Objective To investigate the effect of the activity of CR1, the expression of CD_ 58 , the level of soluble interleukin-2R (SIL-2R) and interleukin-6(IL-6) level in serum on obstructive sleep apnea syndrome (OSAS). Methods Select 20 OSAS cases in hospital and 15 healthy controls of the same age. Use flow cytometry and enzyme-linked immunosorbent assay(ELISA) to detect the activity of CR1, the expression of CD_ 58 and the level of SIL-2R, IL-6 in serum. Results (1)The erythrocytes cancer cell rosette(ECR1CaRR)of the OSAS group was lower than that of control group(P0.05). There were significant positive dependability between the level of SIL-2R,IL-6 in serum and SIT90(P0.05). Conclusions There are relations between the level of SIL-2R,IL-6 in serum and the condition of OSAS cases, which can be used to evaluate and define in clinical work,there is a accommodative role between erythrocyte immune function and some cytokines.

Objective To explore the therapeutic mechanism of blood- activating and blood- stasis- removing (BABAR) therapy for polycythemia vera (PV).Methods Ten first- visit or un- relieved outpatients and inpatients were treated with BABAR therapy for 12 weeks. Healthy volunteers served as the normal control. Before treatment and 1, 4, 8 and 12 weeks after treatment, the apoptotic rates of bone marrow mononuclear cells (BMMC) was analyzed with the TUNEL method. The expression of bcl- 2 and p53 was observed by the method of immunohistochemistry and their mRNA expression by the method of hybridization in site.Results One, four and eight weeks after treatment, the apoptotic rates of BMMC was increased as compared with those before treatment (P 0.05).The gene expression level of Bcl- 2 and p53 and their RNA expression level in the patients before treatment were higher than those in the normal control(P

bjective　To analyze the drug resistance screening status and drug resistance influencing factors of high-risk groups of drug-resistant pulmonary tuberculosis in Qingdao, and to understand the inclusion of rifampicin patients in treatment, so as to provide a reference for the prevention and treatment of drug-resistant pulmonary tuberculosis. Methods　The medical records of 726 cases of drug-resistant pulmonary tuberculosis among high-risk populations registered in Qingdao from 2018 to 2022 were obtained from the National Health Insurance Information System of the China Center for Disease Control and Prevention. The drug resistance to five anti-tuberculosis drugs, namely isoniazid (INH), rifampicin (RFP), ethambutol (EMB), levofloxacin (Lfx), and amikacin (Am), in the high-risk populations of drug-resistant pulmonary tuberculosis was analyzed. Univariate and multivariate logistic regression were used toidentify factors influencing rifampicin resistance, and the detection and inclusion of treatment for rifampicin-resistant patients were evaluated. Results　Of the 726 subjects, 278 were drug-resistant, with a total drug resistance rate of 38.29%. The drug resistance for the five anti-tuberculosis drugs in descending order was: INH 25.90%(188/726), RFP 22.87%(166/726), Lfx 14.19%(103/726), EMB 11.29%(82/726), Am 2.48%(18/726). Analysis of the drug resistance spectrum showed that among those resistant to one drug, RFP was most common, accounting for 13.67% (38/278); among those resistant to two drugs, INH+RFP was predominant, accounting for 15.83% (44/278); among those resistant to three drugs, INH+RFP+Lfx was most frequent, at 7.19% (22/278); and among those resistant to four drugs, INH+RFP+EMB+Lfx was highest, at 6.12% (17/278). Multivariate logistic regression analysis of rifampicin resistance showed that compared with patients under 25 years of age, the risk of developing rifampicin resistance was lower in the groups aged 45 to under 65 and those aged 65 and above (OR=0.356, 95%CI: 0.181-0.700; OR=0.352, 95%CI: 0.170-0.729). Compared with migrant patients in other provinces, local patients from within the same county or district had a lower risk of developing rifampicin resistance (OR=0.599, 95%CI:0.383-0.962). Compared with patients who were smear-positive at the end of the second month of initial treatment, the risk of developing rifampicin resistance was higher in patients with relapse/return, failure of retreatment/chronic, and other categories of patients (OR=9.380, 95%CI:3.717-23.671;OR=25.749, 95%CI:8.037-82.490; OR=36.651, 95%CI:8.438-159.201). Conclusions　The situation of drug-resistant pulmonary tuberculosis in Qingdao cannot be ignored. Individuals under 25 years old, migrants from other provinces, and patients with relapse/return, failure of retreatment/chronic, and other categories are significant risk factors for developing rifampicin resistance in the high-risk groups of drug-resistant pulmonary tuberculosis.

Objective: To evaluate the role of endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) in lymph node staging and resectability assessment of patients with non-small cell lung cancer (NSCLC). Methods: The clinical data of 154 patients with NSCLC who underwent EBUS-TBNA from March 2015 to December 2018 were collected. All accessible mediastinal and hilar lymph nodes were systematically explored and punctured using EBUS-TBNA. EBUS-TBNA and CT were used for preoperative staging and resectability evaluation. Results: The sensitivity, specificity and accuracy of EBUS-TBNA were 94.2%, 100.0% and 96.0%, respectively, while those of CT were 89.9%, 31.8% and 72.0%, respectively. The differences were statistically significant (P<0.05). The sensitivity, specificity and accuracy of EBUS-TBNA in lymph nodes with short diameter less than 15 mm were 92.4%, 100.0% and 96.0%, respectively, while those of CT were 80.7%, 34.8% and 60.1%, respectively, with statistical differences (P<0.05). The staging of 62 patients was changed, 27 cases were up-regulated and 35 cases were down-regulated. Among them, 32 cases had been changed to resectable. The evaluating resectability of EBUS-TBNA showed excellent consistency with that of pathological results (Kappa=0.95). The sensitivity and specificity were 100.0% and 97.2%, respectively. Conclusion EBUS-TBNA can systemically evaluate the metastatic status of NSCLC patients and improve the accuracy of preoperative lymph node staging and resectability assessment.

BACKGROUNDThe breathhold contrast-enhanced three-dimensional magnetic resonance angiography (MRA) using T1-weighted gradient-echo imaging sequence is the standard technique for MRA of the thorax. However, this technique is not desirable for certain patients with respiratory insufficiency, serious renal impairment, or allergy to contrast agents. The objective of this study was to optimize and evaluate a non-contrast-enhanced free-breathing pulmonary MRA protocol at 3 Tesla.

METHODSThe time-of-flight protocol was based on a two-dimensional T1-weighted turbo field echo sequence with slice-selective inversion recovery and magnetization transfer preparation together with respiratory navigator gating, cardiac gating, and parallel imaging. Optimal values for time of inversion delay, flip angle and slice thickness were experimentally determined and used for all subjects.

RESULTSExcellent pulmonary MRA images, in which the 7th order branches of pulmonary arteries could be reliably identified, were obtained in the 12 free-breathing healthy volunteers. TI of approximately 300 ms provides the best suppression of background thoracic and cardiac muscles and effective inflow enhancement. With increasing flip angle, the pulmonary vessels gradually brightened and exhibited optimal contrast at 20 degrees-30 degrees. The 2 mm slice thickness and 0.5 mm slice overlap is suitable for visualization of the peripheral pulmonary vessel.

CONCLUSIONSThe MRA protocol at 3 Tesla may have clinical significance for pulmonary vascular imaging in patients who are not available for contrast-enhanced 3D MRA and CT angiography examination or are unable to sustain a long breath-hold.

Adult ; Aged ; Contrast Media ; Female ; Humans ; Magnetic Resonance Angiography ; methods ; Male ; Middle Aged ; Pulmonary Artery ; anatomy & histology ; Pulmonary Circulation ; physiology ; Pulmonary Veins ; anatomy & histology ; Young Adult

Objective:To evaluate the diagnostic efficiency and safety of endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA)in lymph node staging of non-small cell lung cancer(NSCLC)in elderly patients.Methods:Thirty-five patients aged ≥70 years and 58 patients aged 60-69 years with NSCLC receiving EBUS-TBNA in our hospital from March 2015 to December 2018 were enrolled.All patients underwent EBUS for all visible mediastinal and hilar lymph nodes, and those with enlarged lymph nodes(short axis ≥6 mm)were further examined with TBNA.The diagnostic efficiency and safety of EBUS-TBNA were analyzed.Results:The sensitivity of EBUS-TBNA was 0.94, the specificity was 1.00, the Yoden index was 0.94, the positive predictive value was 1.00, and the negative predictive value was 0.82.Tumor staging was changed in 20 patients after EBU-TBNA, resulting in changes in assessment on tumor resectability in 5 cases.EBUS-TBNA had excellent agreement with postoperative pathology in evaluating resectability(Kappa=0.95). The sensitivity and specificity were 1.00 and 0.97, respectively.The incidence of complications of EBUS-TNBA was 6.5%.The elderly group had a worse performance status( P<0.05)compared with the control group, but the complication rates(5.7% vs 6.9%, P>0.05)were similar between the two groups. Conclusions:EBUS-TBNA is highly effective and safe in the diagnosis of NSCLC in patients aged 70 and older.

Objective To evaluate the role of endobronchial ultrasound guided transbronchial needle aspiration (EBUS?TBNA) in lymph node staging and resectability assessment of patients with non?small cell lung cancer (NSCLC). Methods The clinical data of 154 patients with NSCLC who underwent EBUS?TBNA from March 2015 to December 2018 were collected. All accessible mediastinal and hilar lymph nodes were systematically explored and punctured using EBUS?TBNA. EBUS?TBNA and CT were used for preoperative staging and resectability evaluation.Results The sensitivity, specificity and accuracy of EBUS?TBNA were 94.2%, 100.0% and 96.0%, respectively, while those of CT were 89.9%, 31.8% and 72.0%, respectively.The differences were statistically significant (P＜0.05).The sensitivity, specificity and accuracy of EBUS?TBNA in lymph nodes with short diameter less than 15 mm were 92.4%, 100.0% and 96.0%, respectively, while those of CT were 80.7%, 34.8% and 60.1%, respectively, with statistical differences (P＜0.05). The staging of 62 patients was changed, 27 cases were up?regulated and 35 cases were down?regulated. Among them, 32 cases had been changed to resectable. The evaluating resectability of EBUS?TBNA showed excellent consistency with that of pathological results ( Kappa＝0.95). The sensitivity and specificity were 100.0% and 97.2%, respectively. Conclusion EBUS?TBNA can systemically evaluate the metastatic status of NSCLC patients and improve the accuracy of preoperative lymph node staging and resectability assessment.

Objective To evaluate the role of endobronchial ultrasound guided transbronchial needle aspiration (EBUS?TBNA) in lymph node staging and resectability assessment of patients with non?small cell lung cancer (NSCLC). Methods The clinical data of 154 patients with NSCLC who underwent EBUS?TBNA from March 2015 to December 2018 were collected. All accessible mediastinal and hilar lymph nodes were systematically explored and punctured using EBUS?TBNA. EBUS?TBNA and CT were used for preoperative staging and resectability evaluation.Results The sensitivity, specificity and accuracy of EBUS?TBNA were 94.2%, 100.0% and 96.0%, respectively, while those of CT were 89.9%, 31.8% and 72.0%, respectively.The differences were statistically significant (P＜0.05).The sensitivity, specificity and accuracy of EBUS?TBNA in lymph nodes with short diameter less than 15 mm were 92.4%, 100.0% and 96.0%, respectively, while those of CT were 80.7%, 34.8% and 60.1%, respectively, with statistical differences (P＜0.05). The staging of 62 patients was changed, 27 cases were up?regulated and 35 cases were down?regulated. Among them, 32 cases had been changed to resectable. The evaluating resectability of EBUS?TBNA showed excellent consistency with that of pathological results ( Kappa＝0.95). The sensitivity and specificity were 100.0% and 97.2%, respectively. Conclusion EBUS?TBNA can systemically evaluate the metastatic status of NSCLC patients and improve the accuracy of preoperative lymph node staging and resectability assessment.

Objective:To assess the efficacy of neoadjuvant treatment with PD-1 (programmed cell death protein 1) inhibitors combined with paclitaxel (albumin-conjugated) and cisplatin (TP regimen) for locally advanced hypopharyngeal squamous cell carcinoma and laryngeal organ function preservation.Methods:Data of 53 patients, including 51 males and 2 females, aged 38-70 years old, who were diagnosed with locally advanced hypopharyngeal squamous carcinoma confirmed by histology and enhanced CT at the Cancer Prevention and Control Center of Sun Yat-sen University during the initial treatment from January 1, 2019 to January 15, 2023, were retrospectively analyzed. All patients received neoadjuvant therapy with PD-1 inhibitors combined with albumin-bound paclitaxel (260 mg/m 2) and cisplatin (60 mg/m 2) for 3 to 4 cycles. The main outcome measures were larynx dysfunction-free survival (LDFS), overall survival (OS), and progression-free survival (PFS). Survival curves were plotted using the Kaplan-Meier method, and Cox multifactorial analysis was further performed if Cox univariate analysis was statistically significant. Results:The overall efficiency was 90.6% (48/53). The 1-year and 2-year LDFS rates were 83.8% (95% CI: 74.0% to 94.8%) and 50.3% (95% CI: 22.1% to 91.6%), the 1-year and 2-year OS rates were 95.2% (95% CI: 88.9% to 100.0%) and 58.2% (95% CI: 25.6% to 81.8%), and the 1-year and 2-year PFS rates were 83.9% (95% CI: 74.2% to 94.9%) and 53.5% (95% CI: 32.1% to 89.1%). Adverse events associated with the neoadjuvant therapy were mainly myelosuppression (45.3%), gastrointestinal reactions (37.7%) and hypothyroidism (20.8%). Conclusion:The neoadjuvant treatment of locally advanced hypopharyngeal squamous cell carcinoma using PD-1 inhibitors combined with paclitaxel and cisplatin can provide with a higher survival rate with a improved laryngeal organ function preservation rate.