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Objective To explore the influence of biphasic positive airway pressure (BiPAP) ventilation on lung function and serum cytokines in the treatment of patients with bronchial asthma .Methods 107 patients with moderate to severe bronchial asthma were divided into two groups according to the random number table method .The control group (n =54) received general supportive treatment such as expectorant ,suck oxygen,balancing the water and electrolyte,anti-infection treatment.The observation group (n =53) was given BiPAP non-invasive ventilation based on the treatment of the control group .After treatment for 7 days,the clinical efficacy,improvement of lung func-tion and serum cytokines between the two groups were compared .Results The effective rate of the observation group was 88.68%,which was higher than 72.22% of the control group,the difference was statistically significant (χ2 =4.592,P =0.032).The total effective rate of the observation group was 96.23%,which was higher than 83.64% of the control group,the difference was statistically significant (χ2 =4.677,P =0.031).The FEV1 ,FEV1 /FVC,PEF levels of the observation group after treatment were (1.95 ±0.27)L,(65.33 ±6.21)%,(5.55 ±0.34)L/s,respec-tively,which were higher than those of the control group [(1.66 ±0.24)L,(58.24 ±6.09)%,(4.70 ±0.39)L/s], the differences were statistically significant (t =-5.872,-5.961,-12.016,all P <0.05).The serum levels of IL-4,IL-5,IL-13,IL-17,IFN-γof the observation group after treatment were (136.77 ±84.63) pg/mL, (145.06 ±67.33) pg/mL,(12.67 ±4.02) ng/mL,(7.15 ±0.87) ng/L,(507.51 ±169.33) ng/L,respectively, which were lower than those of the control group [(186.95 ±81.36) pg/mL,(193.35 ±63.20) pg/mL,(14.59 ± 3.97)ng/mL,(7.76 ±0.99) ng/L,(655.76 ±183.95) ng /L],the differences were statistically significant (t =3.136,P =0.000;t =3.832,P =0.000;t =2.497,P =0.015;t =3.389,P =0.000;t =4.341,P =0.000).Conclusion BiPAP non-invasive ventilation in the treatment of patients with moderate to severe bronchial asthma can effectively improve the lung function and reduce inflammatory cytokines ,which has important reference value in clinic .
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Objective To analyze the clinical and pathological features,diagnosis and differential diagnosis,treatment and prognosis of retroperitoneal angiomyolipoma (RAML).Methods The clinical data of 3 cases diagnosed with RAML,during 2012 to 2014 were studied.The expression of AE1/AE3,Vimentin,HMB45,Melan-A,S-100,SMA,CD10,CD34 and Ki-67 were detected by full automatic immunohistochemistry instrument.Four cases were followed up,the relevant published articles were reviewed as well.Results Four patients contained 3 female and 1 male.Three patients of them were found because of abdominal pain and discomfort symptom,1 case was found on examination.All of them more than 10 cm,and the boundary was not clear.Tumor resection + nephrectomy were used for treatment.Macroscopically,the tumor were consisted of fat,muscle cells and thick walled blood vessels.But they had different proportion.Immunohistochemically:AE1/AE3 negative; Vimentin,HMB45,Melan-A,SMA were positive; S-100 was positive in 3 cases and negative in 1 case; Ki-67 proliferation index were ＜5％.Conclusions The RAML is a rare benign retroperitoneal stromal tumor,which has a complex and diverse pathological organizations.The diagnosis can be made by special immune phenotype in combination with microscopic appearance.