Objective To investigate the clinical curative effect of tiotropium bromide combined with azithro -mycin in the treatment of elderly patients with chronic obstructive pulmonary disease ( COPD) and its effect on lung function.Methods 100 senile COPD patients were randomly divided into the two groups ,50 cases in each group.The control group was given tiotropium therapy , while the observation group used tiotropium bromide combined with azithromycin.The clinical efficacy and pulmonary function indices were compared between the two groups .Results Borg score and 6min walking distance (6MWD) of the observation group after treatment were (2.31 ±0.17) points and (380.13 ±15.07)m,which were significantly better than (3.17 ±0.26)points,(270.41 ±13.03)m of before treatment and (2.84 ±0.25)points,(320.18 ±14.78)m of the control group (t=6.84,8.56,7.90,8.73,7.79, 8.21,all P<0.05);FVC,FEV1 and FEV1/FVC of the observation group after treatment were (2.54 ±0.44) L, (2.13 ±0.35)L and (72.38 ±5.61)%,which were significantly higher than (1.63 ±0.37)L,(1.24 ±0.24)L and (47.30 ±5.48)%before treatment and (2.18 ±0.39) L,(1.69 ±0.35) L and (61.66 ±5.32)% of the control group (t=6.35,7.76,7.02,8.04,7.14,7.95,6.91,7.41,7.60,all P<0.05).Conclusion Tiotropium bromide combined with azithromycin has significant curative effect in the treatment of senile COPD and can obviously improve the pulmonary function of patients ,which has good clinical application value .

Object This experiment was conducted to study the relationship between CFTR gene expression in the intestinal tissues and secretory diarrhea.Methods Twenty-four Kunming mice were selected, half male and half female, and were randomly divided into 3 groups ( n=8 in each group):control group with intraperitoneal injection of 0.2 mL nor-mal saline, and the experimental group of mice by intraperitoneal injection of lipopolysaccharide(LPS) (6 mg/kg· bw). The mental state and intestinal morphology of the mice at 1 h and 8 h after LPS injection were observed to assess whether the secretory diarrhea model was successfully established.The expression of CFTR gene segments of intestine tissue was de-tected by fluorescence quantitative PCR.Results LPS induced secretory diarrhea.CFTR gene was expressed in the mouse duodenum, jejunum, ileum and colon tissues with different expression abundance.It was highest in the colon, but the difference was not significant between intestinal segments.Compared with the control group, LPS up-regulated the tran-scription level of CFTR gene in the duodenum, jejunum and ileum, and down-regulated the transcription of CFTR gene in the colon.Conclusions The results of our study suggest that the changes of the transcriptional level of CFTR gene are closely related with the diarrhea induced by LPS and the effects in different intestinal segments on the diarrhea is different. The jejunum plays a crucial role and the colon plays a least role in the Cl-secretion.

Objective:To investigate the characteristics of neointimal hyperplasia (NIH) in patients with in-stent restenosis (ISR) over 5 years post-drug-eluting stent (DES) implantation based on optical coherence tomography (OCT).Methods:In this cross-sectional study, patients with DES-ISR who underwent OCT examination at PLA General Hospital between March 2010 and March 2022 were retrospectively included. All patients were divided into≤5 years DES-ISR group and>5 years DES-ISR group according to the time interval after DES implantation. Quantitative and qualitative analyses were conducted on OCT images to compare the clinical data and lesion characteristics of two patient groups. Furthermore, the independent clinical predictive factors of in-stent neoatherosclerosis (ISNA) were analyzed by multivariable logistic regression.Results:A total of 230 DES-ISR patients with 249 lesions were included, with an age of (63.1±10.4) years and 188 males (81.7%). The median interval after DES implantation was 6 (2, 9) years. There were 117 patients (122 ISR lesions) in the≤5 years DES-ISR group, and 113 patients (127 ISR lesions) in the>5 years DES-ISR group. Compared with≤5 years DES-ISR,>5 years DES-ISR showed more heterogeneous patterns (65.4% (83/127) vs. 48.4% (59/122), P=0.007), diffuse patterns (46.5% (59/127) vs. 31.2% (38/122), P=0.013), macrophage accumulations (44.1% (56/127) vs. 31.2% (38/122), P=0.035) in NIH and higher prevalence of ISNA (83.5% (106/127) vs. 72.1% (88/122), P=0.031). According to multivariable logistic regression, the independent predictive factor for ISNA was female ( OR=0.44, 95% CI 0.21-0.90, P=0.026). Female ( OR=0.48, 95% CI 0.23-0.99, P=0.046) and low-density lipoprotein cholesterol level ( OR=1.62, 95% CI 1.01-2.59, P=0.046) were independent predictive factors, respectively, for lipid ISNA. Calcified ISNA was independently associated with time interval of post-DES implantation ( OR=1.18, 95% CI 1.07-1.29, P=0.001). Conclusion:DES-ISR patients with a time interval of>5 years after stent implantation have a higher prevalence of ISNA and more complex lesions. Gender, the level of low-density lipoprotein cholesterol, and the time interval post-DES implantation are independently correlated with ISNA, lipid ISNA, and calcified ISNA.