Objective: To investigate the morbidity of chronic obstructive pulmonary diseases (COPD) in residents aged 30 years and above in Sichuan Province, and analyze the effect of smoking on the risk of morbidity on COPD. Methods: From 2004 to 2008, people were randomly selected from Pengzhou, Sichuan Province. All the local people aged 30-79 years were asked to receive questionnaire survey, physical examination and pulmonary function testing, and long-term follow-up to determine the morbidity of COPD. Cox proportional hazard regression model was used to analyze the relationship between smoking and COPD. Results: In 46 540 participants, the current smoking rates were 67.31% in males and 8.67% in females, there were 3 101 new cases of COPD, with a cumulative incidence of 6.66%. Adjusted for age, gender, occupation, marriage, income level, educational level, BMI, daily total physical activity, current cooking frequency, whether there was smoke exhaust device at present and frequency of passive smoking exposure, multivariate Cox proportional hazard regression analysis showed that compared with the non-smoking population, current smoking and quitting smoking increased the risk of COPD, with HR of 1.42 (95%CI:1.29-1.57) and 1.34 (95%CI:1.16-1.53). Compared with people who never or occasionally smoke, the risk of morbidity on COPD increased with the increase of average daily smoking volume, mixed smoking at present, mixed smoking at the beginning increased the risk of COPD, with HR of 1.79 (95%CI: 1.42-2.25) and 2.12 (95%CI: 1.53-2.92), started smoking at the age of <18 years old and ≥18 years old increased the risk of COPD, with HR of 1.61 (95%CI:1.43-1.82) and 1.34 (95%CI: 1.22-1.48), inhaling into the mouth, throat and lung during smoking increased the risk of COPD, with HR of 1.30 (95%CI: 1.16-1.45), 1.63 (95%CI: 1.45-1.83) and 1.37 (95%CI: 1.21-1.55). Adjusted for multiple confounding factors and adjusted for regression dilution bias, the average daily smoking volume, the age of starting smoking and the depth of smoking inhalation had an impact on the incidence of COPD, and the gender difference was particularly prominent. Conclusions: Smoking increased the risk of morbidity on COPD, which was related to the average daily smoking volume, the type of smoking, the age of starting smoking and the depth of smoking inhalation. Tobacco control should comprehensively consider the specific characteristics of smoking, so as to prevent COPD.
Female ; Male ; Humans ; Adolescent ; Prospective Studies ; Smoking ; Morbidity ; Pulmonary Disease, Chronic Obstructive ; China

Objective To evaluate the effect of methylprednisolone sodium succinate combined with tropisetron on postoperative nausea and vomiting(PONV)under microvascular decompression of hemifacial spasm.Methods From January to June 2019,485 patients undergoing microvascular decompression for facial spasm at Department of Neurosurgery,Peking University People's Hospital were randomly assigned into two groups with random number table method.For group A(n=242),2 ml saline was administrated by intravenous drip before induction and 5 mg tropisetron after operation.For group B(n=243),40 mg methylprednisolone sodium succinate was administrated by intravenous drip before induction and 5 mg tropisetron after operation.The anesthesia time,operation time,and incidence of PONV in 0-24 h and 24-48 h were recorded for the comparison of the remedial treatment rate of nausea and vomiting between the two groups.Results There was no significant difference in age,gender,smoking history,body mass index value,American Society of Anesthesiologists score,medical history,surgical side,PONV history,operation time or anesthesia time between the two groups(all P > 0.05).The incidence of PONV in group A was 35.5% and 18.2% during 0-24 h and 24-48 h,respectively,which was significantly higher than that(18.5%,χ
Antiemetics ; Double-Blind Method ; Hemifacial Spasm/surgery* ; Humans ; Indoles ; Methylprednisolone Hemisuccinate/therapeutic use* ; Microvascular Decompression Surgery ; Tropisetron

The potential role of total saponins extracted from Lilium lancifolium bulbs (TSLL) on the proliferation, apoptosis, migration and invasion of human lung cancer A549 cells and its possible mechanism were discussed. Effect of TSLL on proliferation of A549 cells were detected by CCK-8, clone formation assay and EdU staining. Effect of TSLL on apoptosis morphology of A549 cells was observed by fluorescence microscope using Annexin V/PI double staining and Hoechst 33342 staining. Effect of TSLL on cell migration and invasion was detected by Transwell migration test and Transwell invasion test, respectively. Western blot was used to detect TSLL on the expression change of intracellular associated proteins. Results showed that TSLL intervention in A549 cells within 24, 48 or 72 h significantly inhibited cell growth, and its IC₅₀values were about 229, 173 and 71 mg·L⁻¹, respectively. TSLL significantly reduced the clone formation rate of A549 cells and decreased the DNA synthesis rate of A549 cells in a concentration dependent manner. TSLL induced A549 cells apoptosis and reduced the migratory behavior of A549 cells. TSLL decreased invasion of A549 cells to the artificial basement membrane. The expression level of intracellular PCNA and the ratio of Bcl-2/Bax protein were down-regulated and procaspase 3 was activated. In addition, TSLL had no obvious effect on epithelial mesenchymal transition (EMT) related marker proteins E-cadherin and vimentin expression. The above results indicated that TSLL possess inhibitory effects against proliferation, migration and invasion of lung cancer A549 cells and apoptosis-induced effect. The anti-proliferation effect of TSLL is very likely by inhibiting intracellular DNA synthesis through reducing the expression of PCNA in lung cancer cells. And the apoptosis induction of TSLL on lung cancer cells is associated with the regulation of Bcl-2 and Bax proteins expression. Nevertheless, there is no incontestable correlation between anti-invasion and metastasis effects of TSLL and EMT in lung cancer cells.
Apoptosis ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Epithelial-Mesenchymal Transition ; Humans ; Lung Neoplasms ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Saponins

OBJECTIVETo study the characteristics and clinical effect of total hip arthroplasty(THA) for osteoarthritis and (or) avascular necrosis of femoral head after failure of internal fixation of acetabular fracture.

METHODSFrom February 2009 to October 2014, 31 patients (31 hips) with hip traumatic osteoarthritis and (or) femoral head avascular necrosis after failure of internal fixation of acetabular fracture were treated with THA including 26 males and 5 females, who injured when the average age of(41±12) years. THA were performed, and the duration ranged from 3 to 132 months with a mean of(20.6±26.9) months secondary to traumatic osteoarthritis and(or) femoral head avascular necrosis. All THA were performed with posterior-lateral approach. The postoperative complications were observed. VAS and Harris hip scores were compared pre-operation and post-operation.

RESULTSTwenty-seven cases were followed up, and the duration ranged from 12 to 80 months with a mean of (43.2±11.7) months. One patient had infection around prosthesis. Aseptic loosening occurred in 1 patient, dislocation of prosthesis in 1 patient. No sciatic nerve injury occurred. Hip function and gaits were obviously improved. To the last follow-up, VAS score was decreased from 7.6±1.2 pre-operatively to 1.2±0.9 post-operatively, while the Harris score was improved from 45.5±13.6 pre-operatively to 88.5±7.8 post-operatively, both differences were statistically significant(<0.01). The post-operative ROM of hip was significantly improved compared to pre-operative ROM(<0.05), in addition to extension motion. X-ray showed all the acetabular cups were stable, one femur stem subsided 3 mm. Heterotopic ossification occurred in 2 cases.

CONCLUSIONSCorrect dealing with of internal fixation implants, looking out potential infection and reasonable reconstruction of acetabular bone deficiency were the key to the success of THA for osteoarthritis and(or) avascular necrosis of femoral head after failure of internal fixation of acetabular fracture.

Objective To discuss the effect of Weifuchun combined with colloidal bismuth pectin capsules on Notch 1, β-catenin and phosphatase and tensin homolog deleted on chromosome ten ( PTEN) in patients with precancerous lesion of gastric carcinoma.Methods A total of 115 patients with precancerous lesion of gastric carcinoma were randomly divided into experiment group ( n =60 ) and control group (n=55).Patients in experiment group were given Weifuchun 1.44 g, colloidal bismuth pectin capsules 150 mg, 3 times a day, while patients in control group given omeprazole 20 mg, 2 times a day, and sucralfate 0.25 g, 3 times a day, all patients treated for 4 weeks.The expressions of Notch1, β-catenin and PTEN of the two groups were observed.Results After treatment , the total effective rate of experiment group (68.3%) was significantly higher than that of control group (43.6%, P<0.01 ).After treatment , the positive rates of Notch 1 ,β-catenin in experiment group were decreased compared with those before treatment , and experiment group significantly lower than those in control group (P<0.01).After treatment, the positive expression of PTEN in experi-ment group was improved significantly , and significantly higher than thatin control group ( P<0.05 ) .Conclusion Weifuchun combined with colloidal bismuth pectin capsules can reduce the expression of Notch1,β-catenin of patients with precancerous lesion of gastric carcinoma , and enhance the expression of PTEN, which also had significant effect on improving the therapeutic effect and safety of treatment.

Previous studies suggested that smoking and passive smoking could increase the risk of breast cancer, but the results were inconsistent, especially for Chinese females. Thus, we systematically searched cohort and case-control studies investigating the associations of active and passive smoking with breast cancer risk among Chinese females in four English databases (PubMed, Embase, ScienceDirect, and Wiley) and three Chinese databases (CNKI, WanFang, and VIP). Fifty-one articles (3 cohort studies and 48 case-control studies) covering 17 provinces of China were finally included in this systematic review. Among Chinese females, there was significant association between passive smoking and this risk of breast cancer [odds ratio (OR): 1.62; 95% confidence interval (CI): 1.39-1.85; I2 = 75.8%, P < 0.001; n = 26] but no significant association between active smoking and the risk of breast cancer (OR: 1.04; 95% CI: 0.89-1.20; I2 = 13.9%, P = 0.248; n = 31). The OR of exposure to husband's smoking and to smoke in the workplace was 1.27 (95% CI: 1.07-1.50) and 1.66 (95% CI: 1.07-2.59), respectively. The OR of light and heavy passive smoking was 1.11 and 1.41, respectively, for women exposed to their husband's smoke (< 20 and ≥ 20 cigarettes per day), and 1.07 and 1.87, respectively, for those exposed to smoke in the workplace (< 300 and ≥ 300 min of exposure per day). These results imply that passive smoking is associated with an increased risk of breast cancer, and the risk seems to increase as the level of passive exposure to smoke increases among Chinese females. Women with passive exposure to smoke in the workplace have a higher risk of breast cancer than those exposed to their husband's smoking.
Breast Neoplasms ; China ; Cohort Studies ; Female ; Humans ; Occupational Exposure ; Odds Ratio ; Risk Factors ; Smoking ; Tobacco Smoke Pollution

OBJECTIVETo observe the change of erythrocyte theology in rabbits with acute renal failure (ARF).

METHODSThirty-eight healthy rabbits were randomly divided into control group (n = 8), model group (establishing ARF model via intramuscular injection 1% HgCl2, and divided into 12 h, 24 h, 48 h subgroups, all n = 10), the arterial blood sample was taken out through carotid artery at corresponding times after anesthetization with urethane, for detecting the indices of renal function and erythrocyte rheology.

RESULTSThe levels of urea and creatinine in plasma of model rabbits at 12 h, 24 h and 48 h were higher than those of control group, and there was a rise trend along with the time extension. The erythrocytes electrophoresis time at 12 h of model group was higher, the electrophoresis rate and migration rate of erythrocytes were lower compared with those of control group; the erythrocytes electrophoresis time at 24 h of model group was lower and the electrophoresis rate and migration rate were higher compared with those of model group at 12 h; and there were no statistical differences in erythrocytes electrophoresis indices between model group at 48 h and other groups. Meanwhile, there was a rise trend in erythrocyte sedimentation rate (ESR), K value of equation and emendation along with the time extension of ARF, but these indices only at 48 h of model group was lower significantly than that of control group. There were no statistical differences in aggregation index and deformability index of erythrocytes among groups.

CONCLUSIONDuring the process of ARF, the erythrocytes electrophoresis time lengthen and electrophoresis rate and migration rate decrease at early stage, and these indices gradually return to normal; the indices of ESR increase gradually.

Acute Kidney Injury ; blood ; physiopathology ; Animals ; Erythrocyte Indices ; Erythrocytes ; physiology ; Hemorheology ; Rabbits

OBJECTIVETo evaluate the clinical efficacy and safety of treatment of chronic primary glomerulopathy (CPG) patients of Shen deficiency and dampness heat syndrome (SDDHS) by Yishen Qingli Granule (YQG) combined with low-dose Tripterygium Wilfordii multiglycoside Tablet (TWT).

METHODSTotally 231 CPG patients of SDDHS were enrolled in this study (including 60 patients from First Affiliated Hospital of Nanjing University of Chinese Medicine, 58 from First Affiliated Hospital of Nanjing Medical University, 46 from Xinqiao Hospital of Third Military Medical University, 35 from First Affiliated Hospital of Guangzhou University of Chinese Medicine, 14 from First Affiliated Hospital of Soochow University, and 18 from Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine). They were randomly assigned to the control group (116 cases) and the trial group (115 cases) according to block group method. There were 217 cases in the safety analysis set (109 cases in the trial group vs 108 cases in the control group), and 203 cases in the full analysis set (99 cases in the trial group vs 104 cases in the control group). All patients received basic treatment such as ACEI/ARB. Furthermore, YQG (consisting of raw astragalus 10 g, prepared Polygonum Multiflorum 10 g, Pyrrosia 10 g, 1.5 g each package, containing 10 g of crude drugs) was additionally given to patients in the trial group, each package, twice daily. The TWT (10 mg) was given, twice a day. The TWT dose was adjusted according to 24 h urinary total protein (UTP). The placebos of YQG and TWT were administered to those in the control group. The treatment course consisted of 24 weeks and the follow-up visit lasted for 24 weeks. The biochemical indices were observed before and after treatment including 24 h UTP, urine red cell count (U(RBC)), renal functions (BUN, SCr), blood routine test (WBC), and liver functions (SGPT, SGOT). Reverse reactions such as gastrointestinal discomfort, skin rash, and irregular menstruation were also observed.

RESULTSCompared with the control group, the total effective rate was better in the trial group (82.83% vs 61.54%, P < 0.01). Results of stratified comparison of UTP showed better efficacy in the trial group (0.8-3.0 g/24 h, P < 0.01). The UTP decline occurred in the trial group after 8 weeks of treatment, with stable action, showing statistical difference when compared with the control group (P < 0.01). In the trial group, U(RBC) level decreased after treatment but changed more significantly. But there was no statistical difference in the changes when compared with the control group (P > 0.05). After treatment, there were no statistical difference in safety indicators such as WBC, SGPT, and SGOT between the two groups after treatment (P > 0.05).

CONCLUSIONOn the basis of basic treatment such as ACEI/ARB, application of YQG combined with low-dose TWT had better effect in controlling proteinuria of CPG patients, and could help stabilizing their conditions with less adverse reactions.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Kidney Diseases ; diagnosis ; drug therapy ; Kidney Glomerulus ; pathology ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; methods ; Treatment Outcome ; Tripterygium

BACKGROUNDCurrently available evidence suggests that outcomes are less favorable when left main (LM) bifurcation lesions are treated with 2-stent techniques compared with a single-stent technique. We aimed to evaluate the long-term outcomes of the 2-stent techniques for treating unprotected LM bifurcation lesions in Chinese patients.

METHODSWe enrolled 301 consecutive patients treated with drug-eluting stents (DES) implantation using 2-stent techniques for unprotected LM bifurcation lesions (MEDINA 1, 1, 1, 70.5%). The 2-stent techniques included crush technique, V stenting, T stenting, and Culottes stenting. After stenting, both vessels were redilated at a high pressure before final kissing balloon (FKB). Clinical and angiographic data were analyzed. The primary endpoints were major adverse cardiac events (MACE), which included death, myocardial infarction, and target lesion revascularization.

RESULTSImmediate procedural success was obtained in all cases with a FKB success rate of 95.3%. Follow-up data were available for all patients. The overall incidence of angiographic in-stent restenosis (ISR) rate was 20.3% and most ISRs were of the focal type. During long-term follow-up (mean duration, (54 ± 22) months), the cumulative incidence of MACE was 11.0%, with 8 (2.7%) deaths, 7 (2.3%) myocardial infarctions, and 18 (6.0%) repeated lesion revascularization. MACEs in high SYNTAX score terciles were significantly higher compared with those in low and intermediate SYNTAX score terciles (P = 0.001).

CONCLUSIONSAlthough percutaneous coronary intervention (PCI) with 2-stent technique for unprotected LM bifurcation lesions was accompanied with a slightly high incidence of ISR, the long-term clinical follow-up is acceptable. Technical modifications and stent innovations may further improve both the angiographic and clinical outcomes for patients with LM bifurcation disease treated by PCI.

Adult ; Aged ; Aged, 80 and over ; Coronary Artery Disease ; mortality ; therapy ; Coronary Restenosis ; epidemiology ; Drug-Eluting Stents ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; adverse effects ; methods ; Time Factors ; Treatment Outcome

OBJECTIVETo evaluate the clinical effects of ultra-early application with intermittent pneumatic compression (IPC) in preventing postoperative lower limbs deep venous thrombosis (DVT) of intertrochanteric fractures in elder patients.

METHODSFrom May 2008 to May 2010, 80 patients with intertrochanteric fractures were randomly divided into ultra-early group and postoperative group. In ultra-early group, there were 21 males and 19 females, ranging in age from 67 to 86 years with an average of (76.4 +/- 13.27) years; in postoperative group, there were 26 males and 14 females, ranging in age from 68 to 89 years with an average age (75.8 +/- 12.71) years. IPC was respectively used at the 3rd day before operation (ultra-early group) and postoperative that day (postoperative group). Serum D-dimer of all the patients were measured at the 3rd day before operation and at the 3rd, 7th,14th days after operation. Lower limbs DVT were observed by ultrasound at the 3rd, 14th days postoperatively. Perioperative bleeding volume of patients were compared between two groups.

RESULTSThere was no statistical difference in the serum D-dimer concentration and lower limbs DVT between two groups at the 3rd day before operation (P > 0.05). There was no statistical difference in perioperative bleeding volume between two groups (P > 0.05). In ultra-early group, Serum D-dimer concentration at the 3rd, 7th days after operation was respectively (351.00 +/- 104.34), (412.31 +/- 106.95) microg/ml; and in postoperative group, the item was respective (419.34 +/- 145.38), (509.16 +/- 146.05) microg/ml; serum D-dimer concentration in ultra-early group was lower than postoperative group (P < 0.05). There was no significant differences in serum D-dimer concentration at the 14th day after operation between two groups (P > 0.05). Incidence of DVT in postoperative group was 22.5%, which was higher than that of ultra-early group at the 14th day after operation (P < 0.05). There was no significant differences at the 3rd day after operation between two groups (P > 0.05).

CONCLUSIONCompared with postoperative application with IPC, ultra-early application with IPC could reduce the level of serum-dimer and the incidence of DVT without increase perioperative blood of intertrochanteric fracture in elder patients.

Aged ; Aged, 80 and over ; Case-Control Studies ; Female ; Fibrin Fibrinogen Degradation Products ; analysis ; Hip Fractures ; surgery ; Humans ; Intermittent Pneumatic Compression Devices ; Male ; Postoperative Complications ; prevention & control ; Time Factors ; Venous Thrombosis ; prevention & control