Objective To study the effect of atomized inhalation of pulmicort respules combined with tulobuterol in the treatment of children with wheezing pneumonia and its influence on serum inflammatory factors.Methods 90 children with asthmatic bronchopneumonia were selected,and they were randomly divided into observation group and control group,45 cases in each group.The control group received routine western medicine and atomized inhalation of ambroxol hydrochloride.The observation group was treated with pulmicort respules inhalation combined with tulobuterol paste service on the basis of the control group.After 1 course of treatment,the efficacy was evaluated.The improvement of clinical symptoms,clinical efficacy,serum cytokine level,inflammatory index and adverse reaction were compared between the two groups.Results The disappearance time of clinical signs such as shortness of breath,cough,wheezing and pulmonary rales in the observation group were significantly shorter than those in the control group [(7.58±0.72)d,(8.42±1.33)d,(5.66±0.74)d,(7.76±0.75)d vs.(4.21±0.29)d,(2.59±0.71)d,(3.41±0.69)d,(5.29±0.71)d,P<0.01],and there were statistically significant differences between the two groups(t=29.124,25.940,14.913,16.044,all P<0.05).The total effective rate in the observation group was 93.3%,which was significantly higher than 80.0% in the control group(χ2=5.214,P<0.01).There was no significant difference in the ECP and Eos levels between the two groups before treatment(P>0.05).The ECP and Eos in the peripheral blood of the two groups were significantly lower than those before treatment(t=8.363,4.307,13.431,12.949,all P<0.05).The ECP and Eos of the observation group were significantly lower than those of the control group(t=7.792,5.838,all P<0.05).IL-4,IL-6 and IL-10 in peripheral blood of the two groups before treatment were not significantly different(all P>0.05).After treatment,the levels of IL-4,IL-6 and IL-10 were significantly decreased and the IFN-γ level was significantly higher than before treatment(t=17.216,20.051,17.891,15.417,32.724,26.709,28.112,26.708,all P<0.05).The levels of inflammatory cytokines in the peripheral blood of the observation group were significantly better than those of the control group(t=9.306,4.150,5.117,4.124,all P<0.05).No serious adverse events occurred in the two groups during the treatment.Conclusion Pulmicort respules combined with tulobuterol is effective in the treatment of children with wheezing pneumonia.It can relieve the symptoms of cough and wheezing.The mechanism may be related to the imbalance of Th1/Th2 imbalance and the reduction of airway inflammation.

Aim To investigate the effects of dopamine(DA)on insulin secretion from rat islets and the possible mechanism.Methods Pancreatic islets were obtained from the pancreatic of male SD rats by collagenase P digestion and histopaque-1077 density gradient separation.Insulin secretion experiment was used to observe the change of insulin release after DA treatments.As to study the potential mechanisms of the effects of DA,patch-clamp experiment and calcuim image technique were applied to test the depolarization-evoked Ca2+ currents,action potential duration and intracellular Ca2+ concentration.Results In 2.8 mmol·L-1 glucose,DA had no effect on insulin secretion;in 16.7 mmol·L-1 glucose,dopamine inhibited insulin secretion in a dose-dependent manner.DA inhibited the inward calcium current,shorten the action potential duration,and reduced the intracellular Ca2+ concentration.Conclusion DA inhibits insulin secretion maybe by decreasing the inward calcium current leading to shorten the action potential duration and reduce the intracellular Ca2+ concentration.

Objective To analyze the efficacy and tolerance of methotrexate(MTX)in remission maintenance of Crohn′s disease (CD).Methods From June 2012 to August 2015 ,49 CD patients who received MTX as mainly treatment medication to maintain remission were enrolled.The pre-medication history,efficacy,dosage and side effects of MTX were analyzed.The effects of inducing strategy on disease recurrence were analyzed.Chi-square test and t test were used for statistical analysis.Results Among the 49 patients,34 (69.4%)received steroids for remission inducing,nine (18.4%)received infliximab for remission inducing and six (12.2%)achieved remission after operation.In the 44 patients treated with azathioprine (AZA)before,the median treatment time was one month and the dosage for withdrawal of AZA was (42.0 ± 14.8)mg/d.The most common reason was leucopenia (81 .8%, 36/44).Till the time point of follow-up,46 of the 49 CD patients still took MTX orally with a median treatment time of 16 months,and the weekly dosage was (12.7 ±2.0)mg.Thirty-one cases (67.4%) achieved clinical stability,while 15 cases (32.6%)underwent clinical recurrence.The median Crohn′s disease activity index (CDAI)was 123.5 ± 66.6.The weekly dosage of clinical stability group was (12.5 ±2.1)mg,and that of clinical recurrence group was (13.0 ±1 .7 )mg,there was no statistically significant difference between the two groups (t =0.802,P =0.426 ).The recurrence rate of steroids-induced remission group was 41 .2% (14/34 ),which was higher than that of infliximab and surgery-induced remission group (1/15),and the differnce was statistically significant (χ2 =5 .177,P =0.023 ). The common side effects were gastrointestinal reaction (26.5 %, 13/49 ), impaired liver function (20.4%,10/49)and leukopenia (12.2%,6/49).Only three cases could not tolerate the side effects and underwent medication withdrawal.Conclusions As a second-line immunosuppressant for maintanence remission in CD,MTX is effective and well-tolerated in patients.So it can be an important option during the long course of CD.

Objective To investigate the clinical efficacy of Qingfeihuatan oral solution in the treatment ofchildren with chronic cough.Methods According to the digital table,a total of 116 patients with cough variantasthma induced by chronic cough were randomly divided into control group and observation group,each group had58 cases.The two groups were given budesonide and formoterol fumarate powder for treatment,on this basis,theobservation group added Xiao'er Qingfeihuatan oral solution,the two groups were continuously treated for 4 weeks.Thechanges of lung function indicators,clinical efficacy and adverse reaction etc were observed.Results Aftertreatment,the clinical total effective rate of the observation group was 94.8％,which of the control group was 77.6％,the difference was statistically significant (x2 =3.625,P ＜ 0.05).The lung function indicators of FEV,FEV1 andFEV1/FEV in the two groups had statistically significant differences between before and after treatment (all P ＜0.05),but the pulmonary function indicators of FEV,FEV1 and FEV1/FEV in the observation group compared withthe control group had statistically significant differences (all P ＜ 0.05).The incidence rate of adverse reactions in theobservation group was 13.8％,which in the control group was 15.5％,the difference was not statistically significant(x2 =0.034,P ＞ 0.05).Conclusion On the basis of routine treatment,Qingfeihuatan oral solution in the treatmentof children with chronic cough can significantly improve the pulmonary function of patients,improve the clinicaltreatment effect,and has good safety and great clinical significance.

Objective To investigate the relationship between ischemic time and thrombus types in patients with ST-segment elevation myocardial infarction (STEMI).Methods Eighty-two STEMI patients undergone emergency percutaneous coronary intervention (PCI) and coronary thrombus aspiration (CTA) from Sep.2012 to Apr.2016 were included and divided into 3 groups according to the ischemic time:≤4 hours (n=36),4-7 hours (n=30) and ＞7 hours (n=16).Visible aspirated thrombi were collected and separated into erythrocyte-rich type,platelet/fibrin-rich type and combined type thrombi by HE dying.The percentage difference of the 3 types thrombi was compared among the 3 groups.Results The percentage of platelet/fibrinrich type,erythrocyte-rich type and combined type thrombi in the 3 groups were as follows:in ≤4h group:61.1％(22/36),8.3％(3/36) and 30.6％(11/36),P=0.019;in 4-7h group:23.3％(7/30),10.0％(3/30) and 66.7％(20/30),P=0.012;and in ＞7h group:43.8％(7/16),12.5％(2/16) and 43.8％(7/16),P=0.913.For platelet/fibrin-rich type thrombi,the percentages in 3 periods were 61.1％(22/36),19.4％(7/36) and 19.4％(7/36),P=0.009;For combined type thrombi,the percentages in 3 periods were 28.9％(11/38),52.6％(20/38) and 18.4％(7/38),P=0.013;For erythrocyte-rich type thrombi,the percentages in 3 periods were 37.5％(3/8),37.5％(3/8) and 25.0％(2/8),P=0.895.Conclusions The types of intracoronary aspirated thrombi differ from various periods.Ischemia time may be an important predicted factor.

Objective To examine the influence of gender difference on the reperfusion delay in patients with ST-elevation myocardial infarction (STEMI).Methods A total of consecutive 325 patients with STEMI were analyzed admitted in the 306 Hospital of PLA from Jan.2011 to Dec.2015.Patients were divided into two groups:male group (n=268) and female group (n=57).The clinical data and the time intervals including symptom onset to first medical contact (So-to-FMC),transfer delay (FMC-to-D),FMC to balloon dilatation (FMC-to-B),activation delay and door to balloon (D-to-B) time were compared between different gender groups,and the prognosis was observed.Results The overall median of pre-hospital delay was 125 minutes.The median of prehospital delay time (male 119.5min vs.female 160.0min) and So-to-FMC time (male 69.5min vs.female 100.0min) were longer in female than in male patients,but no statistical difference existed (P＞0.05) between the two groups in pre-hospital delay,So-to-FMC,FMC-to-B,D-to-B and total ischemia time.Compared with male patients,female patients were more likely to have additional comorbidities,such as hypertension and diabetes mellitus,and lower rate of smoking (P＜0.05).However,the incidence of major adverse cardiac and cerebrovascular events (MACCE) showed no significant difference between female and male patients at 30-day (male 5.22％ vs.female 5.26％) and I-year (male 10.82％ vs.female 8.77％) follow-up (P＞0.05).Conclusion The influence of gender on reperfusion delay is gradually weakening.

Objective To evaluate the effects of surgery under ketamine anesthesia during mid-pregnancy on cognitive function of offspring rats.Methods Thirty healthy pregnant Sprague-Dawley rats at14 days of gestation,aged 9-10 weeks,weighing 270-310 g,were assigned to 3 groups (n=10 each)using a random number table method:exploratory laparotomy under ketamine anesthesia group (KSgroup),ketamine anesthesia group (K group) and control group (C group).In KS group,ketamine 20mg/kg was injected via the caudal vein,and then ketamine was continuously infused at a rate of 130mg · kg-1 · h-1 after loss of right reflex to maintain anesthesia for 2 h,and exploratory laparotomy was per-formed after anesthesia was stable.Group K received no exploratory laparotomy and the other treatmentswere similar to those previously described in group KS.The equal volume of normal saline was given insteadin group C.The cliff avoidance,passive avoidance,and Morris water maze tests were used to evaluate the spatial perception and learning and memory ability of the offspring rats on postnatal days 7,23 and 30.Hippocampal tissues of rat offsprings were obtained at 24 h after the end of Morris water maze test to determine neural precursor cell-expressed developmentally downregulated protein 9 (NEDD9) and postsynaptic density 95 (PSD-95) protein and mRNA expression by quantitative polymerase chain reaction or Western blot.Results Compared with group C,the score of cliff avoidance was significantly decreased,the results of Morris water maze test showed that the escape latency was significantly prolonged,the platform-crossing times were decreased,the time spent in the second quadrant was shortened,the expression of NEDD9 and PSD-95 was down-regulated (P ＜ 0.05),and no significant changes were found in the expression of NEDD9 and PSD-95 mRNA in KS group,and no significant changes were found in the indexes mentioned above in K group (P＞0.05).There was no significant difference in the numberof errors in passive avoidance test among the three groups (P＞0.05).Conclusion Ketamine anesthesia during mid-pregnancy exerts no effect on the cognitive function of offspring rats,abdominal surgery under ketamine anesthesia impairs the spatial perception and learning and memory ability of offspring rats,and the mechanism is related to down-regulating the expression of NEDD9 and PSD-95 in hippocampi of offspring rats.

Objective: To investigate the impact of symptom onset to first medical contact (SO-to-FMC)time on the prognosis of patients with acute ST-segment elevation myocardial infarction(STEMI). Methods: The clinical data of 341 consecutive STEMI patients, who were hospitalized to our hospital and received primary percutaneous coronary intervention(PCI) from August 2011 to April 2016, were retrospectively analyzed. The patients were divided into ≤90 min group (201 cases) and >90 min group (140 cases) according to the SO-to-FMC time. The treatment time, mortality and incidence of major adverse cardiac and cerebro-vascular events(MACCE) were analyzed. The risk factor of 1-year mortality after PCI and 1-year incidence of MACCE during the post-discharge follow-up period were analyzed by binary logistic regression analysis. The predictor of 4.5-year mortality after PCI was analyzed by multivariate Cox regression analysis. Methods The door to balloon time (104(88, 125) min vs. 111(92, 144)min, P=0.023), first medical contact to balloon time(146(119, 197) min vs. 177(125, 237)min, P=0.005), and symptom onset-to-balloon time(200(170, 257) min vs. 338(270, 474)min, P<0.001)were all significantly shorter in the ≤90 min group than in>90 min group. The 30-day mortality (2.99% (6/201) vs. 7.86%(11/140), P=0.042), 1-year mortality (2.89 (5/173) vs. 9.57(11/115), P=0.015), 1-year incidence of MACCE during the post-discharge follow-up period(1.16%(2/173) vs. 6.96%(8/115), P=0.021), and 4.5-year cumulative mortality(3.00% vs. 11.20%, P=0.007) after PCI were significantly lower in the ≤90 min group than in the >90 min group. Moreover, the 4.5-year incidence with free of MACCE (97.20% vs. 88.80%, P=0.025) during the post-discharge follow-up period was significantly higher in the ≤90 min group than in the >90 min group. In-hospital mortality was similar between the two groups (2.49%(5/201) vs. 6.43%(9/140), P=0.071). Results: The door to balloon time (104(88, 125) min vs. 111(92, 144)min, P=0.023) , first medical contact to balloon time(146(119, 197) min vs. 177(125, 237)min, P=0.005), and symptom onset-to-balloon time(200(170, 257) min vs. 338(270, 474)min, P<0.001) were all significantly shorter in the ≤90 min group than in >90 min group. The 30-day mortality(2.99% (6/201) vs. 7.86%(11/140), P=0.042), 1-year mortality (2.89(5/173) vs. 9.57(11/115), P=0.015), 1-year incidence of MACCE during the post-discharge follow-up period (1.16%(2/173) vs. 6.96%(8/115), P=0.021), and 4.5-year cumulative mortality (3.00% vs. 11.20%, P=0.007) after PCI were significantly lower in the ≤90 min group than in the >90 min group. Moreover, the 4.5-year incidence with free of MACCE (97.20% vs. 88.80%, P=0.025) during the post-discharge follow-up period was significantly higher in the ≤90 min group than in the >90 min group. In-hospital mortality was similar between the two groups (2.49%(5/201) vs. 6.43%(9/140), P=0.071). Results of binary logistic regression analysis showed that the SO-to-FMC time >90 min was the risk factor of 1-year mortality(OR=2.90, 95%CI 1.22-6.92, P=0.016) and 1-year incidence of MACCE (OR=5.19, 95%CI 1.21-22.20, P=0.026) during the post-discharge follow-up period. Multivariate Cox regression analysis demonstrated that the SO-to-FMC time >90 min was the risk factor of 4.5-year mortality after PCI in patients with STEMI (HR=2.88, 95%CI 1.10-7.53, P=0.031). Conclusion Shorting the SO-to-FMC time can significantly reduce the treatment time of STEMI patients, short and long-term mortalities and the incidence of MACCE, and improve the prognosis of patients with STEMI.

Objective:To explore the mechanism of lysosomal membrane permeabilization(LMP)inuranyl acetate-induced death of human kidney proximal tubular epithelial HK-2 cells.Methods:HK-2 cells were exposed to uranyl acetate at concentrations of 100, 300 and 600 μmol/L for 24 h, then in tracellular reactive oxygen species (ROS)and mitochondrial superoxide were measured by DCFH-DA and MitoSOX probe, respectively. HK-2 cells were divided into four groups: blank control group, NAC or CA-074 Me group, uranyl acetate exposure group and uranyl acetate exposure plus NAC or CA-074 Me group. Two-color immune of luorescence staining was used to detect the co-localization of galectin-1 and lysosomal associated membrane protein-1 (LAMP-1) to measure the extent of LMP, and to detect the non- co-localization of cathepsin B and LAMP-1 to reflect the release of cathepsin B in lysosomes. Calcein-AM/PI double staining method was used to detect cell death. One-color immune of luorescence staining of cleaved-caspase-3 expression was used to detect apoptosis. Results:Intracellular ROS and mitochondrial superoxide levels were significantly increased in HK-2 cells after exposure with 100, 300 and 600 μmol/L uranyl acetate for 24 h, about 1.1-2.5 times or 4.0-28 times, respectively( tROS=17.98, 11.84, 11.75, P< 0.05; tmitochondrial superoxide=6.14, 16.02, 13.06, P< 0.05), and they also increased with uranyl acetate concentrations ( tROS=10.10, 10.37, 5.59, P< 0.05; tmitochondrial superoxide=21.50, 15.16, 5.93, P< 0.05). The percentage of co-localization of galectin-1 and LAMP-1 and the percentage of non- co-localization of cathepsin B and LAMP-1 were markedly increased in HK-2 cells after exposure with 600 μmol/L uranyl acetate for 24 h, 5.4-6.7 times or 1.5-2.1 times, respectively ( tGalectin-1=15.85, 12.70, P< 0.05; tCathepsin B=5.95, 6.69, P< 0.05), but these increases were inhibited by NAC ( tGalectin-1=4.74, P<0.05; tCathepsin B=4.51, P< 0.05). Moreover, the cell death rate and the cleaved-caspase-3 expression level were also significantly increased in HK-2 cells after exposure with 600 μmol/L uranyl acetate for 24 h, about 28-47 times or 2.4-6.0 times, respectively( tPI=30.40, 10.34, P<0.05; tCleaved-caspase-3=18.49, 9.52, P<0.05), and these increases were obviously diminished by CA-074 Me ( tPI= 6.76, P<0.05; tCleaved-caspase-3=13.47, P<0.05). Conclusions:Exposure to uranyl acetate induces a burst of intracellular ROSthat leads to LMP and consequently causes leakage of cathepsin B from lysosomes to cytoplasm, in turn triggering the lysosomal-dependent cell death and mitochondrial-regulated apoptosis of HK-2 cells.

Objective:To investigate the value of delta radiomics based on longitudinal changes of dynamic contrast enhanced MRI (DCE-MRI) in predicting pathological complete response (pCR) after neoadjuvant therapy (NAT) for breast cancer.Methods:The clinicopathological and imaging data of 117 patients with breast cancer confirmed by surgical pathology from April 2019 to November 2021 at Jiangxi Cancer Hospital were analyzed retrospectively. All patients were female with 23?74 (48±10) years old. The patients were randomly divided into training (81 cases) and test sets (36 cases) at the ratio of 7∶3 according to the number of random seeds in the software. All patients underwent DCE-MRI before and after early NAT (2 courses). The maximum diameter relative regression value of breast tumors before and after early NAT (D%) was calculated and used to construct a conventional imaging model. The delta radiomic features were extracted based on pre-NAT and early-NAT (2 courses) DCE-MRI and selected by redundancy analysis and least absolute shrinkage and selection operator algorithm. A ten-fold cross-validation method was used to construct the delta radiomic model and Radscore was calculated for each patient. All patients were classified into pCR group and non-pCR group according to the surgical pathology after NAT. Significant clinicopathological variables were selected by univariate analysis and stepwise regression method. They were integrated with D% and Radscore to build the combined model and nomogram. The model performance in predicting pCR after NAT in breast cancer was evaluated by the receiver operating characteristic curve and the area under the curve (AUC), and the clinical utility of the models was compared by using clinical decision curves.Results:The combined model had the best diagnostic performance among the three models, with an AUC of 0.90 in the training set and 0.87 in the test set. The Radscore had the highest weight in the nomogram. In the training set, the diagnostic performance of the combined model and delta radiomics model were better than that of the conventional imaging model ( Z=?3.48, P=0.001; Z=2.54, P=0.011). The clinical decision curves showed an overall greater clinical benefit of the combined model compared with the conventional imaging model and delta radiomic model. Conclusions:The addition of significant clinicopathological variables and Radscore of delta radiomic model which represents the longitudinal changes in tumor heterogeneity to the conventional imaging model may improve the predictive ability of pCR. The delta radiomic may serve as a noninvasive biomarker for early prediction of NAT response.