Objective To analyze the risk factors of ANCA-associated systemic vasculitis with pulmonary infection to improve the alertness of clinicians to imprave the survival of patients.Methods Seventyfive AASV patients in Shanghai Renji Hospital from January 2010 to June 2013 were selected,and logistic regression models was applied to analyze the correlation.Results Of 75 AASV patients,39 (52％) cases were males,36(48％) cases were females,the average ages were (56±19),56(75％) cases were MPA,17(23％) cases were WG and 2(3％) cases were CSS.42(56％) cases were diagnosed to have pulmonary infection.Among the patients with pulmonary infection,23 (55％) were males,19 (45％) were females,24 (57％) were older than 60 years old,17(12％) had WG,37(88％) had MPA,and 8(19％) died.Meanwhile,11(26％) had bacterial infection,2(5％) had tuberculosis,2(5％) had fungi infection,and 27(64％) had mixed infections respectively.8(19％) cases died.Multivariate logistic regression analysis showed that those who were older than 60 years (OR=15.13,95％CI 2.16-106.04,P＜0.01),who were diagnosed as MPA (OR=9.00,95％CI 1.37-59.14,P＜0.05),who had hypoproteinemia (OR=17.61,95％CI 3.14-98.74,P＜0.01) and interstitial lung disease (OR=11.83,95％CI 2.19-63.85,P＜0.01) were more likely to complicate with pulmonary infection.Conclusion Those who are elders,diagnosed as MPA,with hypoproteinemia and interstitial lung disease have higher risk to have pulmonary infection among AASV patients,which underscores that clinicians should pay more attention to this complication of AAV patients.

ObjectiveTo investigate the effect of capsaicin on cognitive dysfunction in rats with cerebral ischemia-reperfusion and its possible mechanism. MethodTwelve SD male rats were randomly selected as a sham operation group， and the remaining rats were sutured to replicate the model of middle cerebral artery occlusion （MCAO）. The successfully modeled rats were divided into a model group， a SB203580 ［p38 mitogen-activated protein kinase （p38 MAPK） inhibitor， 1 mg·kg^-1］ group， capsaicin low- and high-dose （50， 100 mg·kg^-1） groups ， and anisomycin （p38 MAPK agonist， 2 mg·kg^-1） + capsaicin （100 mg·kg^-1） group， with 12 rats in each group. After reperfusion and administration， the rats were scored for neurological deficits. Morris water maze and new object recognition experiments were used to test the learning and cognitive abilities of rats. The hematoxylin-eosin （HE） staining was used to observe the pathological changes in the hippocampus of the brain tissue. Immunofluorescence method was used to detect the activation of microglia in the hippocampus. Enzyme-linked immunosorbent assay （ELISA） was used to detect the levels of interleukin-1β （IL-1β）， tumor necrosis factor-α （TNF-α）， and prostaglandin E₂ （PGE₂） inflammatory factors in the brain tissue. Western blot was used to determine the protein expression levels of transient receptor potential vanillin subfamily 1 （TRPV1）， p38 MAPK， p-p38 MAPK， and cyclooxygenase-2 （COX-2） in the hippocampal tissue. ResultAs compared with the sham group， the neurological deficit score， escape latency， the number of Iba-1 positive microglia in the hippocampal CA1 area， the IL-1β， TNF-α， and PGE₂ levels in the brain tissue， and the p-p38 MAPK/p38 MAPK and COX-2 expression in the hippocampus tissue was significantly increased in the model group （P<0.01）. In the model group， the number of crossing the platform position， the novel object discrimination index （DI）， and the TRPV1 expression in the hippocampus tissue was significantly reduced （P<0.01）， the number of hippocampal nerve cells was reduced， and a large number of inflammatory cells infiltrated. As compared with the model group， the neurological deficit score， escape latency， the number of Iba-1 positive microglia in the hippocampal CA1 area， the IL-1β， TNF-α， and PGE₂ levels in the hippocampus tissue， and the p-p38 MAPK/p38 MAPK and COX-2 expression in the hippocampus tissue were significantly reduced in the capsaicin low-dose and high-dose groups （P<0.05，P<0.01）. In the capsaicin low-dose and high-dose groups， the number of crossing the platform position， the DI， and the TRPV1 expression in the hippocampus tissue were significantly increased （P<0.05，P<0.01）， a small amount of inflammatory cells were infiltrated， and the number of nerve cells was significantly increased. The use of anisomycin， an activator of p38 MAPK， increased the expression of COX-2， and significantly weakened the inhibitory effect of capsaicin on the activation of microglia. ConclusionCapsaicin has a protective effect on the cognitive function of rats with cerebral ischemia-reperfusion， and its mechanism may be related to the inhibition of the activation of p38 MAPK/COX-2 signaling pathway， thereby inhibiting the excessive activation of microglia.

Objective　To explore the repair effect of curcumin on injured neurons in Parkinson’s model rats and the related mechanisms.Methods　Forty SD healthy male rats were selected,10 were group,the remaining 30 were established Parkinson’s model,divided into model group,low and high dose groups,and the four groups of rats were intervened separately.The learning and memory abilities of rats in each group were tested.HE staining was performed on brain tissue specimens of rats in each group.The size and number of neurons were counted.The levels of IL-6,IL-1β and TNF-α were detected by enzyme-linked immunosorbent assay.Results　Compared with model group and low dose group,the size and number of neurons in high dose group were higher (P<0.05).Compared with model group and low dose group,rats in high dose group had shorter escape latency and higher number of times crossing the platform at each time point (P<0.05).Compared with model group and low dose group,the levels of IL-6,IL-1β and TNF-α were lower in high dose group (P<0.05).Conclusion　Intervention with curcumin in Parkinson’s model rats can improve the learning and memory ability of rats,increase the size and number of neurons in rat brain tissue,and play a role in neuronal damage repair.Its function may be related to alleviating the inflammatory response in brain tissue,regulating the expression of apoptosis protein.

Objective　To investigate the prognostic value of NLR,PLR,PNR and PWR in acute cerebral infarction.Methods　We enrolled 139 patients who were diagnosed with acute cerebral infarction from Chengde Central Hospital from September 2018 to September 2019.Routine blood test results were collected.Patients were divided into mild stroke and moderate-severe stroke groups according to the NIHSS at admission.After three months,subjects were divided into two groups according to the modified Rankin score (mRS),one group with good prognosis (mRS 0~2) and the other with poor prognosis (mRS 3~6).Logistic regression analysis was performed,the ROC curve was used to evaluate inflammatory markers in predicting prognosis.Results　After adjusting for confounders,PLR and NLR in the group with good prognosis were significantly lower than that of the other group (P<0.005),PWR was higher in good prognosis group (P<0.05).In addition,PLR and NLR in the mild stroke group were significantly lower than the moderate-severe stoke group (P<0.05).The ROC curve showed that the area under the curve of PLR and NLR for predicting the prognosis of acute cerebral infarction at 3 months was 0.721 (95%CI 0.630~0.813;P<0.001),0.765 (95%CI 0.678~0.851;P<0.001) and the area under the curve of the PWR is 0.642.Conclusion　NLR and PLR,as new inflammatory indicators,may be independent factors for predicting the prognosis of AIS,and can also be used to judge the severity of stroke.

Objective To observe the relation of estradiol-stimulated protein (esp1) expression with chromosome ploidy in A549 and Hela cells. Methods Total RNA was extracted from A549 and Hela cells respectively for cDNA. pIRE-S2-EGFP-ESP1 plasmid was transfected into the 2 corresponding tumor cells. Real-time quantitative PCR was used to detect esp1 gene expression. The chromosome changes were analyzed by VIDEOTEST-KARYO 3.1 and chromosome ploidy was analyzed with flow cytometry. Results After the tumor cells were transfected with pIRE-S2-EGFP-ESP1 plasmid, the expression of esp1 gene was up-regulated (P

Objective: To evaluate the effects of ethanol extract of Hedyotis Diffusae Herba (EEHDH) on chronic ulcerative colitis (UC) and the inhibition on intestinal tissue abnormalities hyperplasia. Methods: The C57 mice were randomly divided into five groups: normal, DSS, low-, mid-, and high-dose (2.5, 10.0, and 20.0 g/kg) EEHDH groups. The DSS-induced UC model was employed. The body weight, hematochezia, and stool property were recorded to evaluate the change of physiology daily. The pathology changes of colonic mucosa tissue of mice were evaluated by HE staining, and the expression changes of inflammatory factors IL-6 and TNF-α in serum and tissues were detected by ELISA and real-time PCR, as well as immunohistochemistry was used to analyze the positive rate of Ki67 of the nuclear antigen in epithelial cells of colonic tissues. Results: Compared to the model group, the treatment with mid- and high-dose EEHDH has a relatively slower weight loss and a faster recovery when the stimulation is gone; Meanwhile the symptoms of diarrhea and hematochezia are significantly improved, the pathological damage and intestinal tissue dysplasia are alleviated; The inflammatory factors IL-6, TNF-α, and the positive rate of Ki67 are significantly decreased. Conclusion: EEHDH could attenuate DSS-induced UC and decrease pathological injury, inflammation invasion, and abnormalities hyperplasia, by inhibiting the expression of inflammatory cytokines, such as IL-6 and TNF-α, which indicates that EEHDH is of great value in the treatment of UC and colitis-associated cancer.

Objective: The aim of this study is to determine the accuracy of RSI and RFS in the diagnosis of hypopharyngeal reflux （LPR）, the scores of RSI and RFS were compared in different age groups. To explore the RSI and RFS scoring thresholds for diagnosis of LPR in different age groups. Method: From January 2017 to March 2019, 258 patients with suspected LPR in our hospital outpatient clinic completed the RSI and RFS scales. According to their age, 258 patients with RSI>13 and RFS>7 were selected. They were divided into group A （18-<40 years, n=86）, group B （40-<60 years, n=107） and group C （≥60 years, n=65）. The diagnosis was confirmed by 24 h pH-metry. The diagnostic rate, RSI and RFS scores were compared among the three groups. ROC curve was used to analyze the optimal thresholds for the diagnosis of LPR by RSI and RFS scores. Result: Among the three groups, group C had the highest diagnostic rate（93.85%）. There was no significant difference in RFS score among the three groups （P>0.05）, RSI score was significantly different （P<0.05）, RSI score of group A and group B was higher than that of group C （P<0.05）. According to ROC analysis, the best RSI cutoffs for diagnosing LPR in group C was 11, and the area under the ROC curve was 0.866. Conclusion The RSI score is a good criterion for the diagnosis of LPR. The diagnostic threshold of RSI in elderly patients is different from that in young patients. For elderly patients, the diagnostic threshold for the recommended RSI score is 11.

The aim of this study is to determine the accuracy of RSI and RFS in the diagnosis of hypopharyngeal reflux （LPR）, the scores of RSI and RFS were compared in different age groups. To explore the RSI and RFS scoring thresholds for diagnosis of LPR in different age groups. From January 2017 to March 2019, 258 patients with suspected LPR in our hospital outpatient clinic completed the RSI and RFS scales. According to their age, 258 patients with RSI>13 and RFS>7 were selected. They were divided into group A （18-<40 years, =86）, group B （40-<60 years, =107） and group C （≥60 years, =65）. The diagnosis was confirmed by 24 h pH-metry. The diagnostic rate, RSI and RFS scores were compared among the three groups. ROC curve was used to analyze the optimal thresholds for the diagnosis of LPR by RSI and RFS scores. Among the three groups, group C had the highest diagnostic rate（93.85%）. There was no significant difference in RFS score among the three groups （>0.05）, RSI score was significantly different （<0.05）, RSI score of group A and group B was higher than that of group C （<0.05）. According to ROC analysis, the best RSI cutoffs for diagnosing LPR in group C was 11, and the area under the ROC curve was 0.866. The RSI score is a good criterion for the diagnosis of LPR. The diagnostic threshold of RSI in elderly patients is different from that in young patients. For elderly patients, the diagnostic threshold for the recommended RSI score is 11.

Objective: To discuss the efficacy of Jiawei Changfengyin with retention enema therapy for acute radiation proctitis and investigate its influence on regulating levels of helper T cell(Th)1/Th2. Method: One hundred and twenty-eight patients were randomly divided into control group and observation group by random number table. Patients in control group (64 cases) got montmorillonite powder (3.0 g), dexamethasone (10 mg) and normal saline (100 mL), with retention enema therapy. Patients in observation group (64 cases) got Jiawei Changfengyin(Changfengyin+Xileisan+pearl powder), with retention enema therapy. Both groups of patients received enema once every night, and the treatment course was 4 weeks in both groups. Before and after treatment, scores of main symptoms, proctoscopy, routine examination of stool+occult blood, and KPS scores of quality of life were graded. Levels of Th1 cell factors[interleukin(IL)-1β, IL-8 and interferon-γ(IFN-γ)], Th2 cell factors (IL-4 and IL-10) were detected. Result: The total effective rate for comprehensive clinical efficacy was 95.31% in observation group, higher than 82.81% in control group (χ²=5.132, P<0.05). Scores of each symptom and the total scores in observation group were lower than those in control group (P<0.01). Degree of rectal mucosa injury in observation group was lighter than that in control group (Z=2.764, P<0.05). Score of rectal mucosal injury was lower than that in control group (P<0.01), but score of KSP was higher than that in control group(P<0.05). Levels of IL-1β, IL-8 and IFN-γ in observation group were lower than those in control group, while levels of IL-4 and IL-10 were higher than those in control group (P<0.01). Conclusion: Jiawei Changfengyin can relieve symptoms of acute radiation proctitis, promote healing of rectal mucosa, improve quality of life, and regulate Th1/Th2 cytokines, with good repairing effect for intestinal mucosa.

Objective To investigate the correlation of serum interleukin 33(IL-33) level and regional cerebral blood flow(rCBF) in white matter lesions with the severity of white matter ischemic lesions(WMILs) in patients with WMILs. Methods A total of 104 patients with WMILs admitted to our hospital from November 2021 to April 2022 were divided into mild group(n=36),moderate group(n=42),and severe group(n=26) according to the Fazekas scale scores. Age,histories of hypertension and diabetes,and data of total cholesterol,triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,homocysteine,glycosylated hemoglobin,serum creatinine,and urea were collected. The serum IL-33 level was measured. The values of rCBF in the centrum semiovale and periventricular area were measured by arterial spin labeling. Multivariate Logistic regression was used to analyze the correlation of serum IL-33 level and rCBF values in the centrum semiovale and periventricular area with the severity of WMILs. Results The age,hypertension,creatinine,and homocysteine in the moderate and severe groups were significantly higher than those in the mild group(P<0.05),and the IL-33 level and rCBF values in the severe group were significantly lower than those in the mild and moderate groups(P<0.01). After adjusting for hypertension,age,and other factors,Logistic regression analysis showed that IL-33 level and rCBF values in the periventricular area and centrum semiovale were protective factors for the increased severity of WMILs[odds ratio(OR)=0.818,95% confidence interval(CI) 0.715-0.935,P=0.003;OR=0.659,95%CI 0.506-0.859,P=0.002;OR=0.817,95%CI 0.692-0.966,P=0.018)]. Spearman rank correlation analysis showed that serum IL-33 level and rCBF values in the periventricular area and centrum semiovale were negatively correlated with the severity of WMILs(r=-0.575,P<0.01;r=-0.607,P<0.01;r=-0.644,P<0.01). Conclusion The IL-33 level and rCBF values in the periventricular area and centrum semiovale may be related to the severity of WMILs.