The clinical effect and cost analysis of patients of oral and maxillofacial space infection treated with improved closed negative pressure drainage / 中国实用护理杂志

Objective To explore the clinical effect of patients of oral and maxillofacial space infection treated with improved closed negative pressure drainage combined with hyperbaric oxygen, and the possibility of using this method to decrease the hospital expenses. Methods 156 patients with oral and maxillofacial space infection were divided into control group, closed negative pressure drainage group and improved closed negative pressure drainage combined with hyperbaric oxygen group by random number table. 52 patients in each group. The granulation tissue growth time, the healing of wound, clinical effect of the 8thday, hospitalization days, wound healing time, antibiotic cost, average cost in hospital were recorded after treatment. Results The average wound healing time of patients in improved closed negative pressure drainage combined with hyperbaric oxygen group was(6.06 ± 0.23)days, while the granulation tissue growth time was(16.13 ± 2.89)days, both of them were much shorter than the control group[(15.46 ± 4.68)days and(28.60 ± 3.50)days respectively],as well as the closed negative pressure drainage group [(7.43 ± 0.75) days and (22.67 ± 4.34) days respectively], and the differences were statistically significant which the F values equaled to 6.213 and 8.451, P values all less than 0.05. The total healing rate of patients in closed negative pressure drainage group and improved closed negative pressure drainage combined with hyperbaric oxygen group were both 100.00%(52/52), the difference was statistically significant compared with control group (χ2=6.89, P<0.05). The average hospitalization days of the patients in the closed negative pressure drainage group and improved closed negative pressure drainage combined with hyperbaric oxygen group were (8.20 ± 1.49) days and (7.45 ± 0.42)days, the antibiotic cost were(5 068.34 ± 1 074.68)RMB and (5 001.00 ± 456.00) RMB, the average total cost were (9 457.43 ± 647.23)RMB and (9 249.00 ± 367.00)RMB, all these indexes were much lower that which in control group[(18.40 ± 5.89)days,(21 000.43 ± 2 036.48) RMB and (31 000.66 ± 2 711.36) RMB], and the differences were statistically significant, F values equaled to 15.221, 29.434 and 81.220 each, P values were all less than 0.01. Conclusions Improved closed negative pressure drainage combined with hyperbaric oxygen method could improve the clinical effect of patients with oral and maxillofacial space infection, speed up the granulation tissue, shorten the in-hospital time as well as reduce the medical cost.

[A comparison of clinical features between patients with idiopathic pulmonary fibrosis combined with emphysema and without emphysema].

OBJECTIVE: To investigate the differences of clinical features, pulmonary function tests, chest imaging and prognosis between patients with idiopathic pulmonary fibrosis (IPF) combined with emphysema and without emphysema. METHODS: Of the 117 patients diagnosed as IPF for the first time in the First Affiliated Hospital of China Medical University from January 2002 to January 2007, 23 cases met the diagnostic criteria for combined pulmonary fibrosis and emphysema (CPFE). Thirty-three cases with isolated IPF from 2002 to 2003 were selected as the control group. Clinical characteristics, pulmonary function indexes, PaO2, bronchoalveolar lavage fluid (BALF) results and survival time were retrospectively analyzed and compared between the 2 groups. RESULTS: The smoking indexes (pack-years)were significantly higher in the CPFE group (28 ± 18) compared with the IPF group (18 ± 16), t = 2.10, P < 0.05. No significant difference was observed between the 2 groups in terms of age, gender and the percentage of smokers. The CPFE group showed significantly lower FEV1/FVC% [(77 ± 7)%, (83 ± 8)%, t = 3.55, P < 0.05] and D(L)CO% pred [(44 ± 12)%, (54 ± 16)%, t = 2.48, P < 0.05] compared to those of the IPF group, while TLC%pred was significantly higher in the CPFE group [(77 ± 11)%, (64 ± 12)%, t = 3.93, P < 0.05]. VC% pred and PaO2 showed no significant difference between the 2 groups. The total cell count, the percentages of macrophages, neutrophils, lymphocytes and eosinophils in BALF showed no significant difference between the 2 groups. There was no significant difference in median survival time between the 2 groups. CONCLUSION: Smoking was an important risk factor for IPF combined with emphysema. The pulmonary function of IPF combined with emphysema is characterized by a mild abnormality in the lung volume but a significant decrease in the diffusing capacity. Combined emphysema has no influence on the survival time of patients with IPF.

[Effect of corticosteroids upon the prognosis of idiopathic pulmonary fibrosis].

OBJECTIVE: To investigate the therapeutic effect of corticosteroids upon idiopathic pulmonary fibrosis (IPF) and the impact of corticosteroids upon survival time. METHODS: Clinical data of 94 corticosteroid treatment and 32 non-corticosteroid treatment IPF patients during 2000 - 2004 were retrospectively analyzed and their survival rates compared between two groups. The corticosteroid treatment patients were divided into 3 groups: improved, steady and worsened group according to the pulmonary function data. Therapeutic effects and survival rates were compared between these 3 groups. RESULTS: In the treatment group, 6 (6.4%) patients could not be located, 22 (23.4%) patients survived, and 66 (70.2%) patients died. In the non-corticosteroid treatment group, 1 (3.1%) patients could not be located, 2 (6.3%) patients survived and 29 (90.6%) patients died. No statistically significant difference existed between the two groups (P > 0.05). Sixty-two corticosteroid treatment patients were followed up for 3-6 months. Among them, 19 (30.7%) patients improved, 11 (17.7%) patients remained steady and 32 (51.6%) patients worsened in pulmonary function. In 19 improved patients, 7 (36.8%) survived and 12 (63.2%) died. In 11 steady patients, 3 (27.2%) survived and 8 (72.7%) died. In 32 worsened patients, 3 (9.4%) could not be located, 1(3.1%) survived and 28 (87.5%) died. The survival rate of the improved and steady groups was higher than that of the worsened group (P < 0.01). CONCLUSIONS: There is some therapeutic effect of corticosteroids in the early alveolitis stage of IPF. The prognosis of the patients with improved and steady pulmonary function parameters during the first 3 - 6 months is better than that of worsened patients.

[A retrospective cohort study of prognostic factors for death in patients with idiopathic pulmonary fibrosis].

OBJECTIVE: To investigate the prognostic implications of clinical, radiographic, and physiological variables in idiopathic pulmonary fibrosis (IPF). METHODS: The clinical, pulmonary physiological, bronchoalveolar lavage fluid (BALF) cell differentials and lung high-resolution computed tomography (HRCT) at diagnosis in 126 patients with IPF were retrospectively analyzed. Univariate and multivariate Cox proportional-hazards regression analysis was used to evaluate various parameters associated with hazard ratio (HR). The survival rates of all groups were compared using the Kaplan-Meier method. RESULTS: In 29.6 months of average follow-up time, the survival rate of the IPF patients was 46.8% (59/126), and the median survival time was 30 months after diagnosis. Glucocorticoids and/or cytotoxic drugs for patients with IPF did not change the prognosis. The survival rates between groups by gender and smoking status showed no statistically significant difference (Ward: 0.11, 1.65, P>0.05). The patients were divided into 2 groups by the median (the cutoff point value) of significant variables in univariate Cox proportional-hazards regression analysis, and the survival rates showed statistically significant difference by dyspnea scale, FVC%, TLC%, DLCO%, neutrophil percentage and eosinophil percentage in BALF, and the reticular and honeycomb lung score (Logrank: 13.52-57.52, P<0.05). The results of multivariate Cox proportional-hazards regression analysis showed that TLC%, DLCO%, HRCT reticular score and honeycomb lung score were factors that affected the prognosis of patients with IPF (Wald=5.76-21.48, P<0.05). CONCLUSIONS: TLC%, DLCO%, cell differentials of BALF and the degree of pulmonary fibrosis were the main factors affecting the prognosis of patients with IPF. TLC% and DLCO% showed a negative correlation with the prognosis of patients with IPF. Glucocorticoids and/or cytotoxic drug therapy had no effect on the prognosis of patients with IPF.

[Serum retinol and retinol binding protein-4 levels in patients with chronic obstructive pulmonary disease and their relationship to nutritional status.].

OBJECTIVE: To explore the serum retinol and retinol binding protein-4 (RBP(4)) levels in patients with chronic obstructive pulmonary disease (COPD) and to investigate their relationship with the nutritional status. METHODS: The serum retinol level was determined by high-performance liquid chromatography (HPLC) in 110 outpatients with stable COPD during Sept. 2006 to Sept. 2007, and 90 healthy volunteers served as the controls. The serum RBP(4) level in 62 stable COPD outpatients and 20 healthy controls was measured by enzyme-linked immunosorbent assay (ELISA). Associated factors with the serum retinol and RBP(4) levels were analyzed. t-test and one-way ANOVA were used for the statistic analysis. RESULTS: The serum retinol and RBP(4) levels in COPD patients [(275 +/- 11) microg/L and (7.4 +/- 2.6) mg/L respectively] were significantly lower than those in the healthy controls [(338 +/- 13) microg/L and (11.4 +/- 4.1) mg/L respectively, t = 3.650, t = 4.155 and all P < 0.01]. The serum retinol and RBP(4) levels in COPD patients with malnutrition [(246 +/- 18) microg/L and (6.4 +/- 1.0) mg/L individually] were significantly lower than those in COPD patients without malnutrition [(290 +/- 14) microg/L and (8.2 +/- 3.2) mg/L individually, q = 3.35, P < 0.05 and q = 10.22, P < 0.01 respectively], but the levels of serum retinol and RBP(4) in COPD patients without malnutrition were significantly lower than those in the healthy controls [(338 +/- 13) microg/L and (11.4 +/- 4.1) mg/L respectively, q = 2.26, P < 0.05 and q = 4.82, P < 0.01 respectively]. In a multiple stepwise regression analysis, only body mass index and mid arm circumference were independently associated with the serum retinal level. CONCLUSION: In patients with stable COPD, the levels of serum retinol and RBP(4) were significantly decreased, which was associated with the nutritional status.

[Cell profiles of bronchoalveolar lavage fluid as prognostic indicators of idiopathic pulmonary fibrosis].

OBJECTIVE: To determine whether clinical and physiologic variables and bronchoalveolar lavage fluid (BALF) cell profiles affect the survival of patients with idiopathic pulmonary fibrosis (IPF). METHODS: There were 43 patients with clinically diagnosed IPF in the study. The Kaplan-Meier method and the Log-rank test were used to estimate the survival in the two groups and Cox proportional hazard regression was used to evaluate the Hazard Ratio in the IPF patients. RESULTS: The IPF patients presented with restrictive ventilatory disorders [FVC%: (61 +/- 18)%, TLC%: (54 +/- 13)%] and gas exchange impairment [D(L)CO%: (48 +/- 14)%]. The mean follow-up time was 30.7 months, and the median survival of IPF patients was 28.5 months after diagnosis. FVC ( Wald = 6.71, P < 0.01), TLC ( Wald = 12.37, P < 0.01) , D(L)CO ( Wald = 22.78, P < 0.01), neutrophil ( Wald = 16.26, P < 0.01) and eosinophil ( Wald = 7.73, P < 0.01) percentages were prognostic variables in the univariate Cox proportional hazard regression, and only D(L)CO (HR = 0.93, Wald = 15.77, P < 0.01) and the neutrophil percentage (HR = 1.07, Wald = 6.83, P < 0.01) were prognostic variables for IPF patients in the multivariate Cox proportional hazard regression. CONCLUSIONS: The IPF patients were predominantly old males and presented with restrictive ventilatory disorders and gas exchange impairment. Glucocorticoids and/or cytotoxic drugs could not improve the prognosis for the IPF patients. DLCO and BALF neutrophil percentage were prognostic variables, and DLCO was negatively correlated with the prognosis while the neutrophil percentage was positively correlated with the prognosis in the IPF patients.

[Effects of vitamin A on the proliferation and apoptosis of alveolar cells of experimental emphysema in rats].

OBJECTIVE: To study the effect of vitamin A on experimental emphysema in rats, and on the proliferation and apoptosis of the alveolar cells. METHODS: Twenty-four Wistar rats were randomly divided into 3 groups: a control group (C), an emphysema model group (M) and a vitamin A treatment emphysema group (V), with 8 rats in each group. Experimental emphysema was induced by instilling elastase into the lungs of the rats in group M and group V. Vitamin A injection via esophagus was given from the 5th week to the 8th week after elastase instillation. At the end of 8th week, the lungs of the rats were extracted and fixed. The pathological sections were observed by HE staining. The proliferating cell nuclear antigen (PCNA) was examined by immunohistochemical method. The apoptosis of the alveolar cells was observed by the method of terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling (TUNEL). RESULTS: The mean alveolar number (MAN) in the rats of group M (43 +/- 11) was significantly lower than those in the rats of group C (101 +/- 15) and group V (56 +/- 8). The mean alveolar area (MAA) in the rats of group M [(3763 +/- 504) microm2] was significantly higher than those in the rats of group C [(1919 +/- 270) microm2] and group V [(2710 +/- 276) microm2]. The proliferation index (PI) in the rats of group M [(30.7 +/- 7.6)%] was significantly higher than that in the rats of group C [(9.9 +/- 1.8)%] but was significantly lower than that in the rats of group V [(17.3 +/- 3.5)%]. The apoptosis index (AI) in the rats of group M [(22.0 +/- 4.6)%] was significantly higher than those in the rats of group C [(9.8 +/- 1.7)%] and group V [(17.3 +/- 3.5)%]. PI/AI in the rats of group M (1.03 +/- 0.19) showed no difference compared to that in the rats of group C (1.45 +/- 0.52), but was lower than that in the rats of group V (2.73 +/- 0.64). CONCLUSION: Vitamin A was demonstrated to promote the proliferation of the alveolar cells and inhibit their apoptosis in experimental emphysema of rats, and hence contribute to the improvement of emphysema.

[Changes of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 in the bronchoalveolar lavage fluid and the serum of patients with idiopathic pulmonary fibrosis].

OBJECTIVE: To detect the levels of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the bronchoalveolar lavage fluid (BALF) and the serum of patients with idiopathic pulmonary fibrosis (IPF), and to evaluate the significance of the changes in the pathogenesis of IPF. METHODS: Enzyme-linked immunoadsorbent assay (ELISA) was used to detect MMP-9 and TIMP-1 in the BALF and serum of 30 patients with IPF. RESULTS: The levels of MMP-9 in the BALF and serum of the patients showed no significant difference as compared with those of the control group. The levels of TIMP-1 in the BALF [(522 +/- 81) ng/L] and serum [(166 +/- 29) ng/L] of the patients were higher than those [(201 +/- 31), (87 +/- 16) ng/L] of the control group (P < 0.01). The ratios of MMP-9/TIMP-1 in the BALF (0.53 +/- 0.18) and serum (1.5 +/- 0.3) of patients with IPF were lower than those (1.06 +/- 0.38, 2.6 +/- 0.5) of the control group (P < 0.01, < 0.05). TIMP-1 in the BALF of the patients showed a strong positive correlation with chest CT fibrosis and pulmonary function test scores (P < 0.01), while MMP-9/TIMP-1 in the BALF had negative correlation with them (P < 0.01). CONCLUSION: Pulmonary fibrosis may be associated with increased TIMP-1 and decreased MMP-9/TIMP-1, which is able to inhibit the degradation of extracellular matrix.

[The analysis of risk factors correlated to pulmonary hypertension in obstructive sleep apnea syndrome patients during awake state].

OBJECTIVE: To investigate the development of pulmonary hypertension in obstructive sleep apnea syndrome (OSAS) patients and to analyze the correlated factors. METHODS: Pulmonary arterial pressure was monitored by right cardiac catheterization in 15 OSAS patients, and simultaneously polysomnography was performed. Blood gas analysis and lung function were also measured. RESULTS: Pulmonary arterial pressure at awake state was correlated positively to mean maximal pulmonary pressure during sleep, body mass index (BMI) and hemoglobin (Hb), but negatively to PaO2, the percent predicted forced vital capacity (FVC% pred). Compared with OSAS patients without pulmonary hypertension, the BMI, PaCO2, and Hb of OSAS patients with pulmonary hypertension increased significantly, while FVC% pred and PaO2 decreased. Stepwise linear regression indicated that pulmonary arterial pressure at awake state was closely correlated with mean maximal pressure during sleep (beta = 0.35, standard error 0.10, R(2) = 0.89, P = 0.006) and PaCO2 (beta = 0.72, standard error 0.27, R(2) = 0.94, P = 0.022), and mean maximal pulmonary arterial pressure during sleep was closely correlated to PaCO2, BMI, PaO2 and the ratio of arterial pressure and oxygen concentration during rapid eye movement sleep (RDeltaPAP/DeltaSpO2). The regression equation was y' = -152.70 + 1.92 PaCO2 + 1.37 BMI + 0.67 PaO2 + 16.29 RDeltaPAP/DeltaSpO2. CONCLUSION: Pulmonary arterial pressure increasing in OSAS patients is induced mainly by hypercapnia and hypoxia at day time, and related to forced ventilation capacity, BMI and the ratio of pulmonary arterial pressure and oxygen concentration variation during rapid eye movement sleep. There was no obvious relation between pulmonary arterial pressure and apnea index.

[Regulation of hypothalamus-pituitary-adrenal axis and growth hormone axis in obstructive sleep apnea-hypopnea syndrome patients].

OBJECTIVE: To explore the regulation of hypothalamus-pituitary-adrenal (HPA) axis and growth hormone (GH) axis in obstructive sleep apnea-hypopnea syndrome (OSAHS). METHODS: OSAHS patients (OSAHS group) and subjects with obesity alone (control group) were monitored by polysomnography (PSG). The corticotropin-releasing hormone (CRH), growth hormone releasing hormone (GHRH), corticotropin (ACTH), cortisol and growth hormone levels in plasma were measured by enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay before and after sleep. Their correlation were analyzed. RESULTS: The CRH concentration [(1.66 +/- 0.34), (4.96 +/- 0.98) mmol/L before and after sleep] and cortisol content [(152.93 +/- 136.15), (445.53 +/- 123.09) microg/L before and after sleep] in the OSAHS group were significantly higher than those of the control group [CRH was (0.67 +/- 0.42), (2.27 +/- 1.10) mmol/L, cortisol concentration was (68.94 +/- 20.13), (146.05 +/- 30.48) microg/L, before and after sleep, respectively, all P < 0.01]; GHRH significantly decreased in the OSAHS group [(1.42 +/- 0.07), (1.01 +/- 0.05) mmol/L before and after sleep] compared with the control group [(1.99 +/- 0.34), (1.58 +/- 0.15) mmol/L, respectively; all P < 0.01]; but there was no difference in growth hormone. The ratio of the variation of CRH, GHRH level (DeltaCRH/DeltaGHRH) was significantly higher in the OSAHS group (285.02 +/- 143.32) than that in the control group (71.15 +/- 15.37, P < 0.01). The bivariate correlation analysis of the OSAHS group indicated that DeltaCRH/DeltaGHRH was correlated positively with average awake duration (r = 0.882), but negatively with average blood oxygen concentration (r = -0.696). The average blood oxygen concentration was negatively correlated with average awake duration (r = -0.729). CONCLUSIONS: There are abnormal changes of HPA axis and GH axis in OSAHS patients, and the feedback regulation is disordered. These abnormalities are related to sleep structure variation and hypoxia during sleep.

[Retinoic acid inhibits tumor necrosis factor-alpha induced injury in human lung epithelial cells].

OBJECTIVE: To study the effect of tumor necrosis factor-alpha (TNF-alpha) on the proliferation and apoptosis of type II lung alveolar epithelial cells and the regulation of retinoic acid (RA) to this effect. METHODS: Human type II lung alveolar epithelial cells of the line A569 were cultured and divided into 2 groups: control group (cultured in culture fluid only), TNF-group (cultured in the culture fluid with TNF-alpha 10 micromol/L for 24 or 46 h respectively), RA group (cultured in culture fluid without RA 1 microg/L), and TNF-alpha plus RA group (cultured in culture fluid with TNF-alpha 10 micromol/L + RA 1 microg/L). MTT method was used to test the proliferation of the A549 cells. The cell apoptosis was detected by flow cytometric assay. RESULTS: The proliferation rates of A549 cells treated with TNF-alpha of the concentrations of 0, 0.1, 1, 5, and 10 microg/L were 95.0%, 90.0%, 79.6%, 72.4%, and 59.6% after 24 h (F = 18.04, P < 0.001), and were 93.2%, 82.7%, 61.5%, 50.3%, and 44.7% after 48 h (F = 40.61, P < 0.0001). The inhibition effect on the proliferation of A549 cells treated with 10 microg/L TNF-alpha for 24 h could be reversed, however, the inhibition effect on the proliferation of A549 cells treated with 10 microg/L TNF-a for 48h could not be reversed. RA alone did not significantly promote the proliferation of the A549 cells, but weakened the inhibitory effect of TNF-alpha on the proliferation of the A549 cells. The apoptotic rate of the A549 cells treated with TNF-alpha for 12 h, 24 h and 48 h respectively were 14.3% +/- 3.2%, 18.6% +/- 2.9%, and 43.4% +/- 3.5% respectively, all significantly higher than those of the control group (6.3% +/- 1.2%, 8.2% +/- 1.3%, and 26.1% +/- 2.5% respectively, all P < 0.01), and the apoptotic rate of the A549 cells treated with both TNF-alpha and RA for 12 h, 24 h, and 48h were 4.8% +/- 1.1%, 5.2% +/- 1.3%, and 16.4% +/- 2.3% respectively, all significantly lower than those of the TNF-alpha group (all P < 0.01), and the apoptotic rates of the A549 cells treated with both TNF-alpha and RA for 24 h and 48 h respectively were both significantly lower than those of the control group (both P < 0.05). CONCLUSION: RA relieves the injury of alveolar epithelial cells and protects the pulmonary surfactant by inhibiting the destruction of TNF-alpha to type II lung alveolar epithelial cells.

Immunogenicity in a Prime-boost Regimen of a Modified Vaccinia Virus Ankara (MVA) Vectored Experimental HIV-1 Clade C/B’ Vaccine / 中国生物工程杂志

Objective: To evaluate the immunogenicity of HIV-1 clade C/B’ vaccine based on modified vaccinia virus Ankara (MVA) vector in mice. Methods: Mice were inoculated with 3-dose HIV vaccine by intramuscular injection. Blood sample were collected every second week, and then the antibodies against HIV were detected. At week 6, mice were killed and cellular immune responses were examined by ELISPOT. Result: The number of spot forming cells in the 107 pfu/ml -dose group was more than those of 105 pfu/ml -dose and 106 pfu/ml -dose groups significantly. HIV specific antibodies emerged at week 2 and elevated rapidly at week 4 and week 6. The level of specific IgG in the 107 pfu/ml -dose group was more than those of 105 pfu/ml -dose and 106 pfu/ml -dose groups significantly. Conclusion: The ADMVA induces both humoral immunoresponse and cellular immune responses.

[Serum resistin and leptin in patients with chronic obstructive pulmonary disease and their relationship to nutritional state].

OBJECTIVE: To investigate the serum resistin and leptin levels, their relationship to nutritional state and the associated factors in patients with chronic obstructive pulmonary disease (COPD). METHODS: The serum resistin and leptin levels in 57 stable COPD patients and 31 healthy controls were measured by enzyme-linked immunosorbent assay (ELISA) and radio-immunoassay respectively. Correlated factors of serum resistin and leptin were analyzed. RESULTS: The serum resistin and leptin levels in COPD patients [(2.1 +/- 1.2), (0.65 +/- 0.41) microg/L] were significantly lower than those in the healthy controls [(3.6 +/- 2.3), (1.03 +/- 0.71) microg/L, all P < 0.01]. The serum resistin and leptin levels in patients with malnutrition [(1.7 +/- 0.7), (0.43 +/- 0.16) microg/L] were significantly lower than those in patients without malnutrition [(2.2 +/- 1.2), (0.73 +/- 0.48) microg/L, all P < 0.05]. The serum resistin level in the patients was correlated with the serum leptin level, forced expiratory volume in one second (FEV(1)), and FEV(1)/forced vital capacity (FVC) (r = 0.426 - 0.531, all P < 0.01). The serum leptin level in the patients was correlated with serum resistin, FEV(1)/FVC, body mass index (BMI), percentage of ideal body weight (IBW%), chest circumference and abdominal circumference (r = 0.371 - 0.580, all P < 0.01). CONCLUSION: The serum resistin and leptin levels in stable COPD patients were significantly lower, especially in patients with malnutrition.

[The effect of retinoic acid on C3 and factor B secretion of human alveolar type II epithelial cells induced with cytokines].

AIM: To explore the effect of retinoic acid (RA)on C3 and factor B (Bf) secretion by human alveolar type II epithelial cell line A549 induced with cytokines. METHODS: The levels of C3 and Bf in culture supernatant of A549 cells induced with cytokines were detected by ELISA. The expression of C3 and Bf mRNAs was analyzed by RT-PCR. RESULTS: TNF-alpha, IL-1beta, IL-6 and IFN-gamma could induce the secretion of C3 and Bf of A549 cells. RA alone had no effect on secretion of C3 and Bf of A549 cells but could notably enhance the secretion of C3 and Bf of A549 cells induced by the cytokines. CONCLUSION: RA can up-regulate the expression of C3 and Bf of A549 cells induced with TNF-alpha, IL-1beta, IL-6 and IFN-gamma, and regulate the immunological defence of local lung tissue, which provides a theoretical basis for prevention and treatment of pulmonary diseases by using RA and cytokines.

[Cell apoptosis and the change of Fas/FasL gene in experimental pulmonary fibrosis].

OBJECTIVE: To investigate the changes and significance of cell apoptosis and Fas/FasL gene in pulmonary fibrosis. METHODS: Forty mice were divided into two groups randomly, each group contained twenty mice. TUNEL, immunohistochemistry and in situ hybridization were used to detect the change of cell apoptosis, Fas/FasL mRNA and protein in mice with pulmonary fibrosis caused by bleomycin. RESULTS: The apoptosis index of lung cells in the pulmonary fibrosis group (55.3 +/- 12.2) was higher than that of control group (4.7 +/- 1.0, t = 13.06, < 0.01). The expression of Fas/FasL mRNA (175.8 +/- 21.6, 5.2 +/- 1.6) and protein (956 +/- 96, 285 +/- 76) in the pulmonary fibrosis group was higher than that of control group (mRNA: 26.6 +/- 1.9, 0.5 +/- 0.4, t = 21.7, 8.79, all < 0.01; protein: 491 +/- 96, 100 +/- 18, t = 5.03, 12.81, < 0.01). CONCLUSION: The apoptosis index of lung cells, Fas/FasL genes and protein were up-regulated in lung tissue of pulmonary fibrosis, which may play an important role in the development of disease.

[Study of the mechanisms of dyspnea during exercise in COPD].

AIM: To study the relationships between dyspnea and respiratory drive or respiratory muscle function in COPD. METHODS: Thirty-one patients with COPD and 26 normal subjects were involved in the study. Routine pulmonary function, pulmonary diffusing capacity, P0.1, PI(max) were measured at rest. Oxygen consumption (VO2), carbon dioxide production (VCO2), minute ventilation (VE) etc were observed during exercise test. Dyspnea was assessed with Borg Scale (BS) simultaneously. Arterial blood gas measured before and after exercise. RESULTS: (1) PI(max) of COPD (5.33 +/- 1.95) kPa decreased compared with the normal subjects (7.02 +/- 2.53) kPa, P < 0.05, P0.1 of COPD (0.37 +/- 0.12) kPa increased compared with the normal subjects (0.26 +/- 0.09) kPa, P < 0.05, inspiratory drive efficacy (V(T)/P0.1) of COPD (1.6 +/- 0.31) L/kPa decreased than that of the normal subjects (2.1 +/- 0.53) L/kPa, P < 0.05. P0.1/PI(max) of COPD (0.069 +/- 0.021) was higher than that of the normal individuals (0.037 +/- 0.009), P < 0.01. (2) Peak exercise dyspnea was correlated with dyspnea at rest and P0.1/PI(max) (r = 0.41, P < 0.05 and r = 0.48, P < 0.05, respectively), and P0.1/PI(max) was also positively correlated with the change in BS from rest to maximal exercise (deltaBS) (r = 0.44, P < 0.05) in COPD patients. CONCLUSION: In COPD, breathlessness during exercise is not simply related to hyperinflation and the damaged gas exchange, but also to the relatively increased respiratory drive and dysfunction of respiratory muscle.

[The effect of chronic intermittent hypoxia to hypothalamus-pituitary-adrenal axis and growth hormone level in rats during sleep].

AIM: To research the effect of intermittent hypoxia during sleep on hypothalamus-pituitary-adrenal (HPA) axis and growth hormone (GH) level. METHODS: Rats were respectively exposed to intermittent hypoxia, room air and continuous hypoxia, after 1 day, 3 days, 7 days and 30 days, mRNA levels of corticotropin-releasing hormone (CRH) and growth hormone releasing hormone (GHRH) in hypothalamus of rats were detected using RT-PCR, and the levels of CRH, GHRH, corticotropin(ACTH), cortex ketone, and growth hormone in plasma were measured. RESULTS: After 30 days, the CRH mRNA levels in rats hypothalamus which exposed to intermittent hypoxia were increased significantly than those exposed to continuous hypoxia as well as normal control but GHRH decreased, there was no difference between continuous hypoxia and normal control. After 1 day, 3 days, and 7 days, there was no difference between continuous hypoxia and intermittent hypoxia. After 30 days, the plasmic level of CRH,ACTH and cortex ketone increased, GHRH decreased and GH had no obvious change. CONCLUSION: The rats' HPA axis level increases and GHRH restrained with chronic intermittent hypoxia during sleep, feedback regulation disorders.

The effect of chronic intermittent hypoxia to hypothalamus-pituitary-adrenal axis and growth hormone level in rats during sleep / 中国应用生理学杂志

<p><b>AIM</b>To research the effect of intermittent hypoxia during sleep on hypothalamus-pituitary-adrenal (HPA) axis and growth hormone (GH) level.</p><p><b>METHODS</b>Rats were respectively exposed to intermittent hypoxia, room air and continuous hypoxia, after 1 day, 3 days, 7 days and 30 days, mRNA levels of corticotropin-releasing hormone (CRH) and growth hormone releasing hormone (GHRH) in hypothalamus of rats were detected using RT-PCR, and the levels of CRH, GHRH, corticotropin(ACTH), cortex ketone, and growth hormone in plasma were measured.</p><p><b>RESULTS</b>After 30 days, the CRH mRNA levels in rats hypothalamus which exposed to intermittent hypoxia were increased significantly than those exposed to continuous hypoxia as well as normal control but GHRH decreased, there was no difference between continuous hypoxia and normal control. After 1 day, 3 days, and 7 days, there was no difference between continuous hypoxia and intermittent hypoxia. After 30 days, the plasmic level of CRH,ACTH and cortex ketone increased, GHRH decreased and GH had no obvious change.</p><p><b>CONCLUSION</b>The rats' HPA axis level increases and GHRH restrained with chronic intermittent hypoxia during sleep, feedback regulation disorders.</p>

Study of the mechanisms of dyspnea during exercise in COPD / 中国应用生理学杂志

<p><b>AIM</b>To study the relationships between dyspnea and respiratory drive or respiratory muscle function in COPD.</p><p><b>METHODS</b>Thirty-one patients with COPD and 26 normal subjects were involved in the study. Routine pulmonary function, pulmonary diffusing capacity, P0.1, PI(max) were measured at rest. Oxygen consumption (VO2), carbon dioxide production (VCO2), minute ventilation (VE) etc were observed during exercise test. Dyspnea was assessed with Borg Scale (BS) simultaneously. Arterial blood gas measured before and after exercise.</p><p><b>RESULTS</b>(1) PI(max) of COPD (5.33 +/- 1.95) kPa decreased compared with the normal subjects (7.02 +/- 2.53) kPa, P < 0.05, P0.1 of COPD (0.37 +/- 0.12) kPa increased compared with the normal subjects (0.26 +/- 0.09) kPa, P < 0.05, inspiratory drive efficacy (V(T)/P0.1) of COPD (1.6 +/- 0.31) L/kPa decreased than that of the normal subjects (2.1 +/- 0.53) L/kPa, P < 0.05. P0.1/PI(max) of COPD (0.069 +/- 0.021) was higher than that of the normal individuals (0.037 +/- 0.009), P < 0.01. (2) Peak exercise dyspnea was correlated with dyspnea at rest and P0.1/PI(max) (r = 0.41, P < 0.05 and r = 0.48, P < 0.05, respectively), and P0.1/PI(max) was also positively correlated with the change in BS from rest to maximal exercise (deltaBS) (r = 0.44, P < 0.05) in COPD patients.</p><p><b>CONCLUSION</b>In COPD, breathlessness during exercise is not simply related to hyperinflation and the damaged gas exchange, but also to the relatively increased respiratory drive and dysfunction of respiratory muscle.</p>