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Objective:To investigate the influences of low molecular weight heparin therapy on lung function, coagulation function and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease complicated with lung cancer.Methods:Sixty patients with acute exacerbation of chronic obstructive pulmonary disease complicated with lung cancer were gathered and randomly grouped into a routine group (30 cases) and a heparin group (30 cases). The patients in the routine group were given symptomatic treatment, and the patients in the heparin group were given low molecular weight heparin treatment on the basis of the symptomatic treatment, 4 100 iu/12 h. The coagulation function [activated partial thromboplastin time (APTT), prothrombin time (PT), D-dimer], blood gas analysis indexes [blood oxygen saturation (SaO 2), carbon dioxide partial pressure (PaCO 2), blood oxygen partial pressure (PaO 2) ], vascular endothelial function [nitric oxide (NO), endothelin 1 (ET-1), intercellular adhesion molecule-1 (ICAM-1) ], lung function [forced expiratory volume in first second (FEV1), forced vital capacity (FVC), ratio of FEV1 to predicted value (FEV1%) ], C-reactive protein (CRP), dyspnea (mMRC score) and survival were compared. Results:Compared with those before treatment, the levels of APTT [ (18.46±1.87) vs (11.58±1.25) s, (18.11±1.82) vs (15.57±1.58) s],PT[ (29.53±3.01) vs (22.57±2.36) s, (29.14±2.93) vs (25.48±2.61) s], D-dimer [ (842.59±85.12) vs (435.62±44.57) g/L, (846.63±84.75) vs (551.79±55.64) g/L],PaCO 2[ (58.79±5.92) vs (42.53±4.26) mmHg, (59.14±5.96) vs (50.38±5.07) mmHg],ET-1[ (106.78±10.72) vs (65.37±6.64) ng/L, (105.96±10.61) vs (72.53±7.31) ng/L],ICAM-1[ (231.48±23.35) vs (142.63±14.57) μg/L, (228.79±23.12) vs (165.48±16.72) μg/L], CRP [ (80.39±18.53) vs (9.77±2.08) mg/L, (80.64±19.17) vs (14.86±3.16) mg/L] and mMRC [ (2.64±0.31) vs (1.42±0.22) points, (2.71±0.34) vs (1.78±0.27) points] in both groups were greatly decreased after treatment ( P<0.05), and compared with the routine group, the heparin group were greatly lower ( P<0.05). Compared with those before treatment, the levels of SaO 2[ (0.54±0.15) vs 0.82±0.24) mmHg, (0.56±0.16) vs (0.67±0.20) mmHg],PaO 2[ (56.32±5.65) vs (80.47±8.12) mmHg, (56.89±5.72) vs (72.13±7.25) mmHg],NO[ (54.31±5.46) vs (96.78±10.02) μmol/L, (53.27±5.35) vs (85.64±8.62) μmol/L],FEV1[ (1.21±0.32) vs (1.89±0.45) %, (1.25±0.34) vs (1.57±0.41) %],FVC[ (3.41±0.35) vs (3.78±0.42) L, (3.37±0.32) vs (3.56±0.36) L],FEV1%[ (80.74±8.15) vs (88.46±8.75) %, (79.53±8.02) vs (83.82±8.41) %] in the two groups after treatment were greatly increased ( P<0.05), and compared with the routine group, the heparin group were greatly increased ( P<0.05). A 3-year follow-up of the patients showed that there were 11 survivors in the heparin group (accounting for 36.67%), which was more than that of the conventional group (7 survivors, accounting for 23.33%) ( χ2=8.310, P=0.004) . Conclusion:Low molecular weight heparin can effectively enhance the coagulation function, pulmonary function and vascular endothelial function, regulate blood gas indexes, ameliorate dyspnea in patients with acute exacerbation of chronic obstructive pulmonary disease and lung cancer, and improve patient prognosis.
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Objective To provide objective parameters for differentiating pancreatic cystic tumors via using computed tomography texture analysis (CTTA) to quantify the special imaging features of pancreatic cystadenomas.Methods Enhanced CT images of pancreas from patients who were admitted in Department of Radiology in First Hospital affiliated with Zhejiang University and First People's Hospital of Hangzhou City and pathologically diagnosed as pancreatic serous cystadenomas (n =48) and mucinous cystadenomas (n =34) from January 2009 to December 2016 were retrospectively analyzed.Regions of interest were drawn on the parenchymal phase CT images in 5 slices according to the border of the tumors.Mean grey level intensity (M),variance (V),entropy (E),skewness (Ske) and kurtosis (Kur) were obtained from fine texture (σ =1.0) to coarse texture (σ =2.5).Receiver operating characteristic (ROC) curve for texture parameters with statistically difference was drawn,and the area under curve (AUC),diagnostic sensitivity and specificity were calculated.The diagnostic accuracy of senior and junior doctors was compared with the traditional CT analysis method.Results Reliability coefficient of the two radiologists was 0.809 ～ 0.997 with high consistency.Compared with mucinous cystic tumors,serous cystadenomas had a significantly different V (5.93 ± 9.02 vs 1.29±0.62),E (2.39±0.61 vs2.02±0.39) and Kur(30.18 ±42.55 vs 8.80-±4.34) in Ske0 of 2.5 (P ＜0.05),and there were no statistically significant differences on other parameters.The AUC of differential parameters for diagnosing two kinds of cystic tumors ranged from 0.56 to 0.84.The diagnostic accuracy of the traditional CT analysis method by junior doctor and senior radiologist was 60％ and 71％,respectively.Conclusions CTTA can not only effectively quantify the heterogeneity of pancreatic cystadenomas,but also is effective in the differentiation.
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Objective:To investigate the effects of ginkgo biloba tablets plus relevant mechanism on HPA axis in patients with steroid-dependent asthma.Methods:80 patients with steroid-dependent asthma were divided into control group and experimental group at random,40 cases in every group.The control group were treated with pulmicort respules(1 mg/d) ,patients in the experiment group were given ginkgo biloba tablets in addition to routine treatment(120 mg/d).The therapeutic courses were both 12 weeks.The effective rate of reducing hormone,lung function,the plasma concentrations of ACTH and COR and the levels of PBMC GCR were deter mined before and after treatment.Results:The effective rate of reducing hormone was 89.47%in experimental group,which was 66.67%in control group.There were significant difference at the tows groups(P0.05).After treatment,the lung function, the levels of plasma concentrations of COR and the levels of PBMC GCR were increased significantly than control group( P<0.01,P<0.05),the levels of plasma concentrations of ACTH was decreased significantly than control group(P<0.01).There was a significant positive correlation between the value of FEV1/FVC and the plasma concentrations of COR,the levels of PBMC GCR( r=0.724,0.632, P<0.01).There was a significant negaitive correlation between the value of FEV1/FVC and the plasma concentrations of ACTH( r=-0.668,P<0.01).Conclusion:Ginkgo biloba tablets combined with routine treatment therapy can increase the effective rate of reducing hormone in patients with steroid-dependent asthma,which can improve the lung function maybe by regulate the HPA axis and upgrade the levels of GCR.