Objective To investigate the expression of CEA, NSE and CYFRA21-1 in lung cancer, and the significance of combined determination of three tumor markers in the detection of lung cancer. Methods CEA, NSE and CYFRA21-1 levels in serum of 65 patients with lung cancer, 50 patients with benign lung diseases and 38 normal adults were measured by enzyme linked immunosorbent assay (ELISA). The association of CYFRA21-1, NSE, and CEA level with the type of lung cancer in pathology were also studied. Results In comparison, the serum levels of CEA, CYFRA21-1 were increased more obviously in patients with lung cancer than that of patients with benign lung diseases and the normal adults (P<0.01). The levels of serum and the sensitivity of CEA, NSE and CYFRA21-1 were related to pathology type. The sensitivity and specificity increased by combined measurement of CEA, NSE, and CYFRA21-1. Conclusion These findings suggest that the serum CEA, NSE and CYFRA21-1 levels is increased in patients with lung cancer, and the increasing extents is not same in lung cancer with different pathology types. CEA, NSE and CYFRA21-1 are significant in adjuvant diagnosis of lung cancer.

Objective To evaluate the value and safety of transbronchial needle aspiration (TBNA) in the diagnosis of lung cancer. Methods The cytologic diagnosis of TBNA in 82 patients with enlarged hilar and/or mediastinal lymphnodes or lesions adjacent to the bronchial wall were analyzed retrospectively. All specimens were detected by the ThinPrep cytologic test. Results There were 43 positive cases in the 82 patients, and the positive rate was 52.4 %. There were 18 SCLCs,11squamous cancers, 9 adenocarcinomas and 5 undefinable cancers, respectively. There were 39 patients with local bronchial wall swelling accompanied with abnormal mucosae. TBNA, douche, brushing and forcep biopsy were applied, and the diagnostic rate was 64.1%, 7.7 %, 25.6 % and 48.7 %, respectively. The total positive rate was 76.9 %. 43 patients with normal mucous membrane only underwent TBNA. 18 cases were positive, and the positive rate was 41.9 %. There was no obvious complication in the 82 patients. Conclusion The technique of TBNA enlarged the inspection scope of bronchoscopy. It has significant meaning to the diagnosis of lung cancer. TBNA was an useful and safe method in clinical application and could be used widely.

Objective:To investigate the relationship between serum interleukin-6 and interleukin-10 levels and clinical prognosis in patients with severe acute pancreatitis.Methods:Ninety-two patients with severe acute pancreatitis who received treatment in The Second People's Hospital of Liaocheng from August 2018 to July 2021 were included in this study. Serum interleukin (IL)-6 and IL-10 levels were detected. The Bedside Index of Severity in Acute Pancreatitis (BISAP) score was evaluated. Clinical interventions were performed. The relationship between serum IL-6 and IL-10 levels and the clinical prognosis of severe acute pancreatitis was investigated.Results:Serum IL-6 level [(103.75 ± 15.53) ng/L] was highest in patients who died. Serum IL-10 level [(97.33 ± 13.06) ng/L] was highest in patients with local complications. The highest number of patients with a prognostic outcome of death [26 (37.14%)] was found in patients with a BISAP score ≥ 3. Serum IL-6 level in patients with severe acute pancreatitis was positively correlated with the BISAP score ( r = 0.62, P < 0.05), and serum IL-6 level and BISAP score were negatively correlated with serum IL-10 level ( r = -0.57, -0.61, both P < 0.05). Conclusion:Increased or decreased serum IL-6 and IL-10 levels in patients with severe acute pancreatitis indicate that the patient's condition tends to worsen, and timely intervention according to serum IL-6 and IL-10 levels can improve the clinical prognosis of severe acute pancreatitis.

Objective:To investigate the efficacy of sufentanil combined with butorphanol and sufentanil combined with dezocine for postoperative analgesia of single-port thoracoscopic lobectomy.Methods:A prospective randomized controlled study was conducted. A total of 72 patients who underwent single-port thoracoscopic lobectomy in Shanxi Province Cancer Hospital from October to December 2023 were prospectively selected, and the patients were divided into group A and group B according to randomized numerical table method, with 36 cases in each group. Group A used sufentanil combined with dezocine for postoperative analgesia; group B used sufentanil combined with butorphanol for postoperative analgesia. The visual analogue scale (VAS) scores of pain, Ramasy sedation scores, vital signs monitoring indexes, postoperative adverse reactions, and the time of removing the closed chest drain were compared between the two groups at different time points in the postoperative period.Results:There were 20 males (55.6%) and 16 females (44.4%) in group A, aged (58±10) years old; there were 16 males (44.4%) and 20 females (55.6%) in group B, aged (56±11) years old; there were no statistically significant differences between the two groups in terms of gender, age, body mass index, American Society of Anesthesiologists classification, and surgery time (all P > 0.05). Comparison of the VAS scores of the two groups at 2, 6 and 10 h after surgery showed no statistically significant differences (all P > 0.05); the VAS scores of group B at 12, 24 and 48 h were lower than those of group A, and the differences were statistically significant (all P < 0.01). The Ramasy scores of the patients in group B at 2, 6, 10, 12, 24, and 48 h after surgery were higher than those of group A, and the differences were statistically significant (all P < 0.05). The postoperative chest drain removal time in group A was (4.5±1.7) d, which was longer than that in group B [(3.7±0.8) d], and the difference was statistically significant ( t= 2.58, P = 0.014). Comparison of systolic blood pressure, diastolic blood pressure, oxygen saturation, heart rate, and respiration of patients in the two groups at 2, 6, 10, 12, 24, and 48 h after surgery showed no statistically significant differences (all P > 0.05). The incidence of postoperative adverse reactions in patients of both groups was 16.67% (6/36). Conclusions:The efficacy of sufentanil combined with butorphanol for postoperative analgesia of single-port thoracoscopic lobectomy is better than that of sufentanil combined with dezocine, which may help to accelerate the patient's postoperative recovery.Objective To investigate the efficacy of sufentanil combined with butorphanol and sufentanil combined with dezocine for postoperative analgesia of single-port thoracoscopic lobectomy. Methods A prospective randomized controlled study was conducted. A total of 72 patients who underwent single-port thoracoscopic lobectomy in Shanxi Province Cancer Hospital from October to December 2023 were prospectively selected, and the patients were divided into group A and group B according to randomized numerical table method, with 36 cases in each group. Group A used sufentanil combined with dezocine for postoperative analgesia; group B used sufentanil combined with butorphanol for postoperative analgesia. The visual analogue scale (VAS) scores of pain, Ramasy sedation scores, vital signs monitoring indexes, postoperative adverse reactions, and the time of removing the closed chest drain were compared between the two groups at different time points in the postoperative period. Results There were 20 males (55.6%) and 16 females (44.4%) in group A, aged (58±10) years old; there were 16 males (44.4%) and 20 females (55.6%) in group B, aged (56±11) years old; there were no statistically significant differences between the two groups in terms of gender, age, body mass index, American Society of Anesthesiologists classification, and surgery time (all P > 0.05). Comparison of the VAS scores of the two groups at 2, 6 and 10 h after surgery showed no statistically significant differences (all P > 0.05); the VAS scores of group B at 12, 24 and 48 h were lower than those of group A, and the differences were statistically significant (all P < 0.01). The Ramasy scores of the patients in group B at 2, 6, 10, 12, 24, and 48 h after surgery were higher than those of group A, and the differences were statistically significant (all P < 0.05). The postoperative chest drain removal time in group A was (4.5±1.7) d, which was longer than that in group B [(3.7±0.8) d], and the difference was statistically significant ( t= 2.58, P = 0.014). Comparison of systolic blood pressure, diastolic blood pressure, oxygen saturation, heart rate, and respiration of patients in the two groups at 2, 6, 10, 12, 24, and 48 h after surgery showed no statistically significant differences (all P > 0.05). The incidence of postoperative adverse reactions in patients of both groups was 16.67% (6/36). Conclusions The efficacy of sufentanil combined with butorphanol for postoperative analgesia of single-port thoracoscopic lobectomy is better than that of sufentanil combined with dezocine, which may help to accelerate the patient's postoperative recovery.

ObjectiveBased on the traditional quality evaluation methods summarized in previous dynasties， this paper systematically contrasted cultivated Astragali Radix（CA） and wild-simulated Astragali Radix（WA） from the aspects of character， microstructure and chemical composition by modern technological means. MethodThe collected CA and WA were compared in characters and microscopic characteristics in cross section， and comparative analysis were performed on the contents of cellulose， extracts， carbohydrate， total flavonoids， total saponins， etc. Then ultra-high performance liquid chromatography-quadrupole-time-of-flight mass spectrometer（UPLC-Q-TOF-MS） and desorption electrospray ionization mass spectrometry imaging（DESI-MSI） were used to comparatively analyze the secondary metabolites and their spatial distributions in the xylem and phloem of CA and WA. ResultIn terms of characters， the characters and sectional features of WA was consistent with the characteristics of high-quality Astragali Radix， while the CA was quite different from the traditional high-quality Astragali Radix. In terms of microscopy， the phellem layer of CA was thin， and the section fissures were mostly distributed through the cambium in a long strip shape without obvious growth ring characteristics. The cork layer of WA was thick， and the cracks in the section were distributed in the center of the xylem and the outer edge of the phloem in an irregular cavity shape. The cambium was tight without cracks， and had obvious characteristics of a growth ring. In terms of chemical composition， the contents of water-soluble extract， 80% ethanol extract and sucrose of CA was significantly higher than those of WA， while the contents of total saponins， lignin and hemicellulose were significantly lower than those of WA. And the contents of 100% ethanol extract， total polysaccharides and total flavonoids in both of them were generally similar， but slightly higher in WA. The contents of 2 kinds of monoacyl-substituted flavonoid glycosides in the xylem of WA was significantly higher than those of CA， while the contents of 2 kinds of flavonoid aglycones and one flavonoid glycoside were on the contrary. The contents of 7 saponins in phloem of WA were significantly higher than those of CA. ConclusionThere are significant differences between CA and WA in characters， microstructure and chemical components， in which CA has a fast growth rate and a short planting period， and the primary metabolites such as water-soluble extracts and sucrose are more enriched， which is the reason for its firm texture and sweetness being significantly higher than those of WA. However， the contents of lignin， hemicellulose and some secondary metabolites in WA are significantly higher than those in the CA， which are close to the traditional description of characters and quality. Based on the results of this study， it is suggested to strengthen the production of WA， improve the supply capacity of WA， and gradually upgrade the current standard. It is recommended to increase the contents of monoacyl-substituted flavonoid glycosides， total saponins and other indicators that can characterize different production methods， so as to guide the high-quality production of Astragali Radix.

ObjectiveBased on the experience of traditional quality evaluation， the quality of Atractylodis Macrocephalae Rhizoma（AMR） with different production methods such as direct seeding， transplanting after seedling raising， topping and non-topping， and difference in growth years was compared. MethodVernier caliper was used to measure the trait data of AMR in different production methods. Paraffin sections of AMR with different production methods were made by saffron solid green staining， and the microstructure was observed. The contents of water-soluble and alcohol-soluble extracts in AMR with different production methods were determined according to the 2020 edition of Chinese Pharmacopoeia. The content of water-soluble total polysaccharides in AMR with different production methods was detected by sulfuric acid-anthrone method. Fiber analyzer was used to detect the content of fiber components in AMR with different production methods. The contents of monosaccharides， oligosaccharides and some secondary metabolites in AMR with different production methods were detected by ultra performance liquid chromatography（UPLC）， and the differences of chemical components were compared by multivariate statistical analysis methods such as principal component analysis（PCA） and partial least squares-discriminant analysis（PLS-DA）. ResultIn terms of traits， the 3-year-old AMR with direct seeding and without topping was close to the high-quality AMR with "phoenix-head and crane-neck， strong sweetness and clear aroma" recorded in ancient materia medica， followed by the 3-year-old AMR with topping after transplanting， while the 2-year-old AMR with topping after transplanting with high market circulation rate was generally fat and strong with mild odor. In the microscopic aspect， the arrangement of xylem vessels and fiber bundles in the 3-year-old samples formed two obvious rings. Compared with the 2-year-old samples cultivated in Bozhou and Zhejiang， the 3-year-old samples without topping after transplanting had more wood fibers. In terms of chemical composition， the contents of 70% ethanol extract， fructose， glucose， sucrose， 1-kestose， atractylenolide Ⅰ， chlorogenic acid， neochlorogenic acid， cryptochlorogenic acid and other components in 3-year-old AMR with direct seeding and without topping were significantly higher than those in the other three samples（P<0.05）. The contents of cellulose， 70% ethanol extract， sucrose， atractylenolide Ⅰ， atractylone and other components in 3-year-old AMR with topping after transplanting were significantly higher than those in the 2-year-old AMR with high market circulation rate（P<0.05）， while the contents of water-soluble extract and water-soluble total polysaccharides in 2-year-old samples with topping after transplanting were significantly higher than those in the 3-year-old AMR with topping after transplanting， direct seeding and without topping（P<0.05）. ConclusionUnder the current mainstream production mode， too much manual intervention makes AMR heavily enriched in polysaccharides and increased the yield， but the accumulation of sweet substances， fragrant substances and fiber substances is insufficient， which affects its quality. The current quality standard of AMR has some shortcomings in guiding the high quality production of it， it is suggested to revise the quality standard of AMR， supplement the quantitative analysis of secondary metabolites， and strengthen the production of imitation wild AMR.

By reviewing the research history on quality comparison between wild and cultivated Chinese crude drugs， this paper systematically combed the relevant research reports since the 1950s， and summarized and analyzed the results of existing comparative studies， and found that the existing comparative research on the quality of wild and cultivated Chinese crude drugs were mainly focused on several aspects， including characteristics， microstructures， chemical compositions， pharmacodynamic effects， and genetic diversity. Among these， comparative studies of chemical compositions have been the dominant approach， with a particular emphasis on comparing the contents of index components. However， research on pharmacodynamic effects remained relatively limited. Due to various factors such as sample quantity， sample origin， growth period and cultivation methods， the differences in quality between wild and cultivated Chinese crude drugs vary significantly. In general， most wild Chinese crude drugs exhibited higher quality than cultivated products， with significant differences in their characteristics. The contents and proportions of some chemical components underwent noticeable changes， particularly with a marked increase in the proportion of primary metabolites after cultivation. The quality of cultivated Chinese crude drugs is closely related to the cultivation practices employed. Chinese crude drugs produced through wild nurturing， simulated wild planting， ecological cultivation， and other similar methods demonstrate quality levels comparable to those of wild Chinese crude drugs. Based on the analysis results， it is recommended to explicitly specify the cultivation practices and cultivation period of cultivated Chinese crude drugs in comparative studies of the quality between wild and cultivated Chinese crude drugs. Multiple technical approaches， including characteristics， microscopy， non-targeted metabolomics combined with quantitative analysis of differential components， and bioefficacy evaluation， should be employed to comprehensively assess the quality disparities between wild and cultivated Chinese crude drugs. Moreover， research efforts should be intensified to investigate the changes in pharmacodynamic effects resulting from differences in plant cell wall composition， primary metabolites， and secondary metabolites， in order to guide the production of high-quality Chinese crude drugs.