Objective To observe the clinical effect of ulinastatin(UTI)combined with thymosin alpha 1(Tα1)in the treatment of septic shock.Methods A retrospective analysis was conducted on the clinical data of 88 patients with septic shock admitted to our hospital from June 2021 to October 2023.The patients were divided into UTI group and UTI+Tα1 group according to different treatment methods,with 44 patients in each group.The treatment effects,clinical indicators,microcirculatory perfusion indicators[central venous oxygen saturation(ScvO2),lactate(LAC),capillary refill time(CRT),mean arterial pressure(MAP)],Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,Sequential Organ Failure Assessment(SOFA)score,immune indicators,plas-ma and serum inflammatory indicators[soluble triggering receptor expressed on myeloid cells-1(sTREM-1),procalcitonin(PCT),interleukin(IL)-6,tumor necrosis factor-α(TNF-α)],and prognosis were compared between the two groups.Results After 7 days of treatment,the effective rate of treatment in the UTI+Tα1 group was higher than that in the UTI group(P＜0.05).The dura-tion of vasoactive drug use,mechanical ventilation time,ICU stay,and hospital stay were shorter in the UTI+Tα1 group than those in the UTI group(P＜0.05).After 24 and 72 hours of treatment,ScvO2 and MAP gradually increased,LAC gradually decreased,and CRT gradually shortened in both groups(P＜0.05).After 24 hours of treatment,ScvO2 and MAP were higher,and CRT was shorter in the UTI+Tα1 group than those in the UTI group(P＜0.05).After 72 hours of treatment,CRT was shorter,and MAP was higher in the UTI+Tα1 group than those in the UTI group(P＜0.05).After 7 days of treatment,both APACHE Ⅱ and SOFA scores decreased in both groups compared to treatment before,and their scores were lower in the UTI+Tα1 group than those in the UTI group(P＜0.05).After 7 days of treatment,the levels of CD3+and CD4+T lymphocytes increased in both groups compared to treatment before,and the levels were higher in the UTI+Tα1 group than those in the UTI group(P＜0.05).After 7 days of treatment,the levels of sTREM-1,PCT,IL-6,and TNF-α decreased in both groups compared to treatment before,and the levels were lower in the UTI+Tα1 group than those in the UTI group(P＜0.05).After a 28-day follow-up,there was no sta-tistically significant difference in mortality between the two groups(P=0.398).Conclusion UTI combined with Tα1 can effectively promote the recovery of patients with septic shock,improve micro-circulatory perfusion,reduce plasma sTREM-1 and serum PCT levels,inhibit inflammatory responses,and improve prognosis.

Objective:To investigate the feasibility and clinical value of MRI quantitative evaluation technique in detecting sternocleidomastoid muscle fibrosis in patients with nasopharyngeal carcinoma (NPC) after radiotherapy.Methods:From August 2019 to March 2021, 45 patients with clinically confirmed NPC after radiotherapy and 30 healthy controls who underwent physical examination in Lishui Hospital of Zhejiang University were enrolled in our study. According to the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer (RTOG/EORTC) classification criteria of late radiation reactions respectively, the sternocleidomastoid muscle injury in the NPC group was divided into grade Ⅰ, Ⅱ and Ⅲ, which included 8, 32 and 5 patients respectively. All patients underwent T 1 mapping and T 2 mapping imaging of the neck. Firstly, the mapping images of sternocleidomastoid muscle between the two groups were analyzed and compared. Using NUMARIS/4 software of Siemens image post-processing workstation, the region of interest was manually drawn along the edge of sternocleidomastoid muscle at the level of laryngeal chamber in axial mapping diagram. Then, T 1 and T 2 values and the long and short diameters of sternocleidomastoid muscle were measured respectively. Finally, the differences of the parameters between the two groups were compared by independent sample t-test, Spearman rank correlation was used to analyze the relationship between the average T 1 and T 2 values of bilateral sternocleidomastoid muscles and the grade of late radiation injury. Results:Compared with the control group, the shape of sternocleidomastoid muscle in the NPC group was smaller in shape, with irregular edge and uneven increase of T 1 mapping color scale. There was no significant difference in muscle signal in T 2 mapping. The T 1 values of left and right sternocleidomastoid muscles in the NPC group were (1 524.7±97.6) and (1 496.5±93.2) ms respectively, which were significantly higher than those in the normal control group [(1 231.5±85.3) and (1 275.9±90.9) ms] ( P<0.05), and the T 2 values of left and right sternocleidomastoid muscles in the NPC group were (28.4±4.8) and (28.4±3.6) ms respectively, which were lower than those in the normal control group [(30.4±3.5) and (30.4±3.5) ms] ( P<0.05). The long and short diameters of bilateral sternocleidomastoid muscles in the NPC group were shorter than those in the control group ( P<0.05). The average T 1 and T 2 values of bilateral sternocleidomastoid muscles in NPC patients after radiotherapy were (1 510.6±95.4) and (28.4±4.2) ms respectively, The T 1 value was positively correlated with the classification of advanced radiation injury ( r=0.78, P<0.001), and T 2 value was negatively correlated with the level of advanced radiation injury ( r=-0.87, P<0.001). Conclusion:Mapping quantitative evaluation technique can noninvasively and objectively detect and evaluate sternocleidomastoid muscle fibrosis after NPC radiotherapy, which has potential clinical application value.

Objective To observe the clinical effect of ulinastatin(UTI)combined with thymosin alpha 1(Tα1)in the treatment of septic shock.Methods A retrospective analysis was conducted on the clinical data of 88 patients with septic shock admitted to our hospital from June 2021 to October 2023.The patients were divided into UTI group and UTI+Tα1 group according to different treatment methods,with 44 patients in each group.The treatment effects,clinical indicators,microcirculatory perfusion indicators[central venous oxygen saturation(ScvO2),lactate(LAC),capillary refill time(CRT),mean arterial pressure(MAP)],Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,Sequential Organ Failure Assessment(SOFA)score,immune indicators,plas-ma and serum inflammatory indicators[soluble triggering receptor expressed on myeloid cells-1(sTREM-1),procalcitonin(PCT),interleukin(IL)-6,tumor necrosis factor-α(TNF-α)],and prognosis were compared between the two groups.Results After 7 days of treatment,the effective rate of treatment in the UTI+Tα1 group was higher than that in the UTI group(P＜0.05).The dura-tion of vasoactive drug use,mechanical ventilation time,ICU stay,and hospital stay were shorter in the UTI+Tα1 group than those in the UTI group(P＜0.05).After 24 and 72 hours of treatment,ScvO2 and MAP gradually increased,LAC gradually decreased,and CRT gradually shortened in both groups(P＜0.05).After 24 hours of treatment,ScvO2 and MAP were higher,and CRT was shorter in the UTI+Tα1 group than those in the UTI group(P＜0.05).After 72 hours of treatment,CRT was shorter,and MAP was higher in the UTI+Tα1 group than those in the UTI group(P＜0.05).After 7 days of treatment,both APACHE Ⅱ and SOFA scores decreased in both groups compared to treatment before,and their scores were lower in the UTI+Tα1 group than those in the UTI group(P＜0.05).After 7 days of treatment,the levels of CD3+and CD4+T lymphocytes increased in both groups compared to treatment before,and the levels were higher in the UTI+Tα1 group than those in the UTI group(P＜0.05).After 7 days of treatment,the levels of sTREM-1,PCT,IL-6,and TNF-α decreased in both groups compared to treatment before,and the levels were lower in the UTI+Tα1 group than those in the UTI group(P＜0.05).After a 28-day follow-up,there was no sta-tistically significant difference in mortality between the two groups(P=0.398).Conclusion UTI combined with Tα1 can effectively promote the recovery of patients with septic shock,improve micro-circulatory perfusion,reduce plasma sTREM-1 and serum PCT levels,inhibit inflammatory responses,and improve prognosis.

BACKGROUNDBased on the excellent medical care and management system for Chinese veterans, as well as the detailed medical documentation available, we aim to construct a Chinese Veteran Clinical Research (CVCR) platform on non-communicable diseases (NCDs) and carry out studies of the primary disabling NCDs.

METHODSThe Geriatric Neurology Department of Chinese People's Liberation Army General Hospital and veterans' hospitals serve as the leading and participating units in the platform construction. The fundamental constituents of the platform are veteran communities. Stratified typical cluster sampling is adopted to recruit veteran communities. A cross-sectional study of mental, neurological, and substance use (MNS) disorders are performed in two stages using screening scale such as the Mini-Mental State Examination and Montreal cognitive assessment, followed by systematic neuropsychological assessments to make clinical diagnoses, evaluated disease awareness and care situation.

RESULTSA total of 9 676 among 277 veteran communities from 18 cities are recruited into this platform, yielding a response rate of 83.86%. 8 812 subjects complete the MNS subproject screening and total response rate is 91.70%. The average participant age is (82.01±4.61) years, 69.47% of veterans are 80 years or older. Most participants are male (94.01%), 83.36% of subjects have at least a junior high school degree. The overall health status of veterans is good and stable. The most common NCD are cardiovascular disorders (86.44%), urinary and genital diseases (73.14%), eye and ear problems (66.25%), endocrine (56.56%) and neuro-psychiatric disturbances (50.78%).

CONCLUSIONWe first construct a veterans' comprehensive clinical research platform for the study of NCDs that is primarily composed of highly educated Chinese males of advanced age and utilize this platform to complete a cross-sectional national investigation of MNS disorders among veterans. The good and stable health condition of the veterans could facilitate the long-term follow-up studies of NCDs and provide prospective data to the prevention and management of NCDs.

Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Cross-Sectional Studies ; Disease ; Female ; Health Status ; Humans ; Male ; Veterans ; statistics & numerical data