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Although bronchoscopy has been widely performed in China, little has been known about its current state and development. In order to investigate the clinical application of bronchoscopy and make instructions for future education and development, the Chinese Society of Respiratory Diseases conducted postal surveys in both 2008 and 2010 in China.Questionnaires were sent to 40 tertiary grade A hospitals in 2008 and 58 tertiary grade A hospitals in 2010 to investigate bronchoscopies performed in 2007 and 2009 respectively.Thirty (75%) hospitals returned the completed questionnaires in 2008 and forty-one (71%) hospitals in 2010. All the respondents possessed flexible bronchoscopes. Fifty percent of the respondents had less than five in 2007, while more than 50% of the respondents had 5-9 bronchoscopes in 2009. All the respondents performed a radiograph or CT scan before bronchoscopy. Percentage of general anesthesia and no pre-medication before bronchoscopy increased, while atropine usage decreased in 2009 compared to 2007. During bronchoscopy, pulse oximetry was the most widely used monitoring method. Most respondents used the nasal route to perform routine bronchoscopy. After the procedure, they used sinks to wash and glutaraldehyde to disinfect the bronchoscopes. The total number of flexible bronchoscopies performed during 2007 was 37 874 and the average was 1262. Whereas in 2009, the total number was 60 178 and the average was 1468. Diagnostic bronchoscopy was more widely used than therapeutic bronchoscopy. The mortality rate was 0.076‰ in 2007 and 0.032‰ in 2009.The two surveys, to some extent, reflected the current status and development of bronchoscopy in China. The results are worthy of future education and developing of new guidelines. Regular surveys and monitoring of bronchoscopies across China are needed.

Noninvasive cardiac imaging is now central to the diagnosis and management of patients with moderate probability for coronary artery disease. The aim of this study was to assess the impact of stress myocardial perfusion single photon emission computerized tomography (SPECT) on in-hospital coronary angiography and revascularization for such patients.Between January 2005 and June 2007, 1053 consecutive in-hospital patients (423 women, the average age of (57.2 ± 11.2) years) with suspected coronary artery disease but without any prior interventional treatment were retrospectively analyzed. All patients underwent a 2-day stress/rest (99m)Tc-methoxyisobutylisonitrile (MIBI) myocardial perfusion SPECT, including 984 exercise test and 69 adenosine test.Overall, stress/rest myocardial perfusion SPECT was normal in 973 patients (92.4%) and abnormal in 80 patients (7.6%). A total of 190 patients underwent coronary angiography, 46 underwent percutaneous coronary intervention and 10 coronary artery bypass grafting during hospitalization. From the whole perspective, only 14.7% of patients with normal SPECT underwent coronary angiography, so did 58.8% of patients with abnormal SPECT (χ(2) = 97.0, P0.001); furthermore, the rates of revascularization in patients with normal and abnormal SPECT were 2.8% and 36.3%, respectively (27 out of 973 vs. 29 out of 80, χ(2) = 157.9, P0.001). The extent and severity of ischemia did not add more predictive value for subsequent coronary angiography, but did have impact on revascularization. Multivariate analysis showed that reversible perfusion defect was the most predictive variable for referral rate to coronary angiography (odds ratio = 7.5, P0.001).Abnormal myocardial perfusion SPECT is a powerful referral for in-hospital coronary angiography and revascularization during the same hospitalization. Thus, stress/rest SPECT is an effective gatekeeper for early coronary angiography and invasive treatment for patients with suspected coronary artery disease.

Hepatocyte growth factor (HGF) treats ischemic disease by promoting arteriogenesis, however, its mechanism of action is not known. The notch signaling pathway plays an important role in neovascularization. The relationship between the proliferation and migration ability of artery endothelial cells and the Dll4-Notch-Hey2 signaling pathway in the process of arteriogenesis was investigated as a mechanism of action of HGF.Based on the prophase study cells and supernatant were harvested at the indicated time after human femoral artery endothelial cells (HFAECs) were infected with adenovirus-HGF (Ad-HGF) at 200 pfu/cell. Cells were analyzed for HGF expression and Notch1, Dll4 and Hey2 expression by ELISA and reverse transcription-PCR (RT-PCR). The changes in the proliferation and migration ability of HFAECs were observed by MTT and Transwell migration experiments. Ad-GFP-infected HFAECs were used as control.Compared with the control group the Ad-HGF group's HGF expression was not increased with time, and the induction by HGF of Notch1, Dll4 and Hey2 gene transcription was not enhanced with an increase of HGF. The proliferation ability of Ad-HGF-transduced HFAECs was enhanced and their migration ability was also enhanced in the presence of HGF.Through activating the Dll4-Notch-Hey2 signaling pathway, HGF indirectly promotes the proliferation and migration ability of cells, so that offspring artery branches are formed.

MicroRNAs (miRNAs) are highly conserved small non-coding RNAs of 18 - 25 nucleotides (nt) that mediate post-transcriptional gene regulation. Hepatitis B virus (HBV) can cause either acute or chronic hepatitis B, and is a high risk factor for liver cirrhosis and hepatocellular carcinoma. Some mammalian viruses have been shown to modulate the expression of host cellular miRNAs. However, interactions between the HBV and the host cellular miRNAs are largely unknown.miRNA microarray and Northern blotting analysis were used to compare the expression profile of cellular miRNAs of a stable HBV-expressing cell line HepG2.2.15 and its parent cell line HepG2. mRNA microarray assay and the miRanda program were used to predict the miRNA targets. A flow cytometric assay was further used to investigate the expression of human leukocyte antigen (HLA)-A.Eighteen miRNAs were differentially expressed between the two cell lines. Among them, eleven were up-regulated and seven were down-regulated in HepG2.2.15 cells. Northern blotting analysis confirmed that the expression of miR-181a, miR-181b, miR-200b and miR-146a were up-regulated and the expression of miR-15a was down-regulated, which was in consistent with the results of the microarray analysis. Furthermore, some putative miRNA targets were predicted and verified to be linked with mRNA expression. The 3'-UTR of HLA-A gene had one partially complementary site for miR-181a and miR-181a might down-regulate the expression of HLA-A.HBV replication modulates the expression of host cellular miRNAs, which may play a role in the pathogenesis of HBV-related liver diseases.

Nuclear factor-kappa B (NF-kappaB) is elevated in regulating transcription of many cytokines and inflammatory mediators. The purpose of this study was to investigate the activation and the significance NF-kappaB in lipopolysaccharide (LPS) induced keratitis.LPS induced keratitis model was based on Wistar rats. At 0.5, 1, 3, 6, 12, 24 or 72 hours after LPS treatment, the rat corneas were observed with a slit lamp microscope, then the rats were sacrificed and their corneas were excised for routine histological analysis. The expression of NF-kappaB was detected with immunohistochemical staining. The change of tumour necrosis factors-alpha (TNF-alpha) mRNA expression was identified by reverse transcriptase polymerase chain reaction (RT-PCR).Histological findings demonstrated that LPS treated corneas showed significant changes in corneal structure. Corneal edema, pronounced inflammatory cells infiltration and inordinate collagen fibres were observed. Immunohistochemical results showed that the expression of NF-kappaB and its activation obviously increased after LPS treatment compared with the normal group and control group. Positive cells could be observed at 0.5 hour and peak expression of NF-kappaB was observed between 3 hours and 12 hours after infection, but returned to or approached normal level by 72 hours. RT-PCR showed that the level of TNF-alpha mRNA began to increase 0.5 hour after LPS treatment, peaked at 6 hours and then subsided by 72 hours. NF-kappaB had a positive correlation with the expression of TNF-alpha mRNA (r = 0.964, P0.01), both NF-kappaB and TNF-alpha had a strong positive correlation with the degree of inflammatory response in LPS treated corneas (r = 0.929, P0.01; r = 0.587, P0.05, respectively).The activation of NF-kappaB was increased in LPS treated corneas and was elevated in LPS induced keratitis by promoting overexpression of TNF-alpha mRNA. NF-kappaB may play an important role in the pathogenesis of LPS-associated keratitis in rats.

At present, the therapy for patients with lung cancer that achieves a high rate of cure is surgical resection at an early stage of the disease. The aim of this study is to evaluate quantitative computed tomography (QCT) for predicting postoperative pulmonary function in patients with lung cancer.The data of thirty-one patients with lung cancer who underwent both pulmonary functional tests and QCT scan before operations were collected. A CT program was used to quantify the volume of whole lung parenchyma with attenuation of -910 HU to -600 HU, which was defined as total functional lung volume (TFLV). Similarly, the volume of lung (lobes or segments) with attenuation of -910 HU to -600 HU was defined as regional functional lung volume (RFLV). Forced vital capacity (FVC), forced expiratory volume in first second (FEV1), FVC% and FEV1% (ratio to reference values of the matched population) were obtained from preoperational pulmonary functional tests. According to the formula: predicted FVC (pre-FVC) = preoperative FVC x [1-(RFLV/TFLV)]; predicted FEV1 (pre-FEV1) = preoperative FEV1 x [1-(RFLV/TFLV)], we obtained values of predicted FVC, predicted FEV1, predicted FVC% (pre-FVC/reference values of the matched population), and predicted FEV1% (pre-FEV1/reference values of the matched population). The paired t test and Pearson correlation test were used to assess significance of differences and correlations between CT predicted values and postoperative measured results of FVC, FEV1, FVC% and FEV1%.QCT predicted values correlated well with postoperative FVC, FEV1, FVC% and FEV1% (r = 0.873, 0.809, 0.849 and 0.801 respectively, all P0.01).QCT is an effective and accurate way to predict postoperative pulmonary function in patients undergoing pulmonary resection, regardless of the patients' preoperative pulmonary functional status.

To assess the possibility of using spirometrically controlled computed tomography (CT) to test pulmonary ventilation function.Spiral CT scans under the control of a spirometer were performed on 30 healthy adults. Spiral CT scan was performed at 50% vital capacity (VC) with an 8 mm slice thickness. Mean attenuation values and pixel index (PI) of lung regions were evaluated with semiautomatic evaluation software.There were significant differences in PI values between four pixel intervals.Spirometrically controlled spiral CT with semiautomatic evaluation software is an accurate and reproducible method of measuring lung density and PI, which has the possibility of indicating pulmonary ventilation function.