Objective To study the clinical features of invasive pulmonary aspergillosis (IPA) with chronic obstructive pulmonary diseases (COPD),so as to provide evidence for early diagnosis and treatment.Methods A retrospective analysis was made upon clinical data,diagnosis,treatment and prognosis of 53 patients with IPA and COPD admitted between January 2005 and February 2011 collected in a respiratory unit of the Second Xiangya Hospital Affiliated Central South University.Results There were 53 cases of diagnosed as IPA with COPD,with history of using broad-spectrum antibiotics.And there were 43 cases using steroids more than 2 weeks,51 with obvious breathlessness,and 20 with fever.Early stage didn't present characteristical changes on CT scan.However,after disease progression,32 cases had maculas shadows and nonspecific consolidations in bilateral lung,14 with solitary or multiple nodules,4 with solitary or multiple air crescent sign,and 2 with halo sign.Four patients of COPD with IPA underwent bronchoscopy examination.In fungi pathogeny,sputum positive rate and galactomannan positive rate were 56.6％ and 52.8％,respectively.A total of 53 cases received antifungal treatment.Among 37 cases which underwent mechanical ventilation,24 received noninvasive ventilation and 13 received invasive ventilation.There were 33 cases which were improved and cured,and 20 cases which had no relief after half-a-month treatment or withdrew treatment.Among them,13 cases died because of multiple-organ failure (5/15) or acute renal failure (8/15).Conclusions Early suspected diagnosis,timely examination in allusion to IPA,actively searching for etiological and imaging evidences,early established diagnosis and antifungal treatment would improve prognosis of patients with COPD combined IPA who have history of high doses of cortieosteroids,obvious breathlessness and non-response to antibiotics.

The key to performing spreading moxibustion on the Du meridian and the characteristics of its application are investigated. Summer is the time suitable for spreading moxibustion on Du meridian. The performance on Du meridian points has special requirements for every procedure: selecting moxibustion materials, spreading medication, igniting moxa and cleaning moxibustion sores. There are five large characteristics in the clinical application. The first is accumulating heat and focusing on warm-unblocking; the second is regulating both the whole body and local parts; the third is timing the treatment and making adaptations;the fourth is selecting high-quality materials and guarantee the performance;the fifth is focusing on health maintenance and strengthening nursing. Spreading moxibustion on the Du meridian has a wide area of performance, large moxa cones, a long time, sufficient fire power, strong warm-unblocking force, quick and convenient treatment and a remarkable effect. Mastering the key to the performance and the characteristics of the clinical application can further rich acupuncture and moxibustion treatments and give full play to the role of old and traditional moxibustion.

At present, the percutaneous transhepatic cholangiodrainage (PTCD) and the self-expandable metal stent implantation are commonly recognized as an effective treatment for inoperable malignant biliary obstruction, but the restenosis of biliary stent significantly affect the therapeutic result and prognosis.Percutaneous transhepatic intraductal radiofrequency ablation can be used together with biliary stent implantation, which can prolong the patency time of biliary stent and control the local tumor at the narrowed segment, thus, the therapeutic effect of malignant biliary obstruction can be reliably improved. As a kind of newly-developed therapy, its clinical safety is especially important. This paper aims to make a review about the safety of percutaneous transhepatic intraductal radiofrequency ablation combined with biliary stent implantation in treating malignant biliary obstruction.

Objective To monitor the changes of T lymphocyte subsets during chemotherapy in patients with non-small cell lung cancer(NSCLC).Furthermore,to analyze the relationship between chemotherapy curative effect and the T lymphocyte subsets.Methods 42 cases with NSCLC were selected as the subjects,and 28 people undergoing health examination were selected as control group.All NSCLC patients just received NSCLC standard chemotherapy,then respectively determined T lymphocyte subsets at pre-chemotherapy and after 2,4 courses of chemotherapy.Every two cycles of chemotherapy we would evaluate the effect of chemotherapy.Results Before chemotherapy,the patients′ CD+3(t=3.222,P<0.01),CD+4 (t=9.655,P<0.01),CD+4/CD+8 (t=10.657,P<0.01) and NK lymphocytes (t=5.310,P<0.01) were significantly decreased than those of the control group,and CD+8 lymphocytes (t=7.926,P<0.01) increased significantly.There were no significant differences in patients' gender,age,but Ⅰ-Ⅱ period patients′ CD+4(t=2.097,P<0.05),CD+4/CD+8(t=2.045,P<0.05) immune function were better than Ⅲ-Ⅳ period patients.In patients with adenocarcinoma,CD+8(t=2.015,P<0.05),CD+4/CD+8(t=2.315,P<0.05) immune function were better than squamous carcinoma.The patients received chemotherapy after 2,4 courses,the T lymphocyte subgroup was comprehensively improved (P<0.01).The curative effect of chemotherapy was positively correlated with T lymphocyte function,PR>SD>PD.Conclusion Chemotherapy can improve the NSCLC patients′ T lymphocyte subgroup,and improve the situation related to the curative effect of chemotherapy.

Objective To investigate the level of serum homocysteine(Hcy)in common chronic diseases(diabetes,hypertension, hyperlipidemia,coronary heart disease)and its clinical application value in the community elderly residents.Methods A retrospec-tive study was conducted on the common chronic disease of 1 605 patients who detected Hcy in our center from January 2015 to Oc-tober 2015.Another 117 healthy subjects served as normal control group.Hcy was detected by cyclic enzymatic method.Results The average level of Hcy in serum of patients with diabetes,hypertension,coronary heart disease and hyperlipidemia was higher than that in the health examination group,and the level of Hcy was positively correlated with age(P <0.05).Conclusion The high level of serum Hcy is an important risk factor in common chronic diseases in the community elderly residents,and it should strengthen the examination of Hcy and active intervention to slow down the development of the disease.

Objective To discuss the related factors of the malignant tumor complicated with venous throm-boembolism(VTE),which may provide the clinical evidence for prevention,diagnosis and treatment of this disease. Methods Retrospectively reviewed the clinical data of patients with malignant tumor who were diagnosed with VTE from June 2012 to June 2015 in our hospital.Results Among 74 cases with tumor merger VTE,female with thrombosis was higher than the male.67.57% of the tumor with VTE patients was 45 -80 years old.Lung cancer patient with VTE was the highest almost 36.49%.Patients with deep vein catheterization,a history of surgery or merging of hyper-tension were easy occurred VTE,those were 14 cases (18.92%),12 cases (16.22%)and 11 cases (14.86%) respectively.57 VTE patients underwent radiotherapy or chemotherapy treatment.The platelet count,D -dimer, fibrinogen and CRP were associated with thrombosis.Among 74 cases with VTE,67 cases (90.54%)accepted anticoagulation therapy.Conclusion Sex,tumor disease,chemotherapy or radiotherapy treatment,medical history and coagluative function index were associated with VTE.Early diagnosis and treatment is the key to reduce mortality and improve prognosis of malignant tumor with VTE.

Objective To explore ways for expanding the now-limited coagulation volume of percutaneous microwave coagulation therapy(PMCT) in liver in order to enhance the complete necrosis rate of large hepatic tumors with obviously fewer punctures. Methods Fresh pig livers in vitro and rabbit, pig livers in vivo with and without blood supply were coagulated using the self-designed HM-WIA microwave coagulator to make clear antenna length, microwave power, coagulation time and blood flow influence the microwave volume(MCV).Results The device enlarged the MCV by 3 times using single electrode with an antenna of 36 mm in length along with microwave power of 45-55 W and coagulation time of 15-19 min,the short axis of the coagulation area was 5.6 cm in vitro, 5.3 cm in vivo with no blood supply.The antenna 36 mm in length was proved the best in keeping the finest coagulation shape.The MCV was 2.8 times as large without blood supply as with it (P

0.05),but all statistically distinguishable from fresh allografts(P

Objective To study on the endoscopic, pathologic and immunohistochemical characteristics of gastric stromal tumor. Methods The gastric tumor samples were studied with light microscopy, and in those suspected of mesenchymal tumor the expression of CD11734, CD34 , vimentin, desmin, S-100 etc. were further determined with SP method. The clinical, pathological and endoscopic characteristics were reviewed. Results Twenty-eight cases of mesenchymal cell tumor were diagnosed as stromal tumor and enrolled in this study, with 9 benign, 11 borderline, and 8 malignant cases. Endoscopically, the gastric stromal tumors showed submucosal protuberant lesions, and were situated in fundus (15 cases), body (10 cases) and an-trum (3 cases). Deep concave ulcer presented on tumor surface in 10 patients. Histology revealed the typical stromal tumor features with cell in spindle and/or epithelia shape and arranged in fence-like or spiral forms. All cases were positive for CD117 CD34 , vimentin when assessed, but 28 cases were negative for desmin and 22 cases (18. 2% ) for S-100. Conclusion The gastric stromal tumors were the most common mesenchymal tumors. Microscopically, the tumors were composed of spindle or epithelioid cells. CD117 and CD34 can be used as immune markers to diagnose gastric stromal tumor.

Objective To use HSV 1 tk (herpes simplex virus type Ⅰthymidine kinase)/GCV (ganciclovir) in androgen independent prostate cancer cells(C4 2,PC3) in vitro in order to provide useful basis for clinical use. Methods HSV 1 tk gene was ligated to a pN 2A retroviral vector. Recombinant DNA molecules being introduced into a packaging cell line PA317,the high titer virus producer cells (VPC) were screened.The integration and expression of HSV 1 tk gene in VPC was observed by PCR and RT PCR. VPC was co cultured with these cancer cells in the light of 1∶1,1∶2,1∶4,1∶8.Cell viability (cytotoxicity) was assessed by SRB (sulforhodamine B protein dye binding)after the first day,the third day,the fifth and the seventh day. Results The highest titer VPC producing HSV 1 tk gene was isolated. Retrovirus mediated HSV 1 tk gene therapy was effective and active against such prostate cancer cells.The best one was co culture of VPC and cancer cells at 1∶1 and the fifth day followed by GCV. Compared with C4 2, PC3 decreased remarkably.The activation of apoptosis and other ways failed to be found. Conclusions Retrovirus mediated HSV 1 tk gene therapy in Vitro directly killed the tumor cells by cytolytic activity.