Objective To evaluate the prognostic value of enhanced CURB and CURB-65 score in patients with community acquired pneumonia.Methods A retrospective study was conducted among 555 patients with community-acquired pneumonia recruited.According to the patient's 28 day outcome, they were divided into effective group(n=510, 57 cured and 453 improved) and ineffective group(n=45, 30 did not improve and 15 died).The prognosis of the two groups was evaluated using the enhanced CURB and CURB-65 score, the sensitivity and specificity of the two scoring methods were compared.Results Compared with the ineffective group, the age, length of hospital stay and the prevalence of the complications of chronic diseases were significantly lower than the effective group(P<0.05).The score of enhanced CURB and CURB-65 of ineffective group were significantly higher than the effective group(P<0.05).The sensitivity of enhanced CURB score was significantly higher than that of CURB-65 (P<0.05) while its specificity was significantly lower than that of CURB-65(P<0.05).Conclusion The CURB and CURB-65 score in community acquired pneumonia can effectively assess the severity of the disease and thus guide the treatment of patients with community acquired pneumonia.

Objective:To investigate the effect and mechanism of G protein-coupled receptor, class C, group 5, member A (GPRC5A) on the proliferation and apoptosis of laryngeal cancer cells (LCC).Methods:From June 2015 to December 2018, 22 patients with laryngeal cancer were selected from the People's Hospital of Xinjiang Uygur Autonomous Region. Tumor tissue samples and paracancerous tissue were collected. The expression of GPRC5A in laryngeal cancer tissues and laryngeal cancer cells was detected by real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) and Western blot; pcDNA3.1-GPRC5A and control plasmid pcDNA3.1 were transfected into Hep-2 and AMC-HN-8 cells respectively. Methyl thiazolyl tetrazolium (MTT) assay was used to detect the effect of GPRC5A on the proliferation of laryngeal cancer cells; V-FITC/PI assay was used to detect the effect of GPRC5A on the apoptosis of laryngeal cancer cells; DCFH-DA was used to detect the level of reactive oxygen species (ROS) in laryngeal cancer cells; Western blot was used to detect the protein expression of vascular endothelial growth factor (VEGF), E-cadherin and vimentin in laryngeal cancer cells.Results:(1) The expression of GPRC5A in laryngeal carcinoma tissues and laryngeal carcinoma cells was lower than that in adjacent tissues and normal laryngeal epithelial cells ( P<0.05). (2) Overexpression of GPRC5A could inhibit the proliferation of laryngeal cancer cells and the expression of VEGF, E-cadherin and vimentin ( P<0.05); overexpression of GPRC5A could significantly increase the level of ROS, decrease the level of NAD + and adenosine triphosphate (ATP) ( P<0.05), increase the apoptosis rate ( P<0.05), and significantly increase the protein expression of Caspase-3 and Caspase-9 ( P<0.05). Overexpression of GPRC5A could inhibit the expression of signal transducer and activator of transcription 3/suppressor of cytokine signal transduction 3/myelocytomatosis oncogene (STAT3/SOCS3/C-MYC) pathway related proteins ( P<0.05); the expression of GPRC5A in 22 patients with laryngeal cancer were negatively correlated with STAT3 ( P<0.05). (3) STAT3 and C-MYC inhibitors significantly inhibited the expression of VEGF and E-cadherin in Hep-2 cells ( P<0.05), promoted apoptosis ( P<0.05), decreased the level of interleukin (IL)-6 in Hep-2 cells ( P<0.05), and significantly increased the level of ROS in Hep-2 cells. Conclusions:It suggests that GPRC5A inhibits proliferation and epithelial-mesenchymal transition (EMT), induces oxidative stress and apoptosis of LCC cells potentially by regulating STAT3/SOCS3/C-MYC signaling. These results provide a molecular basis for clinical treatment and diagnosis of laryngeal cancer.

Surgery is usually the first choice for patients with lung cancer,whereas the risk increases with age.A comprehensive evaluation of the patients should be applied in order to bring about the best outcome.By convention,the preoperative assessment includes neoplasm staging,cardio-respiratory function assessment, nutritional status assessment,and etc. The surgical planning includes limited resection,video-assisted thoracoscopic surgery and so on.

Objective:To investigate the effects of cetylpyridinium chloride buccal tablets(CCBT)on dental plaque control.Meth-ods:60 patients with gingivitis,mild or moderate,or chronic periodontitis were divided into control group(without drug treatment), CCBT group (treated with CCBT)and CHX group (treated with compound chlorhexidine gargle)according to the randomized con-trolled single-blind principle.Quigley-Hein plaque index (PI)and bleeding index (BI)of the subjects were recorded,tumor necro-sis factor (TNF-α)and interleukin (IL-1β)in gingival crevicular fluid (GCF)were measured by ELISA before and after 2 weeks'trial.Results:After 2-week treatment,PI and BI in CCBT and CHX groups decreased(P<0.01);TNF-αin GCF decreased(P<0.05),IL-1βcontent was not changed.The changes of PI and BI were not significant between CCBT and CHX groups(P>0.05). In control group PI was decreased(P<0.05),other measurements were not changed(P>005).Conclusion:CCBT is effective in inhibiting plaque accumulation and decreasing GCF TNF-αlevel.

Objective To study the correlation between blood glucose variability and TOAST type of patients with acute ischemic stroke and provide new evidence which can improve the prognosis of ischemic stroke.Methods One hundred and forty-three hospitalized patients with acute ischemic stroke from August 2013 to August 2014 were included.All patients were estimated about the general state of health and performed laboratory examinations and other auxiliary examinations.Then the TOAST type of all cases was classified.The 24-hour blood glucose monitoring was done to the patients to calculate the blood glucose variability.One hundred and forty-three cases were divided into blood glucose variability group ( standard deviation of glucose ( GluSD )≥1.4 mmol/L, 85 cases ) and control group ( GluSD <1.4 mmol/L, 58 cases) according to glucose variability.We estimated the neurologic impairment of the patients with the US National Institutes of Health Stroke Scale ( NIHSS) and the activities of daily living with Barthel index.The relation between blood glucose variability and the prognosis of ischemic stroke was analysed with multivariate analysis.Results Differences were significant in age, history of diabetes and NIHSS score between blood glucose variability group and control group.The degree of neurologic impairment of large artery atherosclerosis (LAA) group (moderate and severe neurologic impairment:43/53(81.0%)) and cardio-aortic embolism ( CE) group ( moderate and severe neurologic impairment:15/17 ) was more serious than that in small artery occlusion ( SAO) group ( moderate and severe neurologic impairment:6/71 ( 8.5%) ) , especially in CE group.The differences were significant (χ2 =7.043,P<0.05).Blood glucose variability in patients with LAA was more obviously than that in other patients.NIHSS score and activities of daily living of the patients estimated on admission and after 2 weeks were not different in the blood glucose variability group, but the difference was significant in control group.The poor prognosis in blood glucose variability group was 2.821 times that in control group ( 95% CI 1.880 -4.233 ).Conclusions The people sufferd ischemic stroke with old age, diabetes or severe case are more vulnerable to abnormal blood glucose variability.Abnormal blood glucose variability is an independent risk factor for acute ischemic stroke and induces difficulty to recovery and poor prognosis.

Objective To understand the epidemic situation and epidemiological characteristics of malaria in Jiangsu Prov?ince from 2005 to 2014,so as to provide the evidence for formulating and adjusting the strategies and measures on malaria elimi?nation in this province. Method The epidemiological data of malaria in Jiangsu province from 2005 to 2014 were collected, and the prevalence situation,infection sources as well as the temporal,regional and population distribution of the cases were an?alyzed. Result A total of 5 069 malaria cases were reported in Jiangsu Province form 2005 to 2014,there were 3 422 cases (67.51%)of vivax malaria,1 497 cases(29.53%)of falciparum malaria,and 150 cases(2.96%)that were unclassified. Among all the reported cases,2 139(42.20%)were local cases,1 131 were(22.31%)imported cases from other places in Chi?na ,and 1 799(35.49%)were imported cases from abroad. There were 3 809 male cases and 1 260 female cases,with a sex ratio of 3.02∶1. The patients were mainly aged from 25 to<60 years(accounting for 67.15%),and were mainly young adult farmers (40.26%)and migrant workers(23.63%),who mainly distributed(accounting for 60.58%)in Xuzhou,Suqian,Huai’an,Su?zhou and Nantong cities. The predominant malaria type from 2005 to 2009 were vivax malaria,while after 2010,it changed to falciparum malaria. Conclusions The malaria epidemic situation has been effectively controlled in Jiangsu Province,which re?flects the initiative achievements of malaria elimination. However,there are still many imported malaria cases from abroad,and the species of the Plasmodium are diverse. Therefore,the imported malaria from abroad still remains the key of malaria control in Jiangsu Province.

Objective To investigate whether the nod-like receptor (NLR) pathway is involved in protection of hydrogen sulfide (H2S) preconditioning during renal ischemia reperfusion.Methods Male Wistar rats were randomly divided into 3 groups:sham operation (Sham) group,renal ischemia/ reperfusion (I/R) group subjected to occlusion of left renal pedicle for 45 min then reperfusion for 24 hours,and sodium hydrosulfide (NaHS) preconditioning group with continuous infusion of NaHS (300 nmol/min) by left renal artery for 15 min before I/R treatment.Renal injuries were evaluated by HE staining.The protein levels of NOD1,NOD2,nuclear NF-κB P65 and caspase-1 were analyzed by Western blot assay.The protein level of MCP-1 and IL-1β expressions was determined by immunohistochemical staining assay.Cell apoptosis were evaluated by Tunel staining assay.Results In I/R group,the renal NOD1 and NOD2 protein expressions were upregulated.Moreover,the nuclear NF-κB P65 expression was also elevated with an increase in its target genes-MCP-1 and IL-1β (All P ＜ 0.01).HE staining revealed the existence of acute tubular necrosis in I/R kidney.TUNEL staining revealed more apoptotic cells in risk zone with the activation of caspase-1 of I/R-treated kidney(P ＜0.01).NaHS preconditioning reversed I/R-induced increase in the expression of NOD1 and NOD2(P ＜0.05).NaHS preconditioning also reduced I/R-induced activation of NF-κB P65 (P ＜ 0.05) and upregulation of MCP-1 and IL-1β (P ＜ 0.01).Moreover,NaHS preconditioning attenuated inflammation,repressed caspase-1 activation and reduced apoptotic cells after I/R.Conclusion Hydrogen sulfide preconditioning can alleviate renal ischemia/reperfusion injury by Nod-like receptor dependent on inflammatory pathway.

Objective To investigate the possible role of oxidative stress in the protection of hydrogen sulfide during renal ischemia reperfusion.Methods Male Wistar rats were randomly divided into 3 groups: sham operation (Sham) group, renal ischemia reperfusion (IR) group subject to occlusion of left renal pedicle for 45 min then reperfusion for 24 h, and sodium hydrosulfide (NaHS) preconditioning group with continuous infusion of NaHS (450 nmol/min) by left renal artery for 10 min before ischemia reperfusion.Renal injuries were evaluated by PAS staining.The protein levels of NADPH oxidase (NOX) 4, NOX2 were analyzed by Western blotting.The reactive oxygen species (ROS) level of renal tissue was determined by dihydroethidium (DHE) staining assay.Renal superoxide dismutase (SOD), malonic dialdehyde (MDA) and Scr, BUN were evaluated by chromatometry assay.Cell apoptosis were evaluated by TdT-mediated dUTP nick end labeling (TUNEL) staining.Results Compared with Sham group, in IR group the renal NOX4 and NOX2 protein expressions, the existence of acute tubular necrosis and ROS expression were up-regulated (all P ＜ 0.01);MDA, Scr, and BUN were increased and SOD was decreased significantly in IR-treated kidney (all P ＜ 0.01);Moreover, more apoptotic cells presented in the risk zone of IR-treated kindey (P ＜ 0.01).The effects induced by IR were inhibited by NaHS.Compared to that in IR group, NaHS precondition reversed IR-induced damages of renal function and renal tissue, increased SOD activity and decreased MDA expression (all P ＜ 0.05), as well as reduced the expression of NOX4, NOX2 and ROS (all P ＜ 0.05).Moreover, NaHS precondition reduced apoptosis after IR (P ＜ 0.05).Conclusions NaHS alleviates renal ischemia reperfusion injury through inhibiting oxidative stress.Hydrogen sulfide can decrease ROS by inhibiting the activation of NOX, further inhibit the activation of NOD-like receptor, and alleviate kidney damage.

This study was aimed to select the best preparation form of Aurea Helianthus in order to provide a scientific basis for research and development of anti-myocardial ischemia drugs.The content of effective index components of preparation of Aurea Helianthus was detected using HPLC-PDA.Acute myocardial ischemia rat model introduced by injecting pituitrin was used to investigate the effect of anti-myocardial ischemia.The quality of preparation from Aurea Helianthus was characterized based on pharmacy and efficacy.And the characterized results were given correlation analysis.The results showed that the HPLC method for quantitative determination was verified by methodology.The average recoveries were in the range of 97.04％-102.44％.All three preparations of Aurea Helianthus had the efficacy of anti-myocardial ischemia in varying degrees.The enrichment had the highest effect with lowest extraction rate and the lowest dosage,which was the best form in medicinal-preparation application of Aurea Helianthus.It was concluded that the content of related drug components was higher with unique proportion in enrichment of Aurea Helianthus which was prepared based on drug system proved a high quality medicine.Therefore,the key to the improvement of efficacy was to explore the fittest proportion and improve the content of related pharmaceutical ingredients pertinently according to drug system.

Objective To explore the association between fibrinogen gene polymorphism(rs1049636) and serum γ′ fibrinogen level and ischemic stroke (IS) .Methods 421 IS patients and 421 age‐and gender‐ matched healthy controls ,including 283 males and 138 females ,were recruited in this assay .The plasma γ′fibrinogen concentration was measured by enzyme‐linked immunosor‐bent assay (ELISA) .Fibrinogen gene polymorphism(rs1049636) were genotyped by using PCR‐LDR assay .Results γ′fibrinogen concentrations in IS patients[(159 .4 ± 97 .4)U/dL] were significantly higher than that in control group[(114 .2 ± 73 .0)U/dL] with statistically significant difference(P<0 .001) .Single nucleotide polymorphism(SNP) analysis showed that rs1049636 C allele was significantly associated withγ′fibrinogen level ,but not associated with increased risk of IS(P=0 .077) .Conclusion An associ‐ation between increasedγ′fibrinogen level and IS existed in Chinese Han population .However ,no association between rs1049636 C allele and IS risk was observed in our study .