Objective To observe clinical symptoms and the length of hospital stay of patients with bronchiolitis under different treatment,and the curative effect of inhalation of hypertonic saline combined with epinephrine in the treatment of bronchiolitis.Methods A total of 158 patients with bronchiolitis under 2 years old between August 2012 and May 2013 in Shengjing Hospital of China Medical University were enrolled.According to the admission dyspnea score (respiratory distress assessment instrument,RDAI),all cases were divided into two major groups,moderate group and severe group.Two major groups were randomly divided into three groups (treatment group 1,2,3)according to the different treatments respectively.Patients in the treatment group 1 were inhaled pulmicort combined with combivent,treatment group 2 were inhaled hypertonic saline,and treatment group 3 were inhaled hypertonic saline combined with epinephrine.The symptoms and signs disappeared days,respiratory assessment change score,length of hospital stay and the curative effect in every group were observed before and after the treatment.Results In the moderate group,there were no significant differences in the length of time of cough,wheeze,lung rales disappears as well as the average length of hospital stay between before and after treatment in three treatment groups respectively (P ＞0.05,respectively).In the severe group,there were significant differences in the respiratory assessment change score and length of hospital stay of treatment group 2 and treatment group 3 than that of treatment group 1 respectively(P ＜ 0.05,respectively).There were no significant differences in the length of hospital stay and length of time of cough,wheeze,lung rales disappears between treatment group 2 and treatment group 3 respectively(P ＞ 0.05,respectively).Conclusion There were no significant differences in the curative effect between each treatment group for the moderate bronchiolitis patients.For the severe bronchiolitis patients,hypertonic saline combined with epinephrine inhalation had better curative effect,less adverse reactions.

Objective To investigate the relationship between mine environment and hypertension in miners. Methods 1736 male miners who worked under the ground and 825 on the ground were recruited in this study. Prevalence of hypertension under the ground and on the ground miners was compared. Results Prevalence of hypertension of miners under the ground was 23.91% and on the ground was 15.52% (χ2 = 23.56,P <0.001 ). Compared to miners on the ground, the relative risk of hypertension under the ground workers was 1.71 (95% CI 1.38 - 2.13 ). Prevalence of hypertension was correlated to the years of ground working (χ2 = 37.00, P < 0.001 ). The binary logistic regression showed significant relationship between mine environment and hypertension under the ground miners ( OR = 1.05,95% CI 1.02 - 1.08 ).Conclusion The underground environment is an important risk factor hypertension to the miners.

Objective To investigate the effects of vasoactive intestinal peptide on transforming growth factor-β1(TGF-β1)expression in lung tis-sue of asthmatic mice with airway remodeling. Methods A total of 30 SPF grade female Balb/c mice were randomly divided into three groups:con-trol(group A),asthmatic(group B),and vasoactive intestinal peptide treatment(group C). Aerosolized ovalbumin was used to establish the asth-matic mice model. Pathological changes of bronchial and lung tissues were observed by HE,the perimeter of basement membrane(Pbm),internal wall area(WAi)and smooth muscle area(WAm)in bronchial lung tissue were analyzed using the pathological image. The expression levels of TGF-β1 mRNA and protein in lung tissue were detected by real-time PCR and Western blot. Results Pathologic changes including collagen deposition,in-filtration of inflammatory cells and smooth muscle layer thickness were found in group B. In addition,the WAi/Pbm and WAm/Pbm were significant-ly higher in group B than those of the group A(P<0.05),and lower in group C than in group B(P<0.05). The expression levels of TGF-β1mRNA and protein in group B were higher than both group A(P<0.05)and group C(P<0.05). Conclusion Vasoactive intestinal peptide may inhibit airway remodeling,which may be associated with reduced expression of TGF-β1.

Bronchiolitis is the main cause of wheezing episodes in infants under 2 years old.Most of them are caused by virus infection.Most of the children with bronchiolitis can recover after clinical treatment, but some of them may have recurrent wheezing or even asthma.There are many risk factors and complicated pathogenesis of recurrent wheezing after bronchiolitis.Risk factors mainly include: susceptible gene, virus type infected in the first wheezing, atopy, exposure to school-age siblings, tobacco exposure, family history of asthma, increased specific IgE, high blood eosinophils count, etc.In this paper, the risk factors of recurrent wheezing after bronchiolitis are introduced as follows.

Objective Allergic asthma is a chronic inflammatory disease of the airways.T lymphocytes play important roles in the pathogenesis of asthma.The voltage-gated Kvl.3 potassium channel may be a key factor in the activation of T lymphocytes.This research aims to detect the function of Kvl.3 channel in the neutrophlial asthma(NA) model and eosinophilic asthma(EA) model.Methods A total of 24 mice were randomly assigned into three groups:control,neutrophilic asthma model and eosinophilic asthma group.Neutrophilic asthma model was established with ovalbumin (OVA)and lipopolysaccharide(LPS);eosinophilic asthma was established with OVA and Al(OH)3;airway responsiveness of mice in each group was measured with a noninvasive pulmonary function instrument;lung inflammation changes were observed by pathological HE staining;IL-17A and IL-4 cytokines levels in bronchoalveolar lavage fluid were evaluated by ELISA;Kvl.3 channel protein level in lung was evaluated by western blot;the change of current density in CD4 +.T lymphocytes were tested by whole-cell patch clamp technique.Results Levels of IL-17A and IL-4 in bronchoalveolar lavage fluid increased in both NA and EA model (P ＜ 0.05).Compare with EA model,the IL-17A level was significantly higer in NA model,while the IL-4 level was significantly lower.In NA and EA model,kv1.3 protein expression in lung tissue was significantly higher than that in the control group(P ＜ 0.05),and kv1.3 protein expression in NA model was significantly higer than that in the EA model (P ＜ 0.05).Current intensity and current density of kv1.3 channel increased in both NA and EA model.While the current intensity and current density of kv1.3 channel were significantly higher in NA model than that in EA model.Conclusion Kv1.3 protein level,Kv1.3 channel current intensity and kv1.3 channel current density increased in both NA and EA model,especially in NA group,providing a new way for treatment of bronchial asthma.

Objective To evaluate the clinical significance of juxtapaillary duodenal diverticula (JPDD) in patients of acute calculous cholangitis (AC) with different severity grade.Methods A retrospective analysis was carried out for 488 AC cases of different severity from January 2011 to December 2013 who underwent duodenoscopy in Dongyang People's Hospital.Results Of the 488 patients, the JPDD was found in 2.87％, 6.15％ and 4.10％ in patients with mild, moderate and severe AC, respectively.The prevalence of JPDD in severe AC were significantly higher in the moderate and mild AC (x2 =4.486, P =0.034;x2 =14.686, P ＜ 0.001);Procalcitonin (PCT) concentrations in severe AC of JPDD were significantly higher in moderate and mild AC of JPDD (t =10.420 9, P ＜ 0.001;t =4.870 4, P ＜ 0.001).The cannulation failure rate and the amylase were significantly higher in JPDD patients compares to patients without JPDD (x2 =36.95, P ＜ 0.001;t =8.29, P ＜ 0.001).Conclusions JPDD detection rate increases with aging and seems to be associated with acute cholangitis (AC) with different severity grade and PCT concentration.JPDD predicts a higher cannulation failure rate and the amylase level after duodenoscopy.

Objective To evaluate the role of procalcitonin in patients with different severity grades of acute cholangitis (AC).Methods A retrospective study was carried out on 147 patients with different severity grades of AC who were treated from May 2012 to November 2013 at the Dongyang People's Hospital.Results Of 147 patients,the PCT concentrations were (165.63 ± 32.67) pg/ml,(348.97 ± 45.78) pg/ml,(758.91 ± 28.94) pg/ml for patients with mild,moderate and severe AC respectively.The PCT concentrations were significantly higher in patients with severe AC than those with moderate AC (P ＜ 0.05),and also in patients with moderate AC than those with mild AC (P ＜ 0.05).The top three bacteria obtained from blood culture from the different severity grades of AC showed no significant diferences (P ＞ 0.05).Conclusion Serum PCT concentrations were elevated in patients with AC and it may be used as a parameter to assess the severity of AC.

BACKGROUND: Oxidation injury can lead to the apoptosis of lens epithelial cells. Some researches have found that body supplement of vitamin C is beneficial to inhibit oxidation injury by increasing the level of vitamin C in aqueous humor.OBJECTIVE: To observe the inhibitive effect of vitamin C on H2O2 induced apoptosis of lens epithelial cell.DESIGN: Randomized controlled trial taking animal's lens as subject.SETTING: Department of Ophthalmology, Medical College of Qingdao University.MATERIALS: 120 adult New Zealand rabbits of both genders, weighing 3-5 kg, were selected. Vitamin C and 300 g/L H2O2 were purchased from Shanghai Guangda Chemical Reagent Factory.METHODS: The experiment was carried out in the Central Laboratory, the Affiliated Hospital of Medical College of Qingdao University from January 2002 to January 2004. ①Culture of lens: 240 lenses were isolat ed from 120 rabbits after being killed. Among them, 192 clear lenses were selected and divided randomly to three groups with 64 lenses in each group: control group, H2O2 group and H2O2+vitamin C group. Lenses in the control group were incubated in non-serum and non- phenolsulfonphthalein MEM medium, those in the H2O2 group incubated in non serum and non- phenolsulfonphthalein MEM medium containing 1 mmol/L H2O2 (62 μL of 30 g/L H2O2 was added into the medium every 6 hours to keep H2O2 level maintain 1 mmol/L in the medium), and those in the H2O2+vitamin C group incubated in non-serum and non- phenolsulfonphthalein MEM medium containing 1 mmol/L H2O2 and 1 mmol/L vitamin C. Under the same culture condition, the lenses in each group were detected at hours 6, 12, 18, 24, 36, 48, 72 and 108 after culture, respectively. ②Measurement of the opacity of lens: Under the white background, two black lines 0.5 mm in width, which were mutually vertical with an interval of 10 mm. The lenses were placed above the crossing to measure the opacity. ③Detecting the apoptosis of lens epithelial cells:The apoptosis of lens epithelial cells was examined using TUNEL method and DNA fragmentation assay under light microscope to calculate the apoptotic rate of epithelial cells.MAIN OUTCOME MEASURES: ①Opacity of the lenses in each group;②apoptotic rate of lens epithelial cells in each group.RESULTS: ①After 108 hours of culture, the opacity of the lenses in the H2O2+vitamin C group was obviously lower than that in the H2O2 group. ②The apoptotic rates in the control group were lower that those in the H2O2group at different time point and those in the H2O2+vitamin C groupat hours 24, 48 and 72 after culture(P＜0.05-0.01). The apoptotic rates in the H2O2+vitamin C group were significantly lower than those in the H2O2group at different time points after culture (P＜0.01). ③The findings of DNA fragment analysis showed that the DNA "ladder" was found in the H2O2 group during 24-72 hours, while no DNA "ladder" but only normal electrophoresis strap were present in the other two groups 24 hours after culture.CONCLUSION: Lens can take refuge from the oxidative injury of H2O2with the addition of vitamin C. As a result, the apoptosis rate of lens epithelial cells and further, cataract formation can be restrained.

Objective To explore effect of grape seed proanthocyanidin extract (GSPE)on airway inflammation and hyperresponsiveness of ovalbumin-induced murine asthma model and the associated regulatory effect on Treg/Th17 imbalance.Methods A total of 40 mice were randomly assigned to four experimental groups:control,asthma model,low dose GSPE (40 mg/kg),and high dose GSPE (80 mg/kg).Acute asthma model was established with OVA;airway responsiveness of mice in each group was measured with a noninvasive pulmonary function instrument;lung inflammation changes were observed by pathological HE staining;Treg/Th17 cytokines levels in bronchoalveolar lavage fluid were evaluated by ELISA;the expressions of forkhead/winged helix transcription factor(Foxp3) mRNA and retinoid-related orphan receptor gammat (RORγt) mRNA in lung tissue of each group were gained by Real-time PCR method.Results GSPE inhibited ovalbumin-induced increases in airway responsiveness(P ＜ 0.05).Histological studies demonstrated that GSPE substantially inhibited OVA-induced airway inflammation in lung tissue.GSPE decreased IL-17A levels and increased IL-10 levels in bronchoalveolar lavage fluid (P ＜ 0.05).In the asthma model group,RORγt mRNA expression in lung tissue was significantly higher than that in the control group(P ＜ 0.05)and Foxp3 mRNA expression was significantly lower than that in the control group (P ＜ 0.05).In the GSPE group,RORγt mRNA expression was lower than that in asthma model group (P ＜ 0.05),however the Foxp3 mRNA expression was higher than that in asthma model group(P ＜ 0.05).Conclusion GSPE could alleviate airway hyperresponsiveness and airway inflammation of in asthmatic mice.It can modify the asthmatic mice Treg/Th17 imbalance by decreasing IL-17A and increasing IL-10 concentration at the level of cytokines;and also by increasing Foxp3 mRNA expression and inhibiting the expression of RORγt mRNA at the transcriptional level,which provide a new way for treatment of bronchial asthma.

Objective To observe the correlation between platelet parameters , platelet activation marker and carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitus. Methods One hundred and ninety-five type 2 diabetic patients were enrolled in this study. The patients were divided into the normal control group, the CIMT increased group and the clot group according to the carotid intima-media thickness. Levels of platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), platelet hematocrit(PCT), urinary 11-dehydro-thromboxane B2 (11-DH-TXB2) and other clinical, biochemical characteristics were measured. Results (1) Levels of serum LDL-C, MPV, PDW, urinary 11-DH-TXB2 and clinical course in the clot group were higher than those in the CIMT increased group and the normal control group (P < 0.05). (2) Compared with the normal control group, the clinical course, serum LDL-C, MPV, PDW and urinary 11-DH-TXB2 were higher in the CIMT increased group (P < 0.05). (3) By using with spearman rank correlation test, carotid intima-media thickness was positively associated with age , course , BMI , GLU , GHbA1C , LDL-C , MPV , PDW and urinary 11-DH-TXB2, whereas carotid intima-media thickness was negative associated with HDL-C, PLT (both P < 0.05). (4) MPV, PDW and urinary11-DH-TXB2 were shown as the independent risk factors for CIMT. Conclusions Platelet activation marker and platelet parameters are associated with carotid intima-media thickness in patients with type 2 diabetes mellitus.