Pulmonary arterial hypertension(PAH)is a severe and progressive pulmonary vascular disease mainly characterized by a continuous increase in pulmonary vascular resistance and rise of pulmonary artery pressure caused by pulmonary arteriolar lesions,ultimately resulting in right heart failure and even death.Pulmonary vascular remodeling is a characteristic pathological change of PAH,and its mechanism involves gene susceptibility,imbalance of vasoactive substances,abnormal energy metabolism and other potential factors.Recent studies have found that inflammatory reaction plays a crucial role in the mechanism of pulmonary vascular remodeling.Inflamma-tory cells are found to infiltrate and accumulate around the pulmonary vessels of PAH patients and of animal models.In addition,significantly high level of cytokines and auto-antibodies were also found in peripheral blood,which is closely related to poor prognosis of PAH.This article reviews the research progress about the potential role of in-flammatory cells in the vascular remodeling of PAH and provides new ideas for developing of safe and effective treatment methods for PAH.

Objective:To make a new simple respirator and observe the oxygen therapy effect of the respirator on patients with severe and critical coronavirus disease 2019 (COVID-19).Methods:Based on the infectivity and hospital requirements of COVID-19, a new simple respirator was designed by the medical staff of the Department of Anesthesiology of the Second Affiliated Hospital of Nanchang University, which was applied on the 22 patients with severe and critical COVID-19 who needed oxygen therapy admitted to the Cancer Center of Tongji Medical College of Huazhong University of Science and Technology from February 15th to March 15th in 2020. The new simple respirator contained two National Utility Model Patents (a respirator: ZL 2015 2 0410623.6, a fluid switch and oxygen suction device: ZL 2017 2 0873509.6), which was mainly composed of anesthesia mask and filter, L-shaped connecting tube, soft breathing bladder, connecting tube and elastic fixing belt. When in use, the anesthesia mask was fixed to the patient's mouth and nose with elastic straps, the connecting tube was inserted into the oxygen meter interface, the oxygen flow was adjusted to 6-10 L/min, and the L-shaped connecting tube was opened immediately after the soft breathing bag was full. The carbon dioxide and excess oxygen in the body was discharged from exhaust port. The oxygen flow was lowered to 2-3 L/min, the patient's respiratory rate (RR) was observed through the soft breathing bag fluctuations, and the oxygen flow was adjusted at any time. The changes of pulse oxygen saturation (SpO 2), RR and heart rate (HR) before and after application of new simple respirator were observed, and the blood gas test results of part of the patients were collected. Results:Twenty-two patients with severe and critical COVID-19 had significantly higher SpO 2 at 10 minutes after application of the new simple ventilator than before application (0.994±0.007 vs. 0.952±0.017, P < 0.01), and RR was significantly lower than that before application (times/min: 27.59±3.63 vs. 29.64±3.81, P < 0.01); after 1 day of application, each index was further improved. All 13 patients who received blood gas analysis indicated no carbon dioxide accumulation. Conclusions:The new simple respirator can significantly improve the oxygen therapy effect of patients with severe and critical COVID-19. At the same time, 2019 novel coronavirus (2019-nCoV) can be filtered through the filter to reduce the formation of aerosol and protect the medical staff and patients.

Objective To evaluate the efficacyof the first line chemotherapy FOLFIRINOX (5-Fu,Leucovorin calcium,Irinotecan,Oxaliplatin) as the treatment of pancreatic cancer.Methods Pertinent studies were identified from the PubMed,Cochrane Library and EMBASE.The outcomes were resection rate and radical (R0) resection rate were analyzed.Data were expressed as weighted pooled proportions with 95％ confidence intervals (95％ CI).Results There were thirteen studies with 408 patients with LAPC and BRPC included.After the treatment,42.0％ (95％ CI:28.0％ ～56.0％) tumorswere resected and 41.0％ (95％ CI:37.0％ ～45.0％) were underwentR0 resection,and median overall survival ranged from 15.5 to 34.5 months,median progression-free survival ranged from 10.0 to 17.8 months.Conclusion The meta-analysis shows that down-staging after first line FOLFIRINOX-based therapy is noticeable in patients with borderline resectable/unresectable PC,and the adverse events were in control.

OBJECTIVETo evaluate the impact of Fc gamma receptor IIIa (FcγR IIIa) polymorphisms on the efficacy of rituximab (RTX) combined chemotherapy for patients with diffuse large B-cell lymphoma (DLBCL).

METHODSFcγRIIIa polymorphisms were analyzed by PCR in 122 patients and 100 healthy controls. All patients received 8(4-12) cycles of RTX combined chemotherapy.

RESULTS78(63.93%) patients with F/F, 5(4.10%) with V/V, and 39(31.97%) with V/F were identified, which were not different compared to controls. Patients with different FcγRIIIa genotypes did not have any difference in terms of gender, age, molecular subtypes, lactate dehydrogenase (LDH) or international prognostic index (IPI). The overall response rate (ORR) was 89.35% with a complete response (CR) of 80.33% and a partial response (PR) of 9.02%. The ORR was 83.33%, 100.00% and 100.00% in F/F, V/V and V/F, respectively. A higher response rate was observed in V/V and V/F as compared with F/F (P<0.05). With a median follow-up of 35 months (range: 12-62 months), 46(37.71%) patients had relapsed and 40 (32.79%) cases progressed and ended in death. The 3-year progress-free survival (PFS) rate was 41.03%, 100.00%, 100.00% in F/F, V/V and V/F, respectively. The 3-year overall survival (OS) rate was 48.72%, 100.00% and 100.00% in patients with three genotypes. The PFS and OS rate were significantly higher in V/V and V/F as compared with F/F (P<0.05).

CONCLUSIONFcγR III a polymorphisms could predict response and prognosis of RTX combined chemotherapy for patients with DLBCL.

Antibodies, Monoclonal, Murine-Derived ; administration & dosage ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Asian Continental Ancestry Group ; genetics ; Disease-Free Survival ; GPI-Linked Proteins ; Humans ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; genetics ; Polymorphism, Genetic ; Prognosis ; Receptors, IgG ; genetics ; Remission Induction ; Rituximab

Objective To explore the relations of morphologies of intracranial tiny aneurysms with gender,age,hypertension and aneurysm lesions of the patients.Methods A retrospective analysis of clinical data of 112 patients with intracranial tiny aneurysms,admitted to our hospital from January 2009 to December 2012,was performed; according to the aneurysm morphologies,these patients were divided into regular-shape and irregular-shape groups (n=56).The influences of age,gender,hypertension and aneurysm lesions of the patients in aneurysm morphologies were analyzed.Results Gender,age and hypertension were not the independent influence factors of aneurysm morphologies,while aneurysm lesions could significantly affect the aneurysm morphologies,being the independent influence factor of aneurysm morphologies (P=0.005).In the comparison of different distributions of tiny aneurysms,the intemal carotid artery and vertebral basilar artery had less irregular aneurysms than anterior communicating artery; the morphologies of small aneurysms in the anterior cerebral artery,posterior communicating artery and middle cerebral artery showed no significant differences as compared with those in the anterior communicating artery,which tended to having irregular shapes.Conclusion The aneurysm lesions are related to the aneurysm morphologies; anterior communicating artery is prone to having irregular-shape aneurysms.