Dyspnea and respiratory muscle strength in end-stage liver disease

AIM:To investigate the prevalence of chronic dyspnea and its relationship to respiratory muscle function in end-stage liver disease.METHODS:Sixty-eight consecutive,ambulatory,Caucasian patients with end-stage liver disease,candidates for liver transplantation,were referred for preoperative respiratory function assessment.Forty of these(29 men) were included in this preliminary study after applying strict inclusion and exclusion criteria.Seventeen of 40 patients(42%) had ascites,but none of them was cachectic.Fifteen of 40 patients(38%)had a history of hepatic encephalopathy,though none of them was symptomatic at study time.All patients with a known history and/or presence of co-morbidities were excluded.Chronic dyspnea was rated according to the modified medical research council(mMRC) 6-point scale.Liver disease severity was assessed according to the Model for end-stage liver disease(MELD).Routine lung function tests,maximum static expiratory(Pemax) and inspiratory(Pimax) mouth pressures were measured.Respiratory muscle strength(RMS) was calculated from Pimax and Pemax values.In addition,arterial blood gases and pattern of breathing(VE:minute ventilation;VT:tidal volume;VT/TI:mean inspiratory flow;TI:duration of inspiration) were measured.RESULTS:Thirty-five(88%) of 40 patients aged(mean ± SD) 52 ± 10 years reported various degrees of chronic dyspnea(mMRC),ranging from 0 to 4,with a mean value of 2.0 ± 1.2.MELD score was 14 ± 6.Pemax,percent of predicted(%pred) was 105 ± 35,Pimax,%pred was 90 ± 29,and RMS,%pred was 97 ± 30.These pressures were below the normal limits in 12(30%),15(38%),and 14(35%) patients,respectively.Furthermore,comparing the subgroups of ascites to non-ascites patients,all respiratory muscle indices measured were found significantly decreased in ascites patients.Patients with ascites also had a significantly worse MELD score compared to non-ascites ones(P = 0.006).Significant correlations were found between chronic dyspnea and respiratory muscle function indices in all patients.Specifically,mMRC score was significantly correlated with Pemax,Pimax,and RMS(r =-0.53,P < 0.001;r =-0.42,P < 0.01;r =-0.51,P < 0.001,respectively).These correlations were substantially closer in the non-ascites subgroup(r =-0.82,P < 0.0001;r =-0.61,P < 0.01;r =-0.79,P < 0.0001,respectively) compared to all patients.Similar results were found for the relationship between mMRC vs MELD score,and MELD score vs respiratory muscle strength indices.In all patients the sole predictor of mMRC score was RMS(r =-0.51,P < 0.001).In the subgroup of patients without ascites this relationship becomes closer(r =-0.79,P < 0.001),whilst this relationship breaks down in the subgroup of patients with ascites.The disappearance of such a correlation may be due to the fact that ascites acts as a "confounding" factor.PaCO2(4.4 ± 0.5 kPa) was increased,whereas pH(7.49 ± 0.04) was decreased in 26(65%) and 34(85%) patients,respectively.PaO2(12.3 ± 0.04 kPa) was within normal limits.VE(11.5 ± 3.5 L/min),VT(0.735 ± 0.287 L),and VT/TI(0.449±0.129 L/s) were increased signifying hyperventilation in both subgroups of patients.VT/TI was significantly higher in patients with ascites than without ascites.Significant correlations,albeit weak,were found for PaCO2 with VE and VT/TI(r =-0.44,P < 0.01;r =-0.41,P < 0.01,respectively).CONCLUSION:The prevalence of chronic dyspnea is 88% in end-stage liver disease.The mMRC score closely correlates with respiratory muscle strength.

Effect of fiberoptic bronchoscopic bronchoalveolar lavage with ambroxol on the SIRS and target organ damage in patients with severe pneumonia complicated by respiratory failure

Objective:To study the effect of fiberoptic bronchoscopic bronchoalveolar lavage with ambroxol on the systemic inflammatory response syndrome (SIRS) and target organ damage in patients with severe pneumonia complicated by respiratory failure.Methods: A total of 68 patients with severe pneumonia complicated by respiratory failure who received inpatient treatment in our hospital between July 2013 and December 2016 were collected and then divided into the control group (n=35) who received conventional therapy and the observation group (n=33) who received fiberoptic bronchoscopic bronchoalveolar lavage with ambroxol + conventional therapy after the therapies were reviewed. The systemic inflammatory response as well as cardiac and liver function before and after treatment were compared between two groups of patients.Results: Before treatment, differences in serum levels of inflammatory factors, myocardial enzyme spectrum and liver function indexes were not statistically significant between the two groups of patients. After treatment, serum inflammatory factors IL-6, IL-8, TNF-α and CRP levels in observation group were lower than those in control group;serum myocardial enzyme spectrum LDH,α-HBDH, CKMB and cTnI levels were lower than those in control group;serum liver function index Alb content was higher than that in control group while ALP, TBA, ALT and AST contents were lower than those in control group.Conclusion:Fiberoptic bronchoscopic bronchoalveolar lavage with ambroxol can effectively reduce the degree of SIRS, and also reduce the cardiac and liver function injury in patients with severe pneumonia complicated by respiratory failure.

Effect of adjuvant noninvasive positive pressure ventilation on blood gas parameters, cardiac function and inflammatory state in patients with COPD and type II respiratory failure

Objective:T o analyze the effect of adjuvant noninvasive positive pressure ventilation on blood gas parameters, cardiac function and inflammatory state in patients with chronic obstructive pulmonary disease (COPD) and type II respiratory failure. Methods:90 patients with COPD and type II respiratory failure were randomly divided into observation group and control group (n=45). Control group received conventional therapy, observation group received conventional therapy+adjuvant noninvasive positive pressure ventilation, and differences in blood gas parameters, cardiac function, inflammatory state, etc., were compared between two groups of patients 2 weeks after treatment. Results:Arterial blood gas parameters pH and alveolar-arterial partial pressure of oxygen [P(A-a)O2] levels of observation group were higher than those of control group while, potassium ion (K+), chloride ion (Cl-) and carbon dioxide combining power (CO2CP) levels were lower than those of control group 2 weeks after treatment;echocardiography parameters Doppler-derived tricuspid lateral annular systolic velocity (DTIS) and pulmonary arterial velocity (PAV) levels were lower than those of control group (P<0.05) while pulmonary artery accelerating time (PAACT), left ventricular end-diastolic dimension (LVDd) and right atrioventricular tricuspid annular plane systolic excursion (TAPSE) levels were higher than those of control group (P<0.05);serum cardiac function indexes adiponectin (APN), Copeptin, N-terminal pro-B-type natriuretic peptide (NT-proBNP), cystatin C (CysC), growth differentiation factor-15 (GDF-15) and heart type fatty acid binding protein (H-FABP) content were lower than those of control group (P<0.05);serum inflammatory factors hypersensitive C-reactive protein (hs-CRP), tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), IL-8, IL-10, and transforming growth factor-β1 (TGF-β1) content were lower than those of control group (P<0.05). Conclusions:Adjuvant noninvasive positive pressure ventilation can optimize the blood gas parameters, cardiac function and inflammatory state in patients with COPD and type II respiratory failure, and it is of positive significance in improving the overall treatment outcome.

Prediction System for Diagnosis and Detection of Coronavirus Disease-2019(COVID-19):A Fuzzy-Soft Expert System

In early December 2019,a new virus named“2019 novel coronavirus(2019-nCoV)”appeared in Wuhan,China.The disease quickly spread worldwide,resulting in the COVID-19 pandemic.In the currentwork,we will propose a novel fuzzy softmodal(i.e.,fuzzy-soft expert system)for early detection of COVID-19.Themain construction of the fuzzy-soft expert systemconsists of five portions.The exploratory study includes sixty patients(i.e.,fortymales and twenty females)with symptoms similar to COVID-19 in(Nanjing Chest Hospital,Department of Respiratory,China).The proposed fuzzy-soft expert systemdepended on five symptoms of COVID-19(i.e.,shortness of breath,sore throat,cough,fever,and age).We will use the algorithm proposed by Kong et al.to detect these patients who may suffer from COVID-19.In this way,the present system is beneficial to help the physician decide if there is any patient who has COVID-19 or not.Finally,we present the comparison between the present system and the fuzzy expert system.

Exploring the Feasibility of Machine Learning to Predict Risk Stratification Within 3 Months in Chest Pain Patients with Suspected NSTE-ACS

Objective We aimed to assess the feasibility and superiority of machine learning(ML)methods to predict the risk of Major Adverse Cardiovascular Events(MACEs)in chest pain patients with NSTE-ACS.Methods Enrolled chest pain patients were from two centers,Beijing Anzhen Emergency Chest Pain Center Beijing Bo’ai Hospital,China Rehabilitation Research Center.Five classifiers were used to develop ML models.Accuracy,Precision,Recall,F-Measure and AUC were used to assess the model performance and prediction effect compared with HEART risk scoring system.Ultimately,ML model constructed by Naïve Bayes was employed to predict the occurrence of MACEs.Results According to learning metrics,ML models constructed by different classifiers were superior over HEART(History,ECG,Age,Risk factors,&Troponin)scoring system when predicting acute myocardial infarction(AMI)and all-cause death.However,according to ROC curves and AUC,ML model constructed by different classifiers performed better than HEART scoring system only in prediction for AMI.Among the five ML algorithms,Linear support vector machine(SVC),Naïve Bayes and Logistic regression classifiers stood out with all Accuracy,Precision,Recall and F-Measure from 0.8 to 1.0 for predicting any event,AMI,revascularization and all-cause death(vs.HEART≤0.78),with AUC from 0.88 to 0.98 for predicting any event,AMI and revascularization(vs.HEART≤0.85).ML model developed by Naïve Bayes predicted that suspected acute coronary syndrome(ACS),abnormal electrocardiogram(ECG),elevated hs-cTn I,sex and smoking were risk factors of MACEs.Conclusion Compared with HEART risk scoring system,the superiority of ML method was demonstrated when employing Linear SVC classifier,Naïve Bayes and Logistic.ML method could be a promising method to predict MACEs in chest pain patients with NSTE-ACS.

Expert consensus on the diagnosis, treatment, and prevention of respiratory syncytial virus infections in children

Background Respiratory syncytial virus(RSV)is the leading global cause of respiratory infections and is responsible for about 3 million hospitalizations and more than 100,000 deaths annually in children younger than 5 years,representing a major global healthcare burden.There is a great unmet need for new agents and universal strategies to prevent RSV infections in early life.A multidisciplinary consensus development group comprising experts in epidemiology,infectious diseases,respiratory medicine,and methodology aims to develop the current consensus to address clinical issues of RSV infections in children.Data sources The evidence searches and reviews were conducted using electronic databases,including PubMed,Embase,Web of Science,and the Cochrane Library,using variations in terms for"respiratory syncytial virus","RSV","lower respiratory tract infection","bronchiolitis","acute","viral pneumonia","neonatal","infant""children",and"pediatric".Results Evidence-based recommendations regarding diagnosis,treatment,and prevention were proposed with a high degree of consensus.Although supportive care remains the cornerstone for the management of RSV infections,new monoclonal antibodies,vaccines,drug therapies,and viral surveillance techniques are being rolled out.Conclusions This consensus,based on international and national scientific evidence,reinforces the current recommendations and integrates the recent advances for optimal care and prevention of RSV infections.Further improvements in the management of RSV infections will require generating the highest quality of evidence through rigorously designed studies that possess little bias and sufficient capacity to identify clinically meaningful end points.

Knowledge and awareness of infection control practices among nursing professionals:A cross-sectional survey from South Asia and the Middle East

BACKGROUND The proficiency of nursing professionals in the infection prevention and control(IPC)practices is a core component of the strategy to mitigate the challenge of healthcare associated infections.AIM To test knowledge of nurses working in intensive care units(ICU)in South Asia and Middle East countries on IPC practices.METHODS An online self-assessment questionnaire based on various aspects of IPC practices was conducted among nurses over three weeks.RESULTS A total of 1333 nurses from 13 countries completed the survey.The average score was 72.8%and 36%of nurses were proficient(mean score>80%).43%and 68.3%of respondents were from government and teaching hospitals,respectively.79.2%of respondents worked in<25 bedded ICUs and 46.5%in closed ICUs.Statistically,a significant association was found between the knowledge and expertise of nurses,the country’s per-capita income,type of hospitals,accreditation and teaching status of hospitals and type of ICUs.Working in high-and upper-middleincome countries(β=4.89,95%CI:3.55 to 6.22)was positively associated,and the teaching status of the hospital(β=-4.58,95%CI:-6.81 to-2.36)was negatively associated with the knowledge score among respondents.CONCLUSION There is considerable variation in knowledge among nurses working in ICU.Factors like income status of countries,public vs private and teaching status of hospitals and experience are independently associated with nurses’knowledge of IPC practices.

Intestinal microbiota in health and disease: Role of bifidobacteria in gut homeostasis

The pool of microbes inhabiting our body is known as "microbiota" and their collective genomes as "microbiome". The colon is the most densely populated organ in the human body, although other parts, such as the skin, vaginal mucosa, or respiratory tract, also harbour specific microbiota. This microbial community regulates some important metabolic and physiological functions of the host, and drives the maturation of the immune system in early life, contributing to its homeostasis during life. Alterations of the intestinal microbiota can occur by changes in composition(dysbiosis), function, or microbiota-host interactions and they can be directly correlated with several diseases. The only disease in which a clear causal role of a dysbiotic microbiota has been demonstrated is the case of Clostridium difficile infections. Nonetheless, alterations in composition and function of the microbiota have been associated with several gastrointestinal diseases(inflammatory bowel disease, colorectal cancer, or irritable bowel syndrome), as well as extra-intestinal pathologies, such as those affecting the liver, or the respiratory tract(e.g., allergy, bronchial asthma, and cystic fibrosis), among others. Species of Bifidobacterium genus are the normal inhabitants of a healthy human gut and alterations in number and composition of their populations is one of the most frequent features present in these diseases. The use of probiotics, including bifidobacteria strains, in preventive medicine to maintain a healthy intestinal function is well documented. Probiotics are also proposed as therapeutic agents for gastrointestinal disorders and other pathologies. The World Gastroenterology Organization recently published potential clinical applications for several probiotic formulations, in which species of lactobacilli are predominant. This review is focused on probiotic preparations containing Bifidobacterium strains, alone or in combination with other bacteria, which have been tested in human clinical studies. In spite of extensive literature on and research into this topic, the degree of scientific evidence of the effectiveness of probiotics is still insufficient in most cases. More effort need to be made to design and conduct accurate human studies demonstrating the efficacy of probiotics in the prevention, alleviation, or treatment of different pathologies.

Safety of polyethylene glycol recombinant human granulocyte colonystimulating factor in treating non-small cell lung cancer patients at Ⅰb stage

Objective:To investigate resistance and safety of HHPG-19K in treating non-small cell lung cancer patients.Methods:A total of 30 cases were selected and randomly divided into 5 groups:three HHPG-19K groups of different dosage(60 μg/kg/day,100 μ g/kg/day,200 μ g/ kg/day),positive control group(Filgrastim,namely G-CSF5 μ g/kg/day) and negative control group.Safety indexes of 5 groups were observed and compared.Results:All patients had adverse event(100%) in three HHPG-19K groups,and increased ALP,ALT and AST were main events.The degree was mild to moderate.There was no significant difference in the incidence of adverse event between dosage groups and positive control group no difference.But the incidence of negative control group was 13%,which was significantly lower than dosage groups and positive control group.Conclusions:Non-small cell lung cancer patients have satisfactory tolerance to HHPG-19K,and have no resistance.Besides,dosage at 100 μ g/kg is the most safe.

Adipose tissue and vascular inflammation in coronary artery disease

Obesity has become an important public health issue in Western and developing countries,with well known metabolic and cardiovascular complications.In the last decades,evidence have been growing about the active role of adipose tissue as an endocrine organ in determining these pathological consequences.As a consequence of the expansion of fat depots,in obese subjects,adipose tissue cells develope a phenotypic modification,which turns into a change of the secretory output.Adipocytokines produced by both adipocytes and adipose stromal cells are involved in the modulation of glucose and lipid handling,vascular biology and,moreover,participate to the systemic inflammatory response,which characterizes obesity and metabolic syndrome.This might represent an important pathophysiological link with atherosclerotic complications and cardiovascular events.A great number of adipocytokines have been described recently,linking inflammatory mileu and vascular pathology.The understanding of these pathways is crucial not only from a pathophysiological point of view,but also to a better cardiovascular disease risk stratification and to the identification of possible therapeutic targets.The aim of this paper is to review the role of Adipocytokines as a possible link between obesity and vascular disease.

Indoor Allergen Levels and Household Distributions in Nine Cities Across China

Objective Chinese allergic subjects have high levels of sensitization to house dust mite （HDM） and other indoor allergens. This study quantifies common indoor allergen levels in Chinese households. Methods Dust samples were collected from nine cities. Major allergens Der p 1 and Der f I from Dermatophagoides pteronyssinus and D. farinae, and specific antigens of Blomia tropicalis, Tyrophagus putrescentiae, Acarus siro, and cockroach species Blattella germanica and Periplaneta americana were measured by ELISA.Results HDM allergens were found in dust samples from bedding in 95% of the Chinese households. The median levels varied from 〈0.006 to 9.2 μg/g of dust, depending on the city. The percentages of households having HDM allergen levels associated with the risk of developing allergy sensitization and asthma were 65% and 25%, respectively. Specific antigens of the storage mite and cockroach were only found in samples from the southern and tropical regions of China. Levels of mite allergens were generally higher in samples from bedding compared to samples from the living room, even for storage mites, whereas levels of cockroach antigens were higher in the living room samples.Conclusion HDM allergens are present in bedding dust samples from most Chinese households. Cities in southern and central China have relatively high levels of HDM major allergens compared to cities in northern and western China. Antigens of storage mites and cockroaches are not as common as HDM allergens.

MicroRNA-126 inhibits the proliferation of lung cancer cell line A549

Objective:To study the role of microRNA-126 in the development of lung cancer.Methods:The biological function of microRNA-126 was delected using EdU assay and CCK-8 assay:the target gene of microRNA-126 was analyzed using real time RT-PCR and Western blot assay.Results:In A549 cell line,overexpression of microRNA-126 inhibils the prolileralion rate:VEGF is the target gene of microRNA-126:microRNA-126 exerts its function via regulating VEGF protein level.Conclusions:microRNA-126 inhibits the proliferation in A549 cell line.

Effect of Simulated Microgravity and its Associated Mechanism on Pulmonary Circulation in Rats

Objective To study the effect of Simulated Microgravity and its Associated Mechanism on Pulmonary Circulation in Rats. Methods Rat tail-suspension model was used to simulate the physiological effects of microgravity and changes in pulmonary blood vessel morphology, pulmonary arterial and venous blood pressure, pulmonary vascular resistance, pulmonary vasomotoricity, as well as the regulation of pulmonary circulation by cytokines produced and released by the lung of rats were measured. Results The walls of pulmonary blood vessels of rats were thickened, and the pulmonary artery was reconstructed with increased pulmonary vascular resistance. The pulmonary blood vessels of rats became more prone to dilation as contractions increased. Rat epithelial Adrenomedulin gene transcription and protein expression were upregulated. The level of basic fibroblast growth Factor of rat was also elevated. Conclusion Findings from the present study on rats revealed that the microgravity can affect pulmonary blood vessel structure, pulmonary arterial pressure, and pulmonary blood vessel self-regulation and cytokine production.

Effects of spaceflight and simulated microgravity on microbial growth and secondary metabolism

Spaceflight and ground-based microgravity analog experiments have suggested that microgravity can affect microbial growth and metabolism. Although the effects of microgravity and its analogs on microorganisms have been studied for more than 50 years, plausible conflicting and diverse results have frequently been reported in different experiments, especially regarding microbial growth and secondary metabolism. Until now, only the responses of a few typical microbes to microgravity have been investigated; systematic studies of the genetic and phenotypic responses of these microorganisms to microgravity in space are still insufficient due to technological and logistical hurdles. The use of different test strains and secondary metabolites in these studies appears to have caused diverse and conflicting results. Moreover, subtle changes in the extracellular microenvironments around microbial cells play a key role in the diverse responses of microbial growth and secondary metabolisms. Therefore, "indirect" effects represent a reasonable pathway to explain the occurrence of these phenomena in microorganisms. This review summarizes current knowledge on the changes in microbial growth and secondary metabolism in response to spaceflight and its analogs and discusses the diverse and conflicting results. In addition, recommendations are given for future studies on the effects of microgravity in space on microbial growth and secondary metabolism.

Establishment of a Predictive Diagnostic Model for Acute Mycoplasma Pneumoniae Infection in Elderly Patients with Community-acquired Pneumonia

We established a diagnostic model to predict acute Mycoplasma pneumoniae （M. pneumonia） infection in elderly Community-acquired pneumonia （CAP） patients. We divided 456 patients into acute and non-acute M. pneumoniae infection groups. Binary logistic regression and receiver operating characteristic （ROC） curves were used to establish a predictive model. The following independent factors were identified： age 〉 70 years; serum cTNT level 〉 0.0S ng/mL; lobar consolidation; mediastinal lymphadenopathy; and antibody titer in the acute phase 〉 1：40. The area under the ROC curve of the model was 0.923 and a score of 2 7 score predicted acute M. pneumoniae infection in elderly patients with CAP. The predictive model developed in this study has high diagnostic accuracy for the identification of elderly acute M. pneumoniae infection.

The association between orthostatic blood pressure changes and subclinical target organ damage in subjects over 60 years old

Background Although recent studies have indicated that both orthostatic hypotension and orthostatic hypertension independently predict cardiovascular events,the underlying mechanisms are still controversial.The aim of the study was to investigate the relationships between orthostatic changes and organ damage in subjects over 60 years old.Methods This is a prospective observational cohort study.One thousand nine hundred and ninety-seven subjects over 60 years old were enrolled.Participants were grouped according to whether they had a drop>20 mmHg in systolic or>10 mmHg in diastolic BP(orthostatic hypotension),an increase in mean orthostatic systolic blood pressure>20 mm Hg(orthostatic hypertension),or normal changes within 3 min of orthostatism.Multiple regression modeling was used to investigate the relationship between orthostatic hypotension,orthostatic hypertension and subclinical organ damage with adjustment for confounders.Results Orthostatic hypotension and orthostatic hypertension were found in 461(23.1%)and 189(9.5%)participants,respectively.Measurement of carotid intima-media thickness(IMT),brachial-ankle pulse wave velocity(baPWV),clearance of creatinine,and microalbuminuria were associated with orthostatic hypotension;measurement of IMT and baPWV were associated with orthostatic hypertension in a cruse model.After adjustment,IMT[odds ratio(OR),95%confidence interval(CI)per one-SD increment:1.385,1.052-1.823;P=0.02],baPWV(OR=1.627,95%CI:1.041-2.544;P=0.033)and microalbuminuria(OR=1.401,95%CI:1.002-1.958;P=0.049)were still associated with orthostatic hypotension,while orthostatic hypertension was only associated with IMT(OR=1.730,95%CI:1.143-2.618;P=0.009).Conclusions Orthostatic hypotension seems to be independently correlated with increased carotid atherosclerosis,arterial stiffness and renal damage in subjects over 60 years old.Orthostatic hypertension correlates with carotid atherosclerosis only.

High prevalence of aspirin resistance in elderly patients with cardiovascular disease and metabolic syndrome

BackgroundMetabolic 症候群被知道是一个 prothrombotic 状态。我们拿了这研究检验阿司匹林抵抗可以与新陈代谢的症候群被联系的一个假设，并且与心血管的疾病(CVD ) 在病人估计阿司匹林抵抗的另外的潜在的决定因素有 CVD 的 469 个老病人全部的 .MethodsA 被招募。有新陈代谢的症候群的 172 个病人并且没有新陈代谢的症候群(控制组) ， 297 收到了每日的阿司匹林治疗(&#x02265；75 mg ) 超过一个月。血小板聚集被轻传播 aggregometry (LTA ) 测量。阿司匹林抵抗被定义为 &#x02265；20% arachidonic 酸(AA )- 并且 &#x02265；70% 腺苷 diphosphate (自动数据处理) 根据 LTA 导致了聚集。阿司匹林半应答者被定义为遇见一个(然而并非) 这些 criteria.ResultsBy LTA， 469 中的 38 个(8.1%) 病人们是阿司匹林抵抗。阿司匹林抵抗的流行与控制组相比在新陈代谢的症候群组是更高的[11.6 % 对 6.6% ，机会比率(或)= 2.039；95% 信心间隔(CI ) ：1.047-3.973 ] 。在 multivariate 逻辑回归分析，新陈代谢的症候群(或 = 4.951， 95% CI：1.440-17.019， P = 0.011 ) 是为有 CVD 和新陈代谢的症候群的病人的重要数字是的阿司匹林 resistance.ConclusionsA 的一个重要风险因素对阿司匹林治疗抵抗。这可能进一步在这些病人增加心血管的病态和死亡的风险。

UROTENSIN II RECEPTOR IN THE RAT AIRWAY SMOOTH MUSCLE AND ITS EFFECT ON THE RAT AIRWAY SMOOTH MUSCLE CELLS PROLIFERATION

Objective. To investigate the characteristics of urotensin II (U II) receptor in the rat airway smooth muscle and the effect and signal transduction pathway of U II on the proliferation of airway smooth muscle cells. Methods. Using 125I UII binding assay to measure the Bmax and Kd of U II receptor. Using the 3H TdR incorporation to determine the effect of U II on the proliferation of airway smooth muscle cells and its signal transduction pathway. Using Fura 2/AM to measure the effect of U II on the cytosolic free calcium concentration. Results. 1. 125I UII binding increased with the time and reached saturation at 45min. The Bmax was (11.36±0.37)fmol/mg pr and Kd was (4.46±0.61)nmol/L. 2. U II increased 3H TdR incorporation of the airway smooth muscle cells in a dose dependent manner. 3. H7, PD98059 and nicardipine, inhibitors of PKC, MAPK, calcium channel, respectively, significantly inhibited U II stimulated 3H TdR incorporation of airway smooth muscle cells. W7, inhibitor of CaM PK, had no effect. 4. Cyclosporin A, inhibitor of CaN, inhibited 3H TdR incorporation of the airway smooth muscle cells induced by U II in a dose dependent manner. 5. U II promoted cytosolic free calcium concentration increase by 18%. Conclusions. 1. There was U II receptor in the rat airway smooth muscle. 2. The effect of U II stimulated 3H TdR incorporation of airway smooth muscle cells was mediated by such signal transduction pathway as Ca2+, PKC, MAPK and CaN, etc.

Study of serum level of sex hormones and expression of their receptors in patients with bronchogenic carcinoma

Objective: To study the serum level of estradiol, progesterone and testosterone (SEL, SPL and STL) and the expression of the receptors of estradiol and progesterone (ER and PR) in 53 cases of bronchogenic carcinoma. Methods: ER and PR in the tissue of the carcinoma were determined with enzyme-linked affinity histochemical method. SEL, SPL and STL were measured with double antibody radioimmunoassay. Results: Most of ER and PR were present in the cytoplasm of the malignant cells (58.2%) and the positive rates of ER and PR were 49.1% and 54.7% respectively. SEL and SPL were significantly higher in the patients with lung cancer than in the subjects of the control groups (P<0.05), no matter whether ER and PR were positive or negative. SEL and SPL were lower in the ER positive, PR positive and both ER and PR positive groups than in the ER negative, PR negative and both ER and PR negative groups. Conclusion: The existence of ER and PR in the patients with bronchogenic carcinoma indicates that the pathogenesis of bronchogenic carcinoma is sex hormone dependent to some extent. ER and SEL are negatively correlated with a correlative coefficient of -1.

Carcinoma ex pleomorphic adenoma of the trachea: A case report

BACKGROUND Carcinoma ex pleomorphic adenoma (CXPA) is defined as a malignant salivary gland tumor arising from a primary or recurrent pleomorphic adenoma.Only three cases of CXPA of the trachea have been reported in the literature.CASE SUMMARY We report a case of tracheal CXPA in a 55-year-old woman,who presented with a more than 3-mo history of progressive dyspnea.Computed tomography of the neck and thorax revealed an inhomogeneous,broad-based lesion arising from the tracheal wall on the right side.Endoscopy revealed a subglottic neoplasm causing up to 90% luminal stenosis.The tumor was resected using a highfrequency electrosurgical snare combined with argon plasma coagulation.Histopathology and immunohistochemistry revealed that the tumor was a CXPA of the trachea.CONCLUSION We report the fourth case of tracheal CXPA,and present the first instance of resection of CXPA using high-frequency electrosurgical snare and laser ablation.We also discuss the pathogenesis,diagnosis,histopathology,and systemic therapy of this rare disease.