 diseases and N0 group (P < 0.05). There was significant difference between the groups of radical and palliative operation and the group of thoracic exploration at postoperative 28th day (P < 0.05). There was significant difference in T subsets between the groups of blood transfusion and non-transfusion at postoperative 14th day (P < 0.05).

CONCLUSIONSThe cellular immune function of the patients with lung cancer was lower than that of the patients with lung benign tumor and normal people. The perioperative immunity of patients with lung cancer decreases after operation and increases later. TNM stage and lymph node metastasis are relative to preoperative but not postoperative immunity. There is no significant correlation between cellular immune function and pathological type of the tumor. Radical and palliative operations can both significantly increase the patients' cellular immune function. Therefore the palliative operation is better than thoracic exploration. Blood transfusion can depress the immune function of the patients, so it is better to avoid perioperative blood transfusion.