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Objective:To analyze the clinical characteristics of Chlamydia psittaci pneumonia in the elderly, and factor related to the disease severity. Methods:Clinical data of 32 elderly patients with Chlamydia pneumoniae pneumonia admitted in the First People′s Hospital of Xiaoshan District from January 2019 to January 2021 were retrospectively analyzed. The patients were diagnosed by the second generation sequencing using bronchoalveolar lavage fluid (BALF) samples. There were 17 patients in moderate group and 15 patients in severe group; the liver function, muscle enzymes, imaging and lymphocyte subsets of the two groups were compared. Results:There were no significant differences in the age, gender and basic diseases, bird contact history, flaccid fever and dry cough symptoms between two groups, while there were significant differences in mental symptoms and gastrointestinal symptoms between the two groups ( P=0.032, 0.018). There were significant differences in ALT , AST, LDH , CK , CK-MB, CRP, BNP , troponin-T and PCT between the two groups (all P<0.001). The increase of leukocytes was not significant in both groups. The moderate group was dominated by single lobe involvement, while the severe group was dominated by multi lobe involvement and pleural effusion ( P=0.043, 0.015, 0.023). The total lymphocytes, T lymphocytes, CD4 + T cells, CD8 + T cells, CD4 +/CD8 + ratio, NK cells, B cells, CD4 +CD8 + double positive T cells decreased in both groups, while those in the severe group decrease more markedly ( P<0.05). CD4 -CD8 - double negative T cells were higher in the severe group than those in the moderate group ( P<0.001). CD4 +/CD8 + ratio and CD4 -CD8 - double negative T cells were correlated with severity index PSI and CURB-65 ( P<0.05). Conclusions:The liver function, muscle enzyme, lymphocyte immune function in patients with Chlamydia psittaci pneumonia are impaired, which were more markedly in severe patients. The multileaf infiltration and increased procalcitonin may indicate the severe pneumonia. CD4 +/CD8 + ratio and CD4 -CD8 - double negative T cells are correlated with the severity of pneumonia.
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Objective:To investigate the effect of Xanthium mongolicum Kitag. ethanol extract (EXM) on airway inflammation induced by house dust mite (HDM) in mice with allergic asthma, and to explore the possible mechanism. Methods:The mice were randomly divided into blank group, model group, positive control group and low, medium and high dose groups, with 6 mice in each group. The low, medium and high dose groups were intragastrically administered with 100, 200 and 400 mg/kg of EXM, and the positive control group was given 1.56 mg/kg salbutamol solution. Mice in the blank group and the model group were intragastrically administered with equal volume of solvent, once a day for 8 consecutive days. Except the blank group, the other groups were sensitized with HDM on the 3rd, 4th and 5th days after administration to establish asthma models. After administration, the number of eosinophils (EOS), total cells and various kinds of cells (neutrophils, macrophages, lymphocytes and EOS) in bronchial irrigation fluid (BALF) of mice were observed. The levels of serum IgE and inflammatory factors (IL-4, IL-5, IL-10 and IL-13) in BALF and lung tissue were measured by enzyme-linked immunosorbent assay (ELISA). Pathological and inflammatory changes of bronchial smooth muscle in mice were observed by HE and PAS.Results:Compared with the model group, the number of EOS significantly decreased ( P<0.01 or P<0.05), the total cells count, macrophages, neutrophils, lymphocytes and EOS in BALF significantly decreased ( P<0.01), the content of IL-4 (142.59 ± 16.51 ng/L, 70.47 ± 20.63 ng/L vs. 212.18 ± 58.51 ng/L), IL-5 (57.49 ± 5.49 ng/L, 47.47 ± 6.30 ng/L vs. 72.65 ± 19.11 ng/L), IL-10 (98.51 ± 18.31 ng/L, 71.85 ± 9.15 ng/L vs. 120.16 ± 23.35 ng/L), IL-13 (85.81 ± 23.66 ng/L, 39.99 ± 17.37 ng/L vs. 149.07 ± 33.19 ng/L) in BALF significantly decreased ( P<0.05), and the content of IL-4 (154.55 ± 25.70 ng/L, 143.30 ± 22.19 ng/L vs. 214.68 ± 31.95 ng/L), IL-5 (87.49 ± 5.95 ng/L, 61.84 ± 8.14 ng/L vs. 97.65 ± 12.10 ng/L), IL-10 (91.28 ± 18.69 ng/L, 62.04 ± 9.39 ng/L vs. 117.80 ± 20.72 ng/L), IL-13 (196.48 ± 15.90 ng/L, 132.02 ± 6.86 ng/L vs. 238.42 ± 28.41 ng/L) in lung homogenate significantly decreased ( P<0.05), the serum IgE level in the high dose group significantly increased ( P<0.05). Conclusion:The Xanthium mongolicum Kitag. can inhibit allergic asthma induced by HDM, which may be through inhibiting the secretion of inflammatory cytokines by pulmonary macrophages.
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Aberrant activation of NLRP3 inflammasome in colonic macrophages strongly associates with the occurrence and progression of ulcerative colitis. Although targeting NLRP3 inflammasome has been considered to be a potential therapy, the underlying mechanism through which pathway the intestinal inflammation is modulated remains controversial. By focusing on the flavonoid lonicerin, one of the most abundant constituents existed in a long historical anti-inflammatory and anti-infectious herb
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Objective To evaluate the clinical efficacy of bronchial artery embolization in the treatment of massive hemoptysis ,and to evaluate the clinical efficacy and adverse reactions of 3-year recurrence and survival . Methods 80 patients with hemoptysis or chronic recurrent hemoptysis were selected as the research subjects , and they were randomly divided into two gourps according to the digital table ,40cases in each group.The interventional embolization group was given bronchial artery embolization .The drug group was treated with phentolamine and pituitrin.The index of the system were observed and evaluated:(1)the effect of controlling massive hemoptysis;(2) the adverse reaction of the patients;(3) the recurrence rate of 3 years.Results (1) The total effective rate of the interventional embolization group was 92.5％,which was significantly higher than 77.5％ of the drug group (χ2 =9.044,P<0.05);(2) The incidence rate of adverse reaction of the interventional embolization group was 12.5％, which was lower than 35.0％of the drug group ,the difference was not statistically significant between the two groups (χ2 =1.742,P>0.05).(3) The 3 years recurrence rate of the interventional embolization group was 7.5％,which of the drug group was 40.0％,the difference between the two groups was statistically significant (χ2 =12.557,P<0.05).The 3 years survival rate of the interventional embolization group was 95.0％,which of the drug group was 92.5％,the difference between the two groups was not statistically significant (χ2 =0.215,P>0.05).Conclusion The bronchial artery embolization in the treatment of hemoptysis has ideal clinical effect .It is a minimally invasive and effective clinical treatment method ,and the effect has safety ,less adverse reaction and low recurrence rate ,which is worthy of extensive promotion and application .
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Objective To observe the effect of moderate acute normovolemic hemodilutionon(ANH)on the cerebral oxygenation in patients undergoing laparoscopic radical prostatectomy. Methods Sixty patients receiv-ing laparoscopic radical prostatectomy were randomly and equally divided into control group and observation group. Patients of observation group were received ANH,but patients of control group were received routine infusion.The artery and the ball portion of the internal jugular vein blood were sampled for blood gas analysis at the time points of 10min after intubation(T1),10 min after ANH(T2),30 min(T3)after pneumoperitoneum and Trendelenburg po-sition,the end of surgery(T4). To calculate oxygen content of arterial,and the hall portion of the internal jugular vein,cerebral oxygen uptake rate,the arterial internal jugular vein bulbar oxygen differenceand lactate difference between the artery and vein,oxygen saturation of internal jugular vein bulbar,to record the bleeding volume,the cases and volume of blood transfusion.Results observation group were not transfuse any allogeneic blood,the vol-ume and cases of allogeneic blood transfusion of control group were significant higher than observation group(P <0.05).The Da-jvO2of observation group were significant lower than those of control group at T2and T3(P<0.05). There were no significant difference between the two groups of SjvO2、CERO2and VADL(P > 0.05). Conclusions The application of moderate acute normovolemic hemodilutionon in patients undergoing laparoscopic radical prosta-tectomy can effectively decrease the volume of allogeneic blood transfusion,don't infect the oxygen providing of brain and the cerebral oxygenation.
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Objective To investigate the expressions of phosphorylated collapsin response mediator protein 2(pCRMP2)and class Ⅲ β-tubulin protein(Ⅲ β tubulin)in elderly patients with stage Ⅲ/Ⅳ non-small cell lung cancer (NSCLC),and to evaluate the value of the expressions of pCRMP2 and Ⅲβ tubulin in predicting the chemotherapeutic sensitivity of taxol.Methods A total of 127 elderly patients with stage Ⅲ/Ⅳ NSCLC were recruited,and expression levels of pCRMP2 and Ⅲ β tubulin were detected by immunohistochemistry and Western blot.Based on the levels of pCRMP2 and Ⅲ β tubulin expression,all patients were divided into four groups,including group A(low expressions of both pCRMP2 and lβ tubulin),group B(high expressions of both pCRMP2 and Ⅲβ tubulin),group C(high expression of only pCRMP2)and group D(high expression of only Ⅲ β tubulin).All patients were assigned to receive two cycles of TP chemotherapy regimens and then evaluate the effect of chemotherapy.If chemotherapy was invalid,a second-line chemotherapy regimen was administered.Relationships of response rate,overall survival(OS)and time on tumor progression(TTP) with expression levels of pCRMP2 and Ⅲ β tubulin protein were assessed.Results Among 127 elderly patients,the high expression rate of pCRMP2 and Ⅲ β tubulin protein were 51.2％ (65 cases) and 47.2％ (60 cases),respectively.The Western blot result displayed that the high expressions of pCRMP2 and Ⅲ β tubulin protein were significantly associated with pathologic stage,and with poorly differentiated adenocarcinoma(all P＜0.05).The pCRMP2 expression was also related to the clinical stage.Meanwhile,the overall survival rate(OS)was significantly lower in patients with high expression of pCRMP2 and Ⅲ β tubulin protein than in patients with low expression of the two proteins(P＜ 0.05).Expression of pCRMP2 and Ⅲβ tubulin protein was related with pathological grade and tissue classification.The remission rate (RR)was significantly higher in group A(65.3 ％)than in other three groups(RR in group C,group D and group B was 48.1％,44.0％,30.8％;all P＜0.05,respectively).There were significant differences in RR between group C,group D and group B(48.1 ％,44.0％,30.8％ respectively,P＜0.05).The OS of four groups were(510.5 ±20.9)d,(215.7±31.5)d,(326.9 ± 25.7)d,(298.7±21.2)d respectively.The OS was significantly longer in group A than in other groups(P ＜ 0.05).Conclusions The expression of pCRMP2 and Ⅲ β tubulin protein in NSCLC can be used to judge prognosis of lung cancer and to predict chemotherapy drug resistance.
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Objective To investigate the expressions of phosphorylated collapsin response mediator protein 2(pCRMP2)and class Ⅲ β-tubulin protein(Ⅲ β tubulin)in elderly patients with stage Ⅲ/Ⅳ non-small cell lung cancer (NSCLC),and to evaluate the value of the expressions of pCRMP2 and Ⅲβ tubulin in predicting the chemotherapeutic sensitivity of taxol.Methods A total of 127 elderly patients with stage Ⅲ/Ⅳ NSCLC were recruited,and expression levels of pCRMP2 and Ⅲ β tubulin were detected by immunohistochemistry and Western blot.Based on the levels of pCRMP2 and Ⅲ β tubulin expression,all patients were divided into four groups,including group A(low expressions of both pCRMP2 and lβ tubulin),group B(high expressions of both pCRMP2 and Ⅲβ tubulin),group C(high expression of only pCRMP2)and group D(high expression of only Ⅲ β tubulin).All patients were assigned to receive two cycles of TP chemotherapy regimens and then evaluate the effect of chemotherapy.If chemotherapy was invalid,a second-line chemotherapy regimen was administered.Relationships of response rate,overall survival(OS)and time on tumor progression(TTP) with expression levels of pCRMP2 and Ⅲ β tubulin protein were assessed.Results Among 127 elderly patients,the high expression rate of pCRMP2 and Ⅲ β tubulin protein were 51.2％ (65 cases) and 47.2％ (60 cases),respectively.The Western blot result displayed that the high expressions of pCRMP2 and Ⅲ β tubulin protein were significantly associated with pathologic stage,and with poorly differentiated adenocarcinoma(all P＜0.05).The pCRMP2 expression was also related to the clinical stage.Meanwhile,the overall survival rate(OS)was significantly lower in patients with high expression of pCRMP2 and Ⅲ β tubulin protein than in patients with low expression of the two proteins(P＜ 0.05).Expression of pCRMP2 and Ⅲβ tubulin protein was related with pathological grade and tissue classification.The remission rate (RR)was significantly higher in group A(65.3 ％)than in other three groups(RR in group C,group D and group B was 48.1％,44.0％,30.8％;all P＜0.05,respectively).There were significant differences in RR between group C,group D and group B(48.1 ％,44.0％,30.8％ respectively,P＜0.05).The OS of four groups were(510.5 ±20.9)d,(215.7±31.5)d,(326.9 ± 25.7)d,(298.7±21.2)d respectively.The OS was significantly longer in group A than in other groups(P ＜ 0.05).Conclusions The expression of pCRMP2 and Ⅲ β tubulin protein in NSCLC can be used to judge prognosis of lung cancer and to predict chemotherapy drug resistance.
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Background:The efficacy of traditional medicine on ulcerative colitis (UC) is often unsatisfactory, hence development of drug based on the pathogenic mechanism of UC becomes a hot topic in the research of UC.It has been revealed in recent studies that activation of nuclear factor-κB (NF-κB) is implicated as a key regulator in the immune and inflammatory responses in UC.Aims:To explore whether bortezomib, a potent proteasome inhibitor that inhibits NF-κB activation can be used for treatment of UC.Methods:Thirty-two BALB/c mice were used to induce acute experimental colitis by drinking 3%dextran sulfate sodium (DSS) freely for 7 days, and then randomly allocated into four groups injected intraperitoneally with 0.2 (low-dose group), 0.6 (medium-dose group), 1.0 mg/kg (high-dose group) bortezomib and normal saline (model control group), respectively.On the 7th day after treatment, the disease activity index (DAI) and histopathological change of colonic tissue were observed;the colitis-related parameters including peripheral blood hemoglobin (Hb), C-reactive protein (CRP) and colonic myeloperoxidase (MPO) activity were measured, and the nuclear translocation of NF-κB was assessed by electrophoretic mobility shift assay.Results:Compared with the model control group, the DAI, CRP, MPO activity, and injury score of colonic tissue were decreased gradually, and the Hb was increased gradually in mice treated with low-, medium-and high-dose bortezomib (P all <0.05).The efficacy of medium-and high-dose bortezomib was notable.In mice treated with medium-and high-dose bortezomib, nuclear translocation of NF-κB was inhibited obviously.Conclusions:Bortezomib can modulate the colonic inflammation in mice with experimental colitis by inhibiting NF-κB activation and subsequently improving the clinical manifestations, colitis-related parameters and tissue damage.Increasing the dosage of bortezomib in a safety range may enhance the treatment response.
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Objective To observe the effect of parecoxib united with local anaesthesia analgesia system on analgesia after radical resection of liver cancer. Methods Ninety patients undergoing elective radical resection of liver cancer were randomly assigned to three groups, with 30 patients in each group. The patients in parecoxib group (P group) received parecoxib 40 mg through vein before the end of operation for 30 min, and were injected parecoxib 40 mg at 12 h, 24 h and 46 h after operation. The patients in local anethsia analgesia system group (L group) received embedding hypodermic pervasion canal in incision subcutaneously, then connected the pump with 0.25% ropivacaine 250 ml, with infusion speed of 4 ml/h.The patients in united group(U group)receiced the same methods with those in P group and L group. When the patients'visual analogue scale (VAS) scores were higher than 5 scores, they were given muscle injection of pethidine 50 mg. The VAS scores and Ramsay sedation scores at the time of tracheal extubation (T0), postoperative 2 h(T1), 6 h(T2), 12 h(T3), 24 h(T4) and 48 h(T5), the adverse reaction rate, dosage of pethidine, and analgesia satisfaction were compared. Results The resting and movement of VAS scores and Ramsay sedation scores at each time in P group and L group had no significant difference (P>0.05). The resting and movement of VAS scores and Ramsay sedation scores at each time in U group were significantly better than those in P group and L group (P 0.05). The rate of drowsiness in U group was significantly lower than that in P group and L group:6.67%(2/30) vs. 26.67%(8/30) and 23.33%(7/30), P < 0.05. The analgesia satisfaction in U group was significantly higher than that in P group and L group:93.33%(28/30) vs. 56.67%(17/30) and 53.33%(16/30), P<0.05. Conclusions The analgesia effect of the parecoxib united with local anaesthesia analgesia system for radical resection of liver cancer is perfect.
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Objective To evaluate the quality of intraoperative wake?up test in the patients undergoing scoliosis correction surgery under etomidate?based anesthesia. Methods Thirty patients of both sexes, aged 13-32 yr, weighing 40-65 kg, of ASA physical statusⅠorⅡ, undergoing elective scoliosis correction surgery, were randomly assigned into etomidate group ( group E, n=15 ) or propofol group (group P, n=15) using a random number table. Anesthesia was induced with etomid 0.3 mg∕kg (group E) or propofol 2mg∕kg ( group P ) injected intravenously, midazolam, fentanyl and rocuronium. The patients were mechanically ventilated after naso?tracheal intubation. Etomidate 0.6-1. 2 mg · kg-1 · h-1 and propofol 8- 10 mg·kg-1 ·h-1 were infused intravenously during surgery in E and P groups, respectively. Both remifentanil and cisatracurium were used for maintenance of anesthesia in the two groups. Cisatracurium infusion was stopped before wake?up test. The infusion rate of propofol was adjusted to 4 mg·kg-1 ·h-1 at 15 min before wake?up test. After the scoliotic angle was corrected, infusion of etomidate and propofol was stopped, and the infusion rate of remifentanil was adjusted to 0.025μg·kg-1 ·min-1 in both groups. The wake?up time was recorded, and the quality of wake?up was assessed. Mean arterial pressure (MAP) and heart rate were recorded before anesthesia ( T0 ) , immediately before the patients were awakened ( T1 ) , when the patients responded to commands from doctors ( T2 ) , and after anesthesia was deepened ( T3 ) . At T0 , the end of surgery ( T4 ) , and 24 h after surgery ( T5 ) , blood samples were collected from the internal jugular vein for determination of plasma cortisol concentrations. Results The patients were awakened successfully in the two groups, and there were no significant differences in the wake?up time, quality of wake?up, and MAP, HR and plasma cortisol concentrations at each time point between the two groups. MAP and HR were significantly higher at T2 than at T0 in the two groups. MAP and HR were within the normal range during wake?up test, and no patients developed severer cardiovascular events in the two groups. Conclusion Etomidate?based anesthesia provides better quality of intraoperative wake?up test in the patients undergoing scoliosis correction surgery, which is similar to that of propofol?based anesthesia.
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Objective To discuss the feasibility of stereotactic radiotherapy plan designing based on MRI. Methods Based on the study of the serious geometric distortion of MRI while MRI was used in the condition of position by the experiment, how to deal with geometric distortion of MRI for patient positioning by the means of software was studied deeply. The basic thought of correction arithmetic for patient positioning images, of which the corrected data being used to correct patient images was created by primitive sparse corrected data calculated from design data and sampling data was brought forward. Supported by arithmetic research, the MRIC software system was designed and implemented. At last, the experiment model MRI was dealt with the MRIC system. Results The correction arithmetic was proved valid by the result of the experiment model MRI can be corrected back to normal state with MRIC system, which implemented the correction arithmetic. Conclusion It's possible that MRI would be used for positioning and plan designing in SRT.
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OBJECTIVE:To provide reference for the quality management of hospital preparation in medical institution.METHODS:The relationship between the cause for some typical ADR events such as "Armillarisin A Injury","Xinfu Injury","Methotrexate Injury","Aesculus Wilsonii Rehd Injury" and drug production were discussed and analyzed by combining with status quo of preparation management in hospital.RESULTS & CONCLUSIONS:Above ADR events were connected with quality management in drug production closely.The quality management system of hospital preparation should be established to strengthen management of whole preparation process and guarantee the safety of hospital preparation.