Objective:To investigate the effect of acetylcysteine effervescent tablets combined with beclomethasone suspension on immune function, erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) levels in patients with chronic obstructive pulmonary disease (COPD).Methods:The clinical data of 102 patients with COPD admitted to Yiwu Central Hospital from January 2022 to June 2023 were retrospectively analyzed. These patients were divided into Group A ( n = 51) and Group B ( n = 51) based on different treatment methods. Group A received symptomatic treatments and beclomethasone suspension, while Group B received the same treatment as Group A plus acetylcysteine effervescent tablets. The clinical efficacy, exercise tolerance, clinical symptoms, quality of life, immune function, and serum ESR and PCT levels were compared between Groups A and B. Results:The total response rate in Group B was 96.08% (49/51), which was significantly higher than that in Group A [82.35% (42/51), χ2 = 5.14, P < 0.05]. After treatment, Group A showed significantly longer distance in the 6-minute walk test (6MWT) and higher levels of CD 3+, CD 4+, and CD 4+/CD 8+ ratio [(317.19 ± 46.70) m, (54.53 ± 7.98)%, (34.76 ± 4.23)%, (1.20 ± 0.28)] compared with before treatment [(266.49 ± 43.01) m, (49.38 ± 8.27)%, (28.75 ± 3.33)%, (0.85 ± 0.21)] ( t6MWT = 5.70, tCD3+= 3.20, tCD4+=7.97, tCD4+/CD8+ = 7.14, all P < 0.001). Group B exhibited significantly longer distance in the 6MWT as well as higher levels of CD 3+, CD 4+, and CD 4+/CD 8+ ratio after treatment [(328.19 ± 41.48) m, (60.02 ± 5.17)%, (36.89 ± 5.59)%, (1.37 ± 0.27)] compared with before treatment [(265.69 ± 49.60) m, (44.33 ± 7.34)%, (28.59 ± 4.35)%, (0.83 ± 0.12)] ( t6MWT = 6.90, tCD3+ = 12.48, tCD4+ = 8.36, tCD4+/CD8+= 13.05, all P < 0.001). After treatment, the distance in 6MWT and the levels of CD 3+, CD 4+, and CD 4+/CD 8+ in Group B were significantly longer or higher compared with Group A ( t6MWT = 3.35, tCD3+ = 10.94, tCD4+ = 5.83, tCD4+/CD8+ = 8.42, all P < 0.05). After treatment, Modified British Medical Research Council Questionnaire (mMRC) score, CAT score, CD 8+ , ESR, and PCT in group A [(1.30 ± 1.04) points, (14.37 ± 4.58) points, (30.61 ± 8.32)%, (24.28 ± 4.88) mm/h, (0.44 ± 0.16) μg/L] were significantly decreased compared with before treatment [(2.53 ± 0.85) points, (20.10 ± 6.34) points, (35.90 ± 9.71)%, (33.26 ± 6.28) mm/h, (0.72 ± 0.16) μg/L, tmMRC = 6.54, tCAT = 5.23, tCD8+ = 4.21, tESR = 8.06, tPCT = 8.83, all P < 0.05). After treatment, mMRC score, CAT score, CD 8+, ESR, and PCT in group B [(1.09 ± 0.90) points, (13.58 ± 3.59) points, (27.63 ± 5.24)%, (23.16 ± 6.71) mm/h, (0.34 ± 0.14) μg/L] were significantly decreased compared with before treatment [(2.47 ± 0.93) points, (19.93 ± 4.60) points, (34.93 ± 5.52)%, (33.25 ± 77.59) mm/h, (0.72 ± 0.12), tmMRC = 7.61, tCAT = 7.77, tCD8+ = 6.85, tESR = 7.11, tPCT = 14.71, all P < 0.05). After treatment, mMRC score, CAT score, CD 8+, ESR, and PCT in group B were significantly lower compared with group A ( tmMRC = 2.87, tCAT = 2.57, tCD8+= 5.74, tESR = 2.57, tPCT = 8.77, all P < 0.05). Conclusion:The combination of acetylcysteine effervescent tablets and beclomethasone demonstrates obvious clinical efficacy in the treatment of COPD patients. The combined therapy effectively improves patients' exercise endurance, clinical symptoms, quality of life, and immune function.

Objective:To explore the relationship between single nucleotide polymorphism of programmed cell death 1 (PD-1) gene and long-term survival in non-small cell lung cancer (NSCLC) patients.Methods:Eighty NSCLC patients admitted to the Yiwu Central Hospital from June 2020 to June 2022 were selected. Polymerase chain reaction restriction fragment length polymorphism was used to detect the PD-1.1 (rs36084323) and PD-1.5 (rs2227981) polymorphisms in the peripheral blood of the patients. Follow-up statistics were conducted on the progression free survival (PFS) and overall survival (OS) of NSCLC patients. We also analyzed the correlation between PD-1 genotype and clinical parameters in non-small cell lung cancer patients. And Cox univariate and multivariate analyses were used to evaluate the influencing factors of PFS and OS in NSCLC patients.Results:The proportion of PD-1.1 AA, AG, and GG genotypes in NSCLC patients was 30.00%, 50.00%, and 20.00%, respectively, while the proportion of PD-1.5 CC, CT, and TT genotypes in NSCLC patients was 55.00%, 38.75%, and 6.25%, respectively. The differences were not statistically significant (all P>0.05). PD-1.1 genotype was correlated with differentiation degree ( P<0.05); PD-1.5 genotype was associated with lymph node metastasis ( P<0.05). The median PFS of patients with PD-1.1 genotype AA, AG, and GG were 15.00(95% CI: 1.65-28.35)months, 15.00(95% CI: 10.53-19.47)months, and 11.00(95% CI: 5.12-16.88)months, respectively. The median OS was 30.00(95% CI: 23.58-36.42)months, 31.00(95% CI: 29.45-32.56)months, and 22.00(95% CI: 11.56-32.44)months, respectively. There was no statistically significant difference in PFS and OS among the three genotypes (all P>0.05). The median PFS of patients with PD-1.5 locus CC and CT+ TT genotypes were 18.00(95% CI: 12.47-23.53)months and 10.00(95% CI: 6.47-13.53)months, respectively. The median OS was 32.00(95% CI: 29.86-34.14)months and 22.00(95% CI: 15.25-28.75)months, respectively, and the differences were statistically significant (all P<0.05). The Cox multivariate analysis results showed that clinical stage, lymph node metastasis, and PD-1.5 locus genotype were independent influencing factors for PFS in NSCLC patients (all P<0.05); Age, clinical stage, lymph node metastasis, and PD-1.5 locus genotype are independent influencing factors for OS (all P<0.05). Conclusions:The PD-1.5 locus polymorphism is associated with long-term survival in NSCLC patients, providing new research ideas for the mechanism research and targeted therapy of NSCLC.