Objective To study the relationship between malnutrition and respiratory muscle strengthas well as the effect of diet supplement on respiratory muscle strength in elderlypatients with chronic cor pulmonale in high altitude areas(HAECCP). Methods 46 patients with HAECCP not in exacerbation were divided into two groups, namely, diet supplement group (23 cases) and control group (23 cases). The caloric intake was increased by 45%-50% in the diet supplement group. Ten parameters with regard to body weight, muscle strength and respiratory function were measured in all the patients. These parameters included percentage of ideal body weight (%IBW), triceps skinfold thickness(TSF), midarm muscle circumference (MAMC), maximal inspiratory pressure(PImax), maximal expiratory pressure (PEmax),maximal transdiaphragmatic pressure(Pdimax),forced expiratory volume in 1 second (FEV_1) ,expressed as percentage predicted (FEV_1%), ratio of FEV_1 to forced vital capacity (FEV_1/FVC), partial pressure of arterial O_2 (PaO_2) and partial pressure of alveolar CO_2(PaCO_2). All the parameters were measured again after 4 weeks. Results There was no significant differece between the parameters in the two groups before the treatment. After 4 weeks of treatment, there was significant improvement in %IBW, serum albumin (Alb), TSF, MAMC, PImax,PEmax,Pdimax in the diet supplement group, indicating the effect of increased nutrition on body weight and respiratory muscle strength. However, no significant difference was found in the parameters of pulmonary function and blood gas analysis after diet supplement. NO change was observed in the parameters of the controls after 4 weeks. Conclusions In stable patients with HAECCP not in exacerbation, the strength of respiratory muscle decreased as a result of malnutrition. After diet supplement, the strength of respiratory muscle increased with accompanying improvement in nutritional status.

AIM: To evaluate whether tolerogenic dendritic cells (DC) loaded with heat shock protein 60 (HSP60) inhibit the progression of aortic atherosclerotic plaque in hypercholesterolemic apolipoprotein E (Apo-E) -null mice. METHODS: Bone marrow derived DC of the mice were loaded with HSP60 and co-cultured with rapamycin to generate tolerogenic DC. The tolerogenic DC, DC loaded only HSP60 and PBS were injected into the ApoE-null mice at 8 weeks of age for three times at a one-week interval. 8 weeks after the last injection, aorta were harvested for HE staining and anti-CD4~+T cell immunostaining. Responses of pleenic cells to HSP60 were also evaluated. RESULTS: Compared with DC, DC_ HSP60 expressed higher levels of CD86, and stimulated T lymphocytes to proliferation significantly, while the tolerogenic DC expressed lower levels of CD86, and inhibited T lymphocytes to proliferation. After immunization with different injection, the numbers of CD4~+ T cells in plaque were increased significantly in DC_ HSP60 group vs in PBS group (P

Objective To evaluate the correlation between the degree of cochlea endolymphatic hydrops(EH) and hearing loss and symptoms in patients with unilateral Meniere's disease. Methods Fifty seven patients with unilateral Meniere's patients were retrospectively quantitatively analyzed, which evaluated the correlation between the cochlea EH and hearing loss and symptoms. The affected ears in the experimental group(57 ears) and the asymptomatic ears in the control group(57 ears), were confirmed by bilateral intratympanic Gd-DTPA injection and 3D real IR MRI scan after 24 h. The maximum length of endolymph space and labyrinth chamber along the modiolus cochleae and their ratio which represented the endolymph space proportion of each turn(R1, the basal turn;R2, the middle turn;R3, the apical turn) were calculated. And the paired t test was used to compare the differences in EH degree between the experimental and control group;Pearson correlation analysis was used to analyze the correlation between the cochlea EH degree and hearing loss and duration of symptoms. Results R1, R1 and R3 of ipsilateral cochlea were higher than normal cochlea(ipsilateral R1:0.354±0.097 vs. normal R1:0.185±0.031, P<0.01;ipsilateral R2:0.445 ± 0.098 vs. normal R2:0.201 ± 0.046, P<0.01;ipsilateral R3:0.467 ± 0.102 vs. normal R3:0.221 ± 0.053, P<0.01). A positive correlation was found between the degree of EH in each turn and high-frequency hearing loss(r=0.275, 0.281, 0.329, respectively;all P<0.05), whereas no correlation was found between the extent of EH and the time of vertigo, tinnitus and hearing loss(P>0.05). In addition, there was a correlation between the degree of EH in the apical turn and low, medium, high-frequency hearing loss(r=0.271, 0.269, 0.329, respectively; all P<0.05). Conclusions The degree of cochlea EH in the basal and second turn showed great relevance with the high-frequency hearing loss, and the apical turn EH degree was relevant with the low, medium, high-frequency hearing loss, but there was no correlation between the EH degree of each turn, ages and symptoms.

Objective To explore the effect of respiratory training on respiratory function and quality life of patients with advanced lung cancer during chemotherapy.Methods A total of 60 patients with advanced lung cancer during chemotherapy in our hospital were randomly divided into observation group and control group by computer group numbers method,with 30 cases in each group,given with EP chemotherapy for both groups.The control group was additionally given conventional nursing,and the observation group was given respiratory training based on the control group,and the change of respiratory function and life quality after intervention were compared.Results FVE1,FVE1/FVC,FVE1％ after exercise in the observation group was higher than that in the control group,the difference was statistically significant (P ＜ 0.05).The physical pain,social function,mental function and vitality after the exercise in the observation group were higher than that in the control group,the difference was statistically significant (P ＜ 0.05).Conclusion Respiratory training can improve the respiratory function and life quality of patients with advanced lung cancer during chemotherapy.

Objective To explore the effect of respiratory training on respiratory function and quality life of patients with advanced lung cancer during chemotherapy.Methods A total of 60 patients with advanced lung cancer during chemotherapy in our hospital were randomly divided into observation group and control group by computer group numbers method,with 30 cases in each group,given with EP chemotherapy for both groups.The control group was additionally given conventional nursing,and the observation group was given respiratory training based on the control group,and the change of respiratory function and life quality after intervention were compared.Results FVE1,FVE1/FVC,FVE1％ after exercise in the observation group was higher than that in the control group,the difference was statistically significant (P ＜ 0.05).The physical pain,social function,mental function and vitality after the exercise in the observation group were higher than that in the control group,the difference was statistically significant (P ＜ 0.05).Conclusion Respiratory training can improve the respiratory function and life quality of patients with advanced lung cancer during chemotherapy.

Objective:To explore the diagnostic value of hand tenosynovitis in rheumatoid arthritis (RA).Methods:Seventy-six RA patients were enrolled for hands ultrasound examination. Forty-five RA patients with synovitis and tenosynovitis were selected as the study group, clinical characteristics, laboratory test results, disease activity score for 28 joint counts (DAS28), were evaluated and assessed, and the health assessment questionnaire (HAQ) was filled out, and semi-quantitative classification the ultrasonic indicators (synovial hyperplasia, synovitis, tenosynovitis, bone erosion) were also assessed. Forty-two non-RA patients with hand tenosynovitis were selected as the control group. Mann-whitney U test, Spearman correlation and paired U test were used for statistical analysis. Results:① In the RA group, synovial hyperplasia [7.50(3.00, 17.50)], synovitis [6.00(2.00, 14.00)], tenosynovitis [6.00(2.00, 12.00)], bone erosion [0.50(0.00, 4.00)] were statisticantly different when compared with in non-RA group in hyperplasia [5.00(3.00, 6.00)], synovitis [3.00(2.00, 4.30)], tenosynovitis [2.00(1.00, 3.00)], bone erosion [0.00(0.00, 1.00)] ( Z=2.143, P=0.032; Z=2.756, P=0.006; Z=5.560, P<0.01; Z=2.550, P=0.011). ② In the RA group, synovial hyperplasia and synovitis were positively correlated with swollen joint counts (SJC), tender joint counts (TJC), platelet (PLT), C-reactive pro-tein (CRP) and DAS28 [synovial hyperplasia ( r=0.806, P<0.01; r=0.486, P<0.01; r=0.326, P<0.05; r=0.450, P<0.01; r=0.413, P<0.01); and synovitis ( r=0.819, P<0.01; r=0.446, P<0.01; r=0.351, P<0.05; r=0.481, P<0.01; r=0.412, P<0.01)]. Tenosynovitis was positively correlated with SJC, CRP and DAS28 ( r=0.436, P<0.01; r=0.496, P<0.05; r=0.359, P<0.05) , bone erosion was positively correlated with disease course and anti-cyclic citrullinated peptide (CCP) antibody ( r=0.418, P<0.01; r=0.338, P<0.05) . ③ The sensitivity of synovial hyperplasia, synovitis, tenosynovitis, bone erosion and synovitis combined with tenosynovitis for the diagnosis of RA was 0.41, 0.61, 0.57, 0.48, 0.61 and the specificity was 0.95, 0.76, 1, 0.83, 0.93, respectively. ④ The largest area under the ROC curve was tenosynovitis [area under the curve (AUC)=0.841], the area under the curve of tenosynovitis and synovitis combined with tenosynovitis was significantly different from synovitis hyperplasia, synovitis and bone erosion [tenosynovitis( Z=3.291, P=0.001; Z=2.651, P=0.008; Z=3.032, P=0.002); synovitis combined with tenosynovitis( Z=4.346, P=0.001; Z=3.753, P=0.001; Z=2.547, P=0.012)]. Conclusion:Synovitis has a high sensitivity for the diagnosis of RA, and tenosynovitis has a high specificity for the diagnosis of RA, synovitis combined with tenosynovitis can improve the specificity for the diagnosis of RA.

Objective:To study the expression of peripheral blood NKT-like cells in patients with systemic sclerosis (SSc), to explore the correlation between NKT-like cells and laboratory and clinical indicators of systemic sclerosis, and investigate the role of NKT-like cells in the occurrence and development of Systemic sclerosis.Methods:Forty-six SSc patients (SSc group) were enrolled from Department of Rheumatology and Immunology of Peking University People 's Hospital during December 2018 to December 2019. Thirty healthy subjects with matched age and sex were selected as healthy control group (HC group). The cell count and percentage of NKT-like cells and other lymphocyte subsets in peripheral blood were detected by flow cytometry. At the same time, other laboratory indexes were determined by different methods. Spearman's correlation analysis, Pearson's correlation analysis, Man-Whitney U test and Fisher's exact test were used to analyze the difference and correlation between NKT-like cells and other clinical and laboratory indicators. Results:Compared with HC group [165(72, 226)cells/μl], the cell count of NKT-like cells in peripheral blood of SSc group[30(19, 58)cells/μl] was significantly decreased ( Z=-5.69, P<0.001). Correlation analysis showed that the cell count of NKT-like cells was positively correlated with total T lymphocytes ( r=0.56, P<0.001), CD4 +T cells ( r=0.42, P=0.004), CD8 +T cells ( r=0.60, P<0.001), B cells ( r=0.50, P<0.001) and NK cells ( r=0.33, P=0.024), respectively. The percentage of NKT-like cells in lymphocytes was also positively correlated with the percentage of CD8 +T cells ( r=0.34, P=0.020), but not significantly correlated with other subset of lymphocytes. The ESR of the NKT-like cell decreased group was significantly higher than that of the NKT-like normal group[15(9, 28) mm/1 h vs 8 (4, 16) mm/1 h, Z=-2.04, P=0.042]. Moreover, the cell count of NKT-like cells was negatively correlated with ESR ( r=-0.34, P=0.019). Conclusion:The cell count and percentage of NKT-like cells in peripheral blood of SSc patients decreased significantly. NKT-like cells were not only positively correlated with a variety of lymphocyte subpopulations, but also negatively correlated with ESR. NKT-like cells may be used as an indicator to monitor the disease activity in patients with SSc.

Objective:To understand the incidence trend and temporal distribution of breast cancer and reproductive system cancers in women in different age groups and areas in China from 2006 to 2017.Methods:Based on the incidences of breast cancer, vulvar cancer, vaginal cancer, cervical cancer, uterine corpus cancer, and ovarian cancer in women, average age at diagnosis and cases in different age groups and areas in China were calculated, standardized through world population. Software Joinpoint 4.5.0.1 was used to calculate average annual percent of change (AAPC).Results:Between 2006 and 2017, the overall age-standardized incidence rate (ASIR) of the six cancers showed an increasing trend from 39.48/100 000 to 51.11/100 000 (AAPC=2.24%, 95% CI: 1.59%-2.89%). The increasing trend was more obvious in rural area (AAPC=4.65%,95% CI:3.67%-5.64%), whereas no significant increase was observed in urban area (AAPC=0.15%,95% CI:-0.26%-0.56%). Except uterine corpus cancer, the incidences of 5 cancers showed increasing trends. The incidences of cervical cancer showed similar upward trends in urban and rural areas. In urban area, the ASIRs of breast cancer, vaginal cancer and vulvar cancer showed no significant increase, while in rural area it showed significant increase. The ASIR of ovarian cancer showed a decreasing trend in urban area and an increasing trend in rural area. The average age at diagnosis increased for all the cancers, except uterine corpus cancer. However, after standardizing through world population, the increases in the standardized average age at diagnosis were observed only in cervical cancer and vaginal cancer from 49.11 and 55.15 years to 52.13 and 58.81 years, respectively. Conclusions:The overall ASIR of breast cancer and reproductive system cancers in women showed increase trend in China in 2006-2017, and the increase trend was more obvious in rural area than in urban area. Meanwhile, the accessibility to medical facilities in rural area needs to be improved to ensure medical care, early diagnosis and early treatment for the purpose of bridging the gap in female cancer incidence between rural area and urban area.