Objective To evaluate the diagnostic value of monocyte chemokine-1(MCP-1)and CD40 ligand(CD40L)levels in patients with bronchiectasis(BE)complicated with pulmonary infection.Methods A total of 94 patients with BE complicated with pulmonary infection who received treatment in Department of Geriat-rics in the hospital from March 2021 to March 2023 were included as the BE complicated infection group.Ac-cording to the Clinical Pulmonary Infection Score(CPIS),they were divided into severe infection group(17 cases).moderate infection group(52 cases).and mild infection group(25 cases).Another 94 cases of BE with-out pulmonary infection were selected as the BE group.94 healthy people who underwent the physical exami-nation during the same period in the hospital were selected as the control group.The distribution of pathogenic bacteria in BE patients complicated with pulmonary infection was analyzed.The levels of serum MCP-1 and CD40L in each group were compared.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum MCP-1 and CD40L in BE complicated with pulmonary infection.Results Total-ly 99 strains of pathogenic bacteria were isolated from 94 BE patients complicated with pulmonary infection.Among them,73 strains(73.74％)were Gram-negative bacteria,mainly Klebsiella pneumoniae.17 strains(17.17％)were Gram-positive bacteria,mainly Staphylococcus aureus.9 strains(9.09％)were fungal strains,mainly composed of Candida albicans.The serum levels of MCP-1 and CD40L in the BE combined with infec-tion group were obviously higher than those in the BE group and the control group(P＜0.05).The levels of serum MCP-1 and CD40L in the severe infection group and the moderate infection group were obviously high-er than those in the mild infection group(P＜0.05),and the serum levels of MCP-1 and CD40L in the severe infection group were obviously higher than those in the moderate infection group(P＜0.05).The area under the curve of the combined diagnosis of serum MCP-1 and CD40L for BE complicated with pulmonary infection was larger than that of the single detection(Z combination-MCP-1=2.896,P=0.005,Zcombination-CD40L=4.547,P＜0.001),with sensitivity of 91.49％and specificity of 76.60％.Conclusion The levels of serum MCP-1 and CD40L in patients with BE complicated with pulmonary infection are elevated,which could be used to assess the severity of pulmonary infection,and the combination of the two has high diagnostic value for BE compli-cated with pulmonary infection.

Objective To study the relationship between exon gene polymorphism of pulmonary surfactant pro-tein B(SP -B)and the susceptibility and severity,prognosis of respiratory distress syndrome (RDS).Methods To detect the gene sequence of SP -B exon by adopting the gene sequencing technology,and samples were 80 prematures of very low birth weight in Southern Han Chinese,who were divided into 2 groups,the RDS and the non RDS,and the difference of genotype in SP -B exon in 2 groups was compared.Results There was no significant difference between 2 pretem groups in the aspects of the gestational age,sex,birth weight and delivery mode etc(all P >0.05).Fifty -nine prematures of very low birth weight had exons heterogenesis,and there were 2 types of mutations,V1 :Exon2:c.[5A >C]+[5A >C]or c.[5A >C]+[=];V2:Exon5:c.[428C >T]+[428C >T]or c.[428C >T]+[=].There were 20 cases of type V1 ,1 8 cases of type V2,3 cases of type V1 +V2 in 45 cases of RDS,and there were 1 2 cases of type V1 ,9 cases of type V2,no case of type V1 +V2 in the non RDS group.Comparing the incidence of V1 and V2 in 2 groups,there were all significant differences(χ2 =3.73,5.02;all P <0.05),and the OR values of 2 polymorphisms to RDS were 3.33 and 4.00,but there was no significant difference in mutation cases and non mutation cases in RDS group when comparing severity and prognostic(χ2 =0.07,P >0.05).Conclusion Gene polymorphism of SP -B exon are risk factors for premature of very low birth weight in southern Han Chinese in RDS.

Objective To explore the effect of Vitamin K1(Vit K1), fresh frozen plasma (plasma) andcryoprecipitate on prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen original(Fbg), thrombin time (TT) of newborns with different gestational ages. Methods The serum of 1,134 newbornsfrom The Third Affiliated Hospital of Guangzhou Medical University was collected from February 2009 to September2012. All newborns had been divided into four groups (according to the gestational age of 28-31+6 weeks, 32-33+6weeks, 34-36+6 weeks and gestational age≥37 weeks).The effect of various interventions (Vit K1, Vit K1+plasmaand Vit K1+cryoprecipitate) on PT, APTT, Fbg, and TT had been recorded. Results (1)The PT and APTT ofeach group with the interventions of Vit k1 were significantly improved (P < 0.05). (2)The PT, APTT, Fbg and TTof each group with the interventions of Vit k1 combined with plasma were significantly improved (P < 0.05). (3)ThePT, APTT and Fbg of each group with the interventions of Vit k1 combined with cryoprecipitate were significantlyimproved (P < 0.05). (4)With Vit k1 combined with plasma, PT and APTT were mostly improved and Fbg wasimproved mostly with Vit k1 combined with cryoprecipitate. Conclusion Vitamin K1, fresh frozen plasma andcryoprecipitate can effectively improvedin the coagulation index of newborns with different gestational ages.

ObjectiveTo explore the control factor of pulmonary microvascular endothelial cells in pulmonary hemorrhage with the RhoA-Rock pathway inhibitors.MethodsHuman pulmonary rnicrovascular endothelial cells were conventionally cultured,and were divided into four groups:control group,inhibitor group,hypoxia group and hypoxia group with inhibitor.As different fluorescein lsothiocyanate-phalloidin and filamentous actin (F-actin) in cytoplasm combined,it issued red fluorescence.We observed the dynamic changes of F-actin by laser scanning confocal microscope in hypoxia human pulmonary microvascular endothelial cells and recorded the value of fluorescence.ResultsThe mean fluorescence intensity of F-actin of hypoxia group in 1 h,12h and 24 h was (64.3 ±5.5)％,(60.3±4.2)％,and (47.8 ±4.6)％ as compared with the control group;the ratio of hypoxia group with inhibitor was (66.2 ±3.2)％,(67.1 ±6.2)％,and (72.5 ± 6.1 ) ％ as compared with the control group.The mean fluorescence intensity of F-actin decreased obviously after 1 h hypoxia treated to cells,decreasing to (64.3 ± 5.5 ) ％ of the control group (P ＜0.05 ) ;to 24 h,decreasing to (47.8 ±4.6) ％ of the control group(P ＜0.05).The mean fluorescence intensity of F-actin decreased to (66.2 ± 3.2) ％ of the control group after 1 h hypoxia treated in inhibitor group,which was more than 1 h in the hypoxic group.F-actin decreased obviously to (72.5 ± 6.1 ) ％ of the control group after 24 h hypoxia treated in inhibitor group.There was significant difference comparing with the hypoxia group after 24 h hypoxia(P ＜0.05).The mean fluorescence intensity of F-actin of inhibitor group without anoxic was invariant comparing with the control group(P ＞0.05).Cortex-like structure disappeared and the stress fibers arranged disorderly after hypoxia.Actin depolymedzated and broke gradually with the extension of hypoxia time.If to be hypoxic after pretreated with RhoA-Rock pathway inhibitor,cortex-like structure by the composition of pednuclear F-actin reappeared,distribution and arrangement of stress fibers in the cytoplasm tended to rule.ConclusionThe RhoA-Rock pathway mediates the damage on F-actin of pulmonary microvascular endothelial cells after hypoxia.Interfering with the RhoA-Rock pathway inhibitors can provide a new direction for the treatment of neonatal pulmonary hemorrhage.