This study was aimed to verify the effects of staged sequential therapy on expressions of matrix metalloproteinase-9 (MMP-9) and its inhibitor TIMP-1 within lung tissues in asthmatic rats with the airway remodeling, by applying a series of tests such as the immunohistochemistry, western blot and real-time fluorescent quantitative PCR. SD rats were randomly divided into 7 groups, which were the asthmatic group (Group X), the normal group (Group Z), the No. 1 sequential therapy group (Group A1), the No. 2 sequential therapy group (Group A2), the No. 3 sequential therapy group (Group A3), the montelukast group (Group M), and the budesonide group (Group B). The asthmatic model was established in each group except Group Z, by sensitization with both ovalbumin (OVA) and aluminium hydroxide via injection at the 1st, 8th and 15th day in a 22-day duration, followed by OVA aerosol inhalation every other day for 8 weeks for asthma activation. At the 8th day after the asthmatic model was established, Group A1 was orally given Ma-Xing Er-Chen Tang (MXECT) during acute phase while given normal saline (NS) during catabasis and stable phase; Group A2 was given MXECT during acute phase, and given modified Jin-Shui Liu-Jun Jian (JSLJJ) during catabasis as well as given NS during stable phase; Group A3 was given MXECT during acute phase, and given modified JSLJJ during catabasis as well as given Liu-Wei Di-Huang (LWDH) Powders during stable phase;Group M was given salbutamol via aerosol inhalation after stimulation, while orally given montelukast during catabasis and stable phase; Group B was given salbutamol via aerosol inhalation after stimulation, while given inhaled budesonide during catabasis and stable phase; Group X was given NS. After the 7-week intervention, the immunohistochemistry, western blot and real-time quantitative PCR were applied to analyze the location and quantitative expression of MMP-9 and TIMP-1, so as to find out the biological mechanism on expressions of MMP-9 and TIMP-1 in lung tissues of asthmatic rats from molecular levels to gene levels. The results of immunohistochemistry, western blot and real-time fluorescent quantitative PCR showed as follows. Compared with Group Z, the contents of MMP-9 and TIMP-1 increased significantly within lung tissues in Group X. Compared with Group X, the contents of MMP-9 and TIMP-1 decreased within lung tissues of asthmatic rats in each treatment group. It was concluded that the expression of MMP-9 and TIMP-1 elevated during asthma. TCM staged sequential therapy can regulate the ratio between MMP-9 and its inhibitor so as to block the airway remodeling, by decreasing the expression of MMP-9 and its inhibitor within lung tissues in asthmatic rats. This is one of the important action mechanisms.

Objective To compare the differences in the levels of lactate dehydrogenase(LDH),creatine kinase(CK),and neuron-specific enolase(NSE)in the cerebrospinal fluid(CSF)between the patients with purulent meningitis(PM)and those with tuberculous meningitis(TBM)and evaluate the utility of the three biomarkers in the differentiation of PM and TBM.Methods Thirty-five PM patients and 45 TBM patients who attended the Department of Neurology from December 2019 to December 2021 were enrolled in this study.The CSF samples were collected from the patients before treatment.The levels of LDH,CK,NSE,and glucose,protein,and chloride in CSF were measured and compared between PM and TBM patients.The correlation between the biomarkers in CSF was analyzed by Pearson correlation coefficient.Linear regression analysis was performed to analyze the risk factors for the occurrence of TBM.Receiver operating characteristic(ROC)curves were plotted to evaluate the discriminative value of CSF LDH,CK,NSE alone or in combination in differential diagnosis of PM and TBM.Results Patient age,gender,clinical features such as fever,pathological signs,vomiting,limb twitching,and CSF levels of glucose and protein did not show significant difference between TBM patients and PM patients(P＞0.05).TBM was associated with significantly higher LDH and NSE levels in CSF and significantly lower CK level and chloride in CSF compared to PM(P＜0.05).Pearson correlation analysis showed that LDH level in CSF was negatively correlated with CK and chloride(r＜0,P＜0.05),and positively correlated with NSE(r＞0,P＜0.05).CK was negatively correlated with NSE(r＜0,P＜0.05),and positively correlated with chloride(r＞0,P＜0.05).NSE was negatively correlated with chloride(r＜0,P＜0.05).Linear regression analysis showed that LDH,CK,NSE,and chloride levels in CSF were all associated with the occurrence of TBM(P＜0.05).ROC curves demonstrated that the AUCs of CSF levels of LDH,CK,NSE alone and in combination for differentiation between PM and TBM were 0.849(95％CI:0.768-0.930),0.858(95％CI:0.779-0.937),0.851(95％CI:0.771-0.931),and 0.954(95％CI:0.911-0.996),respectively.Conclusions The clinical features are similar for PM and TBM patients.However,the levels of LDH,CK,and NSE in CSF are different between PM and TBM.LDH,CK,NSE in combination may improve the differential diagnosis between PM and TBM.

Objective:To investigate the relations of clinical manifestations with sequence numbers detected in the cerebrospinal fluid of varicella-zoster virus (VZV) encephalitis/meningitis patients based on metagenomic next-generation sequencing (mNGS).Methods:Fifty-four VZV encephalitis/meningitis patients admitted to Department of Neurology, Harrison International Peace Hospital from January 2016 to October 2022 were selected. Sequence numbers of VZV in the cerebrospinal fluid of these patients were detected by mNGS; these patients were divided into low-detected sequence number group (≤1 000) and high-detected sequence number group (>1 000) accordingly. Differences in clinical manifestations, auxiliary examination results, treatments and prognoses were compared between the two groups.Results:Twenty-six patients were into low-detected sequence number group and 28 patients were into high-detected sequence number group. Compared with the low-detected sequence number group, the high-detected sequence number group had significantly older age (48.0 [35.5, 65.3] years vs. 63.0 [54.0, 71.8] years), higher proportion of patients using immunosuppressants (0.0% vs. 14.3%), lower proportion of those with meningeal irritation signs (46.2% vs. 17.9%), higher proportions of those with abnormal mental behaviors (15.4% vs. 42.9%), epilepsy (3.8% vs. 28.6%), and consciousness disorders (11.5% vs. 42.9%), greater cerebrospinal fluid pressure (150.0 [127.5, 177.5] mm H 2O vs. 185.0 [152.5, 210.0] mm H 2O), higher electroencephalogram positive rate (11.8% vs. 47.7%), and higher poor prognosis rate at discharge (26.9% vs. 66.7%, P<0.05). Conclusions:The clinical phenotype of the low-detected sequence number group tends to meningitis, while that of the high-detected sequence number group tends to encephalitis. Patients with high-detected sequence numbers have high cerebrospinal fluid pressure and abnormal electroencephalogram, enjoying poor prognosis.