Objective To study the characteristics and prognostic analysis of 83 cases of pulmonary infection in elderly patients in emergency department.Methods Thirty-eight elderly patients with pulmonary infection from January 2013 to December 2015 in our hospital were retrospectively analyzed.Results The number of neutrophils increased in 56 patients(67.46%), the neutrophil-lymphocyte ratio increased in 69 patients(83.13%), and C-reactive protein increased in 74 patients increased(89.16 %).There was significant difference between C-reactive protein detection and neutrophil count(P<0.05).61 cases(73.49%) were complicated with other diseases.While the effect of a single antibiotic treatment is less effective.Conclusion The early symptoms of pulmonary infection in the elderly are easy to ignore, and often associated with other diseases.C-reactive protein, neutrophil-lymphocyte ratio combined with lung imaging can be more accurate response to the elderly pulmonary infection.Early detection and early treatment, combined use of antibiotics can improve the prognosis.

Objective To investigate the proper inner control genes suitable for mRNA expression level comparison of aging rat tissues.Methods Real-time reverse transcription PCR was used to examine in aging rat tissues the expression level of G3pd(glyceraldehyde-3-phosphate dehydrogenase),ACTB(?-actin),H3f3b(H3 histone,family 3B),Arbp(acidic ribosomal phosphoprotein P0)and 18S(18S ribosomal RNA).Results The most stably expressed housekeeping gene in aging rat kidney was ACTB,in heart and lung G3pd showed the minimum variation;Arbp expression was the most stable one in different tissues.Conclusion For aging rat intra-tissue mRNA normalization at least two housekeeping genes should be used: one is the ribosomal RNA gene 18S and another one is Arbp.

This review analyzed the effect of folic acid on pemetrexed efficacy and toxicity, especially high-does folic acid supplementation. The optimal duration for supplementation prior to the first dose of pemetrexed has not been defined. The review also explored whether total plasma homocysteine levels can be as a marker to predict and avoid toxicity from pemetrexed therapy.

Objective To describe the clinical characteristics,CD4+ and CD8+ T cell counts as well as human immunodeficiency virus (HIV) RNA of acute HIV infection in men who have sex with men,and their correlations with the disease progression.Methods One hundred cases of acute HIV infection were followed up.Nuclear acid sequence-based amplification (NASBA) was used for plasma HIV RNA screening.Flow cytometry was served to test the CD4+ and CD8+ T cell counts.Hepatitis B surface antigen (HBsAg) and anti-hepatits C virus (HCV) antibody were detected using enzyme-linked immunosorbent assay.Rapid plasma reagin was applied to screen for Treponema pallidum antibody.Antibody positive specimens were tested with Treponema pallidum particle assay for validation.The positive results were identified as infection.Results Ninety-six cases were aged between 20 and 50 years old.Among 100 cases,9 were HBsAg-positive; 4 were anti-HCV positive; 40 were co-infected with syphilis.During the follow-up period,the median CD4+ T cell counts in the 1st and 3rd month were 510/μL and 499/μL,respectively.The median HIV RNA in 1st,3rd,6th and 24th month were 4.37,4.00,4.31 and 4.43 lg copy/mL,respectively.CD8+ T cell counts did not show significant change during the study.Among 38 rapid progressors,the initial mean CD4+ T cell counts was (358.0± 134.6)/μL,which was significantly lower than that of the non-rapid progressors with a mean CD4+ T cell counts of (559.2±203.4)/μL.Meanwhile,the initial mean HIV RNA of the rapid progressors was 4.71 lg copy/ mL,while that of the non rapid progressor was 4.18 lg copy/mL.The initial CD8+ T cell counts of the rapid progressors and non rapid progressors were 1 250.1/μL and 1 247.2/μL,respectively.Conclusions Acute HIV-1 infected men who have sex with men tend to be young.The initial CD4+ T cell counts and HIV RNA during acute infection could be used to predict the disease progress.

Humans ; Lung ; Lung Diseases ; rehabilitation ; Pneumoconiosis ; rehabilitation ; Respiratory Therapy

AIM: To investigate the changes of bcl-2, bax expression and neuron apoptosis of cerebral cortex in lymphostatic encephalopathy of rats. METHODS: The model of lymphostatic encephalopathy was established by occluding and removing both the shallow and deep cervical lymph nodes in rats. The animals were sacrificed at 1, 2, 3, 5, 7 and 14 days after operation. HE staining was used to observe the structure of brain tissues and TUNEL staining was used to detect in situ cell apoptosis. The expressions of bcl-2 and bax were examined by RT-PCR. RESULTS: Cerebroedema appeared at the second day and was the most serious at the 5th day after blockage of cervical lymphatics. The number of TUNEL positive cells and the expression of bax began to increase at the 2nd day, reached a peak at the 5th day and dropped to control level at the 14th day. The expression of bcl-2 began to increase at the 1st day, reached a peak at the 5th day and dropped to control level at the 7th day. The increasing extent of bax was higher than that of bcl-2. CONCLUSION: The blockage of cervical lymphatics can lead to lymp[JP2]hostatic encephalopathy. Apoptosis is the main form of neuron death in the cortex and has relation to the increasing expression of bcl-2 and bax. [JP]

Objective:To explore the significance of the clinical target volume (CTV) dose optimization in the upper and middle neck in protecting the laryngopharynx, anterior and posterior rings during intensity-modulated radiotherapy (IMRT) and multimodal imaging system for nasopharyngeal carcinoma.Methods:Clinical data of 298 nasopharyngeal carcinoma patients admitted to Jiangsu Cancer Hospital from 2016 to 2018 were retrospectively analyzed. According to the following five strategies of CTV dose optimization in the upper and middle neck: group A, complete optimization of bilateral cervical lymph nodes (CLNs), that is, the CTV doses of bilateral CLNs were 50.4 Gy; group B, complete optimization of unilateral CLNs, that is, the CTV dose of unilateral CLNs was 50.4 Gy and the contralateral CLNs was 60 Gy; group C, incomplete optimization of bilateral CLNs, that is, the CTV doses of bilateral CLNs were 50.4 Gy, while the suspicious positive CLNs were selectively boosted to 60 Gy; group D, incomplete optimization of unilateral CLNs, that is, the CTV dose of unilateral CLNs was 50.4 Gy and the suspicious positive CLNs were selectively boosted to 60 Gy, and the CTV dose of contralateral side was 60 Gy; group E: no optimization, that is, the CTV doses of bilateral CLNs were 60 Gy.Results:Among 298 patients, 215 patients received dose optimization and 83 cases did not receive dose optimization. In the dose optimization schemes, 114 cases were assigned in group A, 36 cases in group B, 60 cases in group C and 5 cases in group D. The median (range) follow-up time was 28.5(6.0-46.3) months. The overall survival rate was 95.6%, the progression-free survival rate was 84.2% and the locoregional control rate of CLNs was 98.0%. Local relapse of CLNs occurred in six patients, including 1 case of retropharyngeal lymph node, 4 cases of Ⅱ area and 1 case of Ⅳ area. The P values of average dose of laryngopharynx in group A, group B, group C and group D compared with that in group E were<0.001, 0.016, 0.001 and 0.572, respectively. The P values of the average dose of the anterior ring in group A, group B, group C and group D compared with that in group E were<0.001, 0.011, <0.001 and 0.805, respectively. The P values of the average dose of the posterior ring in group A, group B, group C and group D compared with that in group E were<0.001, 0.004, <0.001 and 0.252, respectively.Conclusions:Combined with the metastatic rules of CLNs and multimodal imaging system, it is safe to optimize the CTV dose of the upper and middle neck during IMRT in nasopharyngeal carcinoma patients, which can significantly reduce the doses of laryngopharynx, anterior and posterior rings, thereby providing evidence for reducing the CTV dose in the upper and middle neck.

Objective To investigate the clinical significance of combined detection of serum CEA, SCC, CYFRA21-1 before and after radiotherapy in esophagus carcinoma. Methods 226 cases of esophagus carcinoma patient were collected from November, 2006 to December, 2008. ELISA was used to detect the serum CEA, SCC and CYFRA21-1 of patients with esophagus cancer before and after radiotherapy. SPSS13.0 was used for the statistical analysis. Results The positive rate of CEA, SCC and CYFRA21-1 was 11.1 %, 16.8%, 27.4 %, respectively and the combined positive rate was 39.8 % from 226 patient serums before radiotherapy. The longer the lesion length, the later the clinical stage,the deeper the tumor invasion, the higher the mean value of serum CEA, SCC, CYFRA21-1 was. The mean value was lower in the early stage. The mean value of CEA, SCC and CYFRA21-1 was found to be well correlated with tumor size, TNM stage and depth of tumor invasion. Among three tumor biomarkers, the individual difference of CEA and CYFRA21-1 was bigger and the pathological stage and prognosis correlation with CYFRA21-1 was the best. The biomarker value dropped to the level below the normal in 76.7% patient out of 90 cases after radiotherapy. Conclusion The combined detection of serum CEA, SCC, CYFRA21-1 may be used as adjuvant diagnosis for esophagus cancer and has better clinical value for prediction to treatment and prognosis.

Objective To evaluate effects of acitretin and interferon?α(INF?α)alone or in combination on the proliferative activity of and interleukin?15 expression in human cutaneous T?cell lymphoma Hut78 cells. Methods Cultured Hut78 cells were divided into several groups, including blank control group, negative control group, dimethyl sulphoxide (DMSO) group and experimental groups. Cells in experimental groups were additionally classified into several subgroups to be treated with acitretin(0.1-10μmol/L, acitretin groups)or INF?α(5 000-20 000 IU/ml, INF?αgroups) alone, or the combination of 1.0 μmol/L acitretin and IFN?α at concentrations of 5 000- 20 000 IU/ml (combination groups), for 24, 48 and 72 hours. Subsequently, cell counting kit 8(CCK8)assay was performed to assess the proliferative activity of Hut78 cells, and enzyme?linked immunosorbent assay(ELISA)to measure the expression of IL?15 in these cells. Results The proliferative activity of and IL?15 expression in Hut78 cells were both obviously suppressed in the acitretin groups and combination groups compared with the DMSO group, as well as in the INF?αgroups compared with the negative control group, and the inhibitory effects gradually increased with the increase in acitretin or INF?αconcentrations and treatment durations. As repeated measures analysis of variance revealed, there was a significant difference in both proliferation inhibition rates and IL?15 expression among different treatment durations and among different concentrations of acitretin or INF?α(all P<0.05), and there was an interaction effect between treatment durations and drug concentrations(all P<0.05). A significant difference was observed in both proliferation inhibition rates and IL?15 expression at 24, 48 and 72 hours when the 1.0?μmol/L acitretin+ 10 000/20 000?IU/ml IFN?αgroup was compared with the 1.0?μmol/L acitretin group and 10 000/20 000 IU/ml IFN?αgroup(all P<0.05). There was also a significant difference in IL?15 expression at 24, 48 and 72 hours between the 1.0?μmol/L acitretin+50 000?IU/ml IFN?αgroup and 5 000?IU/ml IFN?αgroup(all P<0.05). Conclusions Acitretin and IFN?αboth can inhibit the proliferation of and IL?15 expression in Hut78 cells, the inhibitory effects are enhanced with the increase in drug concentrations and treatment durations, and the combination of acitretin and IFN?α appears to have stronger inhibitory effects than acitretin or IFN?αalone.

Objective To evaluate the diagnostic value of thick-slab single-shot turbo spin-echo (SSTSE)T2 ?-weighted sequence in magnetic resonance fetography (MRF)for fetal abnormalities.Methods 328 of 1 990 pregnant women with the diagnosis of fetal congenital defects on prenatal ultrasound screening or chromosome examination were randomly selected,and 338 fetuses were ob-tained.These fetuses were scanned by conventional magnetic resonance imaging (MRI)and MRF.The diagnostic results from the two MR methods were compared.Results Six hundred and twenty-four lesions were detected by MRF.The primary diagnosis based on conventional MRI was changed for 14 lesions (2.2%).New findings were identified for 48 fetal lesions (8.4%)and 66 ma-ternal lesions.However,78 fetal lesions could not to be identified by MRF.MRF could increase the diagnostic confidence for fetal lesions with high water content (56.1% of the lesions).Conclusion MRF can yield more precise information for fetal extremities, fluid-filled cavities,pathological hydrops and cystic lesions.As an additional aid to the conventional multi-slice T2-weighted se-quence.