Objective To investigate the effect of potassium sodium dehydroandroandrographolide succinate injection on helper T cells in peropheral blood and the content of products of oxidative stress in patients with pulmonary infection.Methods 80 community patients with acquired pneumonia in our hospital were selected as the research subjects.They wererandomly divided into observation group and control group,40 cases in each group.The control group was treated with routine treatment of community-acquired pneumonia,patients in the observation group were given conventional treatment combined with potassium sodium dehydroandroandrographolide succinate injection.The peripheral blood T cell subsets,inflammatory cytokines and oxidative stress were compared in two groups.Results After treatment,malondialdehyde,advanced oxidation protein products of the observation group were (14.61 ± 1.65)U/L,(42.67 ± 5.62)μmol/L,respectively,which were lower than those of the control group.Glutathione peroxidase,superoxide dismutase of the observation group were (243.57 ± 33.64) μg/mL,(21.63 ± 3.78) μg/mL,respectively,which were higher than those of the control group,the differences were statistically significant(t =15.155,15.432,7.651,4.726,all P ＜ 0.05).After treatment,Thl7 of the observation group was (1.03 ± 0.15) ％,Thl7/Treg was (0.21 ± 0.03),which were lower than those of the control group,and Treg was higher than that of the control group,the differences were statistically significant (t =7.315,14.805,4.541,all P ＜0.05).The total effective rate of the observation group was 87.50％,which was significantly higher than 77.50％ of the control group (x2 =2.385,P ＜ 0.05).Conclusion Potassium sodium dehydroandroandrographolide succinate injection can contribute to the improvement of community acquired pneumonia in patients with peripheral blood T cell subpopulation structure,reduce the level of oxidative stress,improve the therapeutic effect,it is worthy of clinical application.

Objective:To investigate the efficacy differences between domestic gefitinib and original gefitinib in the first-line treatment of patients with epidermal growth factor receptor (EGFR) sensitive mutation advanced non-small cell lung cancer (NSCLC) (stage Ⅲ B and Ⅳ). Methods:A total of 91 cases with EGFR sensitive mutation advanced NSCLC in Dezhou People's Hospital of Shandong Province from January 2017 to July 2019 were selected and were randomly divided into the observation group (47 cases) and the control group (44 cases) according to random number table method. The observation group was given the treatment of domestic gefitinib, and the control group was given the treatment of original gefitinib, and then the treatment outcome, adverse reactions, survival status and the cost of two groups were compared.Results:The objective response rate in the observation group and the control group was 91.5% (43/47) and 84.1% (37/44), respectively; the disease control rate in the observation group and the control group was 100.0% (47/47) and 97.7% (43/44), respectively; and the differences were not statistically significant ( χ2 = 2.708, P = 0.224; χ2 = 1.080, P = 0.484). The median progression-free survival (PFS) time of domestic gefitinib group and original gefitinib group was 13.26 months (95% CI 11.34-14.66 months) and 13.19 months (95% CI 12.52-15.48 months), respectively, and the difference was not statistically significant ( P = 0.735). The subgroup analysis showed that the median PFS time of patients with an exon 19 deletion mutation in the observation group and the control group was 12.98 months (95% CI 11.25-14.75 months) and 13.89 months (95% CI 12.04-15.96 months), respectively, and the difference was not statistically significant ( P = 0.604). The median PFS time of patients with an exon 21 L858R missense mutation in the observation group and the control group was 15.08 months (95% CI 11.79-18.21 months) and 11.94 months (95% CI 9.20-14.79 months), and the difference was not statistically significant ( P = 0.114). There was no statistically difference in the incidence of adverse reactions including skin rash, diarrhea, interstitial pneumonia, oral mucositis, nausea and vomiting, myelosuppression, abnormal aminotransferase of the two groups of patients (all P > 0.05). The treatment cost in the observation group and the control group during the treatment period was (2 118.43±137.93) yuan per month and (5 945.48±247.48) yuan per month, respectively, and the difference was statistically significant ( t = 12.854, P = 0.001). Conclusions:Domestic gefitinib and original gefitinib have the same therapeutic efficacy in the treatment of EGFR sensitive mutation advanced NSCLC. The adverse reactions are similar between domestic gefitinib and original gefitinib. Compared with the original gefitinib, the drug economy of domestic gefitinib is better and it can significantly reduce the financial burden of patients, and it can be used as an important option in the first-line treatment of patients with EGFR sensitive mutation advanced NSCLC.

Type 2 diabetes mellitus is an independent risk factor of cognitive impairment. In addition to the vascular damaged with high glucose and metabolic disorder, the disruption of neuronal calcium homeostasis, neurotransmitter and inflammatory response may be pathogenesis of cognitive impairment in type 2 diabetes mellitus patients.

Objective To optimize the enzymolysis condition for Acaudina leucoprocta to research lencoprocta the antioxidant activity of its hyoholysate in vivo.Method Response surface methodology (RSM) was employed to optimize the hydrolysis conditions with protamex.The ICR mice were given ig the hydrolysate of Acaudina lencoprocta obtained under optimal conditions.The activity of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) and the content of MDA in blood serum and liver in mice were analyzed.Results and Conclusion The best hydrolysis conditions were:the amount of enzyme was 2.02%;enzymolysis temperature was 51.18 ℃;enzymolysis time was 127.81min,hydroxyl radical scavenging rate was 73.10%.The activities of SOD,GSH-Px in hydrolysate were significantly enhanced and the content of MDA was significantly lower,which showed that this hydrolysate had remarkable antioxidation activity.So the enzymolysis technology for Acaudina leucoprocta was optimal.

Objective To evaluate the feasibility and efficacy of twin grasper combined with endoloops on closing acute stomach perforation.Methods Two experimental porcines of stomach perforation underwent endoscopic closure by twin grasper combined with endoloops.Survival conditions and closure of perforating were observed.Results Mild infection and abdominal adhesions were observed in one week after operation.The nylon rope fell off and an ulcer-like lesion was presented in the closed position.The methylene blue leak test was negative.Histologic examination revealed chronic inflammatory cells infiltration,granulation,fibroplasias,and regenerative mucous membrane crawling toward the center of perforation.Conclusion The technique of twin grasper combined with nylon ropes in closing the acute stomach perforation is feasible and effective.

Objective To construct and apply a cell line screening Mycobacterium tuberculosis (Mtb)-specific tetramers of CD4+α/β T cell receptor(TCR). Methods The β chains of HLA class Ⅱ (DR) were amplified from tuberculosis patients by PCR. The pMT-HLA-DRB expression vectors that carries the HLA-DR 13 chain and pMT-HLA-DRA-P expression vectors which carries the genes of HLA-DR α chain loaded with Mtb antigen were transfected into S2 cells with the method of calcium phosphate transfection. The expressed Mtb peptide/HLA-DR complexes were primarily identified by the method of cell immunohistochemistry. The cell lines expressing Mtb peptide/HLA-DR complexes were used to screen tetramers of CD4+ TCR by flow cytometry. Results S2 cell lines expressing Mtb peptide/HLA-DR complexes on the cell surface were obtained, two kinds of Mtb specific tetramers of CD4+α/β TCR were screened. Conclusion S2 cell lines expressing Mtb peptide/HLA-DR complexes on the cell surface provide the solid basis of the further research on the TCR tetramers and are helpful for exploring new diagnostic study methods about tuberculosis and developing new vaccines.

OBJECTIVETo investigate the relation of epicardial adipose tissue volume (EATV) determined by dual-source CT (DSCT) cardiac angiography and EAT-derived inflammatory factors to coronary heart disease (CHD) and vulnerable plaque.

METHODSA total of 260 patients underwent cardiac computed tomography to evaluate stenosis of coronary artery, and blood samples were obtained from each patient. CHD was confirmed in 180 patients by DSA and CHD was excluded in the remaining 80 patients (NCHD). Vascular remodeling index and plaque vulnerability parameters (fatty volume, fibrous volume and calcification volume and fiber volume) were measured in CHD patients and correlation with EATV was analyzed. Epicardial adipose tissue (EAT) and intrathoracic adipose tissue (TAT) were collected from 40 CHD patients undergoing CABG surgery, and, mRNA and protein expressions of leptin and MMP9 were detected by RT-PCR and Western blot analysis.

RESULTS(1) The EATV was significantly higher in the CHD group than in NCHD group ((121.2 ± 40.6) mm³ vs. (74.7 ± 18.1) mm³, P = 0.01). (2) Subgroup analysis of the CHD patients demonstrated that EATV was significantly higher in patients with positive remodeling than in patients without positive remodeling ((97.6 ± 42.0) cm³ vs. (75.5 ± 25.4) cm³, P = 0.01). Lipid plaque volume was positively correlated with EATV (r = 0.34, P = 0.002); however, fiber plaque volume was negatively correlated with EATV (r = -0.30, P = 0.008). (3) Logistic regression analysis indicated that EATV was an independent risk factor for positive vascular remodeling (OR = 2.01, 95% CI: 1.30-2.32, P = 0.01). (4) mRNA and protein expression of leptin and MMP9 in EAT was significantly upregulated in 40 CHD patients who received CABG surgery compared to 40 NCHD patients (P < 0.01). However, there was no significant difference (P > 0.05) in mRNA and protein expression of leptin and MMP9 from the SAT between CHD and NCHD patients. (5) In the CHD group, leptin and MMP9 levels in EAT and EATV were positively correlated with lipid plaque volume and fibrous plaque volume (P < 0.05).

CONCLUSIONSEATV is an independent risk factors of coronary heart disease and plaque vulnerability; EAT secretion of inflammatory cytokines from CHD patients is significant increased compared to NCHD patients, EAT secretion of inflammatory cytokines are positively correlated with EATV, both of which are determinants affecting vascular remodeling. Reducing EATV might help to attenuate inflammation and plaque vulnerability and reduce the risk of coronary heart disease.

Adipose Tissue ; Angiography ; Atherosclerosis ; Calcinosis ; Constriction, Pathologic ; Coronary Artery Disease ; diagnosis ; Fibrosis ; Humans ; Leptin ; Pericardium ; Plaque, Atherosclerotic ; Risk Factors ; Tomography, X-Ray Computed

Objective To investigate the curative effect of microwave ablation for non-small cell lung cancer (NSCLC) patients,and to analyze the serum concentration changes of vascular endothelial growth factor (VEGF),arginase-1 (Arg-1),inducible nitric oxide synthase (iNOS) before and after microwave ablation and their correlations.Methods A total of 30 cases of healthy people (control group) and 30 cases of advanced NSCLC (test group) were selected.The serum concentrations of VEGF,Arg-1 and iNOS in control group and test group (before microwave ablation,the first postoperative day,the third postoperative day and the first postoperative month) were measured by enzyme-linked immunosorbent assay (ELISA).Results The effective rate of microwave ablation for advanced NSCLC was 33.3％ (10/30),and the disease control rate was 70.0％ (21/30).The concentrations of VEGF,Arg-1 and iNOS in test group before microwave ablation were (816.56 ± 13.26)pg/ml,(5.17±0.20) ng/ml and (544.18 ± 13.93)pg/ml,which were higher than those in control group (93.43 ± 9.93) pg/ml,(1.08 ± 0.05) ng/ml and (8.08 ± 0.33) pg/ml,and the differences were statistically significant (t =239.093,P ＜ 0.001;t =110.359,P ＜ 0.001;t =210.792,P ＜ 0.001).The concentrations of VEGF were (708.41 ± 10.49) pg/ml,(592.63 ± 7.25) pg/ml and (521.91 ± 8.32) pg/ml on the first day,third day and 1 month after microwave ablation in patients with advanced NSCLC,which were significantly lower than those before treatment (all P ＜ 0.05).The homologous concentrations of Arg-1 were (5.95 ± 0.10) ng/ml,(7.02 ± 0.13) ng/ml and (7.67 ± 0.92) ng/ml,which were significantly higher than those before treatment (all P ＜ 0.05).The homologous concentrations of iNOS were (453.01 ± 9.48) pg/ml,(393.21 ± 9.42) pg/ml and (352.60 ± 8.31) pg/ml,which were significantly lower than those before treatment (all P ＜ 0.05).The expression of iNOS was positively related with VEGF in NSCLC patients before treatment (r =0.379,P =0.039),and the expression of Arg-1 was negatively related with VEGF (r =-0.556,P =0.001).However,the expression of iNOS was not associated with Arg-1 (r =-0.238,P =0.205).Conclusion Microwave ablation is effective for local therapy of NSCLC,which can directly kill cancer cells,and affect the levels of VEGF,Arg-1 and iNOS.VEGF has certain correlation with iNOS and Arg-1,but there was no correlation between iNOS and Arg-1.Microwave ablation can change the tumor microenvironment in a certain extent,and stimulate the body to produce anti-tumor immunity.

Objective:To evaluate the effect of lung recruitment maneuvers combined with individualized positive end-expiratory pressure(PEEP) on the degree of postoperative atelectasis in elderly patients undergoing laparoscopic surgery.Methods:One hundred and forty-three elderly patients, aged ≥65 yr, with body mass index of 18.5-30.0 kg/m 2, scheduled for elective laparoscopic surgery, were assigned to either individualized PEEP combined with recruitment maneuvers (group Ⅱ) or fixed PEEP (group Ⅰ) using a random number table method. PEEP was maintained at 6 cmH 2O starting from the beginning of procedure until the end of the procedure in group I. Individualized PEEP titration was performed after induction of anesthesia in group Ⅱ. The primary outcome measure was the 12-zone lung ultrasound score at 15 min after tracheal extubation. Other outcome measures were the occurrence of postoperative pulmonary complications within 7 days after surgery, Quality of Recovery-15 scale score on 3rd day after surgery, rate of unplanned admission to intensive care units, length of hospital stay, incidence of intraoperative hypoxemia, usage rate of intraoperative vasoactive drugs, and incidence of postoperative hypotension. Results:Compared with group Ⅰ, the lung ultrasound score, driving pressure and postoperative pulmonary complications were significantly decreased, the dynamic lung compliance was increased ( P<0.05 or 0.01), and no significant changes were found in the other parameters in group Ⅱ ( P>0.05). Conclusions:Individualized PEEP combined with recruitment maneuvers can reduce the degree of postoperative atelectasis in elderly patients undergoing laparoscopic surgery.

Objective To analyze of the effect of artificial lengthening femoral head replacement in elderly patients with stage Ⅰ of unstable femoral intertrochanteric fracture.Methods 203 patients with stage Ⅰ of unstable femoral intertrochanteric fracture were selected as the research object,and they were taken artificial lengthening femoral head replacement,among which 65caese were male,female in 138 cases.The Harris scoring,SF-36,VAS pain scores on admission,2 weeks after operation,postoperative follow-up limb were counted,and the pain of the affected limb and the hip scores were compared amond 3 time periods.Results All 203 cases of senile patients with follow-up,average operation time was 83.64 minutes,the intraoperative blood loss was 355.41mL.The curative effect was evaluated according to the Harris score,SF-36 and VAS pain scoring criteria,and the Harris scores of the affected limbs at admission,at 2 weeks after the operation and after the follow-up were (28.26 ± 5.50) points,(68.26 ±5.50) points,(93.13 ± 5.31) points,respectively,the differences were statistically significant (t =-71.27,-1 397.55,-46.07,all P ＜ 0.01);The VAS pain scores were (8.19 ± 0.48) points,(3.53 ± 0.71) points,(0.23 ± 0.42) points,respectively,the differences were statistically significant (t =88.06,324.17,60.84,all P ＜ 0.01).The sf-36 scores:physiological [(8.35 ± 1.24) points,(15.23 ± 2.17) points,(19.21 ± 2.12) points],social/family [(7.01 ±1.13) points,(14.12 ± 2.12) points,(19.85 ± 2.24) points],emotional [(4.83 ± 1.01) points,(10.12 ±1.22)points,(14.87 ± 1.32) points],function [(6.35 ± 1.21) points,(13.67 ± 1.87) points,(16.81 ±2.12) points],additional focus [(8.85 ± 1.45) points,(16.38 ± 2.12) points,(20.21 ± 2.42) points],total quality of life [(47.35 ± 4.76) points,(74.69 ± 5.87) points,(89.21 ± 6.12) points],the differences were statistically significant(-39.77,-62.92,-20.21,-44.87,-71.89,-26.79,-45.04,-89.01,-38.25,-45.79,-63.41,-15.29,-45.20,-60.39,-17.54,-52.12,-76.49,-22.58,all P＜0.O1).Conclusion Artificial lengthening femoral head replacement in elderly patients with stage Ⅰ of unstable femoral intertrochanteric fracture has good clinical effect,intraoperative high safety,less postoperative complications,postoperative limb functional recovery is good,and it is worthy of clinical promotion and application.