Objective: To explore the effects of pulmonary rehabilitation on exercise tolerance ability. Methods:Fifteen (10 males,5 females)stable COPD patients, entered into 48 weeks of rehabilitation program. The lung function, 6 minutes walk distance(6MWD) were measured at pre, post and first post-maximal exercise training. Results: There was no significiant change in FEV1, FEV1/predict and FEV1/FVC at pre, post and first post-maximal exercise training in COPD patients. 6MWD significantly increased in COPD patients after 48 weeks exercise training program. There was no significant change in baseline and first post-maximal exercise training in COPD patients. Conclusion:There were no significant changes in parameters of lung function before and after training. The exercise tolerance in COPD patients was significantly improved by 48 weeks exercise training.

0.05).The blood gas analysis(BGA) and pulmonary function test(PFT) were performed in patients with stable COPD.The cognitive function was evaluated by ESD in both patients with stable COPD and healthy persons as control.The patients were divided into different groups by BGA and PFT(FEV1/Pred).Results:The total score of ESD and the subtest scores of ESD in leaning,memory,calculation,constructive function were obviously lower in the patient group than those in the control group(The mean difference of the total score was 16,with the two groups' total scores as 208.1?17.6/224.3?10.6,t=5.19,P

Objective To understand antimicrobial resistance and therapeutic efficacy of imipenem/cilastatin and meropenem for treatment of multidrug-resistant Pseudomonas aeruginosa (MDRPA)from patients with mechanical ventilation.Methods From January 2010 to December 2015,78 patients with mechanical ventilation and isolated MDRPA from sputum cultures were selected and divided into imipenem/cilastatin (n=44)and meropenem(n=34) treatment groups,basic condition,time of emergence of drug resistance,and therapeutic efficacy of antimicrobial agents between two groups were compared.Results The basic data of two groups were comparable,before treat-ment by imipenem/cilastatin and meropenem,resistance rates of Pseudomonas aeruginosa (P .aeruginosa )to quinolones,ceftazidime,piperacillin,and amikacin were not significantly different (all P >0.05).After patients received antimicrobial agents for 6 days,difference in antimicrobial resistance between imipenem /cilastatin and meropenem treatment groups were not significantly different (22.73% vs 8.82%,P >0.05).On the 8th,10th,and 12th day of treatment,resistance rates of imipenem treatment group were 40.91%,77.27%,and 97.73%, respectively,which were all higher than meropenem treatment group (17.65%,32.35%,44.12%,respectively,all P <0.05).After the treatment with different antimicrobial agents,the average time for the emergence of resistance in imipenem/cilastatin and meropenem treatment group were 9.0 days and 13.5 days respectively.Therapeutic efficacy between two groups was not significantly different (64.71% vs 74.19%,P =0.41).Conclusion Compared with meropenem,imipenem/cilastatin shows higher risk for the emergence of drug resistance during therapy of P . aeruginosa infection in patients with mechanical ventilation,there is no significant difference in therapeutic efficacy between two groups of patients after 7 days of treatment.

Objective To compare FEV1 with BODE in evaluating COPD.Methods Forty-one stable COPD patients,23 males and 18 females,with mean age of 58.8 years,were evaluated for FEV1 and BODE scores,the number and duration of acute exacerbations of COPD(AECOPD),number of admissions and duration of hospitalization caused by AECOPD,and sputum culture.All data were statistically analyzed with SPSS 11.0 for Windows.Results There was a remarkable difference in disease severity between the group with FEV1≥1 L and BODE score

Objective To explore expression of the minichromosome maintenance 2 (MCM2)protein and the mucin-like cell surface adhesion molecule CD24 in non-small cell lung cancer (NSCLC) and their relationship with its prognosis. Methods Seventy-three patients of NSCLC diagnosed for the first time and received surgical treatment in Xuanwu Hospital, Beijing were selected for the study. Expression of the MCM2 and CD24 in pathological specimens of the patients was measured by immunohistochemistry and their relationship with its prognosis was analyzed retrospectively. Results High-level expression of the MCM2 and CD24 was seen in 42 and 54 of 73 NSCLC patients, accounting for 57. 5 percent and 74. 0 percent,respectively. Risk of death for the patients with high-level expression of the MCM2 or the CD4 was significantly higher as compared to those with low-level expression ( P ＜ 0. 05 ). Risk of death for patients with both high-level expression of the MCM2 and CD24 was significantly higher than that in those with only high-level expression of the MCM2 or the CD24 (HR =2. 59, 95%CI 1.40 -4. 80, P=0. 002) and in those with both low-level expression of them ( HR = 15.32, 95 % CI = 2.07 - 113.41, P = 0. 008 ). But there was no significant difference in risk of death between patients with high-level expression of the MCM2 or CD24 and those with low-level expression of both of them ( HR = 5. 60, 95% CI 0. 79 - 44. 82, P = 0. 083 ), and cumulative survival rate of patients with both high-level expression of the MCM2 and CD24 was significantly lower than those with only high-level expression of the MCM2 or the CD24 ( P = 0. 001 ). Conclusions Both expression of the MCM2 and the CD24 are independent prognostic factors for NSCLC and combined detection of the two markers have higher prognostic value for it.

Objective The aim of this study is to evaluate clinical application of BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index in patients with chronic obstructive pulmonary disease (COPD). Methods Forty patients with stable COPD in Xuanwu Hospital of Beijing during September 2003 to December 2007, were recruited in the study, including 25 men and 15 women, aged 38 to 85 years (with a mean of 62 ± 13 years). BODE index was measured for each patient, one year and three years after recruitment, respectively. Severity of COPD, including number and duration of episodes, length of each hospital stay and times of hospitalization due to acute exacerbation of COPD (AECOPD), were recorded. All data were statistically analyzed with SPSS 13.0 software for windows. Results ①There was a remarkable difference in COPD severity between patients with BODE score equal to or greater than five and these with less than five (P <0.01 ). ①BODE score inversely correlated with forced expired volume at the first second ( FEV1 ) in COPD patients (P < 0.01 for those with BODE score equal to or greater than five and P <0.05 for these with BODE score less than five, respectively). ③BODE score positively correlated with number and duration of acute exacerbation, length of hospital stay and times of hospitalization due to AECOPD (P <0. 01 for those with BODE score equal to or greater than five and P < 0. 05 for those with BODE score less than five, respectively). For patients with COPD, their BODE score in the first year positively correlated with that in the third year ( r = 0.834, P < 0.01 ). Conclusions BODE index is a better indicator to evaluate their condition severity in patients with COPD.

Objective To study the relationship between oxidative stress and endothelial cell apoptosis in patients with obstructive sleep apnea-hypoventilation syndrome (OSAHS). Methods Sixth-seven patients definitely diagnosed by potysomnography (PSG) as OSAHS were divided into three groups according to their apnea-hypoventilation index (AHI), 14 in mild group (5 < AHI≤20), 21 in moderate group (20 < AHI≤40) and 32 in severe group (AHI 40). And, 18 healthy persons (AHI <5) were recruited as controls. Blood samples were obtained form all of them after PSG performance for measuring apoptotic endothelial cells (CD146AnnV+) and serum levels of superoxide dismutase (SOD) and malondialdehyde (MDA). Results Serum level of MDA and CD146AnnV+ in moderate and severe OSAHS group were significantly higher than those in control group (all P < 0.05). Serum level of SOD in moderate and severe OSAHS group was significantly lower than that in control group (P < 0.05). CD146AnnV+ correlated positively with AHI, the longest apnea time (LAT) and oxygen desaturation index (ODI) (r = 0.778, 0.609 and 0.689, respectively, all P < 0.05) and correlated reversely with saturation of arterial blood oxygen at night (SaO2min) (r =-0.635, P < 0.01). CD146AAnnV+ correlated positively with serum level of MDA (r = 0. 698, P < 0.01), and correlated reversely with serum level of SOD (r =-0.705, P < 0.01). Results of linear multivariate regression analysis showed that AHI, serum levels of SOD and MDA were independent risk factors for endothelial cells apoptosis in patients with OSAHS. Conclusions There existed oxidative stress due to intermittent hypoxia in patients with OSAHS, which could be one of the major causes in exacerbating endothelial damage.

Objective To investigate the changes in serum level of vascular endothelial growth factor (VEGF), nitric oxide (NO), erythropoietin (EPO) and plasma level of carbon monoxide (CO) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and their clinical significance. Methods Sixty-four patients diagnosed as OSAHS by polysomnography (PSG), were divided into two groups according to apnea-hypopnea index (AHI), 20 in mild group [5/h≤AHI≤20/h, with a mean of (12± 5)/hi and 44 in moderate-severe group[AHI > 20/h, with a mean of (63±23)/h]. Blood samples were obtained from all the patients after PSG for measurement of levels of serum VEGF, NO and EPO and plasma CO. Results Levels of serum VEGF [(101±91) ng/L], NO [(10.3±3.3) μmol/L]and plasma CO [(0.56±0. 35) mg/L]in moderate-severe OSAHS group were significantly higher than those in mild group (all P <0.05). There was no significantly difference in serum level of EPO between the two groups (P> 0.05). Levels of serum VEGF, NO and plasma CO in OSAHS patients positively correlated with AHI and percentage of time with percutaneous arterial blood oxygen saturation lower than 0. 9 (SLT90) of all sleep time (all P < 0. 05), but reversely correlated with the lowest arterial blood oxygen saturation (LSaO2) at night (P>0.05). No correlation between EPO and all the indicators was found (P>0.05). Multiple linear regression analysis showed that LSaO2 was an independent risk factor to affect levels of serum VEGF and plasma CO (R2=0.198, P=0.001, and R2=0.210, P=0.000, respectively) and SLT90 was an independent risk factor to affect serum level of NO (R2= 0. 148, P=0.004) in OSAHS patients. Conclusion Hypoxia at night is a main cause leading to increased level of serum VEGF, NO and plasma CO in OSAHS patients.

Objective To investigate the expression of MCM2 and its prognostic significance in non-small cell lung cancer (NSCLC). Methods The expression of MCM2 was measured by immunohistochemistry in 73 cases of NSCLC and 10 cases of normal lung tissue. The correlations between the expression of MCM2 and clinic-opathological parameters and prognosis were investigated. Results There was no MCM2 expression in normal lung tissue and positive rate of MCM2 expression was 87.7% in NSCLC. The difference between the two groups was significant (P<0.001). The expression of MCM2 in poorly differentiated NSCLC patients was significantly higher than that in moderately- and well-differentiated NSCLC patients (P=0.008). The expression of MCM2 in patients with squamous carcinoma was higher than that in patients with adenocarcinoma (P=0.005). The hazard ratio was significantly higher(RR=3.389, 95 % CI=1.803-7.146,P<0.001), and the accumulated survival rate was significantly lower (P=0.001) in NSCLC patients with higher MCM2 expression than that of lower expression. MCM2 was independent prognostic factor of NSCLC patients (P=0.041). Conclusion MCM2 could reflect the reproductive activity of NSCLC and has some clinical significance for assessing the development and prognosis of NSCLC. MCM2 was a potential target for future treatment.

Objective To study the relation between the levels of protein C(PC),protein S(PS),antithrombin Ⅲ(AT-Ⅲ)with cerebral infarction.Methods 126 patients with cerebral infarction were divided into the groups according to the age,onset time and infarction area and contemporaneous 30 individuals with healthy physical examination were selected as the control group.The levels of PC,PS and AT-Ⅲ were detected.The relation between the change of these indicator levels with the age,onset time and infarction area was analyzed Results The levels of AT-Ⅲ,PC and PS in the acute stage youth group were lower than those in the acute stage middle age and elderly group with statistical differences between them (P <0.05).The level of the AT-Ⅲ,PC and PS in the acute stage group were lower than those in the recovery stage group and the control group,difference had statistical significance(P <0.05).The levels of AT-Ⅲ and PS in the recovery stage group were lower than those in the control group with statistical difference (P <0.05),but the level of PC had no statistical difference between the recovery stage group and the control group.The further study found that the level of AT-Ⅲ,PC and PS in the small infarction group,middle infarction group and large infarction group showed the gradually decreasing trend,the differences had statistical significance (P <0.05).Conclusion The decrease of AT-Ⅲ, PC and PS levels is the importan factor of cerebral infarction occurrence and is closely correlated with cerebral infarction ocurrence especially in the patients less than 45 years old.Observing the change of PC,PS and AT-Ⅲ levels has the important significance for judging the cerebral infarction progression.