OBJECTIVE: To explore the effects of piracetam on superoxide dismutase(SOD) activity and malonaldehyde(MDA) content in brain tissues of D-galactose-induced ageing rats.METHODS: 30 SD rats were randomized to one of the 3 groups: blank control group(NS),model group(D-galactose+NS) and piracetam group(D-galactose+piracetam 432 mg?kg-1?d-1).All the rats were put to death at 90 days after medication,and the SOD activity and MDA content in brain tissues were determined.RESULTS: As compared with the blank control,the SOD activity decreased(P

Objective The effect of different doses of ethylnitrosourea(ENU)and cyclophosphamide(CP)on the loss rate of CD59 on peripheral blood erythrocytes was explored to optimize the detection method of Pig-a gene mutation. Methods According to the weight and loss rate of CD59 on peripheral blood erythrocytes,rats were divided into 4 groups:the control group,CP 40 mg/kg group,ENU 10 mg/kg group and ENU 40 mg/kg group(n=6). The control group was injected i.p. with PBS,other groups were injected i.p. with corresponding solutions. The body weight of rats on days 0,7,14,21, 28, 42 and 56 were recorded. At the same time, blood samples were collected and incubated with antibodies,and the loss rate of RBCCD59-was detected by flow cytometry. Results Compared with the control group, at different time points, the body weight and weight gain of ENU 10 mg/kg group and ENU 40 mg/kg group had no statistically significant difference(P > 0.05),while those in the CP 40 mg/kg group were significantly decreased(P <0.05). The loss rate of RBCCD59-was significantly increased in the CP 40 mg/kg group at 28,42 and 56 days, ENU 10 mg/kg group at 42 and 56 days,and ENU 40 mg/kg group at 7,14,21,28,42 and 56 days,(P < 0.05). The results showed a dose-response relationship. Conclusions Under the conditions of this Pig-a mutation detection method,ENU is superior to CP on raising loss rate of RBCCD59-,ENU 40 mg/kg is better than 10 mg/kg,and 28 days is suitable as the test period.

Objective Using evidence-based nursing method to formulate an nursing program for one heat stroke ( HS) with rhabdomyolysis ( RM) and multiple organ dysfunction syndrome ( MODS) patient, who were treated by continuous renal replacement therapy( CRRT) . Methods Based on fully assessing the patients′conditions, the clinical problems were put forward according to PICO principles. The Cochrane library, MEDLINE, PubMed, EBMR inquiry evidence-based medicine databases, National Guideline Clearinghouse, RNAO, CBM, WanFang database, CNKI and Critical Care Medicine Branch of Chinese Medical Association clinical guidelines were retrieved to collect high quality clinical evidence, and then the optimum nursing program was designed in line with patients′conditions and relatives′willingness. Results Ten trials and one application guideline were included. The available clinical evidence displayed that:(1)HS patient with RM should be given CRRT as soon as possible, it could not only reduce core body temperature, but also effectively removed myoglobin and significantly improved renal function; ( 2 ) Femoral vein catheter was the first choice for establishing vascular access;(3)The systemic anticoagulation with un-fractionated heparin should be scheduled for coagulation laboratory examination and closely observed the hemorrhage; ( 4 ) Routine use of intermittent saline flush pipes was not recommended. So finally a nursing plan was made in combination with literature evidence, patients′ condition and relatives′ willingness: we used CRRT early; choose femoral vein catheter;closely observed of hemorrhage and adjusted the dose of heparin according to activated partial thromboplastin time ( APTT) when using systemic anticoagulation with un-fractionated heparin, not used intermittent saline flush pipes. After CRRT and other comprehensive treatment, the patient regained consciousness after seven days. Myoglobin was down to 200 ng/ ml from 1 455 ng/ ml admission, with astable vital signs. Conclusions HS patients with RM should be given CRRT as soon as possible. Femoral vein catheter is the first choice for establishing vascular access. The systemic anticoagulation with un-fractionated heparin should be scheduled for coagulation laboratory examination and closely observed of hemorrhage. Routine use of intermittent saline flush pipes is not recommended.

The morbidity and mortality of lung cancer are always at the forefront of malignant tumors. To improve the therapeutic effects and overall survival of lung cancer patients is one of the key areas both in clinical medicine and basic research. With the development of precision medicine, targeted treatment based on the characteristics of DNA mutation and immunotherapy targeting PD-1/PD-L1, CTLA-4 and other pathways have promoted the progress of the overall diagnosis and treatment level of lung cancer, which has been widely used in clinical practice. While making the continuous achievements in the above fields, the researchers committed to lung cancer research are gradually shifting their attention to the exploration of RNA level. Some results have been accumulated in the effects of RNA epigenetic modifications on the biological behavior of lung cancer. N6-methyladenosine(m6A) is the most abundant form of mRNA methylation. The dysfunction of m6A modification mediated by related regulatory proteins has been reported to play an important role in the development and progression of lung cancer. This paper focuses on the detection methods of m6A modification, related regulatory proteins and their mode of action, and reviews the effects on the onset, diagnosis, treatment and prognosis of lung cancer. The aim is not only to summarize the researchers' latest understanding of the epigenetic regulatory mechanism, but also to provide new perspectives for the early diagnosis, effective drug use and prognosis judgment of lung cancer.

Objective:Immune checkpoint inhibitors have a high remission rate in the preoperative application of resectable and potentially resectable non-small cell lung cancer when combined with chemotherapy. For the unresectable stage Ⅲ non-small cell lung cancer, whether the transformation can be achieved through this regimen to provide opportunities for surgical resection is controversial. In this study, we evaluated the pattern of transformation therapy by reviewing the efficacy and safety of preoperative therapy and surgery of this group.Methods:A review of 23 patients undergoing surgical resection after transformation therapy by preoperative immunotherapy combined chemotherapy between November 2019 and November 2021 was performed. All patients must clarify the pathological diagnosis of non-small cell lung cancer by biopsy. After the multi-disciplinary treatment team and preoperative imaging assessment, the diagnosis should be consistent with unresectable stage III as described in the Expert Consensus on Multidisciplinary Management of Stage Ⅲ Non-Small Cell Lung Cancer, 2019 Edition. After 2 to 4 cycles of preoperative anti-PD-1 monoclonal antibody combined with chemotherapy, the surgical team assessed the chance of resection and performed surgery. Important indicators such as surgical resection rate, R0 resection rate, MPR, pCR, incidence of grade 3-5 adverse reactions and various other perioperative data were counted.Results:In the whole group, initial imaging evaluation was 10 of stage cⅢA and 13 of stage cⅢB.15 cases had multiple stations N2 lymph nodes metastasis, 9 had enlarged fused N2 lymph nodes metastasis, 6 had large vessel invasion(T4), and 1 had contralateral mediastinal lymph node metastasis(N3). After preoperative neoadjuvant therapy, 17 cases achieved PR, 3 achieved SD and 3 achieved PD. The surgical resection rate of the whole group was 91.3%(21/23, 1 lobectomy combined with superior vena cava reconstruction, 2 sleeve lobectomy, 5 pneumonectomy, 12 lobectomy/combined lobectomy, 1 wedge resection and 2 unresectable cases), R0 resection rate was 95.2%(20/21). MPR was achieved in 13 cases, 8 of them reached pCR. There were no perioperative deaths, median surgical time was 260(190-460) min, median bleeding volume was 100(50-750) ml, median drainage time was 5(3-9) days, and median hospitalization was 7(5-11) days. Two cases got immunotherapy-related grade 3 adverse reactions, one was interstitial pneumonia and the other was immune-related injury involving the eye, oral and genital mucosa. Two cases got surgical complications and one was persistent lung leakage, which stopped after 46 days of conservative treatment; The other was pleural effusion, which was relieved after drainage.Conclusion:For the unresectable stage Ⅲ NSCLC, immunotherapy combined chemotherapy is an effective preoperative downstage method. It can convert 91.3% cases to resectable ones while achieving a good degree of pathological remission. Its side reactions are generally controllable and safety.

Objective: To introduce our experience of 4L lymph node dissection in left lung cancer and to analyze the pattern of 4L LN metastasis. To investigate the prognostic impact of 4L lymph node dissection. Methods: 171 patients with left lung cancer who underwent pulmonary resection andsystematic mediastinal lymph node dissection from March 2016 to March 2019 were collected retrospectively. There were 106 males and 65 females endolled, aged(64.1±7.7) years. 54.4% had a history of smoking. The diameter of the tumors was(3.3±1.9) cm; Central-type tumor were 59 cases(34.5%), peripheral 112 cases(65.5%), upper lobe 95 cases(55.6%) and lower lobe 76 cases(44.4%). The clinical and perioperative data as well as the pattern of lymph node metastasis were analyzed. t test or Mann-Whiteney U test was used for continuous variables, and χ² test or Fisher test was used for categorical variables. Multivariate analysis was performed using a logistic regression model to evaluate the risk factors. Results: The metastasis rate of station 4L was 21.6%. Tumor size, locations(central type/upper lobe), operative type, micropapillary/entity components and vascular invasion were risk factors for 4L LN metastasis in univariate analysis. Tumor size(OR=1.611, P=0.032) and location of upper lobe(OR=2.823, P=0.008) were independent risk factors in multivariate logistic analysis. Through the analysis of ROC curve, the optimal cutoff point of tumor size was 2.5cm. The metastatic rate of 4L was 32.6% when tumor size larger than 2.5 cm and 7.9% when tumor size smaller than 2.5cm.Tumor located in upper lobe tended to metastasize to upper mediastinal lymph nodes, including station 4L, 5 and 6, while the one located in lower lobe tended to metastasize to station 7. Conclusion Station 4L LN involvement is commen in left lung cancer. The dissection of the 4L LN is important, especially for the tumor larger than 2.5 cm or located at upper lobe.

Objective: To determine the first dengue fever case in Taizhou and trace probable transmission sources. Methods: Collected serum of three patients for antigen, antibody and nucleic acid detection. Dengue viruses were isolated and cultured in C6/36 cell. The whole length of E gene was amplified by reverse transcriptase-polymerase chain reaction(RT-PCR) and then sequenced. The phylogenetic tree was drawn. Results: Three cases were positive in nucleic acid detection. Two cases were IgM positive. One case was NSI antigen postive. Three strains of type I dengue virus were isolated from samples. The phylogenetic trees shown that the three strains were on the same branch. The identities of nucleotide were 99.87%. The identities of amino acid were 99.6%-99.8%. Conclusions The dengue virus strains isolated in Taizhou was imported from Guangdong or Southeast Asia and caused location infection.