AIM: To investigate the effects of nitric oxide (NO) on hepatic encephalopathy in cirrhotic rats induced by LPS. METHODS: The cirrhotic model of rats was established by complex pathogeny. Since the end of the 8 th week, the rats were intragastrically-infused with 0.9% salt, L-arginine(L-arg) and LNNA respectively for 2 weeks.The hepatic encephalopathy in cirrhotic rats were induced by 3 mg/kg LPS (ip) 4 hours before the rats were sacrificed. RESULTS: The normal behaviors and electroencephalograph were appeared in L-arg group. LNNA group showed hepatic encephalopathy. The content of NO-_2/NO-_3 of brain tissue was markedly higher in L-arg group than LNNA group(P

BACKGROUNDIt has been proven that clusterin is a newly apoptosis-related factor and upregulates in many tumors. It plays important roles in carcinogenesis and tumor progression. The antiapoptosis of clusterin seems to be relative to other antiapoptosis factors. The aim of this study is to investigate the expression and significance of clusterin in non-small cell lung cancer (NSCLC) tissue.

METHODSThe expression of clusterin, p53 and Bax in NSCLC were detected by immunohistochemical SP method and Western blot assay.

RESULTSPositive expression rate of clusterin was 79.25% (42/53) in NSCLC tissues which was much higher than that in normal lung tissue (2/16, 12.50%) (Chi-square=23.68, P < 0.05). The expression of clusterin was closely related to pathological differentiation (rs=0.464, P < 0.01), clinical stage (rs =0.320, P < 0.01) and lymph node metastasis (rs=0.255, P < 0.05), but not correlated to the sex (Chi-square=0.007, P > 0.05), age (Chi-square=0.707, P > 0.05) and histological type (Chi-square=0.702, P > 0.05). The expression of clusterin in NSCLC was positively correlated to the expression of p53 (rs=0.589, P < 0.01), but was negatively related to the expression of Bax (rs =-0.346, P < 0.01). The relative expression level of clusterin protein in NSCLC was significantly higher than that in normal lung tissue (0.541±0.010 vs 0.201±0.020) (P < 0.05).

CONCLUSIONSClusterin may play an important role in the biological characteristics of NSCLC by the antiapoptosis pathway.

Objective:To explore the clinical effects of ureteroscopic holmium laser urethrotomy combined with fascial dilator urethral dilatation in the treatment of recurrent urethral stricture.Methods:The clinical data of 62 patients with recurrent urethral stricture in the Third People′s Hospital of Datong from October 2016 to September 2018 were retrospectively analyzed.The patients were divided into two groups according to the treatment method.The control group( n=28) underwent ureteroscopic holmium laser urethrotomy, and the combined group( n=34) underwent ureteroscopic holmium laser urethrotomy combined with fascial dilator urethral dilatation.The urodynamic parameters[maximum urinary flow rate(Qmax), residual urine volume(RUV), Abrams-Griffiths(AG)value], lower urinary tract symptoms[International Prostate Symptom Score(IPSS)], erectile function[International Index of Erectile Function-5(IIEF-5)] and sexual life quality[Sexual Life Quality Questionnaire(SLQQ)] were compared between the two groups before surgery and at 6 months after surgery.The perioperative basic indicators and incidence rate of complications and recurrence rate of urethral stricture within 6 months after surgery were analyzed in the two groups. Results:At 6 months after surgery, the Qmax, scores of IIEF-5 and SLQQ in the control group were (19.18±4.67)mL/s, (15.23±3.94)points and (55.69±16.97)points, respectively, which in the combined group were (22.41±4.82)mL/s, (17.54±3.72)points and (64.31±15.80)points, respectively, and the indicators in the two groups were significantly increased compared with before surgery, and the indicators in the combined group were significantly higher than those in the control group( t=2.406, 2.135, 2.208, all P<0.05). The RUV, AG value and IPSS score in the control group were (11.75±3.24)mL, (36.09±7.86) and (13.80±4.18)points, respectively, which in the combined group were (9.46±2.89)mL, (30.58±7.27) and (11.34±3.65)points, respectively, and the indicators in the two groups were significantly decreased compared with before surgery, the indicators in combined group were significantly lower than those in control group( t=2.637, 2.573, 2.216, all P<0.05). The operative time, intraoperative blood loss, gross hematuria duration, hospital stay and catheter indwelling time in the combined group were (35.10±10.26)min, (12.15±2.06)mL, (18.61±5.19)h, (4.72±1.25)d and (14.46±3.20)d, respectively, which were significantly shorter or lower than those in the control group [(44.12±11.95)min, (13.64±2.80)mL, (22.62±5.76)h, (5.81±1.43)d and (27.93±4.48)d] ( t=2.863, 2.143, 2.586, 2.869, 3.151, all P<0.05). Within 6 months after surgery, the incidences of local hematoma, rectal injury and recurrence rate of urethral stricture in the combined group were 2.94%(1/34), 0.00%(0/34) and 5.88%(2/34), respectively, which were significantly lower than those in the control group [25.00%(7/28), 21.43%(6/28) and 28.57%(8/28)] (χ 2=4.830, 5.801, 4.286, all P<0.05). Conclusion:Ureteroscopic holmium laser urethrotomy combined with fascial dilator urethral dilatation can effectively improve the lower urinary tract symptoms in patients with recurrent urethral stricture.And it has few complications and low recurrence rate, and can improve sexual life quality of patients.

Glioma is the most common primary intracranial tumor. Despite surgical resection, radiation therapy, chemotherapy, and Tumor Treating Fields, the median survival period is still less than 21 months. In recent years, immunotherapy for glioma has become a research hotspot. The immune microenvironment of glioma plays an important role in immune escape, which is an important means of malignant progression. Exploring the immune escape mechanism of glioma, understanding the progress of immunotherapy, and extending the survival period of patients with glioma as much as possible are the major challenges facing glioma treatment. Therefore, this article reviews the new understanding of the immune system in the central nervous system, immune cells and immune escape in glioma, and immunotherapy for glioma, to help further understand the mechanism of glioma development and provide new ideas for immunotherapy.

Objective:To compare the cost-effectiveness of hospitalized Chinese patients undergoing nucleic acid screening strategies for hepatitis B and hepatitis C, immunological screening strategy, and no screening strategy under different willingness to pay (WTP). The results might aid to decision-making for the optimal strategy.Methods:In this study, nucleic acid screening, immunological screening and no screening were used as screening strategies, and China′s GDP in 2021 (80 976 yuan) was used as the threshold of WTP to construct a Markov model. After introducing parameters related to the diagnosis and treatment of hepatitis B and C in inpatients, a cohort population of 100 000 inpatients was simulated by TreeAge Pro 2021 software, the total cost, total health effects, incremental cost-effectiveness ratio and average cost-effectiveness ratio of different screening strategies were calculated, and cost-effectiveness analysis was conducted. Univariate and probabilistic sensitivity analysis were used to assess the impact of parameter uncertainty on the final results.Results:Compared with the non-screening strategy, the incremental total cost of the hepatitis B immunological screening strategy for cohort patients was 11 049 536 yuan, and the incremental cost-effectiveness ratio was 24 762 yuan/quality-adjusted life years (QALY), while the total incremental cost of nucleic acid screening was 19 208 059 yuan, and the incremental cost-effectiveness ratio was 29 873 yuan/QALY; the incremental cost-effectiveness ratio of nucleic acid screening and immunological screening was 45 834 yuan/QALY. Compared with the non-screening strategy, the incremental cost-effectiveness ratio of hepatitis C immunological screening strategy was 5 731 yuan/QALY, the incremental cost-effectiveness ratio of nucleic acid screening strategy was 8 722 yuan/QALY, the incremental cost-effectiveness ratio of nucleic acid screening and immunological screening was 45 591 yuan/QALY. The results of probabilistic sensitivity analysis showed that when the cost of nucleic acid testing exceeded 214.53 yuan, it was not cost-effective to perform hepatitis B nucleic acid screening under the WTP as 1 fold GDP. When the cost of nucleic acid testing exceeded 132.18 yuan, it was not cost-effective to conduct hepatitis C screening under the WTP as 1 fold GDP.Conclusions:Nucleic acid screening strategy can achieve more cost-effectiveness and is worthy of vigorous promotion. Compared with no screening, both the nucleic acid and immunological screening strategies are cost-effective, and hepatitis nucleic acid screening is the optimal strategy for hospitalized patients.