Objective To study the correlation between the level of serum high sensitivity C-reactive protein (hs-CRP) and induced sputum cell counts,pulmonary function and asthma control test (ACT) in order to investigate the clinical application value of serum hs-CRP for the acute exacerbation bronchial asthma patients.Methods Thirty acute exacerbation bronchial asthma patients were collected as asthma group,14 healthy people during the same period were collected as control group.The fasting serum hs-CRP was examined in control group and before and after treatment of 5-7 d in asthma group.The induced sputum was obtained by ultrasonic atomizer 4.5％ sodium chloride,and the percentage of eosinophils (EOS％),neutrophil,macrophages,lymphocytes was calculated.The pulmonary function index was determined in control group and before and after treatment in asthma group.ACT score was performed in asthma group.The correlation between the serum hs-CRP and induced sputum differential leukocyte count,the pulmonary function index and ACT score was analyzed by Spearman correlation analysis.The effect of the serum hs-CRP and induced sputum EOS％ on inflammatory response of acute exacerbation bronchial asthma was evaluated by receiver operating characteristic (ROC) curve analysis.Results Two cases were excluded in asthma group.The serum hs-CRP before and after treatment in asthma group was higher than that in control group[4.18(2.12-11.12) and 3.40(2.02-8.91) mg/L vs.1.48(1.03-4.81) mg/L,H =18.939,P＜ 0.01].The serum hs-CRP before treatment was higher than that after treatment in asthma group (P ＜ 0.01).In asthma group,the serum hs-CRP had positive relationship with induced sputum EOS％ (r =0.849,P =0.000).There were negative correlations between the serum hs-CRP and the pulmonary function index such as one second forced expiratory volume percent predicted,one second forced expiratory volume occupied vital capacity ratio,maximum mid-expiratory flow percentage of predicted (r =-0.617,-0.559,-0.398,respectively,P =0.000,0.002,0.036,respectively).It was also found that the serum hs-CRP and ACT score had the remarkable Spearman linear correlation (r =-0.511,P =0.005).The area under the ROC curve of the serum hs-CRP was 0.713 (P =0.003).Conclusions There are significant correlations between the serum hs-CRP and induced sputum EOS％,pulmonary function,ACT score in the acute exacerbation bronchial asthma patients.It is found that hs-CRP could be considered as one of the potential marker to evaluate the systemic inflammation level of bronchial asthma.

Objective To assess whether end-tidal carbon dioxide partial pressure (PET CO2) can predict the fluid responsiveness in septic shock patients.Methods Septic shock patients under mechanical ventilation without spontaneous breathing and with the need of a fluid challenge test were included in this study.Heart rate,central venous pressure,pulse pressure,PErCO2,and CI before and after the fluid challenge test were conducted in all the patients.Results Of the 48 septic shock patients included,34 had preload responsiveness,14 had no responsiveness.△CI and △PET CO2 after the fluid challenge test involume responders were (0.85 ± 0.47) L · min-1 · m-2 and (3.5 ± 2.5) mmHg respectively,which were higher than those in no volume responders (P ＜ 0.05).The fluid-induced changes in PET CO2 and CI were correlated (r =0.072,P ＜ 0.05).The AUCRoc of fluid challenge-induced △PET CO2 as the predictor for volume responsiveness was 0.943,and its sensitivity was 87.9％ and specificity was 93.4％ with a critical value of 5％.The AUCRoc of △PP as the predictor for volume responsiveness was 0.801,and its sensitivity was 68.1％ and specificity was 73.2％ with a critical value of 10％.Conclusion The changes of PETCO2 induced by a fluid challenge test can predict fluid responsiveness with reliability,and have a better sensitivity and specificity than the changes of PP.

Objective To explore the role and mechanisms of ω-3 polyunsaturated fatty acids (ω-3PUFA) alone or in combination with dexamethasone ( DEX) in inducing cell apoptosis and anti -proliferation in multiple myeloma(MM).Methods DEX resistance MM cell line MM1R were treated with different concentra-tions of Eicosapentaenoic acid(EPA)or Docosahexaenoic acid(DHA)alone or in combination with DEX for 24hrs or 48hrs.Cell proliferation was detected by MTT .Cell cycle and apoptosis were measured by flow cytometry .The levels of apoptosis related proteins were analyzed by Western blot .Results The proliferation of MM1R was in-hibited by different concentrations (10,20,50,100μM)of EPA or DHA alone or in combination with 10μM DEX in a dose-and time-dependent manner .Inhibition effect was significantly higher in combinative groups than in single agent groups(P<0.05).The percentage of G0/G1 phase and cell apoptosis rate in MM1R treated with dif-ferent concentrations of EPA or DHA alone was increased in a dose -dependent manner ,and being significantly higher in combinative groups than in single agent groups (P<0.05).The expressive levels of cleaved caspase -3 and Bax were up-regulated ,while pro-caspase-3 and BCL-2 were down-regulated in a dose-dependent manner.Conclusion ω-3PUFA can inhibit DEX resistant MM cell proliferation ,arrest cell cycle and induce cell apoptosis ,and has a synergistic anti -resistant effect in combination with DEX ,may serve as a new ,effective MM drugs.

OBJECTIVE To investigate the effect and mechanism of low concentrations of p,p′-dichlorodiphenyltrichloroethane (p,p′-DDT) on colorectal adenocarcinoma SW620 cell proliferation and apoptosis. METHODS SW620 cells were exposed to low concentrations of p, p′-DDT ranging from 1×10-12 to 1×10-6 mol.L-1 for 48 and 96 h. MTT assay was employed to examine the effect of p,p′-DDT on SW620 cell viability. Different cell stages of cycle and apoptosis rate were determined by flow cytometry after SW620 cells were exposed to 1×10-10 , 1×10-9 and 1×10-8 mol.L-1 for 96 h. Western blotting was used to determine the protein expression of Wnt/ β-catenin signaling components 〔β-catenin, phospho-β-catenin and phospho-glycogen synthase kinase ( GSK) 3β〕, their downstream target proteins ( c-Myc and cyclin D1)and apoptosis related proteins (Bcl-2, Bax, procaspase 8 and procaspase 3). RESULTS The viability of colorectal adenocarcinoma SW620 cells was significantly increased after exposure to low concentrations of p,p′-DDT ranging from 1×10-12 to 1×10-7 mol.L-1 for 96 h. p,p′-DDT 1×10-10 , 1×10-9 and 1×10-8 mol.L-1 exposure led to a decreased percentage of SW620 cells in G1 stage(P<0.01) along with an increased percentage of cells in S stage(P<0.01). Meanwhile, the apoptosis rate was signifi-cantly decreased compared with control group ( P < 0. 01). Exposure to p, p′-DDT from 1 × 10-10 to 1×10-8 mol.L-1 induced upregulation of phospho-GSK3β ( Ser9), β-catenin, c-Myc and cyclin D1 in SW620 cells( P <0.01). Moreover, apoptosis related proteins Bcl-2, procaspase 8 and procaspase 3 were unregulated(P<0.01), and Bax level and caspase 3 activity were decreased in p,p′-DDT-stimulated cells(P < 0.01). CONCLUSION Low concentrations of p, p′-DDT exposure activates Wnt/ β-catenin signaling and affects apoptosis-related proteins, which may be involved in p,p′-DDT-induced cell prolifer-ation as well as suppression of cell apoptosis in SW620 cells.

ATP binding cassette C4(ABCC4,MRP4)plays an important role in transshipment physio-logic,endogenous or exogenous substances. The over expression of ABCC4 gene has been found in many kinds of solid tumors and hematological malignancies. The target gene also influences metastasis and recurrence process. ABCC4 can reduce the intracellular concentration and the sensitivity of various chemotherapy drugs, which is bad for prognosis.

Objective:To investigate the clinical significance of dynamic analysis of plasma brain natriuretic peptide in patients with dilated cardiomyopathy with chronic heart failure.Methods:Ninety patients with dilated cardiomyopathy with chronic heart failure admitted into our hospital firom March 2012 to March 2016 were divided into group A (20 cases),group B (38 cases),and group C (32 cases) according to the NYHA grading.The plasma BNP levels and LVEF,LA,LVEDD,and LVESD in the three groups were detected and compared.The correlation of plasma BNP and cardiac function and ultrasonic cardiogram indexes were analyzed.And the capability of plasma BNP and LVEF in diagnosis of patients were analyzed and compared.Results:The plasma BNP level in group C was markedly higher than that of group A and group B (P＜0.05),and that in group B was much higher than that of group A (P＜0.05).And LA in group C was significantly higher than that of group A (P＜0.05),while differences in LVEF,LVEDD,and LVESD were not obvious (P＞0.05).The plasma BNP was positively correlated to NYHA grading,but had no significant correlation with the LVEF,LVEDD,LVESD,and LA (P＞0.05).Based on results of receiver operating characteristic curve analysis,plasma BNP =523.5 pg/mL was the threshold value for identification of patients with NYHA Ⅲ and Ⅳ (AUC=0.901,P＜0.001),while LVEF had not the capability (AUC=0.392,P=0.276).Conclusion:Detection of plasma BNP level had important clinical significance on diagnosis,screening and cardiac functional grading of patients with dilated cardiomyopathy with chronic heart failure.

Immunosuppressive tumor microenvironment is a part of the tumor microenvironment that plays an immunosuppressive function.It consists of suppressor cells and inhibitory cytokines.In recent years,be-cause of its important role in tumor immunity,CAR-T and PD-1/PD-L1 signal pathway has become a hot top-ic of immunotherapy, which can suppress immune through different mechanisms to promote tumor progression. Therefore,taking more effective anti-tumor therapies against the above mechanisms is possible to rescue the pro-gress of tumor.In this article,the influence of immunosuppression microenvironment in CAR-T cell therapy and PD-1/PD-L1 signaling pathway in the anti-tumor process is reviewed.

Objective To investigate the expression of PCNA in gastric cancer and its relationship with telomerase activity of peritoneal washings and peritoneal dissemination, and to compare the efficacy of telomerase activity and cytology of peritoneal washings for prediction of peritoneal metastasis of gastric cancer. Methods Telomeric repeated amplification protocol (TRAP)-enzyme-linked immunosorbent assay (ELISA) was performed to measure the telomerase activity of peritoneal washings collected from 60 patients with gastric cancer. Exfoliate cytologic analysis of the corresponding samples was used for comparison.Expression of PCNA was measured with immunohistochemical staining.Their relationship with clinicopathologic features were evaluated. Results The positive rate of telomerase activity in peritoneal washing collected from patients with gastric cancer was 41.7%,which well related to serosal invasion, histology types, depth of infiltration and peritoneal metastasis of gastric cancer. The positive rate of telomerase activity increased with the increased depth of infiltration and serosal involvement areas (P

Objective To investigate the clinical,histopathological and dermoscopic features as well as treatment and prognosis of cicatricial alopecia.Methods Clinical data on 53 patients with cicatricial alopecia were retrospectively collected and studied.Pathological and dermoscopic characteristics,as well as treatment modality and prognosis of cicatricial alopecia were analyzed.Results Cicatricial alopecia was characterized by alopecia,disappearance of follicular ostia,and absence or decrease in the number of polisebaceous gland units.Pathologically,focal liquefactive degeneration of basal cells,follicular keratotic plugs,arborising telangiectasia together with a positive immunofluorescence test were usually suggestive of discoid lupus erythematosus,interface dermatitis suggestive of lichen planopilaris,inflammation and mild disruption of elastic fibers suggestive of classic pseudopelade of Brocq.Mucin deposition between hair follicles and sinking of follicular ostia were pathological and dermoscopic characteristics of alopecia mucinosa.Pustules could be visible in both folliculitis decalvans and dissecting cellulitis/folliculitis,with tufted hairs usually seen in the former,and sinus formation in the later.Lymphocytic disorders were treated with immunosuppressors,and neutrophile disorders with antibiotics and retinoids.Conclusions Histopathological examination plays a determinant role in the diagnosis of cicatricial alopecia,which can cause irreducible damage to hair follicles,and require long term treatment.Early diagnosis and appropriate use of drugs may control the development of cicatricial alopecia,and reduce the occurrence of permanent hair loss.

ObjectiveTo assess the relationship of filaggrin expression with atopic diathesis and disease severity in patients with alopecia areata (AA).MethodsThirty-seven patients with AA aged (26.3 ± 10.6) years were enrolled in this study.Atopic diseases were noted in 8 of these patients.Clinical data and laboratory test resuhs were reviewed.Immunohistochemical staining was performed to quantify the expression of filaggrin protein in scalp biopsy specimens from all of the 37 patients with AA and from 10 human controls,and fluorescence-based semiquantitative reverse transcription-PCR to detect the expression of filaggrin mRNA in scalp biopsy specimens from 22 patients with AA and 13 healthy controls.Data were statistically analyzed by Mann Whitney U test,chi-square test,and Spearman's rank correlation test.ResultsThe expressions of filaggrin protein and mRNA were significantly lower in patients with AA than in the controls(P ＜ 0.05 or 0.01 ),and the decrease seemed more obvious in patients with large areas of lesions,long duration of disease,and nail abnormalities,but the degree of decrease was unrelated to the complication with atopic diseases.No significant differences were observed in sex ratio,age at onset,disease duration,area of hair loss,the prevalence of family history or incidence of nail abnormalities and increase in serum IgE and eosinophils,between patients with atopic diseases and those without.ConclusionsThe expressions of filaggrin protein and mRNA are decreased in patients with AA,suggesting that filaggrin may participate in the development of AA and is correlated with the severity of AA.