Reversal effect of Lycium barbarum polysaccharide in combination with oxaliplatin on drug resistance of colon cancer stem cells / 中国组织工程研究

BACKGROUND:Clinical treatment for colon cancer mainly includes fluorouracil,irinotecan and oxaliplatin-based therapy.Studies have shown that membrane transport proteins such as ATP-binding cassette transport protein of G2(ABCG2)mediate the transport of these drugs.However,when patients develop resistance to these chemotherapeutic drugs,the high expression of ABCG2 leads to a significant decrease in the therapeutic effect and raises the problem of drug resistance in colon cancer.New drugs and treatments are urgently needed to improve the efficacy.Lycium barbarum polysaccharide has a wide range of biological activities.It can be used as anti-tumor drug to overcome the damage to normal cells in the process of chemotherapy and radiotherapy in tumor patients. OBJECTIVE:To explore the reversal effect of Lycium barbarum polysaccharide in combination with oxaliplatin on colon cancer drug-resistant cells through in vitro experiments to investigate the possible molecular mechanism of Lycium barbarum polysaccharide reversal on colon cancer drug-resistant cells. METHODS:Colon cancer cell line HCT116 and oxaliplatin-resistant cell line HCT116-OXR were selected for in vitro experiments.The optimal intervention concentration and intervention time of Lycium barbarum polysaccharide and oxaliplatin were determined by CCK8 assay of cell proliferation.Samples were further divided into the HCT116 control group,HCT116-OXR blank treatment group,Lycium barbarum polysaccharide group(2.5 mg/mL Lycium barbarum polysaccharide),and oxaliplatin group(10 μmol/L oxaliplatin),and Lycium barbarum polysaccharide + oxaliplatin group(2.5 mg/mL Lycium barbarum polysaccharide +10 μmol/L oxaliplatin).Cell apoptosis was detected by flow cytometry.The protein expression levels of phosphomannose isomerase(PMI)and ABCG2 were detected by immunofluorescence and western blot assay.Phosphatidylinositol3-kinase(PI3K),protein kinase B(AKT),B-cell lymphoma 2(Bcl-2)and BCL2-Associated X(Bax)were detected by western blot assay. RESULTS AND CONCLUSION:(1)HCT116-OXR was more sensitive to Lycium barbarum polysaccharide compared to HCT116(P<0.05).(2)Compared with the HCT116-OXR blank group,Lycium barbarum polysaccharide + oxaliplatin could promote apoptosis of HCT116-OXR cells(P<0.05).The protein expression of Bcl-2 was significantly down-regulated(P<0.05);the protein expression of Bax was significantly up-regulated(P<0.05);the protein expression of ABCG2,PMI,PI3K and AKT was significantly down-regulated(P<0.05).(3)These results indicate that Lycium barbarum polysaccharide reverses drug resistance in colon cancer by inhibiting PMI/PI3K/AKT signaling pathway,which lays the foundation for studying the molecular mechanism of Lycium barbarum polysaccharide's sensitizing chemotherapeutic effects.

Population survey of Pomacea spp. in Shandong Province and preliminary study on the risk of population infection with Angiostrongylus cantonensis / 中华地方病学杂志

Objective:To study the population distribution of Pomacea spp. in Shandong Province and the risk of angiostrongyliasis cantonensis in the local population, and to provide a basis for scientific prevention and control of related diseases. Methods:From July to December 2021, Yanzhou District of Jining City, Ningyang County of Taian City, and Dongying District of Dongying City were selected as surveillance sites to investigate the population and distribution range of Pomacea spp., live snail samples were collected for morphological and genetic identification, and Pomacea spp. infected with the larva of Angiostrongylus cantonensis was detected by lung test. At the same time, sentinel hospital case surveillance was carried out in Yanzhou District, Jining City, and questionnaire was used to study the local residents' awareness of angiostrongyliasis cantonensis and their personal health behaviors. Results:A total of 312 live snail samples were collected. After morphological identification, they were all Pomacea spp.. After gene sequencing, two populations of Pomacea canaliculata and Pomacea maculata were found. No positive snails infected with Angiostrongylus cantonensis were found. A total of 126 patients with headache as the main neurological symptom were admitted to the sentinel hospital, but there were no monitoring cases that met the inclusion criteria. Among the survey population, 48.38% (134/277) of the respondents had heard of angiostrongyliasis cantonensis, 44.77% (124/277) knew that eating Margarya melanioides might cause angiostrongyliasis cantonensis, and 83.39% (231/277) had no related unhealthy eating behavior. Conclusion:Pomacea spp. is found and reported for the first time in Shandong Province, and there is a risk of population infection with angiostrongyliasis cantonensis.

Energy policy paradox on environmental performance: The moderating role of renewable energy patents.

The environmental and socioeconomic considerations of energy production have become crucial because of the increasingly complex relationship between energy and the environment. This study aims to develop possible mechanisms for perspectives on energy policy and the environment by exploring the mediating role of renewable energy patents. Non-radial data envelopment analysis and panel data models are applied using the panel data from 2010 to 2017 from 30 Chinese provinces. The results show an overall improvement in the environmental performance index (EPI) of China's provinces, but the average EPI is still relatively weak, with an average value between 0.44 and 0.52, which is far below the optimal value 1.. Furthermore, the econometric model offers evidence that provincial renewable energy and emission reduction policies positively impact the enhancement of EPI. The findings have several implications for energy and environmental policies.

Correlations study between grip strength, lung functions, six-minute walk test and left ventricular ejection fraction in patients with coronary artery disease / 中华老年医学杂志

Objective:To investigate the clinical significance of grip strength, three simple lung functions[functional volume capacity(FVC), forced expiratory volume in the first second(FEV1)and peak expiratory flow(PEF)], 6-minute walking distance test(6MWD)and left ventricular ejection fraction(LVEF)for assessing overall integrative function in elderly versus non-elderly patients with coronary artery disease(CAD).Methods:A total of 35 hospitalized CAD patients aged 70.4±10.6 years from January 2017 to December 2018 were retrospectively enrolled.Patients were divided into the non-elderly group(<65 years, n=8)and the elderly group(≥65 years, n=27). FVC, FEV1 and PEF were tested by a portable lung function machine.The grip strength, 6MWD, three simple lung functions(FVC, FEV1, PEF), LVEF and echocardiography were detected after admission.The above indexes were re-examined in outpatient clinic at 3 months after discharge.The results of above indexes were compared at admission versus at three months after discharge.The consistency and correlation between FVC, FEV1, PEF, 6MWD, grip strength and LVEF were analyzed.Results:The detected results of FVC, FEV1, PEF, 6MWD, left-hand grip strength, right-hand grip strength and LVEF showed no significant difference at admission versus at 3 months after discharge( P>0.05)in a total of 35 hospitalized CAD patients.Pearson bivariate correlation analysis showed that FVC, FEV1, PEF, left-hand and right-hand grip strength had pairwise correlation between them( P<0.01).6MWD had no correlation with LVEF.And LVEF was related with FVC and FEV( P<0.01), but not related with PEF, 6MWD and grip strength( P>0.05). The detective values of FVC, FEV1, PEF, 6MWD, left-hand and right-hand grip strength were lower in the elderly group than in the non-elderly group[(2.11±0.66 )L vs.(2.88±0.55) L, (1.74±0.46 )L vs.(2.62±0.49 )L, (5.50±1.79 )m/s vs.(8.22±1.59) m/s, (332.07±115.58)m vs.(446.14±99.81 )m, (25.14±7.87) vs.(35.15±8.30), (27.37±8.39 )kg vs.(38.37±10.20)kg, P<0.01]. LVEF had no significant difference between the two age groups. Conclusions:FVC, FEV1, PEF, 6MWD and grip strength are lower in elderly group than in non-elderly group.A comprehensive set of tests of grip strength, three simple lung function and 6MWT is helpful to evaluate the overall integrative function in elderly CHD patients.

Application value of electrical impedance tomography imaging combined with bedside fiberoptic bronchoscope sputum suction in elderly patients with stroke-associated pneumonia / 中华老年医学杂志

Objective:To evaluate the application value of electrical impedance tomography(EIT)imaging combining bedside bronchoscopy sputum suction by observing the changes of pulmonary ventilation, tidal volume and dynamic pulmonary compliance after bedside bronchoscopy sputum suction in elderly stroke-associated pneumonia(SAP).Methods:A randomized controlled study was conducted.Patients with SAP admitted to the respiratory intensive care unit of Henan Provincial People's Hospital from January 2017 to December 2018 were enrolled as research objects.They were divided into the control group versus observation group with the only difference in receiving bedside bronchoscope sputum suction replacing control's receiving conventional sputum suction.Impedance imaging region of interest 4(ROI4)values collected by using EIT at admission and 1, 3, 5 days after fiberoptic bronchoscope sputum suction were compared between the two groups.Meanwhile, the tidal volume, dynamic lung compliance, the duration of mechanical ventilation and hospitalization time in intensive care unit were recorded in the two groups.Results:A total of 78 patients meeting an inclusion and exclusion criterion were enrolled, with 37 cases in the control group and 41 cases in the observation group.Compared with control group, the bronchoscope sputum suction group showed the significantly increased regional gas distribution values(2.24±0.77% vs.0.49±0.65%, 7.05±0.77% vs.2.49±0.87%, 12.34±1.47% vs.5.57±0.50%, t=10.85, 24.56 and 26.54, respectively, all P<0.001)at 1, 3, 5 days after fiberoptic bronchoscope sputum suction.The tidal volume and dynamic lung compliance were significantly higher in the observation group than in the control group at 1, 3, 5 days after fiberoptic bronchoscope sputum suction.The duration of mechanical ventilation and hospitalization time in the intensive care unit were shorter in the observation group than in the control group(12.22±0.88 d vs.14.65±0.92 d, 18.41±1.12 d vs.21.14±1.06 d, t=11.91 and 11.01, both P< 0.001). Conclusions:For patients with SAP, an intermittent bedside fiberoptic bronchoscope sputum suction can effectively improve the pulmonary ventilation in the dorsal area, optimize pulmonary respiratory dynamics, facilitate the early withdrawal of the mechanic ventilation, and shorten the hospitalization time in the intensive care unit.

Efficacy and safety of statin combined with ezetimibe for elderly patients with coronary heart disease and dyslipidemia / 中华全科医师杂志

Objective:To evaluate the efficacy and safety of statin combined with ezetimibe for elderly patients with coronary heart disease (CHD) and dyslipiclemia.Methods:Clinical data of 293 patients with CHD and dyslipidemia treated with statins and ezetimibe in the outpatient clinic of Beijing Hospital from November 2009 to June 2019 were retrospectively analyzed. There were 153 patients aged ≥65 years (elderly group) and 140 patients aged<60 year (control group). The low density lipid cholesterol reduction (ΔLDL-C), LDL-C compliance rate and safety were compared between the two groups.Results:The longest follow-up time was 9 months, the average follow-up time was 5.3 months in the elderly group, and 5.2 months in the control group. After treatment the TC, LDL-C, and TG levels were lower than those before treatment in both groups ( P<0.05), and there was no significant changed in HDL-C levels. After treatment there were no significant differences in TC [3.50(3.15,4.01) vs.3.49(3.14,4.00) mmol/L], LDL-C [1.85(1.56,2.23) vs.1.85(1.56,2.40) mmol/L], and TG [1.23(0.94,1.57) vs.1.32(0.84,1.70)mmol/L] between two groups (all P>0.05). There were also no significant differences in ΔLDL-C [-0.85(1.14,-0.55) vs.-0.81 (-1.34, -0.50) mmol/L], LDL-C decline rate (29.3% vs. 28.5%), and LDL-C compliance rate [44.4%(68/153) vs.45.0%(63/140)] between two group (all P>0.05). After combined treatment, AST and ALT increased in both groups, but they were still in the normal range. The difference of AST and ALT before and after treatment in the two groups was not statistically significant. There were no significant changes in CK in both groups ( P>0.05). Conclusion:The combined administration of ezetimibe and statin can significantly reduce LDL-C level and increase LDL-C compliance rate in treatment of elderly patients with coronary heart disease and dyslipidemia safety.

Lipid-lowering therapy in the post-statin era / 中华全科医师杂志

Atherosclerotic cardiovascular disease is one of the leading causes of death and disability worldwide.Dyslipidemia mainly with elevated LDL-C is closely related to atherosclerotic cardiovascular disease.Statins are the most effective drugs for lowering LDL-C and play an important role in the prevention and treatment of atherosclerotic cardiovascular disease.However,a considerable number of patients receiving statin therapy can not tolerate its adverse reactions or their low-density lipoprotein can not meet the standard,and the cardiovascular risk remains high.The clinical application of new lipid-lowering drugs such as ezetimibe,PCSK9 inhibitors and cholesterol ester transfer protein(CETP) inhibitors has marked the post-statin era of lipid-lowering therapy.

Progress of PARP inhibitors in breast cancer / 肿瘤研究与临床

PARP inhibitors are a kind of anticancer drugs approved for the clinical treatment of ovarian cancer and primary peritoneal cancer on the basis of the strategy of synthetic lethality. With the publication of two phase Ⅲ clinical trials results, the indications for PARP inhibitors have been expanded to advanced breast cancer with germline BRCA-1/2 mutations. However, the current exploration of PARP inhibitors in breast cancer is still at early stage. This article summarizes the anticancer mechanism of PARP inhibitors and new advances in treatment of breast cancer.

Diagnostic value of circulating miRNAs for predicting pneumonia-associated sepsis in elderly patients / 中华老年医学杂志

Objective To evaluate the predicting value of circulating miRNAs for sepsis secondary to pneumonia in elderly patients.Methods From April 2016 to January 2017,44 cases with sepsis secondary to pneumonia,52 elderly patients with pneumonia and 21 healthy older adults as control were involved in this study.The expression levels of MiRNA-150 5p,miRNA-25-3p,miRNA-122 5p and miRNA-223-3p in plasma were evaluated by fluorescence quantitative PCR.The demographic characteristics,sequential organ failure assessment (SOFA)scores,prognosis and days stayed in ICU were recorded.The area under the receiver operating charaeteristic(ROC)curve was used to calculated the specificity and sensitivity of miRNA in identifying sepsis-associated pneumonia.Results There were significantly differences among levels of circulating miRNA-223-3p in pneumonia,sepsis and healthy control groups(F =36.441,P =0.000),△CT values were 2.39 ± 1.36,1.44± 1.43,and 4.58 ± 0.91,respectively.The relative expression levels of miRNA-223-3p in the three groups were significantly different (P =0.000),which were 0.189 (0.107,0.367),0.361 (0.221,0.735),and 0.044 (0.022,0.061),respectively.The AUC of miRNA-223-3p for predicting sepsis from pneumonia was 0.964(95 ％CI =0.925 1.000).At a cutoff value of 2.759,miRNA-223-3p yielded a sensitivity of 82.9％ and a specificity of 100.0％.Conclusions MiRNA-223-3p expression is up-regulated in patients with sepsis secondary to pneumonia compared to that of patients with pneumonia,and it could be used to predict sepsis associated pneumonia.

Effects of RhoGDI2 gene silencing by siRNA on proliferation and invasion of colon carcinoma cell lines / 中国免疫学杂志

Objective:To study the silencing gene expression level of RhoGDI2 small interfering RNA(siRNA)and the colorectal cancer cell malignant behaviors such as cell proliferation,migration,invasion.Methods:Testing RhoGDI2 expression using Westen blot analysis and Real-time reverse transcription polymerase chain reaction(RT-qPCR)in the colorectal cancer cell lines of RKO,HT29,SW620,SW480,HCT116.The siRNA of RhoGDI2 with Lipofecta mineTM2000 was transfected into target cells,as well as negative control and normal control groups.Cell counting kits(CCK-8)to detect proliferation,Wound healing assay and the Transwell plate migration and invasion was detected.The epithelial-mesenchymal transition(EMT)relevant protein E-cadherin/Vimentin expression was detected.Results:Human colon cancer cell lines RhoGDI2 expression levels decreased in the order of RKO,HT29,SW620,SW480,HCT116:siRNA inhibited RhoGDI2 expression rate of RKO cell by 70%;in silence group,negative control group and blank contro1 group,the proliferation rates were(0.683±0.013),(0.866±0.088),(0.905±0.008),P<0.05;Wound healing assay and Transwell assay suggested RhoGDI2 silencing could inhibit migration;siRNA interference of colon cancer cells downregulated Vimentin,but upregulated E-Cadherin protein.Conclusion:RhoGDI2 down-regulation could significantly inhibit the cell proliferation,migration,invasion of colon cancer cell.

Influence of different initial treatments in prognoses of patients with brain metastases from epidermal growth factor receptor mutations non-small cell lung cancers / 中华神经医学杂志

Objective To evaluate the efficacies of upfront simultaneous integrated boost-intensity-modulated radiation therapy (SIB-IMRT) and epidermal growth factor receptor (EGFR) etyrosine kinase inhibitor (TKI) in patients with epidermal growth factor receptor (EGFR)-mutant non-small-cell lung cancers who developed brain metastasis (BM).Methods Sixty-eight patients diagnosed as having EGFR-mutant non-small-cell lung cancer developed BM were recruited in our hospital from July 2012 to January 2016.Of these patients,45 received upffont EGFR-TKI gefitinib and 23 accepted SIB-IMRT.The clinical data of these patients were recorded;the viability curve and encephalic progressive cumulative incidence curve were compared between the two groups.Cox multiple-factor analysis was performed to analyze the influencing factors of prognoses.Results The median survival time in the SIB-IMRT group was shorter than that in upfront EGFR-TKI group (18.9 months [95％ CI:16.5-21.4 months] vs.27.5 months [95％CI:21.6-33.5 months]).Log-rank test indicated that the survival rate of patients from SIB-IMRT group was significantly higher than that of patients from EGFR-TKI group (P＜0.05);in the patients from SIB-IMRT group,61％ patients had encephalic progressive changes,with the median survival time of 20.7 months (95％CI:9.6-14.2 months);in the patients from EGFR-TKI group,89％ patients had encephalic progressive changes,with the median survival time of 11.9 months (95％CI:19.7-49.2 months).The encephalic progressive cumulative incidence in patients from EGFR-TKI group was significantly higher than that in patients from SIB-IMRT group (P＜0.05).Multiple-factor analysis indicated that initial therapeutic schedule,prognosis evaluation and extra-cerebral metastasis were the key influencing factors of prognoses.Conclusion The patients accepted upfront EGFR-TKI treatment has longer overall survival and progression free survival than those accepted upfront SIB-IMRT in patients with EGFR-mutant non-small-cell lung cancer who develop BM.

The relationship between smoking status and epidermiology of asthma in people aged over 14 years in China / 中华内科杂志

Objective To study the relationship between bronchial asthma and smoking status in Chinese people.Methods Asthma epidemiological survey and stratified-cluster-random method survey were performed in residents over 14 years in 8 provinces (cities) of China from February 2010 to August 2012.Asthma was diagnosed based upon case history,clinical signs and lung function test.Smoking status was investigated by questionnaire.Results Sampling population was 180 099 and 164 215 were valid.A total of 2 034 subjects were diagnosed as asthma including 79 692 men and 84 523 women.The overall prevalence rate of asthma was 1.24％ (2 034/164 215).Smokers were 23.8％ (39 137/164 215) in the whole population.Smokers were 34.5％ (702/2 034) in asthmatic patients,compared with 23.7％ (38 435/ 162 181) in no-asthmatic population.The incidence of asthma was 1.79％ and 1.06％ in smokers and nonsmokers respectively (P ＜0.001),suggesting that OR of smoking was 1.70 (95％ CI 1.55-1.86,P ＜ 0.001).According to asthma control test (ACT) score,the level of asthma control in non smoking group was higher than that in smoking group(43.2％ vs 35.3％).The times of hospitalization due to acute exacerbations (0.51 vs 0.41 events/person/year),total hospitalization rate (27.35 ％ vs 20.12％),annual emergency room visits (0.80 vs 0.60 events/person/year) and emergency room visit rate (31.77％ vs 24.47％) were all much higher in smoking asthmatic patients than those in non smoking asthmatic patients,indicating that the level of asthma control in smoking patients was significantly worse than in non smoking patients.Conclusions The smoking rate in Chinese people over 14 years is still high.The prevalence rate of asthma in smokers is significantly higher than that of non-smokers.The level of asthma control in smokers is significantly worse than that in non smokers.

RhoGDI2 expression and clinical significance in colorectal cancer / 中国免疫学杂志

Objective:To explore the expression and clinical significance of RhoGDI2 in colorectal cancer. Methods:Immuno-histochemistry was used to identify RhoGDI2 expression in clinical samples of colorectal cancer tissues,para-tumorous tissues and lymph node metastasis tissues. The relationships between CRC clinical factors and survival were analyzed. Results: RhoGDI2 expression contributed positively with tumor progression and metastasis in clinical tissues. It was associated with the stage of the tumor,lymph node metastasis, remote metastasis, venous invasion and vessel invasion. Patients with higher RhoGDI2 expression had poorer overall survival. Conclusion:RhoGDI2 showed high expression in colorectal cancer and it was associated with the stage of the tumor,lymph node metastasis,remote metastasis, venous invasion and vessel invasion. Patients with higher RhoGDI2 expression had poorer overall survival.

Relationship between endothelin-1 and p38 MAPK and PI3K/Akt signaling pathways during mechanical stretch-induced enhancement of adhesion of rat pulmonary microvascular endothelial cells / 中华麻醉学杂志

Objective To evaluate the relationship between endothelin-1 (ET-1) and p38 mitogenactivated protein kinase (p38 MAPK) and phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathways during mechanical stretch-induced enhancement of adhesion of rat pulmonary microvascular endothelial cells (PMVECs).Methods Rat PMVECs were seeded in the culture plate at a density of 0.5×105 cells/ml (2 ml/well) and divided into 5 groups (n=24 each) using a random number table:control group (group C),mechanical stretch group (group MS),mechanical stretch plus specific PI3K inhibitor LY294002 group (LY group),mechanical stretch plus specific p38 MAPK inhibitor SB203580 group (SB group),and mechanical stretch plus selective ETA receptor blocker BQ123 group (BQ group).Cells were exposed to 20％ cyclic stretch at 0.3 Hz for 4 h using a sine wave.In LY,SB and BQ groups,LY294002,SB203580 and BQ123 at the final concentration of 10 μmol/L were added,respectively,after mechanical stretch,cells were incubated for 10 min,and then extracted and purified rat polymorphonuclear neutrophil leukocytes (PMNs,5× 105 cells/well) were added and co-incubated with PMVECs for 30 min and then washed out.The concentrations of ET-1 and interleukin-6 (IL-6) in the culture medium were determined using enzyme-linked immunosorbent assay.The expression of phosphorylated p38 MAPK (p-p38 MAPK) and phosphorylated Akt (p-Akt) was detected by Western blot.Adhesion of PMNs was measured by immuno-histochemistry,and the adhesion rate was calculated.The expression of P-selectin mRNA was detected using real-time polymerase chain reaction.Results Compared with group C,the concentrations of IL-6 and ET-1 in the culture medium were significantly increased,the expression of p-p38 MAPK,p-Akt and P-selectin mRNA was up-regulated,and the adhesion rate of PMNs was increased in the other four groups (P＜0.05).Compared with group MS,the concentration of IL-6 in the culture medium was significantly decreased,the expression of p-Akt and P-selectin mRNA was down-regulated,and the adhesion rate of PMNs was decreased in LY,SB and BQ groups,the concentration of ET-1 in the culture medium was significantly decreased in group BQ,and the expression of p-p38 MAPK was significantly down-regulated in SB and BQ groups (P＜0.05).Conclusion The signaling mechanism underlying ET-1-mediated enhancement of rat PMVEC adhesion may be related to activating p38 MAPK and PI3K/Akt signaling pathways.

Effect of sequential treatment with TCM syndrome differentiation on acute exacerbation of chronic obstructive pulmonary disease and AECOPD risk window.

OBJECTIVE: To evaluate the efficacy and safety of the comprehensive interventions based on three Traditional Chinese medicine (TCM) patterns therapy in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and AECOPD risk window. METHODS: A prospective, multi-center, single-blinded, double-dummy and randomized controlled clinical trial is being conducted to test the therapeutic effects of a sequential two stage treatment. A total of 364 patients were enrolled into this study with 182 in each treatment group (TCM and conventional). Patients received medication (or control) according to their assigned group. TCM treatment according to syndrome differentiation for AECOPD were administered twice daily to patients with AECOPD over 7-21days, followed by TCM for AECOPD risk window (RW) over 28days. All patients were followed up for 6 months. Exacerbations were used as the primary outcome measures. Forced expiratory volume in the first second (FEV1) and the modified medical research council dyspnea (MMRC) scale, quality of life and mortality rate were used as secondary outcome measures. RESULTS: Of 364 randomized patients, 353 were included in the intention-to-treat analysis and 290 in the per-protocol analysis. In the TCM group, 16 patients (10.4%) reached the primary end point; 24 (17.7%) in the conventional group (RR 0.59, 95% CI 0.33-1.06; p=0.074). Among patients with a re-exacerbation, the median time to event was 107.5days (interquartile range [IQR], 39.5-129.0) in the TCM and 50days (IQR, 31-130.5) in the conventional group (P=0.011). After exacerbation therapy and a further 180-days follow-up, patients in the TCM group had significant improvements in dyspnea, as measured by MMRC (P=0.003), Patients in the TCM group also had improvements in health-related quality of life (P=0.002), as measured COPD Assessment Test (CAT). There was no difference between groups in death, and recovery of lung function. There were no differences between the TCM and conventional treatment group in adverse events. CONCLUSIONS: In patients presenting to the respiratory department with acute exacerbations of COPD, TCM treatments with syndrome differentiation will have beneficial effects with regard to re-exacerbation, relieving symptoms, improving quality of life for COPD patients.

Study on the correlation between BODE and inflammatory factors in patients with chronic obstructive pulmonary disease / 中国综合临床

Objective To assess the significance and the relationship of BODE index score and inflammation factors in stable chronic obstructive pulmonary disease(COPD).Methods Sixty COPD patients in their stable condition were evaluated for BODE index score and the level of tumor necrosis factor-α(TNF-α),interleukin-8(IL-8) and C reactive protein (CRP) were determined.Results BODE index score in COPD patients was positively correlated with serum concentrations of TNF-α,IL-8 (r =0.455,P ＜ 0.01 ; r =0.303,P ＜0.05),but not with CRP (r =0.111,P =0.398).IL-8 and TNF-α were both significantly negatively correlated to body mass index(BMI),force exhale volume of the first second (FEV1) and 6 minute walking distance (6MWD) (r=-0.417,P ＜0.01;r=-0.538,P＜0.01;r =-0.419,P＜0.01 for IL-8;and r=-0.262,P＜0.05;r=-0.348,P＜0.01;r=-0.334,P＜0.01 for TNF-α).Conclusion The BODE index,as a simple multidimensional grading system for COPD,is closely related to system inflammation,which indicates that system inflammation may contribute to the systemic development of COPD.

Clinical analysis of the association between obstructive sleep apnea hypopnea syndrome and hypertension / 中国综合临床

Objective To study the incidence of hypertension in patients with different severity of obstructive sleep apnea hypopnea syndrome(OSAHS) and to observe the effects of short-term continuous positive airway pressure (CPAP) treatment on hypertension in patients with hypertension Ⅲ complicated with OSAHS.Methods According to sleep apnea hypopnea index (AHI) and the lowest oxygen saturation value at night,184 patients with OSAHS were divided into mild group(n =55),moderate group(n =63) and severe group(n =66).We observed the incidence of hypertension among patients and their mean systolic and diastolic blood pressures before sleep and after wakening.There were 46 patients with severe OSAHS combined with hypertension Ⅲ received short-term (at least 7 days) CPAP treatment.We observed and analyzed the effect of CPAP on blood pressure values.Results In the 184 cases,incidence of hypertension of the three groups were 36.4％ (20/55),42.9％ (27/63) and 62.1％ (41/66) respectively.The incidence of hypertension in OSAHS patients was significantly higher in the severe group than in the moderate group (x2 =4.799,P ＜ 0.05) and the mild group(x2 =7.962,P ＜ 0.05).There were significant differences among mild,moderate and severe OSAHS patients in mean systolic and diastolic blood pressures before sleep Systolic ((135.08 ± 6.71) mm Hg vs.(136.59 ± 15.14) mm Hg vs.(144.73 ± 15.80)mm Hg,F =4.202,P ＜0.05) and Diastolic((90.96 ±6.06)mm Hg vs.(91.41 ± 4.05) mm Hg vs.(94.13 ± 13.97) mm Hg,F =13.690,P ＜ 0.05)) and after wakening Systolic((136.83 ± 8.23) mm Hg vs.(137.89 ± 17.03)mm Hg vs.(148.59 ± 14.83) mm Hg,F =4.158,P ＜0.05) and Diastolic((91.25 ± 9.96) mm Hg vs.(93.40 ± 8.82) mm Hg vs.(98.75 ± 9.39) mm Hg,F =5.638,P ＜0.05)).Severe OSAHS patients had significantly higher systolic and diastolic blood pressures after wakening than before sleeping (P ＜ 0.05).The changes of blood pressure had significant difference after CPAP treatment than before CPAP treatment (Systolic:(175.09 ± 9.66) mm Hg vs.(168.22 ± 8.55)mm Hg,t =3.556,P＜0.05;Diastolic:(105.82 ± 12.44) mm Hg vs.(100.61 ± 11.26) mm Hg,t =2.741,P ＜0.05).Conclusion OSAHS and hypertension are closely related to each other.CPAP is an effective treatment to OSAHS combined with hypertension.

The effects of tumor necrosis factor-α on the cisplatin-resistant human lung adenocarcinoma cell lines A549/DDP / 中国综合临床

Objective To investigate the effects of tumor necrosis factor-α ( TNF-α ) on the resensitization of human lung cancer cell lines A549/DDP to cisplatin (DDP) and to explore the relationship between the expression of TNF-αand resistance-related protein (LRP) in lung tissue.Methods The cytotoxic effects of combinational treatment by TNF-α and cisplatin on A549/DDP were measured by MTT assay.The expression of LRP was assessed by immunocytochemistry methods.Results The IC50 of A549/DDP to cisplatin were decreased from 7.12 ng/L to 5.02 ng/L,4.41 ng/L respectively by 250 U/ml and 1000 U/ml TNF-α treatment ( P ＜ 0.01 ),with the sensitivity of A549/DDP to cisplatin increased by 1.42 and 1.62 fold respectively.LRP was overexpressed in A549/DDP cell.250 U/ml or 1000 U/ml TNF-α plus cisplatin treatment down-regulated the expression of LRP with the positive rates of ( 60.14 ± 6.54 ) ％ and ( 57.23 ± 5.98 ) ％respectively,which were significantly lower than that of cisplatin alone treatment ( 75.97 ± 5.32 ) ％ and control group (79.63 ± 4.78 ) ％ ( both P ＜ 0.01 ).Conclusion Tumor necrosis factor-α can reverse the resistance of A549/DDP to cisplatin,which may be partially attributed to down-regulating LRP expression.

A survey of knowledge on common cold in outpatient clinics / 中华内科杂志

Objective To investigate outpatients' cognition towards common cold and their habituated medication so as to provide evidence for future public healthcare education.Methods Patients who attended hospital for diagnosis and treatment of common cold at least within past three months were asked to fill a questionnaire independently so as to learn their cognition towards common cold and medication habit.Results Among the patients underwent survey,52.2 ％ had incorrect knowledge about common cold; 2.99％ didn't know about the hazards of common cold; 34.80％ couldn't distinguish common cold from influenza; 30.07％ considered common cold couldn't get relief without treatment; 68.24％ didn't know about the proper effects of influenza vaccination; 6.4％ often took oral medicine even intravenous injection when they caught a common cold; 59.77％ often took medication from drugstore without prescription by doctor,and a few asked doctors to prescribe medicine on their request; 9.42％ didn't know about the side effects of drug for cold treatment; and 9.72％ didn't know about the active ingredients of drug for cold treatment.There were significant differences in the common cold cognition among population of different ages and education background.The older or the higher education status patients had a better cognition ( P ＜0.0 ).Conclusion There exist a certain degree of wrong cognition towards common cold among patients of different literacy degree and different age. Public health education on common cold need to be further strengthened.

A survey of knowledge on common cold and its treatment situation among physicians from various levels of hospitals in mainland China / 中华内科杂志

Objective To investigate the cognition of the common cold and current situation of the treatment among physicians from various levels of hospitals in Chinese mainland,so as to provide evidence for future continuing medical education and rational medication.Methods A questionnaire designed for this survey was used to learn about the general information,cognitive degree of the common cold and prescription habits of physician who prescribed for cold within last three months,from various levels hospitals.Results A total of 1001 physicians were interviewed.Among them,749 physicians chose right options that the cold was the common cold and the influenza with 79.84％ in resident physicians and 56.76％ in chief physicians.A total of 745 physicians chose options that the course of common cold will be lasting 4 to 7 days; 895 physicians chose options that old people are the most susceptible for complication; 669 physicians thought the common cold was the most common infection in winter; 841 physicians used clinical methods to diagnose the common cold; 736 physicians thought although the cold was a kind of self-limited disease and symptomatic treatment could alleviate symptoms and improve life quality,patients should see doctor in time if it turns to severer; and 745 physicians held the opinion that treatment of the common cold should focus on relieving symptoms first. In addition, 61.60％ physicians had made prescription based on clinical symptoms; 505(54.24％ ) of them thought compound drugs were priority in treating the common cold.However,there were still 43 physicians prescribed antibiotics for common cold.Conclusions There is misunderstanding and discrepancy in cognition towards common cold and treatment among physicians from various levels of hospticals in mainland China.Physicians should standardize diagnosis and treatment for the common cold according to the domestic and foreign guidelines.