Objective To observe the clinical effects of the children with svstemic inflammatorv re- active syndrome(SIRS)receiving micro-dose heparin at early stage of the diseases.Methods The 53 cas- es diagnosed as SIRS were included in the randomized control trial.They were divided into two groups,26 cases in control group and 27 cases in therapeutic group.The children in control group received therapy for their primary diseases and other routine managements for SIRS.The children in therapeutic group received both above therapy and micro-dose heparin(5-10 U/kg,1 fime/6hours)via subcutaneous injection at earlv stages of diseases for 3 days.Results There were improvements in both control and therapeutic group, platelets count increased,C-reactive protein decreased (P＜0.01),there were significant diffemnce in platelets and C-reactive protein between two groups,the time of platelets recovery in therapeutic group [(28±9)h]Was less than that in control group[(55±14)h](P＜0.01).In therapeutic group,the dumtion of SIRS was shortened (P＜0.05),mortality and the incidence of multiple organ dysfunction svndrome (MODS)and disseminated intravascular eoagultion(DIC)were decreased significantly(P＜0.05).Con- clusion Early micro-dose heparin in SIRS can shorten its duration and decrease the mortality and the inci- dence of MODS in the children with SIRS.

ObjectiveTo study the risk factors for children with incomplete Kawasaki disease(IKD) to decrease the development of coronary artery lesions (CAL).MethodsAll children diagnosed as IKD from Jan.2005 to Apr.2011 in our department were reviewed retrospectively for their clinical data,laboratory values and treatment measures.ResultsEight of the children (8/36,22.2％ ) were positive for CAL.The count of white blood cell( WBC),count of platelet(PLT),hematocrit and C reactive protein(CRP) level were ( 18.36 ± 4.63) × 109/L,(450.30 ± 155.40) × 109/L,( 25.63 ± 3.53 ),( 18.30 ± 3.80) mg/L and ( 13.48 ±3.27) × 109/L,(350.60 ± 56.80) × 109/L,( 33.78 ± 2.24 ),(9.70 ± 2.50) mg/L in the CAL group and non-CAL group respectively.And there were significant differences on the four indexes between CAL group and non-CAL group ( t =2.58,2.65,2.73,2.48,respectively,P ＜ 0.05 ).Pyretolysis time of children first undergoing globulin treatment was (2.5 ± 1.5 ) d and ( 1.5 ± 1.0 ) d in children under 1-year old and those above l-year old respectively,and the difference was significant ( t =2.35,P ＜ 0.05).ConclusionCAL should be cautiously prevented in IKD infants under l-year old with a fever lasting for over 5 days,decreased hematocrit and elevated WBC count,PLT count,Hct and CRP.Infant IKD patients are not so sensitive to intravenous gamma globulin and tend to occur CAL.They should be given an early diagnosis and timely treatment.

Objective To study the relationship between mycoplasma pneumoniae(MP) infection and children asthma,and to observe the treatment effects of macrolide antibiotics (azithromycin) on mycoplasma pneumoniae infection.Methods 250 children of respiratory disease were investigated with olimpus electron gastroscope,200 children asthma;the serum specific antibodies were determined by Diagnostic Kit for measurement of antibodies to mycoplasma pneumoniae (Passive Particle Agglutination) ;and the eosinophilic grannlocytes were serologically analyzed in children with recent asthma.Random selection 42 MP infection positive to macrolides antibiotics (azithromycin) treatment.Results 44 MP infection positive,200 children asthma cases had MP infection with 21％ (42/200) MP positive,the specific antibody titers to MP showed significant difference in children with recent asthma compared with those in the contol group ( x2 =6.14,P ＜ 0.05 ),and correlated with the count of eosinophilic granulocy positively ( r =0.603,P ＜ 0.05) ;The positive rates of specific antibody,infection with MP were significantly higher than those in the control group( t =4.38,P ＜ 0.05 ).MP infection positive group with azithromycin treatment effect is significantly higher than that of cefuroxime group ( x2 =16.18,P ＜ 0.05 ).Conclusion MP infection is closely associated with the pathogenesis of children asthma;and early routine testing for MP antibodies.Macrolides antibiotics can eliminate MP infection,a new generation of macrolides antibiotics(azithromycin) is more advantageous to the control of acute attack of asthma.

AIM:To evaluate the expression level of CXC chemokine receptor 7 (CXCR7) in atherosclerotic apolipoprotein E-deficient ( ApoE-/-) mice induced by high-fat diet ( HFD) and the effects of atorvastatin on it .METH-ODS:ApoE-/-male mice (8-week-old) were used and were randomly divided into 3 groups following 1-week normal ro-dent diet:normal diet control (NDC) group , HFD group and HFD+statins (HFD+Sat) group.HE staining and oil red O staining were used to observe the atherosclerotic lesion burdens in the aortas .The expression of CXCR7 on the aortas was detected by Western blot and immunohistochemistry .The expression of Akt and endothelial nitric oxide synthase ( eNOS) in the aorta was determined by Western blot .RESULTS: Few lesions were found in the aortas in NDC group .Apparent atherosclerotic plaque burdens were seen in HFD group and HFD +Sat group, while the atherosclerotic plaque burdens in HFD+Sat group were notably reduced compared with HFD group .The protein levels of CXCR7, eNOS and Akt in aorta in HFD group and HFD+Sat group were significantly decreased compared with NDC group , while those in HFD+Sat group were increased compared with HFD group .The protein level of p-eNOS in the aorta and the concentration of NO in the plas-ma in HFD group were decreased compared with NDC group and HFD +Sat group.CONCLUSION: In ApoE-/-mice, HFD increases the lipid level and promotes the development of atherosclerosis by downregulating the expression of CXCR 7, Akt and eNOS.Atorvastatin reverses the above effect of hypercholesterolemia on the expression of CXCR 7, Akt and eNOS, thus playing the role in treating atherosclerosis .

Objective To quantitatively assess the cardiopulmonary exercise function of spinal cord injury (SCI) patients and observe the effect of aerobic exercise on cardiopulmonary function, motor function and activities of daily living. Methods From December, 2014 to June, 2016, 34 incomplete SCI patients (ASIA C and D) and 23 healthy controls received cardiopulmonary exercise test (CPET). SCI pa-tients were randomly divided into conventional rehabilitation group (n=17) and aerobic exercise group (n=17). The aerobic exercise group received aerobic exercise for four weeks. They were assessed with CPET, motor and sensory function, walking index for spinal cord injury II (WISCI II) and spinal cord independence measure (SCIM) before and four weeks after training. Results Oxygen uptake (VO2)peak, anaerobic threshold (AT), metabolic equivalent of energy (METpeak), VO2/heart rate (HR)peak, respiratory exchange rate (RER)peak, minute ventilation (VE)peak, work rate (WR)peak and systolic blood pressure (SBP)peak were lower in the patients than in the controls (t>2.714, P<0.05). VO2peak、AT、METpeak、VO2/HRpeak、WRpeak increased in the aerobic exercise group after training (t>2.431, P<0.05). METpeak and WRpeak improved in the conventional rehabilitation group after training (t>3.282, P<0.01). The scores of motor in ASIA and SCIM improved in both groups after training (t>2.985, P<0.05). Conclusion The cardiopulmonary function decreased in incomplete SCI patients, which could be improved by moderate intensity aerobic exercise.

AIM: To investigate the autophagy of breast cancer cells induced by baicalein and to explore its mechanism.METHODS: The effects of baicalein on the viability of MCF-7 cells and 4T1 cells were investigated by MTT assay, and the dosage of the drug was determined.The expression levels of microtubule-associated protein 1 light chain 3-II (LC3-II) and LC3-I in the MCF-7 cells and 4T1 cells treated with baicalein at doses of 25, 50 and 100 μmol/L, or combined with autophagy inhibitor 3-methyladenine (3-MA) were determined by Western blot.In order to confirm the role of baicalein in autophagy, the effect of 3-MA on the apoptosis of both MCF-7 cells and 4T1 cells induced by baicalein was analyzed by flow cytometry.The protein levels of p-mTOR, mTOR, p-AKT and AKT were examined by Western blot and the role of AKT-mTOR pathway in the induction of autophagy in breast cancer induced by baicalein was determined by the combination of activators.RESULTS: Baicalein at 50 μmol/L and above doses significantly inhibited the viability of breast cancer cells in a dose-and time-dependent manner.The expression of LC3-II/LC3-I in both MCF-7 cells and 4T1 cells was significantly enhanced after the action of baicalein, and the ratio of LC3-II/LC3-I was significantly decreased after 3-MA addition.The results of flow cytometry showed that, compared with baicalein group, the combination of baicalein and 3-MA promoted the levels of necrosis and apoptosis.Moreover, the protein levels of p-mTOR and p-AKT were significantly decreased and were rescued by EGF, while their total protein levels were not changed.CONCLUSION: Baicalein induces autophagy through AKT-mTOR pathway both in MCF-7 cells and 4T1 cells.

Objective:To explore the effect of a Chinese medicinal composition ( Xiadanqi) on the prevention of radon exposure induced injuries of lung in vitro and in vivo. Methods:Mice were randomly divided into three groups of blank control group, radon-exposed group alone and radon-exposed group intervened with Chinese medicinal composition. The pathological changes of lung tissues in each group after 120 WLM were observed by HE and Masson staining, and the expressions of α-SMA protein and Vimentin protein in lung tissues were detected by immunohistochemistry staining. The levels of oxidative stress in lung tissue of each group were detected with SOD and MDA kits. At the same time, a radon exposed cell model and a radon exposure + Xiadanqi intervention cell model were constructed using an ecological radon chamber. The cell adhesion abilities of different groups were detected by an adhesion kit. The cell migration ability of each group was determined by the transwell migration experiment. The expression of E-cadherin and Vimentin protein was detected by Western blot. Results:Compared with the radon exposure group, the concentration of MDA was decreased ( t=4.43, P<0.05), the activity of SOD was increased ( t=3.22, P<0.05), and α-SMA and Vimentin protein expressions were decreased ( t=3.08, 7.57, P<0.05) in lung tissue of mice intervened with 2 mg/g Xiadanqi. In vitro, compared with radon exposure group, the migration ability was reduced ( t=4.78, 13.01, P<0.05), the cell adhesion property was enhanced ( t=3.41, 12.55, P<0.05), the expression of E-cadherin protein was increased ( t=2.96, 19.57, P<0.05), and the expression of Vimentin protein was obviously reduced ( t=21.00, 33.32, P<0.05) in radon-exposed cells with the treatment of Chinese medicine (150 μg/ml and 200 μg/ml). Conclusions:The Chinese medicinal composition ( Xiadanqi) has a certain radioprotective effect on radon exposure induced injury by reducing oxidative stress, attenuating EMT and fibrosis, and thus it may be applied as a protective agent for radon induced injury.

Objective To investigate the clinical value of prophylactic high-flow nasal cannula oxygen therapy (HFNC) in reducing postoperative pulmonary complication (PPC) in elderly patients with non-small cell lung cancer (NSCLC). Methods The clinical data of elderly patients (over 60 years) with NSCLC who underwent video-assisted thoracoscopic lobectomy or segmental resection at the Department of Thoracic Surgery, Fujian Provincial Hospital from January 2021 to March 2022 were retrospectively analyzed. According to whether receiving HFNC after surgery, they were divided into a conventional oxygen therapy (CO) group and a HFNC group. The CO group were matched with the HFNC group by the propensity score matching method at a ratio of 1 : 1. We compared PPC incidence, white blood cell (WBC) count, procalcitonin and C-reactive protein on postoperative day (POD) 1, 3 and 5 and postoperative hospital stay between the two groups. Results A total of 343 patients (165 males, 178 females, average age of 67.25±4.79 years) were enrolled, with 53 (15.45%) receiving HFNC. Before matching, there were statistical differences in gender, rate of combined chronic obstructive pulmonary disease, pathology type and TNM stage between the two groups (all P<0.05). There were 42 patients successfully matched in each of the two groups, with no statistical difference in baseline characteristics (P>0.05). After propensity score matching, the results showed that the PPC incidence in the HFNC group was lower than that in the CO group (23.81% vs. 45.23%, P=0.039). WBC count on POD 3 and 5 and procalcitonin level on POD 3 were less or lower in the HFNC group than those in the CO group [ (8.92±2.91)×109/L vs. (10.62±2.67)×109/L; (7.68±1.58)×109/L vs. (8.86±1.76)×109/L; 0.26 (0.25, 0.44) μg/L vs. 0.31 (0.25, 0.86) μg/L; all P<0.05]. There was no statistical difference in the other inflammatory indexes or the postoperative hospital stay between the two groups (P>0.05). Conclusion Prophylactic HFNC can reduce the PPC incidence and postoperative inflammatory indexes in elderly patients with NSCLC, but does not shorten the postoperative hospital stay.

Objective:To retrospectively analyze the treatment status of tyrosine kinase inhibitors (TKI) in newly diagnosed patients with chronic myeloid leukemia (CML) in China.Methods:Data of chronic phase (CP) and accelerated phase (AP) CML patients diagnosed from January 2006 to December 2022 from 77 centers, ≥18 years old, and receiving initial imatinib, nilotinib, dasatinib or flumatinib-therapy within 6 months after diagnosis in China with complete data were retrospectively interrogated. The choice of initial TKI, current TKI medications, treatment switch and reasons, treatment responses and outcomes as well as the variables associated with them were analyzed.Results:6 893 patients in CP ( n=6 453, 93.6%) or AP ( n=440, 6.4%) receiving initial imatinib ( n=4 906, 71.2%), nilotinib ( n=1 157, 16.8%), dasatinib ( n=298, 4.3%) or flumatinib ( n=532, 7.2%) -therapy. With the median follow-up of 43 ( IQR 22-75) months, 1 581 (22.9%) patients switched TKI due to resistance ( n=1 055, 15.3%), intolerance ( n=248, 3.6%), pursuit of better efficacy ( n=168, 2.4%), economic or other reasons ( n=110, 1.6%). The frequency of switching TKI in AP patients was significantly-higher than that in CP patients (44.1% vs 21.5%, P<0.001), and more AP patients switched TKI due to resistance than CP patients (75.3% vs 66.1%, P=0.011). Multi-variable analyses showed that male, lower HGB concentration and ELTS intermediate/high-risk cohort were associated with lower cytogenetic and molecular responses rate and poor outcomes in CP patients; higher WBC count and initial the second-generation TKI treatment, the higher response rates; Ph + ACA at diagnosis, poor PFS. However, Sokal intermediate/high-risk cohort was only significantly-associated with lower CCyR and MMR rates and the poor PFS. Lower HGB concentration and larger spleen size were significantly-associated with the lower cytogenetic and molecular response rates in AP patients; initial the second-generation TKI treatment, the higher treatment response rates; lower PLT count, higher blasts and Ph + ACA, poorer TFS; Ph + ACA, poorer OS. Conclusion:At present, the vast majority of newly-diagnosed CML-CP or AP patients could benefit from TKI treatment in the long term with the good treatment responses and survival outcomes.