Objective:To investigate whether systemic immune inflammation index(SII)-C-reactive protein/albumin(CRP/Alb)can predict postoperative survival in non-small cell lung cancer(NSCLC)patients.Methods:A total of 262 patients with NSCLC who underwent surgery in Hebei Provincial People's Hospital from January 2017 to November 2020 were included.SII and CRP/Alb expressions in patients after surgery were analyzed by K-M survival curve analysis,Cox multivariate risk regression analysis and ROC curve analysis.Results:Patients with high SII expression(>961.78)and high CRP/Alb expression(>0.025)had worse outcomes than patients with low SII and CRP/Alb expressions,respectively(P<0.001).SII-CRP/Alb score(P=0.032),age≥60 years(P=0.038)and T stage T2～T3(P<0.001)were significantly associated with shorter overall survival.AUC of SII-CRP/Alb scores were larger than SII and CRP/Alb scores,respectively.Conclusion:SII-CRP/Alb score can effectively evaluate postoperative survival status of patients with NSCLC,and SII-CRP/Alb score are independent predictors of postoperative overall survival in NSCLC patients.

Objective:To investigate whether systemic immune inflammation index(SII)-C-reactive protein/albumin(CRP/Alb)can predict postoperative survival in non-small cell lung cancer(NSCLC)patients.Methods:A total of 262 patients with NSCLC who underwent surgery in Hebei Provincial People's Hospital from January 2017 to November 2020 were included.SII and CRP/Alb expressions in patients after surgery were analyzed by K-M survival curve analysis,Cox multivariate risk regression analysis and ROC curve analysis.Results:Patients with high SII expression(>961.78)and high CRP/Alb expression(>0.025)had worse outcomes than patients with low SII and CRP/Alb expressions,respectively(P<0.001).SII-CRP/Alb score(P=0.032),age≥60 years(P=0.038)and T stage T2～T3(P<0.001)were significantly associated with shorter overall survival.AUC of SII-CRP/Alb scores were larger than SII and CRP/Alb scores,respectively.Conclusion:SII-CRP/Alb score can effectively evaluate postoperative survival status of patients with NSCLC,and SII-CRP/Alb score are independent predictors of postoperative overall survival in NSCLC patients.

Objective:To investigate the difference between routine pulmonary ventilation function test (PFT) and impulse oscillometry (IOS) in children with bronchial asthma (BA) control and children without BA control.Methods:A total of 165 BA children admitted to the Shenzhen Longhua District People′s Hospital from January to December 2023 were selected. 73 children with asthma control test score ≥23 were selected as the control group, and 92 children with asthma control test score <23 were selected as the control group. The difference of indexes between the two groups were statistically compared in terms of PFT [forced expiratory volume in one second (FEV 1), ratio of FEV 1 to forced vital capacity (FVC) (FEV 1/FVC), instantaneous forced expiratory flow at 50% of forced vital capacity (FEF 50), instantaneous forced expiratory flow at 75% of forced vital capacity (FEF 75), maximum mid expiratory flow (MMEF), peak expiratory flow (PEF)], and IOS metrics [respiratory resistance at 5 Hz (R5), respiratory resistance at 20 Hz (R20), difference between R5 and R20 (R5-R20), reactance at 5 Hz (X5), total respiratory impedance at 5 Hz (Z5), resonance frequency (Fres), reactance area (AX)]. The predictive value of PFT and IOS indexes to BA was analyzed. Results:The levels of FEV 1, FEV 1/FVC, FEF 50, FEF 75, PEF and MMEF in PFT index of the control group were significantly higher than those in the non-control group, and the levels of Z5, R5, R20, R5-R20, X5, AX and Fres in IOS index were significantly lower than those in the non-control group. There was statistical significance between the two groups (all P<0.05). The area under the curve (AUC) predicted by PFT indexes was less than 0.7, and the AUC of FEF 50 and MMEF (all 0.633) was the largest. Among the IOS indexes, Z5, R5, R5-R20, X5, AX and Fres predicted the AUC of BA uncontrolled to be >0.7, while AX had the largest predictive value for BA uncontrolled (AUC=0.786, 95% CI: 0.736-0.836), sensitivity was 78.26%, specificity was 64.13%. Conclusions:All indexes of PFT and IOS have good sensitivity in evaluating the degree of BA control in children, and IOS has better clinical value in predicting uncontrolled BA, among which AX has the greatest predictive value for uncontrolled BA.

Objective:To investigate the difference between routine pulmonary ventilation function test (PFT) and impulse oscillometry (IOS) in children with bronchial asthma (BA) control and children without BA control.Methods:A total of 165 BA children admitted to the Shenzhen Longhua District People′s Hospital from January to December 2023 were selected. 73 children with asthma control test score ≥23 were selected as the control group, and 92 children with asthma control test score <23 were selected as the control group. The difference of indexes between the two groups were statistically compared in terms of PFT [forced expiratory volume in one second (FEV 1), ratio of FEV 1 to forced vital capacity (FVC) (FEV 1/FVC), instantaneous forced expiratory flow at 50% of forced vital capacity (FEF 50), instantaneous forced expiratory flow at 75% of forced vital capacity (FEF 75), maximum mid expiratory flow (MMEF), peak expiratory flow (PEF)], and IOS metrics [respiratory resistance at 5 Hz (R5), respiratory resistance at 20 Hz (R20), difference between R5 and R20 (R5-R20), reactance at 5 Hz (X5), total respiratory impedance at 5 Hz (Z5), resonance frequency (Fres), reactance area (AX)]. The predictive value of PFT and IOS indexes to BA was analyzed. Results:The levels of FEV 1, FEV 1/FVC, FEF 50, FEF 75, PEF and MMEF in PFT index of the control group were significantly higher than those in the non-control group, and the levels of Z5, R5, R20, R5-R20, X5, AX and Fres in IOS index were significantly lower than those in the non-control group. There was statistical significance between the two groups (all P<0.05). The area under the curve (AUC) predicted by PFT indexes was less than 0.7, and the AUC of FEF 50 and MMEF (all 0.633) was the largest. Among the IOS indexes, Z5, R5, R5-R20, X5, AX and Fres predicted the AUC of BA uncontrolled to be >0.7, while AX had the largest predictive value for BA uncontrolled (AUC=0.786, 95% CI: 0.736-0.836), sensitivity was 78.26%, specificity was 64.13%. Conclusions:All indexes of PFT and IOS have good sensitivity in evaluating the degree of BA control in children, and IOS has better clinical value in predicting uncontrolled BA, among which AX has the greatest predictive value for uncontrolled BA.

Intravascular large B-cell lymphoma(IVLBCL)is an aggressive extranodal large B-cell lymphoma,cocurrence in the same organ with other malignancies is very rare,especially in the lung.Here,we report a rare case of lung adenocarcinoma with IVLBCL.The patient was admitted to the hospital due to diarrhea associated with fever and cough.A computed tomography(CT)scan of the chest showed an irregular patchy high-density shadow in the upper lobe of the right lung with ground-glass opacity at the margin.After admission,the patient was given anti-infection treatment,but still had inter-mittent low fever(up to 37.5 oC).The pathological diagnosis of percutaneous lung biopsy(PLB)was lepidic-predominant ad-enocarcinoma with local infiltration,which was proved to be invasive nonmucinous adenocarcinoma of the lung with IVLBCL after surgery.This paper analyzed the clinicopathological characteristics and reviewed the relevant literature to improve the knowledge of clinicians and pathologists and avoid missed diagnosis or misdiagnosis.

Objective To prepare specific mouse monoclonal antibody (mAb) against human adenovirus type 55 Hexon protein (HAdV55 Hexon). Methods The Hexon genes of HAdV55, 3, 4, 7, 16 and 21 were chemically synthesized as templates for PCR amplification. The prokaryotic expression plasmids pET28a-HAdV55 Hexon and eukaryotic expression plasmids pCAGGS-HAdV3, 4, 7, 16, 21 and 55 Hexon were constructed respectively. The pET28a-HAdV55 Hexon plasmid was transformed into E. coli competent cell BL21 (DE3) and was induced by IPTG. After the purified inclusion body was denatured and renatured, Hexon55 protein was purified by tangential flow filtration system. pCAGGS-HAdV55 Hexon was used to immunize BALB/c mice by cupping, and HAdV55 Hexon protein was used to booster immunization. The anti-HAdV55 Hexon mAb was prepared by hybridoma technique and the titer and subclass were determined. The specificity of antibody was identified by Western blot using HEK293T cells transfected with pCAGGS-HAdV55 Hexon and by immunofluorescence assay (IFA) using BHK cells transfected with pCAGGS-HAdV55 Hexon. Both clones with high titer were selected, and the cross-reactivity of pCAGGS-HAdV3, 4, 7, 16, 21 and 55 Hexon transfected cells were analyzed by Western blot analysis and IFA. Results PET28a-HAdV55 Hexon and pCAGGS-HAdV55 Hexon, 3, 4, 7, 16 and 21 expression plasmids were successfully constructed. BL21 transformed with pET28a-HAdV55 Hexon was induced by IPTG. The HAdV55 Hexon protein was mainly expressed in the form of inclusion body. After denaturation and renaturation, the purified HAdV55 Hexon protein was obtained by ultrafiltration. Six hybridoma cell lines secreting HAdV55 Hexon mAb were obtained. The antibody subclass analysis showed that 2 strains were IgG2a subtypes and 4 strains were IgG2b. Two specific HAdV55 Hexon antibodies with high titer were obtained, and there was no cross-reactivity with HAdV3, 4, 7, 16, 21 Hexon. Conclusion The specific mice mAb against HAdV55 Hexon provides an experimental basis for establishing its antigen detection method.
Animals ; Mice ; Humans ; Adenoviruses, Human/genetics* ; Escherichia coli/genetics* ; HEK293 Cells ; Isopropyl Thiogalactoside ; Blotting, Western ; Immunoglobulin G ; Antibodies, Monoclonal ; Antibody Specificity ; Mice, Inbred BALB C

Objective    To investigate the early clinical results of MitraClip system in domestic patients. Methods     We retrospectively analyzed the clinical data of 36 patients who underwent transcatheter edge-to-edge repair procedure using MitraClip system in Beijing Fuwai Hospital, Shenzhen Fuwai Hospital and Fuwai Yunnan Cardiovascular Hospital between January and June 2021. There were 24 males and 12 females, with a median age of 70 (47-86) years. Ten (27.8%) patients had 3+ mitral regurgitation (MR) and 26 (72.2%) patients had 4+ MR preoperatively. Results    All procedures were successfully performed. The reduction in MR was 2+ at least immediately after surgery, and 91.7% of patients had MR≤2+ at 3 days postoperatively. There was no statistical difference in left ventricular ejection fraction change postoperatively. Forward velocity and peak gradient of mitral valve were increased after the procedure. Mean gradient of mitral valve were increased at 3 days postoperatively than immediately after surgery (P<0.001). Two patients had acute pericardial effusion intraoperatively, and received pericardial puncture and drainage immediately. Conclusion    MitraClip system has been applied well in domestic patients and can significantly improve MR. This sutdy has a good consistency with foreign studies, and the early results are satisfactory.

With the research progress on the biology and pathogenesis of cancer, immune checkpoint inhibitors (ICIs) have come into being, bringing a new hope for the survival of patients with advanced cancer and opening a new era of cancer immunotherapy. However, with the wide application of immunotherapy in clinical practice, ICI-related adverse events (irAEs) have gradually emerged and are widely known by first-line clinicians. ICIs primarily activate T cells that can attack normal tissues and organs in the body and cause a variety of adverse reactions. Checkpoint inhibitor pneumonitis (CIP) is one of the rare complications with poor prognosis in irAEs. This article reviews the therapeutic mechanism of some ICIs; the incidence, risk factors, pathogenesis, and clinical and imaging manifestations of CIP; and the classification and treatment management of CIP.

Objective:To explore the clinical characteristics of pediatric glucose transporter type 1 deficiency syndrome (GLUT1 DS), evaluate the efficacy and safety of ketogenic diet therapy (KDT).Methods:Clinical data of 19 children with GLUT1 DS admitted to Children′s Hospital of Fudan University, Tianjin Children′s Hospital, Shenzhen Children′s Hospital, Children′s Hospital of Nanjing Medical University and Jiangxi Provincial Children′s Hospital between 2015 and 2019 were collected retrospectively. The first onset symptom, main clinical manifestations, cerebrospinal fluid features and genetic testing results of patients were summarized, the efficacy and safety of ketogenic diet treatment were analyzed. Results:Among the 19 cases, 13 were males and 6 females. The age of onset was 11.0 (1.5-45.0) months,the age of diagnosis was 54.0 (2.8-132.0) months. Epilepsy was the first onset symptom of 13 cases. Different forms of tonic-clonic seizures were the most common types of epilepsy (7 cases with generalized tonic-clonic seizures, 5 cases with focal tonic or clonic seizures, 4 cases with generalized tonic seizures). Antiepileptic drugs were effective in 4 cases. Paroxysmal motor dysfunction was present in 12 cases and ataxia was the most common one. All patients had different degrees of psychomotor retardation. Among 17 patients received cerebrospinal fluid examination, cerebrospinal fluid (CSF) glucose level was lower than 2.2 mmol/L and CSF glucose/glycemic index was<0.45 in 16 cases, only 1 case presented normal CSF glucose level (2.3 mmol/L) and normal CSF glucose/glycemic index(0.47). SLC2A1 gene mutations were found in 16 patients, missense, frameshift and nonsense mutations were the common types with 5 cases, 5 cases and 3 cases respectively. All 19 patients were treated with ketogenic diet, which was effective in 18 cases in seizure control, 11 cases in dyskinesia improvement and 18 cases in cognitive function improvement. No serious side effects were reported in any stage of KDT.Conclusions:The diagnosis of GLUT1 DS is often late. It is necessary to improve the early recognition of the disease and perform CSF glucose detection and genetic testing as early as possible. The KDT is an effective and safe treatment for GLUT1 DS, but a small number of patients have not response to diet therapy.

Objective To compare the accuracy, image quality and radiation dose between prospective ECG?gated sequential and high?pitch acquisition on 128?slice dual?source CT (DSCT) angiography in infants and children with congenital heart disease (CHD). Methods Ninety?two children with CHD from October 2011 to February 2013 were prospectively enrolled and assigned into two groups according to random number table. Forty?six patients underwent DSCT angiography with sequential mode, and the other 46 patients were examined with high?pitch mode. With surgical and/or DSA results as the standard, the diagnostic accuracy and sensitivity of the two groups for the intracardiac structures, extracadiac and coronary artery anomalies were evaluated, and the comparison was analyzed by Fisher exact test. A 5?grade scoring system was used to interpret the image quality of intracardiac structures, great vessels and the proximal and middle segments of coronary arteries. Interobserver agreement on grades of image quality was assessed by Kappa statistics. The image quality scores were compared using the Mann?Whitney U test. The Student t test or the Mann?Whitney U test was used to analyze the differences between the two groups regarding to patients' age, weight , heat rate, CT attenuation, image noise and SNR in the ascending aorta and the pulmonary trunk as well as radiation dose. Results All 92 patients successfully underwent DSCT angiography. The diagnostic accuracies of intracardiac anomalies by high?pitch group and sequential group were 95.65%(88/92) and 99.28%(274/276), showed significant difference between the two groups (P<0.05), but no significant difference in the sensitivity of intracardiac anomalies (P>0.05) .There was no significant difference in the diagnostic accuracy and sensitivity of extracadiac anomalies between the two groups (P>0.05). The diagnostic accuracies of coronary artery anomalies by high?pitch group and sequential group were 93.48%(43/46) and 100.00%(46/46), showed no significant difference between the two groups (P>0.05), but there was significant difference in the sensitivity of coronary artery anomalies (50.00%(3/6) , 100.00% (11/11)) (P<0.05). There was excellent agreement for image quality scoring of the intracardiac structures, great vessels and the proximal and middle coronary arteries between the two observers (Kappa=0.81, 0.85, 0.85, P<0.05). The median image quality scores of extracardiac great vessels were both 5.00 in high?pitch group and sequential group, and there was no significant difference between the two groups (U=981.000, P>0.05). The median image quality scores of intracardiac structures and proximal and middle segments of coronary arteries respectively by high?pitch group were 4.00 and 3.00, and 5.00 and 4.00 respectively by sequential group. The image quality of intracardiac structures (U=594.500, P<0.05) and proximal and middle segments of coronary arteries (U=397.500, P<0.05) was significantly better in the sequential group than that in the high?pitch group. There was no significant difference between the two groups in CT attenuation, noise and SNR of the ascending aorta and pulmonary trunk. The mean effective doses of the high?pitch group and the sequential group were(0.27±0.11)and(0.39±0.17)mSv, and showed significant difference between the two groups (t=4.316, P<0.05). Conclusions Both sequential and high?pitch mode of 128?slice DSCT angiography provide high accuracy for the assessment of CHD in infants and children, while the high?pitch mode, though with some image quality declined, shows further significantly lower radiation dose.