Objective:To explore the correlation between lymph node metastasis rate and prognosis in non-small cell lung cancer (NSCLC) patients with stage Ⅲ A/N 2. Methods:The clinical data of 350 NSCLC patients with stage Ⅲ A/N 2 receiving surgical treatment from January 2012 to June 2015 in Shanxi Provincial Cancer Hospital were retrospectively analyzed. The patients were divided into the high lymph node metastasis rate group and the low lymph node metastasis rate group according to the optimal cutoff value of lymph node metastasis rate determined by Cox hazard regression model. The relationship between clinicopathological features and lymph node metastasis rate was analyzed. Prognostic risk factors were analyzed by using Cox regression model, and overall survival (OS) and disease-free survival (DFS) of both groups were analyzed by using Kaplan-Meier method. Results:The optimal cutoff value of lymph node metastasis rate was 0.2. There were 180 cases with high lymph node metastasis rate (>0.2) and 170 cases with low lymph node metastasis rate (≤0.2). The proportion of the patients with adenocarcinoma and the highest lymph node metastasis in the high lymph node metastasis rate group was higher than that in the low lymph node metastasis rate group [72.2% (130/180) vs. 52.9% (90/170), 52.8% (95/180) vs. 29.4% (50/170), all P<0.05]. The proportion of patients with jumping N 2 lymph node metastasis, single station N 2 lymph node metastasis and single station N 2 lymph node metastasis in the highest group was lower than that in the low lymph node metastasis rate group [51.1% (92/180) vs. 71.8% (122/170), 25.0% (45/180) vs. 44.1% (75/170), 38.9% (70/180) vs. 75.3% (128/175), all P<0.05]. Cox multi-factor regression model analysis showed that adenocarcinoma, multiple stations N 2 lymph node metastasis, lymph node metastasis rate were independent risk factors of DFS for NSCLC patients with stage Ⅲ A/N 2 ( HR = 2.201, 95% CI 1.444-3.355; HR=2.971,95% CI 1.950-4.529; HR=3.543, 95% CI 1.874-6.699; all P<0.05). Lymph node metastasis rate was an independent risk factor of OS for NSCLC patients with stage Ⅲ A/N 2 ( HR = 3.669, 95% CI 1.941-6.938, P<0.05). The 5-year OS rate of the low lymph node metastasis rate group was higher than that of the high lymph node metastasis rate group (64.00% vs. 36.58%, χ2 = 11.422, P = 0.001). The 5-year DFS rate in the low lymph node metastasis rate group was higher than that in the high lymph node metastasis rate group (45.00% vs.18.32%, χ2 = 13.624, P<0.01). Conclusion:Lymph node metastasis rate is an independent influencing factor for the prognosis of NSCLC patients with Ⅲ A/N 2 stage, and it can effectively evaluate the prognosis.

It is difficult to select the appropriate ventilation mode in clinical mechanical ventilation. This paper presents a nonlinear multi-compartment lung model to solve the difficulty. The purpose is to optimize respiratory airflow patterns and get the minimum of the work of inspiratory phrase and lung volume acceleration, minimum of the elastic potential energy and rapidity of airflow rate changes of expiratory phrase. Sigmoidal function is used to smooth the respiratory function of nonlinear equations. The equations are established to solve nonlinear boundary conditions BVP, and finally the problem was solved with gradient descent method. Experimental results showed that lung volume and the rate of airflow after optimization had good sensitivity and convergence speed. The results provide a theoretical basis for the development of multivariable controller monitoring critically ill mechanically ventilated patients.
Exhalation ; Humans ; Lung ; physiology ; Models, Biological ; Nonlinear Dynamics ; Pulmonary Ventilation ; Respiration ; Respiration, Artificial ; Tidal Volume

PurposeTo study the pharmacokinetic characteristics of omeprazole in Chinese extensive and poor metabolizers.Methods The pharmacokinetics of omeprazole was studied in eighteen healthy volunteers. After a single oral dose of omeprazole capsule(40 mg), the plasma concentrations of omeprazole and its two metabolites, 5-hydroxyomeprazole and omeprazole sulfone, were determined with reversed HPLC method. The plasma concentration-time data were analyzed to estimate the pharmacokinetic parameters. Results Both plasma omeprazole concentration and the pharmacokinetic parameters exhibited marked interindividual variation. The metabolic ratio (MR= plasma omeprazole/5-hydroxyomeprazole) obtained 3.5 h after medication was used to distinguish between extensive and pcr)r metabolizers (EMs, PMs). The variances of AUC(0-12) caused by the two metabolizer phenotypes accounted for 75.4 % of the total interindividual variances. AUC(0-12) of omeprazole was (1 971.78 ±1 221.78)ng·h/ml in EMs( n=12) and (8 587.18±2 855.48) ng·h/ml in PMs (n = 6),respectively (P<0.01),and CL in EMs and PMs was estimated as (16.00±9.71) and (4.79±1.32) L/h (P<0.01). Accordingly,significantly lower level of plasma 5-hyclroxyomeprazole was found in PMs, revealing a slower hydroxylation rate compared with EMs. Conclusions The results suggest that individualized dose regimen of omeprazole, based on identification of metabolizer phenotype, can be of great benefit from the viewpoint of pharmacoeconomics.

Bilingual teaching is a challenge to university.Biochemistry Department of Guilin Medical College made research on relationship between bilingual teaching and professional courses learning,restrictive factors of bilingual teaching and how to further bilingual teaching,and so on.Training teachers,exploring teaching methods and establishing rational evaluation system are most important for bilingual teaching nowadays.

Objective To investigate the changes and roles of hypoxia inducible factor 1?(HIF 1?) expression in myocardial tissues in rats following severe scald. Methods Male Wistar rats inflicted with 40% TBSA Ⅲ degree scald were used as animal models. HIF 1? protein in myocardial tissues was detected by Western blot and immunohistochemical technique. Results HIF 1? protein expression in rat myocardial tissues increased significantly in the early stage following scald. The difference in HIF 1? level between the left and right ventricles was significant. The increased HIF 1? protein was mainly located in the nucleus. Conclusion HIF 1? protein expression in myocardial tissues of rats can be induced by severe scald and HIF 1? protein expression in the left ventricle is significantly higher than that in the right ventricle. The increased HIF 1? protein in the nucleus can induce downstream cytokine expression.

ObjectiveTo examine the effect of Xuebijing Injection on the number of T lymphocytes and Toll-like receptors as adjuvant therapy of severe abdominal infections.MethodsA total of 78 patients with severe abdominal infection who were hospitalized in the intensive care unit were divided into control group and treatment group. The patients in control group received conventional therapy alone, while the patients in treatment group received Xuebijing Injection (50 mL twice daily for 2 weeks) in addition to conventional therapy. Blood sample was drawn before and after 2-week treatment to determine T lymphocytes. The peripheral blood mononuclear cells were separated to determine the expression of Toll-like receptors (TLR) 2 and TLR4. The Acute Physiology and Chronic Health Evaluation (APACHE) II score and gastrointestinal function score were recorded before and after treatment.ResultsThe levels of CD3+, CD4+ and CD4+/CD8+ of peripheral blood in the Xuebijing-treated patients were signiifcantly higher than those in control group (P<0.01), but the levels of CD8+ was signiifcantly lower than that in control group (P<0.01). The levels of TLR2 and TLR4 mRNA of the peripheral blood mononuclear cells in the treatment group were signiifcantly lower than those in control group (P<0.01). The APACHE II score and gastrointestinal function score in treatment group were signiifcantly lower than those in control group (P<0.01).ConclusionXuebijing Injection as adjuvant therapy of severe abdominal infection can improve the number of T lymphocytes, and reduce the expression of Toll-like receptors.

To evaluate the effect of delayed treatment with monoclonal antibody to tumor necrosis factor-alpha (TNF-? MAb) on systemic hemodynamics and multiple organ dysfunction following prolonged hemorrhagic shock and resuscitation. Method: Adult male Sprague-Dawley rats were subjected to prolonged hemorrhagic shock (MAP of 4.00-4.66 kPa for 180 rain)followed by resuscitation over 50 min. The animals were treated intravenously with either TNF-? MAb (20.0 mg/kg) or the control protein(albumin,20.0 mg/kg)15 rain after the end of resuscitation(65 min after shock). Result: Compared to the albumin controls, delayed treatment with TNF-? MAh significantly reduced the total peripheral resistance index (P

Objective To investigate the relationship between activation of Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway and multiple organ dysfunction in rats with sepsis. Methods Using a sepsis model produced by cecal ligation and puncture (CLP), 98 male Wistar rats were randomly divided into normal control group (n=10), CLP group (n=40), AG490 (JAK2 inhibitor) treatment group (n=24) and rapamycin (RPM, STAT3 inhibitor) treatment group (n=24). At serial time points, the animals in each group were sacrificed, then tissue samples from the liver, lungs, kidneys and small intestine were harvested to detect STAT1/3 activity, pulmonary myeloperoxidase (MPO) and small intestinal diamine oxidase (DAO) activities. Meanwhile, organ function parameters including serum aspartate transaminase (AST) and blood urea nitrogen (BUN) contents were also measured. Results At 2 hours after CLP, STAT1 activities were found to be enhanced rapidly in the liver, lungs and small intestine, peaking at 6-24 hours, but their increase was delayed in the kidneys. Compared with STAT1, STAT3 activities were weaker and detected only in the liver and lungs, with no detectable STAT3 in the small intestine and kidneys. Pretreatment with either AG490 or RPM significantly lowered STAT1 activities in the liver, lungs and small intestine as well as STAT3 activities in the liver and lungs (P0.05). Conclusions These data suggest that abdominal infection can result in intensive activation of STAT1 and STAT3 in vital organs, and they play important roles in the pathogenesis of sepsis. Inhibition of JAK/STAT pathway can attenuate multiple organ dysfunction secondary to CLP-induced sepsis in rats.

Objective To investigate the effects of inhibition of nuclear factor-kappa B (NF-?B) by pyrrolidine dithiocarbamate (PDTC) on tissue pro- and anti-inflammatory cytokine expression in rats with postburn Staphylococcus aureus sepsis and its potential regulating mechanism. Methods Thirty-four male Wistar rats were randomly divided into normal control group (n=6), scald control group (n=6), postburn sepsis group (n=12),and PDTC treatment group (n=10). Tissue samples from the liver, kidneys and lungs were collected to determine tumor necrosis factor-? (TNF-?) and interleukin-10 (IL-10) mRNA expression as well as their protein levels. Results Both TNF-? mRNA and protein expressions in the liver, kidneys and lungs of postburn septic animals were up-regulated rapidly at 0.5-2 hours (P

Objective To compare the clinical effects of palliative drainage to pancreatic and periampullary carcinoma which could not be excised with the operation.Methotis A retrospective study was accomplished on the palliative drainage treatment of 68 patients with pancreatic and petiampullary carcinoma hospitalized from 1996 to 2003.Results The disease course was two days to eight months.A definite preoperative diagnosis was made for 64 cases.Among them.single test diagnosed 24 cases and multiple tests diagnosed 40 cases.56 patients suffered from jaundice before operation.34 patients were treated by Roux-Y choledochojejunostomy.Choledochoduodenostomy was performed in 16 patients,cholecystduodenostomy for biliary by pass Was performed in 8 patients and stented internal drainage of the biliary duct in the liver and duodenostomy was performed in 10 patients.After reducing jaundice,12 patients was performed surgical resection.The second operation was performed in 4 patients because of postoperative jaundice and in 3 patients because of pylofic obstruction.The pefioperative compllcations include 4 cases of jaundice pyloric,3 cases of obstruction,2 cases of postoperative bleeding and 5 cases of infection of incisional wound.The aver-age stay in hospital waa 13.3 days(8～22 days).Conclusion Multiple tests were helpful to make a definite preoper-ative diagnosis.The selection of palliative drainage method based on the condition of patients had good curative effect in clinic.Surgocal exploration and reducing jaundice could set win conditions for second operation.