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The basement membrane is a specialized extracellular matrix between the epithelium and the mesenchyme.In stratified epithelium,only the basal cells in contact with the basement membrane exhibit the apical-basal polarity,whereas the epithelial cells do being not in contact with the basement membrane do not exhibit the apical-basal polarity.The basement membrane plays an important role in epithelial cell polarization.It is an important extracellular matrix(ECM)structure in the multicellular organisms,is situated between the epithelium and the mesenchyme,and is produced jointly by the epithelial cells and mesenchymal cells.Its components mainly include Laminin,type Ⅳ collagen(Col-Ⅳ),nidogen(NDG),and heparan sulfate proteoglycans(HSPG),and each component plays the different role in influencing the epithelial cell polarity.The network scaffold formed by Col-Ⅳ and Laminin is the main structure of the basement membrane,and the integrity of the structure affects the epithelial cell polarization.This review summarizes the composition and structure of the basement membrane,focuses on its role in epithelial cell polarization and its mechanism,and compiles the current status of biomimetic basement membrane materials that promotes the epithelial cell polarization,and provides the theoretical foundation for further exploration of the establishment and maintenance of epithelial cell polarity.
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Transcatheter aortic valve replacement(TAVR)has become one of the effective methods for treating patients with aortic valve disease.With the continuous maturity of technology,innovation of instruments and increasing experience,the indications for TAVR has been expanded.Following international trends,the number of TAVR in China has steadily increased with each passing year.In 2023,the long-term follow-up results of TAVR in low-risk AS patients further confirm the long-term benefits of TAVR.The relevant research on TAVR for patients with aortic regurgitation and patients with bicuspid aortic stenosis provide evidence support for the expansion of TAVR indications.At the same time,the development of valve devices and new technological innovations are emerging in an endless stream,and the new concept of full life cycle management is increasingly being valued.Especially in China,the development of local devices is progressing rapidly,and multiple devices have entered the clinical research stage.The clinical manifestations and research results are worth pursuing.
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Tunneling nanotube (TNT) is a newly discovered communication mode between animal cells in recent years, which have important physiological and pathological significance. However, the role of TNT in bone biology is still unclear. At present, there are many reports about tunneling nanotubes in bone marrow mesenchymal stem cells, osteoclast precursor cells, osteoblasts and immune cells. This review describes the research advances of TNT and its research progress in bone biology. It looks forward to the research direction of TNT in oral and maxillofacial bone development and bone biology, to provide new strategies for the maintenance of bone homeostasis and the treatment of bone diseases.
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Animals , Bone and Bones , Nanotubes , Osteoclasts , Biology , Cell Communication/physiologyABSTRACT
Fibro-osseous lesions is a class of diseases with obvious similarities in clinical manifestations and pathological features, which has been attracting the attention of clinicians and pathologists. The latest WHO 2022 Classification (5th edition) included six of these diseases (cemento-osseous dysplasia, segmental odontomaxillary dysplasia, fibrous dysplasia, juvenile trabecular ossifying fibroma, psammomatoid ossifying fibroma and familial gigantiform cementoma) in the " fibro-osseous tumours and dysplasias ", and put forward new ideas on the diagnosis and treatment of these diseases. According to the latest WHO 2022 Classification (5th edition), the clinical and pathological features, diagnosis and differential diagnosis of these six diseases were described.
Subject(s)
Humans , Fibroma, Ossifying/pathology , Diagnosis, Differential , Cementoma/pathology , Jaw Neoplasms , Facial BonesABSTRACT
Objective:To evaluate our novel path based on anatomical division of the anterior lateral wall of calcaneus and the sustentaculum tali for precise sustentacular screw placement in the surgical treatment of calcaneal fractures of Sanders types Ⅱ and Ⅲ.Methods:The anterior lateral wall of the calcaneus was divided into the anterior-superior zone S 1, the anterior-inferior zone S 2, the posterior-superior zone S 3 and the posterior-inferior zone S 4 for demarcation of the screw insertion points by our method of Four Zones, and into the front, middle and rear sections by our method of Three Sections for demarcation of the screw target points. The specimens were scanned by CT and modeled by Mimics. On the 3D virtual model of the calcaneus, one screw was placed from each zone of the anterior lateral wall of the calcaneus to the sustentaculum tali body. The screw placement target for S 1 and S 2 was the medial intersection point P 1 of the front and middle sections of the sustentaculum tali, and that for S 3 and S 4 was the medial intersection point P 2 of the middle and rear sections of the sustentaculum tali. It was observed whether the screws were placed in the bone channel. A total of 72 patients were included who had been admitted to Department of Orthopaedics, Suqian Hospital Affiliated to Xuzhou Medical University for calcaneal fractures of Sanders types Ⅱ and Ⅲ from January 2017 to January 2021. They were divided into an anatomical division group and a 3D printing group according to their screw placement method for the sustentaculum tali. In the anatomical division group of 32 patients subjected to screw placement based on our anatomical division, there were 25 males and 7 females, aged from 24 to 60 years; in the 3D printing group of 40 patients subjected to screw placement assisted by 3D printing, there were 31 males and 9 females, aged from 25 to 58 years. The disparities between the parameters of sustentacular screw placement and the actual values were compared in the anatomical division group, and the total number of screws, screws on average, distribution of screws, and accuracy of screw placement were compared between the 2 groups. Results:All the screws which were virtually placed in the specimens of the calcaneus from S 1 and S 2 to P 1 and from S 3 and S 4 to P 2 passed through the bony channel, with no perforation into the tarsal sinus. There was no significant difference in the general date between the anatomical division group and the 3D printing group, showing they were comparable ( P > 0.05). In the anatomical division group, a total of 52 screws were placed to the sustentaculum tali with an average of (1.63 ± 0.48) screws per patient, and 2 screws were placed in 20 patients, yielding an accuracy rate of screw placement of 92.3% (48/52). There were no statistically significant differences between the parameters and the actual values of screw placement in the anatomical division group ( P > 0.05). In the 3D printing group, a total of 63 screws were placed to the sustentaculum tali with an average of (1.58 ± 0.49) screws per patient, and 2 screws were placed in 23 patients, yielding an accuracy rate of screw placement of 93.7% (59/63). There were no significant differences in the above comparisons between the anatomical division group and the 3D printing group ( P > 0.05). Conclusion:In the surgical treatment of calcaneal fractures of Sanders types Ⅱ and Ⅲ, the sustentacular screw placement based on our anatomical division of the anterior lateral wall of the calcaneus and the sustentaculum tali can lead to similar clinical accuracy as 3D printing-assisted screw placement does.
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Objective:To evaluate the clinical application of virtual and simulation techniques to aid pre-operative design for precise screw placement into the sustentaculum tali in the treatment of intra-articular calcaneal fractures.Methods:From January 2016 to January 2019, 68 patients were treated at Department of Orthopaedics, Suqian Hospital Affiliated to Xuzhou Medical University for intra-articular calcaneal fractures of Sanders types Ⅱ-Ⅳ. According to different designs of screw placement into the sustentaculum tali, they were assigned into a control group (38 cases and 42 feet) and an observation group (30 cases and 33 feet). There were 24 males and 14 females with an age of 39.3 years±8.8 years in the control group. There were 17 males and 13 females with an age of 42.0 years ± 7.6 years in the observation group. The control group was given a routine placement design based on the X-ray and MSCT scanning images of the injured feet. In the observation group, a Mimics model was first constructed using the X-ray and MSCT scanning images of the normal or less injured feet for further virtual screw placement into the sustentaculum tali on a 3D printed model. The disparity was investigated between the parameters designed and the actual values in both groups. The 2 groups were compared in terms of average placements, screw distribution, placement accuracy, placement time and Maryland scores of foot function one year after operation.Results:There were no significant differences in the preoperative general data between the 2 groups, showing comparability ( P>0.05). The design parameters and actual values in the control group were respectively as follows: 17.7°±3.2° versus 15.1°±5.9° in upward oblique angle, 20.3°±2.1° versus 16.2°±6.8° in backward oblique angle, and 47.9 mm ± 3.8 mm versus 45.4 mm ± 4.2 mm in length of screw path, showing significant differences ( P< 0.05). The design parameters and actual values in the observation group were as follows: 16.5°±3.5° versus 17.1°±3.9° in upward oblique angle, 20.9°±4.3° and 19.6°±3.8° in backward oblique angle, and 48.1 mm ± 3.1 mm versus 47.3 mm ± 3.8 mm in length of screw path, showing insignificant differences ( P>0.05). The average screw placements into the sustenta culum tali in the observation group (1.6±0.5) were significantly more than those in the control group (1.2±0.4). Compared with the control group, the observation group had a higher rate of placement of 2 screws[60.6 % (20/23) versus 16.7% (7/42)], higher accuracy of placement [94.3% (50/53) versus 77.6% (38/49)], less placement time for each screw (9.6 mm±3.9 min versus 13.2 mm±4.7 mm), less placement time for each foot (15.6 mm±4.8 min versus 20.5 mm±3.8 mm), and higher Maryland scores at one year after operation (94.2±6.5 versus 89.7±6.9). All the above comparisons were statistically significant ( P<0.05). Conclusions:Application of virtual and simulation techniques to aid pre-operative design for precise screw placement into the sustentaculum tali can improve the outcomes of intra-articular calcaneal fractures, because it increases the number of screws placed, enhances quality of screw placement, shortens operation time, and thus facilitates functional recovery of the injured foot.
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The polarity of ameloblasts and odontoblasts is crucial for their differentiation and function. Polarity-related molecules play an important role in this process. This review summarizes the process of polarity formation of ameloblasts and odontoblasts and their related regulators.
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Ameloblasts , Cell Differentiation , OdontoblastsABSTRACT
Objective Mifepristone (MIF) can inhibit triple-negative breast cancer cell (TNBC) survival at high concentra-tions. The purpose of the present study is to study the effect of mifepristone derivatives on triple-negative breast cancer cell (TNBC) survival at low concentrations. Methods SUM149PT and HCC1937 triple negative breast cancer cells were used in the study; the experiment was set in four groups: DMSO group,MIF group(10 μmol/L MIF),5 μmol/L FZU-00,033 group and 10 μmol/L FZU-00,033 group. They were treated with 24,48,72 h,and cell viability was measured by SRB. KLF5 overexpression HCC1937 cell line was used in the study; the experiment was set in four groups: PCDH-DMSO group(PCDH vector,DMSO),PCDH-FZU-00,033 group (PCDH vector,10 μmol/L FZU-00,033),KLF5-DMSO group(overexpress KLF5,DMSO),KLF5-FZU-00,033 group(overexpress KLF5,10 μmol/L FZU-00,033). Cell apoptosis was investigated by detecting PARP cleavage using Western blot. In order to investi-gate how FZU-00,033 reduced cell viability,we detected KLF5 protein expression after drug treatment. On the basic of the original PC-DH-DMSO group,PCDH-FZU-00,033 group,KLF5-DMSO group and KLF5-FZU-00,033 group,5 μmol/L PCDH-FZU-00,033 group (PCDH vector,5 μmol/L FZU-00,033),5 μmol/L KLF5-FZU-00,033 group(overexpress KLF5,5 μmol/L FZU-00,033). Western blot was used to detect the effect of FZU-00,033 in KLF5 overexpression cell line. Results Compared with DMSO group,5 μmol/L FZU-00,033 group,10 μmol/L FZU-00,033 group and MIF group decreasd TNBC cell viability more efficiently at 24,48,72h (P<0.01); the cell survival rate of DMSO group,5 μmol/L FZU-00,033 group,10 μmol/L FZU-00,033 group and MIF group was [(100±4)%,(17±2)%,(5±1)%,(58±1)%] respectively in SUM149PT cell line and was [(100±7)%,(39±1)%,(30±1)%,(62±1)%] respectively in HCC1937 cell line. Compared with MIF group,5 μmol/L FZU-00,033 group and 10 μmol/L FZU-00,033 group decreasd TNBC cell viability more efficiently at 24,48,72 h (P<0.01). Compared with DMSO group,5 μmol/L FZU-00,033 group,10 μmol/L FZU-00,033 group and MIF group suppressed KLF5 expression more potently and increased cell apoptosis. Com-pared with 10 μmol/L MIF group,5 μmol/L FZU-00,033 group and 10 μmol/L FZU-00,033 group significantly increased apoptosis. Compared with PCDH-DMSO group,10 μmol/L PCDH-FZU-00,033 group decreasd TNBC cell viability more efficiently at 48,72 h and cell survial rate was [(100±6)% vs (39±2)%,P<0.05] and [(100±3)% vs (21±1)%,P<0.05] respectively. Compared with KLF5-DMSO group,10 μmol/L KLF5-FZU-00,033 group decreasd TNBC cell viability more efficiently at 48,72h and cell survial rate was [(100±1)% vs (47±1)%,P<0.05] and [(100±1)% vs (27±1)%,P<0.05] respectively; Meanwhile,Compared with 10 μmol/L PCDH-FZU-00,033 group,10 μmol/L KLF5-FZU-00,033 group increased TNBC cell viability more efficiently at 48,72 h (P<0.05). Compared with PCDH-DMSO group,5 μmol/L PCDH-FZU-00,033 group and 10 μmol/L PCDH-FZU-00,033 group in-creased cell apoptosis; Compared with KLF5-DMSO group,5 μmol/L KLF5-FZU-00,033 group and 10 μmol/L KLF5-FZU-00,033 group increased cell apoptosis. Conclusion Novel mifepristone derivative FZU-00,033 suppressed TNBC cell viability partially through suppressing KLF5 expression.
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Objective:To study the expressions of cell polarity related proteins CDC42 and PAR3 during tooth germ development in the mice,and to discuss their possible roles during tooth development in the mice.Methods:The whole heads were obtained from the mouse embryo on the days 13.5,14.5,16.5 and 18.5 (E13.5,E14.5,E16.5 and E18.5) and the mice on the postnatal days 1 (PN1) and 5 (PN5).The tissues were fixed in paraformaldehyde,decalcified,dehydrated,embedded in paraffin,and sectioned.The histology of tooth germ was observed by HE staining.The expressions of CDC42 and PAR3 during tooth germ development were detected by immunohistochemistry staining.Results:The HE staining results showed that E13.5,E14.5,E16.5 and E18.5were the bud stage,the cap stage,the early and the late bell stage of tooth germ development,respectively;the tooth germ of PN1 mice showed the matured odontoblasts and ameloblasts;the tooth germ of PN5 mice showed the completed tooth crown development.The immunohistochemistry staining results showed that CDC42 expressed in the tooth germ of the mice at E13.5,E14.5 and E16.5;the CDC42 expression at E 18.5 was reduced compared with E13.5,E14.5 and E16.5;CDC42 mainly expressed in the odontoblasts and ameloblasts of the tooth germ of the mice at PN1 and PN5;PAR3 weakly expressed in the tooth germ of the mice at E13.5 and E14.5,and it was increased at E16.5 and E18.5.At PN1 and PN5,the expressions of PAR3 were decreased compared with E18.5.Conclusion:CDC42 and PAR3 partieipat in the mouse tooth development;during the early stage of tooth germ development,they may be involved in the proliferation and migration of mouse dental germ;during the late stage,CD42 and PAR3 may be involved in the differentiation of the odontoblasts and the ameloblasts,especially in the establishment and maintenance of cell polarity.
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The bone morphogenetic protein (BMP) family is an important factor in the regulation of cell ular life activities and in the development of almost all tissues. BMP-mediated signaling plays an important role in tooth root development, which is a part of tooth development. Epithelial and mesenchymal interactions are involved in tooth root development, but the BMP signaling pathway has a different effect on tooth root development in epithelial and mesenchymal. This review summarizes the advances of BMP signaling in tooth root development.
Subject(s)
Bone Morphogenetic Protein 2 , Bone Morphogenetic Protein 7 , Bone Morphogenetic Proteins , Physiology , Odontogenesis , Signal Transduction , Tooth , Tooth RootABSTRACT
Objective:To investigate the diagnosis and prognosis of one patient with carcinoma ex pleomorphic adenoma (CXPA)composed of three malignant components in parotid gland,and to raise the clinicians'awareness of the disease.Methods:A patient was presented to hospital because of the mass in left parotid gland region for more than 30 years and the accompanied pain lasted for one month.After color ultrasonography,the left parotid gland tumor resection was performed. Results: The operation was successful. The postoperative pathological diagnosis results comfirmed as CXPA,it was composed of three malignant components,including non-specific adenocarcinoma,ductal carcinoma,and myoepithelial carcinoma.Conclusion:CXPA composed of three malignant components at the same time are extremely rare.CXPA is difficult to diagnose and its prognosis is poor.The clinicians are supposed to improve the understanding of CXPA.
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Objective To identify the efficacy of granulocyte-macrophage colony-stimulating factor (GM-CSF) gargle in patients who had oral mucositis after allogeneic hematopoietic stem cell transplantation. Methods A total of 134 patients were enrolled in this study from 2014 to 2015. They were randomly divided into two groups:the experimental group (n=65) and the control group (n=69). Both groups received preventive measures for oral mucositis. But once oral mucositis occurred, the control group continued with the routine nursing measure, while the experimental group added GM-CSF gargle based on previous routine nursing measure. The effective rate and healing time were compared between two groups. Results The effective rate of the experimental group (81.54%, 53/65) was significantly higher than that of the control group (24.64%,17/69) (χ2=43.434, P=0.000). The median healing time in the experimental group was 4.5 days, shorter than 9.0 days in the control group (Z=-5.379, P< 0.01). Conclusions GM-CSF gargle can control the oral mucositis after allogeneic hematopoietic stem cell transplantation.
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In recent years,chimeric antigen receptor T -cells(CAR-T cells)therapy becomes the new rapid development of adoptive tumor immunotherapy .Its main characteristic is to identify specific T cell receptor of tumor antigen by genetic engineering modification and give its targeting ,killing and persistent treatment .The CAR-T was mentioned for the first time in 1989,and has developed to the fourth generation .CD19-CAR-T treatment technique shows activity in phase I clinical trials of multiple research centers .CAR-T therapy is ex-pected as a new way to cure relapse/refractory hematological malignancies .
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Leukemia stem cells(LSC) are the root causes of the leukemia, and are also the main reason for the leukemia relapse. Researchers hope that there are some methods to specifically mark the LSC and to clear them for promoting the advancements in the treatment of leukemia. This review discusses the biological characteristics of LSC and its microenvironment, the current internationally recognized main methods for specific marking of LSC, including marking LSC self-renewal, apoptosis signaling pathways, microenvironment, cell cycle-related signaling pathways and LSC-specific immune phenotype, so as to eliminate LSC and minimal residual disease through these marking ways. But, at present, there are no specific methods to remove leukaemia stem cells independently, possibly the combination of LSC immune phenotype with blocking the microenvironment signaling pathways can target at and remove LSC, thus improving the prognosis of leukemia.
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Animals , Humans , Apoptosis , Immunophenotyping , Leukemia , Metabolism , Pathology , Neoplastic Stem Cells , Signal Transduction , Tumor MicroenvironmentABSTRACT
Objective:To study the effect of IL-24 on the differentiation and function of osteoclasts.Methods:Mature osteoclasts were isolated from long bones of neonate rats.Optimal multiplicity of infection(MOI)of AdCMV-EGFP was determined.Then osteo-clasts and RAW264.7 cells were transfected with AdCMV-EGFP and AdCMV-IL-24 respectively.The function of osteoblasts was studied by the observation of bone resorption lacunae,the differentiation of RAW264.7 cells was evaluated by the expression of osteo-clast related genes examined with real-time PCR.Results:Osteoclasts were TRAP positive with more than 2 neclei.MOI=400 was suitable for AdCMV-EGFP transfection.The resorption lacunae area in AdCMV-IL24 transfected cells was larger than that in AdCMV-EGFP transfected cells(P<0.05).Real-time PCR showed that under induced conditions,osteoclastic related genes NFATc1,CTSK and TRAP were changed in RAW264.7 cells transfected with AdCMV-IL-24.Conclusion:IL-24 may promote the differentiation and function of osteoclasts.
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OBJECTIVE: To investigate the involvement of ephrinB2 in periodontal tissue remodeling in compression areas during orthodontic tooth movement and the effects of compressive force on EphB4 and ephrinB2 expression in osteoblasts and osteoclasts. METHODS: A rat model of experimental tooth movement was established to examine the histological changes and the localization of ephrinB2 in compressed periodontal tissues during experimental tooth movement. RAW264.7 cells and ST2 cells, used as precursor cells of osteoclasts and osteoblasts, respectively, were subjected to compressive force in vitro. The gene expression of EphB4 and ephrinB2, as well as bone-associated factors including Runx2, Sp7, NFATc1, and calcitonin receptor, were examined by quantitative real-time polymerase chain reaction (PCR). RESULTS: Histological examination of the compression areas of alveolar bone from experimental rats showed that osteoclastogenic activities were promoted while osteogenic activities were inhibited. Immunohistochemistry revealed that ephrinB2 was strongly expressed in osteoclasts in these areas. Quantitative real-time PCR showed that mRNA levels of NFATc1, calcitonin receptor, and ephrinB2 were increased significantly in compressed RAW264.7 cells, and the expression of ephrinB2, EphB4, Sp7, and Runx2 was decreased significantly in compressed ST2 cells. CONCLUSIONS: Our results indicate that compressive force can regulate EphB4 and ephrinB2 expression in osteoblasts and osteoclasts, which might contribute to alveolar bone resorption in compression areas during orthodontic tooth movement.
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Animals , Rats , Bone Resorption , Gene Expression , Immunohistochemistry , Models, Animal , Osteoblasts , Osteoclasts , Real-Time Polymerase Chain Reaction , Receptors, Calcitonin , RNA, Messenger , Tooth Movement TechniquesABSTRACT
ObjectiveTo investigate the impact of health education and psychological intervention on quality of life of patients with asthma.MethodsNinety-six patients with bronchial asthma were assigned to the treatment group and the control group. The participants in the treatment group were treated with routine therapy and health education and psychological intervention.Results The awareness of bronchial asthma,self monitoring of health condition,and simple strategies to treat acute or serious asthma were improved in the treatment group. The overall effective rate of the treatment group was significantly higher than that of the control group (93.75% vs 62.5%,P <0.01 ),and forced expiratory volume in one second (FEV1),peak expiratory flow (PEF) and ACT score were significantly improved (all P < 0.01 ).Moreover,episode of bronchial asthma was significantly reduced after the combined intervention (P <0.01 ).ConclusionHealth education and psychological intervention may contribute to effective prevention and treatment of asthma,improved quality of life of patients,and reduced family and social economic burden.
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Objective To investigate the characteristics of pathogens and bacterial susceptibility in the pa-tients with ventilator-associated pneumonia (VAP). Methods The clinical characteristics of aetiological germ and bacterial susceptibility in 20 patients with VAP who were treated in the hospital department of respiratory medicine were analyzed. Results 20 patients with bronchial secretions cultured bacteria was 42. It showed that the isolating rate of gram-negative bacilli(GNB), gram-positlve cocci and fungus was 71.4%, 16.7% and 11.9% respeotively. Conclusions The main bacterium in patients with VAP was GNB,which exhibited higher resistance to common anti-biotics. More attention should be paid to the cultivation of aetiological bacteria and selection of antibiotics in the treat-ment of VAP.
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Objective To evaluate the clinical effect of noninvasive positive pressure ventilation (NIPPV)on chronic obstructive pulmonary disease (COPD) with type Ⅱ respiratory failure. Methods Seventy-six cases of COPD with type Ⅱ respiratory failure were randomly divided into two groups.All patients were treated with antibiotics and other coventional therapy, 6 hours of intravenous drop infusion coramine was added to the control group (38 cases) and 6 hours of NIPPV was added to the treatment group (38 cases). Vital signs and arterial blood gas analysis were evaluated. Results After 6 hours of treatment, blood pressure, heart rate, respiratory rate and pH were significantly improved in the treatment group than those in the control group (P< 0.05 or < 0.01).Compared with the control group, there was a significant improvement of pH in the treatment group (P < 0.05). PaO2 increased [(81.7 ± 6.3) mm Hg (1 mm Hg = 0.133 kPa) vs (50.6 ± 4.3) mm Hg, (67.6 ± 7.4) mm Hg vs (50.8 ± 5.2) mm Hg] and PaCO2 decreased [(49.6 ± 4.5) mm Hg vs (78.5 ± 10.4) mm Hg, (60.8 ± 6.1)mm Hg vs (76.8 ± 8.3) mm Hg] was found in both groups, the amplitudes of PaO2 and PaCO2 before and after treatment were more singnificant in the treatment group (P < 0.01). Conclusion NIPPV on COPD with type Ⅱ respiratory failure can improve clinical symptom and arterial blood gas analysis more significantly than conventional therapy.
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Objective To evaluate the clinical effect of ambroxol, budesonide and obstructive combinedly atomized inhalation on old patients with acute exacerbation of chronic obstructive pulmonary disease(COPD). Meth-ods 60 old patients with acute exacerbation of COPD were allocated into two groups in random, the control group(n =30) and the treated group(n =30). The control group was received conventinal theray,but the treated group re-ceived combinedly atomized inhalation on basis of conventional therapy. The two groups were treated in five-seven days, and were recorded the changes of clinical symptom, physicak sign, arterial blood gas analysis and the related side effect (for example, liver and renal function, blood sugar, etc). Results There are significant difference be-twcen the two groups in clinical effect (P < 0.05). Conclusion Ambroxol, budesonida and terbutaline combinedly atomized inhalation in the treatment of old patients with acute exacerbation of COPD was effective, little side effect and very safe.