Objective:To observe the efficacy of external diaphragm pacing (EDP) combined with recombinant human growth hormone (rhGH) in the treatment of severe chronic obstructive pulmonary disease (CDOP).Methods:By the prospective study method, 80 patients with severe COPD were admitted to the Xianju People′s Hospital(Zhejiang Southeast Campus of Zhejiang Provincial People′s Hospital)/Xianju Hospital Affiliated to Hangzhou Medical College from April 2021 to April 2023 were divided into the combined group and the conventional group by the random number table method, with 40 cases in each group. All of them received anti-infection, nutritional support, and other conventional treatment. In addition, the combined group was given EDP+rhGH treatment, and they were intervened for 20 d. The diaphragm function, nutrition, pulmonary function, and serum levels of interleukin (IL-6), IL-23, type Ⅱ alveolar cell surface antigen (KL-6) changes before and after treatment and prognosis were compared between the two groups.Results:After treatment, the diaphragm function index diaphragm maximum expiratory pressure (MIP), diaphragm thickness (DTei), and diaphragm mobility (DE) in the combined group were higher than those in the conventional group: (45.36 ± 7.04) cmH 2O (1 cmH 2O = 0.098 kPa) vs. (42.28 ± 6.43) cmH 2O, (0.32 ± 0.12) cm vs. (0.27 ± 0.06) cm, (3.40 ± 1.02) cm vs. (1.85 ± 0.64) cm, there were statistical differences ( P<0.05). After treatment, the nutritional status indexes of serum albumin (ALB), transferrin (Tf), and total protein (TP) in the combined group were higher than those in the conventional group: (34.62 ± 5.13) g/L vs. (31.75 ± 4.93) g/L, (2.21 ± 0.46) g/L vs. (2.00 ± 0.42) g/L, (63.80 ± 8.25) g/L vs. (60.24 ± 6.97) g/L, there were statistical differences ( P<0.05). After treatment, the percentage of forced expiratory volume in the first second (FEV 1) to the expected value (FEV 1%) and the ratio of FEV 1 to forced vital capacity (FEV 1/FVC) in the combined group were higher than those in the conventional group: (60.17 ± 6.30)% vs. (57.25 ± 6.24)%, (61.30 ± 7.04)% vs. (57.12 ± 7.25)%, there were statistical differences ( P<0.05). After treatment, the levels of IL-6, IL-23, and KL-6 in the combined group were lower than those in the conventional group: (23.13 ± 4.26) ng/L vs. (26.60 ± 4.75) ng/L, (20.84 ± 6.16) μg/L vs. (25.00 ± 5.89) μg/L, (375.10 ± 45.18) kU/L vs. (400.25 ± 46.27) kU/L, there were statistical differences ( P<0.05). The mechanical ventilation time and intensive care unit stay time in the combined group were shorter than those in the conventional group: (150.46 ± 10.24) h vs. (189.67 ± 15.43) h, (7.00 ± 2.03) d vs. (9.84 ± 2.72) d, there were statistical differences ( P<0.05). The rate of extubation within 1 week in the combined group was higher than that in the conventional group, and the 28-day mortality was lower than that in the conventional group: 90.00%(36/40) vs. 72.50%(29/40), 5.00%(2/40) vs. 22.50%(9/40), there were statistical differences ( χ2 = 4.02, 5.16, P<0.05). Conclusions:In the patients with severe COPD, EDP combined with rhGH can significantly improve the diaphragm function, nutritional status, and lung function, decrease serum IL-6, IL-23, and KL-6 levels, shorten the mechanical ventilation time, and reduce the 28-day mortality.

Objective:To observe the efficacy of external diaphragm pacing (EDP) combined with recombinant human growth hormone (rhGH) in the treatment of severe chronic obstructive pulmonary disease (CDOP).Methods:By the prospective study method, 80 patients with severe COPD were admitted to the Xianju People′s Hospital(Zhejiang Southeast Campus of Zhejiang Provincial People′s Hospital)/Xianju Hospital Affiliated to Hangzhou Medical College from April 2021 to April 2023 were divided into the combined group and the conventional group by the random number table method, with 40 cases in each group. All of them received anti-infection, nutritional support, and other conventional treatment. In addition, the combined group was given EDP+rhGH treatment, and they were intervened for 20 d. The diaphragm function, nutrition, pulmonary function, and serum levels of interleukin (IL-6), IL-23, type Ⅱ alveolar cell surface antigen (KL-6) changes before and after treatment and prognosis were compared between the two groups.Results:After treatment, the diaphragm function index diaphragm maximum expiratory pressure (MIP), diaphragm thickness (DTei), and diaphragm mobility (DE) in the combined group were higher than those in the conventional group: (45.36 ± 7.04) cmH 2O (1 cmH 2O = 0.098 kPa) vs. (42.28 ± 6.43) cmH 2O, (0.32 ± 0.12) cm vs. (0.27 ± 0.06) cm, (3.40 ± 1.02) cm vs. (1.85 ± 0.64) cm, there were statistical differences ( P<0.05). After treatment, the nutritional status indexes of serum albumin (ALB), transferrin (Tf), and total protein (TP) in the combined group were higher than those in the conventional group: (34.62 ± 5.13) g/L vs. (31.75 ± 4.93) g/L, (2.21 ± 0.46) g/L vs. (2.00 ± 0.42) g/L, (63.80 ± 8.25) g/L vs. (60.24 ± 6.97) g/L, there were statistical differences ( P<0.05). After treatment, the percentage of forced expiratory volume in the first second (FEV 1) to the expected value (FEV 1%) and the ratio of FEV 1 to forced vital capacity (FEV 1/FVC) in the combined group were higher than those in the conventional group: (60.17 ± 6.30)% vs. (57.25 ± 6.24)%, (61.30 ± 7.04)% vs. (57.12 ± 7.25)%, there were statistical differences ( P<0.05). After treatment, the levels of IL-6, IL-23, and KL-6 in the combined group were lower than those in the conventional group: (23.13 ± 4.26) ng/L vs. (26.60 ± 4.75) ng/L, (20.84 ± 6.16) μg/L vs. (25.00 ± 5.89) μg/L, (375.10 ± 45.18) kU/L vs. (400.25 ± 46.27) kU/L, there were statistical differences ( P<0.05). The mechanical ventilation time and intensive care unit stay time in the combined group were shorter than those in the conventional group: (150.46 ± 10.24) h vs. (189.67 ± 15.43) h, (7.00 ± 2.03) d vs. (9.84 ± 2.72) d, there were statistical differences ( P<0.05). The rate of extubation within 1 week in the combined group was higher than that in the conventional group, and the 28-day mortality was lower than that in the conventional group: 90.00%(36/40) vs. 72.50%(29/40), 5.00%(2/40) vs. 22.50%(9/40), there were statistical differences ( χ2 = 4.02, 5.16, P<0.05). Conclusions:In the patients with severe COPD, EDP combined with rhGH can significantly improve the diaphragm function, nutritional status, and lung function, decrease serum IL-6, IL-23, and KL-6 levels, shorten the mechanical ventilation time, and reduce the 28-day mortality.

Objective: To observe the therapeutic efficiency of adenovirus-mediated interleukin-12 gene(AdmIL-12) and CD40 ligand gene(AdmCD40L) intratumoral transfer in established murine melanoma in vivo. Methods: C57BL/6 mice were inoculated subcutaneously with B16 cells to establish the murine melanoma model. The tumor-bearing mice were injected intratumorally with murine IL-12 gene and CD40L gene recombinant adenovirus. Tumor growth and the survival of tumor-bearing mice were observed. The CTL activity was measured in vitro by lactate dehydrogenase(LDH) release assay. Results: Both AdmIL-12 and AdmCD40L can be efficiently expressed in vitro and in vivo. The treatment with AdmIL-12 could significantly inhibit the tumor growth and prolong the survival period of the tumor-beraing mice. Splenic CTL activity of the mice was also enhanced after IL-12 gene transfer. But the anti-tumor effects of AdmCD40L gene were not significant. In contrast, Co-delivery of IL-12 gene and CD40L gene lead to stronger antitumor effects than IL-12 gene alone. Conclusion: Adenovirus-mediated interleukin-12 gene and CD40 ligand gene transfer together intratumorally has significant therapeutic effects on mice melanoma in vivo.