Objective To investigate the changes in peripheral blood T-lymphocyte levels in patients with epithelial ovarian cancer(OC),and to analyze their relationship with patients'pathological parameters and their predictive value for patients'prognosis.Methods A total of 60 epithelial OC patients were selected as the case group,and 85 benign ovarian tumor patients were selected as the benign group.All patients in the case group received laparoscopic surgery and were followed up for 3 years.According to the prognosis,patients were divided into the good prognosis group(n=32)and the poor prognosis group(n=28).The peripheral blood levels of CD3+,CD4+and CD8+were detected,and the ratio of CD4+/CD8+was calculated.The peripheral blood levels of T lymphocytes in epithelial OC patients with different clinicopathological characteristics were compared.Receiver operating characteristic curve(ROC)was drawn to analyze the prognostic value of peripheral blood T lymphocytes in patients with epithelial OC.Results Compared with the benign group,the peripheral blood levels of CD3+,CD4+and CD4+/CD8+were decreased in the case group,and the CD8+level was increased(P＜0.05).Compared with epithelial OC patients with stage Ⅰ-Ⅱ,high differentiation,no peritoneal effusion and no lymph node metastasis,the peripheral blood CD3+and CD4+levels in epithelial OC patients with stage Ⅲ-Ⅳ,moderate and low differentiation,with peritoneal effusion and lymph node metastasis were lower,while CD8+was higher(P＜0.05).Compared with the good prognosis group,the peripheral blood levels of CD3+and CD4+were lower in the poor prognosis group,while the CD8+level was higher(P＜0.05).ROC analysis showed that the area under the curve(AUC)of combined detection of CD3+,CD4+,CD8+and CD4+/CD8+to predict the prognosis of epithelial OC patients was 0.952,which was higher than that of single detection of CD3+,CD4+,CD8+and CD4+/CD8+(P＜0.05).Conclusion Peripheral blood T-lymphocyte levels are correlated with clinicopathological characteristics and prognosis of patients with epithelial OC,and the combined testing of each index is more advantageous in predicting the prognosis of patients with epithelial OC.

Objective To investigate the changes in peripheral blood T-lymphocyte levels in patients with epithelial ovarian cancer(OC),and to analyze their relationship with patients'pathological parameters and their predictive value for patients'prognosis.Methods A total of 60 epithelial OC patients were selected as the case group,and 85 benign ovarian tumor patients were selected as the benign group.All patients in the case group received laparoscopic surgery and were followed up for 3 years.According to the prognosis,patients were divided into the good prognosis group(n=32)and the poor prognosis group(n=28).The peripheral blood levels of CD3+,CD4+and CD8+were detected,and the ratio of CD4+/CD8+was calculated.The peripheral blood levels of T lymphocytes in epithelial OC patients with different clinicopathological characteristics were compared.Receiver operating characteristic curve(ROC)was drawn to analyze the prognostic value of peripheral blood T lymphocytes in patients with epithelial OC.Results Compared with the benign group,the peripheral blood levels of CD3+,CD4+and CD4+/CD8+were decreased in the case group,and the CD8+level was increased(P＜0.05).Compared with epithelial OC patients with stage Ⅰ-Ⅱ,high differentiation,no peritoneal effusion and no lymph node metastasis,the peripheral blood CD3+and CD4+levels in epithelial OC patients with stage Ⅲ-Ⅳ,moderate and low differentiation,with peritoneal effusion and lymph node metastasis were lower,while CD8+was higher(P＜0.05).Compared with the good prognosis group,the peripheral blood levels of CD3+and CD4+were lower in the poor prognosis group,while the CD8+level was higher(P＜0.05).ROC analysis showed that the area under the curve(AUC)of combined detection of CD3+,CD4+,CD8+and CD4+/CD8+to predict the prognosis of epithelial OC patients was 0.952,which was higher than that of single detection of CD3+,CD4+,CD8+and CD4+/CD8+(P＜0.05).Conclusion Peripheral blood T-lymphocyte levels are correlated with clinicopathological characteristics and prognosis of patients with epithelial OC,and the combined testing of each index is more advantageous in predicting the prognosis of patients with epithelial OC.

Objective:To investigate the distribution characteristics and clinical significance of non-bacterial respiratory pathogens in children with respiratory tract infection.Methods:A total of 5 718 children with respiratory tract infection treated in outpatient, emergency and inpatient of Children′s Hospital Affiliated to Capital Institute of Pediatrics from January to December 2019 were retrospectively analyzed.Pharyngeal swabs were collected and nucleic acids of 7 common non-bacterial respiratory pathogens were detected and analyzed by double amplification technique. Chi square test was used to compare the rates. Results:A total of 5 718 children were included in the study.At least one respiratory pathogen nucleic acid positive was detected in 1 835 cases (32.09%). A total of 98 children had mixed infection of more than 2 pathogens (1.71%), which were mainly Mycoplasma pneumoniae (MP) and parainfluenza virus (PIV). The positive rates of 7 respiratory pathogens from high to low were MP (12.31%), PIV (6.23%), RSV (6.14%), influenza A virus (4.62%), adenovirus (2.80%), influenza B virus (1.40%) and chlamydia pneumoniae (0.33%). The positive rate of pathogens in male patients was 32.07% (1 073/3 346 cases), which was 32.12% (762/2 372 cases) in female patients.There was no significant difference in the positive rate of pathogens between males and females ( χ2=0.002, P=0.964). The positive rate of MP infection in male patients was significantly lower than that in females (11.48% vs. 13.49%) ( χ2=5.217, P=0.022). The total positive rate of infection in the 6 to <12 years old group was the highest (42.41%). The total positive rate (44.93%) and mixed infection rate (3.33%) were significantly higher in the fourth quarter than those of the others (30.43% vs.27.31% vs.34.59% vs.44.93%, 1.23% vs.1.10% vs.1.40% vs.3.33%; χ2=110.971, 26.968, all P<0.001). The total positive rate of pathogen infection in the outpatient and emergency department was 41.74% (606/1 452 cases), which was significantly higher than that of hospitalized children (31.13%) (1 328/4 266 cases) ( χ2=54.438, P<0.001). Conclusions:Non-bacterial respiratory pathogens are important pathogens leading to respiratory tract infections in children, among which MP infection is the most prevalent.Timely and accurate detection of pathogens is helpful for the diagnosis and treatment of respiratory tract infection and avoiding the abuse of antibiotics.

Objective To explore the related factors and clinical significance of the effect of irrigation on infant with dacryocystitis. Methods A total of 318 eyes of 262 infant were treated with dacryocystitis, and their overall curative effect was observed. Single factor correlation analysis and multivariate Logistic regression were used to analyze 8 factors related to efficacy, such as age of children, length of medical history, severity of symptoms, degree of operation of nurses, degree of parental cooperation, compliance with medication, massage therapy and treatment methods. The effect of each factor on the curative effect. Results It was found that the total effective rate was 90.56 percent of the lacrimal passage in children with 318 tear channel obstruction and dacryocystitis.Single factor analysis results show that the factors influencing the curative effect of single in treatment (χ2= 88.984, P < 0.01), symptom severity (χ2=14.185,P < 0.05) length of history (χ2=18.783, P < 0.05) difference and massage therapy (χ2=10.081, P < 0.05) was statistically significant, the three factors of multiariable Logistic regression analysis results showed that the treatment (P=0.000, OR=0.148,95％ CI 0.052- 0.419) and massage therapy (P=0.012, OR=3.390, 95％ CI 1.309- 8.777) affected infant lacrimal duct flushing out main factors influencing the efficacy of tong. Conclusions The main influencing factors are the different treatment modalities, severity of symptoms the length of medical history and massage therapy in the related factors that affect the effect of infantwith dacryocystitis.

Objective Experimental model of experimental autoimmune Myasthenia Gravis (EAMG) were established to explore the effect of Zini-Huangqi-Gegen decoction and Peiyuan-Guben powder on EAMG rats model.Methods Experimental animals were randomly divided into the control group (n=10) and the model group (n=30).The model rats were induced by murine AChR-α97-116 peptide immunostaining for EAMG rats model.After the first immunization,the general condictions and body weight of rats were observed,and the Lennon score was used to evaluate the rats.The second immunization was performed on the 1 1th day after the first immunization.On the 15th day after the first immunization,the rats were randomly divided into the model group(n=8),Huangqi-Gegen decoction and Peiyuan-Guben powder group (abbreviated Huangpei group,n=8) and Prednisone group (n=8) according to the Lennon score.Huangpi group rats were treated with Huangqi-Gegen decoction (21.5 g/kg) combined with Peiyuan-Guben powder (0.8 g/kg),prednisone group with 0.005 4 g/kg prednisone aqueous solution,the control group and the model group oral volume of distilled water.The rats were administered with a body weight of 10 ml/kg once a day for a total of 56 days.At the 70th day after the first immunization,serum was extracted from the rats.The Anti-AChR-α97-116 IgG and its subtype in serum were detected by ELISA.The IL-4,IL-10,IL-17 in serum were detected by ELISA.Results Compared with the model group,the weight of the rats in the Huangpei group and the prednisone group significantly increased after the 28th day of the first immunization (P＜0.05).After the 36nd day of the first immunization,the Lennon score of the Huangpei group significantly decreased (P＜0.05).At the end of the administration,the amplitude of EMG amplitude attenuation (41.83％ ± 7.45％ vs.67.76％ ± 4.32％) in the Huangpei group significantly decreased (P＜0.05),and the serum IgG (1.15 ± 0.07 vs.1.24 ± 0.08),IgG1 (0.17 ± 0.01 vs.0.25 ± 0.03),IL-4 (16.54 ± 1.66 pg/ml vs.25.64 ± 1.74 pg/ml),IL-10 (113.65 ± 12.87 pg/ml vs.121.54 ± 10.44 pg/ml),IL-17 (43.58 ± 3.54 pg/ml vs.65.76 ± 3.59 pg/ml) in the rat serum significantly decreased (P＜0.05).Conclusions Huangqi-Gegen decoction and Peiyuan-Guben powder can increase the body weight of rats,decrease the concentration of AChR-Ab in serum,the concentrations of IL-4,IL-10 and IL-17 in serum,and effectively improve the symptoms of EAMG rats.

Objective To investigate the clinical efficacy of implementation of standardized enteral nutrition (EN) and its effects on prognosis in patients with severe traumatic brain injury (sTBI) undergoing mechanical ventilation (MV). Methods Eighty-eight patients with sTBI undergoing MV admitted to the Department of Critical Care Medicine of Yuyao People's Hospital from January 2016 to December 2017 were enrolled, they were divided into a control group (42 cases) and an experiment group (46 cases) depending on the demarcation timing of January 1, 2017, the beginning time of implementing standardized EN. All the patients received early EN and conventional treatment in the two groups. Additionally, the procedure of standardized EN was implemented in the experiment group. The differences in starting time of EN, the first defecation time, the rates of EN therapeutic energy and protein supply reaching their respective targets, duration of MV and ICU stay and 28-day mortality were compared between the two groups. Results The starting time of EN (hours: 25.61±8.74 vs. 32.79±8.63) and first defecation time (days: 3.03±0.79 vs. 3.61±0.89) were significantly earlier in the experiment group than those in the control group (both P < 0.05); the rates of energy and protein supply reaching the respective targets on the 5th day and 7th day after receiving EN were all significantly higher in the experiment group than those in the control group [rates of energy supply reaching target on the 5th day: (44.83±13.99)% vs. 37.59±10.88, and on the 7th day: (68.07±10.68)% vs. (62.69±9.87)%; rate of protein supply reaching target on the 5th day: (31.93±9.49)% vs. (27.06±8.08)%, and on the 7th day: (62.09±9.91)% vs. (54.55±11.27) %, all P < 0.05]; the durations of MV (hours: 9.24±2.91 vs. 10.67±3.41) and ICU stay (days: 12.09±3.37 vs. 13.93±4.98) in the experiment group were significantly shorter than those in the control group (all P < 0.05). No statistical significant difference in the 28-day mortality was observed between the experiment group and control group [21.74% (10/46) vs. 19.05% (8/42), P > 0.05]. Conclusion The efficacy of implementation of standardized EN in patients with sTBI undergoing MV is very significant, as it can significantly improve the rate of reaching EN target, and shorten the duration of MV and ICU stay.

Objective To establish a risk prediction model of diabetic retinopathy (DR) for type 2 diabetic patients (T2DM).Methods A total of 315 T2DM patients (600 eyes) were enrolled in the study.There were 132 males (264 eyes) and 183 females (366 eyes).The mean age was (67.28± 12.17) years and the mean diabetes duration was (10.86 ± 7.81) years.The subjects were randomly assigned to model group and check group,each had 252 patients (504 eyes) and 63 patients (126 eyes) respectively.Some basic information including gender,age,education degree and diabetes duration were collected.The probable risk factors of DR including height,weight,blood pressure,fasting glucose,glycosylated hemoglobin (HbAlc),blood urea,serum creatinine,uric acid,triglyceride,total cholesterol,high-density lipoprotein,low density lipoprotein cholesterol and urinary protein.The fundus photograph and the axial length were measured.Multivariate logistic regression was used to analyze the correlative factors of DR and establish the regression equation (risk model).Receiver operating characteristic (ROC) curves were used to determine the cut-off point for the score.The maximum Youden Index was used to determine the threshold of the equation.The check group was used to check the feasibility of the predictive model.Results Among 504 eyes in the model group,170 eyes were DR and 334 eyes were not.Among 126 eyes in the check group,45 eyes were DR and 81 eyes were not.Multivariate logistic regression analysis revealed that axial length [β=-0.196,odds ratio (OR)=0.822,P＜0.001],age (β=-0.079,OR=0.924,P＜0.001),diabetes duration (β=0.048,OR=1.049,P=0.001),HbAlc (β=0.184,OR=1.202,P=0.020),urinary protein (β=1.298,OR=3.661,P＜0.001) were correlated with DR significantly and the simplified calculation of the score of DR were as follows:P=7.018-0.196X 1-0.079X2+0.048X3+0.148X4+ 1.298X5 (X1=axial length,X2=age,X3=diabetes duration,X4=glycosylated hemoglobin,X5=urinary protein).The area under the ROC curve for the score DR was 0.800 and the cut-offpoint of the score was-1.485.The elements of the check group were substituted into the equation to calculate the scores and the scores were compared with the diagnostic threshold to ensure the patients in high-risk of DR.The result of the score showed 84％ sensitivity and 59％ specificity.ROC curve for the score to predict DR was 0.756.Conclusion Axial length,age,diabetes duration,HbA1c and urinary protein have significant correlation with DR.The sensitivity and specificity of the risk model to predict DR are 84.0％ and 59.0％ respectively.The area under the ROC curve was 0.756.

Objective To investigate the clinical efficacy of conventional treatment combined with flupentixol and melitracen in patients with reflux esophagitis (RE).Methods From June 2012 to March 2015, a total of 182 patients were selected as study subjects from newly diagnosed RE patients.The anxiety and depression scores were evaluated according to Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD).And then patients were divided into HAMA and HAMD negative conventional treatment group and combined treatment group, HAMA and HAMD positive conventional treatment group and combined treatment group.Rabeprazole and mosapride were administrated in conventional treatment group.For patients in combined treatment group, on the base of conventional treatment flupentixol and melitracen were added.The treatment course was eight weeks.The degree of anxiety and depression, RE symptoms and mucosal healing under gastroscope were evaluated before and after treatment.Adverse drug reaction was observed.Chi square test or t test was performed for statistical analysis.Results Eight weeks after treatment, the scores of HAMA and HAMD in HAMA and HAMD positive combined treatment group were 7.930 ±3.832 and 9.630 ± 3.650, which were both lower than those of conventional treatment group (11.660 ± 4.108 and 12.170 ± 4.459), and the differences were statistically significant (t=3.683 and 2.233;both P＜0.05).The symptom scores of heartburn, regurgitation, chest pain of HAMA and HAMD positive combined treatment group were 0.700±0.591,0.780± 0.629 and 0.720±0.621, respectively, which were lower than those of conventional treatment group (1.280 ± 0.502, 1.370 ± 0.610 and 1.040 ± 0.842), and the differences were statistically significant (t =5.133, 4.413 and 2.114, all P＜0.05).There were no statistical significance in symptoms scores between HAMA and HAMD negative combined treatment group and conventional treatment group (all P＞0.05).After treatment, the mucosal healing rate of HAMA and HAMD positive combined treatment group was 91.3％ (42/46), which was higher than that of conventional treatment group (71.7 ％, 33/46), and the difference was statistically significant (x2 =5.845, P =0.016).The incidence of adverse events of HAMA and HAMD negative combined treatment group was 4.8％ (2/42), and that of HAMA and HAMD positive combined treatment group was 2.2％(1/46).Conclusions The conventional treatment combined with flupentixol and melitracen in RE patients accompanied with anxiety and depression was remarkable and safe.RE patients without obvious anxiety or depression, preventive use of antianxiety and antidepressant medicine can not improve the efficacy.