Objective To investigate the level of plasma GDF-15 in patients with COPD and its clinical value in the diagnosis of COPD in the stable stage and in acute exacerbation stage. Methods From 2015 to 2016, 58 cases of patients with COPD were enrolled ,including COPD patients in the stable stage and in acute exacerba-tion stage. 29 cases of COPD patients diagnosed in our hospital were enrolled in the experimental group ,and 29 cases of age-,gender and body mass index-matched healthy people were enrolled in the control group. Compared and analyzed the blood cell count ,determination of plasma GDF-15 and C-reactive protein were performed and ana-lyzed. Spearman correlation analysis was conducted to compare levels of GDF-15 and C-reactive protein between pa-tients with the stable stage of COPD and those with acute exacerbation stage of COPD. The diagnostic efficacy was compared between GDF-15 and C-reactive protein in differentiatingthe COPD in acute exacerbation period and in the stable period. Results Level of GDF-15 in the stable COPD patients was significantly increased compared with that in the control group. The plasma GDF-15 level was significantly increased in acute exacerbation COPD patients compared to patient with the stable COPD(P<0.001). For the stable COPD patients,GDF-15 level and C-reactive protein level was positively correlated(r = 0.776,P < 0.001). In acute exacerbation COPD patients, GDF-15 level and C-reactive protein level was positively correlated (r = 0.877,P < 0.001). The ROC curves showed that the GDF-15 level on the diagnosis of acute exacerbation COPD patients with an AUC was 0.783(95%CI,0.666~0.900,P<0.001)and with the diagnostic accuracy was 69%. C-reactive protein in the acute exacer-bation of AUC diagnosis of COPD was 0.686(95%CI:0.549~0.823,P<0.01)and the diagnostic accuracy rate was 59%. Conclusion The plasma level of GDF-15 was significantly increased in COPD patients compared with people in the healthy control group. Plasma GDF-15 and C- reactive protein were highly correlated in the stable stage of COPD patients and in acute exacerbation stage of COPD patients. The diagnostic accuracy of GDF in patients with the stable stage of COPD and with acute exacerbation stage of COPD was higher than C-reactive pro tein.

Objective To compare the differences of electrical activity in calf muscle of children with growing pains from normal children when standing and heel raising. Methods 32 children with growing pains and foot pronation were as growing pains group, and 32 normal children as control group. All the children were measure with surface electromyography (sEMG) of tibialis anterior, peroneus longus, medial gastrocnemius and tibialis posterior when standing and heel raising. Results The root mean square (RMS) of peroneus longus increased significantly in growing pains group when standing (P<0.01). The RMS decreased significantly in medial gastrocnemius (P<0.05) and increased significantly in tibialis posterior (P<0.01) when heel raising. Conclusion The characteristics of electrical activity in calf muscle is difference from the normal in the growing pains children with foot pronation during standing and heel raising.

Objective To investigate the effect of simvastatin on oxidative stress and inflammatory reac-tion in patients with stable moderate to severe chronic obstructive pulmonary disease and its mechanism. Meth-ods Sixty patients diagnosed with chronic obstructive pulmonary disease were randomly divided into the simvas-tatin group and the placebo group.The simvastatin group was treated with simvastatin in 40 mg/d for 12 weeks,and the placebo group with placebo.The general clinical features,the concentration of inflammatory factors,pulmonary function,6-minute walk test and MRC score were compared between the two groups.Results There was no signif-icant difference between these two groups in basic features. There was a decrease of IL-6,TNF-a and Hs-CRP in concentration in the simvastatin group after treatment. which was significantly lower than that of the placebo group after treatment.The 6-minute walk test in the simvastatin group was much better than that in the placebo group(P=0.00).MRC score was improved compared with therapy before(P=0.02).There was no significantly difference in 6-minute walk test and MRC score before and after treatment in the placebo group(P=0.81). The PaO2 was im-proved after treatment in the simvastatin group compared with therapy before and that in the placebo group after therapy(P<0.05)respectively.There was no significantly difference in FEV1and FVC between these two groups. Conclusion Simvastatin can decrease the concentration of inflammatory factors in stable moderate to severe chron-ic obstructive pulmonary disease,and improve the pulmonary function.

ObjectiveTo study the characteristics and the impact of lymph node metastasis on radical resection for pancreatic head cancer to provide a theoretical basis for lymphadenectomy in radical resection.To study the reliability of using a surgical microscope to detect lymph nodes in radically resected specimens of pancreatic head cancer.MethodsLymph nodes in the specimens after radical pancreaticoduodeneetomy (pancreaticoduodenectomy + D2 regional lymphadenectomy) were identified using a surgical microscope and they were grouped using the JPS standard.The position and the frequency of the lymph nodes retrieved,and their association with other clinicopathologic factors were analysed.The results were compared with the data published in 2004 on 46 patients to evaluate the reliability of using a surgical microscope.ResultsLymph node metastasis was detected histopathologically in 101 patients (67.3％).The median number of lymph nodes retrieved in the specimens as detected using the surgical microscope was 38.2.The most commonly involved lymph node groups were No.13 (64.5％),No.14 (51.7％),No.17 (38.6％),No.12 (25.8％),No.16 (20.8％).Lymph node metastasis was significantly associated with tumour T stage,tumour invasion and differentiation,preoperative serum level of CA19-9 and CA72-4,but not with patient age,sex,or tumour location.There were no significant differences between the results and the data of the previous study in 2004.ConclusionsExtended lymphadenectomy is necessary because extensive lymph node metastasis was common.Surgical microscopy is an effective and reliable method to detect lymph nodes in resected specimens of pancreatic head cancer for accurate pathologic staging.