Objective:To study the comprehensive surgical treatment of brucellosis with chest wall cysts as the main manifestation.Methods:Retrospective analysis was made on the general information epidemiological characteristics, clinical manifestations, laboratory examinations, imaging examinations, treatment and outcomes of five patients with brucellosis mainly manifested by chest wall cysts admitted to the 948 Hospital of the People's Liberation Army from July 2019 to June 2022.Results:Among the 5 patients, there were 4 males and 1 female, aged between 23 and 64 years old, with a clear history of contact with cattle and sheep. The main clinical manifestation was painless cystic masses on the chest wall. Both the serum tiger red plate agglutination test (RBPT) and the test tube agglutination test (SAT) were positive. Four cases were infected with Brucella and one case was infected with Actinobacillus pleuropneumoniae (considered as Brucella infection based on the overall condition). All patients exhibited abnormal chest wall signals (manifesting as hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging) on magnetic resonance imaging(MRI), and were ultimately diagnosed with brucellosis presenting predominantly as chest wall cysts. After complete removal of the chest wall cyst through surgery, a combination treatment of rifampicin capsules and doxycycline hyclate tablets was given for 6 weeks. There were no significant adverse reactions and the wound healed in one stage. During the postoperative follow-up period of 11 - 40 months, MRI reexamination demonstrated no evidence of chest wall cyst recurrence, and all SAT results were negative. Conclusions:Patients with brucellosis presenting as chest wall cysts are clinically rare and lack specific symptoms. Surgical resection of the affected lesion combined with early, standardized, combined, and full course antimicrobial therapy results in a good prognosis for the patient.

Objective:To study the comprehensive surgical treatment of brucellosis with chest wall cysts as the main manifestation.Methods:Retrospective analysis was made on the general information epidemiological characteristics, clinical manifestations, laboratory examinations, imaging examinations, treatment and outcomes of five patients with brucellosis mainly manifested by chest wall cysts admitted to the 948 Hospital of the People's Liberation Army from July 2019 to June 2022.Results:Among the 5 patients, there were 4 males and 1 female, aged between 23 and 64 years old, with a clear history of contact with cattle and sheep. The main clinical manifestation was painless cystic masses on the chest wall. Both the serum tiger red plate agglutination test (RBPT) and the test tube agglutination test (SAT) were positive. Four cases were infected with Brucella and one case was infected with Actinobacillus pleuropneumoniae (considered as Brucella infection based on the overall condition). All patients exhibited abnormal chest wall signals (manifesting as hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging) on magnetic resonance imaging(MRI), and were ultimately diagnosed with brucellosis presenting predominantly as chest wall cysts. After complete removal of the chest wall cyst through surgery, a combination treatment of rifampicin capsules and doxycycline hyclate tablets was given for 6 weeks. There were no significant adverse reactions and the wound healed in one stage. During the postoperative follow-up period of 11 - 40 months, MRI reexamination demonstrated no evidence of chest wall cyst recurrence, and all SAT results were negative. Conclusions:Patients with brucellosis presenting as chest wall cysts are clinically rare and lack specific symptoms. Surgical resection of the affected lesion combined with early, standardized, combined, and full course antimicrobial therapy results in a good prognosis for the patient.

Objective:To evaluate the clinical efficacy of Qingfei-Xiaoyan Decoction combined with anti infective mechanical ventilation in the treatment of senile severe pneumonia. Methods:A total of 102 patients with severe pneumonia in our hospital from June 2018 to May 2021 who met the inclusion criteria were randomly divided into two groups by random number table method, with 51 in each group. The control group was treated with anti-infection mechanical ventilation, and the study group was treated with Qingfei-Xiaoyan Decoction on the basis of the control group. Both groups were treated for 2 weeks. TCM syndrome scores were performed before and after treatment. The severity of infection was evaluated by clinical pulmonary infection score (CPIS), FVC, FEV1 and peak expiratory flow (PEF) were detected by pulmonary function meter, and the levels of TNF-α, high mobility group box 1 (HMGB1) and CRP were detected by enzyme-linked immunosorbent assay, adverse events were recorded and clinical efficacy was evaluated. Results:The total effective rate was 94.1% (48/51) in the study group and 80.4% (41/51) in the control group, and there was significant difference between the two groups ( χ2=4.320, P=0.038). After treatment, the TCM syndrome score and CPIS score of the study group were significantly lower than those of the control group ( t values were 14.203 and 11.403, respectively, all Ps<0.01), FVC, FEV1 and PEF in the study group were significantly higher than those in the control group ( t values were 4.663, 3.451 and 13.220, respectively, all Ps<0.01), and the levels of serum CRP, TNF-α and HMGB1 in the study group were significantly lower than those in the control group ( t values were 14.672, 10.277 and 24.453, respectively, all Ps<0.01). During the treatment, no serious adverse reactions occurred in both groups. Conclusions:Qingfei-Xiaoyan Decoction combined with anti-infective mechanical ventilation has a significant effect in the treatment of senile severe pneumonia. It can alleviate clinical symptoms, improve lung function, reduce inflammatory reaction with safety.

Objective To evaluate the effects of remifentanil on the metastasis of human lung adenocarcinoma cells and expression of interleukin-7 receptor (IL-7R).Methods Human adenocarcinoma cell line A549 cells were seeded in 24-well plates at a density of 2× 105 cells/ml (72 wells).The cells were divided into 4 groups (n =18 each) using a random number table:normal control group (group C) and remifentanil 2,4 and 6 ng/ml groups (group R2,group R4,group R6).In R2,R4 and R6 groups,remifentanil at the final concentrations of 2,4 and 6 ng/ml was added,respectively,and the cells were incubated for 4 h.The equal volume of normal saline was given instead of remifentanil in group C.The cells were collected at 24 h after the following incubation.The invasion of cells was determined by Transwell invasion assay,and the invaded cells were counted.The migration of cells was determined by cell scratch test,and cell migration rates were calculated.The expression of IL-7R in cells was detected by Western blot.Results Compared with group C,the number of invaded cells and cell migration rates were significantly decreased in R2,R4 and R6 groups,and the expression of IL-7R was down-regulated in R4 and R6 groups (P＜0.05).Compared with group R2,the number of invaded cells and cell migration rates were significantly decreased,and the expression of IL-7R was down-regulated in R4 and R6 groups (P＜0.05).Compared with group R4,the number of invaded cells and cell migration rates were significantly decreased,and the expression of IL-7R was down-regulated in group R6 (P＜0.05).Conclusion Remifentanil can inhibit metastasis of human lung adenocarcinoma cells and down-regulate the expression of IL-7R.

Objective To investigate the effect of surgical trauma on the expression of COX-2 and PGE2in the hippocampus in aged rats. Methods Forty-five 18-month-old male SD rats weighing 500-600 g were randomly divided into 3 groups (n = 15 each): group Ⅰ control (group C); group Ⅱ anesthesia (group A) and group Ⅲ surgery + anesthesia (group S). Anesthesia was induced by intraperitoneal 1% pentobarbital sodium 50 mg/kg in group A and S. The animals underwent appendectomy and splenectomy under anesthesia in group S.Cognitive function was assessed by open field test and Y-mase test on the 1st, 3rd and 7th day after anesthesia and surgery (T1-3). The animals were sacrificed after behavior tests at T1.2.3 and the hippocampi were removed for determination of the expression of COX-2 mRNA (by RT-PCR) and PGE2 content (by ELISA). Results The time the animal spent in the central square was significantly prolonged, the number of crossing grid and standing on the back legs and the number of right response were decreased, the total reaction time was prolonged and the COX-2mRNA expression at T1 and PGE2 content in the hippocampus were increased at T1,2 in group S as compared with group C and A. There was no significant difference in the variables mentioned above between group C and A. Conclusion Surgical trauma can induce early postoperative cognitive dysfunction through up-regulation of COX-2 mRNA expression and by increasing PGE2 content in the hippocampus in aged rats.