Objective To explore the correlation between volumetric capnography(VCap)and traditional pulmonary function in chronic obstructive pulmonary disease(COPD),so as to assess whether VCap can be used as alternative indicators for the evaluation of COPD severity when some of the elderly COPD patients do not accomplish the traditional pulmonary function tests.Methods 960 patients admitted to Fujian Geriatric Hospital from June 2008 to June 2015 and undergoing pulmonary function tests were included in the study.They were divided into 2 groups of the COPD group(640 cases)and the control group(320 cases).The pulmonary function of COPD group was divided into 4 subgroups(Ⅰ~Ⅳ).All persons received tests of traditional pulmonary function and VCap.The correlations between VCap and traditional pulmonary function indexes and between VCap and COPD severity were observed.Results The differences in Vm25-50/VT,Vm50-75/VT,dC/dV3,SR23 of VCap between the 4 subgroups(COPDⅠ~COPDⅣ)and control group were statistically significant(all P<0.05),while the difference in dC/dV2 of VCap between the 4 subgroups(COPDⅠ~COPDⅣ)and control group was not statistically significant(t=-0.22,-0.43,0.26 and 0.64,all P>0.05).The difference in CO2 max between the COPD Ⅲ group(severe or more severe group)and control group was statistically significant(t=6.91 and 4.65,all P<0.05).The difference in VD-B/VT and VD-F/VT of VCap between the COPD(Ⅱ~Ⅳ)group(from moderate to very severe group)and control group were statistically significant(all P<0.05).CO2 max,VD-B/VT,VD-F/VT,Vm25-50/VT,Vm50-75/VT,dC/dV3,SR23 of VCap showed correlation with traditional pulmonary function.The correlation between dC/dV3 and the seven traditional pulmonary function indexes seen above was statistically significant(|r|>0.555,P<0.05).The specificity of Vm25-50/VT of VCap for the diagnosis of COPD was best,but its sensitivity was poor than other indexes of VCap.The indexes with both high sensitivity and high specificity were Vm50-75/VT and dC/dV3.Conclusions When the patients with COPD manifest the mild airflow limited,Vm25-50/VT,Vm50-75/VT,dC/dV3 and SR23 of VCap are gradually increased with abnormal VCap figures when the illness progressed.The CO2max of VCap might be one of the indexes for assessing the severity of severe or more severe COPD.

Objective To evaluate the applicability of small molecular markers of nephrotoxicity that in prediction of drug toxicity.Method Extracts of five kinds of traditional Chinese medicines (Tripterygium wilfordii,Strychni semen,Aristolochiafangchi,Rhei Radix et Rhizoma,and Xanthium sibiricum) that had known as nephrotoxicity were ig given to rats to establish renal injury models,and the blood samples were collected after administration for 1 and 7 d.Then blood samples were analyzed by UPLC/Q-TOF-MS for five kinds of small molecule biomarkers-thymidine,lyso-phosphatidylcholine (LPC 16:1),LPC (18:4),LPC (20:5),and LPC (22:5).The support vector machine (SVM) prediction model was established to determine the toxicity.The levels of Cr and BUN in serum were determined by automatic biochemical analyzer.The rats in each group were sacrificed after blood collection,and the kidneys were taken for HE staining.Result No toxicity was observed in the control group,and the biochemical test results showed no renal injury after mentioned five kinds Chinese herbs were given for 1 d,while SVM model of nephrotoxicity had been found abnormal.After administration for 7 d,the results of SVM model show renal toxicity,which were consistent with biochemical and pathological examination.Conclusion Metabonomics combined with the earlier established SVM model enabled prediction of drug nephrotoxicity more sensitively,quickly and \ccurately,and it is of great significance for the discovery of drug toxicity as well as the prevention and treatment of drug-induced renal injuries in clinic.

Objective To evaluate the impact of different ages, different gender, with or without exercise and different fracture sites on the nutritional status using mini nutritional assessment (MNA-SF) in hospitalized elderly fracture patients. Methods A total of 1 353 hospitalized elderly patients with fracture were included. The MNA-SF investigations were completed within 3 days after admission. The diet, body weight, physical activity, psychological trauma or stress, psychological problems, body mass index (BMI), calf circumference (CC), history of aerobic exercise and the fracture sites were recorded three days after admission. The nutritional status were evaluated including normal nutrition, risk of malnutrition and malnutritional status. The relationships of nutritional status were analyzed between different ages, different gender, with or without exercise, different fracture sites. Results There were significant differences in the incidence of normal nutrition, risk of malnutrition malnutrition and non-normal nutritional status between different ages, different gender, with or without exercise, femoral intertrochanteric fracture and upper limb fracture. There were also significant differences in the incidence of normal nutrition, risk of malnutrition and malnutrition between femoral neck fracture and upper limb fracture. Conclusion There is a higher incidence of non-normal nutritional status in patients older than 80 years, female, with no regular exercise and with femoral intertrochanteric fracture.

Objective To investigate the CT diagnostic value of small bowel wall thickness and density in differentiating simple small bowel obstruction (SI) from strangulative small bowel obstruction (ST).Methods Fifty-three cases with thickened small bowel wall (thickness ＞ 3 mm) confirmed on CT scan were reviewed,including 27 cases of SI and 26 cases of ST,in conjunction with their proven intraoperational,pathological and clinical findings.Of the 53 cases,35 cases also underwent postcontrast CT scan.CT manifestations of relationships between thickened small bowel wall and its density were classified as normal,higher or lower density in tunica mucosa of small bowel wall,higher or lower density in full thickness of small bowel wall for exploring the differential diagnostic features between SI and ST on CT scan.Chi-square or Fisher exact test were used to test the proportion difference of CT scan between SI and ST.Results In cases with normal density in tunica mucosa (NDTM) on precontrast CT,there were 21 cases of SI and 6 cases of ST(x2 =15.859,P ＜0.01).However,in cases with NDTM on postcontrast CT,there were 13 cases of SI and 5 cases of ST,and there was no significant difference (x2 =1.377,P ＞ 0.05).Thus,NDTM showed no convincing value in differentiating SI from ST.In cases with lower density in tunica mucosa (LDTM) on precontrast CT,there were 4 cases of SI and 5 cases of ST (P ＞ 0.05).In cases with LDTM on postcontrast CT,there were 4 cases of SI and 4 cases of ST (P ＞ 0.05).Thus,LDTM also showed no value in differentiating SI from ST.The lower density in full thickness of small bowel wall (LDFTS) was revealed in 0 of SI and 10 cases of ST on precontrast CT (P ＜ 0.01),and 0 of SI and 5 cases of ST on postcontrast CT (P ＜ 0.01),indicating that LDFTS showed significant value in differentiating SI from ST.Conclusion Combining the small bowel wall thickness and density,CT manifestations of early bowel wall pathological changes in small bowel obstruction can be acquired,adding some value in the differential diagnosis between SI and ST.

Objoctive To investigate circulating leveh of soluble vascular cell adhesion molecule-1(sVCAM-1)in the peripheral of intrahepatic cholestasis of pregnancy(ICP).To reveal the pathogenesis of ICP.Methods Maternal scram sVCAM-1 levels were determined in 49 women which 15 eases were normal pregnant women and 34 with ICP.The latter were composed of 14 women with mild,20 with severe ICP.sVCAM-1 was measured by ELISA.Results The levels of serum sVCAM-1 was significantly elevated in women with mild and severe compared with control subjects(P＜0.01),and markedly decreased to normal 5 days after dilively(P＞0.05).The sVCAM-1 level were negatively correlated with weight of neonatal(r=-0.643,P＜0.01).Conclusion Elevated levels of sVCAM-1 indicate that a primary endothelial cell dysfunction play an important role in the ICP.And it influences the neonatal.

Objective To investigate the changes of iron-related proteins in different sex mice before and after burns.Methods The burn model in mice were prepared with 90 ℃ vapor.Both liver and spleen iron contents were measured by colorimetric method.Hepatic hepcidin and Fpn1 mRNA content were determined with RT-PCR.The Fpn1 protein was determined with Western blot.Results After burns,the content of spleen iron was increased and the expression of hepatic hepcidin was decreased in male mice,and at the same time the Fpn1 of liver and spleen was reduced.The content of iron homeostasis abnormality in female mice was less serious.Conclusion The change of iron-related proteins after burns may be one cause of iron homeostasis abnormality.The differences of iron-related protein expression in different sex after burns suggest that estrogen has a potentially protective function.