A 69-year-old man with fever,pulmonary nodules,joint pain and superficial lymphadenopathy was admitted to our hospital.The patient had a history of ten year hypertension.She smoked a pack of cigarettes daily for forty years and quitted for fifteen years.Family history of coronary heart disease,diabetes,cancer or other diseases was negative.Chest CT showed a nodule in the left lung lower lobe.Percutaneous lung biopsy revealed a large number of atypical B cell proliferation and infiltration which involved the vessel wall.The atypical B-cell phenotype and genotype was EBERs (+),CD20 (+),CD30 (+),CD15 (-).The patient was diagnosed as pulmonary lymphomatoid granulomatosis (LYG),an angiodestructive and angioinvasive lymphoproliferative disorder which is an Epstein-Barr virus associated B cell disorder with reactive T lymphocytes.The patient received six courses of chemotherapy.In this rare case,misdiagnosis of LYG often occurred due to the complex clinical presentation and non-specific imaging.Percutaneous or open lung biopsy is the main choice in the diagnosis of LYG.

Objective To report the use of self expanding metallic stents in treatment of benign tracheobronchial stenosis. Methods Nineteen patients with benign tracheobronchial stenosis were treated with implantation of self expanding stents (Ultraflex, Microvasive). Results Stents produced immediate improvement in clinical pulmonary sign and symptoms. Pulmonary function tests in 10 patients demonstrated a mean improvement in FEV1of 45%, FVC of 38%. Following up duration ranged from 10-18 months. Complications included recurrent pneumonia in 3 patients, airway obstruction due to granuloma formation in 2 patients, and stent migration in 1 patient. They were treated successfully with antibiotic therapy, laser therapy, and stent reimplantation, respectively. Conclusion Self expanding metallic stent implantation is a feasible and effective method of treating benign tracheobronchial stenosis.

On the basis of motor status of the frontalis musecle and the mouth corner 4 to 20 days after the onset, the degree and prognosis of facial paralysis of 218 cases were evaluated for 1～3 years. 44 cases belonged to neurapraxic type. In this type,visible motor recovery of frontalis and mouth corner was observed in 15 to 29 days after onset. Mild paralysis type (93 cases), in whom visible motor power of mouth corner appeared following the motor recovery of frontalis 14～20 days after onset, showed a total recovery in 24 to 40 days (84%). In moderate paralysis type, slight or absent visible motor recovery of frontalis was observed. Visible frontalis and mouth corner motor power appeared 20 days to 2 months after onset, with normal frontalis recovery in 42 cases.In 3 cases frontalis motor power recovered for 25% to 50%, and in 45 cases (67%) residual symptoms and complications were observed. Severe paralysis type consisted of 75% of patients, 36 patients, in whom the frontalis did not completely recover and 92% had residual symptoms and complications.Therefore, according to motor status of the frontalis and mouth corner, facial paralysis could be classified in predicting the prognosis.

ObjectiveIn our study, the electrical current intensities of 0.05ms square wavelenth in I/t curve were explored in diagnosing damage degree and predicting prognosis of facial paralysis.MethodsAccording to tested 0.05ms intensity values of fronto-occipital muscle and orbicular muscle of mouth in healthy side of 236 cases with facial paralysis and that values of 30 cases with completely-absent nerve, the standard of diagnosing slight, moderate and severe facial paralysis was made. A follow-up survey for the recovery of 198 cases evaluated by House-Brachmann facial nerve grading system was made for one to three years.ResultsIt is found that there were 113 slight cases and 89% of them recovered in 40 days, 112 cases reached to H-B Ⅰgrade; 82% of 49 moderate cases recovered in 4-5 months; 36 severe cases appeared visible mouth corner movement in 2-5 months after onset, and 92% of them had complications or sequelae.Conclusions Intensities of 0.05ms square wavelenth can help in diagnosing damage degree and predicting prognosis of facial paralysis.

Objective To evaluate the changes of left ventricular regional function in normal subjects with aging and the influencing factors by Doppler tissue imaging. Methods One hundred and twelve normal subjects were divided into four groups according to age: I group with age≤18 years old ; II group with 18 60 years old. Using a quantitative tissue velocity analysis system and tissue tracking, the peak velocities of different ventricular segments at systole, early and late diastole (Vs, Ve,Va) , the Ve/Va ratios were obtained and the effects of age, gender, heart rate and STd were analyzed. Results (1) Peak velocities of different segments of each wall were decreased one by one from mitral annulus, the basal, middle segment to the apical portion. (2) Peak velocities of different ventricular walls were significantly different, with the antero- and posterio-inter-ventricular septum being the lowest CVe (6. 89?2. 60) ,(7. 94?2. 64)cm/s]and with the latero-,posterio-,antero, and inferior walls of the left ventricle being higherCVe (9. 85?3. 02) , (9. 80?3. 09), (8. 86?3. 16), (8. 23?2. 48) cm/s] . (3) Peak velocities of different segments were associated with age, STd, BMI, heart rate and not associated with gender. (4) The Ve/Va ratios were increased one by one from mitral annulus, basal, middle segment to apical portion, and were significantly lower in III group and IV group than in I group and II group. Conclusions Peak velocities of different segments at different walls change regularly and age is the most important influencing factor to the diastolic velocities.

AIM: To investigate the effects of nitric oxide (NO) inhalation on nitric oxide synthase (NOS) and endothelin-1 (ET-l) of patients with hypoxic pulmonary hypertension. METHODS: Examined 13 pulmonic blood samples to determine the concentration of NOS in leukocyte and ET - 1 in plasma before NO inhalation, 30 minutes after inhalation, 2 and 12 hours after stopping of inhalation respectiviy. RESULTS: The values taken before inhalation was NOS (0.70 ? 0.21 )mol/min?mg-l, ET-1 (78.89 ? 46.59) Pmol/L; 30 minutes after inhalation (0.74?0.14)mol/min.mg-l, ET - 1 (88 .27 ? 45 .41 )pmol/L; 2 hours after stopping of inhalation NOS (0.64 ? 0.22)mol/min.mg-1, ET - 1 (80.76?42.66)pmol/L; and 12 hours after stopping of inhalation NOS (0. 63? 0. 17)mol/min.mg-1, ET-1(61.07?29.44)pmol/L. NO significant difference was found in the values of NOS and ET- 1 before and after inhalation, P＞ 0. 05. CONCLUSION: The effects of NO inhalation on NOS and ET-l in patients with hypoxic pulmonary hypertension are not significant according to the above investigation.

Objective To evaluate the prevalence of obstructive sleep apnea syndrome (OSAS) and its characteristics in elderly patients with cardiovascular diseases, and provide reference for the clinical decisions. Methods All patients who were hospitalized in department of cardiovascular medicine from January to June in 2007 were invited to participate in the current study. A total of 317 hospitalized elderly patients were recruited into this study. All participants were assessed by portable bedside nocturnal polysomnograph and Epworth sleepiness scale (ESS). Results Among 317 patients, 281 cases (88.6%) met the criterion of obstructive sleep apnea (OSA) [apnea and hypopnea index (AHI)≥5] and 47 cases (14.8%) met the criteria of obstructive sleep apnea syndrome (OSAS) (AHI≥5 and ESS≥9). When the severity of OSA (as indicated by AHI) was considered as a dependent variable, multiple regression analysis indicated that it was significantly associated with minimal SaO2 and the oxygen desaturation index, while age, habitual snoring, ESS, BMI, mean SaO2 and the duration of SaO2≤ 90% did not show significant effects on the severity of OSA. Conclusions High prevalence of obstructive sleep apnea syndrome (with daytime sleepiness) is found in elderly hospitalized patients and the rate of obstructive sleep apnea is much higher in patients without daytime sleepiness symptoms. Minimal SaO2 and the oxygen desaturation index are the important predicting factors for the severity of OSA, while age, BMI, habitual snoring, sleepiness are not correlated with the severity of OSA after adjusting minimal SaO2 and oxygen desaturation index.

Objective To increase the ultimate yield of periplocin in Periploca sepium adventitious root cultures by a two-stage culture based on nitrogen source.Methods Firstly,the effects of nitrogen source(NH<'+><,4>-NO<'-><,3>-)at different ratios and different total initial nitrogen amounts on the accumulation of biomass and secondary metabolites in adventitious root cultures of P sepium were investigated,and growth and production media for the two-stage culture based on the above results were established.Results The highest biomass and periplocin content were obtained in the culture medium of 15 mmol/L total nitrogen amount with NH<'+><,4>-NO<,3>(1:2)and 30 mmol/L total nitrogen amount with nitrate as the sole nitrogen source.By adopting a fed-batch cultivation strategy,the dry weight adventitious root,periplocin content and yield were increased by 136%,108%,and 389%,respectively when compared with those of the control,reaching up to 8.13 g/L,157.15 μg/g,and 1277.63 μg/L,respectively.Furthermore,it was found that in the process of two-stage culture,the adventitious roots grew thicker significantly after they were transferred into production medium directly.Conclusion The ultimate yield of periplocin in P.sepium adventitious root cultures could be significantly increased by a two-stage culture based on nitrogen source.

OBJECTIVE To investigate the pathogenic causes of lower respiratory tract infections(LRTIs) in the elderly in Guangzhou area.METHODS Pathogens obtained from 107 patients with LRTIs were performed by multiple diagnostic tools that including bacterial culture,PCR and specific immunological assays.RESULTS A bacterial cause was established in 42(68.5%) and an atypical pathogen cause in 25(31.6%) of the 107 patients.Mycoplasma pneumoniae and Haemophilus influenzae remained the most important pathogens for LRTIs.CONCLUSIONS In the prescription of antibiotics in the elderly with LRTIs,not only bacteria but also atypical pathogens should be taken into account.

Objective To investigate the activation of nuclear factor-B (NF-B)and hypoxia-inducible factor-1 (HIF-1)in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Subjects were classified into mild-to-moderate OSHAS group (n = 16), severe OSAHS group (n = 14) and the matched control group (n=30). Gene and protein expressions of NF-B and HIF-1 were measured by RT-PCR, Western blot in peripheral blood mononuclear cells (PBMC). Results NF-κB p65 mRNA and NF-κB p65 protein,HIF-1α mRNA and HIF-1α protein in PBMC were significantly higher in severe OSAHS group than those in mild–to-moderate group and control group (P<0.01). But there were no significant difference in NF-κB p65 mRNA and NF-κB p65 protein between mild-to-moderate group and control group (P=0.068, P=0.254 respectively). Only gene (P<0.05) not the protein (P=0.777) of HIF-1αwas higher in mild-to-moderate as compared with control group. Both NF-κB p65 mRNA and HIF-1αmRNA were positively correlated with AHI (r=0.493, P=0.006, r=0.508, P=0.004), while negatively correlated with nighttime lowest blood oxygen saturation (LSaO2)(r=-0.488, P=0.006, r=-0.46, P=0.011). There was a positive correlation between NF-κB p65 protein level and AHI (r=0.669, P<0.001). HIF-1αprotein level was positively correlated with AHI, ODI (r=0.628, P=0.001;r=0.480, P=0.018). There were positive correlations between NF-κBp65mRNA and HIF-1αmRNA (r=0.543, P=0.002), NF-κBp65 and HIF-1αprotein respectively (r=0.716, P<0.001). Conclusions As the gene and protein of NF-κB and HIF-1 were up-regulated in patients with OSAHS, and also positively correlated with the severity of sickness. We conclude that both NF-κB and HIF-1 were involed in the pathogenesis of OSAHS.