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Important/potential value of macrolides has been proved in the management of chronic respiratory diseases by increasing basic and clinical trials.Through three face-to-face discussions,10 experts examined important data and drafted this consensus related to macrolides:(1) mechanism of nonantiinfective effects;(2) clinical use in chronic respiratory diseases;(3) cautions of long-term use.The mechanism out of non-antiinfective effects includes anti-inflammatory effect,modifying airway secretion,immune-regulation related to antibacterial effect,corticoid saving effect and anti-viral effect.The efficacy of long-term use of low-dose macrolides is definitely confirmed in diffuse panbronchiolitis,chronic rhinosinusitis.It is considerably used in bronchiectasia,cystic fibrosis,severe asthma and chronic obstructive pulmonary disease.Further studies should be conducted in cryptogenic organizing pneumonia and respiratory viral infection.It should be paid attention to its possible adverse effects (including drug interactions,cardiac toxicity,ototoxicity and disturbance of intestinal flora) and drug resistance in long-term use.A Chinese consensus for non-antiinfective effects and clinical use of macrolides is developed for the first time,which aims to expand their rational use and the further research.
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The paper proposes and realizes a programmable wireless neural stimulation system which can be used as a solution of functional electrical stimulation to treat neural diseases. The system is composed of two parts: controller and neural stimulator. The controller can transmit pulse parameters to the stimulator wirelessly, and the stimulator can generate bidirectional pulses with charge balance. The simulator takes use of ADCs to sample on the bidirectional pulse output, which compared with preset amplitude to the DAC output voltage to realize the voltage calibration. Through the test, the whole system works stably and the output of the biphasic charge balanced circuit is definite. The stimulator output ranges from 0 to 5 V ajustably, and the frequency ranges from 1 Hz to 200 Hz ajustably, while the pulse width ranges from 500 μs to 1500 μs ajustably. The duration of the stimulation can be set from 10 s to 10 min.
Subject(s)
Electric Stimulation , Equipment Design , Wireless TechnologyABSTRACT
<p><b>OBJECTIVE</b>To investigate the impact of the weekday of surgery on the prognosis of patients with colorectal cancer.</p><p><b>METHODS</b>A retrospective analysis was conducted in patients with colorectal cancer who underwent radical resection in Fudan University Shanghai Cancer Center(FUSCC) between January 2007 and December 2013, and 4 971 patients were identified eligible. Statistical analyses were carried out between patients who received surgery on Monday to Thursday and those who received surgery on Friday. Chi-square test was used to analyze the relationship between clinicopathological parameters and day of surgery. T test was used to compare continuous variables between groups. The 5-year overall survival (OS) and disease-free survival (DFS) were calculated by the Kaplan-Meier method, and compared by log-rank test.</p><p><b>RESULTS</b>There were no statistically significant differences between two groups in age, gender and pathological grade et al (all P>0.05). However, the number of dissected lymph node was higher in patients who received surgery on Monday to Thursday (median 16) compared with patients who received surgery on Friday (median 14), with statistically significant difference (P=0.038). The 5-year OS and DFS in all eligible patients were 78.0% and 55.0%, respectively. 5-year OS of patients in Monday to Thursday surgery group and Friday surgery group was 79.6% and 77.2%, while 5-year DFS in two groups was 57.8% and 50.4%. There were no significant differences in OS and DFS between two group, with P=0.882 and P=0.210, respectively. Subgroup analyses were conducted according to different pathological stages. 5-year OS of patients at stage I( in Monday to Thursday surgery group and Friday surgery group was 94.7% and 90.6% (P=0.742) and 5-year DFS was 85.1% and 78.2% (P=0.765). 5-year OS of patients at stage II( in two groups was 85.5% and 83.7% (P=0.496) and 5-year DFS was 72.7% and 62.8% (P=0.121). 5-year OS of patients at stage III( in two groups was 69.7% and 69.4%(P=0.354) and 5-year DFS was 41.8% and 37.4% (P=0.976). No statistically significant differences manifested in subgroup analyses.</p><p><b>CONCLUSION</b>Patients with colorectal cancer undergoing surgery on Monday to Thursday have similar long-term prognosis with those on Friday.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , China , Colorectal Neoplasms , General Surgery , Disease-Free Survival , Lymph Node Excision , Neoplasm Staging , Prognosis , Retrospective Studies , Time FactorsABSTRACT
Objective To explore the correlation between the expressions of matrix metalloproteinase -9 (MMP-9), Toll-likeReceptor 4 ( TLR4) and lung revascularization in patients with chronic obstructive pulmonary disease .Methods Lung tissues frompatients with chronic obstructive pulmonary disease (COPD) (COPD group,n =25) and those without COPD (non-COPD group,n =25) were obtained from surgically resected specimens .The ratio of the area of the wall to that of the pulmonary arterioles (WA %) andthe ratio of the thickness of the wall to the external diameter of the pulmonary arterioles (WT %) were analyzed by computer-based imageanalysis system.Immunohistochemical technique was applied to investigate the expressions of TLR 4, proliferative cell nuclear antigen(PCNA) and MMP-9 in vascular smooth muscle cells.Results ⑴ The inflammatory infiltration degree, WA %, and WT %were significantly higher than that of non -COPD group ( P <0.01), respectively.⑵Compared with non-COPD group, the expressionsof PCNA, TLR4, and MMP-9 in vascular smooth muscle cells were increased significantly ( P <0.01).⑶The expressions of TLR4,MMP-9 had a positive correlation with WA%, WT%, degree of inflammatory infiltration, and the expression of PCNA ( r =0.67,0.74,0.47,0.44;0.59,0.71,0.61,0.33, P <0.01), up-regulated expression of TLR4 was closely related with the expression of MMP-9 ( r =0.55, P <0.01).Conclusions The pulmonary arterioles of COPD patients showed marked inflammatory and arteriolemuscularization, the TLR4 might aggravate inflammation,induced upregulation of MMP-9 expression, played an important role in the pulmonary vascular remodeling process.
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Objective To explore the role and correlation of peroxisome proliferator-activated receptor γ (PPAR-γ) and Toll-like receptor 4 (TLR4) on pulmonary vascular remodeling of chronic obstructive pulmonary disease(COPD).Methods Ninety male patients who underwent surgery for squamous cell carcinoma were enrolled as our subjects.All patients were divided into COPD group and uon-COPD group based on lung function,and 45 cases in each group.Peripheral lung tissues without tumor infiltrated after lobectomy were taken to assess the degree of arterial inflammation,percentage of wall thickness to vessel diamater (WT％) and percentage of wall area to total vascular area(WA％) were measured through Hematoxylin-Eosin(HE) staining under light microscope.The expression of PPARγand TLR4 were determined by immunohistochemistry.Results The distribution of WA％ and WT％ in COPD group were (43.98 ±6.43)％ and (27.37 ±3.34)％,higher than that of non-COPD group ((26.09 ± 2.82) ％,t =-13.949,P =0.000 ; (15.57 ± 1.75) ％,t =-7.140,P =0.000).The expression of PPAR-γand TLR4 in COPD group were (10.74 ± 8.81) ％,(3 1.41 ± 14.67) ％ respectively,and (28.22 ± 15.08)％,(4.67 ± 4.47)％ in non-COPD group.The differences were statistic significantly(t =5.483,P =0.000; t =-9.555,P =0.000).And there was negative correlation between the expression of PPARγand TLR4 (r =-0.404,P ＜ 0.01).Conclusion The pulmonary vascular of COPD patients showed the obviously inflammatory cell infiltration,fibrosis and proliferation,and PPAR-γ and TLR4 participate in the regulation of pulmonary vascular remodeling.
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OBJECTIVE@#To explore the correlation between snoring and carotid artery plaques in the elderly population.@*METHOD@#Sixty-seven patients with snoring and 61 healthy volunteers accepted questionnaire on sleep apnea were analyzed in the survey. Multivariate Logistic regression analysis was used to analyze the factors affecting carotid artery plaques.@*RESULT@#Among the non-snorers (n = 61), mild snorer (n = 18), moderate snorers (n = 24) and severe snorers (n = 25) groups, the prevalence of carotid artery plaques in four groups were 19.7%, 44.4%, 62.5%, 84.0% respectively. There was statistically significant differences between groups. After multivariable adjustment, the moderate and severe snorers were still risk factors affecting carotid artery plaques, the OR (95% CI) values were 4.378 (1.181-16.225), and 19.572 (3.316-115.528) respectively.@*CONCLUSION@#The moderate and severe snoring in the elderly population were relevant to the increased prevalence of carotid artery plaques, and was a risk factor on carotid artery plaques.