Objective:To investigate the effect of baicalin(BA)on the polarization of macrophages in rats with lung injury in-duced by severe acute pancreatitis(SAP),and its regulatory mechanism on janus protein tyrosine kinase 2/signal transducer and acti-vator of transcription 3(JAK2/STAT3)signaling pathway.Methods:The SAP rat model was constructed.Low and high doses of BA were used for intervention.SC-39100,a specific agonist of JAK2/STAT3,was used to rescue the function.ELISA was used to detect the content of TNF-α,IL-6 and IL-10.TUNEL was used to detect apoptosis in lung tissue.Immunofluorescence was used to detect the polarization of macrophages in lung tissue.Western blot was used to detect cell the expression of phosphorylated protein tyrosine ki-nase 2(p-JAK2),phosphorylated signal transducer and activator of transcription 3(p-STAT3),TNF-α,IL-6,IL-10,TGF-β1 in lung tissue.Results:BA could significantly downregulate the content of TNF-α and IL-6 in serum,as well as the rate of cell apoptosis in lung tissue.BA could significantly upregulate the content of IL-10 in serum.BA could regulate the polarization of macrophages to-wards M2.Western blot results showed that BA could significantly downregulate the expressions of p-JAK2,p-STAT3,TNF-α and IL-6,upregulate the expressions of IL-10 and TGF-β1.The expression of SC-39100 could partially reverse the protective effect of BA on lung tissue,and the differences were statistically significant(all P<0.05).Conclusion:BA can significantly inhibit cell apoptosis in the rat model of SAP lung injury,alleviate the pathological damage of the animal lung tissue,and promote the polarization of macro-phages in the lung tissue towards M2,which may be related to the inhibition of JAK2/STAT3 signaling pathway phosphorylation.

Objective:To investigate the effect of baicalin(BA)on the polarization of macrophages in rats with lung injury in-duced by severe acute pancreatitis(SAP),and its regulatory mechanism on janus protein tyrosine kinase 2/signal transducer and acti-vator of transcription 3(JAK2/STAT3)signaling pathway.Methods:The SAP rat model was constructed.Low and high doses of BA were used for intervention.SC-39100,a specific agonist of JAK2/STAT3,was used to rescue the function.ELISA was used to detect the content of TNF-α,IL-6 and IL-10.TUNEL was used to detect apoptosis in lung tissue.Immunofluorescence was used to detect the polarization of macrophages in lung tissue.Western blot was used to detect cell the expression of phosphorylated protein tyrosine ki-nase 2(p-JAK2),phosphorylated signal transducer and activator of transcription 3(p-STAT3),TNF-α,IL-6,IL-10,TGF-β1 in lung tissue.Results:BA could significantly downregulate the content of TNF-α and IL-6 in serum,as well as the rate of cell apoptosis in lung tissue.BA could significantly upregulate the content of IL-10 in serum.BA could regulate the polarization of macrophages to-wards M2.Western blot results showed that BA could significantly downregulate the expressions of p-JAK2,p-STAT3,TNF-α and IL-6,upregulate the expressions of IL-10 and TGF-β1.The expression of SC-39100 could partially reverse the protective effect of BA on lung tissue,and the differences were statistically significant(all P<0.05).Conclusion:BA can significantly inhibit cell apoptosis in the rat model of SAP lung injury,alleviate the pathological damage of the animal lung tissue,and promote the polarization of macro-phages in the lung tissue towards M2,which may be related to the inhibition of JAK2/STAT3 signaling pathway phosphorylation.

Abstract: Objective　To explore the clinical features and survival prognosis of stage Ⅳ non-small cell lung cancer (NSCLC) and provide a reference for prognosis evaluation and prevention and treatment of the disease. Methods A retrospective analysis was performed on 195 patients with stage Ⅳ NSCLC admitted to the Department of Medical Oncology and the Department of Respiratory Medicine of the First Affiliated Hospital of Hainan Medical University from 2016 to 2020, who were diagnosed pathologically and available for the analysis and study. Patients' hospitalization records and follow-up information were collected to analyze the survival of the patients at the cut-off of follow-up. The Kaplan-Meier method was used to calculate survival rates, and the Log-rank method was employed for univariate analysis of factors affecting survival. The risk factors for patients' survival prognosis were analyzed by multivariate Cox regression model. Results The median survival time for patients with stage Ⅳ NSCLC was 17.05 months (95% CI: 12.64-21.45), with cumulative survival rates of 70.7%, 41.5%, and 22.0% at 1, 2, and 3 years, respectively. The results of multivariate analysis suggested that gender (HR=0.697, 95% CI: 0.486-0.999, P=0.049), functional status scale (Karnofsky, KPS) (HR=1.535, 95% CI: 1.038-2.270, P=0.032), computed tomography (CT) tumor location (HR=1.481, 95%CI:1.003-2.186, P=0.036), pathology type (HR=1.181, 95%CI:0.715-1.950, P=0.019), metastatic site (HR=1.710, 95%CI:1.214-2.409, P=0.002), N stage (HR=2.094, 95%CI:0.973-4.509, P=0.006), gene mutation (HR=2.387, 95%CI:1.590-3.584, P<0.001), treatment with chemotherapy-containing regimen (HR=1.713, 95%CI:1.094-2.683, P= 0.019), and combination therapy (HR=1.874, 95%CI:1.253-2.802, P=0.002) were independent prognostic factors affecting the survival of patients with stage Ⅳ NSCLC (all P<0.05). In the subgroup analysis, metastatic site and chemotherapy-containing treatment regimen were independent prognostic factors affecting the survival of mutation-positive patients with stage Ⅳ NSCLC, and patients who received targeted therapy had longer survival time. The metastatic site, chemotherapy-containing treatment regimen, and combination therapy were prognostic factors affecting the survival prognosis of patients with gene mutation-negative stage Ⅳ NSCLC or unknown status. Conclusions In this study, gender, KPS score, CT tumor location, pathologic type, metastatic site, N stage, gene mutation, treatment with chemotherapy-containing regimen, and combination therapy were the important factors affecting the survival prognosis of patients with stage Ⅳ NSCLC. In terms of treatment options, chemotherapy remains an indispensable basic treatment option. Moreover, comprehensive treatment can prolong survival compared to a single treatment option. Patients with positive gene mutations who received targeted drugs had longer survival times; therefore, detecting gene mutation status and selecting corresponding targeted drugs in the treatment of stage Ⅳ NSCLC could extend survival periods.

Objective To investigate the effects and mechanism of TET2 inhibitor itaconate in prolifer-ation and migration of breast cancer cell line MDA-MB-231.Methods The MDA-MB-231 cells were treated for 24 h with dimethyl sulfoxide(DMSO)and 1,5 μmol/L itaconate respectively.The cellular apoptosis was determined by flow cytometry to determine the available itaconic acid concentration.The immunofluorescence was performed to determine the inhibiting effect of itaconate on hydroxymethylcytosine(5hmC)expression level.The cell counting and MTS were performed to determine the effect of itaconate on cell proliferation and activity.The Transwell experiment was performed to determine the effect of itaconate on cell transfer ability.The methylation-specific real-time fluorescence quantitative PCR(qPCR)was used to detect the effects of ita-conic acid treatment on the methylation of promoter regions of genes related to cell proliferation and migra-tion.qPCR was used to detect the effects of itaconate on the cellular proliferation,migration related genes ex-pression.Results 5 μmol/L itaconate treating the cells had no significant effect on the cellular apoptosis,mo-reover could inhibit 5hmC expression level.The cell count and MTS results showed that itaconate could pro-mote the cell proliferation(increase by about 58％,P＜0.05)and increase the cell activity(increase by 42％,P＜0.05).The Transwell experiment results showed that itaconate increased the cell migration(increase by 55％,P＜0.05).The methylation-specific qPCR showed that the itaconate treatment significantly promoted the methyaltion of the promoters p21 and PTEN.The qPCR results showed that itaconate significantly inhibi-ted the expression levels of p21 and PTEN(P＜0.05).Conclusion Itaconate promotes the proliferation and migration of MDA-MB-231 cells through inhibiting 5hmC level of p21 and PTEN and decrease its expression.

Objective To observe the effect of aerobic exercise combined with impedance training on the blood pressure variability and other blood-related indexes of patients with hypertension. Methods Ninety patients with essential hypertension were randomly divided into group A, group B and group C, each of 30. All were treated with conventional anti-hypertensive drugs. Groups B and C additionally underwent 40 minutes of aerobic training and group C also received resistance training. There were 3 training sessions a week for 12 weeks. Each subject's 24 h systolic blood pressure (24hSBP), 24 h diastolic blood pressure (24hDBP) and their standard deviations were ob-served before and after the 12 weeks. Blood indexes were examined and a plasma arteriosclerosis index was calculated. Results Before the treatment, there were no significant differences in any of the average measurements among the three groups. After the treatment, the average 24hSBP and 24hDBP of all three groups had decreased significantly, but larger decreases were observed in groups B and C. Compared with group B, the average 24hSBP and 24hDBP of group C had decreased significantly more. The average levels of atherogenic index of plasma ( AIP) and lipoprotein phospholipase A2 of groups B and C were significantly lower than before the treatment and also significantly lower than group A's average. The decrease in group C was significantly greater than in group B. Conclusions Anti-hyperten-sive drugs can lower blood pressure, but cannot effectively control blood pressure variation, reduce blood lipids or im-prove the arteriosclerosis index. Long-term, regular aerobic exercise can decrease these indicators and reduce cardio-vascular disease risk in elderly patients with hypertension. Aerobic exercise combined with mild to moderate circulato-ry resistance exercise is more effective than aerobic exercise alone.

[Summary] During the past 10 years, the prevalence of obesity and type 2 diabetes mellitus ( T2DM) worldwide has increased greatly.Western dietary pattern is often regarded as the primary causes of the metabolic diseases like obesity and T2DM.A number of other diets have been shown to be effective for the management of obesity and T2DM, such as the Mediterranean diet, the vegetarian diet, the low-calorie diet and the macrobiotic diet.In addition, recent studies have suggested that an imbalance of the intestinal microbiota may be involved in the development of obesity and T2DM.The main regulator of the intestinal microbiota is diet, and the composition of microbiota is impacted by long time diet pattern.This article reviews the recent advance in the influence of different diet patterns on human metabolism and gut microbiota.

Objective:To evaluate the staining of different resin artificial teeth treated by different coloring agents.Methods:1 6 teeth of each brand of Endura Anterio,Heraeus's three color synthetic resin teeth,synthetic resin teeth,Efucera-A,KaiFeng synthetic resin teeth were respectively made into test specimens.A surface roughness tester was used to measure Ra along 3 tracks on each sur-face.The specimens of the same brand were respectively immersed into coffee,tea and vinegar as the test groups and distilled water as a control for 4 weeks.The initial and further color of each specimen was measured using a colorimeter.The CIE L* a* b* values were recorded and color differences (ΔE)after immersion were calculated.Data were statistically analyzed by ANOVA.Results:The color stability of the specimens in coffee and tea was significantly affected by the coloring agents(P <0.05),the higher ΔE was ob-served in coffee than in tea(P <0.05).There were no statistically evident color change in water and in vinegar(P >0.05).The ΔE values in the same coloring agent were as follows:Efucera-A,Heraeus's three color synthetic resin teeth,Endura Anterio,synthetic resin teeth and KaiFeng synthetic resin teeth (P <0.05).Conclusion:Extrinsic pigment can make resin artificial teeth stained,and the staining susceptibility of five resin artificial teeth is different.

Objective To explore the curative effect of ulinastatin against toxic acute kidney injury(AKI) in rats and its mecha-nism .Methods Twenty-four male SD(Sprague Dawley) rats were randomly divided into 3 groups ,control group ,model group and treatment group with 8 rats in each group .Rats were subcutaneously injected gentamicin(300 mg/kg of body weight per day) for 3 days to establish models of toxic AKI .Rats in treatment group were intraperitoneally injected with a 7-day course of ulinastatin(30 000 U/kg of body weight per day) from 4th day .Dectetion of serum level of creatinine and Cystatin-C(Cys C) ,urinary concentra-tion of kidney injury molecule-1 (Kim-1 ) and neutrophil gelatinase-associated lipocalin (NGAL ) ,activity of superoxide dismutase (SOD) and glutathione peroxidase(GSH-Px) ,content of malondialdehyde ,levels of tumour necrosis factor-alpha(TNF-α) and inter-leukin-1β(IL-1β) in homogenate of renal tissues as well as observation of renal pathological changes and semiquantitative score in each group were conducted on 11th day .Results In model group ,degeneration and necrosis of renal tubular epithelial cell ,dilatation of renal tubular cavity and inflammatory cell infiltration in renal interstitial were observed .Renal pathological changes were milder in treatment group ,when compared with the model group .Renal pathological semiquantitative score ,serum level of creatinine and Cys C ,urinary concentration of Kim-1 and NGAL ,content of malondialdehyde ,levels of TNF-α and IL-1β in homogenate of renal tissues were higher in model group than in control group ,while those in treatment group were lower than in model group(P<0 .01 , respectively) .And activity of SOD and GSH-Px in homogenate of renal tissues were lower in model group than in control group ,and those in treatment group were higher than in model group and control group(P<0 .01 ,respectively) .Conclusion Ulinastatin pos-sesses a curative role in toxic AKI in rat via inhibiting oxidative stress and down-regulating levels of proinflammatory factor in renal tissues .

Objective To investigate the feasibility of serum cardiac troponin T(cTnT) as a marker of cardiovascular events and hemodialysis (HD) adequacy in maintainence hemodialysis (MHD) patients.Methods Forty-seven cases of MHD patients were randomly divided into two groups (group A and group B).Group A received intermittent HD 4 h thrice one week,and group B received intermittent HD 4 h twice one week plus high-flux hemodiafiltration(HDF) 4 h once one week.Serum examination for blood biochemical indicator,cTnT and echocardiogram was performed every three months and at the time of recruitment.All the patients were followed up until the occurrence of death or cardiovascular events.Results After 3 months treatment,serum cTnT deceased significantly in group B compared with group A,and maintained the lower levels throughout the follow-up.E/A and LVEF had been reduced since 3 months treatment in group A,but stable in group B,E/A was lower in group A after 18 months treatment than that in group B,LVEF was lower in group A after 12 months treatment than that in group B.There were positive correlations between cTnT and E/A or LVEF in 42 cases who accomplished the follow-up of 12 months (r =0.54,0.66,P ＜0.05).Kaplan-Meier survival curve showed that the occurrence of cardiovascular events in patients with cTnT≥0.1μ g/L was higher than that with cTnT ＜0.1 μg/L in (28.5 ± 9.7) months' follow- up (Log-rank test: P =0.02).Both survival analysis and Cox analysis indicated that serum cTnT was a predictor of cardiovascular events in MHD patients.Conclusions Serum level of cTnT can be used as a marker of HD adequacy,and it is a predictor of cardiac events in MHD patients.Regular high-flux HDF increases the adequacy of HD treatment and improves the quality of life in MHD patients.

Objective To explore the value of combined measurement of urine N-acetyl-beta-D-glucosaminidase (NAG) activity and serum Cystatin C in diagnosing diabetic nephropathy (DN) in early phase. Methods Sixty-two cases with type 2 diabetes (diabetic group) were divided into three groups according to their 24 hours urinary albumin excretion (24hUAE) : group A (normal albuminuria, 20 cases), group B (microalbuminuria, 22 cases) and group C (macroalbuminuria, 20 cases). Furthermore, 30 healthy people were involved in control group. 24hUAE,NAG,serum creatinine (SCr) and serum Cystatin C were measured, and endogenous creatinine clearance rate (Ccr) was calculated by Cockcroft-Gault formula. All these indexes among three groups were compared. Results The levels of urinary NAG activity and serum Cystafin C in diabetic group was significantly higher and Ccr was significantly lower than those in control group(P < 0.01). The levels of urinary NAG activity and serum cystatin C gradually increased in group A, B and C(P< 0.05 or < 0.01). While no significant difference was observed between group A and group B in the level of SCr (P > 0.05). There were significant positive correlations among the levels of urinary NAG activity, serum Cystatin C,24hUAE and SCr (P< 0.01),and all above showed negative correlations with Ccr (P<0.01). Co-detection of urinary NAG activity and serum Cystatin C had significantly higher positive rate [80.6%(50/62)] than single one [58.1%(36/62),61.3%(38/62)](P<0.05). Conclusion Co-detection of urinary NAG activity and serum Cystatin C may indicate early renal damage in DN, and it is valuable in diagnosing DN in early phase.