Objective To explore the effect of chlamydia pneumoniae(CP)infection on T lymphocyte subsets in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 176 patients with acute exacerbations of COPD who were admitted to hospital from Jan.2001 to Jan.2005,and 46 healthy subjects were selected.Chlamydia pneumoniae-specific serum IgG,IgA,IgM antibodies were measured by microimmunofluorescence(MIF)test;the flow cytometer was used to analyze the frequency of CD+_3,CD+_4 and CD+_8 lymphocytes in patients with COPD and controls.Results The rate of acute chlamydia pneumoniae infection in COPD patients with acute exacerbations was 27.3% and that of chronic CP infection was 19.3%.They were all significantly higher than that in healthy subjects(P﹤0.01).The frequency of the CD+_3 and CD+_4 lymphocytes showed no difference in each group.The frequency of CD+_8 lymphocyte in COPD patients of chronic CP infection rose and the CD+_4/CD+_8 ratio was decreased in comparison with controls.On the other hand,the CD+_8 lymphocytes and the CD+_4/CD+_8 ratio showed no difference between chronic CP infection group,no CP infection group and controls.Conclusion The chlamydia pneumoniae infection is a rather frequent event in acute exacerbations of COPD,and it is an important reason to cause the disorder of cell-mediated immunity in COPD patients.The disorder of cell-mediated immunity may be involved in pathogenesis of COPD.

Objective To investigate the effect of propofol on LPS-induced TLR4 expression in rat alveolar type Ⅱ epithelial cells. Methods The primarily cultured alveolar type Ⅱ epithelial cells isolated from male rats were randomly assigned to one of 5 groups: group Ⅰ cells were incubated for 3 h without any additive (control) ; group Ⅱ cells were incubated with LPS 1 μg/ml for 3 h (LPS) ; group Ⅲ , Ⅳ , Ⅴ cells were incubated with LPS 1 μg/ml + propofol 25, 50 and 100 μmol/L respectively for 3 b (P1-3). TLR4 mRNA and TLR4 protein expression was detected by real time PCR and Western blot. TNF-α release amount was measured using ELISA. Results LPS significantly' increased TLR4 mRNA and protein expression in alveolar type Ⅱ epithelial cells as well as TNF-α release amount. Propefol at 50 and 100 μmol/L significantly inhibited LPS-imluced increase in TLR4 mRNA and protein expression and TNF-α release amount. Conclusion Propofol can dose-dependently inhibit LPS-induced inflammation in alveolar type Ⅱ epithelial ceils, through down-regnlation of TLR4 gene and protein expression.

Objective To investigate the accuracy of end-tidal carbon dioxide (PETCO2) in reflecting arterial carbon dioxide (PaCO2) during mechanical ventilation via laryngeal mask airway (LMA) in children. Methods Fifty-two ASA Ⅰ patients, aged 2-9 yr, weighing 10-30 kg, undergoing orthopaedic surgery under general anesthesia, were randomized into 2 groups (n = 26 each) : LMA group and endotracheal tube (ETT) group. After anesthesia was induced with fentanyl, propofol and succinycholine, LMA or ETT was inserted and the children were mechanically ventilated. After the hemodynamics was stable, arterial blood samples were obtained to detect PaCO2, and PETCO2 was recorded simultaneously. Results There was no significant difference in PaCO2 and PCT CO, between groups LMA and ETT ( P ＞ 0.05) . There was no significant difference between PaCO2 and PETCO2 in LMA group (P ＞ 0.05). Conclusion When mechanical ventilation is performed via LMA in children, PETCO2 can reliably reflect PaCO2 and guide the regulation of ventilatory parameters.

Liver Imaging Reporting and Data System was released online in 2011 by America College of Radiology (ACR) for standardizing the performance,interpretation and reporting of CT and MR imaging examinations of the liver in patients at risk for hepatocellular carcinoma.This article overviewed the profile of this system,its updated version and recent progress on its clinical application.

There are many practical problems to be solved in 7-year program teaching.The whole teaching thought should be widened further.With practical experiences of diagnostics teaching for 7-year program students for many years,we have summed up the results of 7-year program teaching reform.Appling to the holistic teaching mode reform of diagnostics of 7-year program,we have attained the first step achievements.

Objective To evaluate the clinical efficacy of primary intracoronary stenting in the infarct related artery in elderly patients after acute myocardial infarction(AMI). Methods Percutaneous transluminal coronary angioplasty(PTCA) plus primary coronary stenting was performed for 41 AMI patients(≥70 years) within 12 hours from the onset of chest pain. Infarct related arteries were left anterior descending artery in 21 patients(51 2%), left circumflex in 7(17 1%), right coronary artery in 13(31 7%). Thrombolysis in myocardial infarction (TIMI) showed that blood flow was grade 0 in 29 patients, grade 1 in 7, grade 2 in 5. Results Forty eight stents were implanted in the infarct related artery for 41 patients. One patient died of cardiac shock during the procedure, and the success rate was 97 6%(40/41). Grade 3 of blood flow after TIMI was gained in 37 patients(90 2%). One patient died of renal failure while hospitalizing. The clinical successful rate was 95 1%(39/41). Thirty six patients were followed up, 1 patient with restenosis of infarct related artery was performed cutting balloon angioplasty, and 1 patient with congestive heart failure was rehospitalized. Other 34 patients did not manifested angina pectoris. Conclusions Primary coronary stenting for the infarct related artery in elderly patients after AMI is safe and effective with a high successful rate and less complications.

Objective To investigate the clinical significance of quantitation of TGF-?1 mRNA of peripheral blood mononuclear cell (PBMC) in type 2 diabetic patients at different stages of nephropathy (DN). Methods TGF-?1 mRNA transcription in PBMC was analyzed quantitatively by RT-PCR and dot blot in 93 cases of type 2 diabetic patients and 35 normal controls. Correlation of TGF-?1 mRNA in PBMC with 24 hours urinary albumin excretion rate (UAER) was also analysed. Results TGF-?1 mRNA level of PBMC in type 2 diabetic patients was significantly higher than that in normal controls (1.56?1.00 vs 1.03?0.25, P

0 05) One patient of group A had in stent thrombosis after procedure Fifty one patients of group A and 41 of group B were followed up (from 1 to 39 months) after procedure, and 48 of group A and 37 of group B without cardiac events, such as death, AMI 3 patients of group A and 4 of group B were repeated coronary angiography because of chest pain There were 1 patient with restenosis and 2 with severe stenosis in non infarct related artery in group A, and 1 with restenosis and 3 with severe stenosis in non infarcted related artery in group B Conclusion Compared with short stenting in short lesions, long coronary stenting in long or diffuse infarct related artery disease after AMI is the same as a high procedure success rate, low complication and good clinical outcomes

Objective The purpose of this study was to determine the feasibility and efficiency of direct stent implantation with intravascular ultrasound (IVUS) guidance Methods 12 native vessel target lesions in 12 patients were studied by coronary angiography and direct stent implantation Ultrasound imagines obtained at the treatment site before and after stenting were analyzed quantitatively for in lesion vessel wall diameter, in lesion minimal lumen diameter and in lesion vessel length Direct stent deployment was performed with IVUS guidance The ends of follow up were acute or subacute thrombosis and major cardiac events (MCE: cardiogenic death, angina pectoris, myocardial infarction and revascularization correspondence with target vessel) Results Direct stenting was successfully performed in 12 patients with IVUS guidance Coronary angiography showed that there was no residual stenosis and TIMI 3 flow was obtained in all patients Further balloon dilation of the stent was performed by observation of the IVUS imagines in two patients The final IVUS imagines showed that ratio of minimal lumen diameter/maximum lumen diameter ≥0 7 and in lesion minimal lumen diameter increased from 1 2?0 87 mm to 3 4?2 8 mm No thrombosis and MCE were found in all patients in 1 4 months follow up Conclusion Direct stenting with IVUS guidance in selected patients had higher success rates, less complications and better clinical results

Objectives To investigate the etiological factors,clinical features and treatment of pediatric primary spontaneous pneumothorax (PSP). Methods The clinical data of 84 PSP patients under the age of 18 from Departments of Emergency,Respiratory Diseases and Thoracic Surgery of our hospital from June 1999 to June 2009 were collected. There were 72 males (85.7%) and 12 females (15.3%) with a ratio of 6 to 1. Their age ranged from 14 to 18 (mean 17.06). Patients with pneumothorax following trauma,pneumonia,iatrogenic and other underlying causes were excluded. Therapeutic methods included oxygen therapy for 4.8% patients,closed drainage of pleural cavity for 57.1% patients,and surgery for 38.1% patients,But there were 31 patients receiving surgical treatment after closed drainage was failed. The period of follow-up ranged from 1 to 123 months (mean 25.73 months) through telephone or outpatient. Results Eighty-four patients were included,of whom 96.4% had chest pain,7.1% had chest tightness,66.7% had dyspnea,8.3% had shortness of breath and 14.3% had cough. There were 96.4% patients having decreased breathing sound and 3.6% having absent breathing sound. Bullae or blebs occurred mostly in apex and upper lobe. Twenty-one patients suffered from recurrent pneumothorax. Smokers (66.7%,n=9) had higher recurrent rate than non-smokers (22.0%,n=75). Conclusion PSP should be considered when symptoms such as chest pain and dyspnea appear in teenagers. Closed drainage of pleural cavity combined with surgical procedure is recommended for treatment. PSP patient with a history of smoking has higher recurrent rate of PSP.