Objective To investigate the chronic obstructive pulmonary disease with acute exacerbation(AE-COPD) of eonseiousneas. Methods For January 2004 to June 2008, AECOPD clinical data were reviewed retroepec-tively. Results 5 yeats treated 310 eases with AECOPD,impaired consciousness occurred in 16. 8% (52/310) : 29cases of pulmonary encephalopathy, hypotonic encephalopathy 12 cases ,5 cases of cerebral infarctinn,4 cases of drug-induced;clinical symptoms often show a variety,may be characteristic,but the cause of death by up to 55.6% of the total number of deaths(10/18). Conclusion AECOPD had high incidence of disturbance of eonseiousneas,and it isdiflleult to avoid completely;should pay attention to identify,first perform head CT or MR/examination to exclude or-ganic brain disease,according to arterial blood gas analysis,bloed electrolyte,to further determine the cause.

Objective To investigate pulmonary heart disease acute exacerbation of changes in the characteristics of thyroid function and significance. Methods Pulmonary heart disease with acute exacerbation of 200 cases as the observation group,in the same period 200 cases of healthyas control group, observation euthyroid sick syndrome (euthyroid sick syndrome, ESS) occurred, compared the observe and control groups, observer group in the survival group died with the group,ESS thyroid hormone treatment before and after the test results,ESS and death. Results Pulmonary heart disease with acute exacerbation of ESS incidence of 42. 5% (85/200) ;section observe the admission T3 ,FT3 lower than the control group;observer group in the survival group died and TSH group no significant difference,the group died T3 ,FT3 ,T4 ,FT4 were lower than the survival group( P＜0. 05 ) ;improvement in the treatment of primary disease, thyroid hormone, or return to near normal ; ESS mortality occurred in 30. 59% higher than a change of 13.04% mortality rate. Conclusion Serum thyroid hormone levels to reflect changes in the pulmonary heart disease in patients with acute exacerbation of the state of the body and severity of the dynamic serum levels of thyroid hormone can observe the development of pulmonary heart disease and prognosis.

Cyr61/CCN1 is a secreted extracellular matrix ( ECM) protein, which has been shown to regulate a multitude of cellular responses.Many researches indicate that Cyr61 plays important roles in oncogenesis and development of tumor and is considered to be a novel potential oncogene.This review would provide a comprehensive summary about the roles of Cyr61 in the diagnosis and treatment of tumor.

Individualized quality of life measurement intends to explore the individual perspectives and unique preference in health service. The individualized quality of life instruments have been widely used in other countries. However, little research has been done in China. The individualized quality of life measurement could provide unique evidence of how the target population feels and what they value individually, which help better understanding of their quality of life and health service provision.

Objective:To explore the role and mechanism of the B7-H1 expressed by auto-keratinocytes in the intermingled skin grafting model in vitro(MELC). Methods:The intermingled skin grafting model(MELC) was established in vitro. Flow cytometry was performed to detect the expressions of B7-H1 in keratinocytes. The expressions of PD-1 in lymphocytes were measured at the same time. The levels of IL-10,Foxp3 and GATA-3 mRNA in lymphocytes were detected by Real-time quantitative PCR. Results: Through flow eytometry,in the MELC with auto-keratinocytes,the expression of B7-H1 in auto-keratinocytes and the PD-1 in lymphocytes were rising trend and the rising rate was in time-dependent manners(P<0. 01). RT-PCR assay indicated that the relative levels of IL-10, Foxp3,GATA-3mRNA expression were significant raised and the rising rate was in time-dependent manners (P<0. 01). Conclusion:In the intermingled skin grafting model,the auto-keratinocytes could express B7-H1 to enhance the expression of PD-1 in T cells. When B7-H1 combined with PD-1,the Th2 cells and Foxp3+Tregs were induced and suppressed the immune response in the intermingled skin grafting model.

Objective:To investigate the effect of ossotide combined with antibiotics on efficacy and serum levels of tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ) and interleukin-1beta (IL-1β) in patients with brucellosis osteoarthritis.Methods:Using a prospective study, 66 patients with brucellosis osteoarthritis admitted to Jiangshan Beilin Hospital from May 2016 to May 2019 were selected as the study subjects, aged from 28 to 70 years old. The patients were randomly divided into the control group ( n = 33) and the observation group ( n = 33). The control group was treated with antibiotics alone, and the observation group was treated with ossotide injection on the basis of the treatment. Both groups were treated for 2 months. The clinical efficacy was compared between the two groups, the pain visual analogue scale (VAS) scores, the Barthel index of activities of daily living, and the Fugl-Meyer assessment (FMA) scores were compared between the two groups before treatment and 2 months after treatment. The higher the VAS score was, the more severe the pain was. The higher the Barthel index was, the stronger the activity of daily living was. The higher the FMA score was, the better the motor function was. At the same time, the serum levels of TNF-α, IFN-γ and IL-1β were compared between the two groups before treatment and 2 months after treatment. Results:The total effective rate of the observation group (96.97%, 32/33) was significantly higher than that of the control group (78.79%, 26/33), and the difference was statistically significant (χ 2 = 5.12, P < 0.05). After 2 months of treatment, the VAS score [(3.12 ± 0.85) points] of the observation group was significantly lower than that of the control group [(4.08 ± 0.97) points, P < 0.05], Barthel index [(64.72 ± 6.98) points] and FMA score [(58.70 ± 5.58) points] were significantly higher than those of the control group [(56.65 ± 6.72), (51.43 ± 5.33) points, P < 0.05]. After 2 months of treatment, serum levels of TNF-α [(12.30 ± 2.35) ng/L], IFN-γ [(10.87 ± 2.26) ng/L] and IL-1β [(324.28 ± 127.60) ng/L] of the observation group were significantly lower than those of the control group [(14.35 ± 3.13), (15.76 ± 3.21), (390.29 ± 131.37) ng/L, P < 0.05]. Conclusion:Ossotide combined with antibiotics can improve the therapeutic effect of brucellosis osteoarthritis and reduce the serum levels of TNF-α, IFN-γ, and IL-1β.

Objective To observe the nutritional biochemical indicators of paraquat poisoning patients, analyze and compare the nutritional status of patients and understand the changing trend of each indicator. Methods A total of 104 patients with acute paraquat poisoning who were admitted to the emergency department of the Second Hospital of Hebei Medical University from December 2015 to December 2017 were enrolled, and divided into the cure group (patients who survived >30 days) and the death group. Nutritional biochemical indicators including serum protein (ALB, PA, TP) and serum lipids (TCh, TG, LDL) were selected for dynamic observation. The observation time points were set as follows: immediate treatment of poisoned patients (day 1 on admission), on day 4, 7, 10, 13 and 16 after admission, and on day 30 after follow-up. The nutritional biochemical indicators of the two groups on day 1 and 4 were statistically analyzed and compared by t test. The nutritional status of the patients in the cure group was analyzed, and the Repeated Measures Anova was performed to understand the trend of each indicator over time. Results In the cure group, the TP level decreased from (73.34±5.75)g/L on day 1 to (51.95±6.05)g/L on day 4, t=20.34, P<0.01; and the TCh level decreased from (4.37±0.98) mmol/L on day 1 to (3.03±1.01)mmol/L on day 4, t=7.56, P<0.01. In the death group, the TP level decreased from (72.25±8.80)g/L on day 1 to (49.07±5.48)g/L on day 4, t=12.38, P<0.01, and the TCh level decreased from (4.38±0.88)mmol/L on day 1 to (2.51±1.07) mmol/L on day 4, t=7.94, P<0.01. Compared with the cure group, serum levels of ALB, TP and TCh in the death group decreased greater from day 1 to day 4 (all P<0.05). In addition, dynamic observation of the indicators in the cure group within 16 days after admission showed that, after treatment, the levels of ALB and TP recovered slowly and were still lower than normal . While the levels of PA and lipid rose rapidly after 10 days of admission. Conclusions Paraquat poisoning seriously affects the nutritional status of patients, and the serum protein levels decline significantly and can not be recovered easily. Therefore, sufficient attention should be paid to the treatment, and timely and appropriate nutritional support should be provided.

Objective To Pulse oximetry saturation has been wildly used clinically.It has been reported that pulse oximetry plethysmographic waveform (POP) reflected the peripheral tissue perfusion.In this study,we parameterized POP,observed the value of POP parameters in normal adults,and established the normal reference value range.Methods A multi-center prospective descriptive study.Total of 1 019 adult volunteers with normovolemia from 7 cities were enrolled in this study.Sex,age,height,weight and pulse oximetry data in awake and spontaneous breathing under in quiet conditions in the room temperature were collected.POP parameters and perfusion index were analyzed using MATLAB 2012a software.The normal reference value ranges of POP parameters,including the amplitude of POP (Amp) and the area under the curve of POP (AUC),were formulated.Results Statistical differences of POP parameters were detected between men and women in the normal adult.The 95％ confidence reference value of POP parameters in normal population was as follows:Amp (104.8-2298.7) PVA and AUC (3265.8-6028.5) PVPGin total,Amp (129.4-2433.6) PVA and AUC (3319.0-5862.2) PVPG in male;Amp (89.5-2138.2) PVA and AUC (3163.9-5929.9) PVPG in female.Conclusions POP,including the amplitude of POP (Amp) and the area under the curve of POP (AUC),had normal reference value ranges in normal adults.

OBJECTIVE: To compare the applicability of two risk assessment methods to assess the occupational health risk of key industries of dichloromethane in Shenzhen City. METHODS: The Singapore ministry of manpower risk(MOM) method and the comprehensive index method were used to evaluate the risk of 123 positions in 47 key industries of dichloromethane in Shenzhen City. Then the risk classification results of the two assessment methods were compared. RESULTS: The results of MOM method showed that the median and the 0 th to 100 th percentile [M(P_0-P_(100))] of risk of dichloromethane in electronics industry was 2(2-3), and the risk level was low to medium. The M(P_0-P_(100)) of risk of dichloromethane in printing industry was 2(2-4), and the risk level was low to high. The results of the comprehensive index method showed that the M(P_0-P_(100)) of risk of dichloromethane in electronics industry and printing industry were 3(3-4), and the risk level was medium to high. There was no significant difference in the assessment results of occupational health risk of dichloromethane between the electronic industry and the printing industry by MOM evaluation method(P>0.05). The occupational health risk assessment of dichloromethane in printing industry was higher than that in electronic industry by the comprehensive index method(P<0.01). Both evaluation methods were not consistent in the electronics industry and the printing industry(k values were-0.01 and 0.04, all P>0.05). After merging the evaluation results of the two industries, there was no consistency in the evaluation results of the two evaluation methods(k value=0.01, P>0.05). CONCLUSION: The risk level of dichloromethane in printing industry is higher than that in printing industry in Shenzhen City. The comprehensive index method may comprehensively and objectively assess the occupational health risk level of dichloromethane in key industries in Shenzhen City.

Objective:To investigate the role of chemokine receptor CX3CR1 in chronic skin inflammation and its regulatory mechanism.Methods:Wild type (WT) C57BL/6 mice and Cx3 cr1 GFP/GFP mice were induced by DNFB to establish acute and chronic allergic contact dermatitis (ACD) model. Ear inflammation and swelling were observed with hematoxylin-eosin (HE) staining. Flow cytometry (FCM) was used to detect the changes in classical Langerhans cell (LC) and monocyte-derived LC (Mo-LC), as well as the expression of major histocompatibility complex Ⅱ (MHCⅡ), inducible nitric oxide synthase (iNOS) and TNF-α. Changes in epidermal LC in UV irradiation-induced dermatitis models were also analyzed. In human chronic skin inflammation, CX3CL1 expression was detected using immunohistochemistry, RT-PCR and Western blot and CD1a, CD14 and CD207 expression was observed with immunofluorescence staining. Results:In the chronic ACD model, Cx3 cr1 GFP/GFP mice showed significantly alleviated ear inflammatory and swelling as compared with WT mice, but no significant difference was found in the acute ACD model. The percentages of Mo-LC were decreased in the chronic ACD model and after three weeks of UV irradiation. Moreover, MHCⅡ, TNF-α and iNOS expressed by Mo-LC were significantly upregulated as compared with those by classical LC. CX3CL1 expression was significantly upregulated and the numbers of CD14 + monocytes and CD1a + langerin - Mo-LC were dramatically increased in human chronic skin inflammation. Conclusions:CX3CR1 might maintain inflammatory response by regulating local remodeling of Mo-LC in chronic skin inflammation.