Objective To study the expression of both nuclear factor-κB(NF-κB)and tumor necrosis fac-tor-α(TNF-α)in pulmonary intravascular macrophages(PIM)of rats with hepatopulmonary syndrome (HPS)and the effect of pyrrolidine dithiocarbamate(PDTC)on their expression.Methods The Sprague-Dawley(SD)rats were randomly divided into four groups:control,control+PDTC1CCl4,CCl4+PDTC groups.Arterial blood was collected for measurement of blood gas.Venous blood was sampled for hepatic function and endotoxin level.The mesenteric lymph nodes were dissected for bacteriology studies.Proteins of NF-κB and TNF-a of lung tissue were examined by immunohistochemistry.The activity of NF-κB in lung tissues was measured using electrophoretic mobility shift assay (EMSA).By real-time polymerase chain reaction (PCB)using SYBR Green I,the mRNA expression of TNF-α in lung tissues were detected.Results CCl4 group developed HPS with decreased PaO2 and PaCO2,increased alveolar-arterial oxygen difference(A-aDO2),abnormal hepatic function and increased endotoxin level.Culture-positive mes-enteric lymph nodes were found in 62.5%(5/8)of CCl4,group and 66.7%(6/9)of CCl4+PDTC group(P>0.05 J.All lungs from CCl4 and CCl4+PDTC group showed no accumulation of larse mononuclear macrophagelike cells within the lumen of numerous small muscular and nonnulscular pulmonary vessels.The percentages of vessels with more than 1O adherent macrophages was 60.8%(292/480)in CCl4 group but only 19.6%(106/540)in CCl4+PDTC group(P<0.01).The protein expression of NF-κB and TNF-α Was localized to PIM in CCl4 group.The NF-κB activity and mRNA expression of TNF-α in CCl4 group was significantly higher than that in control,con-trol+PDTC group and CCl4+PDTC group(P<0.05).Conclusion The TNF-α expression in PIM induced by NF-κB play an important role in HPS.The inhibitor of NF-κB PDTC can repress PIM activation and decrease the ex-pression of TNF-α.As result.HPS severity is reduced.

Objective To observe the therapeutic effect of Bushen Tongluo Pill (Pills for reinforcing kidney and removing obstruction of meridians) on rheumatoid arthritis (RA).Methods Totally 100 RA patients were randomized into treatment group and control group with 50 cases in each group.The treatment group (50 cases) was administered Bushen Tongluo Pill and the control group (50 cases) was prescribed Celecoxib capsules and Methotrexate tablets for 3 months.The changes after treatment in the clinical symptoms including joint pain,swelling,joint functions,hand grip strength,and in the laboratory indices including erythrocyte sedimentation rate (ESR),rheumatoid factors (RF),and C-reactive protein (CRP),and the untoward effect as well were observed.Results The total effective rate of the treatment group was higher than that of the control (P0.05).Conclusion Bushen Tongluo Pill is effective for RA,the effect was superior to that of Celecoxib capsules and Methotrexate tablets.

Objective To improve the recognition of dermatomyositis (DM) complicated with intracranial neoplasma and to explore its pathogenesis aimed to collect the experience of diagnosis and treatment. Methods Twelve DM patients complicated with intracranial neoplasma were analysed and the literature of recent 23 years were reviewed. Results DM complicated with intracranial neoplasma was associated with the p53 genic mutation and it was rare because of blood-brain barrier and scanty of lymphocytes in brain tissue. Correct diagnosis depended on clinical manifestations and the computerized tomography or the magnetic resonance imaging of brain. Glucocorticoid was the first choice treatment.However, removal the neoplasma was necessary. Conclusion DM complicated with intracranial neoplasma is rare. Clinicians should make the diagnosis promptly and chosen the appropriate treatment.

OBJECTIVE:To explore the clinical efficacy of 131I in the treatment of hyperthyroidism.METHODS:131I therapy for 784 cases of hyperthyroidism was analyzed retrospectively.The dose of 131I(?Ci) was calculated with formula:?Ci=the weight of thyroid(g)?80-120(?Ci?g-1)/the highest absorbed iodine rate(%).Clinical efficacy was evaluated according to the results.RESULTS:394 cases were relieved completely after once therapy,523 cases after twice therapies and 547 cases after three times of therapies.577 patients were visited at random and 94.80% of them were cured.Early-stage toxic reaction had been found in 46 cases with incidence of 7.97%.Hyperthyroidism crisis had not been developed.Temporary hypothyroidism had been found in 68 cases with incidence of 11.79%,while permanent hypothyroidism had been found in 146 cases with incidence of 25.30%.CONCLUSION:131I has an obvious effect on hyperthyroidism with one disadvantage of high incidence of hyperthyroidism.However,131I is an effective therapy which is safe,economical,simple and convenient.

Objective To investigate the clinical epidemiological characteristic of the cancer in upper digestive tract detected by endoscopy and pathologically diagnosed in Xi'an.Methods Patients with cancer of upper digestive tract,detected by endoscopy and pathologically diagnosed from 1991.1 to 2002.12 were selected.The main clinical data,epidemiologyical,endoscopic manifestation and the pathological characteristics were studied.Results The overall diagnosis rate of upper digestive tract cancer was 8.13% in 12 years.Of all the patients who underwent endoscopy,cancer of esophagus,cardia,stomach and duodenum was 3.42%,1.44%,3.26% and(0.01%),respectively.Although the incidences of esophageal cancer and gastric cancer fluctuated,they showed remarkable decreasing tendency(P=0.000).Meanwhile,the incidence of cardiac adenocarcinoma increased slightly(P=0.000).The male/female ratio of cardiac cancer is 6.29∶1,which is much higher than that of esophageal cancer and gastric cancer(P=0.000).The ratio of squamous cell cancer and adenocarcinoma in esophagus didn't chang in 12 years((P=0.562)),and the adenocarcinoma of esophagus did not show any remarkable tendency (P=0.557).Conclusion Esophageal cancer is the most frequent cancer of upper digestive tract in Xi'an.The detection rate of esophageal cancer and gastric cancer has decreased respectively,and cardiac cancer has increased.Cardiac cancer is different from either esophageal or gastric cancer.

Objective:To investigate the effectiveness and safety of early combined with tirofiban in the treatment of elderly patients with acute ischemic stroke after intravenous thrombolysis with alteplase.Methods:Elderly (60-75 years old) patients with acute ischemic stroke received intravenous alteplase thrombolysis in the Department of Neurology, Traditional Chinese Medicine Hospital of Huangdao District, Qingdao from January 2018 to May 2020 were enrolled prospectively. According to whether tirofiban is combined or not, they were divided into tirofiban group and non-tirofiban group. Tirofiban was pumped intravenously 2 h after intravenous thrombolysis, first 0.4 μg/(kg·min) for 30 min, then 0.1 μg/(kg·min) for 24 h. The efficacy endpoints included National Institutes of Health Stroke Scale (NIHSS) score at 7 d after treatment and modified Rankin Scale (mRS) score at 90 d after onset. 0-2 was defined as good outcome, and >2 was defined as poor outcome. The safety endpoints included the incidence of hemorrhagic transformation, symptomatic intracranial hemorrhage (sICH) and mortality within 90 days after onset.Results:A total of 124 patients with acute ischemic stroke were enrolled. The median age was 68 years (range, 60-75 years). There were 73 males (58.9%) and 51 females (41.1%). There were 62 patients (50%) in the tirofiban group and 62 (50%) in the non-tirofiban group. The median baseline NIHSS score was 14. Hemorrhagic transformation occurred in 7 patients (5.6%), of which 2 were sICH (1.6%). The follow-up at 90 d after onset showed that 68 patients (54.8%) had a good outcome, 56 (45.2%) had a poor outcome, of which 4 (3.2%) died. The NIHSS score at 7 d after treatment (5.52±4.79 vs. 7.35±3.80; t=2.357, P=0.020) and the rate of good outcome at 90 d after onset (64.5% vs. 45.2%; χ2=4.689, P=0.030) in the tirofiban group were significantly better than those of the non-tirofiban group, and there were no significant differences among the incidence of hemorrhagic transformation (4.8% vs. 6.5%; P=1.000), sICH (1.6% vs. 1.6%; P=1.000), and 90 d mortality (3.2% vs. 3.2%; P=1.000). Conclusion:After intravenous thrombolysis with alteplase, the early combined treatment with tirofiban in elderly patients with acute ischemic stroke can significantly improve the efficacy and outcome, and will not increase the risk of hemorrhagic transformation, sICH and death.

Objective To evaluatate the impact of different anastomotic location and preventive ileostomy on postoperative anastomotic fistula in rectal cancer patients.Methods The clinical data of 316 cases of rectal cancer patients after total mesorectal excision from January 2015 to January 2016 were analyzed retrospectively.Patients were divided into anterior resection (AR) group,low anterior resection (LAR) group,uhra-low anterior resection (ULAR) group according to the anastomotic location.There were 33 cases of anastomotic fistula with preventive ileostomy or without and anastomotic leakage varied from mild to severe as grade A,B,C.Results There was no statistically significant difference in the incidence of anastomotic fistula between the different anastomotic location (x2 =3.829,P =0.147).In anterior resection group and low anterior resection group,there was no statistically significant difference in the incidence of anastomotic fistula whether or not a preventive ileostomy was performed (x2 =0.606,1.096,P =0.436,0.326).While in uhralow anterior resection group,preventive ileostomy helped dicrease the incidence of anastomotic fistula (x2 =11.667,P =0.001),and once happened the severity of the anastomotic fistula tended to be less severe.Conclusion The incidence of anastomotic fistula does not vary with anastomotic level in our study.Preventive ileostomy reduces the incidence of anastomotic fistula in patients with ultralow anterior resection.

OBJECTIVE: To observe the effect of infrared laser stimulation on Neiguan (PC 6) for bradycardia of rabbits induced by injection of pituitrin. METHODS: 10.6 microm CO(2) infrared laser, 650 nm semiconductor red laser and the compound laser of their aggregation were sent out by a compound laser sanatory instrument to stimulate Neiguan (PC 6) respectively for the purpose of analyzing the differences of the effects exerted by infrared laser and red laser as well as the changes of the effects after their aggregation. RESULTS: After 30 min and 40 min of the injection of pituitrin, the heart rate showed no significant difference between 10.6 microm CO(2) infrared laser group and the normal control group (P>0.05). However, the heart rate showed significant difference between the 650 nm semiconductor red laser group and the normal control group (P<0.05). After 30 min of the injection of pituitrin, the heart rate of the compound laser group were significantly different to that of the untreated group (P<0.05), and it was not significantly different to that of the normal control group (P>0.05). However, the heart rate of non-acupoint stimulated by the compound laser group showed no significant difference to that of the untreated group (P>0.05), and it was significantly different to that of the normal control group (P<0.05). CONCLUSION: Stimulation on Neiguan with 10.6 microm CO(2) infrared laser can evidently improve the bradycardia induced by injection of pituitrin, while the 650 nm semiconductor red laser has no such function, but they have coordinating effect. The thermal effect produced by CO(2) infrared laser stimulating acupoint is probably beneficial for semiconductor laser penetrating skin as well as the biochemical reactions it carries. The improvement of heart rate produced by the laser stimulation on Neiguan (PC 6) has relative specificity.

Objective To prospectively evaluate the risk factors of complete resection in early gastric cancer (EGC) with endoscopic submucosal dissection (ESD),and to guide the choice of treatment methods.Methods This study prospectively evaluated the endoscopic features of 66 EGCs,including the lesion size,presence or absence of ulceration,the extent of differentiation,invasion depth and entire margins of the EGC,then compared them with postoperative pathologic results and analysed these factors.Results The lesion size of the high grade intmepithelial neoplasia (H) group and the intramucosal carcinoma (M) group were mainly less than 30 mm (90.9％ vs.88.5％),but 57.1％ of the submucosal carcinoma (SM) were more than 30 mm.There was a significant difference between any two of three groups (P ＜ 0.05).Fourteen EGCs who got ulceration without invasion beyond mucosal muscularis underwent ESD successfully,and the basal or dissected margin had no residual tumor cells confirmed pathologically.And no tumor cell infiltration or lymph node metastasis was discovered.Of 45 EGCs with ESD,the underestimation rate for horizontal extent determined by white light and chromoendoscopy was higher than that of magnifying endoscopy with narrow-band imaging (ME-NBI) (15.6％ vs.2.2％,P ＜0.05).Diagnostic accuracy for the extent of differenciation by conventional endoscopy was 93.9％ (31/32,P ＞ 0.1),but it's unable to determine the extent of differentiation by ME-NBI.The accuracy of the group H was 84.8％ (28/33),that of M was 57.7％ (15/26),that of SM was 71.4％ (5/7),and there was a significant difference between group H and group M (P ＜ 0.05).Conclusion To achieve complete resection of EGC with ESD,the lesion more than 30 mm,presence of ulceration,undifferentiated type,deep infiltration should be considered as the risk factors,and it's also important to identify the horizontal extent of EGC to avoid unnecessary operation.

lusions Cardiac MSCT can accurately assess the RV size and function in comparison to MRI. Patients with severe COPD have RV dysfunction.