Forensic Analysis of 43 Medical Disputes Caused by Death after Cardiac Surgery / 法医学杂志

Objective To explore the causes and characteristics of medical disputes caused by death after cardiac surgery and to analyze the pathological changes after cardiac surgery and the key points of forensic anatomy, thus to provide pathological evidence for clinical diagnosis and treatment of cardiac surgery and judicial appraisal as well as reference for the prevention of medical disputes in such cases. Methods Forensic pathological cases of medical disputes caused by death after cardiac surgery which were accepted by the Center for Medicolegal Expertise of Sun Yat-Sen University from 2013 to 2018 were analyzed retrospectively from aspects such as causes of death, pathological diagnosis, surgery condition, medical misconduct, and so on. Results The causes of death after cardiac surgery of 43 patients were abnormal operation, low cardiac output syndrome, postoperative infection, postoperative thrombosis, and other diseases. Among the 43 cases, there were 18 cases without medical fault while 25 cases had medical fault. Conclusion The medical disputes caused by death after cardiac surgery are closely related to the operative technique and postoperative complications. The causes of medical faults include defects in diagnosis and treatment technique, as well as unfulfillment of duty of care.

Develop standardized lung function training to help prevent and control chronic respiratory diseases / 中国实用内科杂志

Pulmonary function examination is one of the key techniques in the diagnosis and treatment of respiratory diseases, and it is also an appropriate technology for the comprehensive prevention and control of chronic respiratory diseases. However, the role and significance of pulmonary function examination in the diagnosis and treatment of respiratory diseases are not well understood by clinicians in China, and the lack in professional training and evaluation of pulmonary function examination practitioners in China leads to poor quality of pulmonary function examination, which seriously restricts the clinical application of pulmonary function examination in China, and seriously affects the early detection, early diagnosis and comprehensive prevention and control of chronic airway diseases.Therefore, it is of great significance to carry out standardized training on clinical application and quality control of pulmonary function examination, which is helpful to promote the standardization of pulmonary function examination techniques in China, improve the quality level of pulmonary function examination in China, further promote the popularization of pulmonary function examination, and better play the guiding role of pulmonary function examination in the diagnosis and treatment of clinical diseases, so as to improve the diagonosis and treatment level of respiratory system diseases in China.

Overview of standardized training programme for clinical application and quality control of pulmonary function testing in China / 中国实用内科杂志

Pulmonary function testing(PFT) is an appropriate technique for comprehensive prevention and control of chronic airway diseases. In 2015, the National Clinical Research Center for Respiratory Diseases launched the national standardized training and assessment programme on clinical application and quality control of PFT. There are four steps for the overall programme. The first step is to establish the standard and outline of standardized training for PFT. The second step is to carry out standardized training based on the established standard and outline. The third step is to conduct post-training assessment, evaluate the training effect, and certify the trainees who master the training content. The last step is to carry out quality control in those who have obtained the certification,and evaluate the application of training content in clinical practice. With the progress of the programme, clinicians' awareness of the importance of PFT will be increased, physicians' and techinicians' operate on skills and clinical application abilities of PFT will be promoted, while the qualities of PFT in China will be improved. It will be of great significance to the construction of Pulmonary and Critical Care Medicine(PCCM).

Association between awareness of smoking-related evidence and smoking cessation treatments provided by hospital chest physicians in Guangzhou, China: a multi-institutional cross-sectional survey / 中华流行病学杂志

<p><b>OBJECTIVE</b>Factors associated with smoking cessation interventions initiated by hospital chest physicians in China had not been studied. We examined if the physicians' awareness of emerging evidence regarding negative effects of smoking was associated with the initiation of smoking cessation.</p><p><b>METHODS</b>A cluster randomized cross-sectional survey was conducted from July 2011 to August 2011 in hospital-based chest physicians (n = 354) in Guangzhou, China.</p><p><b>RESULTS</b>Of those who responded (n = 354, 92.2%), 63.8% were aware of emerging evidence regarding negative effects of smoking and 64.5% initiated smoking cessation programs with their patients who smoked. Regarding the related awareness on smoking differed across physicians depending on their affiliation to evidence hospitals(χ(2) = 54.7, P > 0.001), i.e., primary (44.9%), secondary (55.1%)and tertiary hospitals (87.0%)was further supported by the related odds ratio (OR = 1.732, 95%CI:1.072-2.797, P < 0.05). Smoking status of physicians was related to their practice on smoking cessation, supported by the odds ratio (OR = 4.251, 95% CI:1.460-12.380, P = 0.008). Smoking cessation practice by physicians also depended on their affiliated hospitals. Physicians working at primary and secondary hospitals were less aware of the fact that smoking could reduce patients' responsiveness to inhaled corticosteroids than those working at the tertiary hospitals(χ(2) = 37.9, P > 0.001). Furthermore, these physicians would less frequently prescribed medication related to smoking cessation(χ(2) = 137.71, P < 0.001).</p><p><b>CONCLUSION</b>Physicians who were better aware of the health hazards of smoking might more actively provide smoking cessation advice in their clinics. The awareness might correlate with the hospital levels they worked and the smoking status while the the advice they provided might correlate with their educational background, job title, department affiliation and smoking status, but not with the level of hospitals.</p>

The modification of apoptosis correlated gene, protein and protein activity in rat hippocampus induced by benzoa pyrene sub-chronic exposure / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To observe the effects of subchronic exposure to benzo[a]pyrene (B[a]P) on the mRNA and protein expression levels of apoptosis-related genes (bax, bcl-2, caspase-3, caspase-6, and caspase-9) and the activities of Caspase-3, Caspase-6, and Caspase-9 in the hippocampal neurons of rats and to investigate the neurotoxic mechanism by which B[a]P induces the apoptosis of neurons.</p><p><b>METHODS</b>Fifty-two healthy SD rat were randomly divided into five groups according to preliminary neurobehavioral test results: blank control group, solvent control group, and 1.0, 2.5, and 6.25 mg/kg B[a]P exposure groups; the rats in exposure groups were intraperitoneally injected with B[a]P every other day for 90 days. The Morris water maze was used to test the learning and memory ability of rats; flow cytometry was used to measure the apoptosis ratio of hippocampal neurons; real-time quantitative PCR and Western blot were used to measure the mRNA and protein expression levels of apoptosis-related genes; spectrophotometry was used to measure the activities of their en-coded proteins.</p><p><b>RESULTS</b>Compared with the blank control group, solvent control group, and 1.0 mg/kg B[a]P exposure group, the 2.5 and 6.25 mg/kg B[a]P exposure groups hada significantly longer mean escape latency period (P < 0.05) and a significantly increased number of times of platform crossing (P < 0.05), and the 6.25 mg/kg B[a]P exposure group had significantly lower length and percentage of time spent in the platform quadrant (P < 0.05). The early apoptosis ratio rose as the dose of B[a]P increased (P trend < 0.05); the early apoptosis ratios of 1.0, 2.5, and 6.25 mg/kg B[a]P exposure groups were significantly higher than those of blank control group and solvent control group (P < 0.05). Compared with the blank control group, solvent control group, and 1.0 and 2.5 mg/kg B[a]P exposure groups, the 6.25 mg/kg B[a]P exposure group had significantly increased Bax expression (P < 0.05) and significantly decreased Bcl-2 expression and Bcl-2/Bax ratio (P < 0.05). The 2.5 and 6.25 mg/kg B[a]P exposure groups had significantly higher expression levels of Caspase-3 and Caspase-6 than the blank control group, solvent control group, and 1.0 mg/kg B[a]P exposure group (P < 0.05). The activities of Caspase-3, Caspase-6, and Caspase-9 were significantly higher in the 2.5 and 6.25 mg/kg B[a]P exposure groups than in the blank control group and solvent control group (P < 0.05). There was a positive correlation between the activities of Caspase-3, Caspase-6, and Caspase-9 and early apoptosis ratio of hippocampal neurons in rats (r = 0.793, P = 0.019; r = 0.886, P = 0.006; r = 0.773, P = 0.025). There were no significant differences in the mRNA expression of Bax, Bcl-2, Caspase-3, Caspase-6, and Caspase-9 among these groups (P > 0.05).</p><p><b>CONCLUSION</b>Subchronic exposure to B[a]P can induce apoptosis of hippocampal neurons; its mechanism may be related to the fact that B[a]P can induce upregulated expression of Bax, inhibit expression of Bcl-2, lead to decrease in Bcl-2/Bax ratio, induce upregulated expression of Caspase-3 and Caspase-6, and cause increase in the activities of Caspase-3, Caspase-6, and Caspase-9.</p>

Effects of subchronic benzoapyrene exposure on hippocampal cholinergic system in rats / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To observe the effects of subchronic benzo[a]pyrene (B[a]P) exposure on the neurobehavior and hippocampal acetylcholine (Ach) level, acetylcholinesterase (AChE) activity, and mRNA and protein expression of nicotinic acetylcholine receptor α7 subtype (nAChR α7) in rats, and to investigate the neurotoxic mechanism of B[a]P.</p><p><b>METHODS</b>Sixty healthy male SD rats were randomly divided into blank control group, solvent control group, and B [a]P exposure groups. Each rat in the exposure groups was intraperitoneally injected with B[a]P at 1.0, 2.5, or 6.25 mg/kg once every other day for 90 days. The learning and memory ability of the rats was examined by Morris water maze test and step-down test; the hippocampal Ach level was measured by alkaline hydroxylamine method; the AChE activity was measured by DNTB method; the mRNA and protein expression levels of hippocampal nAChR α7 were measured by quantitative PCR and Western blot.</p><p><b>RESULTS</b>The 2.5 and 6.25 mg/kg B[a]P exposure groups showed significantly lower learning and memory abilities than the blank control group and solvent control group (P < 0.05); also, the two groups had significantly lower hippocampal Ach levels than the blank control group, solvent control group, and 1.0 mg/kg B[a]P exposure group (P < 0.05). The 6.25 mg/kg B[a]P exposure group showed significantly lower hippocampal AChE activity than the blank control group, solvent control group, and 1.0 mg/kg B[a]P exposure group (P < 0.05). There were no significant differences in the mRNA and protein expression levels of nAChR α7 among all groups (P > 0.05). The hippocampal Ach level was negatively correlated with the mean escape latency period and total distance travelled (r = -0.567, P < 0.01; r = -0.503, P < 0.01) but positively correlated with the time in platform quadrant (r = 0.800, P < 0.01).</p><p><b>CONCLUSION</b>Subchronic B[a]P exposure may impair the learning and memory ability in rats, which is related to the downregulation of hippocampal Ach level.</p>

The inhibitory effects of arresten protein on tumor formation / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To examine the inhibitory effects of recombinant purified arresten on tumor formation.</p><p><b>METHODS</b>Purified arresten protein was incubated with human umbilical vein endothelial cells (HUVECs) and HeLa cells in vitro. The effect on proliferation of HUVECs and HeLa cells was examined using 3-(4,5)-dimethylthiahiazo (-z-y1)-3,5-di-phenytetrazoliumromide assay, and apoptosis of these cells monitored by flow cytometry. The effect on migration of HUVECs and HeLa cells was examined by Boyden chamber. Twenty colon carcinoma-bearing C67BL/6 mice were used to investigate the antitumor effects of arresten protein. The mice were randomly divided into arresten treatment group (n = 10) and control group (n = 10). The microvessel densities of the tumors were measured by immunohistochemical staining with anti-CD31 monoclonal antibody.</p><p><b>RESULTS</b>Arresten inhibited the proliferation and migration of HUVECs in a dose-dependent manner while promoting apoptosis. However, arresten had no significant effects on the proliferation and apoptosis of HeLa cells. The migration of HeLa cells was modestly inhibited by arresten. The arresten treatment group of mice showed no weight loss or unusual behavior during the course of treatment, and the tumor growth was significantly decreased; in contrast, the control group of mice exhibited rapidly growing tumors and cachexia. A dramatically decreased microvessel density in tumor tissues was found in arresten-treated mice compared with that in the control mice.</p>

The relationship between single nucleotide polymorphisms of JWA gene and susceptibility to hypertension in workers exposed to heat stress / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study the relationship between JWA polymorphisms and the susceptibility to hypertension in workers exposed to heat stress.</p><p><b>METHODS</b>The exposure group included 158 steelworkers and rollers and 76 workers unexposed to heat stress served as control group. The general information was collected according to a questionnaire and the blood pressure was examined for all subjects. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was used to analyze the site 76 in promoter and site 723 in the 3rd exon of JWA gene in the peripheral lymphocytes. PHASE 2.0 software was utilized to calculate the haploid type.</p><p><b>RESULTS</b>In the exposure group, JWA76 G/G genotype frequencies of sub-group with normal blood pressure, sub-group with higher blood pressure and sub-group with hypertension were 82.35%, 69.70% and 65.00%, respectively, there were significant differences among 3 sub-groups (P < 0.05). JWA 76 G/G genotype frequencies decreased with blood pressure (χ² = 4.86, P = 0.027). The multiple logistic regression analysis showed that the subjects with G/C genotype were compared to the subjects with G/G genotype in the exposure group, the adjusted OR value was 3.67 (95%CI: 1.21 approximately 11.05) for the risk of hypertension and higher blood pressure. the subjects with GG/CT haploid type were compared to the subjects with non-GG/CT haploid type in the exposure group, the adjusted OR values for the risks of hypertension and higher blood pressure were 8.30 (1.39 approximately 49.44) and 8.55 (1.53 approximately 47.48), respectively.</p><p><b>CONCLUSION</b>The gene polymorphisms at site 76 and GG/CT haploid type of JWA gene were associated with hypertension in workers exposed to high temperature.</p>

Role of necroptosis in aluminum induced SH-SY5Y cell death / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study whether necroptosis exists or not in neural cell death induced by aluminum.</p><p><b>METHODS</b>SH-SY5Y cells were treated with 4 mmol/L AlCl(3) x 6H(2)O The cell viability was determined with CCK-8 kit after treated with Nec-1 at different dosages (0, 30, 60, 90 micromol/L). Mitochondria membrane potential (MMP), content of reactive oxygen species (ROS), and apoptotic rate/necrotic rates were measured with cytometry.</p><p><b>RESULTS</b>Nec-1 ameliorated the necrotic-like cell morphology, the cell viability were 0.28 +/- 0.05, 0.58 +/- 0.03, 0.68 +/- 0.04, and 1.03 +/- 0.17, there were significant differences between the Nec-1 treated groups and that of controls (t values were 3.25, 3.36, 4.56; P < 0.05). After Nec-1 treatment, the necrotic rates were 16.46% +/- 0.54%, 10.40% +/- 0.64%, 5.43% +/- 0.68%, and 6.28% +/- 0.35%, there were significant differences between the Nec-1 treated cells and that of controls (t values were 3.62, 7.32, 6.96; P < 0.05); while the apoptotic rates were 8.68 +/- 0.36, 7.66 +/- 0.53, 5.68 +/- 0.41, and 4.13 +/- 0.41, there was no significant difference among the groups (F = 6.33, P = 0.11). Cytometry had shown the increased cell MMPs after Nec-1 treatment, which were 67.54 +/- 6.36, 49.42 +/- 5.96, 84.79 +/- 6.86, and 95.51 +/- 7.01, there were significant differences as comparing MMPs of the middle and high dosage of Nec-1 treated cells with those of controls (t values were 3.21, 4.01; P < 0.05); while ROS contents in the Nec-1 treated SH-SY5Y cells were 54.07 +/- 3.32, 52.79 +/- 2.36, 54.68 +/- 1.91, and 59.23 +/- 2.96, there was no significant difference among the groups (F = 5.26, P = 0.19).</p><p><b>CONCLUSION</b>Nec-1, as a specific inhibitor of necroptosis, might effectively block the cell death pathway induced by aluminum, it indicates that necroptosis should be one of the major causes of the SH-SY5Y cell toxicity induced by aluminum, and necroptosis also plays an important role in aluminum induced SH-SY5Y cell death.</p>

Remifentanil combined with low-dose ketamine for postoperative analgesia of lower limb fracture: a double-blind, controlled study / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the adjuvant effect of intraoperative and postoperative low-dose ketamine administration to remifentanil consumption in patient-controlled analgesia (PCA) for lower limb fracture.</p><p><b>METHODS</b>A total of 200 patients with lower limb fracture receiving the surgery were randomly divided into 4 groups. In Groups A, B and C, patients received 0.5 mg/kg ketamine infusion under general anesthesia, and ketamine in a dose of 0.1 mg/ kg, 0.05 mg/kg, 0.01 mg/kg per hour continuously for 24 hours after surgery, respectively. The control group (Group D) received an equivalent volume of normal saline only. With 20 microgram/ml remifentanil in normal saline, postoperative PCA was administered with a background infusion at 2 ml/h following 2 ml as a loading dose and 1ml demand dose with a 3-minute lockout period. Remifentanil consumption, 11-point visual analog scale (VAS) scores, global satisfaction score (GSS), and side effects were also recorded by the acute pain service.</p><p><b>RESULTS</b>Cumulative PCA remifentanil consumption in Groups A and B were (1378+/-77) microgram and (1531+/-402) microgram, significantly lower than (1807+/-510) microgram and (1838+/-523) microgram in Groups C and D (P<0.01). VAS scores in Groups A and B were significantly lower than those in Groups C and D (P<0.01). In the first 12 hours after operation, GSS was improved (P<0.01). No respiratory depression was observed. No significant difference in side effects was observed among groups.</p><p><b>CONCLUSION</b>Low-dose ketamine can relieve postoperative pain and moderately decrease remifentanil consumption for PCA, with no obvious side effects of ketamine.</p>

Peak inspiratory flow generated through different analogue dry powder inhalers in Shenzhen healthy preschool children / 中华儿科杂志

<p><b>OBJECTIVE</b>Dry powder inhalers (DPIs) are increasingly being used to deliver drugs for the treatment of asthma. It is known that DPIs require a crucial minimal inspiratory flow. Previous studies have demonstrated that the peak inspiratory flow (PIF, L/min) through a DPI is dependent on the type of device, the age of the patient, and the level of bronchial obstruction. However, the peak inspiratory flow of healthy preschool children in China remains scant in the literature. The present study aimed to analyze the ability of inspiring flow through the resistance state of ordinary use inhaler in Shenzhen healthy preschool children by measuring the peak inspiratory flow through the different analogue dry powder inhalers and go further into the relationship between it and the age, weight and forced expiratory volume of the children.</p><p><b>METHOD</b>A survey in 370 healthy preschool children aged 3 to 6 years (75 children aged 3 years, 104 children aged 4 years, 100 children aged 5 years and 91 children aged 6 years) was carried out in Shenzhen. Peak inspiratory flow (PIF) was measured without and with resistances, which mimicked the internal resistances of several inhalers, Diskus, Turbuhaler, Autohaler, Surehaler by PIF meter (In-check DIAL) and then data PIF-N, PIF-D, PIF-T, PIF-A and PIF-S were obtained. Peak expiratory flow (PEF) was measured by PEF meter (MicroPeak, USA). These two measurements were made in a well-controlled setting, and at least three attempts were recorded to establish maximum achievement. Six spirometry parameters forced vital capacity (FVC), forced expiratory volume at 0.5 second (FEV 0.5), forced expiratory volume at 0.75 second (FEV 0.75), forced expiratory volume at one second (FEV1), maximal mid expiratory flow rate (FEF 25 - 75, PEF were measured by using COSMED spirometry of Italy and the FVC measurements should be around the quality control for spirometry in preschool children which we suggested and published in 2005. All data were expressed as mean +/- SD and analyzed with the statistical software SPSS 12.0 for Windows. Pearson's test was used for calculation of the significances of the correlation coefficients. Variance analysis was used for analysing the variability of inspiratory flows through the inhalers.</p><p><b>RESULTS</b>Results were obtained from 295 children aged 3 - 6 years who successfully finished the tests. The PIF-N, PIF-D, PIF-T, PIF-A and PIF-S were significantly different among the groups aged 3 yrs, 4 yrs, 5 yrs and 6 yrs. The peak inspiratory flow significantly increased with age. The PIF-N, PIF-D, PIF-T, PIF-A and PIF-S in the children of 110 cm height and above were significantly higher than those in the children below 110 cm height, so were the parameters between the children of 120 cm height and above and the children below 120 cm. PIF correlated significantly with age, height and weight and the Pearson coefficient was 0.3 - 0.5. The PIFs in different inhalers varied because of the different inner resistances. The minimum and optimum PIFs in resistances of Diskus, Autohaler and Surehaler could be achieved in almost all subjects, but those in resistances of Turbuhaler could be achieved in only 87.5% subjects, most of whom aged 3 yrs or below 100 cm height. There were good correlations between the PIFs in different resistances and main parameters of ventilation function (FVC, FEV 0.5, FEV 0.75, FEV1, FEF 25 - 75, PEF), PEF was the best among them (Pearson correlative coefficient was 0.6).</p><p><b>CONCLUSION</b>The inspiratory ability of the children can be predicted and assessed by using routine measurement of lung function of normal pre-school children. As to the pre-school children of varying ages, the variety of inspiratory ability should be considered completely in the selection of inhaler used during the treatment. The best inhaler suitable for them should be selected properly in order to obtain the best efficacy of treatment individually.</p>

Relationship between heat shock protein 72 and DNA genetic damage in peripheral blood lymphocytes of coke oven workers / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the relationship between heat shock protein 72 (Hsp72) and DNA genetic damage in peripheral blood lymphocytes of coke oven workers and the role of Hsp72 in protection of cells from genetic damage induced by coke oven emissions.</p><p><b>METHODS</b>Two hundred and sixty-seven coke oven workers and thirty controls without occupational PAHs exposure were investigated. Benzo[a]pyrene concentrations in the ambient air individually collected were assayed by high performance liquid chromatography (HPLC). Western Blot was used to measure Hsp72 levels and Comet assay was used to evaluate DNA damage degree. Personal information was collected by questionnaire.</p><p><b>RESULTS</b>The Hsp72 level (G+/-S(G)) and olive comet tail moment (G+/-S(G) of peripheral blood lymphocytes in high-exposure workers (1.24 +/- 0.42 and 4.49 +/- 1.24) were significantly higher than those in low-exposure workers (1.01 +/- 0.35 and 2.99 +/- 1.10, P < 0.05) and control (0.85 +/- 0.34 and 2.40 +/- 1.00, P < 0.05) respectively. The Hsp72 median level of all subjects was used as the limit to divide subjects into high Hsp72 level group and low Hsp72 level group. The rate with high Hsp72 level was 36.7%, 43.1% and 58.3% in control, low exposure and high exposure workers respectively and had a rising tendency following exposure level (P = 0.003). In high Hsp72 level group Hsp72 level in high exposure workers was significantly higher than that in control (P < 0.05), and there was a rising tendency along with the increase of exposed levels. But the olive comet tail moment had no significant difference among three exposed groups (P > 0.05). In low Hsp72 level group there no difference among three exposed groups about Hsp72 levels. The olive comet tail moment in high exposure workers was significantly higher than that in low exposure workers and control (P < 0.01) and high exposure workers in Hsp72 positive group and there was a rising tendency along with the increase of exposed levels. Hsp72 levels had strong negative correlation with the olive comet tail moment (r = -0.503, P < 0.01) in high exposure workers.</p><p><b>CONCLUSION</b>The coke oven emissions can induce hsp72 expression. Hsp72 play a role of protecting cells from DNA damage induced by coke oven emissions.</p>

Study on the prevalence rate of chronic obstructive pulmonary disease in northern part of Guangdong province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the prevalence of chronic obstructive pulmonary disease (COPD) and its risk factors in population over 40 years old in northern part of Guangdong province.</p><p><b>METHODS</b>Using uniform scheme, procedures and questionnaire, a cluster-randomized-sampling survey for the population aged over 40 years in a rural area of Shaoguan in the northern part of Guangdong province was performed. Spirometry was performed for every participant, followed by a bronchodilatation test when bronchial obstruction was present.</p><p><b>RESULTS</b>There were 1468 cases with complete data from 1498 people aged >or= 40 years including 640 males, 828 females with an average age of 54.3 years old. The total prevalence of COPD was 12.0%. The prevalence of COPD in males was significantly higher than that in females (18.3% vs. 7.1%, P < 0.01). Only 80.7% of the patients with COPD presented one or more symptoms as cough, phlegm, or dyspnoea. Underdiagnosis of COPD would be quite serious. Only 26.1% of the cases was previously diagnosed to have chronic bronchitis, emphysema, or COPD. Smoking was an important risk factor to COPD and 78.4% of the patients with COPD were smokers. However, relation of biomass and COPD called for further investigation.</p><p><b>CONCLUSION</b>Prevalence of COPD was much higher than expected in the northern part of Guangdong while smoking was an most important risk factor of COPD. Lung function test seemed to be of great importance to COPD diagnosis, especially in the earlier period of COPD.</p>

Feasibility and predicted equations of spirometry in Shenzhen preschool children / 中华儿科杂志

<p><b>UNLABELLED</b>Morbidity of chronic lung disease in young children is relatively high, and could increase in the future. Pulmonary function testing is used for clinical assessment of patients with suspected or obvious pulmonary disease to assess the severity of dysfunction and to evaluate therapeutic effectiveness. In the recent few years, forced expiratory parameters assessing lung function have been measured in older children. In order to assess abnormalities of lung function in preschool patients with respiratory disorders based on changes of forced expiratory parameters, adequate reference values are needed. However, such data in healthy preschool children remain scant in the literature.</p><p><b>OBJECTIVE</b>The aim of this study was to characterize the spirometry of preschool children and establish the normal lung function prediction equations for Chinese preschool children.</p><p><b>METHODS</b>A survey in 343 healthy preschool children (184 boys and 159 girls) aged 3 to 6 years (73 children aged 3 years, 96 children aged 4 years, 91 children aged 5 years and 83 children aged 6 years) was carried out in Shenzhen in 2004. Eleven flow volume tests parameters, i.e., forced vital capacity (FVC), forced expiratory volume at 0.5 second (FEV(0.5)), forced expiratory volume at 0.75 second (FEV(0.75)), forced expiratory volume at one second (FEV(1)), maximal mid expiratory flow rate (FEF(25%-75%)), peak expiratory flow (PEF), forced expiratory time (FET100%) were measured by using COSMED spirometry produced in Italy. Stepwise multiple regressions and non-linear regressions were carried out with the statistical software SPSS10.0 for Windows to identify the best predictors of lung function parameters using standing height, weight, age and gender as potential determinants.</p><p><b>RESULTS</b>Spirometric tests could be successfully carried out by using imagery methods in the following percentages of children: 69.9% of 3 to 4 years old, 70.8% of 4 to 5 years old, 92.3% of 5 to 6 years old and 91.6% of 6 to 7 years old children, 77.7% of the selected population (217/279) of children performed at least two acceptable tests respectively. The average forced expiratory time (FET) was 1.61 +/- 0.52 sec (x +/- s), the 5th percentile value was 0.9 sec, 18 of 279 (6.5%) children produced a FET less than 1 second. Forced expiratory volume in 0.50 and 0.75 sec (FEV(0.5), FEV(0.75)) were thus measured necessary in preschool children. All lung volumes and flow rates increased with age, height as well as weight growth in both gender groups. The correlation among most lung function parameters was higher in height than in age and weight in boys. Whereas the correlation among most lung function parameters was higher in age than in height and weight in girls. The regression equations of lung function were established. By comparison with the equations derived from this study and from studies by Nystad, it was found that there was a difference between the predicted values.</p><p><b>CONCLUSION</b>Spirometric testing is feasible in preschool children by using imagery methods and may be useful for both clinical practice and research. The correlation among most lung function parameters was higher in height than in age and weight in boys. Whereas the correlation among most lung function parameters was higher in age than in height and weight in girls.</p>

Protective effect of a bacterial extract against acute exacerbation in patients with chronic bronchitis accompanied by chronic obstructive pulmonary disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Immunostimulating agents made from bacterial extracts represent a class of medications that contains antigens derived from several bacterial strains and their potential ability to prevent bacterial infections results from the stimulation of the nonspecific component of the immune system. The present study investigated the effect of the oral immunostimulant Broncho-Vaxom, which includes material from eight different species of bacteria that are frequently present in the lower respiratory tract, on the frequency and severity of acute exacerbation in patients with chronic bronchitis accompanied by chronic obstructive pulmonary disease (COPD).</p><p><b>METHODS</b>Ninety patients with chronic bronchitis complicated with COPD were randomly divided into groups A and B. Forty-nine subjects in group A received oral capsules containing 7 mg Broncho-Vaxom, while 41 patients in group B received similar placebo capsules. Both groups took one capsule daily for the first 10 days of each month for 3 consecutive months. The frequency of acute exacerbation, symptom scores, and lung function were recorded for the following one year period.</p><p><b>RESULTS</b>There was a significant decrease in the incidence, duration, and severity of acute exacerbation, as well as a reduction in the course of antibiotics administered and in the dosage of bronchodilator and mucolytic agent in group A, as compared to group B (P < 0.05, respectively). Symptom scores for cough, sputum, dyspnea, as well as symptoms observed upon auscultation of the chest also improved significantly in group A as compared to group B (P < 0.05, respectively). The bacterial clearance rate in sputum cultures from patients who received no antibiotics for the first 3 months was also significantly higher in group A compared to group B (P < 0.01).</p><p><b>CONCLUSIONS</b>Orally administered Broncho-Vaxom is associated with a decrease in the incidence of acute exacerbation and a decrease in the need for antibiotics and symptomatic relief medications in patients with chronic bronchitis accompanied by COPD. Broncho-Vaxom is also associated with a decrease in symptom scores. Without causing any apparent adverse effects, this drug may also help to eradicate pathogenic bacteria in the airways.</p>

The study on induced expression of heat-shock protein(HSP)70s in lung carcinoma patients / 肿瘤研究与临床

Objective To analyze the expression level of HSP72 and HSP73,the subtypes of HSP70, in peripheral blood lymphocytes from lung carcinoma patients on both basic and heat injury conditions,and to explore the significance of HSP70 in the development of lung cancer.Methods Lung cancer patients were selected'as experimental group,and the health people with similar age,gender,vocational history and inhabi- tation to the experimental group were chosen as control group.The blood lymphocytes from both groups were isolated,cultured and treated with heat injury at either 37℃or 42℃.The expressions of HSP72 and HSP73 in the isolated lymphocytes were determined by Flow Cytometry.Results There were much higher expressions of HSP72 and HSP73 in control group(21.97?2.40 vs 12.77?0.66)than which in experimental group(HSP72 19.0?2.12 vs HSP73 11.74?0.68,P