Objective:To investigate relationship between serum immunoglobulin(Ig),forkhead box protein P3(Foxp3)and therapeutic effect of nivolumab in patients with advanced non-small cell lung cancer(NSCLC).Methods:A total of 180 advanced NSCLC patients admitted to Hengshui People's Hospital between January 2020 and January 2024 were selected as NSCLC group,and 180 healthy individuals who underwent physical examinations during same period were selected as healthy group.Serum IgA,IgM,IgG and Foxp3 levels were measured,and differences in serum IgA,IgM,IgG and Foxp3 levels between two groups were compared,as well as their differences of levels in different clinical characteristics of advanced NSCLC patients.Advanced NSCLC patients were treated with nivolumab on basis of paclitaxel and carboplatin chemotherapy,and divided into treatment effective group(n=82)and treatment ineffective group(n=98)based on efficacy.Differences of serum IgG and Foxp3 levels between two groups were compared,and efficacy of serum IgG and Foxp3 in predicting therapeutic effect of nivolumab in advanced NSCLC patients was analyzed.Results:Serum IgG and Foxp3 levels in NSCLC group were higher than healthy group(P<0.05),and there was no statistically significant difference in serum IgA and IgM levels between two groups(P>0.05).Serum IgG and Foxp3 levels in TNM stage Ⅳ and poorly differentiated NSCLC patients were higher than stage Ⅲ NSCLC patients(P<0.05).TNM stage Ⅳ,proportion of low differentiation,and serum IgG and Foxp3 levels in ineffective group were higher than effective group(P<0.05).Logistic regression analysis showed that differentiation level,high IgG and high Foxp3 levels were risk factors for ineffective treatment with nivolumab in advanced NSCLC patients(P<0.05).Predictive efficacy of combination of serum IgG and Foxp3 in treatment of advanced NSCLC patients with nivolumab was superior to any single therapy,with an AUC of 0.978,sensitivity of 96.75%,and specificity of 92.13%.Conclusion:Elevated serum IgG and Foxp3 levels in patients with advanced NSCLC are risk factors for nivolumab treatment failure,and can be used as a reference index to predict therapeutic effect of nivolumab.

Objective:To investigate relationship between serum immunoglobulin(Ig),forkhead box protein P3(Foxp3)and therapeutic effect of nivolumab in patients with advanced non-small cell lung cancer(NSCLC).Methods:A total of 180 advanced NSCLC patients admitted to Hengshui People's Hospital between January 2020 and January 2024 were selected as NSCLC group,and 180 healthy individuals who underwent physical examinations during same period were selected as healthy group.Serum IgA,IgM,IgG and Foxp3 levels were measured,and differences in serum IgA,IgM,IgG and Foxp3 levels between two groups were compared,as well as their differences of levels in different clinical characteristics of advanced NSCLC patients.Advanced NSCLC patients were treated with nivolumab on basis of paclitaxel and carboplatin chemotherapy,and divided into treatment effective group(n=82)and treatment ineffective group(n=98)based on efficacy.Differences of serum IgG and Foxp3 levels between two groups were compared,and efficacy of serum IgG and Foxp3 in predicting therapeutic effect of nivolumab in advanced NSCLC patients was analyzed.Results:Serum IgG and Foxp3 levels in NSCLC group were higher than healthy group(P<0.05),and there was no statistically significant difference in serum IgA and IgM levels between two groups(P>0.05).Serum IgG and Foxp3 levels in TNM stage Ⅳ and poorly differentiated NSCLC patients were higher than stage Ⅲ NSCLC patients(P<0.05).TNM stage Ⅳ,proportion of low differentiation,and serum IgG and Foxp3 levels in ineffective group were higher than effective group(P<0.05).Logistic regression analysis showed that differentiation level,high IgG and high Foxp3 levels were risk factors for ineffective treatment with nivolumab in advanced NSCLC patients(P<0.05).Predictive efficacy of combination of serum IgG and Foxp3 in treatment of advanced NSCLC patients with nivolumab was superior to any single therapy,with an AUC of 0.978,sensitivity of 96.75%,and specificity of 92.13%.Conclusion:Elevated serum IgG and Foxp3 levels in patients with advanced NSCLC are risk factors for nivolumab treatment failure,and can be used as a reference index to predict therapeutic effect of nivolumab.

Objective:To explore the feasibility of a stable pig-to-monkey orthotopic liver transplantation (LT) model and provide a favorable experimental tool for preclinical studies of xenotransplantation.Methods:In this retrospective analysis, the authors reviewed the perioperative conditions and outcomes of 7 pig-to-monkey orthotopic liver transplants performed by a xenotransplantation research team of Second Xiangya Hospital.Gene-edited Banna miniature pigs were selected as donors and rhesus monkeys with similar anatomical characteristics, physiology, biochemistry and immune mechanism to humans were selected as recipients for pig-monkey xenogeneic orthotopic LT.Based upon classic transplantation procedures, whole liver xenogeneic orthotopic transplantation was performed.Surgical processes were modified for minimizing intraoperative hemorrhage and shortening anhepatic period.A bile duct drainage tube was implanted for observing bile secretion.ATG + anti-CD20 + snake venom factor and FK-506 were utilized for immunoinduction pre-operation while tacrolimus, mycophenolate mofetil (MMF) and methyl prednisolone for postoperative immunomaintenance therapy.Antibiotics and antiviral agents were also applied and thrombin complex for improving coagulation functions.Results:All procedures were successfully completed.After the stability and maturity of our model, in case No.7, donor's acquisition operative duration was 42 min without heat ischemic time, donor's trimming time 87 min, donor cold retention time 128 min, recipient's operative duration 123 min and anhepatic phase 27 min.Subhepatic inferior vena cava was occluded for 38 min.Blood loss was around 10 ml.And 4/7 models survived post-operation and the longest survival time was 27 h. Among 3 non-survival cases, the causes were anesthesia accident (n=1) and immaturity of early operation (n=2). Model No.7 had a biliary secretion volume of 86 ml post-operation.Conclusions:Qualified donor acquisition, high-quality vascular anastomosis, intraoperative reduction of blood loss, shortening of anhepatic period, strict fluid replenishing and careful monitoring are essential for boosting the success rate of pig-monkey liver xenotransplantation model.Optimization of donor gene combination and advanced immunosuppression protocol help to further achieve the long-term survival of pig-monkey liver xenotransplantation model.

Liver transplantation is a curable therapy to save the life of patients with end-stage liver diseases of different causes. The serious shortage of liver donors led to the death of a large number of patients with end-stage liver disease. Genetic-engineered pigs used for xenotransplantation are one of the potential solutions to alleviate the liver donor shortage, but currently clinical application of such xenogeneic liver grafts is hindered by acute rejection, thrombocytopenia, and coagulation dysfunctions in patients. The development of genetic-engineering technology and the application of new immunosuppressants have controlled the acute rejection of liver xenotransplantation to some extent. However, acute humoral rejection may become another major issue for the long-term graft failure. This review summarized and discussed the potential and underlying mechanisms and preventive measures of acute humoral rejection in liver xenotransplantation.

OBJECTIVE: To compare the mid- and long-term outcomes of patients receiving mitral valve replacement through robotically assisted and conventional median sternotomy approach. METHODS: The data of 47 patients who underwent da Vinci robotic mitral valve replacement in our hospital between January, 2007 and December, 2015 were collected retrospectively (robotic group). From a total of 286 patients undergoing mitral valve replacement through the median thoracotomy approach between March, 2002 and June, 2014, 47 patients were selected as the median sternotomy group for matching with the robotic group at a 1:1 ratio. The perioperative data and follow-up data of the patients were collected, and the quality of life (QOL) of the patients at 30 days and 6 months was evaluated using the Quality of Life Short Form Survey (SF-12). The time of returning to work postoperatively and the patients' satisfaction with the surgical incision were compared between the two groups. RESULTS: All the patients in both groups completed mitral valve replacement successfully, and no death occurred during the operation. In the robotic group, only one patient experienced postoperative complication (pleural effusion); in median sternotomy group, one patient received a secondary thoracotomy for management of bleeding resulting from excessive postoperative drainage, and one patient died of septic shock after the operation. The volume of postoperative drainage, postoperative monitoring time, ventilation time, and postoperative hospital stay were significantly smaller or shorter in the robotic group than in the thoracotomy group ( CONCLUSIONS Robotically assisted mitral valve replacement is safe and reliable. Compared with the median sternotomy approach, the robotic approach is less invasive and promotes faster postoperative recovery of the patients, who have better satisfaction with the quality of life and wound recovery.
COVID-19/drug therapy* ; Humans ; Mitral Valve/surgery* ; Quality of Life ; Retrospective Studies ; Robotic Surgical Procedures ; Sternotomy ; Thoracotomy ; Treatment Outcome

Objective To evaluate the effect of sevoflurane preconditioning on the function of sar-coplasmic reticulum in cardiomyocytes during ischemia-reperfusion (I∕R) in isolated rat hearts. Methods Healthy adult male Sprague-Dawley rats, weighing 270-300 g, were anesthetized with intraperitoneal pen-tobarbital. Their hearts were excised and perfused in a Langendorff apparatus with K-H solution saturated with 95％ O2-5％ CO2 at 37 ℃ . Twenty-four isolated rat hearts successfully perfused in the Langendorff ap-paratus were divided into 3 groups (n= 8 each) using a random number table: control group (group C), I∕R group and sevoflurane preconditioning group (group SP). Myocardial ischemia was induced by interrup-ting perfusion for 30 min followed by 120 min reperfusion. In group SP, the hearts were perfused with 2. 4％ sevoflurane for 10 min starting from 10 min before ischemia. Left ventricular developed pressure (LVDP) and left ventricular end-diastolic pressure (LVEDP) were recorded at 5, 10, 15, 30 and 60 min of reperfusion. Coronary effluent was collected at 10 min before reperfusion for measurement of the levels of lactate dehydrogenase (LDH) and cardiac troponin I (cTnI). Myocardial specimens were obtained at 120 min of reperfusion for examination of the pathological changes (using HE staining) and for determination of myocardial infarct size (by TTC staining), sarcoendoplasmic reticulum Ca2+-ATPase (SERCA2a) activity (with a spectrophotometer) and expression of Bcl-2, Bax and SERCA2a ( by Western blot). Results Compared with group C, LVDP was significantly decreased and LVEDP was increased at each time point, myocardial infarct size was increased, the levels of LDH and cTnI in coronary effluent were increased, the expression of Bax was up-regulated, the expression of Bcl-2 and SERCA2a was down-regulated, and the activity of SERCA2a was decreased in group I∕R (P<0. 01). Compared with group I∕R, LVDP was signifi-cantly increased and LVEDP was decreased at each time point, myocardial infarct size was decreased, the levels of LDH and cTnI in coronary effluent were decreased, the expression of Bax was down-regulated, the expression of Bcl-2 and SERCA2a was up-regulated, the activity of SERCA2a was increased (P<0. 01), and the pathological changes were significantly attenuated in group SP. Conclusion The mechanism by which sevoflurane preconditioning reduces I∕R injury in isolated rat hearts may be related to improving the function of sarcoplasmic reticulum in cardiomyocytes.

Objective To provide new experimental evidences associated with the mechanisms of inhaled anesthetics, the effects of sevoflurane on the electric activities of inhibitory interneurons in basal forebrain area (BF) were observed.Methods C57BL/6 mice, aged 2-3 weeks, were used and BF sections were cut for whole patch-clamp recording.Artificial cerebrospinal fluid containing sevoflurane was given and action potential, inhibitory postsynaptic potential were recorded.Results Sevoflurane could increase the frequency of firing rate of inhibitory interneurons in basal forebrain area (P<0.001), which could increase the frequency of action potential caused by depolarization current (P<0.05), and increase the frequency of spontaneous inhibitory postsynaptic currents of pyramidal neurons (P<0.05), while AP-depended miniature inhibitory postsynaptic currents were not significantly changed.Conclusion The basal forebrain inhibitory interneurons are involved in the anesthetic effect of sevoflurane.

Objective To establish an efficient HPLC method for the determination of uric acid in plasma of hyperuricemia model mice,and the evaluation of uric acid lowering effect of Lesinurad.Methods The Laballiance Series Ⅲ HPLC system was adopted with Kromasil C18 column (100 mm × 4.6 mm,5 μm).The mobile phase consisted of methanol-0.5％ acetic acid (10:90) for isocratic elution with a flow rate of 0.4 mL/min.The detection wavelength was set at 283 nm.The established HPLC method was used to detect the plasma uric acid level of mice at 0.5,1.0,and 2.0 h time points after which being ip injected with 250 and 500 mg/kg uric acid.Lesinurad of 250 and 500 mg/kg was ig given to mice,0.5 h later,mice were ip injected with 500 mg/kg uric acid to establish hyperuricemia model,and 1 h later,the established HPLC method was used to detect the plasma uric acid level of mice.Results There was a good linear relationship between peak area and the concentration of plasma uric acid in the range of 7.5-150 μg/mL (r =0.997).The specificity,repeatability,precision,stability,and recovery of the established HPLC method was in accordance with the guiding rules of biological sample determination.Compared with the endogenous serum uric acid concentration of control group mice,serum uric acid concentration of 250 mg/kg dose group was significantly increased 0.5 h after ip administration with uric acid (P ＜ 0.01),and serum uric acid concentration of 500 mg/kg dose group was significantly increased 0.5,1.0,and 2.0 h after ip administration with uric acid.Compared with model group,the concentration of uric acid in plasma decreased significantly in low dosage group administered with Lesinurad (P ＜ 0.05),while decreased more significantly in high dosage group (P ＜ 0.01).Conclusion This convenient,rapid,and accurate method can be applied to the determination of uric acid in mouse plasma and the evaluation of relative drugs,which provide an efficient analysis way for establishing hyperuricemia model and screening relative drugs.

Monoclonal antibody ( mAb ) represents a class of therapeutics experienced dramatic development over the past 30 years. Because of the tremendous differences in physicochemical and biological properties between mAbs and small molecules, the mAb therapeutics significantly differ from the chemical drugs in pharmacokinetic characteristics and underlying mechanisms. Full understanding of those characteristics and mechanisms may efficiently guide the screening and development of mAb medi-cines, and would well support their safety evaluation and clinical dosage regimen designing. This review is to summarize pharma-cokinetics and underlying mechanisms of mAbs from the aspects of absorption, distribution and elimination, as well as the ap-proaches for prediction of mAb pharmacokinetics in humans.

Purpose To study the expression of HIF-1αand Glut-1 in the molecular subtypes of breast carcinoma and their correlation with basal-like breast carcinoma. Methods 803 cases of invasive breast carcinoma from our database were identified. The clinicopath-ologic findings and the biologic markers including estrogen receptor ( ER) , progesterone receptor ( PR) , and human epidermal growth factor receptor-2 (HER-2) status were reviewed. Immunohistochemical MaxVision stains for cytokeratin 5/6 (CK5/6) and epidermal growth factor receptor ( EGFR) were performed. All breast carcinomas were subclassified into Luminal A, Lumincal B, HER-2 over-expression, normal-like, and basal-like subtypes according to Nielsen criteria. Immunohistochemical stain was also used to detect the expression of HIF-1αand Glut-1. Results Positive expression rates of HIF-1αprotein in basal-like, HER-2 over-expression, normal-like, Luminal A and Luminal B substypes were 77. 89% (74/95), 56. 06% (37/66), 55. 76% (92/165), 31. 97% (141/441), 25. 00% (9/36), respectively. The positive expression rates of Glut-1 protein were 80. 00% (76/95), 57. 58% (38/66), 58. 18%(96/165), 34. 01% (150/441), 25. 00% (9/36), respectively. The positive expression rates of HIF-1α and Glut-1 in the basal-like, HER-2 over-expressing and normal-like subtypes were remarkably higher than that in Luminal A and Luminal B subtypes ( P<0. 004 5) and the expression of HIF-1a and Glut-1 was negatively correlated with the expression of ER (P<0. 01). In the ER-negative breast cancers, the positive expression rates of HIF-1a and Glut-1 in basal-like substype were much higher than that in the other sub-types (P<0. 004 5), and the expression of HIF-1α was positively correlated with expression of Glut-1 in basal-like breast carcinoma (P<0. 01). Conclusion The overexpression of HIF-1αand Glut-1 may be closely related to the ER-negative breast cancer and HIF-1α and Glut-1 might play an important role in the development of basal-like breast carcinoma.