Comparison of the clinical characteristics and comprehensive assessments of the 2011 and 2017 GOLD classifications for patients with COPD in China.

OBJECTIVE: Compared with the 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD), there have been significant changes in the 2017 GOLD classification. The purpose of this study was to analyze the changes in clinical characteristics of the new A-B-C-D system and to explore its role in comprehensive assessment of COPD. SUBJECTS AND METHODS: A total of 631 stable COPD patients were included in a cross-sectional survey. Data collected included baseline data and pulmonary function testing results, respiratory muscle strength, symptoms and quality of life, exercise capacity, nutritional status, and anxiety and depression as a comprehensive assessment. Based on the 2011 GOLD and 2017 GOLD classifications, patients were divided into Groups A1-D1 and Groups A2-D2, respectively. RESULTS: In the 2011 GOLD, 64 subjects in Group C1 were reclassified into Group A2 (41.6%), while 77 subjects in Group D1 were reclassified into Group B2 (27.1%). The old and new grading systems were somewhat consistent (Cohen's kappa=0.6963, P<0.001). Lung function was lower, while the body mass index, airflow obstruction, dyspnea, and exercise capacity index (BODE index) was higher in Group A2 than in Group A1 (P<0.001). In Group B2, lung function, 6-minute walking distance (6MWD), and respiratory muscle strength were significantly lower than in Group B1 (P<0.001), while the BODE index (P<0.001) was higher. In comprehensive assessment, subjects in Groups B2 and D2 had significantly lower lung function, 6MWD, respiratory muscle strength, quality of life, higher symptom scores, and BODE index than subjects in Group A2 (P<0.001). The differences between Group A2 and C2 were small. CONCLUSION: Compared with the 2011 GOLD, the 2017 GOLD reclassified more patients into Groups A and B, those with significantly worse lung function and higher BODE index. In the comprehensive assessment of the new classification, Groups B and D may have greater disease severity. However, the effectiveness of the new grading system in predicting patient prognosis, and its guidance on the use of drugs, remains to be explored in future studies.

[Disinfection Action of Ultraviolet Radiation and Chlorination on Escherichia coli and Poliovirus].

We chose Escherichia coli (E. coli) and poliovirus as a typical pathogenic bacterium and virus, respectively. The effects of two typical disinfectants (chlorine and ultraviolet) on each of them were investigated based on microbial culture and quantitative PCR methods. The results showed that Poliovirus was appreciably more resistant to chlorine (required disinfection dose for 1-log microbial reduction:10.14 mg·L-1·min for E. coli; 19.2 mg·L-1·min for poliovirus) and ultraviolet (UV) light (required UV dose for 1-log microbial reduction:1.81 mJ·cm-2 for E. coli; 6.37 mJ·cm-2 for poliovirus) than E. coli for the microbial culture. For PCR, this study revealed that 1-log gene reduction required UV doses and ct values of at least one to two orders of magnitude higher than that for the microbial culture. The damage of RNA in Poliovirus was more seriously than that of DNA in E. coli. Single-stranded RNA was more sensitive to UV irradiation than DNA. The result evaluated with the quantitative PCR method showed opposite result to that of the traditional culture method in which the Poliovirus was more tolerant. The required UV doses for 1-log nucleic acid reduction were 135 mJ·cm-2 and 270.3 mJ·cm-2 for E. coli and poliovirus, respectively. Nucleic acid damage required a higher dose of disinfectants than microbial inactivation, which was probably attributed to the phenomenon of viable but non-culturable (VBNC) cells, other molecular targets of inactivation and the persistence of nucleic acid after cell death.

[Study on transvaginal hydrolaparoscopic pelvic adhesiolysis in the infertile women.].

OBJECTIVE: To investigate the safety and efficacy of transvaginal hydrolaparoscopic pelvic adhesiolysis (THLPA) treatment in the infertile women. METHODS: From May 2007 to Sep. 2008, 30 infertile patients underwent THLPA. The dye-test, hysteroscopy, and dye-test using catheterization of tubal ostium by hysteroscopy were performed at the same time. Pelvic adhesions were scored according to the revised American Fertility Society classification of endometriosis (1985). The adhesions were graded as mild (score 1-9), moderate (10-19), and severe (>/= 20). Twenty-four cases were in mild adhesions, 5 moderate adhesions, and 1 severe adhesion. The duration of the operation and discharge, pelvic adhesions score, tubal patency, complications, and pregnancy rate were investigated. RESULTS: (1) THPLA: the majority of pelvic adhesions in all patients were successfully performed adhesiolysis. Only a little filmy adhesions of proximal peritube of 7 tubes and proper ligament of 5 ovaries and cohesive adhesions of 4 ovaries did not underwent surgical lysis. (2) Tubal patency: 35 tubes were of proximal occlusion by dye-test, of which 21 (60%, 21/35) were unobstructed and 4 (11%, 4/35) were partly unobstructed after the dye-test using catheterization of the tubal ostium by hysteroscopy. (3) The duration of operation: the overall operative time were (32 +/- 6) minutes in mild adhesion, (52 +/- 6) minutes in moderate adhesion, and 83 minutes in severe adhesion. Of which the time of THLPA were (11 +/- 5) minutes in mild adhesion, (35 +/- 7) minutes in moderate adhesion, and 62 minutes in severe adhesion, respectively. (4) The duration of discharge: the postoperative discharge time was 120 - 175 minutes. No complications occurred. (5) The rate of pregnancy: in the (15.8 +/- 4.3) months' follow-up, the rate of pregnancy was 45% (13/29), which one patient lost follow-up. CONCLUSIONS: THLPA is safe, efficacious and not being hospitalized management. When compared with laparoscopy, it is simpler, more economic, and less minimally invasive approach. The appropriate indication of THLPA is to treat filmy, especially mild pelvic adhesions. It could partly avoid transabdominal operative laparoscopy for the infertile women.

Twist is transcriptionally induced by activation of STAT3 and mediates STAT3 oncogenic function.

To explore the basis of metastasis, we compared the human breast cancer lines MCF-7 and MDA-MB453, which have low invasive ability, with their sublines MCF7-I4 and MDA-MB453-I4 with high invasive ability for gene expression and signaling pathways. We previously showed that the I4 lines had dramatically elevated levels of Twist compared with their parental lines. In this study, we observed significantly increased STAT3 Tyr(705) phosphorylation, but not the STAT3 protein levels, in the I4 lines. Activation of STAT3 by interleukin-6 or expression of activated Src induced Twist expression at protein and mRNA levels. Inhibiting STAT3 by a small molecule inhibitor, JSI-124, STAT3 small hairpin RNAs, or dominant negative STAT3 resulted in significant reduction of Twist protein and mRNA expression. STAT3 directly bound to the second proximal STAT3-binding site on the human Twist promoter and activated its transcriptional activity. Inhibition of STAT3 reduced migration, invasion, and colony formation of the I4 cells. Ectopic expression of Twist significantly rescued those phenotypes. Ten normal and 46 tumor specimens of breast tissues were examined for activation of STAT3 and expression of Twist. There was a strong correlation between Tyr(705) p-STAT3 and Twist level in the late stage tumor tissues. Our results indicate that activated STAT3 transcriptionally induces Twist, which plays an important role in promoting migration, invasion, and anchorage-independent growth. Together with our previous observation that Twist transcriptionally induces AKT2 to mediate Twist-promoted oncogenic functions, we conclude that STAT3, Twist, and AKT2 form a functional signaling axis to regulate pivotal oncogenic properties of cancer cells.

[Application of fertiloscopy in infertile women].

OBJECTIVE: To investigate the advantages of fertiloscopy in the examination and therapy of infertile women. METHODS: One hundred and fifteen infertile patients underwent fertiloscopy including transvaginal hydrolaparoscopy (THL), conventional dye-test, hysteroscopy, and dye-test using catheterization of the tubal ostium by hysteroscopy from May 2003 to Mar 2005. Access to the pouch of Douglas was achieved in 110 patients (95.7%). The primary infertile patients (primary group) and secondary infertile patients (secondary group) included respectively 49 and 61 cases. The patients of tubal occlusion in two groups were respectively 21 and 22 cases preoperatively. The fallopian tube patency, pelvic adhesions, complete evaluation (all pelvic organs seen) or not, and intra- and postoperative complications were observed. RESULTS: There was no significant difference in the percentage of uni- and bilateral tubal patency cases between two groups postoperatively (69.4%, 34/49 vs 68.9%, 42/61) (P > 0.05). Of the cases that were bilateral tubal occlusion in both groups preoperatively, the uni- and bilateral tubal patency cases accounted for respectively 47.6% (10/21) and 50.0% (11/22) (P > 0.05) postoperatively. There was no significant difference in the percentage of pelvic adhesions cases between two groups (42.9%, 21/49 vs 60.7%, 37/61; P > 0.05). The overall complete evaluation rate of pelvic organs was 69.1% (76/110), the rates of both groups were respectively 77.6% (38/49) and 62.3% (38/61, P > 0.05). The rate of additional transabdominal operative laparoscopy was 18.2% (20/110) after fertiloscopy, of which, the rate of primary group was only 8.2% (4/49), much less than that of secondary group (26.2%, 16/61; P < 0.05). Seventeen women underwent transabdominal operative minilaparoscopy after fertiloscopy. No complications including pelvic organ injury, rectum perforation, intra- and postoperative bleeding, and postoperative pelvic inflammation occurred. CONCLUSIONS: THL is simple, convenient, and complication-free for the infertile women. Fertiloscopy could be used as a first-line and one-stop procedure in the pelvic assessment of infertile women without clinical or ultrasound evidence of pelvic disease instead of transabdominal laparoscopy. Transabdominal laparoscopy should be only used as a complementary procedure after fertiloscopy.