Objective:To study the effect of erythromycin(EM) on cigarette smoke-induced histone deacetylase-3(HDAC3) protein expression in human macrophages in vitro .Methods:The Aqueous cigarette smoke extract ( CSE) was always prepared fresh on the day of the experiment .The U937 monocytic cells were differentiated into macrophages by using phorbol 12-myristate 13-acetate (PMA) according to standard procedures .The U937 differentiated cells were treated with either CSE (1%) or EM (1 μg/ml) pre-treatment, and HDAC inhibitor trichostatin A (TSA;100 ng/ml) for 24 h.HDAC activity was measured with a colorimetric assay kit and Western blot was used for HDAC3 and factor nuclear-kappaB (NF-κB) protein assays.The levels of tumor necrosis factor-α(TNF-α) release in the supernatant were determined by enzyme linked immunosorbent assay (ELISA).Results:CSE(1%) significantly de-creased HDAC activity and HDAC 3 protein levels at 24 h.Preincubation with EM (1μg/ml ) for 24 h significantly inhibit CSE (1%) induced decrease of HDAC3 protein expression.Furthermore, Preincubation with EM(1 μg/ml) for 24 h significantly inhibit NF-κB activity and TNF-αrelease in human macrophages .Conclusion:EM is able to restore HDAC3 levels decreased by cigarette smoke and inhibit NF-κB activity resulting in decreasing CSE-mediated TNF-αrelease, which has shown an important explanation that EM possess the anti-inflammatory effect induced by cigarette smoke .

Background and purpose: Natural killer/T cell lymphoma in poor effects, the production of multidrug resistance is one of the reasons to reduce the chemotherapy effect or failure. This study aimed to discuss the multidrug resistance associated protein 4 (ABCC4/MRP4) gene and multidrug resistance associated protein 5 (ABCC5/MRP5) gene expression in NK/T cell lymphoma SNK-6, YTS cell lines and NK/T cell lymphoma tissues, and the relationship between the level of ABCC4/MRP4, ABCC5/MRP5 gene expression and the clinical efifcacy. Methods:Real-time lfuorescence quantitative PCR (Real time-PCR) and immunohistochemical method (IHC) were used to detect the ABCC4/MRP4, ABCC5/MRP5 gene and protein expression. Results:Compared with the normal NK cells, ABCC4/MRP4 and ABCC5/MRP5 gene in SNK-6, YTS cell lines were highly expressed (P<0.05); Compared with rhinitis tissues, the expression of ABCC4/MRP4, ABCC5/MRP5 gene was higher in the NK/T cell lymphoma tissues (P<0.05);The expression level of ABCC4/MRP4 and ABCC5/MRP5 gene was negative correlation with clinical efifcacy (P<0.05). Conclusion: The expression of ABCC4/MRP4 and ABCC5/MRP5 gene affects the of clinical efifcacy of NK/T cell lymphoma.

ObjectiveTo investigate the clinical features of patients with hepatic myelopathy (HM) in China. MethodsThe articles on HM, published in China from January 2009 to December 2018, were collected to analyze the clinical features, laboratory examination results, diagnosis, treatment, and prognosis of HM patients. ResultsA total of 94 articles were included, with 562 patients in total, among whom there were 489 male patients and 73 female patients. Their age ranged from 17-81 years, with a mean age of 46.3±17.5 years. Hepatitis B cirrhosis was the most common etiology (64.4%), followed by alcoholic cirrhosis (10.3%) and hepatitis C cirrhosis (9.2%). The clinical manifestations of HM mainly included decline of muscle strength (89.50%), tendon hyperreflexia (76.87%), ataxia, and movement disorder (76.51%). Laboratory examination showed an increase in blood ammonia by 92.31% and a reduction in albumin by 88.96%. Imaging diagnosis mainly depended on electromyography (64.92%) and spinal cord MRI (22.82%), and abdominal color Doppler ultrasound, CT, or MRI alone has limited clinical value. After comprehensive medical treatment, no patient (0%) was cured, 106 patients (18.86%) were improved, 211 patients (37.54%) had no response, 31 patients (5.52%) worsened, 129 patients (22.95%) died, and 53 patients (9.43%) were not explained. A total of 39 patients underwent liver transplantation, with an improvement rate of 5641%. ConclusionHM is a rare complication of end-stage liver disease and is mainly observed in middle-aged men. It has the main manifestation of chronic and progressive spastic paraplegia of both lower limbs. Currently, there is no effective treatment method, and liver transplantation is feasible for some patients, with poor treatment response and poor prognosis.

Purpose: There is no optimal prognostic model for T-cell lymphoblastic lymphoma (T-LBL). Here, we discussed the predictive value of total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) measured on 18F-fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) in T-LBL. Materials and Methods: Thirty-seven treatment naïve T-LBL patients with PET-CT scans were enrolled. TMTV was obtained using the 41% maximum standardized uptake value (SUVmax) threshold method, and TLG was measured as metabolic tumor volume multiplied by the mean SUV. Progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier curves and compared by the log-rank test. Results: The optimal cutoff values for SUVmax, TMTV, and TLG were 12.7, 302 cm3, and 890, respectively. A high SUVmax, TMTV, and TLG indicated a shorten PFS and OS. On multivariable analysis, TMTV ≥ 302 cm3, and central nervous system (CNS) involvement predicted inferior PFS, while high SUVmax, TLG and CNS involvement were associated with worse OS. Subsequently, we generated a risk model comprising high SUVmax, TMTV or TLG and CNS involvement, which stratified the population into three risk groups, which had significantly different median PFS of not reached, 14 months, and 7 months for low-risk group, mediate-risk group, and high-risk group, respectively (p < 0.001). Median OS were not reached, 27 months, and 13 months, respectively (p < 0.001). Conclusion Baseline SUVmax, TMTV, and TLG measured on PET-CT are strong predictors of worse outcome in T-LBL. A risk model integrating these three parameters with CNS involvement identifies patients at high risk of disease progression.

Purpose: There is no optimal prognostic model for T-cell lymphoblastic lymphoma (T-LBL). Here, we discussed the predictive value of total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) measured on 18F-fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) in T-LBL. Materials and Methods: Thirty-seven treatment naïve T-LBL patients with PET-CT scans were enrolled. TMTV was obtained using the 41% maximum standardized uptake value (SUVmax) threshold method, and TLG was measured as metabolic tumor volume multiplied by the mean SUV. Progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier curves and compared by the log-rank test. Results: The optimal cutoff values for SUVmax, TMTV, and TLG were 12.7, 302 cm3, and 890, respectively. A high SUVmax, TMTV, and TLG indicated a shorten PFS and OS. On multivariable analysis, TMTV ≥ 302 cm3, and central nervous system (CNS) involvement predicted inferior PFS, while high SUVmax, TLG and CNS involvement were associated with worse OS. Subsequently, we generated a risk model comprising high SUVmax, TMTV or TLG and CNS involvement, which stratified the population into three risk groups, which had significantly different median PFS of not reached, 14 months, and 7 months for low-risk group, mediate-risk group, and high-risk group, respectively (p < 0.001). Median OS were not reached, 27 months, and 13 months, respectively (p < 0.001). Conclusion Baseline SUVmax, TMTV, and TLG measured on PET-CT are strong predictors of worse outcome in T-LBL. A risk model integrating these three parameters with CNS involvement identifies patients at high risk of disease progression.

The critically ill coronavirus disease 2019 (Covid-19) patients usually present acute respiratory distress syndrome (ARDS), or even acute respiratory failure, and require mechanical ventilation (MV) to provide support for breathing. However, clinical studies have found an extraordinarily high mortality rate (>50%) for those Covid-19 patients who underwent MV. Considering the mechanical nature of MV, the high mortality rate is highly possible to be associated with mechanical stretch-induced lung injury during MV. Thus, it is imperative to understand the MV-induced pathological alterations in the respiratory system and corresponding mitigation measures in order to improve the therapy of critically ill Covid-19 patients. Ventilator-induced lung injury in therapy of critically ill Covid-19 patients involves several biomechanical factors and mechanisms, including changes in respiratory parameters, inflammatory cytokines storm, ciliary-mucus system, airway smooth muscle cells, lung fibrosis, and stretch-activated cell signaling. It is hoped that these biomechanical issues can be diligently investigated, so as to provide insights for optimizing the therapy for Covid-19 as well as other respiratory diseases.

Pre-rheumatoid arthritis （Pre-RA） is the asymptomatic state of rheumatoid arthritis （RA）， and its progression showed complexity， dynamics and significant individual differences. The dynamic prediction model is valuable in identifying individual risks and taking timely preventive and control measures. It is believed that applying the dynamic prediction model to traditional Chinese medicine （TCM） clinical studies of Pre-RA is expected to predict the critical state of Pre-RA to RA， reveal the evolution of Pre-RA， reflect the external authenticity of the TCM clinical studies， and complement the clinical efficacy evaluation method. Accordingly， it is envisioned to construct a dynamic prediction model for Pre-RA progression based on TCM clinical trial data through the dynamic prediction model algorithm， and to apply long-term follow-up cohort data for external validation， thereby providing a basis for scientific warning and clinical decision-making on the evolution of Pre-RA.

Objective:To explore the prevalence and risk factors of sarcopenia in patients with maintenance dialysis (MHD).Methods:It was a cross-sectional study. Patients who received MHD treatment in the Blood Purification Center of Hainan Provincial People's Hospital in October 2019 were included as study subjects. The patients were divided into sarcopenia group and non-sarcopenia group according to whether they had sarcopenia or not. Chest CT imaging and laboratory examination data were collected. Dual-energy X-ray absorptiometry was used to measure the skeletal muscle mass. Chi-square test or Mantel-Haenszel trend chi-square test was used to compare the clinical data of patients with and without sarcopenia. Multivariate logistic regression equation was used to analyze the risk factors of sarcopenia.Results:A total of 182 MHD patients were enrolled in the study, and the prevalence of sarcopenia was 33.5% (61/182). The proportions of age ≥60 years old, diabetic nephropathy, tunneled-cuffed catheter, body mass index <18 kg/m 2, serum albumin <40 g/L, low density lipoprotein cholesterol ≥3.37 mmol/L, left ventricular ejection fraction <50%, chest CT-suspected pulmonary tuberculosis (PTB) and PTB in sarcopenia group were higher than those in non-sarcopenia group (all P<0.05). Multivariate logistic regression analysis results showed that left ventricular ejection fraction <50% (≥50% as a reference, OR=3.250, 95% CI 1.035-10.206, P=0.044), low-density lipoprotein cholesterol ≥3.37 mmol/L (<3.37 mmol/L as a reference, OR=6.354 ,95% CI 1.675-24.108, P=0.007), chest CT-suspected PTB (normal as a reference, OR=7.433, 95% CI 1.531-36.083, P=0.013), and PTB (normal as a reference, OR=28.871, 95% CI 3.208-259.872, P=0.030) were independent influencing factors of sarcopenia in MHD patients. Conclusions:The prevalence of sarcopenia is higher in MHD patients. Blood low-density lipoprotein cholesterol ≥3.37 mmol/L, ejection fraction <50%, chest CT-PTB and suspected PTB are independent risk factors of sarcopenia in MHD patients. Correcting left ventricular systolic function, regulating blood lipids and preventing PTB as early as possible can reduce the prevalence of sarcopenia in MHD patients.