Objective:To investigate the clinical characteristics and prognosis of secondary hemophagocytic syndrome (HPS) in adults.Methods:The clinical data of 43 adult patients with primary secondary HPS in Mianyang Central Hospital of Sichuan Province from January 2014 to June 2020 were retrospectively analyzed. The patient's clinical manifestations and biochemical indicators were summarized. The clinical characteristics of patients between high-level ferritin (≥5 000 μg/L) group and low-level ferritin (<5 000 μg/L) group, lymphoma-related HPS group and infection-related HPS group were compared. Logistic regression model was used for multivariate survival analysis.Results:All patients had fever as the main complaint, and infections were manifested at the onset or during treatment. In all patients, 88.4% (38/43) had hemophagocytosis in the bone marrow; 88.4% (38/43) had varying degrees of cytopenia; 36.6% (15/41) had reduced fibrinogen [median value 0.93 g/L (0.50-1.35 g/L)]; 76.7% (33/43) had elevated aminotransferase. Compared with the low-level ferritin group (19 cases), the high-level group (21 cases) had a lower proportion of monocytes (0.081±0.040 vs. 0.163±0.076, P = 0.016), the incidence of fibrinogen reduction and the incidence of aminotransferase elevation were high [60.0% (12/20) vs. 11.1% (2/18), P = 0.002; 95.2% (20/21) vs. 52.6% (10/19), P = 0.006]. Compared with infection-related HPS patients, lymphoma-related HPS patients had a higher incidence of lymphadenopathy [72.7% (16/22) vs. 27.8% (5/18), χ2 = 8.021, P = 0.005] and a lower incidence of aminotransferase elevation [59.1% (13/22) vs. 94.4% (17/18), χ2 = 4.848, P = 0.028]. Multivariate analysis showed that the high proportion of neutrophils ( OR = 0.886, 95% CI 0.786-0.998, P = 0.046) and high-level albumin ( OR = 0.376, 95% CI 0.156-0.907, P = 0.030) after treatment were protective factors for survival of patients. Conclusions:Among adult patients with primary secondary HPS, the proportion of monocytes in patients with ferritin ≥5 000 μg/L is low, and liver damage and fibrinogen reduction are more likely to occur. Lymphoma-related HPS patients are more likely to have lymphadenopathy, and infection-related HPS patients are more likely to have liver damage. After treatment, a low proportion of neutrophils and hypoproteinemia indicate a poor prognosis in adult patients with secondary HPS.

Objective To investigate the changes in behavioristics,substantia nigra tyrosine hydroxylase (TH) immunoreactive cells,and ultrastructure of substantia nigra neurons in rats after manganese exposure via intracerebral injection.Methods A total of 72 healthy male Sprague-Dawley rats were randomly divided into exposure group and control group,with 36 rats in each group.The stereotactic technique was used for injection of 1 μl MnCl2·4H2O(1 mol/L) into the corpus striatum in the exposure group,and the control group was injected with the same volume of normal saline.The changes in rotational behavior,number of TH immunoreactive cells in the substantia nigra,and ultrastructure of the substantia nigra induced by apomorphine were observed at 8 hours and 1,3,7,15,and 30 days after injection,and this measure was compared with manganese exposure via intraperitoneal injection.Results After apomorphine induction for 30 minutes,the exposure group showed a gradual increase in the number of rotations over the time of manganese exposure (F=176.921,P＜0.01) and a significantly higher number of rotations than the control group (F=482.654,P＜0.01).The exposure group showed a gradual reduction in the mean A value of TH immunoreactive cells in the injured substantia nigra over the time of exposure(F=12.009,P＜0.01),and this value differed significantly between the injured substantia nigra in the exposure group and the contralateral substantia nigra in the exposure group and the injured side in the control group(F=36.131,P＜0.01).At 3,7,15,and 30 days after exposure,the injured substantia nigra showed a significantly lower mean A value of TH immunoreactive cells than the contralateral side in the exposure group (all P＜0.01).At 7,15,and 30 days,the injured substantia nigra in the exposure group showed a significantly lower mean A value than the injured side in the control group (all P＜0.01).After manganese exposure,substantia nigra neurons showed the changes including mitochondrial swelling,dilatation of the endoplasmic reticulum,and demyelination of nerve fibers in different stages,which suggested the dynamic process of dopaminergic neuron injuries.Compared with manganese exposure via intraperitoneal injection,manganese exposure via intracerebral injection can induce behavioral changes and injuries of the substantia nigra-striatum system more quickly.Conclusion Manganese exposure via intracerebral injection induces behavioral changes and injuries of substantia nigra dopaminergic neurons in rats within a short time.

Objective To investigate the changes in behavioristics,substantia nigra tyrosine hydroxylase (TH) immunoreactive cells,and ultrastructure of substantia nigra neurons in rats after manganese exposure via intracerebral injection.Methods A total of 72 healthy male Sprague-Dawley rats were randomly divided into exposure group and control group,with 36 rats in each group.The stereotactic technique was used for injection of 1 μl MnCl2·4H2O(1 mol/L) into the corpus striatum in the exposure group,and the control group was injected with the same volume of normal saline.The changes in rotational behavior,number of TH immunoreactive cells in the substantia nigra,and ultrastructure of the substantia nigra induced by apomorphine were observed at 8 hours and 1,3,7,15,and 30 days after injection,and this measure was compared with manganese exposure via intraperitoneal injection.Results After apomorphine induction for 30 minutes,the exposure group showed a gradual increase in the number of rotations over the time of manganese exposure (F=176.921,P＜0.01) and a significantly higher number of rotations than the control group (F=482.654,P＜0.01).The exposure group showed a gradual reduction in the mean A value of TH immunoreactive cells in the injured substantia nigra over the time of exposure(F=12.009,P＜0.01),and this value differed significantly between the injured substantia nigra in the exposure group and the contralateral substantia nigra in the exposure group and the injured side in the control group(F=36.131,P＜0.01).At 3,7,15,and 30 days after exposure,the injured substantia nigra showed a significantly lower mean A value of TH immunoreactive cells than the contralateral side in the exposure group (all P＜0.01).At 7,15,and 30 days,the injured substantia nigra in the exposure group showed a significantly lower mean A value than the injured side in the control group (all P＜0.01).After manganese exposure,substantia nigra neurons showed the changes including mitochondrial swelling,dilatation of the endoplasmic reticulum,and demyelination of nerve fibers in different stages,which suggested the dynamic process of dopaminergic neuron injuries.Compared with manganese exposure via intraperitoneal injection,manganese exposure via intracerebral injection can induce behavioral changes and injuries of the substantia nigra-striatum system more quickly.Conclusion Manganese exposure via intracerebral injection induces behavioral changes and injuries of substantia nigra dopaminergic neurons in rats within a short time.

Acute lung injury （ALI） is a common and highly lethal clinical syndrome characterized by acute progressive respiratory failure. Currently， the treatment of ALI primarily involves respiratory support therapy and symptomatic pharmacotherapy， yet there is still a lack of specific and effective pharmacological treatments. Qingwen Baidu decoction is a traditional Chinese medicine formula that has the effects of clearing heat， removing toxin， cooling blood， and purging fire. Its pharmacological effects include anti-inflammatory， antipyretic， antibacterial， antiviral， sedative， and so on. The flavonoids， phenols， terpenes， and other components contained in this formula have strong pharmacological activity， which can regulate the inflammatory response caused and oxidative stress in ALI and maintain the integrity of alveolar-capillary barrier （ACB） by anti-apoptosis， anti-pathogen infection， and anti-pulmonary fibrosis， thereby improving the pathological changes of lung tissue. Among them， flavonoids have been reported more， and their mechanism of action is complex and diverse. For example， quercetin， luteolin， and baicalin act on multiple important targets， such as signal transducer and activator of transcription 3 （STAT3）， mitogen-activated protein kinase 3 （MAPK3）， etc. and participate in the regulation of Toll-like receptor 4 （TLR4）/myeloid differentiation primary response 88 （MyD88）/nuclear factor kappa B （NF-κB）， nuclear factor erythroid 2-related factor 2（Nrf2）/Kelch-like ECH-associated protein 1 （Keap1）， and silent information regulator 1 （SIRT1）/forkhead box protein O1 （FoxO1） signaling pathways， thereby intervening in pathological events such as inflammation， oxidative stress， cell apoptosis， and fibrosis. This paper aims to review the research progress on Qingwen Baidu decoction and its active ingredients in the prevention and treatment of lung injury in the expectation of providing reference for its subsequent pharmacological mechanism research and theoretical support for its clinical application and drug development in the treatment of ALI.