Objective:To discuss the expressions of autotaxin(ATX)and lysophosphatidic acid receptor 3(LPA3)in serum and lung tissue of the chronic obstructive pulmonary disease(COPD)patients,and to clarify the role of ATX and LPA3 in the occurrence and development of COPD.Methods:A total of 40 COPD patients were collected and brought into acute exacerbation of COPD group(AECOPD group);after treatment,those stabilized patients were included in COPD stable group(n=40);additionally,40 healthy individuals were recruited as control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect the ATX levels in the serum of the subjects in various groups.Another 80 patients who underwent lobectomy were divided into COPD smoking group(CS group,n=20),COPD non-smoking group(CNS group,n=20),non-COPD smoking group(HS group,n=20),and non-COPD non-smoking group(HNS group,n=20).The general informations of the subjects in various groups were collected.HE staining was used to observe the pathomorphology of lung tissue of the patients in various groups;immunohistochemical staining was used to detect the expression levels of ATX and LPA3 proteins in lung tissue of the patients in various groups;real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression levels of ATX and LPA3 mRNA in lung tissue of the patients in various groups;Pearson correlation analysis was used to evaluate the correlations of continuous variables with normal distribution,and Spearman correlation analysis was used to evaluate the correlations of other variables.Results:Compared with control group,the percentage of forced expiratory volume in the first second to predicted value(FEV1％pred)and the percentage of forced expiratory volume in the first second to forced vital capacity(FEV1/FVC)of the patients in COPD stable group were significantly decreased(P＜0.05).Compared with COPD stable group and control group,the level of ATX in serum of the patients in AECOPD group was increased(P＜0.05);compared with control group,the level of ATX in serum of the patients in COPD stable group was increased(P＜0.05).The serum ATX level of the patients in AECOPD group was positively correlated with COPD Assessment Test(CAT)scores(r=0.581,P＜0.001)and showed no correlations with smoking history,white blood cells(WBC),percentage of neutrophils(NEUT％),neutrophil to lymphocyte ratio(NLR),and body mass index(BMI)(P＞0.05).The serum ATX level of the patients in COPD stable group was positively correlated with WBC and CAT score(r=0.384,P=0.014;r=0.463,P=0.003)and negatively correlated with FEV1％pred and FEV1/FVC(r=-0.393,P=0.012;r=-0.353,P=0.025).Compared with CS group and CNS group,the FEV1％pred and FEV1/FVC of the patients in HS group and HNS group were increased(P＜0.05).The immunohistochemical staining results showed that compared with CS group,the expression levels of ATX and LPA3 proteins in lung tissue of the patients in HS group and HNS group were decreased(P＜0.05).Compared with CNS group,the expression levels of ATX and LPA3 proteins in lung tissue of the patients in HS group and HNS group were decreased(P＜0.05).The RT-qPCR results showed that compared with CS group,the expression levels of ATX and LPA3 mRNAs in lung tissue of the patients in HS group and HNS group were decreased(P＜0.05);compared with CNS group,the expression levels of ATX and LPA3 mRNAs in lung tissue of the patients in HS group and HNS group were decreased(P＜0.05).The correlation analysis results showed that the expression level of ATX protein in lung tissue of the COPD patients was positively correlated with the expression level of LPA3 protein(r=0.723,P＜0.001).Conclusion:The expression levels of ATX and LPA3 mRNA and proteins in lung tissue of the COPD patients are increased.The serum ATX levels in both AECOPD group and COPD stable group are increased,suggesting that these factors may be involved in the inflammatory response of COPD,promoting its occurrence and development.

Objective To investigate the changes and predictive value of Omentin-1 levels in patients with type 2 diabetes mellitus(T2DM)under different bone metabolic status.Methods A total of 120 T2DM pa-tients admitted to a hospital from June 2021 to December 2022 were selected and divided into group A(normal bone mass,T-value-1.0,36 cases),Group B(bone loss,-2.5＜T-value＜-1.0,49 cases)and group C(osteoporosis,T-value-2.5,35 cases)according to different bone mineral density.Another 50 healthy sub-jects who underwent physical examination in a hospital during the same period were selected as the healthy control group.Basic data,serum Omentin-1 and bone metabolism levels of the 4 groups were compared,and the correlation between serum Omentin-1 and bone metabolism and blood glucose levels was analyzed by Pear-son correlation analysis.Multiple stepwise regression analysis was conducted to analyze the factors affecting bone mineral density in T2DM patients.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum Omentin-1 level in T2DM with osteoporosis.Results The fasting blood glucose(FBG)level of groups A,B and C was higher than that of healthy control group,and the hemoglobin A1c(HbA1c)and homeostasis model assessment of insulin resistance(HOMA-IR)of healthy control group,group A and group B were lower than that of group C,with statistical significance(P＜0.05).Omentin-1,type Ⅰ procollagen N-terminal propeptide(P Ⅰ NP)and osteocalcin(BGP)in healthy control group,group A and group B were higher than those in group C,while the β-CTX sequence of type Ⅰ collagen in healthy con-trol group,group A and group B was lower than that in group C,and the difference was statistically signifi-cant(P＜0.05).Pearson correlation analysis showed that the serum Omentin-1 level in T2DM patients was negatively correlated with the levels of HbA1c,HOMA-IR and β-CTX(r=-0.770,-0.807,-0.759,P＜0.05),and positively correlated with the levels of P Ⅰ NP and BGP(r=0.868,0.879,P＜0.05),but no sig-nificant correlation with FBG level(r=-0.085,P=0.152).Omentin-1,P Ⅰ NP,β-CTX,BGP,HbA1c and HOMA-IR were independent influencing factors of BMD in T2DM patients(P＜0.05).ROC curve analysis showed that the area under the curve of serum Omentin-1 level predicting T2DM with osteoporosis was 0.835(95％CI:0.764-0.906),and when the cut-off value was 50.325 ng/mL,the sensitivity was 0.854,the speci-ficity was 0.801,and the Youden index was 0.655.Conclusion Serum Omentin-1 expression is low in T2DM patients,and its expression is closely related to bone mineral density,bone metabolism and insulin resistance in T2DM patients,and can effectively predict the occurrence of T2DM with osteoporosis.

Objective To investigate the expression levels and clinical significance of cold-inducible RNA-binding protein(CIRBP)and triggering receptor expressed on myeloid cells-1(TREM-1)in peripheral blood of patients with chronic obstructive pulmonary disease(COPD).Methods Forty hospitalized COPD patients from October 2022 to June 2023 were selected as the acute exacerbation group.After treatment,they entered the stable phase and were included in the stable phase group.During the same period,40 healthy individuals underwent physical exami-nations as the control group.General information from each group was collected,peripheral blood was collected,and the levels of CIRBP and TREM-1 in plasma were measured using enzyme-linked immunosorbent assay(ELISA).The relative expression levels of CIRBP mRNA and TREM-1 mRNA were measured using real-time fluorescence quantitative polymerase chain reaction(qRT-PCR),and lung function was measured in COPD patients and healthy individuals.Results The expression levels of CIRBP and TREM-1 in peripheral blood during the acute exacerba-tion of COPD were higher than those in the stable phase group,and the differences were statistically significant(all P＜0.001);The expression levels of CIRBP and TREM-1 in peripheral blood during acute exacerbation and stable phases were higher than those in the control group,and the differences were statistically significant(all P＜0.001);In both acute exacerbation and stable phases,CIRBP levels were positively correlated with TREM-1 levels;The levels of CIRBP and TREM-1 during acute exacerbation were positively correlated with white blood cell count,neutrophil percentage,neutrophil to lymphocyte ratio;The stable CIRBP and TREM-1 levels were negatively correla-ted with the percentage of forced expiratory volume at 1 second to the expected value,and the ratio of forced expira-tory volume to forced vital capacity at 1 second.They were positively correlated with white blood cell count,neutro-phil percentage,and neutrophil/lymphocyte ratio.Conclusion The expression levels of CIRBP and TREM-1 are el-evated in the peripheral blood of COPD patients.The expression of CIRBP is correlated with TREM-1 expression,and is associated with clinical indicators such as lung function,white blood cell count,neutrophil percentage,neutro-phil to lymphocyte ratio,monocyte to high-density lipoprotein ratio,etc.,suggesting that CIRBP and TREM-1 may jointly participate in the occurrence and development of COPD.

Liver transplantation has become the most effective treatment of end-stage liver disease. Nursing care for enhanced recovery is safe and effective in the management after liver transplantation, which is conducive to the early recovery of body function of the recipients. In this article, relevant literature review was conducted to summarize the standard operation procedure (SOP) of nursing care for enhanced recovery after liver transplantation from the postoperative vital signs and fluid temperature management, gastrointestinal function and nutrition management, early grading activities, sedation, analgesia and sleep management, infection prevention and control, etc.

Objective To investigate the effects of breviscapine injection on intestinal mucosal barrier damage induced by intestine ischemia-reperfusion (IIR). Methods 44 old SD rats were randomly divided into four groups:sham,intestine ischemia-reperfusion(IIR),EB+IIR,LN+IIR. Breviscapine injection 20 mg/(kg·d) was given intraperitoneally in EB+IIR group. L-NAME(100 mg/kg)was given intravenously 30 min before surgery in LN+IIR group. Rats were subjected to superior mesenteric artery occlusion consisting of 45 min of ischemia and 4 h of reperfusion;sham laparotomy served as controls. Intestine pathology was assayed by H&E staining. Concen-trations of SIgA,iNOS,eNOS and NO in intestinal mucosa,also endotoxine in plasma,were determined by ELI-SA. Results IIR induced serious intestinal mechanical and immune barrier damage ,evidenced as poor intestine pathology,depression of intestinal SIgA and eNOS levels,elevation of intestinal iNOS/NO levels. However,brevis-capine injection pretreatment could promote eNOS/NO production ,down-regulated iNOS expression ,leading to ele-vating SIgA concentration in intestine ,attenuate endotoxemia induced by IIR. The protection was canceled when application of L-NAME. Conclusion Breviscapine pretreatment attenuates ischemia-reperfusion-induced intestinal mucosal barrier damage via promoting eNOS/NO production.

Objective To study the expression of miR-146a in the serum of sepsis and the diagnostic value.Methods Serum miR-146a expression was detected in 98 patients diagnosed with sepsis,69 patients with severe sepsis and 30 healthy controls.ROC plots were used to evaluate the diagnostic value.Results The expression of miR-146a was decreased successively in healthy group,general sepsis group and severe sepsis group.In the diagnosis of sepsis,at the optimal expression cutoff miR-146a value of 0.805,the sensitivity was 0.967 and specificity 0.940,with an AUC of 0.983.In the diagnosis of sepsis severity degree,at the optimal expression cutoff miR-146a value of 0.530,the sensitivity was 0.796 and specificity 0.986,with an AUC of 0.943.Conclusion miR-146a can be a potential marker in diagnosis of sepsis and severity degree .

Objective To investigate the curative effect and mechanism of α lipoic acid combined with epalrestat and methylcobalamin in patients with type 2 diabetes mellitus (T2DM) complicated with pe-ripheral neuropathy ( DPN) . Methods A total of 160 cases of patients with DPN were randomly divided into the control group ( treated with methylcobalamin and epalrestat) and the observation group ( treated with methylcobalamin, epalrestat and α lipoic acid) , and all patients were treated for 4 weeks. The therapeutic effect, nerve conduction velocity, oxidative stress index and related proteins expression in serum were ob-served in two groups. Results The effective rate of treatment in the observation group was higher than that in the control group (87. 50％ vs 75. 0％) (χ2 = 4. 103,P<0. 05). After treatment, the sensory nerve conduction velocity ( SNCV) and motor nerve conduction velocity ( MNCV) of median nerve and common peroneal nerve were significantly better in the observation group than the control group ( P<0. 05 ) . After treatment, the level of superoxide dismutase ( SOD) was significantly higher in the observation group than the control group, while the level of malondialdehyde ( MDA ) was significantly lower the control group (P<0. 05). After treatment, the level of Bcl-2 protein was significantly higher in observation group than the control group, while the levels of Bax and Caspase-3 proteins were significantly lower than the control group (P<0. 05). Conclusions The application ofαlipoic acid combined to epalrestat and methylcobal-amin in the treatment of DPN can significantly improve the sensory and motor nerve conduction.

Objective To investigate the prevention effect and mechanism of glucocorticoid aerosol inhalation on pulmonary infection after hepatectomy. Methods Clinical data of 66 liver cirrhosis patients complicated with primary liver cancer (liver cancer) undergoing hepatectomy in the Third Afifliated Hospital of Sun Yat-sen University between January 2013 and December 2014 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. The patients were divided into the treatment group and control group according to the treatment methods. In the treatment group, 36 patients were included, 28 males and 8 females, aged from 21 to 66 years with a median age of 43 years. All patients were given with aerosol inhalation of 1 mg of budesonide (pulmicort)+30 mg of ambroxol (mucosolvan), twice daily for consecutive 6 d. In the control group, 30 patients were included, 18 males and 12 females, aged ranging from 23 to 67 years with a median age of 48 years. All cases were given with aerosol inhalation of 30 mg of ambroxol (mucosolvan), twice daily for consecutive 6 d. The changes of the arterial blood gas analysis results and X-ray radiography were observed between two groups. Arterial blood gas analysis results of two groups were compared using t test and the ratio was compared using Chi-square test. Results After aerosol inhalation, partial pressure of oxygen (PaO2) and oxygenation index (OI) in the treatment group were (116±15) and (590±42) mmHg (1 mmHg=0.133 kPa), signiifcantly higher compared with (85±17) and (452±54) mmHg before treatment( t=2. 4 2 6 , 2. 5 3 3;P<0.05). In the control group, PaO2 and OI were (101±16) and (535±50) mmHg after aerosol inhalation, signiifcantly higher compared with (86±16) and (460±56) mmHg before treatment (t=3.401, 2.440;P<0.05). In the treatment group, alveolar-arterial oxygen difference (A-aDO2) was (65±18) mmHg, significantly lower than (96±22) mmHg before treatment (t=-3.578, P<0.05). After aerosol inhalation, signiifcant differences were observed in PaO2 and A-aDO2 between the treatment group and control group (t=3.925, -6.355; P<0.05). In the treatment group, the postoperative incidence of pulmonary infection was 6%(2/36), significantly lower compared with 13%(4/30) in the control group (χ2=15.240, P<0.05). Conclusion Inhalation of glucocorticoid aerosol effectively prevents the incidence of pulmonary infection after hepatectomy probably through enhancing PaO2, improving oxygenation status of tissues and organs and increasing pulmonary ventilation function.

Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Oximetry ; Pneumoconiosis ; blood ; complications ; Prognosis ; Respiratory Insufficiency ; blood ; etiology