Objective To explore the clinical effect of duloxetine hydrochloride combined with tandospirone in the treatment of anxiety and depression in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 82 COPD patients with anxiety and depression who were admitted to The People's Hospital of Rugao from March 2017 to September 2022 were enrolled and divided into two groups by random number table,with 41 cases in each group.The control group was given duloxetine hydrochloride(40 mg/d,20 mg each time,bid),and the observation group was given duloxetine hydrochloride(40 mg/d,20 mg each time,bid)and tandospirone(30 mg/d,10 mg each time,tid)for 8 weeks.The clinical efficacy,the degree of anxiety and depression,lung function,neurotransmitter levels,adverse drug reactions,and the safety of therapeutic regimens were evaluated.Results The total effective rate of the observation group was significantly higher than that of the control group(95.12%[39/41]vs 78.05%[32/41],P<0.05).Hamilton depression scale(HAMD)score,Hamilton anxiety scale(HAMA)score,and Pittsburgh sleep quality index(PSQI)were decreased after treatment in both groups,and these scores in the observation group were lower than those in the control group(all P<0.05).After treatment,the levels of nerve growth factor(NGF)and 5-hydroxytryptamine(5-HT)in both groups were increased,and BDNF and 5-HT in the observation group were higher than those in the control group(all P<0.05).The forced expiratory volume in the first second(FEV1)and the ratio of FEV1 to forced vital capacity(FEV)after treatment were higher than those before treatment(P<0.05).There were no significant differences in FEV1 or FEV1/FVC between groups after treatment(P>0.05).The adverse reaction rates of observation group and control group were 24.39%(10/41)and 14.63%(6/41),respectively(P>0.05).Conclusion Duloxetine hydrochloride combined with tandospirone can increase neurotransmitter levels and improve the degree of anxiety and depression in COPD patients.

Objective To explore the value of serum tumor markers combined with microRNA(miR)-1246 in evaluating the sensitivity of concomitant radiochemotherapy(CCRT)for locally advanced non-small cell lung cancer(NSCLC).Methods The clinical data of 110 NSCLC patients admitted to The People's Hospital of Rugao from March 2019 to March 2022 were collected.All the patients underwent CCRT and were divided into sensitive group(complete or partial response)and insensitive group(stable or progressive disease)according to therapeutic effects 1 month after treatment.The clinical data of the 2 groups were detected at admission.The levels of serum tumor markers and miR-1246 at admission and after treatment were compared between the 2 groups.Logistic regression analysis was used to analyze the influence factors of CCRT sensitivity in NSCLC patients,and receiver operating characteristics(ROC)curve was used to analyze the predictive value of serum tumor markers combined with miR-1246 on CCRT sensitivity in NSCLC patients.Results One month after treatment,47 patients had a complete or partial response and 63 patients had stable or progressive disease.The serum levels of neuronal enolase(NSE),carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125)and miR-1246 in the insensitive group were significantly higher than those in the sensitive group(P<0.05).Logistic regression analysis showed that NSE,CEA,CA125,and miR-1246 were independent risk factors for CCRT sensitivity(P<0.05).ROC curve analysis showed that the area under the curve(AUC)values of NSE,CEA,CA125,and miR-1246 alone in evaluating CCRT sensitivity were 0.790(95%CI:0.702-0.862),0.816(95%CI:0.731-0.884),0.800(95%CI:0.713-0.870),and 0.795(95%CI:0.711-0.869),respectively.The AUC value of the combined assessment of the above 4 indexes was 0.923(95%CI:0.857-0.965).Conclusion Both serum tumor markers and miR-1246 are valuable for assessing CCRT sensitivity in NSCLC patients,and their combination has a higher value for assessing CCRT sensitivity.

ObjectiveTo study the effects of perindopril on myocardial energy metabolism and ultrastructural changes in rats with chronic heart failure (CHF) induce by isoproterenol. MethodsTotally 55 male SD rats were randomly (random number) divided into two groups, namely control group (Group C) and CHF model group. The CHF rat models were made by subcutaneous injection of isopreteronol (ISO) in doses of 20 mg · kg-1 · d-1, 10mg · kg-1 · d-1 and 5 mg/kg/d for successive 3 days and then 3 mg· kg-1· d-1 for9 days. Four weeks later, the rats in CHF model group were randomly further divided into two subgroups, namely untreated subgroup (group M ) and perindopril treated subgroup (group P). After treatment for five weeks in average, echocardiography and myocardial pathology examination carried out to assess the cardiac function and structure changes of these rats. The levels of ATP, ADP, AMP, lactic acid (LA) and sarcoplasmic reticulum Ca2+ -ATPase (SERCA) activity in myocardium were determined by enzymatic reaction. ResultsCompared with rats in group M, the ejection fraction of left ventricle (EF) and fractional shortening of short axis of left ventricle (FS) of the rats in group P increased by 3.25％ and 7. 33％, respectively. Compared with rats in group C, the myocardial ATP, AMP, TAN (total adenosine) and LA significantly decreased in rats of group M. There were no significant differences in the levels of ADP, AMP, ATP/ADP and TAN between group C and group P (P ＞0. 05). Compared with rats in group M, the myocardial SERCA activity increased by 16. 41％ in rats of group P. The myocardial injury found under microscope and electronic microscope was ameliorated by treatment with peidolapril in rats of group P in comparison with rats of group M. ConclusionsPerindopril can improve myocardial energy metabolism,and lessen the pathological changes of ultrastructure, enhancing the cardiac function of rats with CHF induced by ISO.