Surgical approaches for esophageal carcinoma are many and varied. Minimally invasive techniques are increasingly used widely in esophagectomy as they not only ensure patients' therapeutic effects, but also reduce trauma and accelerate recovery. The lymph nodes excisional area of esophageal carcinoma is still in controversy. It is necessary to carry out further researches on selective lymph nodes excision, which can decrease complication rate and improve patients' survival in the meantime.
Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Humans ; Lymph Node Excision ; methods ; Minimally Invasive Surgical Procedures

Benzene ; poisoning ; Humans ; Leukemia ; chemically induced

Objective To study the effect of immunotherapy on expression of CD14+mHLA-DR and the serum levels of immunoglobulin (IgG, IgA and IgM) in patients with severe pneumonia, so as to discuss the feasibility of immunotherapy for severe pneumonia. Methods From January 2012 to April 2014, 120 cases of patients with severe pneumonia treated in the intensive care unit (ICU) and pneumonia department were collected. Patients were randomly divided into control group (60 cases) and treatment group (60 cases). The control group was administrated with conventional therapy , and the treatment group was given thymosin α1 for immune treatment for 7 days. The mHLA-DR expression and the level of IgG , IgA and IgM of the two groups before and after the treatment were compared. Results After thymosin α1 treatment, mHLA-DR expression rate was elevated , and the serum levels of IgG , IgA and IgM were elevated in the treatment group , and the difference was statistically significant (P < 0.05). While there was no statistically significant difference betweenthe above indicators before and after treatment (P > 0.05). Conclusion After immune treatment with the use of thymosin α1 , immunologic suppression can be prevented , and cellar immune function of severe pneumonia patients can be improved.

Objective:To investigate the ability of chymase inhibitors on tryptase release from human colon mast cells.Methods:Human mast cells were dispersed from colon tissue with collagenase and hyaluronidase,and were challenged with stimulus for 15 min at 37℃.Tryptase assay performed following previous procedures.In brief,a 96-well microtitre plate was coated with antiserum to human tryptase.The tryptase levels in the samples were detected with a monoclonal antibody specific to tryptase and the reaction was visualized by addition of OPD.Results:At 15 min and 35 min following incubation,anti-IgE and calcium ionophore were able to provoke significant tryptase release from human colon mast cells.Chymase inhibitors ZIGPFM,TPCK and ?1-antitrypsin had no stimulatory effect on colon mast cells at both 15 min and 35 min incubation periods.All the chymase inhibitors were able to inhibit anti-IgE induced tryptase release in a concentration dependent manner with a maximum of 37%,40% and 36.6% inhibition being achieved with 1 ?mol/mL of ZIGPFM,80 ?mol/mL of TPCK,30 ?mol/mL of ?1-antitrypsin,respectively.Preincubation of inhibitors of ZIGPFM and TPCK with cells for 20 min at 37℃ before challenging with anti-IgE was able to slightly enhance their inhibitory actions.Amastatin,a specific inhibitor of aminopeptidase,had no effect on anti-IgE induced tryptase release.All the chymase inhibitors were able to inhibit calcium ionophore induced tryptase release,the maximum inhibition were 23%-35.3%.And the extent of inhibition by ZIGPFM was increased when colon mast cells were preincubated for 20 min before calcium ionophore being added.However,the same treament failed to improve the action of TPCK.Conclusion:We found for the first time that inhibitors of chymase were able to inhibit anti-IgE and calcium ionophore induced tryptase release from human colon mast cells,which may indicated a potential of a novel therapy for the treatment of inflammatory bowel disease or other mast cell related diseases.

Aim To investigate the ability of chymase inhibitors o n histamine release from human colon mast cells. Methods Human ma st cells were dispersed from colon tissue with collagenase and hyaluronidase, an d were challenged with stimulus for 15 min at 37℃.A glass fibre-based fluorome tric assay was used to measure histamine in the supernatants of dispersed mast c ells.Results chymase inhibitors ZIGPFM, TPCK and ? 1-antitry psin failed to induce significant histamine release from colon mast cells. All t he chymase inhibitors were able to inhibit anti-IgE induced histamine release i n a concentration dependent manner with a maximum of 37%, 26% and 36.8% inhibit ion being achieved with 1 mmol?L -1 of ZIGPFM, 80 mmol?L -1 of TPCK , 30 mmol?L -1 of ? 1-antitrypsin, respectively. Preincubation of inhib itors of ZIGPFM and TPCK with cells for 20 min at 37℃ before challenging with a nti-IgE was able to slightly enhance their inhibitory actions. All the chymase inhibitors were able to inhibit calcium ionophore induced histamine release, th e maximum inhibition was 23.6%～35%.And the extent of inhibition by TPCK was in creased when colon mast cells were preincubated for 20 min before calcium ionoph ore being added. However, the same treament failed to improve the action of ZIGP FM. Conclusion In the current study, we found that inhibitors o f chymase were able to inhibit anti-IgE and calcium ionophore induced histamine release from human colon mast cells, which may indicate a potential of a novel therapy for the treatment of inflammatory bowel disease or other mast cell relat ed diseases.

This study adopted a large sample, multicenter, registered hospital centralized monitoring nested prospective case-control study design. From the real world clinical application of Shenqi Fuzheng injection, monitored 30 026 cases of patients with the use of Shenqi Fuzheng injection. A total of 51 adverse drug reaction (ADR) cases was monitored, including 1 case of severe adverse reactions. ADR incidence rate was 1.7 per 1,000. Blood samples were collected from patients with allergic reactions and their matched controls. Related biological indicators of allergic reactions were unified detected and analysed in order to explore the mechanism of allergic reaction and promote the clinical safety.
Case-Control Studies ; Drug Hypersensitivity ; etiology ; Drugs, Chinese Herbal ; adverse effects ; Humans ; Injections ; Product Surveillance, Postmarketing ; Prospective Studies

Objective To establish a rat model of coal-burning-borne fluorosis,and to observe the expression changes of bone morphogenetic protein-2 (BMP-2) and bone morphogenetic protein-3 (BMP-3) in the serum of rat treated with different dose of fluoride and different treatment duration.Methods A total of 120 clean grade SD rats(body mass between 80 to 120 g) weaned for 4 weeks were randomly assigned into four groups,which were control,low-dose fluorid,medium-dose fluorid and high-dose fluorid groups,respectively,and 30 rats in each group (female 15,male 15).All of the rats were fed with coal drying corn from fluorosis area.Ten rats were killed by femoral artery bleeding 30 d,90 d and 180 d after exposed to fluoride,respectively.Serum BMP-2 and BMP-3 level was tested by enzyme-linked immunosorbent assay (ELISA).Results ①Results of BMP-2:after exposed to fluoride for 90 d and 180 d,the differences of serum BMP-2 level between groups were statistically significant(F=385.08,173.98,all P ＜ 0.01).In low-dose fluorid,medium-dose fluorid and high-dose fluorid groups,the expression of serum BMP-2 at 90 d[(18.80 ± 0.43),(22.22 ± 0.85),(25.14 ± 0.69)μg/L] and 180 d[(7.98 ± 0.68),(8.97 ± 0.78),(15.04 ± 0.89)μg/L] was higher than that of control group[(12.54 ± 1.29),(7.53 ± 0.97)μg/L,all P ＜ 0.05],and the level of BMP-2 increased with increasing dose of fluoride (all P ＜ 0.05).Within each group,the difference of serum BMP-2 was statistically significant(F =55.42,511.58,686.35,671.64,all P ＜ 0.01).The expression of BMP-2 in each group at 90 d [(12.54 ± 1.29),(18.80 ± 0.43),(22.22 ± 0.85),(25.14 ± 0.69)μg/L] was higher than that at 30 d[(11.75 ± 1.15),(11.42 ± 1.07),(11.38 ± 0.92),(11.15 ±1.03)μg/L,all P ＜ 0.05].The expression of BMP-2 in each group at 180 d[(7.53 ± 0.97),(7.98 ± 0.68),(8.97 ± 0.78),(15.04 ± 0.89) μg/L] was lower than that at 90 d.②Results of BMP-3:the difference between groups was not statistically significant at every experimental stage(F =0.7215,1.2951,0.0964,all P ＞ 0.05).Conclusions Longer excessive fluoride intake stimulates the expression of BMP-2 in rats,but with prolonged fluoride intake,the stimulation becomes weak.The effect of fluoride on BMP-3 is not as sensitive as that on BMP-2.

Objective:To investigate the clinical value of peripheral monocyte and neutrophil count in predicting the response of patients with metastatic non-small cell lung cancer (mNSCLC) to immunosuppressive checkpoint inhibitors (ICI).Methods:The clinical data of 34 adult mNSCLC patients who received nafulizumab or pabolizumab in Danzhou People's Hospital of Hainan Province from January 2017 to March 2019 were retrospectively analyzed. The correlation of the demographic characteristics, clinical data, hematological examination results in the first two weeks before the treatment and two weeks after ICI treatment with prognosis was recorded and observed.Results:The baseline mean monocyte count [(0.52±0.09)×10 9/L vs. (0.60±0.12)×10 9/L] and neutrophil count [(4.27±0.87)×10 9/L vs.(5.39±1.02)×10 9/L] of patients with ICI reaction were lower than those of patients without ICI reaction, and the differences were statistically different ( t = -2.572, -2.727, all P < 0.05). However, there was a negative correlation between the monocyte count of the patients who responded to ICI and the reaction time ( r = -0.507, P < 0.05). The median reaction time in patients with monocyte count >0.70×10 9/L was shorter than that in patients with monocyte count ≤0.70×10 9/L (8 weeks vs. 12 weeks, χ2=4.162, P = 0.041). There was no correlation between monocyte count and time of reaction duration, progression of free survival (PFS) and overall survival (OS) ( r = -0.214, 0.182, 0.232, all P > 0.05). The decrease rate of neutrophil count in response group was higher than that in non-response group (22% vs. 2%, P < 0.05). After the first administration, cutoff value of neutrophil count was 4.2×10 9/L; the response rate of patients with neutrophil count ≤ 4.2×10 9/L was higher than that of patients with neutrophil count > 4.2×10 9/L [86.7% (13/15) vs. 36.8% (7/19), χ2=6.657, P < 0.05]. Conclusion:Peripheral blood monocyte and neutrophil count can predict the response to ICI therapy in patients with mNSCLC.

ObjectiveTo explore the association between angiotensin converting enzyme (ACE) gene insertion/deletion(I/D) polymorphism and cerebral infarction among Chinese people. MethodsThe ACE gene polymorphism was determined by PCR-RFLP in 242 patients with cerebral infarction and 283 controls. Multiple logistic regression was performed to explore the risk factors for cerebral infarction. ResultsAfter adjusting age, gender, alcohol drinking, smoking, education,history of diabetes mellitus and the primary hypertension, there was no significant association between ACE I/D polymorphism and cerebral infarction, either was hypertension and diabetes mellitus. The primary hypertension significanlly increased risk of cerebral infarction (OR=7.28,P =0.000). Both ACE ID/DD genotype and the primary hypertension showed a significant gene-environment interaction(r=1.62,OR=7.29), something as super multiplicative type 2 interaction. ConclusionAlthough ACE gene polymorphism is not risk factors of cerebral infarction, but ID/DD genotype had shown significant gene-environment interaction with primary hypertension in occurrence of cerebral infarcion.

Abstract: Objective　To investigate the clinical and laboratory characteristics of pulmonary infection caused by Nocardia otitidiscaviarum. Methods　The clinical data of a patient with pulmonary infection caused by Nocardia otitidiscaviarum were reported, and the clinical characteristics, laboratory characteristics and drug sensitivity of pulmonary infection caused by Nocardia otitidiscaviarum were summarized in combination with the relevant literature at home and abroad from January 2010 to December 2022. Results　A 67-year-old female patient was admitted to the hospital on June 30, 2020 because of "repeated chest tightness and shortness of breath for 3 years, aggravated cough, expectoration and fever". The sputum, alveolar lavage fluid and blood of the patient were collected for culture, and the detected pathogenic bacteria were identified. There are pathogenic bacteria growing in sputum and alveolar lavage fluid, which are identified as Nocardia otitidiscaviarum by Autof ms mass spectrometer. According to the results of pathogenic bacteria and the patient's condition, meropenem combined with compound sulfamethoxazole tablets were given anti-infection treatment, and the patient's condition improved and discharged. Conclusion　The clinical manifestations and imaging features of nocardiosis are lack of specificity, and are prone to misdiagnosis and missed diagnosis. Etiology is the key to disease diagnosis, and clinical examination and culture should be conducted in time.