Objective To investigate the role of NF-κB activation in the inflammatory mechanism of chronic obstructive pulmonary disease (COPD).Methods Monocyte were collected from patients with COPD and were cultured,and stimulated with lipopolysaccharide (LPS) ; NF-κB p65 activation was measured by immunohistochemistry; SOD ,MDA and IL-8 and lung function were determined synchronously.Results The NF-κB p65 was induced by LPS in monocyte in all subjects, but it was most markedly done in COPD patients with exacerbateions; There was positive correlation between the NF-κB p65 activation of monocytes and levels of IL-8 and MDA in circulation, but it was negative correlation to SOD.Conclusion NF-κB plays a vital role in regulating product of IL-8 in monocyte in COPD.

BACKGROUND:Injection of isoproterenol is known to induce proliferation and hypertrophy of acinar cells in rodent salivary glands. However, the clonal proliferation ability of stem/progenitor cells of salivary glands by isoproterenol remains unclear.
OBJECTIVE:To study the proliferation and activation ability of stem/progenitor cells of submandibular gland with colony assay by intraperitoneal injection of isoproterenol.
METHODS:Sprague-Dawley rats were randomly divided into two groups, isoproterenol and control groups, respectively intraperitonal y injected with isoproterenol and normal saline for 5 consecutive days. The gland tissues were harvested, and the stem/progenitor cells of submandibular gland were obtained by enzyme digestion in vitro. The number of clonal colonies of each group was analyzed. The larger colony cells were col ected for immunohistochemistry staining with CD90.1, laminin andα6β1.
RESULTS AND CONCLUSION:The number of middle and low proliferative potential colony-forming cells was less but high proliferative potential colony forming cells were significantly more in isoproterenol group compared with control group (P<0.05). However, there was no significant difference in the total number of the colonies between two groups (P>0.05). The high proliferative potential colony forming cells were positive for CD90.1, laminin andα6β1. Results showed that isoproterenol treatment model cannot increase the cellnumber, but enhance the proliferation ability of stem/progenitor cells from the submandibular gland.

Objective To establish a scald-induced pain model using a constant-temperature electrical scald instrument in rats.Methods Thirty-six pathogen-free male Sprague-Dawley rats, weighing 200-250 g, were randomly divided into 4 groups (n =9 each) using a random number table: control group (group C), scald for 5 s group (group S5), scald for 10 s group (group S10), and scald for 15 s group (group S15).The rats were anesthetized with intraperitoneal chloral hydrate.In S5, S10 and S15 groups, the plantar surface of the left hindpaw of rats were exposed to a constant-temperature electrical scald instrument (85 ℃) for 5, 10 and 15 s, respectively.The plantar surface of the left hindpaw of rats was exposed to an electrical scald instrument (room temperature) for 10 s in group C.At 1 day before treatment (T0),and 1, 3, 5, 7 and 14 days after treatment (T1-5), the mechanical and thermal pain thresholds were measured.Immediately after treatment, and at 24 h after treatment, the total body condition, wound color, and shape of the margin of the wound were observed and recorded.At 24 h after treatment, 3 rats were randomly sacrificed, and the skin from the plantar surface of the left hindpaw was removed for microscopic examination.Results Compared with group C, the thermal pain threshold at T1-2, and the mechanical pain threshold at T1-3 were significantly decreased in group S5, and the thermal pain threshold,and mechanical pain threshold were significantly decreased at T1-4 in group S10 (P＜0.05).The thermal pain threshold ＞ 25 s, and the mechanical pain threshold ＞30 g at T1-5 in group S15.The swelling in foot was bovious, burn blister appeared, and the degree of damage was aggravated in group S10 compared with S5 and S15 groups.Conclusion The scald-induced pain model is successfully established using a constant-temperature electrical scald instrument in rats.

Objective To study the clinical characteristics of primary hypoparathyroidism in adults.Methods The clinical data of 200 cases with adult-onset primary hypoparathyroidism in Peking Union Medical College Hospital during December 1987 to December 2015 were collected and analyzed retrospectively.Among them, 128 cases were followed up for a median period of 3 years.Results The major manifestations at their first visits were tetany and numbness in the distal extremities (81.5%,163/200 and 62.0%, 124/200).Thirty-two percent of the cases (62 cases) had history of seizures, and 60.9%( 98/161 ) and 74.4% ( 96/129 ) of them were with intracerebral calcifications and cataracts , respectively.Most of subjects(155/200)had more than one year delay in diagnosis.Hypercalciuria occurred in 67.2%( 86/128 ) of the cases during the follow-up.No significant differences in the clinical characteristics and biochemical markers between the hypercalciuria subjects and the non -hypercalciuria subjects.Renal nephrocalcinosis or stones were found in 6.5%( 5/77 ) of the cases , and kidney function decreased in 6.6%(6/91) of the patients.Kidney function was negatively associated with age and duration of disease.Conclusions The predominant manifestations of primary hypoparathyroidism in adults included tetany and numbness in the distal extremities and seizures .It is often misdiagnosed.Calcium supplement combined with vitamin D or its metabolites effectively relieve clinical symptoms and signs.The serum and urinary calcium levels should be monitored frequently to reduce renal complications .

Toll-like receptor 4 (TLR4), a type Ⅰ transmembrane protein, has been extensively studied in the Toll-like receptor family at present. TLR4 ligands include lipopolysaccharides ( LPS) present in the outer membrane of gram-negative bacteria and monophosphoryl lipid A ( MPLA) which is a derivative of LPS. TLR4 agonists, alone, as a major component of compound adjuvants or in combination with other TLRs agonists, have been widely used as adjuvants in various vaccines and demonstrated great potential in vaccine development. This review addressed the discovery, application, features and prospect of novel vac-cine adjuvants based on TLR4 agonists, aiming to provide reference for rational use of adjuvants and further development.

Objective To explore the changes of plasma endothelin-1 (ET-1), nitrousoxide (NO), blood gas analysis, and blood rheology in patients with chronic bronchitis (CB), pulmonary emphysema (PE) and pulmonary heart disease (PHD) at different periods.Methods The plasma ET-1, NO, blood viscosity, hematocrit (Hct) and aggregation index (AI) of patients in groups of CB, PE and PHD, and the subjects of the control group were tested and compared. Blood gas analysis of subjects in four groups also performed and compared. Each group had 40 cases.Results In PE and PHD patients, the ET-1 level was higher, the indexes of blood gas analysis and blood rheology were abnormal. When PE developed into PHD, the ET-1 and PaCO2 tended to increase, PaO2 tended to decrease. When CB developed into PE and PHD, the blood viscosity, pressure volume and AI tended to increase, but NO tended to decrease.Conclusion When CB developed into PE or PHD, ET-1, PaCO2 tend to increase and NO, pH, PaO2 tend to decrease; increased red blood cells, blood viscosity and AI become severe.

Objective To explore the efficacy and safety of 980 nm diode laser therapy for treatment of benign prostatic hyperplasia (BPH). Methods Data of 170 patients with BPH treated with 980nm diode laser system were reviewed. The mean operative time, blood loss, surgical complications, the international prostate symptom score (IPSS), bladder residual urine volume and flow rate changes were collected and analyzed. Results One hundred and seventy cases were safe during the perioperative period. The average operation time was (74 ± 11) min, surgical removal of prostate tissue mass of (54±12) g, blood loss (72±11) ml. There was no TUR syndrome occurred. 170 patients were followed up 2 to 24 months. The IPSS decreased from preoperative 25.0±5.5 to 9.0±2.5. The maximum flow rate increased from preoperative (6.2±2.3)ml/s to post-operative (17.4±3.5) ml/s. The residual urine volume decreased from preoperative (210.0±25.6) ml to postoperative (25.2±4.6) ml. All the differences were statistically significant (P＜0.05). Conclusion Transurethral vaporization of 980 nm diode laser could be a safe and effective treatment modality for BPH.

Objective To observe the expression of PD-L1 in breast cancer tissue and to investigate its correlation with cellu-lar immunity.Methods One hundred and fourteen paraffin-embedded specimens of breast cancer were collected from the Qian′an Municipal People′s Hospital.The expression of PD-L1 in breast tumor tissue was detected by immunohitochemical technique,then the relationship between PD-L1 expression and tumor clinicopathological characteristics was analyzed;the levels of peripheral blood CD3+,CD3+CD4+,CD3+CD8+,CD3-CD19+,CD3-CD16+CD56+cells and CD4+/CD8+in the patients with PD-L1 negative and PD-L1 positive of the two groups were detected by the flow cytometry.Results Among 114 cases of breast cancer specimen,35 ca-ses(30.7%)were PD-L1 expression positive with the expression rate of 30.7%.The PD-L1 expression was correlated with the tumor size,histological grade and Ki-67 high expression(P<0.05);the cellular immunity status in the patients with PD-L1 negative expression was better than that in the patients with PD-L1 positive expression(P<0.05).Conclusion The PD-L1 expression is closely correlated with the poorer clinicopathological characteristics of breast cancer,its mechanism may be correlated with the dis-ruption of cellular immunity in the patients with PD-L1 positive expression.

Objective: To explore the feasibility and advantages of totally laparoscopic radical cystectomy plus ρshape orthotopic ileal neobladder, and to summarize the experiences. Methods: The clinical data of 11 patients with bladder cancer admitted to the second hospital of Hebei medical university from October 2018 to May 2019 were retrospectively analyzed. All patients were male, aged 33 to 77 years, with an average of 64.4 years. Body mass index ranged from 18.0 to 31.8 kg/m^2, with an average of 23.2 kg/m². One case underwent partial cystectomy and 10 cases underwent transurethral resection of bladder tumor, with 10 cases of invasive urothelial carcinoma and 1 case of adenocarcinoma. No case underwent neoadjuvant therapy, and all cases were clinically staged as cT_2a-3bN_0-2M₀. Totally laparoscopic radical cystectomy and ρ shape orthotopic ileal neobladder intraperitonealy were performed. The specific procedures were described as follows. After bladder resection, the ileal segment of 55 cm in length was intercepted at 25 cm from ileocecal valve, with the proximal part retaining 15 cm lumen as the input loop, and the distal part of 40 cm ileum being folded in 1∶1 ratio. The folded intestinal segment was made into a allantoic sac by using a linear incision closure device, forming a "ρ" shape with the input loop, bilateral ureters and the input loop. Anastomosis of wall, distal end of allantoic and urethra was performed.Record the perioperative data such as operation time, estimated bleeding, postoperative recovery, complications, and follow-up results. Result: All of the 11 cases underwent successfully operation, and no cases were transferred to open surgery. The operation time ranged from 320 to 440 minutes, with an average of 357.1 minutes. The estimated amount of bleeding ranged from 100 to 300 ml, with an average of 207.1 ml. The total time of intestinal tract procedure was 80-100 minutes, with an average of 89.3 minutes, and the time of allantoic preparation was 14-19 minutes, with an average of 16.1 minutes. The pain score was 2-5 points at 4 hours after operation, with an average of 3.8 points, and 1-4 points at 24 hours after operation, with an average of 2.3 points. Postoperative exhaust time ranged from 2.5 to 3.5 days, with an average of 3.0 days.Catheter removed 21 days after operation, with 9 cases of urinary incontinence, including mild in 6 cases, moderate in 2 cases and severe in 1 case, with daytime pad of 0-3 and nighttime pad of 1-3.which improved gradually following pelvic exercise for 4-18 weeks. Postoperative hospital stay ranged from 7 to 13 days, with an average of 10.4 days. The drainage removal time was 4-11 days, with an average of 6.7 days. Postoperative pathology revealed 7 cases of high-grade invasive urothelial carcinoma, 3 case of low-grade invasive urothelial carcinoma and 1 case of adenocarcinoma. The tumors invade the prostate in adenocarcinoma patient, with left (3/13) and right (1/9) positive lymph nodes. One case of high-grade invasive urothelial carcinoma had both left (2/11) and right (1/9) positive lymph nodes, and the other cases were negative. The margin were negative in all patients. Pathological staging was pT_2a-4aN_0-2M₀. Postoperative adjuvant chemotherapy with gemcitabine+ cisplatin regimen were performed in 9 patients.The follow-up period ranged from 3 to 29 weeks, with an average of 17.4 weeks, the patients with adenocarcinoma died of multiple organ failure at the 13th week after operation, and the other cases have no recurrence or metastasis. Dual J-tube was removed in 9 cases in the last follow-up, and the new bladder volume was estimated 300-350 ml, with residual urine of 0-43 ml and 19 ml of average. There is no stone formation in the new bladder.No hydronephrosis or ureteral dilatation aggravated. Conclusions Totally laparoscopic radical cystectomy plus ρ shape orthotopic ileal neobladder simplify the procedure of making allantoic storage and shorten the procedure time. The patients suffered less pain and recovered quickly after operation.It is a safe and feasible surgical procedure based on this study.

Objective:To summarize the correlation between anterior pituitary function and tumor size in patients with different hormone-secreting pituitary adenomas.Methods:This was a retrospective case series study. The clinical data of 1 946 patients with pituitary adenoma hospitalized in the First Medical Center of Chinese PLA General Hospital from January 1, 2005, to December 31, 2020, were collected. The correlation between tumor size and anterior pituitary hormone levels was analyzed using Spearman rank correlation analysis in different types of pituitary adenomas.Results:The median age of the 1 946 patients was 45.1 years, of which 857 (44.0%) were men. The maximum tumor diameter of the patients [ M ( Q1, Q3)] was 22 (14, 30) mm. Tumor size in nonfunctioning adenomas ( n=1 191) was negatively correlated with adrenocorticotropic hormone (ACTH) ( r=-0.11, P<0.001), growth hormone ( r=-0.13, P<0.001), and luteinizing hormone (men: r=-0.26, P<0.001, women: r=-0.31, all P<0.001). The tumor size of somatotropic adenomas ( n=297) was positively correlated with growth hormone ( r=0.46, P<0.001), but negatively correlated with male testosterone ( r=-0.41, P<0.001). The tumor size of ACTH-secreting pituitary adenomas ( n=155) was positively correlated with the ACTH level at 8∶00 AM ( r=0.25, P<0.001); however, no correlation was found with cortisol at 8∶00 AM ( P>0.05). The tumor size of prolactinomas ( n=303) was positively correlated with the prolactin level (men: r=0.34, P=0.001; women: r=0.13, P=0.070). Conclusions:The correlation between the function of the anterior pituitary and size of the tumor depends on the cellular origin of the pituitary adenoma and specific type of hormone secretion. In somatotroph adenomas, ACTH-secreting pituitary adenomas, and prolactinomas, there is a positive correlation between tumor size and level of hormones secreted by the corresponding tumors. In patients with nonfunctioning adenomas, the tumor size was negatively correlated with the hormone levels of the pituitary-adrenal and pituitary-growth hormone axes.