Objective To investigate the effect of Shenqi Fuzheng injection on serum CRP,IL-6 and IL-10 levels in elderly patients with coronary heart disease.Methods 64 elderly patients with coronary heart disease from Wenling First People's Hospital hospital were selected and randomly divided into the control group and the experiment group.32 cases in each group, the control group were treated by conventional symptomatic treatment, the experiment group were treated with Shenqi Fuzheng injection on the base of control group.The serum ( C-reactionprotein,CRP) ,white blood cell mediated IL-6 and leukocyte mediated element IL-10, systolic blood pressure, diastolic blood pressure(DBP),glycerin,total cholesterol(TC),triglyceride(TG), low density lipoprotein(LDL-C) and high density lipoprotein(HDL-C) levels were recorded,and the clinical efficacy and adverse reaction conditions were compared.Results The effective rate of treatment in the control group was 68.75% lower than that in the experiment group 90.63%(P<0.05). Compared with the control group after treatment,the serum CRP, IL-6, IL-10, systolic blood pressure, diastolic blood pressure, TC,TG and LDL-C levels were lower,theHDL-C level was higher,has statistical significance(P<0.05).Conclusion Shenqi Fuzheng injection in the treatment of elderly patients with coronary heart disease has a significant effect,can reduce serum CRP, IL-6 and IL-10 levels.

Objective To investigate the clinical effect of alprostadil in the treatment of coronary heart disease and its effect on myocardial microcirculation and hemorheology.Methods From January 2015 to October 2017,100 patients with coronary heart disease admitted to the First People's Hospital of Wenling were randomly divided into two groups according to the digital table,with 50 cases in each group.The control group was treated with routine therapy.The observation group was treated with alprostadil on the basis of routine treatment.The clinical efficacy,myocardial microcirculation index and hemorheology index were compared between the two groups.Results The total effective rate of the observation group was 96％ (48/50),which was higher than 82％ (41/50) of the control group,and the difference between the two groups was statistically significant (x2 =5.005,P ＜ 0.05).After treatment,the cardiac troponin Ⅰ and myocardial troponin T in the observation group were (0.023 ±0.014)μg/L,(0.012 ±0.006)μg/L,respectively,which in the control group were (0.037 ± 0.015) μg/L,(0.019 ± 0.008) μg/L,respectively,the differences between the two groups were statistically significant (t =4.825,4.950,all P ＜ 0.05).The erythrocyte hematocrit,plasma viscosity,erythrocyte sedimentation rate,erythrocyte electrophoresis time in the observation group were (25.69 ± 3.87) ％,(293.42 ± 12.73) s,(15.21 ± 4.59) mm/h,(1.29 ± 0.37) mp/s,respectively,which in the control group were (32.54 ± 4.52) ％,(326.17 ± 18.65) s,(21.85 ± 5.93) mm/h,(1.76 ± 0.43) mp/s,respectively,the differences between the two groups were statistically significant (t =8.140,10.256,6.261,10.256,all P ＜ 0.05).Conclusion Alprostadil in the treatment of coronary heart disease can improve the clinical efficacy and improve the patients'myocardial microcirculation and hemorheological indicators.

Objective To investigate the effect of dexmedetomidine on activations of pulmonary extracellular signal-regulated kinase 1/2 (ERK 1/2 )and serine-threonine kinase (Akt) during isolated lung ischemia-reperfusion injury (LIRI)in rats.Methods Forty-five adult male Spra-gue-Dawley rats were randomly divided into three groups (n=1 5 each):control group (group C),is-chemia-reperfusion group (group IR)and dexmedetomidine group (group DEX).Isolated rat lungs were maintained for normal physical activity,and only received ventilation and perfusion for 150 min in the IL-2 ex-vivo lung perfusion system in group C.Isolated rat lungs were subjected to 60 min of is-chemia and apnea followed by 75 min reperfusion and ventilation 15 min after perfusion in the IL-2 ex-vivo lung perfusion system in groups IR and DEX.Dexmedetomidine with a dose of 10 nmol/L was ad-ministrated into perfusion fluid at the onset of reperfusion in group DEX,and the same volume of saline was injected when perfusion for 75 min and at the onset of reperfusion in groups C and IR,respectively.Patho-logical changes of lungs were examined and the injured alveolus rate (IAR)was counted under light micro-scope.The expression levels of ERK 1/2 or Akt mRNA and phosphorylate-ERK 1/2 (p-ERK 1/2 )or phosphorylate-Akt (p-Akt)protein of lung tissue were tested by reverse transcription-polymerase chain re-action (RT-PCR)and Western blot,respectively.Results Compared with group C,the IAR and the ex-pression levels of ERK 1/2 and Akt mRNA or p-ERK 1/2 and p-Akt protein in lung tissue were high-er in groups IR and DEX (P<0.05).Compared with group IR,the IAR and the expression levels of ERK 1/2 and Akt mRNA or p-ERK 1/2 and p-Akt protein in lung tissue were lower in group DEX (P<0.05).Conclusion Dexmedetomidine may reduce LIRI in rat isolated lungs via inhibiting the expressions of IL-6 and IL-8,and the mechanism may be related to suppressing activations of ERK 1/2 and Akt.

Objective:To investigate the regularity of cervical lymph node metastasis of hypopharyngeal carcinoma and its influence on patient prognosis,to guide the therapeutic strategies for hypopharyngeal carcinoma.Methods:A total of 140 hypopharyngeal squmous cell carcinoma patients who received surgery in Tianjin Medical University Cancer Institute and Hospital from January 2000 to December 2016 were analyzed retrospectively.χ2test was adopted for the analysis of the counting data,and Kaplan-Meier method was used for survival analysis,and the Cox regression model was used to analyze the factors affecting the prognosis.Results:The total rate of lymph node metastasis was 68.6% of the total 140 patients.The rate of occult lymph node metastasis in cN0 patients was 25.0%.The rate of bilateral lymph node metastases was 25%.The most common areas of lymph node metastasis are region II,Ⅲ,andⅣ.The rates of lymph node metastasis were 10.7%,10.4%,7.9% in regionⅠ,ⅤandⅥ,respectively.The total rate of extranodal extension were 66.7%.Univariate analysis showed that cervical lymph node metastasis was closely related to tumor pathological grade(P=0.012),and was not related to gender,age,primary tumor site,tumor T stage(P<0.05).The 3-year and 5-year overall survival rates of patients were 61.0% and 49.1%, respectively.Cox regression analysis showed that the diameter of metastatic lymph nodes(P=0.012),number(P=0.039),and extranodal extension(P=0.010)were significantly related to the survival of patients with hypopharyngeal carcinoma.When the diameter of metastatic lymph nodes≥2.8 cm,number≥2,with extranodal extension,the prognosis is poor.Conclusions:Hypopharyngeal carcinoma has a dismal prognosis,with high rate of lymph node metastasis.Cervical lymph node metastasis is an important factor of the prognosis.The active treatment strategy for the lymph nodes is the key to improve the therapeutic effect of hypopharyngeal carcinoma.

Objective To evaluate the effect of ulinastatin on programmed necrosis in hippocampal neurons in a rat model of global cerebral ischemia-reperfusion (I/R).Methods Forty-eight clean-grade healthy adult male Sprague-Dawley rats,aged 8 weeks,weighing 280-320 g,were divided into 3 groups (n=16 each) using a random number table method:sham operation group (Sham group),global cerebral I/R group (I/R group) and ulinastatin group (UT group).Global cerebral I/R was produced by 4-vessel occlusion method in chloral hydrate-anesthetized rats in I/R and UT groups.Ulinastatin 100 000 U/kg was injected via the tail vein at the onset of ischemia in group UT,and the equal volume of normal saline was given instead in Sham and I/R groups.Neurological deficit score (NDS) was estimated at 6,12 and 24 h of reperfusion.Animals were sacrificed at 24 h of reperfusion,brains were removed and the hippocampi were obtained for examination of pathological changes (with a light microscope) and for determination of the malondialdehyde (MDA) content and superoxide dismutase (SOD) activity (by spectrophotometry),and expression of receptor-interacting protein kinase 1 (RIPK1),RIPK3,and mixed lineage kinase domain-like protein (MLKL) in hippocampal tissues (by Western blot).Results Compared with Sham group,the NDS was significantly increased at each time point,the MDA content was increased,the SOD activity was decreased,and the expression of RIPK1,RIPK3 and MLKL was up-regulated in I/R and UT groups (P＜ 0.05).Compared with I/R group,the NDS was significantly decreased at each time point,the MDA content was decreased,the SOD activity was increased,and the expression of RIPK1,RIPK3 and MLKL was down-regulated in UT group (P＜0.05).The pathological changes of hippocampi were significantly attenuated in UT group when compared with I/R group.Conclusion The mechanism by which ulinastatin ameliorates global cerebral I/R injury is related to inhibiting programmed necrosis in hippocampal neurons of rats.

Endovascular mechanical thrombectomy (EMT) has become the main treatment of acute ischemic stroke, but the pathological study of thrombi retrieved with EMT is still very limited. This article reviews the routine staining, special components, expression of immune factors, electron microscopic morphology, imaging features of the pathological components of thrombi retrieved with EMT, and their correlation with the etiological differentiation and outcomes of stroke.