Objective To explore the application value of glucocorticoid in the treatment of elderly patients with severe pneumonia(SP)and respiratory failure(RF).Methods A retrospective analysis was performed on the clinical data of 208 elderly patients with SP and RF in the hospital between January 2022 and December 2023.According to use of glucocorticoid or not,patients were divided into non-hormone group(n=83)and hormone group(n=125).According to propensity score matching method,there were 71 patients in each group.The clinical indexes,disease improvement,blood gas indexes,laboratory biochemical indexes and prognosis were compared between the two groups.Results The ventilator use time and length of hospital stay in hormone group were shorter than those in non-hormone group(P<0.05).After 7 d of treatment,score of Glasgow coma scale(GCS),oxygen-ation index(P/F),blood oxygen saturation(SaO2)and lymphocyte count(TLC)in hormone group were higher than those in non-hormone group,while scores of acute physiological and chronic health evaluation Ⅱ(APACHE Ⅱ)and sequential organ failure assessment(SOFA),partial pressure of carbon dioxide(PaCO2),blood lactic acid (LAC)and procalcitonin(PCT)were lower than those in non-hormone group(P<0.05).The survival curves showed that 28 d survival rate in hormone group was higher than that in non-hormone group(P<0.05).Cox pro-portional hazard model showed that no use of glucocorticoids was an independent risk factor of 28d death in elderly patients with SP and RF(P<0.05).Conclusion Glucocorticoid can shorten ventilator use time and length of hospital stay,alleviate disease severity,promote the recovery of blood gas indexes,improve biochemical indexes and increase survival rate in elderly patients with SP and RF.

Objective To explore the application value of glucocorticoid in the treatment of elderly patients with severe pneumonia(SP)and respiratory failure(RF).Methods A retrospective analysis was performed on the clinical data of 208 elderly patients with SP and RF in the hospital between January 2022 and December 2023.According to use of glucocorticoid or not,patients were divided into non-hormone group(n=83)and hormone group(n=125).According to propensity score matching method,there were 71 patients in each group.The clinical indexes,disease improvement,blood gas indexes,laboratory biochemical indexes and prognosis were compared between the two groups.Results The ventilator use time and length of hospital stay in hormone group were shorter than those in non-hormone group(P<0.05).After 7 d of treatment,score of Glasgow coma scale(GCS),oxygen-ation index(P/F),blood oxygen saturation(SaO2)and lymphocyte count(TLC)in hormone group were higher than those in non-hormone group,while scores of acute physiological and chronic health evaluation Ⅱ(APACHE Ⅱ)and sequential organ failure assessment(SOFA),partial pressure of carbon dioxide(PaCO2),blood lactic acid (LAC)and procalcitonin(PCT)were lower than those in non-hormone group(P<0.05).The survival curves showed that 28 d survival rate in hormone group was higher than that in non-hormone group(P<0.05).Cox pro-portional hazard model showed that no use of glucocorticoids was an independent risk factor of 28d death in elderly patients with SP and RF(P<0.05).Conclusion Glucocorticoid can shorten ventilator use time and length of hospital stay,alleviate disease severity,promote the recovery of blood gas indexes,improve biochemical indexes and increase survival rate in elderly patients with SP and RF.

Objective:To investigate the protective effect of moxibustion on joints and its influence on the expression levels of S100 calcium binding protein A8(S100A8),S100 calcium binding protein A9(S100A9),serum amyloid A1(SAA1),and related inflammatory factors in rats with adjuvant arthritis(AA).Methods:Forty Wistar rats were randomly divided into a normal group,a model group,a moxibustion group,and a medication group,with 10 rats in each group.Except for the normal group,AA models were established in the other three groups by exposing rats to wind-cold-dampness environmental conditions combined with complete Freund's adjuvant.After successful modeling,the moxibustion group received moxibustion intervention,while the medication group was administered tripterygium glycosides tablets via oral gavage.The normal and model groups underwent similar handling and fixation without additional interventions.After 15 d of intervention,hematoxylin-eosin staining was used to assess pathological changes in the knee joint synovial membrane.Western blotting was performed to detect the protein expression of S100A8,S100A9,and SAA1 in the synovial tissue.Enzyme-linked immunosorbent assay was used to measure the serum levels of interferon(IFN)-γ,interleukin(IL)-6,and IL-23.Results:Compared to the normal group,the model group exhibited significantly increased protein expression of S100A8,S100A9,and SAA1 in the knee joint synovial tissue,as well as elevated serum levels of IFN-γ,IL-6,and IL-23(P<0.01).Histopathological analysis revealed marked synovial hyperplasia and extensive infiltration of inflammatory cells in the model group.Compared to the model group,both the moxibustion and medication groups showed significant reductions in the protein expression of S100A8,S100A9,and SAA1 in the synovial tissue,as well as decreased serum levels of IFN-γ,IL-6,and IL-23(P<0.01).Additionally,synovial tissue in these two groups displayed minimal hyperplasia and only mild inflammatory cell infiltration.Notably,compared to the moxibustion group,the medication group exhibited significantly higher protein expression of S100A9 in the synovial tissue(P<0.05),while no significant differences were observed in the expression of S100A8,SAA1,or serum levels of IFN-γ,IL-6,and IL-23(P>0.05).Both intervention groups showed comparable degrees of synovial inflammation,clear tissue structure,and no obvious hyperplasia.Conclusion:Moxibustion can alleviate joint swelling and reduce inflammatory responses in AA rats.Its mechanism may involve regulating the protein expression of S100A8,S100A9,and SAA1 in the knee joint synovial tissue.

Objective:To investigate the protective effect of moxibustion on joints and its influence on the expression levels of S100 calcium binding protein A8(S100A8),S100 calcium binding protein A9(S100A9),serum amyloid A1(SAA1),and related inflammatory factors in rats with adjuvant arthritis(AA).Methods:Forty Wistar rats were randomly divided into a normal group,a model group,a moxibustion group,and a medication group,with 10 rats in each group.Except for the normal group,AA models were established in the other three groups by exposing rats to wind-cold-dampness environmental conditions combined with complete Freund's adjuvant.After successful modeling,the moxibustion group received moxibustion intervention,while the medication group was administered tripterygium glycosides tablets via oral gavage.The normal and model groups underwent similar handling and fixation without additional interventions.After 15 d of intervention,hematoxylin-eosin staining was used to assess pathological changes in the knee joint synovial membrane.Western blotting was performed to detect the protein expression of S100A8,S100A9,and SAA1 in the synovial tissue.Enzyme-linked immunosorbent assay was used to measure the serum levels of interferon(IFN)-γ,interleukin(IL)-6,and IL-23.Results:Compared to the normal group,the model group exhibited significantly increased protein expression of S100A8,S100A9,and SAA1 in the knee joint synovial tissue,as well as elevated serum levels of IFN-γ,IL-6,and IL-23(P<0.01).Histopathological analysis revealed marked synovial hyperplasia and extensive infiltration of inflammatory cells in the model group.Compared to the model group,both the moxibustion and medication groups showed significant reductions in the protein expression of S100A8,S100A9,and SAA1 in the synovial tissue,as well as decreased serum levels of IFN-γ,IL-6,and IL-23(P<0.01).Additionally,synovial tissue in these two groups displayed minimal hyperplasia and only mild inflammatory cell infiltration.Notably,compared to the moxibustion group,the medication group exhibited significantly higher protein expression of S100A9 in the synovial tissue(P<0.05),while no significant differences were observed in the expression of S100A8,SAA1,or serum levels of IFN-γ,IL-6,and IL-23(P>0.05).Both intervention groups showed comparable degrees of synovial inflammation,clear tissue structure,and no obvious hyperplasia.Conclusion:Moxibustion can alleviate joint swelling and reduce inflammatory responses in AA rats.Its mechanism may involve regulating the protein expression of S100A8,S100A9,and SAA1 in the knee joint synovial tissue.

Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.

OBJECTIVE: To detect the ABO / RhD blood type of infants younger than 6 months in different gestational age and month old with automatic microcolumn glass sphere and tube method, and compare the result of the two methods. METHODS: The data of 896 samples of infants younger than 6 months from January 2018 to February 2019 was collected. The two methods were used to detect ABO/RhD blood type in all samples and compare the detection rate of ABO/RhD antigen and ABO reverse typing and agglutination intensity of the two methods. RESULTS: Three hundred and eight cases of type A (34.4%), 281 cases of type B (31.4%), 210 cases of type O (23.4%), 97 cases of type AB (10.8%), and 896 positive cases of RhD blood type were detected out by two methods. There were no significant differences of ABO/RhD antigen agglutination intensity between two methods (P > 0.05). Except for type AB, the detection rate of ABO reverse typing in infants with type B was significantly higher than that with type A and type O (P < 0.05). The agglutination intensity of type A reverse cell was higher than type B reverse cell (P < 0.05). The fully automatic microcolumn glass sphere method exhibited higher detection rate of ABO reverse typing in the samples of type A and type O group and agglutination intensity of ABO reverse typing in all types as compared with the tube method (P < 0.05). The detection rate and agglutination intensity of ABO reverse typing in term group were significantly higher than those in preterm group (P < 0.05). The fully automatic microcolumn glass sphere method exhibited higher detection rate of ABO reverse typing and agglutination intensity compared with the tube method between two groups (P < 0.05). The detection rate and agglutination intensity of ABO reverse typing in group IV (4-6 months old) were significantly higher than those in groups I, II and III (young than 3 months old) (P < 0.05). The fully automatic microcolumn glass sphere method exhibited higher detection rate of ABO reverse typing in I, II, III groups and agglutination intensity of ABO reverse typing in the 4 groups compared with the tube method (P < 0.05). CONCLUSION ABO / RhD blood group antigen can be accurated detected in majority of infants, but the detection rate of ABO antibody is related to gestational age and month age of infants. The detection rate and agglutination intensity of the fully automatic microcolumn glass sphere method in ABO reverse typing are higher than those of the tube method, especially for premature infants and children within 3 months old.
ABO Blood-Group System ; Blood Grouping and Crossmatching ; Humans ; Infant

Objective:To investigate the relationship between indicators of carotid atherosclerosis and onset of ischemic stroke in patients with non-valvular atrial fibrillation (NVAF).Methods:This is a case-control study, a total of 397 NVAF patients with newly diagnosed ischemic stroke (case group) and 3 038 NVAF patients without ischemic stroke (control group) from January 2015 to December 2017 were included in the study. Differences in general clinical features and carotid atherosclerosis indexes between the two groups were compared. Univariate and multivariate logistic regressions were used to analyze the correlation between carotid atherosclerosis indexes and ischemic stroke.Results:Proportions of patients with carotid intima thickening, carotid plaque, stable plaque, unstable plaque, and moderate to severe stenosis were higher in the ischemic stroke group than those in the control group (82.1% vs. 64.4%, 69.3% vs. 50.3%, 43.6% vs. 30.6%, 25.7% vs. 19.7%, and 7.3% vs. 4.0%, respectively, all P <0.05). After adjustment of age, gender, heart failure, hypertension, low density lipoprotein -cholesterol and drug use, multivariate analyses showed that subjects with carotid intima thickening, carotid plaque, stable plaque, unstable plaque, moderate to severe stenosis had 1.766, 2.111, 1.892, 2.256 and 1.824 times the risk for the development of ischemic stroke compared with the subjects without any carotid atherosclerosis indicators. Conclusion:Carotid atherosclerosis, especially with unstable carotid plaque, is associated with ischemic stroke in patients with NVAF.

OBJECTIVE: To explore the effect of selective lumbosacral posterior rhizotomy(SPR) on lower limb spasticity and gross motor function in patients with cerebral palsy. METHODS: From January 2018 to October 2018, 47 patients with cerebral palsy were treated with rehabilitation alone and SPR combined with rehabilitation. According to whether SPR was performed, the patients were divided into group A and group B. Group A was treated with rehabilitation combined with SPR at lumbosacral level, and group B was treated with rehabilitation alone. There were 23 cases in group A, including 15 males and 8 females, with an average age of (7.30±3.25) years old; 24 cases in group B, 13 males and 11 females, with an average age of (7.00±3.09) years old. Forty-seven patients were assessed with modified Ashworth(MAS) and Gross Motor Function Scale(GMFM-88 items) before and after treatment. The changes of MAS and GMFM-88 scores before and after treatment were compared to evaluate the degree of spasm and the improvement of gross motor function in the two groups. RESULTS: All 47 patients were followed up. At 6 months after treatment, the MAS classification of the two groups was significantly improved(<0.05), and the improvement of group A was more obvious than that of group B(<0.05). Six months after treatment, the D, E and total scores of GMFM-88 between two groups were significantly improved compared with those before operation(<0.05). The improvement of D and total scores in group A was more obvious than that in group B. There was no significant difference in the improvement of area E between two groups. CONCLUSIONS Selective posterior rhizotomy combined with rehabilitation can significantly improve the spastic state and gross motor function of lower limbs in children with cerebral palsy, and can effectively promote the reconstruction and recovery of motor function of lower limbs in children with cerebral palsy.
Cerebral Palsy ; surgery ; Child ; Child, Preschool ; Female ; Humans ; Lower Extremity ; Male ; Movement ; Muscle Spasticity ; Rhizotomy

Objective To investigate the effect of tamoxifen on the estrogen receptor α36 (ERα36) in breast cancer patients and its mechanism.Methods The patients with breast cancer treated from January 2010 to January 2015 were randomly selected.Among the 100 patients treated with tamoxifen,20 mg · d-1 tamoxifen was given daily for the treatment group.And receive starch slices of 100 patients,as the control group.After 5 d of treatment,ERα36 cells were sorted out of the breast cancer suppressor cell population of the two groups by fluorescence activated cell sorting device from the ERα36 membrane-targeting receptor.The expression of ERα36 was detected by immunohistochemistry.Then the proliferation and metastasis of ERα36 cells were compared between the two groups.Finally,combined with disease-free surial (DSF) and average no transfer surial (MFS) in two groups.Results The positive expression of ERα36 in treatment group and control group were 42,53 cases;the less than 2 cm in tumor size in the 2 group were 11,24 cases;comparison between two groups,the difference was statistically significant (all P ＜ 0.05).It indicating that the expression of ERα36 was associated with the deterioration of breast cancer cells.Of the treatment group of patients with 58 cases of metastatic cases,significantly higher than the control group of 42 cases,and the treatment group died in 28 cases,while the control group died in 19 cases,the difference was statistically significant between the 2 groups (all P ＜ 0.05).Multivariate regression analysis showed that tamoxifen treatment was negatively correlated with DFS and MFS in these patients.It indicating that compared with the absence of tamoxifen treatment,the prognosis of patients treated with tamoxifen was worse,and the mortality and metastasis were higher in patients treated with tafloxacin,the absence of metastatic survival of ERα36 tumors treated with tamoxifen was significantly shorter.Conclusion Selective tamoxifen will result in acquired and primary drug resistance in breast cancer patients,with significant side effects on ERα36 in patients with breast cancer.

OBJECTIVETo compare the differences between weak ABO antigen patients and normal ABO antigen patients with acute leukemia, and to explore the clinical significance of weak ABO antigen in acute leukemia.

METHODSThe ABO blood group was detected in 110 newly diagnosed acute leukemia patients(including 68 cases of AML and 42 cases of ALL) and 68 normal controls. Then the leukemia subtype, age, sex, laboratory test, risk status of leukemia patients, and DNA methylation of ABO promoter were compared between patients with weak and normal ABO antigen.

RESULTSThe weak ABO antigen was found in patients with newly diagnosed acute leukemia, and was not found in ALL patients or normal group. No statistical differences were found in the distribution of ABO blood group, age, hepatosplenomegaly, lymphadenovarix, plt, precursor cell clusters derived from bone marrow, immunopheno-typing, LDH level, and risk status between AL patients of weak and normal ABO antigen groups (P>0.05). Compared with patients in normal ABO antigen group, the pateins in weak ABO antigen group had higher percentage of male(77.8% vs 30%), lower WBC(32.26×10/L vs 82.69×10/L) and Hb level(64.00 g/L vs 85.94 g/L) and higher DNA methylation level (18.91% vs 10.76%) (P<0.05).

CONCLUSIONThe cases of weak ABO antigen frequently appear in the male AML patients, the DNA methylation level of ABO gene promoter in patients with weak ABO antigen is significantly higher than that in patients with normal ABO antigen.