Objective To observe the MSCT features of invasive pulmonary tuberculosis,and to investigate its effect on the prognosis.Methods 60 patients with invasive pulmonary tuberculosis were selected as the study subjects.The gold standard was in sputum culture and histopathology.The clinical value of MSCT in the diagnosis of invasive pulmonary tuberculosis was evaluated.The distribution and morphological characteristics of the lesions in the invasive pulmonary tuberculosis were observed and analyzed.The patients were divided into the treatment group and the death group.The morphological changes of lung lesions were compared between the two groups.Results In 60 patients,a total of 45 patients with invasive pulmonary tuberculosis were diagnosed,MSCT of infiltrating pulmonary tuberculosis diagnostic sensitivity,specificity,positive predictive rate,negative predictive rate,correct rate,misdiagnosis rate,missed diagnosis rate,diagnostic accordance rate were 93.3%,80.0%,93.3%,80.0%,73.3%,20.0%, 6.7%,90.0%,respectively.On the lung multiple patchy shadow,real change shadow,multiple nodules,cavity shadow, on the unilateral lung syndrome,and branch sign and halo sign is the main sign of invasive pulmonary tuberculosis. Before treatment,MSCT signs of deterioration of chest between the treatment group and death group had no statistically significant difference(P>0.05).After 4 weeks of treatment,the proportion of effusion lesions in the treatment group was significantly decreased compared with before and during the same period of treatment(37.5%vs 76.9%;3.1%vs 92.3%),the differences were statistically significant(χ2 =5.750,16.541,all P<0.05).After 8 weeks of treat-ment,the proportions of effusion,nodules and cavity lesions in the treatment group were significantly lower than those in the deteriorated group(3.1% vs 92.3%;0.0% vs 15.4%;6.2% vs 38.5%),the differences were statistically significant (χ2 =16.541,5.152,7.302,all P<0.05).Conclusion Morphological changes of MSCT in invasive pulmonary tuberculosis have certain characteristics.In the diagnosis,differential diagnosis and therapeutic evaluation of invasive pulmonary tuberculosis,MSCT has high value.

According to the current situation of the medical ethics education,much emphasis should be put on strengthening the practicalness of medical ethic education;to achieve this goal,the following aspects should be guaranteed: to combine the medical ethic education tightly with medical practices;to face all the difficulties and exert every means to work out the ethical issues emerged from the medical and healthy practice;to impart ethical education to professional curriculum,especially the course of clinical field work.

Objective To explore the protective roles of Emodin in the intestinal mucosal lay of rats with severe acute pancreatitis (SAP) and its mechanism. Methods SD rats (n=30) were divided into 3 groups: sham operation group, SAP group and Emodin group (SAP rats treated with Emodin). The SAP rat models were established via retrograde injection of 3%sodium taurocholate to pancreatic duct. Rats in Emodin group were peritoneally injected with Emodin (2.5 mg/100 g) at both 1 hour and 3 hour after sodium taurocholate injection. Apoptosis of intestinal epithelial cell was detected by TUNEL analy?sis. The expression of glucose-regulated protein78 (GRP78) protein was assessed by immunohistochemistry. Results Com?pared with sham operation group, apoptosis in intestinal epithelial cells and the expression of GRP78 protein were increased significantly in SAP group(P<0.05). Emodin treatment reduced AP-induced mucosal intestinal epithelial cell apoptosis (P<0.05). But there is no significant difference of GRP78 expression between SAP group and Emodin group(P>0.05). Conclusion Emodin has a protective effect on intestinal layer in rats with SAP through inhibiting intestinal epithelial cell apoptosis. However, ER stress is not likely to be involved in this protective effect.

Objective To evaluate the role of Src tyrosine kinase in damage to alveolar epithelial cells caused by mechanical stretch.Methods MLE-12 cells cultured in vitro were randomly divided into 3 groups using a random number table:mechanical stretch group (group S),dimethyl sulfoxide control group (group D),and Src tyrosine kinase inhibitor PP2 group (group P).In D and P groups,dimethyl sulfoxide 30 μl/ml and PP2 100 μmol/L were added to the culture medium,respectively,and the cells were then cultured for 30 min.The cells underwent mechanical stretch for 8 h with frequency of0.5 Hz and amplitude of 20％ in the three groups.At 0,2,4 and 8 h of mechanical stretch,MLE-12 cells in 3 wells of each group were collected for determination of cell apoptosis with flow cytometry and expression of occludin using Western blot.The apoptosis rate was calculated.Results Compared with S group,no significant changes were found in the apoptosis rate and expression of occludin at each time point in group D,and the apoptosis rate was significantly decreased,and the expression of occludin was up-regulated at 2,4 and 8 h of mechanical stretch in group P.Conclusion The activation of Src tyrosine kinase is involved in damage to alveolar epithelial cells caused by mechanical stretch.

Objective To evaluate the effect of recombinant human annexin A5 on the expression of phosphorylated protein kinase C alpha (p-PKCα) and p120-catenin during endotoxin-induced damage to cardiomyocytes.Methods H9c2 cells cultured in vitro were randomly divided into 3 groups (n=18 each) using a random number table:control group (group C),endotoxin group (group L),and recombinant human annexin A5 group (group A).Recombinant human annexin A5 (final concentration 5 ng/ml) was added,and the cells were incubated for 2 h in group A,and then lipopolysaccharide (final concentration 1 μg/ml) was added,and the cells were incubated for 4 h in L and A groups.At 4 h of incubation,cell apoptosis was detected using the cell apoptosis detection kit,the intercellular space was measured using the confocal microscopy,and the expression of p-PKCα and p120-catenin was determined by Western blot.The apoptosis rate was calculated.Results Compared with group C,the apoptosis rate was significantly increased,the intercellular space was significantly widened,the expression of p120-catenin was significantly down-regulated,and the expression of p-PKCα was significantly up-regulated in group L (P＜0.05).Compared with group L,the apoptosis rate and intercellular space were significantly decreased,the expression of p120-catenin was significantly up-regulated,and the expression of p-PKCα was significantly down-regulated in group A (P＜0.05).Conclusion Recombinant human annexin A5 can inhibit phosphorylation of PKCα and up-regulate the expression of p120-catenin,thus attenuating endotoxin-induced damage to cardiomyocytes.

ObjectiveTo investigate the relationships between T and NK cells in peripheral blood and the relapse or metastasis of malignant tumors.MethodsFlow cytometry was used to test the percentages ofT and NK cells in peripheral blood of 48 malignant tumor patients with relapse or metastasis (relapse or metastasis group) and 48 malignant tumor patients without relapse or metastasis(control group).ResultsCompared with control group,the ratio of Th/Ts decreased,CD4+/CD25+ raised and the activities of NK cells decreased in relapse or metastasis group (0.95 ±0.52 vs.1.35 ±0.43,7.15 ±3.81 vs.6.01 ±2.67,0.2053 ±0.1135 vs.0.2501 ±0.0745)(P＜0.01 or ＜0.05).ConclusionsTesting the T and NK cells in peripheral blood of malignant tumor patients regularly can know their immune status and find the relapse or metastasis early.It is easy and useful in patients' follow-up.

Objective To evaluate the clinical efficacy and adverse effects of brucea javanica oil emulsion combined with DP chemotherapy in treating advanced non-small-cell lung cancer.Methods Totally 48 patients with advanced non-small-cell lung cancer were divided into two groups randomly by mechanical sampling method.Twenty-four cases in treatment group were treated by brucea javanica oil emulsion combined with DP chemotherapy, while 24 cases in control group were treated by DP chemotherapy only.The clinical effects were evaluated after treatment of two cycles.Results The short-term effective rate was 54.2% (13/24) in treatment group and 45.8% (11/24) in control group, and there was no significant difference between two groups ( χ2 = 0.333, P = 0.564).The rate of increased and stable life quality was 87.5%(21/24) in treatment group and 58.3%(14/24) in control group,and there was significant difference between two groups (χ2 = 5.169,P = 0.023).The rate of increased and stable weight was 79.2% (19/24) in treatment group and 45.8%( 11/24) in control group, and there was significant difference between two groups (χ2 = 5.689,P = 0.017).The incidence of nausea or vomiting was 45.8% (11/24) in treatment group and 41.7%( 10/24 ) in control group, and there was no significant difference between two groups (χ2 = 0.085, P = 0.771 ).Compared with those in control group, patients in treatment group had less adverse effects in decreasing of peripheral blood leucocytes and showed better immune function.Conclusion Brucea javanica oil emulsion combined with DP chemotherapy in treating advanced non-small-cell lung cancer has good clinical effect, especially enhances the quality of life, improves immune function and decreases the adverse effects of chemotherapy.

Objective: To make a quantitative evaluation on the short term effect of particulate matter with aerodynamic diameter no more than 2.5 μm (PM_2.5) on cumulative excess mortality rate (CER) and years of life lost (YLL) in residents in Changping district of Beijing. Methods: The death data in local residents, daily mortality, meteorology data and air pollution data (PM_2.5, SO₂ and NO₂ concentrations) in Changping from 2014 to 2017 were collected. Distributed lag non-linear model was used to assess the age and gender specific cumulative lag effects of PM_2.5 on cardiovascular CER and daily YLL in Changping. Results: The effects of PM_2.5 on cardiovascular CER and YLL were obvious on lag 7 days and lag 9 days, respectively, peaking on day 14, and lasting for 21 days. On lag0-21 days, for a 10 μg/m³ increase in PM_2.5, the population based CER of cardiovascular disease death was 0.021% (95%CI: 0.004%-0.038%), and the YLL was 1.47 (95%CI: 0.23-2.70) years. Greater PM_2.5 effect were observed in males and the elderly. Conclusion PM_2.5 increased the risk of cardiovascular disease death and YLL.

Objective To construct a prognostic nomogram for predicting the prognosis of patients with colorectal cancer ( CRC) , and verify its accuracy. Methods The clinical pathologic data from 438 CRC patients hospitalized in the Third Affiliated Hospital of Soo-chow University during January 2006 and May 2013 were retrospectively analyzed. The independent risk factors for predicting the prog-nosis of CRC were determined by the univariate and multivariate regression model. The prognostic nomogram was established by the R-language software. Then, the nomograms of postoperative 3-year and 5-year disease free survivals ( DFS) were drawn, and compared with the actual status. The internal validation and accuracy of the nomogram were determined by the Bootstrap method and the calculat-ed concordance index ( C-index) , respectively. The sensitivity and specificity of the nomogram for predicting the 3-year and 5-year DFS were compared with those of TNM system established by the American Joint Committee On Cancer (AJCC) (7th ed.) by using the time-dependent ROC curve. Results Among 438 CRC patients, the metastasis of CRC occurred in 233 patients, including 105 liver metas-tasis and 57 lung metastasis. Multivariate COX regression analysis showed that tumor differentiation degree, TNM stage, serum CEA level, serum CA19-9 level, neutrophil lymphocyte ratio ( NLR) and P53 level were the independent risk factors of CRC. The C-index of the constructed nomogram for predicting the survival rate of CRC patients was 0.678. The predicted 3-year and 5-year DFS by the no-mogram were highly coincident with the actual status. The analysis results of the time-dependent ROC curve showed that the sensitivity and specificity of the established nomogram for predicting the postoperative 3-year and 5-year DFS were higher than those of AJCC-TNM stage.Conclusion The established nomogram may accurately predict the prognosis of CRC patients, which may be helpful for clinicians to follow up or make beneficial treatment for CRC patients.

Objective To investigate the accuracy of CT in the diagnosis of central lung cancer and the clinical significance of magnetic resonance imaging ( MRI) supplementary diagnosis ,in order to provide reference for clinical diagnosis.Methods From January 2015 to October 2017,30 patients with suspected central lung cancer treated in General Hospital of Lingchuan County Medical Group were selected in the research .All patients were examined by CT and MRI ,and the results of pathological examination were taken as the standard .The results of CT and MRI were observed and the value of MRI supplementary examination in CT diagnosis was analyzed .Results The sensitivity,specificity and accuracy of CT in the diagnosis of central lung cancer were 68.0％,20.0％and 60.0％, respectively .After MRI imaging supplementary diagnosis , the diagnostic sensitivity , specificity and accuracy of diagnosis of central lung cancer were 92.0％,80.0％ and 90.0％, respectively.Conclusion The accuracy of diagnosis of central lung cancer by CT is low .In order to ensure the accuracy of diagnosis ,it is necessary to carry out MRI supplementary diagnosis to the patients .