ObjectiveTo study the changes and clinical significance of vascular endothelial growth factor (VEGF) in sputum of patients with pulmonary arterial hypertension associated with chronic obstructive pulmonary disease (COPD).MethodsThe sputum VEGF levels of 52 cases with pulmonary arterial hypertension associated with COPD during stable period (group A),60 cases with COPD during stable period (group B) and 50 normal persons (group C) were detected by enzyme linked immunosorbent assay (ELISA)method.The pulmonary function,arterial blood gas analysis and pulmonary artery systolic pressure (PASP)were detected.ResultsThe sputum VEGF levels of group A,B and C were (4.30±0.93),(2.64±0.57)and ( 1.48±0.32 ) μ g/L respectively,which had significant difference ( F =31.612,P ＜ 0.01 ).The percentage of forced expiratory volume in the first second (FEV1) in predicted value (FEV1％) of group A,B and C were (48.68±10.53 )％,(67.56±14.61 )％,( 101.60±21.97 )％ respectively,which had significant difference (F =28.983,P ＜ 0.01 ),as well as PASP had [ (55.02±11.90),(23.50±5.08 ),(16.16±3.49) mm Hg (1 mm Hg =0.133 kPa),F=34.887,P＜ 0.01 ].The arterial partial pressure of oxygen (PaO2) and carbon dioxide(PaCO2) of three groups had no significant difference (F=2.159,3.167,P ＞ 0.05).The sputum VEGF level had significantly negative correlation with FEV1％ (r =-0.562,P ＜ 0.05),and positive correlation with PASP(r =0.783,P＜0.05),while had no correlation with PaO2,PaCO2(r =-0.318,0.275,P＞0.05).ConclusionsThe sputum VEGF level of patients with pulmonary arterial hypertension associated with COPD expresses high level,which has significant correlation with pulmonary function and PASP.Therefore,VEGF plays an important role in the pathogenesis of pulmonary arterial hypertension associated with COPD.

Objective To explore the effect of exposure of the recurrent laryngcal nerve(RLN) in prevention of RLN injury during thyorid surgery.Methods The clinical data of 810 cases of thyroid operation in which the RLN was exposed in 252 cases(group A) and was unexposed in 558 cases(group B) were analyzed.Results Although the extent of thyroid resection was greater in group A than in group B,the rate of RLN injury in group A(1.19 %) was significantly lower than that of group B(3.05 %,P

Objective To analyze the treatment effect of deep venous thrombosis (DVT) in acute pulmonary thromboembolism (PTE) with thrombolytic and anticoagulant therapy. Methods Post hoc analysis of data from a prospective multicenter randomized control thrombolytic and anticoagulant trial of 516 patients with acute symptomatic PTE from June 2002 to December 2004. Thrombolytic therapy was performed in patients with massive and sub-massive PTE and anticoagulant therapy was given in patients with non-massive PTE. A total of 362 patients that accepted compression uhrasonography (CUS) before and 14 days after treatment constituted this study. Results The ratio of detected DVT by CUS 14 days after treatment was reduction than that before treatment ( x2 = 22. 667, P < 0. 001 ), but 11.6% patients had new or recurrent DVT. The rates of recanalization in thrombolysis group and anticoagulant group were 56. 5% and 47. 8% respectively (x2 = 1. 435 ,P =0. 231 ). The results after three months follow up showed not recovery in 30. 4% DVT patients and new or recurrent DVT in 10. 4% patients. Conclusions The normalization rate of DVT is low during 14 days treatment, and recurrence rate is high. Thrombolysis has no better rate of recanalization than anticoagulant. The prognosis of DVT hasn't improved significantly during short term treatment.

Objective To observe the changes in fibrinolytic factors in rats with pulmonary thromboembolism (PTE) after recombinant prourokinase ( rPro-UK) treatment and its significance .Methods PTE was induced in male Sprague-Dawley (SD) rats by injecting heated 125iodine-labeled fibrinogen(Fib) autologous thromboemboli into external jugular veins.Twenty-eight rats were randomly assigned into following groups (7 rats each):①healthy control group;②PTE 5 d group,the rats in which were sacrificed at 5 d after the PTE model was made; ③ PTE3d receiving rPro-UK thrombolytic treament groups including multibolus treatment sub group ( rPro-UK was given in 1 mg/kg on the post-PTE third day followed by 2 consecutive days of a lower dose 0.25 mg/kg and rats were sacrificed 2 h after the last injection at the same time as PTE5d group) and single bolus treatment sub group ( rPro-UK was given in 1 mg/kg on the post-PTE third day followed by 2 consecutive days of 0.5 ml saline and rats were sacrificad at the same time as the former group ).The rats were quickly sacrificad at the fixed time through carotid bleeding and plasma samples were reserved for analysis of uroki -nase-type plasminogen activator (u-PA), urokinase-type plasminogen activator receptor (u-PAR), fibrinogen (Fib) andα2-antiplasmin (α2-AP) .Results ①Plasma concentrations of u-PA and u-PAR were increased were significantly in rPro-UK multibolus treatment sub group than in PTE 5 d group(Pu-PA <0.05,Pu-PAR <0.01)and rPro-UK single bolus treatment sub group(Pu-PA <0.01,Pu-PAR <0.05),correlated with the thrombolysis rate in rPro-UK multibolus treatment sub group (ru-PA =0.766,P<0.05;ru-PAR=0.785,P<0.05).② No difference of plasma Fib and α2-AP was seen between Pro-UK treatment groups and PTE 5 d group(P >0.05).Conclusion ① Plasma levels of endogenous u-PA and u-PAR are increased at different time points after PTE and are further enhanced after Pro-UK treatment, which promotes endogenous fibrinolysis and thrombus lysis .This is probably related to increased synthesis and secretion of endothelial cells which may be a key thrombolytic mechanism of Pro-UK.②Absence of systemic activation of the fibrinolytic system in Pro-UK multibo-lus treatment sub group means that the regimen is feasible and Pro-UK is fibrin specific .

Objective To discuss possible mechanism of chronic obstructive pulmonary disease(COPD)coagulation and fibrinolysis dysfunction.Methods Totally 47 healthy controls(Group A)and 38 cases of AECOPD(Group B)were chosen respectively.The plasma levels of vWF,Factor Ⅹ,TF,TFPI,TM,PC,tPA,PAI-1 and D-dimer were measured by ELISA method,and the blood AT-Ⅲ activity was measured by chromogenic assay.The cases of Group B were measured for RBC,WBC,PLT,PH,PaO2,PaCO2,HCO-3,PT,APTT,FBG,and so on.Results The plasma levels of vWF,TF,Factor Ⅹ,t-PA and D-dimer in Group B were significantly higher than those in Group A while TM and PC were significantly lower in Group B(P

AIM:To investigate the therapeutical effect of Geranium sibirium extract on the patients with low rectal carcinoma,reserving anus reducing complication and increasing survival rate. METHODS:The treatments included extrasomatic radiotherapy near to tumor,intracavity and extracavity microwave diathermy as well as oral administration of Geranium sibirium extract.All the 30 patients were treated. RESULTS:The four-year follow -up showed that except 4 cases had local recurrence and 5 cases had distant metastasis,four-year survival rate and tumor -free survival rate were 86.7%(26/30) and 83%(25/30),respectively. CONCLUSION:With general treatment and low dose radiotherapy ,the therapeutics of reserving anus in low rectal carcinoma may increase survival quality ,reduce complication and recurrence rate.

Objective To investigate the differences in clinical symptoms and risk factors between non-elderly and elderly patients with acute pulmonary thromboembolism(PTE).Methods Totally141 patients with acute PTE and 100 sex and age-matched healthy controls were enrolled in the study.The final diagnosis was confirmed by CT pulmonary angiography (CTPA) and/or pulmonary angiography and/or pulmonary perfusion imaging as well as medical history.The patients with acute PTE were divided into two groups according age:elderly group (n=78,age≥60 years),young group (n =63,age ＜ 60 years).Multivariate Logistic regression analysis was performed to identify independent risk factors of PTE and to confirm the risk of each factor.Results The morbidity rate of dyspnea,cough,chest distress and chest pain were 88.5％ (69 cases),76.9％ (60 cases),56.4％ (44 cases),15.4％ (12 cases) in elderly group,which was similar to 84.1％ (53 cases),69.8％ (44 cases),63.5％ (40 cases),25.4％ (16 cases) in young group (all P＞0.05)； while the morbidity rate of hemoptysis in elderly group [9.0％ (7 cases)] was lower than in young group [23.8％(15 cases)](P＜0.05).9％ (7 cases) in elderly patients without any symptoms were more than 1.6％ (1 cases) in young patients,but no significant differene (P＞0.05).There were more risk factors in the elderly group accompanying with diabetes (x2 =7.41,P ＜ 0.01),hypertension (x2 =14.51,P＜ 0.01),chronic obstructive pulmonary diseases (COPD) (x2 =7.42,P＜0.01) and previous stroke (x2 =4.91,P＜0.05)compared with young group.Independent risk factors for elderly acute PTE included COPD (OR:3.29,95％CI:1.04-10.46),previous deep veneus thrombosis(DVT) (OR:4.72,95％CI:1.68-13.27),cancers (OR:4.35,95％CI:1.00-18.13) and previous stroke (OR:5.13,95％CI:1.15-24.52).Independent risk factors for non-elderly PTE included previous DVT (OR:11.94,95％ CI:3.35-42.60)and cancers (OR:11.44,95％CI:1.44-89.92).Conclusions Much attention should be paid to the identification of diagnosis of acute PTE depending on the non-specific clinical features,although dyspnea may be the most frequency symptoms,but unexplained cough and chest distress should be alert for PTE.COPD,cancer,DVT and previous stroke are independent and important risk factors for elderly acute PTE.

Objective:To study the influence of some process parameters on the product granularity in pharmaceutical air jet pulverization process.Methods:The method of quadratic regressive orthogonal experiment was used.Results:The mathematics model describing the relationship between the parameters studied and product granularity was established.Conclusion:The conclusions in the experimental study have instructional significance for pharmaceutical production.

The module design of pharmaceutical superfine pulverization matched up GMP was attempted. The integral of mechanism and electricity into the whole pulverization process was designed and established.

BACKGROUND:Induced pluripotent stem cel technology have solved the contradiction between the ethics and immune rejection, and this high-efficient and safe technique is becoming the mainstream of today’s research. OBJECTIVE:To comprehensively review the safety and application of induced pluripotent stem cel s.METHODS:A computer-based online retrieval of PubMed and CNKI was performed to search relevant papers published from January 2006 to April 2016, with the key words of“induced pluripotent stem cel , reprogramming, clinical application, safety, transcription factor, disease mode”in English and Chinese, respectively. RESULTS AND CONCLUSION:In recent years, research on induced pluripotent stem cel s has attracted much attention from the scientific community and the medical community, and this technique has successful y gained induced pluripotent stem cel s and overcome the problems of immunity and ethics. However, it is limited to the theoretical and laboratory research due to the inability to solve the safety, efficiency and re-differentiation mechanism of induced pluripotent stem cel s. Therefore, we are faced with enormous difficulties and chal enges, which involve al aspects of basic research, including how to safely and effectively induce the differentiation of induced pluripotent stem cel s into the desired cel type and how to establish a suitable disease model as wel as a high-throughput drug screening platform.