OBJECTIVE To investigate the levels of high-mobility group box 1(HMGB1)protein,soluble fms-like tyrosine kinase 1(sFLT-1)and lactate-to-albumin ratio(LAR)in patients with severe pulmonary infection-associ-ated sepsis undergoing continuous renal replacement therapy(CRRT),and their correlation with 28-day clinical outcomes.METHODS A total of 102 patients with severe pulmonary infection-associated sepsis undergoing CRRT admitted to the People's Hospital of Nanchuan Chongqing from Jul.2021 to Jul.2024 were enrolled.Based on 28-day clinical outcomes,they were divided into a favorable prognosis group(71 cases)and a poor prognosis group(31 cases).The levels of HMGB1,sFLT-1,lactate,albumin and LAR were compared between the two groups.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of HMGB1,sFLT-1 and LAR for 28-day clinical outcomes in patients with severe pulmonary infection-associated sepsis undergoing CRRT.RESULTS Gram-negative bacteria were the predominant pathogens in patients with se-vere pulmonary infection-associated sepsis undergoing CRRT.The poor prognosis group had higher lactate levels(4.01±1.07 mmol/L)and lower albumin levels(27.46±4.15 g/L)than the favorable prognosis group(P＜0.05).The levels of HMGB1(62.66±15.66 ng/ml),sFLT-1(0.71±0.17 ng/ml)and LAR(14.59±3.64％)in the poor prognosis group were significantly higher than those in the favorable prognosis group(P＜0.05).The combined detection of HMGB1,sFLT-1 and LAR yielded an area under the curve(AUC)of 0.949 for predicting poor 28-day mortality in patients with severe pulmonary infection-associated sepsis undergoing CRRT,superior to the single detection of the indexes(P＜0.05),with a sensitivity of 93.55％and specificity of 87.32％.CONCLUSIONS In patients with severe pulmonary infection-associated sepsis undergoing CRRT,gram-negative bacteria are the predominant pathogens.Patients with poor prognosis exhibit abnormally elevated levels of HMGB1,sFLT-1 and LAR,and the combined detection of these three markers demonstrates high predictive value for 28-day mortality.

OBJECTIVE To investigate the levels of high-mobility group box 1(HMGB1)protein,soluble fms-like tyrosine kinase 1(sFLT-1)and lactate-to-albumin ratio(LAR)in patients with severe pulmonary infection-associ-ated sepsis undergoing continuous renal replacement therapy(CRRT),and their correlation with 28-day clinical outcomes.METHODS A total of 102 patients with severe pulmonary infection-associated sepsis undergoing CRRT admitted to the People's Hospital of Nanchuan Chongqing from Jul.2021 to Jul.2024 were enrolled.Based on 28-day clinical outcomes,they were divided into a favorable prognosis group(71 cases)and a poor prognosis group(31 cases).The levels of HMGB1,sFLT-1,lactate,albumin and LAR were compared between the two groups.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of HMGB1,sFLT-1 and LAR for 28-day clinical outcomes in patients with severe pulmonary infection-associated sepsis undergoing CRRT.RESULTS Gram-negative bacteria were the predominant pathogens in patients with se-vere pulmonary infection-associated sepsis undergoing CRRT.The poor prognosis group had higher lactate levels(4.01±1.07 mmol/L)and lower albumin levels(27.46±4.15 g/L)than the favorable prognosis group(P＜0.05).The levels of HMGB1(62.66±15.66 ng/ml),sFLT-1(0.71±0.17 ng/ml)and LAR(14.59±3.64％)in the poor prognosis group were significantly higher than those in the favorable prognosis group(P＜0.05).The combined detection of HMGB1,sFLT-1 and LAR yielded an area under the curve(AUC)of 0.949 for predicting poor 28-day mortality in patients with severe pulmonary infection-associated sepsis undergoing CRRT,superior to the single detection of the indexes(P＜0.05),with a sensitivity of 93.55％and specificity of 87.32％.CONCLUSIONS In patients with severe pulmonary infection-associated sepsis undergoing CRRT,gram-negative bacteria are the predominant pathogens.Patients with poor prognosis exhibit abnormally elevated levels of HMGB1,sFLT-1 and LAR,and the combined detection of these three markers demonstrates high predictive value for 28-day mortality.

Objective To evaluate the clinical curative effect,survival rate and adverse reactions of three-dimensional conformal radiotherapy(3D-CRT )in combination with chemotherapy on lymph nodes metastasis of esophageal carcinoma.Methods Using supraclavicular 3D-CRT combined with chemotherapy on and simple 3D-CRT supraclavicular lymph node metastasis of esophageal cancer patients,3D-CRT com-bined synchronous chemotherapy (treatment group),51 cases,only 3D-CRT 49 cases (control group).3D-CRT combined synchronous chemotherapy 51 cases (treatment group),simple 3D-CRT 49 cases (control group).These patients 3D-CRT were given the total dose of 50 ~60Gy/25 ~30F.TN chemotherapy regi-mens were applied:paclitaxel 135 mg/m2 ,d1;Nedaplatin 25 mg/m2 ,d1,1 ~3,21 days cycle in fist week and fourth week.Results Local control and treatment group survival rates in 1,2 year were significantly higher than that of control group (P <0.05).Treatment group adverse reaction rate is higher than the con-trol group,but there was no statistically significant difference.Conclusions The recent curative effect and survival rate could be significantly improved by 3D-CRT joint TN synchronous chemotherapy regimen for pa-tients with supraclavicular lymph node metastasis of esophageal cancer,but the relatively high incidence of adverse reactions,clinical application should be considered comprehensively according to actual situation.

Objective To investigate the effect of different pressures of hyperbaric oxygen (HBO) treatment on neuropathic pain (NP) in rats.Methods Twenty-four healthy male Sprague-Dawley rats were randomly divided into 4 groups (n =6 each):sham operation group (group S),NP group,treatment with HBO at 2.0 atmosphere absolute group (group HBO2.0) and treatment with HBO at 2.5 atmosphere absolute group (group HBO2.5).The animals were anesthetized with intraperitoneal 5 ％ chloral hydrate 300 mg/kg.NP was induced by chronic constrictive injury.The left sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1-mm intervals with 4-0 silk thread.After the rats were placed in the HBO chamber,the pressure was increased at a rate of 10 kPa/min until the desired pressure was reached,and then the pressure was maintained at this level for 60 min.The pressure was then decreased at a rate of 10 kPa/min until the normal pressure was reached.HBO treatment was performed once a day for 5 consecutive days starting from 1st day after operation in groups HBO2.0 and HBO2.5.While the rats were only placed in the HBO chamber and stayed for 100 min in groups S and NP.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 0,1and 2 h after leaving the HBO chamber (T0.2).Results Compared with group S,MWT was significantly decreased and TWL was shortened in group NP (P ＜ 0.05).Compared with group NP,MWT was significantly increased and TWL prolonged at T1 during the treatment (P ＜ 0.05),while no significant change was found in MWT and TWL at T2 during the treatment in groups HBO2.0 and HBO2.5 (P ＞ 0.05).There was no significant difference in MWT and TWL at each time point during the treatment between groups HBO2.0 and HBO2.5 (P ＞ 0.05).Conclusion Treatment with different pressures of HBO can reduce NP in rats,but the change in pressure dose not affect the analgesic efficacy.

Objective To evaluate the clinical efficacy of three-dimensional conformal radiotherapy (3D-CRT) combined with thermochemotherapy in the treatment of locally advanced pancreatic cancer (LAPC).Methods From June 2008 to June 2011,70 patients with LAPC were divided into radiotherapy group (30 patients) and combination group (40 patients).Radiotherapy used 3D-CRT with a 90％ to 95％ isodose curve,a single dose of 1.8 to 2.OGy,and total radiation dose 50 ～ 70 Gy.The combination group patients received simultaneous thermotherapy at 41.5 ～43.5 ℃ (1 h/fraction,twice a week for 6 times),and hyperthermia given simultaneously injected using arsenic trioxide 20 mg,recombinant mutant human tumor necrosis factor(rmhTNF) intravenous infusion of 10 million U,4 to 6 times,or 3D-CRT at the same time and the treatment given after gemcitabine(0.6 ～ 1.0 g/m2) on Days dl and 8 and cisplatin (DDP) (20 ～ 30 mg/m2) on Days d1-3 intravenous infusion,repeated every 28 days for 3 ～ 6 cycles.Results At 3 months after treatment,the total response (complete remission and partial remission) rate was 70.0％ (49/70),the efficiency of radiotherapy combined with chemotherapy,and radiotherapy combined with thermo-chemotherapy were 56.5％ and 88.2％,and the radiotherapy alone group was 56.7％.There were significant difference in efficiency between radiotherapy combined with thermo-chemotherapy group compared to radiotherapy-chemotherapy group and radiotherapy group (x2 =4.68,4.98,P ＜ 0.05),the last two groups showed no significant difference (P ＞ 0.05).The 1-year and 2-year survival rate was 46.8％ and 20.3％,respectively.The 1-year and 2-year survival rates were 52.4％ and 26.7％ in combination group,and 42.5％ and 16.2％ in radiotherapy group (x2 =14.17,P ＜ 0.05 ; x2 =9.74,P ＜ 0.05).No serious complications such as perforation,bleeding,and high fever were seen during treatment and follow-up.Conclusions 3D-CRT combined with thermochemotherapy is well tolerated and is relatively effective for the LAPC patients.

Objective To investigate artemin and its receptors GFRα3 expression in human pancreatic ductal adenocarcinoma and its significance. Methods Expression and distribution of artemin and GFRα3 in 100 cases of human pancreatic ductal adenocarcinoma(PDAC) and 40 cases of normal pancreatic tissue were detected by immunohistochemistry and RT-PCR, quantitative RT PCR. Relations of artemin and GFRα3 with clinicopathological characteristics, especially nerve invasion were analyzed. Results Nerve invasion was detected in 64 out of 100 cases of PDAC, and the rate of nerve invasion was 64%. The ratio of expression of Artemin, GFRα3 protein in PDAC/normal pancreatic tissue was 2.697 ± 0.231 and 2.599 ± 0.588; the ratio of expression of Artemin, GFRα3 mRNA was 7.01 and 4.63. Artemin and GFRα3 expression were associated with tumor location, differentiation degree, TNM staging, nerve invasion node metastasis, but it was not associated with age, sex and tumor size. Artemin and GFRα3 expression was more positively expressed in cancer cells close to nerve tissue than cells far from nerve tissue. Conclusions Artemin and GFRα3 were involved in the development of pancreatic cancer and their high expression was closely related to perineural invasion.

ObjectiveTo determine the peripheral serum expressions and clinical value of carcinoembryonic antigen (CEA) and carbohydrate antigen CA19-9,CA242,CA72-4 and a single sialic acid ganglioside (CA50) antigen in advanced pancreatic cancer patients treated by three-dimensional conformal radiotherapy (3D-CRT) combined with endogenous field hyperthermia.Methods60 patients inoperable,advanced pancreatic cancer were treated by 3D-CRT combined with endogenous field hyperthermia.Radiation dose (DT) was 46 ～ 66 GY/23 ～ 33 F.Hyperthermia temperature was 41 ～ 43 ℃ 2 times/week,lasted 60 min each time.The expressions of CEA,CA19-9,CA242,CA72-4 and CA50 in peripheral serum were detected by Electrochemiluminescence immunoassay (ECLIA) every 2 weeks during treatment,and correlation were analyzed with tumor diameter,clinical stage,lymph node metastasis.Results From the 8th week,with 3D-CRT combined with endogenous field hyperthermia ongoing,CEA,CA19-9,CA50 andCA242 expression levels showed a gradual decline.CEA,CA19-9,CA50 and CA242 expression levels were (6.22 ± 2.71 ) μg/L,(43.44 ± 12.93 ) μg/L,(23.21 ± 7.71 )g/L and (24.26 ± 8.92) μg/L in 6 weeks,respectively.The difference was statistically significant among week 6 and week 0,week2,week 4 ( P ＜0.05),however there was no significant difference between week 6 and week 8 ( P ＞ 0.05 ).The CA724 expression did not change significantly ( P ＞ 0.05 ).There were positively correlation between CEA,CA199,CA50 and CA242 with pancreatic cancer tumor size,clinical stage and lymph node metastasis( respectively r =0.877,0.725,0.826,all P ＜ 0.01 ),however CA72-4 had no correlations ( P ＞ 0.05).ConclusionsCEA,CA19-9,CA50 and CA242 expressions in peripheral serum of pancreatic cancer patients were closely related to the treatment.Their joint detection can be served as independent objective evaluation reference information for the treatment efficacy and prognosis.

Objective To investigate the efficacy and safety of oxycodone hydrochloride controlled-release tablets combined with gabapentin in the treatment of painful diabetic neuropathy.Methods Eighty patients with painful diabetic neuropathy were divided into group A and group B with 40 cases each by random digits table.Patients of group A received simple oxycodone hydrochloride controlled-release tablets,while patients of group B received oxycodone combined with gabapentin.The intensity of pain, oxycodone dosage, quality of life and adverse effect in two groups was observed and compared.Results The pain was obviously relieved in two groups, and the effective analgesic rate at 21-28 d after treatment in group B was superior to group A[95.0% (38/40) vs.62.5% (25/40)], there was significant difference between two groups (P＜0.05).Numerical rating scale NRS score at 28 d after treatment in group B and group A was 1.2 ± 0.3 and 2.8 ± 0.5 respectively,and there was significant difference between two groups (P＜ 0.01 );the oxycodone dosage at 28 d after treatment in group B was lower than that in group A[(32.2 ± 4.3 )mg vs.(40.3±5.5 ) mg], and there was significant difference between two groups (P ＜ 0.05 ); the quality of life in group B was superior to group A, and there was significant difference between two groups (P ＜ 0.05 or ＜ 0.01 );the incidence of dizzy at 7, 14 d after treatment in group B was higher than that in group A[35.0% (14/40) vs.15.0% (6/40) and 30.0% (12/40) vs.10.0% (4/40)],and there was significant difference between two groups (P ＜ 0.05 ).Conclusion Oxycodon hydrochloride controlled-release tablets combined with gabapentin is effective and safe for the management of painful diabetic neuropathy.

Objective To investigate the role of the expression of prostate stem cell antigen(PSCA)in the development of perineural invasion in pancreatic carcinoma.Methods The histopathologic and immunohis-tochemical(SABC)studies were performed on 80 patients with pancreatic carcinoma.The overall incidence of PSCA expression,perineural,lymphatic and vascular vessel invasion were counted to investigate the relationships among them.Results Perineurel invasion was positively correlated with lymphatic and vascular vessel invasion (P<0.01).A positive corelation Was found between tumor PSCA expressioa(53 cases)and the perineurel in-vasion(66 cases).A definite correlation Was also found between cancer differentiation and PSCA tyxplres-sion.Conclusion PSCA is one of the most important molecules and may play a role as a "navigating" and " docking" molecule in the developmeat of perineural invasion.

Objective: To investigate the effect of nerve growth factor-β(NGF-β) on the proliferation and cell cycle of human pancreatic cancer MIA PaCa-2 cells. Methods: MIA PaCa-2 cells were treated with different concentrations of NGF-β and K252a (inhibitor of NGF-β receptor TrKA) alone or in combination. Clone forming rate, proliferation, and cell cycle of MIA PaCa-2 cells treated with different strategies were examined by clone formation assay, MTT, and flow cytometry, respectively. Results: NGF-β significantly increased the clone formation and proliferation of MIA PaCa-2 cells (P<0.05, P<0.01). K252a significantly inhibited the proliferation of MIA PaCa-2 cells (P<0.05), while NGF-β combined with K252a had no significant effect on the proliferation of MIA PaCa-2 cells. NGF-β arrested MIA PaCa-2 cell cycle in S phase, K252a arrested cell cycle in G_0/ G_1 phase, and NGF-β combined with K252a arrested cell cycle in S phase. Conclusion: NGF-β can enhance the proliferation of pancreatic carcinoma MIA PaCa-2 cells.