Objective To explore clinical value of tumor specific growth factors (TSGF) in serum and bronchoalveolar lavage fluid (BALF) on differential diagnosis of benign and malignant periphery solitary pulmonary nodules (PSPN). Methods Serum and BALF from both normal and afflicted side were collected from 211 patients with PSPN(case group) and from 196 patients without any type of tumor (control group). TSGF and carcinoembry-onic antigen (CEA) in serum and BALF were measured in both groups. Results In the malignant PSPN patients, CEA in serum, normal and afflicted side were 28.73 (SD: 15.61) μg/L,63.31 (SD:21.28) μg/L and 85.54(SD: 26.19)μg/L,respectively, which was significantly higher than that of the benign PSPN patients (7.21(SD:2.43) μg/L, 12.36(SD:6.93)μg/L and 14.65 (SD:8.07)μg/L,respectively), as well as that of the control group (4.68 (SD: 1.25) μ/L and 11.06(SD:8.03) μg/L in serum and BALF, respectively (P < 0.05). TSGF in the serum and BALF from the normal and afflicted side of malignant PSPN patients was 88.73 (SD:13.51)μg/L, 110.73 (SD: 18.64) μg/L and 162.80(SD:58.89) μg/L, respectively, which were significantly higher than that of the benign PSPN patients (56.31(SD: 2.43) μg/L, 79.25 [SD: 36.86] and 86.29 (SD: 37.07) μg/L, respectively) (P <0.05). Furthermore, in the malignant PSPN patients, TSGF and CEA in the afflicted side were significantly higher than that of the normal side. Sensitivity, specificity and accuracy of TSGF in BALF from the afflicted side for malig-nant diagnosis were 86.6%,100.0% and 98.6%,respectively,which was higher than that of CEA (70.2% ,78. 9% and 76.5% respectively) and that of serum TSGF (73.1% ,88.9% and 85.7% respectively). Conclusions TSGF in bronchoalveolar lavage fluid and serum has a significant role in differential diagnosis of benign and malig-nant periphery solitary pulmonary nodules. Furthermore, measurement of TSGF in bilateral BALF is helpful in diag-nosis of tumor location.

Objective To explore the HEART risk score in predicting 30-day major adverse cardiovascu-lar events (MACE)for the patients presenting to Emergency Department (ED) with acute chest pain. Methods Patients presented in our ED with acute chest pain were enrolled from January,2016 to April,2016. All cause MACE of each patient were followed up at 30 days by Health insurance information management System and call . Results Total 209 patients were enrolled(mean age 65.28 ± 16.85 years;52.63%male). The age,hypertension, ratio of ACS,SpO2,in-patient number HEART score in MACE subject were significantly higher than that in non MACE patients(P<0.05). The blood pressure at admission of MACE patients was significantly decrease than that in non MACE patients(P<0.05). The MACE within 30 days was 5.74%. The respective areas under the curve (AUC)for 30-day MACE(95% CI)was 0.908(0.846 ~ 0.974). The percent of patients with 30-day MACE with HEART scores between 0% and 3,4 ~ 6,and 7 ~ 10 was 0%,2.5%,and 27%,respectively. Conclusion HEART score can be simple,rapid and accurate prediction of emergency department of patients with acute chest pain within 30 days of MACE,effective elimination of low-risk patients with MACE,it plays a very important role for disease assessment and diagnosis and treatment process in emergency department.

Objective:To investigate the efficacy of dexmedetomidine combined with transversus abdominis plane block in laparoscopic radical resection of colorectal cancer and its effect on serum CXCL8 level.Methods:A total of 72 patients who planned to undergo laparoscopic radical resection of colorectal cancer in Changzhou Hospital of Traditional Chinese Medicine from March 2017 to March 2021 were selected as the research subjects, and they were divided into transversus abdominis plane block anesthesia group (group A) and dexmedetomidine combined with transversus abdominis plane block anesthesia group (group B) by random number table method with 36 cases in each group. The operation time, intraoperative blood loss, fluid supplementation, visual analogue score (VAS) and Ramsay sedation score at different times after operation, and serum CXCL8 level after operation were compared between the two groups of patients. The adverse reactions of the two groups of patients were compared.Results:There was no significant difference in operation time and fluid supplementation between the two groups (both P > 0.05). The VAS scores of patients in group B at 4, 8 and 24 hours after operation were lower than those in group A [(2.8±0.6) points vs. (4.2±1.2) points, (2.1±1.0) points vs. (3.4±1.1) points, (1.8±0.4) points vs. (2.5±0.7) points, all P < 0.05], and the Ramsay sedation scores of patients in group B at 4, 8 and 24 hours after operation were higher than those in group A [(4.3±1.2) points vs. (2.7±0.7) points, (3.5±1.1) points vs. (2.2±1.0) points, (2.4±0.9) points vs. (1.6±0.6) points, all P<0.05]. Serum CXCL8 levels of patients in group B at 2, 24 and 48 hours after operation were lower than those in group A [(78±16) ng/ml vs. (87±19) ng/ml, (68±14) ng/ml vs. (75±15) ng/ml, (52±10) ng/ml vs. (61±13) ng/ml, all P<0.05]. The incidence rates of adverse reactions in group A and group B were 8.3% (3/36) and 13.9% (5/36), and the difference was not statistically significant ( P > 0.05). Conclusions:Dexmedetomidine infusion during laparoscopic radical resection of colorectal cancer under general anesthesia combined with transversus abdominis plane block can help reduce postoperative pain, increase sedative effect, and reduce serum CXCL8 level.

OBJECTIVE The 5-HT2A receptor is the major target of classic hallucinogens.Both DOM(2,5-dimethoxy-4-methylamphetamine)and lisuride act at 5-HT2A receptors,and lisuride shares comparable affinity with DOM and acts as a partial agonist at 5-HT2A recep-tors.However,not like DOM,lisuride lacks hallucinogenic properties.Impulsive decision-making refers to the prefer-ence for an immediate small reinforcer(SR)over a delayed large reinforcer(LR).The current study aims to compare the effects of DOM and lisuride on impulsive decision-making and further to investigate the possible receptor mechanisms responsible for the actions of the two drugs.METHODS Impulsive decision-making was evaluated in male Sprague-Dawley rats by the percent-age of choice for the LR in delay discounting task(DDT).Delay to the LR changed in an ascending order(0,4,8,16,and 32 s)across one session.RESULTS DOM(0.3 and 0.5 mg·kg-1)increased impulsive decision-making,and the effects of DOM(0.5 mg·kg-1)was blocked by the 5-HT2A receptor antagonist ketanserin(1.0 mg·kg-1)rather than the 5-HT2C receptor antagonist SB-242084(1.0 mg·kg-1).Contrarily,lisuride(0.1,0.3 and 0.5 mg·kg-1)decreased impulsive decision-making.The effects of lisu-ride(0.3 mg·kg-1)were not antagonized by ketanserin(1.0 mg·kg-1),selective 5-HT1A antagonist WAY-100635(1.0 mg·kg-1)or selective dopamine D4 receptor antagonist L-745870(1.0 mg·kg-1),but were attenuated by the selec-tive dopamine D2/D3 receptor antagonist tiapride(40 mg·kg-1).CONCLUSION DOM and lisuride have contrasting effects on impulsive decision-making via distinct recep-tors.DOM-induced increase of impulsivity is mediated by the 5-HT2A receptor,while lisuride-induced inhibition of impulsivity is regulated by the dopamine D2/D3 receptor.

Objective:To explore the effect of Rehmanniae Radix combined with Scrophulariae Radix on renal microinflammation in diabetic nephropathy (DN) rats. Methods:50 Sprague Dawley (SD) rats were adaptively fed for 1 week, and then 10 rats were randomly selected as the blank control group, and the rest were treated with STZ intraperitoneal injection combined with high-fat diet to induce DN model. After 4 weeks, the successful modeled rats were randomly divided into model group, Rehmannia glutinosa Scrophularia group (5.25 g/kg) and metformin group (200 mg/kg), with 10 rats in each group. After 8 weeks of administration, fasting blood glucose was measured by blood glucose meter; microalbuminuria was measured by benzalkonium chloride turbidimetry; serum cystatin, TNF-α, IL-6 and hs-CRP levels were measured by ELISA kit; renal pathological changes were detected by HE staining, Masson staining and PAS staining; the expression of MCP-1, NF-κB (total) and p-NF-κB protein in renal tissue was detected by Western blot.Results:Compared with the model group, the body weight of rats in DHXS group was significantly decreased ( P<0.05). The content of fasting blood glucose[(18.06 ± 5.69) mmol/L vs. (29.42 ± 0.63)mmol/L], 24-hour urine protein [(11.02 ± 1.77)mg/d vs. (31.61 ± 0.65)mg/d], serum cystatin [(208.16 ± 12.07)ng/ml vs. (278.05 ± 19.33)ng/ml], TNF-α [(9.13 ± 1.46)pg/ml vs. (73.16 ± 8.30)pg/ml], IL-6[(4.27 ± 1.07)pg/ml], hs-CRP[(219.36 ± 22.02)ng/ml vs. (266.97 ± 15.80)ng/ml] in DHXS group were significantly decreased ( P<0.05), and the expression level of p-NF-κB (0.49 ± 0.07 vs. 0.84 ± 0.12) and MCP-1 (0.44 ± 0.02 vs. 0.64 ± 0.11) in renal tissue of rats in DHXS group were significantly reduced ( P<0.05). Conclusion:Rehmanniae Radix combined with Scrophulariae Radix can protect kidney by inhibiting the over activation of NF-κB, and reducing the expression of MCP-1 related protein to reduce renal micro inflammation.