Preliminary study of finger temperature recovery in patients with diabetes mellitus following cold stimulation.

OBJECTIVE: To explore the difference in temperature recovery following cold stimulation between participants with and without diabetes mellitus (DM). MATERIALS AND METHODS: The participants without (control group; n = 25) and with (DM group; n = 26) DM were subjected to local cold stimulation (10º C for 90 s). The thermal images of their hands were continuously captured using a thermal camera within 7 min following cold stimulation, and the highest temperature of each fingertip was calculated. According to the temperature values at different timepoints, the temperature recovery curves were drawn, and the baseline temperature (T-base), initial temperature after cooling (T0), temperature decline amplitude (T-range), and area under the temperature recovery curve > T0 (S) were calculated. Finally, symmetry differences between the two groups were analysed. RESULTS: No statistical differences in the T-base, T0, and T-range were observed between the DM and control groups. After drawing the rewarming curve according to the temperature of the fingertips of the patients following cold stimulation, the S in the DM group was significantly lower than that in the control group (p < 0.05). Furthermore, the asymmetry of the base temperature of the hand was observed in the DM group. CONCLUSIONS: Following cold stimulation, the patients with DM exhibited a different rewarming pattern than those without DM. Thus, cold stimulation tests under infrared thermography may contribute to the early screening of diabetic peripheral neuropathy in future.

Long head of biceps tendon transposition for massive and irreparable rotator cuff tears: A systematic review and meta-analysis.

BACKGROUND: Superior capsular reconstruction (SCR) with long head of biceps tendon (LHBT) transposition was developed to massive and irreparable rotator cuff tears (MIRCTs); however, the outcomes of this technique remain unclear. AIM: To perform a systematic review of biomechanical outcomes and a meta-analysis of clinical outcomes after LHBT transposition for MIRCTs. METHODS: We performed a systematic electronic database search on PubMed, EMBASE, and Cochrane Library. Studies of SCR with LHBT transposition were included according to the inclusion and exclusion criteria. Biomechanical studies were assessed for main results and conclusions. Included clinical studies were evaluated for quality of methodology. Data including study characteristics, cohort demographics, and outcomes were extracted. A meta-analysis was conducted of the clinical outcomes. RESULTS: According to our inclusion and exclusion criteria, a total of six biomechanical studies were identified and reported an overall improvement in subacromial contact pressures and prevention of superior humeral migration without limiting range of motion (ROM) after LHBT transposition for MIRCTs. A total of five clinical studies were included in the meta-analysis of LHBT transposition outcomes, consisting of 253 patients. The results indicated that compared to other surgical methods for MIRCTs, LHBT transposition had advantages of more significant improvement in ROM (forward flexion mean difference [MD] = 6.54, 95% confidence interval [CI]: 3.07-10.01; external rotation [MD = 5.15, 95%CI: 1.59-8.17]; the acromiohumeral distance [AHD] [MD = 0.90, 95%CI: 0.21-1.59]) and reducing retear rate (odds ratio = 0.27, 95%CI: 0.15-0.48). No significant difference in American Shoulder and Elbow Surgeons score, visual analogue scale score, and University of California at Los Angles score was demonstrated between these two groups for MIRCTs. CONCLUSION: In general, SCR with LHBT transposition was a reliable and economical technique for treating MIRCTs, both in terms of biomechanical and clinical outcomes, with comparable clinical outcomes, improved ROM, AHD, and reduced the retear rates compared to conventional SCR and other established techniques. More high-quality randomized controlled studies on the long-term outcomes of SCR with LHBT transposition are required to further assess.

Pregnancy-Induced Hemophagocytic Lymphohistiocytosis: A Case Report and Literature Review.

Hemophagocytic lymphohistiocytosis (HLH) is a rare but devastating disease characterized by dysregulated immune response and hyperinflammation. To our knowledge, pregnancy-induced HLH has been rarely reported in the literature. A 30-year-old pregnant woman presented persistent fever for 21 days since 17 weeks of pregnancy. The possible etiologies such as infection, autoimmune disorder, and malignancy had been ruled out based on a series of exhaustive examinations. The disease progressed despite the use of broad-spectrum antibiotics and dexamethasone. The patient was diagnosed as pregnancy-induced HLH, and finally recovered completely after termination of pregnancy by caesarean and the continuous use of glucocorticoid which played a crucial part in controlling hyperinflammation. Pregnancy-induced HLH could be fatal if effective treatment was not initiated timely. Further studies are needed to improve early diagnosis and etiology identification of HLH.

Long-term Outcome of Multiple Small-diameter Drilling Decompression Combined with Hip Arthroscopy versus Drilling Alone for Early Avascular Necrosis of the Femoral Head.

BACKGROUND: Avascular necrosis of femoral head (AVNFH) typically presents in the young adults and progresses quickly without proper treatments. However, the optimum treatments for early stage of AVNFH are still controversial. This study was conducted to evaluate the therapeutic effects of multiple small-diameter drilling decompression combined with hip arthroscopy for early AVNFH compared to drilling alone. METHODS: This is a nonrandomized retrospective case series study. Between April 2006 and November 2010, 60 patients (98 hips) with early stage AVNFH participated in this study. The patients underwent multiple small-diameter drilling decompression combined with hip arthroscopy in 26 cases/43 hips (Group A) or drilling decompression alone in 34 cases/55 hips (Group B). Patients were followed up at 6, 12, and 24 weeks, and every 6 months thereafter. Radiographs were taken at every follow-up, Harris scores were recorded at the last follow-up, the paired t-test was used to compare the postoperative Harris scores. Surgery effective rate of the two groups was compared using the Chi-square test. RESULTS: All patients were followed up for an average of 57.6 months (range: 17-108 months). Pain relief and improvement of hip function were assessed in all patients at 6 months after the surgery. At the last follow-up, Group A had better outcome with mean Harris' scores improved from 68.23 ± 11.37 to 82.07 ± 2.92 (t = -7.21, P = 0.001) than Group B with mean Harris' scores improved from 69.46 ± 9.71 to 75.79 ± 4.13 (t = -9.47, P = 0.037) (significantly different: t = -2.54, P = 0.017). The total surgery effective rate was also significantly different between Groups A and B (86.0% vs. 74.5%; χ2 = 3.69, P = 0.02). CONCLUSION: For early stage of AVNFH, multiple small-diameter drilling decompression combined with hip arthroscopy is more effective than drilling decompression alone.

[Preparation of Platelet-Rich Plasma from the White Slurry and Its Effect on MSC Proliferation].

OBJECTIVE: To isolate platelet-rich plasma(PRP) from the white slurry(WS), a depleted fraction of the clinical blood supply, so as to provide an easier method to harvest PRP for related studies and clinical use. METHODS: The protocols preparing PRP from whole blood and WS were compared. The morphological characteristics of the different PRPs were observed under transmission electron microscope; the expression of the platelet markers CD41a and CD42b were detected by the flow cytometry. Moreover, the ingredients of the PRPs were measured by using cytoanalyzer. for detecting the physiological function of the PRP, the harvested PRP were added to MSC culture and the cell proliferation was detected by using CCK-8 method. RESULTS: a large amount of PRP from WS was easier harvested. the WS-derived PRP shared similar morphological characteristics and ingredients as compared with whole blood-derived PRP. Importantly, the WS-derived PRP exhibited a higher expression of CD41a and CD42b than that of traditional PRP, which indicate that the WS is a promising reservoir for PRP. CONCLUSION: The WS can be used to prepare PRP, and the novel PRP share similar biological characteristics as traditional PRP prepared from whole blood. The present study provides an easier and economical method to harvest PRP and this findings may be helpful for PRP related studies.

[Effects of Shock Wave on the Proliferation and Osteogenic Differentiation of Human Bone Marrow Mesenchymal Stem Cells].

OBJECTIVE: To explore the effects of the shock wave on the capacity of mesenchymal stem cells(MSCs) to proliferate and differentiate into osteoblasts. METHODS: MSCs were isolated from the bone marrow of healthy donors. The human bone marrow MSCs(BM-MSCs) were divided into 3 groups including blank control group,osteoinduced group and shock wave group. The MSCs in blank control group were cultured with common mediam; the MSCs in osteoinduced group were treated with osteogenic agents and cultured; the MSCs in shock wave group were cultured with common medium and stimulated by shock wave. The morphology of MSCs in each groups were observed by micoscopy; the CCK-8 was used to detect the proliferation ability of MSCs; the alkaline phosphatase staining and von Kossa staining were used to evaluale the differentiation potential of MSCs in each groups. RESULTS: The results of CCK-8 revealed the shock wave could promote cell proliferation as compared with blank control group. The results of alkaline phosphatase and Von Kossa staining showed that the shock wave displayed a stronger ability to promote the human BMMSC differentiation into osteoblasts cells in comparison with the osteoinduced group. The blank control group was weakly positively stainined. CONCLUSION: The shock wave treatment can promote proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells.

[Clinical research on suture anchor fixation for the treatment of avulsion fracture of tibial intercondylar eminence under arthroscopy].

OBJECTIVE: To evaluate the early clinical effects of suture anchor fixation for the treatment of avulsion fracture of tibial intercondylar eminence under arthroscopy. METHODS: From July 2012 to January 2015, 22 patients with the avulsion fracture of tibial intercondylar eminence were treated with arthroscopic suture anchor fixation. There were 12 males and 10 females, with an average age of 22.8 years old(ranged, 18 to 33 years old). Nine patients had the fractures in the right knee and 13 patients had the fractures in the left knee. The mean duration from injury to surgery was 6.8 days(ranged, 3 to 11 days). According to the improved Meyers-McKeever classification, 13 cases were type II, 7 cases were type III, and 2 cases were type IV. The clinical outcomes were evaluated by the range of motion, the Lysholm score, the IKDC 2000 subjective knee score, the axial shift test, and the anterior drawer test. RESULTS: All the incisions healed by first intention, and no complications occurred. All the patients were followed up, and the mean duration was 32.8 months (ranged, 18 to 42 months). The knee range of motion was improved from preoperative (49.37±7.69) ° to (126.38±5.58) °at the latest follow-up(P<0.01). Lysholm score was improved from preoperative 43.4±5.6 to 79.2±6.2 at the latest follow-up(P<0.01). And the IKDC 2000 score was improved from preoperative 52.6±6.2 to 81.4±5.7 at the latest follow-up(P<0.01). At the latest follow-up, the patient underwent physical examination. One patient had a positive result of axial shift test at the 18th month after operation with grade II laxity of anterior cruciate ligament. One patient had a weakly positive result of anterior drawer test at the 24th month after operation. CONCLUSIONS: Absorbable suture anchor fixation for the treatment of avulsion fracture of tibial intercondylar eminence under arthroscopy can provide accurate reduction and stable fixation, which can be applied to treat all types of fractures including comminuted fracture, and it is not necessary to remove the implant in the second operation.

[Clinical research of popliteal cyst excision combined with debridement of the knee under arthroscopy with local anesthesia].

OBJECTIVE: To evaluate the clinical effects of popliteal cyst excision combined with debridement of the knee under arthroscopy with local anesthesia. METHODS: From February 2009 to August 2014, 52 patients with popliteal cysts were treated in our hospital, including 34 males and 18 females with an average age of 43.6 years old ranging from 14 to 62 years old; 29 cases were on the right knee and 23 on the left knee. Preoperative diagnosis was performed according to MRI findings and to determine whether other knee disorders were associated with the disease, 52 patients were diagnosed as popliteal cyst before operation; 23 cases of simple meniscus injury or cartilage injury, 18 cases of osteoarthritis, 7 cases of cruciate ligament injury, 2 cases of gouty arthritis, 1 case of rheumatoid arthritis, 1 case of pigmented villonodular arthritis. The preoperative clinical manifestations involved knee swelling in 21 cases, knee joint pain in 16 cases, joint lock in 8 cases, leg weakness in 4 cases, and knee joint snapping in 4 cases. Cyst size was 4.0 cm× 3.3 cm to 6.2 cm× 5.3 cm. According to the Rauschning and Lindgren standards, 1 case was grade I, 9 cases were grade II, 42 cases were class III. The rehabilitation plan should be made according to the patient's specific injuries and intraoperative management. During the postoperative follow-up, the postoperative curative effect was evaluated by the standard grading of Rauschning and Lindgren of popliteal cyst. RESULTS: All the incisions healed by first intention, and no complications occurred. All the cases were followed up from 25 to 64 months (averaged 39.6 months). For the Rauschning and Lindgren grading, 43 cases were grade 0, 8 cases were grade I, 1 case were grade II. CONCLUSIONS: Local anesthesia under arthroscopy and popliteal cyst removal knee joint cavity debridement is effective, less trauma, quick recovery, short term effect is good. The recurrence rate is also low because of the primary disease of the knee joint is also treated. After the operation, the rehabilitation plan should be made according to the intraoperative treatment and actively trained so as to recover at an early date.

[Clinical research of treating the avulsed fracture of humerus greater tuberosity using an arthroscopic double-row suture anchor fixation technique].

OBJECTIVE: To evaluate the early clinical effects of treating the avulsed fracture of humerus greater tuberosity using the double-row suture anchor fixation technique. METHODS: Total 20 patients with the avulsed fracture of the greater tuberosity of the humerus were treated from September 2009 to January 2013. There were 12 males and 7 females, with an average age of 46.8 years old(24 to 69 years old). Eleven patients had injuries on right shoulder joint and 8 patients had injuries on left side. The injury mechanism included 10 cases of traffic accident, 6 cases of sports injury, and 3 cases of falls. The mean interval from injury to surgery was 34.9 d (ranged, 3 to 72 d). The affacted arm was suspended and fixed within 3 weeks after operation. The swing exercise of shoulder joint was performed from the 2nd day after operation. The strap was removed 3 weeks after operation, and painless active exercise was performed 6 weeks after operation. The patients were followed up in the outpatient department 6, 12 and 24 weeks after operation, and then every 6 months. AP and lateral X-ray films were taken at each follow-up time. At the latest follow-up, protractor was used to measure activity of patients; and VAS pain score, California University of Losangeles(UCLA) standard, American Shoulder and Elbow Surgeons (ASES) score were used to evaluate therapeutic effects. RESULTS: All the patients were followed up, with a mean duration of 35.2 months (ranged, 24 to 48 months). All the incisions were healed on the first stage without secondary acromion impingement and other complications. All the patients had bony union within 12 weeks. The movements of shoulder joints including flexion, abduction, external rotation, internal rotation were increased obviously(P<0.05). The UCLA score was increased from preoperative 15.2±5.3 to 35.6±6.1 at the latest follow-up. The ASES score was increased from preoperative 31.2±5.4 to 91.2±6.8 at the latest follow-up (P<0.05). CONCLUSIONS: It has satisfactory curative effects for the avulsed fracture of humerus greater tuberosity using the double-row suture anchor fixation technique, especially the cases of small or comminuted fractures. It has several advantages such as firm fixation, simple and secure operation as well as quick postoperative recovery. Finally, patient should take exercises actively after operations.

[Clinical research on arthroscopic treatment for cruciate ligament cysts of the knee].

OBJECTIVE: To evaluate the early clinical effects of arthroscopic treatment for cruciate ligament cysts of the knee. METHODS: From September 2008 to January 2014, 23 patients with cruciate cysts were treated with arthroscopic surgery. There were 11 males and 17 females, with an average age of 28.3 years old (ranged, 16 to 56 years old). Twenty patients had injuries on the right knee and 8 patients had injuries on the left knee. Eight patients had a history of injury,5 patients had a history of chronic injury,and the other 15 patients had no obvious reasons for the symptom. Before the operation, 24 patients were clearly diagnosed as the cruciate ligament cysts of knee joint,and 4 patients were diagnosed as other problems of the knee, but the diagnosis were corrected after the operation. According to the MRI before the surgery,all the patients could be divided into 3 types: 14 were type I, 6 were type II, 8 were type III. After the operation, the patients were suggested to have a rest for 2 weeks, and take exercises everyday at the same time. The knee range of motion, Lysholm score, International Knee Documentation Committee (IKDC) 2000 subjective score, GLASGOW criteria, and McMurray test, pivot shift test, and anterior drawer test were observed to evaluate clinical results. RESULTS: All the incisions healed at the first stage without complications. Twenty-five patients were followed up, and the duration ranged from 12 to 52 months, with a mean of 26.7 months. Three patients accepted the reconstruction of ACL or tightened elongated ACL using bipolar radio frequency. The Lysholm score increased from preoperative 59.80 +/- 6.58 to 75.32 +/- 6.49 at the latest follow-up; IKDC 2000 score increased from preoperative 65.36 +/- 6.26 to 81.00 +/- 5.76 at the latest follow-up. According to GLASGOW criteria,23 patients got an excellent result and 2 good. CONCLUSION: It has a satisfactory curative effect on ACL reconstruction using bipolar radio frequency. It has advantages of firm fixation, simple and secure operation as well as quick postoperative recovery. It's very important to check the MRI before operations, and carefully seek the cysts during the operations, avoiding the omission of any cysts,especially the cases of multiple cysts. Finally, patients should take exercises actively after operations.

Density functional theory investigation on Pd-catalyzed cross-coupling of azoles with aryl thioethers.

In the present study, a density functional theory (DFT) study has been carried out on the Pd-catalyzed coupling of azoles with aryl thioethers. Our effort is mainly put into identifying the most feasible catalytic cycle, and especially the origin of chemoselectivity for the exclusive aromatic Csp(2)-S bond activation (in the presence of an alkyl Csp(3)-S bond). The coupling mainly consists of three steps: C-S activation, NaO(t)Bu mediated C-H palladation, and reductive elimination. The Csp(2)-S activation is favored over Csp(3)-S activation, and thus di(hetero)aryls are the predicted products. This conclusion well reproduces Wang's recent experimental observations. The rate- and chemoselectivity determining steps of the C-H/Csp(2)-S activation mechanism are C-H palladation and C-S activation steps, respectively. Analyzing the origin of chemoselectivity, we found that the easiness of Pd catalyzed C-S activation is independent of the C-S bond strengths in thioether substrates. By contrast, d-π* backdonation in Csp(2)-S-Pd intermediates is the main driving force for the favorable Csp(2)-S activation (over the Csp(3)-S activation).

Corrigendum.

[This corrects the article on p. 253 in vol. 5, PMID: 25425503.][This corrects the article on p. 171 in vol. 5, PMID: 25192875.][This corrects the article on p. 315 in vol. 5, PMID: 25167857.][This corrects the article on p. 45 in vol. 6.].

Antimicrobial peptide LL-37 circulating levels in chronic obstructive pulmonary disease patients with high risk of frequent exacerbations.

BACKGROUND: Exacerbations of chronic obstructive pulmonary disease (COPD) increase the decline in lung function, deterioration in health status and risk of death. The assessment of exacerbation risk is important in the grading of COPD. The most common cause of COPD exacerbation is respiratory tract infection. The only known human cathelicidin antimicrobial peptide, LL-37, play an important role in innate defense against infection. Its gene expression is regulated by the bioactive form of vitamin D. The objective of the present study was to explore the relationship between LL-37 plasma levels, vitamin D status and exacerbation risk in patients with COPD. METHODS: COPD patients and normal subjects were recruited from Beijing Hospital for this study. COPD patients were divided into low risk group and high risk group according to the criteria of GOLD strategy. The plasma concentrations of LL-37 were measured by ELISA technique to explore the difference in LL-37 levels between groups. The plasma levels of 25-hydroxy vitamin D [25(OH)D] were analyzed using electrochemiluminescence immunoassay (ECLIA). RESULTS: A total of 84 COPD patients and 51 normal subjects (control group) were recruited. COPD patients were divided into low risk group (37 cases) and high risk group (47 cases), depending on forced expiratory volume in one second (FEV1)%pred and exacerbation frequency in the previous year. The plasma concentrations of LL-37 in control group, low risk group and high risk group were 20.7±5.8, 19.5±4.1 and 17.9±3.9 µg/L respectively. The plasma concentration of LL-37 was significantly lower in high risk group than in control group (P=0.006). But there was no significant difference between low risk group and high risk group (P=0.152). The plasma concentrations of 25(OH)D in control group, low risk group and high risk group were 18.1±9.4, 13.1±6.9 and 9.3±5.8 ng/mL respectively. The plasma concentration of 25(OH)D was significantly higher in control group than in low risk group (P=0.004) or high risk group (P<0.001). The plasma concentration of 25(OH)D was significantly lower in high risk group than in low risk group (P=0.031). Hospitalization frequency for COPD exacerbations was negative correlated with plasma levels of LL-37 (r=-0.290, P=0.048) and 25(OH)D (r=-0.341, P=0.020) in high risk group. There was not significant correlation between LL-37 and 25(OH)D in COPD patients (r=0.115, P=0.303). CONCLUSIONS: The plasma levels of LL-37 and 25(OH)D were lower in COPD patients with high risk of frequent exacerbations than normal subjects. Low plasma levels of LL-37 and 25(OH)D might be predictors of exacerbation risk in COPD patients.

Quantum-chemical predictions of pKa's of thiols in DMSO.

The deprotonation of thiols (on the S-H bond) is widely involved in organic and bio-organic reactions. With the aid of density functional theory (DFT) calculations, the present study focuses on predicting the pKa's of thiols. Efforts were first put in searching for an appropriate computational method. To achieve this goal, the accuracy of 13 different DFT functionals (i.e., B3LYP, BB1K, PBE, M06, M05, M06-2X, M06-L, M05-2X, TPSS, MPW1K, MPWB1K, MPW3LYP, TPSSLYP1W) and 6 different total electron basis sets (6-31G(d), 6-31+G(d), 6-31+G(d,p), 6-311+G(d,p), 6-311++G(d,p), 6-311++G(2df,2p)) (with DMSO solvent and SMD solvation model) were examined. The M06-2X/6-311++G(2df,2p) (M1) method was found to give the best performance in reproducing the reported 16 pKa's of thiols, with a standard deviation (SD) of about 0.5 pKa unit. Meanwhile, the M1 method was found to be excellent in reproducing the gas phase Gibbs free energies of 17 thiols, providing extra evidence for the reliability of the M1 method in treating thiol systems. On this basis, M1 was then used to predict the pKa's of 291 thiols whose experimental pKa values remain unknown. Accordingly, the scope of pKa's of different thiols was constructed.

[Pulmonary mucormycosis: report of 5 cases and review of 46 cases reported in China].

OBJECTIVE: To describe the clinical manifestations and diagnosis of pulmonary mucormycosis. METHODS: We presented 5 proven diagnosed cases of pulmonary mucormycosis in our hospital and reviewed all proven cases of pulmonary mucormycosis previously reported in mainland China. Publications in the form of case reports and articles between January 1982 and December 2011 were searched from Wan Fang Data and China Hospital Knowledge Database. RESULTS: Of the 5 patients in our hospital, the main symptoms included cough, fever, and hemoptysis. Two cases were diagnosed by transbronchial lung biopsy (TBLB), 1 by surgery, 1 by CT-guided percutaneous lung biopsy, and 1 by blood culture. Three patients were cured by antifungal chemotherapy alone, 1 was cured by surgery, and 1 died. Forty-six proven diagnosed cases of pulmonary mucormycosis were retrieved from Wan Fang Data and China Hospital Knowledge Database using key word (pulmonary mucormycosis). Of the 51 patients in total, there were 31 males and 20 females, with a mean age of (47 ± 13)years. The most common risk factors for pulmonary mucormycosis were poorly controlled diabetes mellitus (18 cases), administration of immunosuppressants (7 cases), malignancy (5 cases) and kidney diseases (5 cases). Chest CT showed nodules (27 cases), infiltrates (21 cases), and cavities (18 cases). White blood cell count and neutrophil percentage were elevated in 26 patients. Eighteen cases were diagnosed by histological study of transbronchial biopsy or TBLB specimen. The diagnosis was proven with surgical specimen in 15 patients, CT-guided percutaneous lung biopsy specimen in 7 patients, autopsy in 4 patients, skin biopsy in 1 patient, and renal biopsy in one patient. Three cases were diagnosed by pleural effusion cultures and 2 were diagnosed by blood cultures. Administration of low-dose liposomal amphotericin B (AMB) alone or combined with posaconazole in 12 patients were effective and safe. Fourteen patients who had received surgical resection were cured. CONCLUSIONS: There were no specific clinical features of pulmonary mucormycosis. Transbronchial biopsy and CT-guided percutaneous lung biopsy are useful diagnostic tools for pulmonary mucormycosis. Surgical resection and administration of low-dose liposomal AMB alone or combined with posaconazole were all effective and safe.

[Endobronchial lipoma: report of 2 cases and review of the Chinese literature].

OBJECTIVE: To describe the epidemiology of endobronchial lipoma and to propose appropriate diagnostic and therapeutic policies for this tumor. METHODS: Two cases of endobronchial lipoma were presented and 38 cases reported in literatures published in mainland China were reviewed. RESULTS: Thirty-one male and 9 female patients were included, with a mean age of (53 ± 11) years. The overwhelming majority of the tumors (n = 37) were found in the trachea, left or right main bronchi and lobular bronchi. The main symptoms included cough, dyspnea, fever and hemoptysis. Chest CT showed fat or soft tissue density endobronchial masses in 75% (21/28) cases. Eight patients (22.2%) were diagnosed by histological study of the transbronchial biopsy specimen. Thirty-two patients underwent surgical resection. Bronchoscopic resection was carried out in 7 cases. CONCLUSION: CT and bronchoscope are highly useful diagnostic tools for endobronchial lipoma. Bronchoscopic resection should be considered as the first choice of treatment for endobronchial lipoma.

The role of serum leptin and tumor necrosis factor-alpha in malnutrition of male chronic obstructive pulmonary disease patients.

BACKGROUND: Leptin is a protein mainly secreted by adipocytes, and the major function of leptin was its role in body weight regulation. It is suggested that increased levels of circulating leptin may contribute to anorexia in pathologic conditions including chronic obstructive pulmonary disease (COPD). Recent studies have provided evidence for a link between leptin and proinflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha). This study aimed to explore the role of serum leptin in the malnutrition of COPD patients, and to observe the changes of serum leptin levels during acute exacerbation, also to investigate relationship between leptin and TNF-alpha. METHODS: Seventy-two COPD patients and 34 control subjects participated in this study. Seventy-two COPD patients were divided into 3 groups: group COPD IA (patients without malnutrition during acute exacerbation, n = 25), group COPD IB (patients without malnutrition during stable disease, n = 29), group COPD II (patients with malnutrition during stable disease, n = 18). To eliminate the effect of sex differences, all patients and controls were male. Body mass index (BMI), percent ideal body weight (IBW%), triceps skin-fold thickness (TSF), mid-upper arm circumference (MAC), mid-upper arm muscle circumference (MAMC), serum leptin and TNF-alpha levels, serum prealbumin (PA), serum transferrin (TF), serum albumin (Alb), total lymphocytes count (TLC), forced expiratory volume in one second (FEV(1)), maximal inspiration pressure (MIP) and maximal expiration pressure (MEP) were measured in all participants. Leptin levels were measured by radioimmunoassay. TNF-alpha levels were measured by ELISA. The between group difference and correlation of these parameters were analyzed. RESULTS: Serum leptin levels were significantly lower in group COPD II [(4.07 +/- 3.42) ng/ml] than in group COPD IB [(9.72 +/- 6.67) ng/ml] and controls [(8.21 +/- 5.41) ng/ml] (P < 0.05). There was no statistically significant difference in serum leptin levels between group COPD IA [(10.82 +/- 6.40) ng/ml], group COPD IB [(9.72 +/- 6.67) ng/ml] and controls [(8.21 +/- 5.41) ng/ml]. There was no statistically significant difference in serum TNF-alpha levels between group COPD II [(8.03 +/- 3.37) pg/ml], group COPD IA [(8.90 +/- 1.60) pg/ml], and group COPD IB [(7.25 +/- 2.08) pg/ml]. There was no significant correlation between leptin and TNF-alpha in any group. CONCLUSIONS: Leptin was not involved in anorexia and weight loss of COPD patients. There was no statistically significant difference in serum leptin levels between COPD patients during stable stage and acute exacerbation, and there was no significant correlation between TNF-alpha and leptin during the regulation of the energy balance in COPD patients.

[Role of serum leptin and tumor necrosis factor-alpha in malnutrition of male chronic obstructive pulmonary disease patients].

OBJECTIVE: To explore the function of serum leptin in COPD patients with malnutrition, and to investigate the relationship between leptin and TNF-alpha. METHODS: A total of 81 subjects (47 COPD patients and 34 control subjects) participated in this study. The 47 COPD patients were divided into 2 groups: group COPD I (patients without malnutrition during stable disease, n=29), group COPDII (patients with malnutrition during stable disease, n=18). To eliminate the effect of sex differences, all the patients and controls were male. Body mass index (BMI), percent ideal body weight (IBWå), triceps skin-fold thickness (TSF), mid-upper arm circumference (MAC), mid-upper arm muscle circumference(MAMC),serum leptin and tumor necrosis factor-alpha(TNF-alpha) levels, serum prealbumin (PA), serum transferrin (TF), serum albumin(Alb),total lymphocytes count (TLC), forced expiratory volume in one second (FEV(1)), maximal inspiration pressure(MIP)and maximal expiration pressure(MEP)were measured in all participants. Leptin levels were measured by radioimmunoassay. TNF-alpha levels were measured by ELISA. The between group difference and correlation of these parameters were analysed. RESULTS: (1) Serum leptin levels were significantly lower in group COPDII (4.07+/-3.42 microg/L) than in group COPD I (9.72+/-6.67 microg/L) and controls (8.21+/- 5.41 microg/L, P<0.05). (2) There were no statistical differences in serum TNF-alpha levels between group COPDII (8.03+/-3.37 ng/L)and group COPD I (7.25+/- 2.08 ng/L). (3) There was no significant correlation between leptin and TNF-alpha in any group. CONCLUSION: Leptin was not involved in anorexia and weight loss of COPD patients. There was no significant correlation between TNF-alpha and leptin during the regulation of the energy balance in COPD patients.