Objective To observe and compare the clinical effect of aerosol inhaled and systemic glucocorticoid treatment and its influence on the expression of procalcitonin ( PCT) and hyper-sensitive C reactive protein ( hs-CRP) in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods 146 elderly patients with AECOPD were enrolled prospectively.The patients were divided in three groups randomly, including inhalation group (48 cases referred as 2 mg of budesonide nebulization every 8 hours with therapeutic course of 5 days), intravenous group (50 cases referred as 40 mg methylprednisolone intravenous injection once daily with therapeutic course of 5 days), and control group (48 cases with no glucocorticoid ) .All the patients were treated with routine oxygen therapy, anti-inflammation, bronchodilators (β2 receptor agonist and doxofylline) and mucolytics, and so on.The levels of serum PCT and hs-CRP were detected before and after five days treatment, and also the clinical parameters such as symptoms, blood gas analysis, lung function, hospital days, fasting blood glucose and adverse reaction were simultaneously recorded. Results The general clinical data demonstrated no significant difference among the groups.Compared with the control group, the total effective rate, improvement rate of lung function (FEV1%pred and FEV1/FVC) and of blood gas parameters (pH value, PaO2 and PaCO2) in the inhalation group and intravenous group were higher, with shorter hospital days(P<0.05), while with no obvious difference between the two group.The levels of the serum PCT and hs-CRP were decreased in the patients enrolled after treatment, compared with the prior treatment (P<0.05).Compared with the control group, the levels of serum PCT and hs-CRP in the inhalation group and intravenous group decreased significantly, while with no obvious difference between the two groups.The levels of fasting blood glucose in the intravenous group were the highest;compared with the control group, the adverse effect incidence of the inhalation and intravenous groups were higher obviously, with the most obvious in the intravenous group ( P<0.05 ). Conclusion Application of glucocorticoid is benefit to improving the clinical symptom and lung function, and to rectifying hypoxemia and to shortening hospital days.The aerosol inhaled and systemic glucocorticoid application shows equivalent clinical efficiency on anti-airway inflammation.The glucocorticoid inhalation has fewer adverse effects and is recommended to treat the elderly patients with AECOPD .

Objective To study the method and diagnostic value of curved planar reformation(CPR)of body canals with multislice spiral CT.Methods 50 patients with various disease of chest and abdomen scanned by multislice spiral CT.CPR of canals of chest and abdomen were performed.Results The images of CPR were acquired satisfactory in all cases.3 cases were normal.There were vascular diseases of chest in 6 cases,lung cancer in 9 cases,disease of abdominal vessels in 10 cases,disease of biliary tract in 10 cases.Carcinoma of the head of pancrease in 4 cases,ureter cancer in 4 cases,ureter stone in 2 cases,tuberculosis of ureter in 1 case,malformation of ureter in 1 case.Conclusion CPR of body canal with multislice spiral CT is an effective method in the diagnosis of various diseases of chest and abdomen.It is an useful supplement of routine CT scan.

2 cm, 8 were operated and 2 were untreated. All the lesions were located outside the rectum. There were 3 cases of death and 5 cases of distant or lymph node metastasis. Out of the 44 cases, distant or lymph node metastasis occurred in 6 cases, the metastasis rate being 13.6%. Conclusions[WTBZ] Endoscopy is the first choice to diagnose digestive tract carcinoids, which, if ≤ 1 cm in diameter, can be treated with EMR.

Objective:To study the correlation of leucocyte level of peripheral blood with degree of pyretic pulmonary syndrome in different bacterial pneumonia patients and to provide evidence in clinical practice.Methods:To observe pneumonia patients that had been healed in our respiration department of The Jiangxi Province Chinese Medicine Hospital from January,2006 to December,2007 years,incorporating the non-foundation disease or the chronic obstuctive pulmonary disease or chronic cor corpulmonale,We were to summarize relation degree of pyretic pulnonary syndrome to the white blood cell countingthe neutral granular cell percentage relevance.Results:From the non-foundation disease's pneumonia patients group,degree of pyretic pulnonary syndrome and the peripheral blood white blood cell counting and the neutral granular cell level had obvious relevance(P

Objective To analyze the differences of morphological and microvascular characteristics between hyperplastic polyps and colorectal adenoma (CA) under narrow band imaging (NBI) without magnification endoscopy,and to evaluate the value of NBI in differential diagnosis.Methods Patients with rectal polyps diagnosed by common endoscopy and pathologically confirmed CA and hyperplastic polyps were recruited in this study and under NBI examination.The pit pattern was divided into type A and B according to modified Kudo pit pattern classification.And the vascular pattern was classified into three types,type Ⅰ with invisible microvascular,type Ⅱ with even microvascular arranged along pit and type Ⅲ with uneven microvascular and irregular arranged.The differences of morphological and microvascular characteristics between hyperplastic polyps and CA were compared and the inter-observer consistency of NBI without magnification endoscopy was evaluated.Results Overall,87 patients with 107 polyps (73 CAs,34 hyperplastic polyps) underwent NBI without magnification endoscopy examination.The maximum diameter and the proportion of polyps with sublobe was higher in CA group than that of hyperplastic polyps group (P =0.0023 and 0.0047).In CA group,most pit shapes were type B (86.3％,63/73),and most vascular pattern types were Ⅱ/Ⅲ (82.2％,60/73).The sensitivity,specificity and accuracy of CA diagnosed with features of type B pit shape or Ⅱ/Ⅲ vascular pattern type was 97.3％,82.4％ and 92.5％.The sensitivity,specificity and accuracy of CA diagnosed with combined features of type B pit shape and Ⅱ/Ⅲ vascular pattern type was 71.2％,91.2％ and 77.6％.The mean kappa value of inter-observer consistency was 0.761.Conclusions There are differences in pit shapes and vascular pattern characteristics between CA and hyperplastic polyps.According to these two facts,CA and hyperplastic polyps can be initially differential diagnosed by NBI without magnification endoscopy.

ObjectiveTo determine the features of antrum gastritis by magnified narrow band imaging (M-NBI) and to evaluate the feasibility of target biopsy with M-NBI.MethodsA total of 69 consecutive patients who underwent M-NBI were recruited in the study.The gastric mucosa of antrum was observed under M-NBI and the gastric microstructure patterns were classified into 5 type.M-NBI findings were compared with the conventional histological findings.In addition,the interobserver agreement was assessed.ResultsA total of 173 gastric antral sites from 69 patients were examined by M-NBI.Type A was mainly normal sites (89.8％,44/49),while type B and C were chronic inflammation (53.3％,24/45 )and active inflammation (74.3％,26/35).Compared with the type A group,the inflammatory degree in type B (P＜0.001 ) group and type C group (P＜0.001) was significantly higher.The sensitivity,specificity,accuracy of the type B and type C pattern for predicting antrum gastritis were 87.5％,78.0％ and 81.5％.The sensitivity,specificity,accuracy of the type D and type E pattern for predicting intestinal metaplasia of antrum were 83.8％,90.4％ and 77.5％,respectively.The kappa value for the interobserver agreement was 0.734 [ 95％ CI(0.591-0.977 ) ].ConclusionMicrostructure features of antrum gastritis determined by M-NBI are highly correlated with histopathology,and can evidently help diagnosis.

Objective To investigate the value of colonoscopy with narrow band imaging (NBI) in predicting the histology of colorectal polypoid lesions. Methods A total of 173 colorectal polypoid lesions from 125 patients were included in the study. The lesions were diagnosed as neoplastic (adenoma or cancer)or non-neoplastic based on pit patterns and/or capillary patterns (CP), which was compared with the results of pathology, and the sensitivity, specificity and accuracy of each method were evaluated. Results In differentiation between neoplastic and non-neoplastic lesions, the sensitivity, specificity and accuracy of CP (94. 83% , 91. 23% and 93.64% , respectively), and those of CP combined with pit patterns (95. 69% ,96.49% and 95. 59% , respectively) were significantly higher than those of conventional colonoscopy (80. 17% , 84.21% and 81.50% , respectively, P<0.05). In differentiation between adenoma and cancer,the sensitivity, specificity and accuracy of CP were 86.90% , 100.00% and 87.93% , respectively.Conclusion NBI is superior to conventional colonoscopy in differentiation between neoplastic and non-neoplastic lesions, as well as in differentiation between adenoma and carcinoma.

Objective: To observe the effects of Small Qinglong Decoction medicine-containing serum on ASMC proliferation action induced by ET-1.Methods: There were six groups in the experiment: normal group(10% normal control serum),model group(ET-1 added 10% normal control serum),Small Qinglong Decoction high dose group(ET-1 added 10% Small Qinglong Decoction high dose serum),Small Qinglong Decoction middle dose group(ET-1 added 10% Small Qinglong Decoction middle dose serum),Small Qinglong Decoction low dose group(ET-1 added 10% Small Qinglong Decoction low dose serum) and Dexamethasone group(ET-1 added 10% Dexamethasone serum),eight slots every group.ASMC proliferation status of 24h,48h and 72h were detected with MTT chromometry.Results: Compared with model group,ASMC proliferation in Small Qinglong Decoction low dose group medicine-containing serum each stage and middle dose group24h and 72h all had significant difference(P

BACKGROUND:To overcome the disadvantages of traditional mechanical analysis of specimens, and establish the finite element model of realistic foot, are the important basements for the finite element mechanical analysis on foot.
OBJECTIVE:To establish three-dimensional finite element model of foot and lay the foundation for the finite element analysis of normal foot and foot injury.
METHODS:A healthy female volunteer was involved in this study and was detected with spiral CT scanning on the feet. The resulting image was used to reconstruct the three-dimensional model by using Mimics software. Then entity model was generated in Geomagic software. Final y three-dimensional finite element model was established based on the digital main structure in Ansys. RESULTS AND CONCLUSION:The established finite element digital model of human foot included al bone, cartilage and ligament, skin and soft tissue. The three-dimensional finite element model of human foot was established based on CT data and using Mimics, Geomagic, Ansys softwares. The established model had similar size and shape with skeletal mode, and can rotate freely in any angle for a variety of measurement, the foot bones can be arbitrarily split or merge, which is suitable for biomechanical analysis.

Objective:To investigate the correlation between the expression of angiogenic factors (MVD, IGF-1, and STAT3) in colorectal carcinoma and adenoma and the microvascular characteristics under narrow band imaging (NBI), in order to evaluate the fea-sibility of NBI in real-time observation of angiogenesis. Methods:Patients with pathologically confirmed colorectal polyps were re-cruited and examined by NBI. Vascular patterns were classified into typeⅠ(invisible or faintly visible), typeⅡ(clearly visible and regularly arranged in a round, oval honeycomb-like pattern), and typeⅢ(clearly visible and irregularly arranged in terms of size and caliber or irregularly winded). Immunohistochemical staining was performed to determine the expression of CD34, IGF-1, and STAT3. Histological results were compared with the vascular patterns under NBI. Results:The NBI endoscopy results of 64 sites (15 adenocar-cinomas, 29 adenomas, and 20 normal tissues) from 58 patients were introduced and examined in this study. Adenomas ranked the first (82.1%, 23/28) among the vascular patternⅡcases, whereas early adenocarcinomas dominated the vascular patternⅢcases (66.7%, 10/15). The expression levels of MVD-CD34 and IGF-1 in normal mucosa, adenomas, and adenocarcinomas were significantly differ-ent (P<0.0001 and P=0.0062, respectively). All the expression levels of MVD-CD34, IGF-1, and STAT3 in sites displaying vascular pat-ternsⅠ,Ⅱ, andⅢwere significantly different (P<0.0001, P=0.0010, and P=0.0055, respectively). Spearman correlation coefficients between the NBI vascular patterns and the MVD-CD34, IGF-1, and STAT3 expression levels were 0.67, 0.41, and 0.40, respectively. Conclusion:Vascular pattern analysis through an NBI system can be a promising tool to evaluate angiogenesis of colorectal lesions in real-time endoscopic observation.