OBJECTIVE To establish a reliable mouse eosinophilic chronic rhinosinusitis model,study the histological and immunological effects of glucocorticoids on type 2 inflammatory cells and factors in nasal mucosa,and provide an animal model basis for the biological treatment of CRS and related research of resistance to glucocorticoids in vivo.METHODS The CRS model group was treated with ovalbumin and Staphylococcal enterotoxins B.The dexamethasone intervention group received an additional weekly intraperitoneal injection of dexamethasone for 8 weeks.The expression of type-2 innate lymphoid cell(ILC2)in the nasal mucosa was detected with immunofluorescence and the expression of tryptase+mast cells,eosinophil cationic protein(ECP),IL-5,IL-25,and IL-33 in the nasal mucosa was detected with immunohistochemical.RESULTS The nasal mucosa eosinophils in the dexamethasone intervention group was lower than in the CRS model group(P<0.05).Thy-1+ST2+ILC2 cells in the dexamethasone intervention group were less than those of the CRS model group,and Thy-1+ST2+ILC2 cells were rare in the control group.Tryptase+mast cells were moderately positive in the CRS model group and weakly positive in the control group and in the dexamethasone intervention group.ECP and IL-5 were strongly positive in the CRS model group and weakly positive in the control group and the dexamethasone intervention group.IL-25 was moderately positive in the control group,strongly positive in the CRS model group,and weakly positive in the dexamethasone intervention group.IL-33 was weakly positive in the control group,while the CRS model group and the dexamethasone intervention group were strongly positive.CONCLUSION Intraperitoneal injection of dexamethasone reduce the number of eosinophils,Thy-1+ST2+ILC2 cells and tryptase+mast cells in the nasal mucosa of the mouse CRS model.It can also down-regulate the expression of ECP,IL-5,and IL-25 in tissues,but it does not have a significant effect on the expression of IL-33 in tissues.

Objective To investigate the effect of esketamine on postoperative depression in frail elderly patients undergoing thoracoscopic radical resection of lung cancer.Methods A total of 88 frail elderly patients undergoing elective thoracoscopic radical resection of lung cancer were assigned randomly(using a randomization table)and in a double-blind way(blinding applies to both researchers and patients)to an esketamine group(Esk group,n=44)and a normal saline group(NS group,n=44).In the Esk group,0.25 mg/kg esketamine was injected intravenously during anesthesia induction,followed by continuous infusion of esketamine at 0.125 mg/kg per hour until 20 min before the end of surgery.In the NS group,equivalent volumes of normal saline were administered using the same method.The primary outcome was the score for the 17-item Hamilton Rating Scale for Depression(HAMD-17)on days 7 and 30 after surgery.The secondary outcomes included sleep quality and cognitive function.Sleep quality was assessed using the numerical rating scale(NRS)on days 1,3,and 7 after surgery and the Pittsburgh Sleep Quality Index(PSQI)on day 30 after surgery.Cognitive function was assessed using the Mini-Mental State Examination(MMSE)on days 1,3,7,and 30 after surgery.The other indicators included the levels of serum brain-derived neurotrophic factor(BDNF),5-hydroxytryptamine(5-HT),S100β protein,and neuron specific enolase(NSE)at 24 hours(T1),48 hours(T2),and 72 hours(T3)after surgery,as well as perioperative data and postoperative safety outcomes.Results Three patients were excluded from the Esk group and the NS group,respectively,and eventually,41 patients in each group were included in the statistical analysis.There were no statistically significant differences between the two groups in terms of age,sex,body mass index,American Society of Anesthesiologists(ASA)classification,comorbidities,educational attainment,and the scores for HAMD-17,PSQI,and MMSE 1 day before surgery(P＞0.05).Concerning the primary outcome,compared with those of the NS group,the HAMD-17 scores of patients in the Esk group were significantly lower at 7 days(median[P25,P75])(7[6,8]vs.7[6,12],P=0.045)and 30 days(6[6,7]vs.7[6,9],P=0.020)after surgery.Concerning the secondary outcomes,compared with those of the NS group,the sleep NRS scores of patients in the Esk group were significantly lower at 1,3,and 7 days after surgery(P＜0.01),and the MMSE scores were significantly higher(P＜0.05).Concerning the other indicators,compared with those of the NS group,the concentrations of serum BDNF and 5-HT in the Esk group were significantly higher(P＜0.05 or 0.01)at T1-T3,while the content of S100β was significantly lower(P＜0.01)at T1-T3;the levels of serum NSE were significantly lower at T1 and T2(P＜0.01);the consumption of propofol,sufentanil,remifentanil,and sevoflurane during surgery in the Esk group was significantly reduced(P＜0.05 or 0.01);the incidence of postoperative nausea/vomiting and hyperalgesia was significantly lower(P＜0.01);the duration of postoperative mechanical ventilation,length-of-stay in postanesthesia care unit(PACU),and postoperative length-of-stay in the hospital were significantly shorter(P＜0.01).Conclusion Esketamine can improve the postoperative depressive state,sleep quality,and cognitive function in frail elderly patients undergoing thoracoscopic radical resection of lung cancer.

Objective:To analyze the effect of dexmedetomidine combined with esketamine anesthesia on non-cardiac surgery for coronary heart disease and the effect on hemodynamics,stress response and postoperative complications of patients.Method:A total of 106 patients with coronary heart disease who were going to undergo laparoscopic abdominal surgery from Oct 2021 to Nov 2022 in our hospital were selected and randomly divided into the control group and the observation group,with 53 cases in each group.All patients underwent conventional surgical treatment.The control group was given dexmedetomidine anesthesia,while the observation group was given dexmedetomidine combined with esketamine anesthesia.The surgical indicators,incidence of postoperative complications,diastolic blood pressure(DBP),systolic blood pressure(SBP),pain visual analog scale(VAS),Ramsay sedation score,and the levels of oxide dismutase(SOD),malondialdehyde(MDA),cortisol(Cor)and blood glucose(GLU)were compared between the two groups.Results:There was no statistically significant difference in the operation time between the two groups(P＞0.05),but the postoperative sufentanil dosage of the observation group was lower than that of the control group,and the number of effective compressions was higher than that of the control group(P＜0.05).At 12 h postoperatively,there was no significant difference between the VAS score and Ramsay sedation score of the two groups(P＞0.05),and the VAS score and Ramsay sedation score in the observation group were better than those in the control group at 4 h and 8 h postoperatively(P＜0.05).The levels of MDA,GLU and Cor in both groups increased and the level of SOD decreased at 4 h postoperatively(P＜0.05),and the level of SOD in the observation group was higher than that of the control group,and the levels of MDA,GLU and Cor were lower than those of the control group(P＜0.05).Before anesthesia,there was no statisti-cally significant difference in hemodynamic indexes between the two groups(P＞0.05).Compared with before anesthesia,there were changes in HR,SBP,DBP,and RR of the two groups at the end of the operation and 24 h after the operation(P＜0.05),and the HR,SBP,DBP,and RR of the observation group were better than those of the control group(P＜0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(P＜0.05).Conclusion:Dexmedetomidine combined with esketamine anesthesia can effectively stabilize the hemodynamics of patients,reduce postoperative stress response,and reduce postoperative complications.

Objective: To investigate the effect of blood eosinophils on clinical effect of endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: From March 2011 to March 2016, 72 cases with CRSwNP were treated by endoscopic sinus surgery in Department of Otorhinolaryngology Head and Neck Surgery, Peking University People′s Hospital. The clinical records were retrospectively reviewed, and the cases were divided into eosinophilia elevated and non-elevated group according to blood eosinophils, and nasal polyps were evaluated for histopathology eosinophil count. Statistical analysis was performed to compare two groups′ pre- and post-operative symptoms of VAS score, sinus computed tomography (CT) scans scores according to the Lund-Mackay system and the outcome of surgery. Both groups′ factors that might have affected their outcome were analyzed by t-test, Chi square, Pearson Correlation Coefficient and Willcoxon rank sum test. Results: Seventy two cases were followed up from 24 to 78 months.The average follow-up time was 56 months. The VAS score in the eosinophilia elevated group (n=16) was higher than that in the non-elevated group(n=56), and the difference was statistically significant (11.44±7.13 vs 4.98±5.64, t=3.726, P<0.05). The control of symptoms in the peripheral blood eosinophilia elevated group was less than that in the non-elevated group, and the difference was statistically significant (Z=-1.979, P<0.05). There was a positive correlation between eosinophil counts in peripheral blood and tissues of 72 cases (r=0.429, P<0.05). Conclusion There is a significant correlation between tissue and blood eosinophil counts, and eosinophilia group has poorer outcomes.

Objective: To clone , express and purify of Dermatophagoides farinae ( Der f 11 ) , and then test its immunogenicity.Methods:The gene coding for Der f 11 was synthesized ,and was then linked with the pET-32a vector.The expression plasmid pET32a(+)-Der f 11 was induced by IPTG.After purification of recombinant allergens Der 11 proteins through the Ni +affinity chromatography ,immunological allergic patients serum as the Primary antibody.Results: We obtain high purity recombinant Der f 11 protein.The results of SDS-PAGE show that the expression product is about 118 KD.Recombinant allergen Der f 11 test 15 dust mites allergic patients serum specific IgE , positive rate was 20%.Conclusion: Recombinant allergen Der f 11 obtained has the similar immunologic activity to natural Der f 11 protein.It can lay the foundation for the specific diagnosis ,treatment and further experimental studies of the dust mite allergy disease.

0.05).The concentration of IL-6 in sputum of multi-virus infection group(122.51?39.86)ng/L was higher than in single virus infection group(65.30?34.92)ng/L.The concentration of IL-6 in sputum of bacteria-virus mixed infection group(120.31?46.62)ng/L was higher than in bacteria or virus single infection group(83.61?47.83)ng/L.Conclusion Streptococcus pneumonia and influenza virus A infection are important factors in AECOPD at early stage.Virus infection would prolong recovery time,increase inflammation of the airway and even induce bacteria infection.Therefore,we should pay more attention to the virus infection in COPD patients,especially A-type influenza virus.

Objective:To establish an Ehrlich reaction-colorimetry method for determining furostanol saponins in saponins extract from Radix Asparagi.Methods: Based on the coloration reaction between furostanol saponins and p-dimethylaminobenzaldehyde,a colorimetry method was established to determine the content of furostanol saponins in saponins extract from Radix Asparagi at 510 nm.Saponins AC-9 was measured as reference in the determination.Results: The standard curve of saponins AC-9 showed good linearity in the range of 0.08-0.40 mg and the average recovery was 99.79%(RSD=(1.05%).) Conclusion: This method is rapid,accurate and easy to be carried out,and it can be used to control the quality of Radix Asparagi.