Prevention for moderate or severe BPD with intravenous infusion of autologous cord blood mononuclear cells in very preterm infants-a prospective non-randomized placebo-controlled trial and two-year follow up outcomes.

Background: Bronchopulmonary dysplasia (BPD) is the primary severe complication of preterm birth. Severe BPD was associated with higher risks of mortality, more postnatal growth failure, long term respiratory and neurological developmental retardation. Inflammation plays a central role in alveolar simplification and dysregulated vascularization of BPD. There is no effective treatment to improve BPD severity in clinical practice. Our previous clinical study showed autologous cord blood mononuclear cells (ACBMNCs) infusion could reduce the respiratory support duration safely and potential improved BPD severity. Abundant preclinical studies have reported the immunomodulation effect as an important mechanism underlying the beneficial results of stem cell therapies in preventing and treating BPD. However, clinical studies assessing the immunomodulatory effect after stem cells therapy were rare. This study was to investigate the effect of ACBMNCs infusion soon after birth on prevention for severe BPD and long term outcomes in very preterm neonates. The immune cells and inflammatory biomarkers were detected to investigate the underlying immunomodulatory mechanisms. Methods: This single-center, prospective, investigator-initiated, non-randomized trial with blinded outcome assessment aimed to assess the effect of a single intravenous infusion of ACBMNCs in preventing severe BPD (moderate or severe BPD at 36 weeks of gestational age or discharge home) in surviving very preterm neonates less than 32 gestational weeks. Patients admitted to the Neonatal Intensive Care Unit (NICU) of Guangdong Women and Children Hospital from July 01, 2018 to January 1, 2020 were assigned to receiving a targeted dosage of 5 × 107 cells/kg ACBMNC or normal saline intravenously within 24 h after enrollment. Incidence of moderate or severe BPD in survivors were investigated as the primary short term outcome. Growth, respiratory and neurological development were assessed as long term outcomes at corrected age of 18-24 month-old. Immune cells and inflammatory biomarkers were detected for potential mechanism investigation. The trial was registered at ClinicalTrials.gov (NCT02999373). Findings: Six-two infants were enrolled, of which 29 were enrolled to intervention group, 33 to control group. Moderate or severe BPD in survivors significantly decreased in intervention group (adjusted p = 0.021). The number of patients needed to treat to gain one moderate or severe BPD-free survival was 5 (95% confidence interval: 3-20). Survivors in the intervention group had a significantly higher chance to be extubated than infants in the control group (adjusted p = 0.018). There was no statistical significant difference in total BPD incidence (adjusted p = 0.106) or mortality (p = 1.000). Incidence of developmental delay reduced in intervention group in long term follow-up (adjusted p = 0.047). Specific immune cells including proportion of T cells (p = 0.04) and CD4+ T cells in lymphocytes (p = 0.03), and CD4+ CD25+ forkhead box protein 3 (FoxP3)+ regulatory T cells in CD4+ T cells increased significantly after ACBMNCs intervention (p ï¼œ 0.001). Anti-inflammatory factor IL-10 was higher (p = 0.03), while pro-inflammatory factor such as TNF-a (p = 0.03) and C reactive protein (p ï¼œ 0.001) level was lower in intervention group than in control group after intervention. Interpretation: ACBMNCs could prevent moderate or severe BPD in surviving very premature neonates and might improve neurodevelopmental outcomes in long term. An immunomodulatory effect of MNCs contributed to the improvement of BPD severity. Funding: This work was supported by National Key R&D Program of China (2021YFC2701700), National Natural Science Foundation of China (82101817, 82171714, 8187060625), Guangzhou science and technology program (202102080104).

Wnt5a-Flt1 activation contributes to preterm altered cerebral angiogenesis after prenatal inflammation.

OBJECTIVE: Intraventricular hemorrhage (IVH) causes morbidity and mortality in preterm infants and prenatal exposure to inflammation contributes to brain injury. Moreover, prenatal exposure to severe inflammation increases the risk of IVH in preterm neonates. The current study investigated whether intrauterine exposure to inflammation affects cerebral angiogenesis and its underlying mechanisms. METHODS: Wnt5a, flt1, and vascular endothelial growth factor (VEGF)-A levels in cord blood serum (stored in a bio-bank) of the enrolled patients were measured via enzyme-linked immunosorbent assay. A preterm prenatal inflammation exposure model was established in rats by intraperitoneal injection intraperitoneally during pregnancy. Angiogenesis of cerebral tissue was analyzed using immunohistochemistry. Wnt5a, flt1, and VEGF-A expression levels were measured via immunohistochemistry, immunofluorescence, or western blotting. The correlation between Wnt5a and flt1 expression and the cerebral vessel area was also analyzed. RESULTS: The Wnt5a and flt1 levels in the cord blood serum were significantly higher in the amnionitis group than in the non-amnionitis group. The VEGF-A level in the cord blood serum was significantly lower in the amnionitis group. In the rat model, preterm rats in the prenatal inflammation group exhibited increased microglial cell infiltration and decreased vessel area and diameter in the cerebral tissue compared to the control group. Wnt5a was located in microglial cells, and Wnt5a and flt1 expression in brain tissue significantly increased after prenatal lipopolysaccharide (LPS) exposure. VEGF-A expression declined after prenatal LPS exposure. The cerebral vessel area was negatively correlated with Wnt5a and flt1 expression. CONCLUSION: Disordered cerebral angiogenesis is associated with increased Wnt5a-Flt1 activation in microglial cells after exposure to intrauterine inflammation.

IL-2 gene polymorphisms affect tacrolimus response in myasthenia gravis.

PURPOSE: The IL-2 gene polymorphisms have been reported to be associated with the development of autoimmune disease. However, there are no published studies examining the influence of the IL-2 gene polymorphisms on the response of myasthenia gravis (MG) patients to tacrolimus (Tac). The goal of this study was to investigate the relationship between the polymorphisms of IL-2 and Tac response in MG patients. METHODS: Ninety-two MG patients treated with Tac were studied, including 57 Tac-effective patients and 35 Tac-ineffective patients. Then, we selected four single-nucleotide polymorphisms (SNPs: rs2069776, rs2069772, rs2069762, rs2069763) in the IL-2 gene. Next, we analyzed the distribution of genotypes, allelic frequencies of SNPs, and haplotype frequencies among polymorphisms in the two groups of patients. RESULTS: The distribution of the allelic frequency of the rs2069762 variant differed between the Tac-effective and Tac-ineffective patients (P = 0.02). Genotypes G/T and G/G of rs2069762 were differently distributed between the two groups when the wild genotype T/T was assigned as a reference (P < 0.001 for G/T; P = 0.003 for G/G). Patients with the TAGG haplotype tended to be Tac-ineffective (P < 0.001, OR: 0.15, 95% CI: 0.05-0.43). CONCLUSION: Myasthenia gravis patients with the rs2069762 variant, rs2069762 G/T and G/G genotype, and TAGG haplotype for IL-2 tended to respond poorly to Tac treatment.

The correlation between chorioamnionitis-induced abnormal placental microvessel and platelet metabolism of preterm infants / 中华实用儿科临床杂志

Objective@#To observe the effect of chorioamnionitis on placental microvessel and platelet metabolism in premature and the correlation between them.@*Methods@#With clinical randomized controlled trial (RCT), the cases were matched by 11 according to gestational ages and divided into 2 groups according to the placental pathology results: chorioamnionitis group and control group, 32 cases in each group.Dates were obtained for preterm infants (gestational age<37 weeks) admitted to the Department of Neonatology at Guangdong Women and Children Hospital, born between June and December 2016.The platelet parameter [platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT)], birth weight, thrombocytopenia, hemorrhage complication, miscrovascular density (MVD) in placenta, platelet activating factors (CD62p, CD63) and thrombopoietin (TPO) in preterm infants were recorded and compared.@*Results@#In chorioamnionitis group, the infant birth weight[(1.90±0.41) kg vs.(2.31±0.62) kg] and the PLT in 72 hours [<24 h (197.97±63.43)×109/L vs.(266.34±69.92)×109/L; 24-72 h (202.28±29.70)×109/L vs.(256.38±69.96)×109/L] were significantly lower compared with the control group, and the differences were statistically significant(all P<0.05). The incidence of early thrombocytopenia(37.50% vs.9.38%), intracranial hemorrhage(40.62% vs.15.63%), MPV [(8.73±0.89) fL vs.(8.27±0.64) fL] and PDW[(59.46±5.90)% vs.(55.20±5.37)%] in 24 hours were significantly higher in chorioamnionitis group, and the differences were statistically significant (all P<0.05). The placental MVD in chorioamnionitis group significantly decreased[(9.08±1.35)% vs.(12.89±1.36)%, P<0.05 ]. The level of CD62p, CD63 and TPO in umbilical cord blood were significantly higher in chorioamnionitis group[(25.37±5.20)% vs.(10.35±2.94)%, (9.49±1.58)% vs.(4.04±1.21)%, (271.08±197.22) μg/L vs.(141.87±78.10) μg/L, all P<0.05]. The placental MVD was positively associated with PLT (r=0.74, P<0.05) and negatively associated with CD62p, CD63 and TPO among infants with chorioamnionitis (r=-0.64, -0.44, -0.44, all P<0.05).@*Conclusions@#The chorioamnionitis may decrease the MVD in placenta and activate platelet in fetal circulation, damaged placental microvessel may activate platelet further.

The correlation betWeen chorioamnionitis＿induced abnormal placental microvessel and platelet metabolism of preterm infants / 中华实用儿科临床杂志

Objective To observe the effect of chorioamnionitis on placental microvessel and platelet metabo-lism in premature and the correlation between them. Methods With clinical randomized controlled trial( RCT),the cases were matched by 1: 1 according to gestational ages and divided into 2 groups according to the placental pathology results:chorioamnionitis group and control group,32 cases in each group. Dates were obtained for preterm infants(ges-tational age<37 weeks)admitted to the Department of Neonatology at Guangdong Women and Children Hospital,born between June and December 2016. The platelet parameter[platelet count(PLT),mean platelet volume(MPV),plate-let distribution width( PDW),plateletcrit( PCT)],birth weight,thrombocytopenia,hemorrhage complication,miscro-vascular density(MVD)in placenta,platelet activating factors( CD62p ,CD63 )and thrombopoietin( TPO)in preterm infants were recorded and compared. Results In chorioamnionitis group,the infant birth weight[(1. 90 ± 0. 41)kg vs. (2. 31 ± 0. 62)kg]and the PLT in 72 hours[<24 h(197. 97 ± 63. 43)×109/L vs.(266. 34 ± 69. 92)×109/L;24-72 h(202. 28 ± 29. 70)×109/L vs.(256. 38 ± 69. 96)×109/L]were significantly lower compared with the con-trol group,and the differences were statistically significant( all P <0. 05). The incidence of early thrombocytopenia (37. 50% vs. 9. 38% ),intracranial hemorrhage(40. 62% vs. 15. 63% ),MPV[(8. 73 ± 0. 89)fL vs.(8. 27 ± 0. 64)fL] and PDW[(59. 46 ± 5. 90)% vs.(55. 20 ± 5. 37)% ]in 24 hours were significantly higher in chorioamnionitis group, and the differences were statistically significant(all P<0. 05). The placental MVD in chorioamnionitis group signifi-cantly decreased[(9. 08 ± 1. 35)% vs.(12. 89 ± 1. 36)% ,P<0. 05 ]. The level of CD62p ,CD63 and TPO in umbilical cord blood were significantly higher in chorioamnionitis group[(25. 37 ± 5. 20)% vs.(10. 35 ± 2. 94)% ,(9. 49 ± 1. 58)% vs.(4. 04 ± 1. 21)% ,(271. 08 ± 197. 22)μg/L vs.(141. 87 ± 78. 10)μg/L,all P<0. 05]. The placental MVD was positively associated with PLT( r=0. 74,P<0. 05)and negatively associated with CD62p ,CD63 and TPO among infants with chorioamnionitis(r= -0. 64,-0. 44,-0. 44,all P<0. 05). Conclusions The chorioamnionitis may decrease the MVD in placenta and activate platelet in fetal circulation,damaged placental microvessel may activate platelet further.

A new method for screening latent tuberculosis infection in Beijing army recruits / 军事医学

Objective To investigate the Mycobacterium tuberculosis infections in 2014 among Beijing army recruits, and evaluate a new method for screening latent tuberculosis infections.Methods A total of 194 army recruits were subjected to chest X-ray examination purified protein derivative(PPD) skin test, antibody detection, and interferon gamma release assay(IGRA) by ELISA combined with recombinant protein CFP10-ESAT6 and latent infection protein Rv2628.Results The positive rates of PPD skin test and antibody test were 49.7% and 15.5%, respectively.The latent infection rate of IGRA test was 22.2% in 194 cases after CFP10-ESAT6 stimulation.After stimulation of latent tuberculosis infection(LTBI) with Rv2628, IFN-γ level was significantly higher than that in healthy control group (P0.05).There was no significant difference between antibody negative and positive groups after stimulation by CFP10-ESAT6 and Rv2628 (P>0.05).The area under the ROC curve of Rv2628 diagnosis of tuberculosis infection was 0.84.When Youden index was 0.621,the specificity was 94.7% and sensitivity was 67.4%.ConclusionCombined detection of antigens Rv2628 and CFP10-ESAT6 specific IFN-γ values can be potentially used for differential diagnosis of active or latent tuberculosis infections.

PGRN over-expression inhibits LPS-induced alveolar epithelial cell injury / 中国病理生理杂志

AIM:To investigate the effects of progranulin (PGRN) on the proliferation, apoptosis and inflammatory responses in lipopolysaccharide (LPS)-induced human alveolar epithelial A549 cells and HPAEpiC cells.METHODS:The cells were divided into 4 groups:control group (the normal cultured cells), LPS group [the cells were treated with LPS (10 mg/L)], PGRN+LPS group (the cells were transfected with pcDNA3.1-PGRN plasmids and then treated with LPS), and pcDNA3.1+LPS group (the cells were transfected with pcDNA3.1-EGFP plasmids and then treated with LPS).The cell viability was measured by MTT assay, cell proliferation was measured by BrdU incorporation assay, and cell apoptosis was analyzed by flow cytometry.The expression of PGRN at mRNA and protein levels was detected by RT-qPCR and Western blot.The protein levels of caspase-3, Bcl-2, Bax, IL-1β, IL-6, TNF-α, p65 and p-IκB-α were determined by Western blot.RESULTS:Compared with control group, the cell proliferation rate was decreased (P<0.05), and the apoptotic rate was increased (P<0.05) in LPS group.The protein levels of caspase-3 and Bax were significantly up-regulated (P<0.05), and the expression of Bcl-2 was down-regulated (P<0.05).The protein levels of IL-1β, IL-6 and TNF-α were significantly up-regulated (P<0.05), and the protein levels of p65 and p-IκB-α were enhanced (P<0.05).Compared with LPS group, the cell proliferation rate was increased (P<0.05), and the apoptotic rate was decreased (P<0.05) in PGRN+LPS group.The protein levels of caspase-3 and Bax were significantly down-regulated (P<0.05), and the expression of Bcl-2 was up-regulated (P<0.05).The protein levels of IL-1β, IL-6 and TNF-α were significantly down-regulated (P<0.05), and the protein levels of p65 and p-IκB-α were decreased (P<0.05).CONCLUSION:PGRN over-expression may alleviate LPS-induced abnormal proliferation, apoptosis and inflammatory cytokine production in the A549 cells and HPAEpiC cells, which may be associated with the regulation of NF-κB signaling pathway.

Dynamic Comprehensive Evaluation of Performance Indicators after Reorganization for 10 Years in Xinjiang / 现代医院

Objective To study the performance indicators after reorganization for 10 Years in enterprise hospital.Methods The performance indices from 2005 to 2014 of a Class One Grade A hospital was evaluated by rank sum ratio.Results The reform was in the doldrums in 2005, improved slightly in 2006 and 2007, increased significantly and steadily in 2008, reached the best in 2014.Conclusion Evaluating the performance of hospital management with rank sum ratio is scientific and clear, which has certain practical value.

Efficiency of hearing screening combined with gene mutation screening in neonates with high-risk of hearing impairment / 中华围产医学杂志

ObjectiveTo investigate the significance of hearing screening combined with gene screening for neonates with high-risk of hearing impairment.MethodsNeonates admitted to the Neonatal Department of Guangdong Women and Children Hospital between July 2013 and June 2014 were enrolled in this study. They were divided into high-risk group (with high-risk for hearing impairment) (n=3 129), and control group (n=5 106). Neonate hearing screening was carried out using otoacoustic emission and automated auditory brainstem response. Blood samples were collected using a standard protocol for detecting the mutations of four common deafness genes, includingGJB2,GJB3,SLC26A4 and mitochondrial 12s rRNA.Chi-square test was used to compare the differences of the pass rate of hearing screening and positive rate of gene mutations between the two groups.ResultsThe rates of failure on otoacoustic emission, automated auditory brainstem response or both in the high-risk group were 11.92% (373/3 129), 10.32% (323/3 129) and 4.83% (151/3 129), respectively, higher than those in the control group [5.03%(257/5 106), 6.56%(335/5 106) and 2.02% (103/5 106)] (χ2=130.265, 37.354 and 51.196, allP=0.000). In the high-risk group, the overall positive rate of gene mutations was 5.63% (176/3 129), and theGJB2 andSLC26A4 gene mutation rates were 3.04% (95/3 129) and 2.40% (75/3 129)], all higher than the control group [3.15% (161/5 106), 2.04% (104/5 106) and 1.06% (54/5106)] (χ2=30.301, 8.216 and 22.517, allP0.05]. The rates of failure on otoacoustic emission and automated auditory brainstem response of the neonates with deafness gene mutations were 9.50% (32/337) and 10.39% (35/337), respectively, higher than the neonates without [1.14% (90/7 898) and 1.29% (102/7 898)] (χ2=154.621 and 163.399, both P=0.000).ConclusionCombined hearing screening is of clinical significance for neonates with high-risk of hearing impairment.

Methodological evaluation on serum free light chains detected by immunoturbidimetry / 国际检验医学杂志

Objective To perform the methodological evaluation on Beckman Immage 800 automatic special protein analyzer for determining serum freeκ,λlight chains (sFLC) .Methods The Beckman Immage800 automatic special protein analyzer was used to quantitatively detect sFLC values for investigating its precision and accuracy ,analyzing its detecting range ,interference and residual contamination rate ,meanwhile verifying its reference intervals .Results The low and high values of within‐run precision coefficients of variation(CV) forκsFLC were 7 .84% and 2 .95% respectively ;which of between‐run precision CV were 7 .38% and 5 .57% re‐spectively .The within‐run precision CV for λFLC were 4 .59% and 3 .94% respectively ,which of between‐run precision CV were 3 .97% and 2 .01% respectively ;bias for detecting theκFLC andλFLC fixed quality serum and the target values was less than 5% , when the analytical detection ranges of κFLC andλFLC were 10 .8-128 .0 mg/L and 10 .1-121 .0 mg/L ,a value was 0 .95-1 .05 , r2 ≥0 .98;the carry‐over rates of κFLC andλFLC were 0 .411% and 0 .216% respectively .The interference test results showed that when free hemoglobin≤342 .0 μmol/L ,conjugated bilirubin ≤342 .0 μmol/L ,hemoglobin≤5 g/L and chyle ≤2 400 turbidness , which had no influence on sFLC results ;among 40 healthy subjects undergoing the physical examination ,1 case of κFLC detection results exceeded the reference interval recommended by the manufacturer ,while theλFLC detection values in these 40 cases were all within the reference interval recommended by the manufacturer .Conclusion The main analytical performance of the Beckman Im‐mage800 automatic special protein analyzer for detecting sFLC meets the requirements of quality objectives and can provides the sci‐entific and precise evidence of diagnosis and treatment for clinic .

Effects of Triptolide on Proliferation and Apoptosis of Cyst-lining Epithelial Cells of Polycystic Kidney Disase / 医药导报

Objective To investigate the effect of triptolide (TP) on proliferation and apoptosis of cyst-lining epithelial cells with autosomal dominant polycystic kidney disease ( ADPKD). Methods Primary cultured cyst-lining epithelial cells were treated with TP at different concentrations for 12 h,24 h,48 h and 72 h, respectively.The proliferation activity of the cells was evaluated by Brdu assay. The cell cycle distribution was determined by flow cytometry. The apoptotic and apoptotic ratio were determined by FITC-AnnexinV binding/ PI. The morphological changes of cyst-lining epithelial cells were observed under transmission electron microscope. Results TP significantly inhibited the proliferation of cyst-lining epithelial cells and induced apoptosis in a dose- (10-40 ng?mL-1 )and time-dependent(12-48 h) manner. Typical ultrastructural changes of apoptotic cells were observed under electron microscope. Conclusion TP significantly inhibited the proliferation of cyst-lining epithelial cells and induced the apoptosis of cyst-lining epithelial cells, thus inhibited cyst forming and delayed cyst developing. The mechanism may involve several targets and pathways.

Dissolution Determination of Cephalexin from Different Preparations by Optical Fiber in-Situ Process Anal-ysis / 中国药师

Objective:To develop a UV optical fiber in situ process monitoring method for the dissolution behavior of five cepha-lexin solid dosage forms and compare the drug dissolution behavior of different cephalexin preparations. Methods: The dissolution of five different cephalexin preparations was on-line monitored according to the dissolution method for cephalexin tablets in Chinese Phar-macopeia (2010 edition) combined with a six channel optical fiber chemical sensor in situ dissolution monitor. Results:The dissolu-tion curves could show the drug release characteristics of different cephalexin preparations, and the five different preparations exhibited various drug release features. Conclusion:An in-situ, real time, on-line and process analysis of dissolution can be obtained by optical fiber dissolution test system automatically. The release characteristics of different preparations can be presented through dissolution curves directly, which can provide reference for the overall assessment of drug internal quality and clinical medication.

Clinical Application of Pharyngeal Flora in the Treatment of Respiratory Tract Infection / 现代检验医学杂志

Objective With density in healthy people pharyngeal flora of the reference[1],study the respiratory tract infection and the treatment process of the change of density and pharyngeal flora infection treatment of correlation analysis,by using the density of the pharyngeal flora changes to evaluate the treatment of patients with respiratory tract infection and progno-sis.Methods Collected 102 cases of patients with upper respiratory tract infection and 219 cases of lower respiratory tract infection in patients with pharyngeal swab for bacterial culture,study clinical symptom change with the change of pharyngeal bacteria density of correlation.Results 62 cases of upper respiratory tract infection and the treatment group patients with pharyngeal flora normal no treatment group on the symptoms improved and recovered,no statistical difference (P >0.05), and 60 patients with upper respiratory tract infection and pharyngeal abnormal bacterium group the treatment group and treatment group in pharyngeal flora and CPIS score was statistically difference (P <0.05).For 219 patients with lower re-spiratory tract,including 121 cases of bacterial pneumonia,74 cases of severe pneumonia,and 24 cases of patients with lung abscess treatment observation,found that when back to normal pharyngeal flora,the accuracy of clinical pathological changes were 92.6%,86.5% and 87.5%,respectively.Conclmion Pharyngeal bacteria density between healthy people maintained a certain bacteria species and the number of stable,but when respiratory infections bacteria can disorders with the application of broad-spectrum antibiotics can lead to serious result in pharyngeal dysbacteriosis should be combined with pharyngeal bacteria in respiratory anti-infection treatment density changes to evaluate the clinical treatment,can reduce the number of days with antibiotics,patients with avoid induce drug-resistant bacteria and respiratory dysbacteriosis.

Clinical effect of tiotropium bromide combined with seretide on treating moderate and severe chronic obstructive pulmonary disease patients in stable phase / 中国综合临床

Objective To investigate the clinical effect of tiotropium bromide combined with Seretide in treatment of moderate to severe chronic obstructive pulmonary disease( COPD) patients. Methods From Jan. 2012 to Oct. 2013,76 severe COPD were selected as our subjects and they were randomly divided into the control group(38 cases)and research group(38 cases). Patients in control group were used Seretide(1 time both at morning and night,the does was 50 μg/ 500 μg),and in research group were given tiotropium bromide with thiophene beside Seretide(1 time every day). The two groups were received routine treatment,including anti infection,cough and asthma,according to the change of illness. The pulmonary function,blood gas index, respiratory symptoms and 6 minutes walking distance(6 MWD)were recorded. Results Forced expiratory volume in one second( FEV1),forced vital capacity( FCV),FEV1 / FCV of patients in research group after ftreatment were(2. 22 ± 0. 48)L,(3. 28 ± 0. 32)L,(66. 23 ± 9. 22)% respectively,higher than those in the control group,and the differences were significant((1. 78 ± 0. 35)L,(2. 85 ± 0. 47)L,(56. 83 ± 7. 85)% ;t= 5. 39,4. 66,4. 78;P < 0. 01). Partial pressure oxygen(PaO2 )of patients in research group after treatment was (72. 83 ± 5. 28)mmHg,significantly higher than that of control group((65. 36 ± 3. 22)mmHg). However, partial pressure of carbon dioxide( PaCO2 )was(43. 28 ± 3. 52)mmHg,significantly lower than the control group((48. 76 ± 2. 85)mmHg;t = 7. 44,7. 45,P < 0. 01). Dyspnea( MMRC)score in research group was (1. 38 ± 0. 32),lower than the control group(1. 76 ± 0. 35),and 6 MWD was(428. 36 ± 32. 85)m,higher than that of control group((398. 65 ± 28. 38)m;t = 4. 93,4. 21,P < 0. 01). Conclusion The treatment plan of tiotropium bromide combine with Seretide on moderate and severe COPD patients is proved with the better clinical effect and it can improve the partial pressure of oxygen and then promote repair mechanism of lung injury as well as promote the quality of life of patients with ascension.

Analysis of Peripheral Blood Lymphocyte Immunophenotypes in Syphilitic Patients with Flow Cytometry / 中华皮肤科杂志

Objective To characterize the human cell mediated immune response to Treponema pallidum(TP), and to determine the effect of TP infection on the various lymphocyte subpopulations and natural killer cells in the peripheral blood of the patients. Methods Twenty four untreated patients with early syphilis were analyzed,including 3 groups of 8 patients with disseminated syphilides,palmoplantar syphilides and latent syphilis each. Monoclonal antibodies of CD labeled with either fluorescein isothiocyanate or phycoerythrin were used on a flow cytometry to detect the changing of peripheral blood lymphocyte immunophenotypes. Results The results showed that the percentages of panT,T H,NK cells and the ratio of T H/T S were significantly lower (P0.05). Conclusion It suggests that there is prominent suppression of cellular immunity in the untreated patients suffering from early syphilis. Meanwhile, the difference of 3 groups in skin lesions was due to the different dermatobarrier function against the systemic invasion of TP, rather than attributed to the alteration of the lymphocyte immunophenotypes in the peripheral blood.