Objective To investigate the long-term effect of direct percutaneous coronary intervention (PCI) on left ventricular remodeling in patients aged ≥75 years with acute myocardial infarction (AMI).Methods 108 cases of patients with acute myocardial infarction were collected into the study.Direct PCI were completed in patients in PCI group within 12 hours of onset.Patients in non-PCI group received conventional conservative treatment with drugs.Patients were followed up for 0.5-8.0 years,and cardiac function (NYHA) and the detected ultrasonic cardiogram were evaluated during follow-up.Results The 106 patients received follow-up.Two female patients who were not treated with PCI died during follow-up,one patient died of sudden cardiac death and another patient died of severe pneumonia.Compared with non-PCI group,direct PCI group showed that cardiac function (NYHA) grade was lower(t=3.17,P＜0.05),the end-systolic and end-diastolic volume of left ventricle were less(t=3.50、3.90,all P＜0.01),the left ventricular ejection fraction was increased (t=2.00,P＜0.05),the ventricular wall motion index was smaller (t=2.96,P＜0.01).E/A ratio was higher,E wave deceleration time was shorter,and left ventricular mass index was smaller (t=4.04,4.29,4.70,respectively,all P＜0.01),the left ventricular long and short axis diameter were decreased (t=2.30,t=5.53,P＜0.05 or 0.01),and Spherical index was increased (t=2.97,P＜0.01).Conclusions Direct PCI treatment improves chronic ventricular remodeling in elderly patients with AMI and contributes to long-term improvement in cardiac function.

Objective:To study the mechanism of interleukin-10(IL-10)inhibiting the function of dendritic cells(DCs).Meth-ods:Cultured C57BL/6 mouse bone marrow-derived DCs were divided into 5 groups:control group,LPS stimulated group,IL-10 treated group,IL-10+Rapamycin treated group and Rapamycin treated group .The regulatory mechanism of IL-10 on dendritic cells were evalua-ted from DCs function ,Flow cytometry was used to analyse the expression of DCs surface co-stimulator CD80 ,CD40 expression ,the abil-ity of uptaking antigen and stimulating T cell to proliferate;ELISA was used to detect the cytokines IL-6 and TNF-α.Western blot was used to analyse the autophagy related protein LC3.Compared the differences between the groups.Results:(1)Compared to LPS stimu-lated group,IL-10 treated group,DCs surface co-stimulator CD40,CD80 were decreased,IL-6 and TNF-αsecretion level and the ability to stimulate T cell to proliferate were decreased ,the ability to capture OVA antigen was increased .Compared to IL-10 treated group ,the DCs surface co-stimulator CD80 was decreased ( P<0.05 ) ,IL-6 and TNF-αsecretion level and the ability to stimulate T cell to prolifer-ate were increased(P<0.0001)in IL-10+rapamycin treated group.In addition,autophagy related proteins LC3Ⅱ/LC3Ⅰwas decreased in IL-10 treated group.Conclusion:IL-10 may regulate functions of DCs through inhibiting the autophagy of DCs .

Objective:To analyze the clinical characteristics and pathogenic distribution of severe pneumonia in adults in order to provide basis for clinical diagnosis and treatment.Methods:From June 2021 to April 2022, 145 patients with pneumonia admitted to the Department of Respiratory and Critical Care Medicine of the Second People's Hospital of Guangdong Province. According to whether they meet the diagnostic criteria for severe pneumonia, they were divided into severe ( n=63) and mild ( n=82) groups, and the clinical features between the two groups were compared. At the same time, the role of FilmArray detection in severe pneumonia was discussed. The measurement data were tested using independent sample t test or Mann-Whitney U test, and the counting data were tested using Chi-square test or Fisher exact probability method. Results:The age of the patients in the severe group was (72.67±1.71) years, male patients accounted for 84.1%, and the median hospitalization time was 16 days. Nine patients died in hospital; most of them had fever, shortness of breath, and change of consciousness, accompanied by hypertension, diabetes, cerebrovascular disease, chronic kidney disease, and tumor history. Compared with the mild group, the total number of leukocytes, neutrophil ratio, procalcitonin, and C-reactive protein were higher in the severe group, but the CD3 +, CD4 +, and CD8 + cell counts were lower ( P<0.05). The positive rate of FilmArray detection in the severe group was 81%, and the mixed infection of multiple bacteria accounted for 50%, which was higher than that of traditional culture ( P<0.05). The top four pathogens in severe group were Pseudomonas aeruginosa, Acinetobacter baumannii complex, Klebsiella pneumoniae, and Staphylococcus aureus, which were significantly higher than that in the mild group ( P<0.05). Resistance genes were detected in patients with severe disease, which was significantly higher than that in patients with mild disease (70.7% vs. 17.5%, P<0.05). Conclusions:Severe pneumonia is more common in elderly men, with more basic diseases and poor immunity. FilmArray has a high positive rate and can detect multiple pathogens, which may have a role in the rapid diagnosis of severe pneumonia.