Objective To analyze the nutritional status and risk factors of disease condition grading in patients with chronic obstructive pulmonary disease (COPD), and to provide the reference for clinical diagnosis and treatment.. Methods A total of 518 patients with COPD who were admitted to the hospital from February 2020 to February 2023 were selected as the study subjects (COPD group). Among the 520 cases of non-COPD patients in respiratory and critical care wards were included in control group . The patients with COPD were divided into 265 cases in malnutrition group and 253 cases in normal nutrition group according to the nutritional status. The nutritional status of patients with different disease condition grades was observed . The basic information and clinical examination status were compared between both groups, and multivariate logistic regression analysis was used to explore the risk factors of malnutrition in patients with COPD. Results The nutritional indicators of BMI, IBM and ALB in COPD group were lower than those in control group (P<0.05). The higher the disease condition grade , the lower the levels of nutritional indicators (P<0.05). The proportions of smoking history, number of acute exacerbations ≥twice a year, comorbidity types≥4, ALB<35 g/L, CRP≥60 mg/L, CAT score≥10 points and FEV1/FVC<50% in malnutrition group were higher than those in normal nutrition group while the proportion of ventilator use was lower than that in normal nutrition group (P<0.05) . Multivariate Logistic regression analysis showed that the number of acute exacerbations≥ twice a year, comorbidity types≥4, CRP≥60 mg/L and FEV1/FVC<50% were independent risk factors of malnutrition in patients with COPD, and ventilator use was a protective factor (P<0.05). Conclusion The nutritional status of COPD patients is poor , and the more serious the disease condition grade , the worse the nutritional status . The number of acute exacerbations , types of concurrent diseases , CRP , FEV1/FVC are all influencing factors of malnutrition in COPD patients.

Chronic obstructive pulmonary disease (COPD) is characterized by progressive and incomplete reversible airflow limitation, and COPD is mainly caused by small airway lesions and seriously endangers human health due to its high incidence rate and mortality rate. At present, the occurrence of COPD can be effectively prevented by detecting the characteristics of small airway lesions, so the study of small airway lesions has positive significance in the prevention and early intervention of COPD. This paper reviews the research progress on characteristics, detection methods and diagnosis and treatment methods of small airway lesions in COPD, so as to provide a theoretical basis for clinical research.

ObjectiveTo explore the improving effects and its synergistic mechanism of Olibanum before and after processing with vinegar on glycodesoxycholic acid（GDCA） intervention in mice with ulcerative colitis（UC） based on the perspective of intestinal flora. MethodC57BL/6J male mice were randomly divided into the normal group， model group， GDCA group， Olibanum group（1.5 g·kg^-1） and vinegar-processed Olibanum（1.5 g·kg^-1） group， with 6 mice in each group. Mice in the normal group drank water freely， and mice in the other groups were given 2% dextran sulfate sodium（DSS） periodically to establish a UC mouse model. During the modeling， GDCA group， Olibanum group and vinegar-processed Olibanum group were intervened by intraperitoneally injection of GDCA（0.05 g·kg^-1）. From the 13^th day after modeling， Olibanum group and vinegar-processed Olibanum group were given the corresponding doses of drugs by gavage， once a day， for 36 d. During this period， the body mass of mice was recorded and the disease activity index（DAI） was assessed. On day 48， faeces were collected for 16S rRNA and metagenomic sequencing to analyse changes in intestinal flora. On the 49^th day， hematoxylin-eosion（HE） staining was used to observe the colon histological lesions， enzyme-linked immunosorbent assay（ELISA） was used to determine serum levels of tumour necrosis factor-α（TNF-α）， interleukin（IL）-1β and IL-6， and Spearman correlation analysis was used to explore the correlation between differential bacterial species and inflammatory factor levels. ResultCompared with the normal group， the model group showed a significant decrease in body weight（P<0.01）， a significant increase in DAI（P<0.05）， and a significant increase in TNF-α， IL-1β and IL-6 levels（P<0.01）， and there was partial infiltration of inflammatory cells in the colon. Compared with the model group， mice in the GDCA group showed a significant decrease in body weight， a significant increase in DAI and levels of TNF-α， IL-1β and IL-6（P<0.01）， and severe disruption of colonic crypt structure， extensive infiltration of inflammatory cells， and a significant decrease in goblet cells. Compared with the GDCA group， both the Olibanum and vinegar-processed Olibanum groups showed a significant recovery in body weight， a significant decrease in DAI and levels of TNF-α， IL-6 and IL-1β（P<0.05， P<0.01）， and the modulating effect of vinegar-processed Olibanum was significantly better than that of Olibanum. Alpha diversity showed that Chao1 index of UC mice significantly increased（P<0.01） and Shannon index decreased significantly（P<0.05） in UC mice after GDCA intervention. Beta diversity showed that the microbial community structure of the 5 groups had significant changes， Olibanum and vinegar-processed Olibanum could modulate the changes in the structure of the intestinal flora in UC mice after GDCA intervention. Microbial sequencing results indicated that， compared with the normal group， the Firmicutes/Bacteroidetes ratio in the model group was significantly higher（P<0.05）， and the relative abundance of 3 genera and 5 species of flora changed significantly（P<0.05， P<0.01）. Compared with the model group， the Firmicutes/Bacteroidetes ratio in the GDCA group was significantly higher（P<0.05）， the relative abundance of 7 pathogenic bacterial genera and four species was significantly increased（P<0.05， P<0.01）， and the relative abundance of three beneficial bacterial genera and Bacteroides_intestinalis was significantly decreased（P<0.05， P<0.01）. Olibanum group and vinegar-processed Olibanum group could modulate the Firmicutes/Bacteroidetes ratio， the relative abundance of pathogenic bacteria and beneficial bacteria， and the vinegar-processed Olibanum group was significantly superior to Olibanum group in terms of modulating the Firmicutes/Bacteroidetes ratio， the relative abundance of the three genera and five species of bacteria（P<0.01， P<0.05）. Correlation analysis showed that the relative abundance of Bacteroides_intestinalis was negatively correlated with the levels of TNF-α， IL-6 and IL-1β， the relative abundance of Prevotella_sp_CAG873， Bacteroides_sp_CAG927， Bacteroidales_bacterium_52_46 and Bacteroidales_bacterium was positively correlated with TNF-α， IL-6 and IL-1β levels. ConclusionGDCA can exacerbate UC colonic inflammation， and Olibanum and vinegar-processed Olibanum have an ameliorative effect on GDCA-mediated UC， with the vinegar-processed Olibanum showing a stronger ameliorative effect， the mechanism may be related to the regulation the abundance and structure of intestinal beneficial and pathogenic bacteria， and the reduction of inflammatory factor levels.

Chronic obstructive pulmonary disease (COPD) is a common respiratory system disease, with high incidence rate and mortality. So far, the pathogenesis of COPD has not been clearly determined. Microinflammatory state refers to the growth and reproduction of certain pathogens in the body due to bacteria, viruses and fungi infections, which causes inflammatory response of local tissues and the whole body, it is manifested by a slight and continuous increase of inflammatory marker proteins and inflammatory cytokines in systemic circulation. This article reviewed the literature on microinflammatory state and COPD. It is concluded that microinflammatory state will lead to the imbalance of proinflammatory and anti-inflammatory mechanisms, which can cause ischemic and hypoxic destruction and injury of lung tissue cells, and further aggravate lung injury. The common inflammatory factors such as C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin (IL) in microinflammatory state are closely related to the severity of COPD, which may promote disease progression, continuously affect lung function, arterial blood gas and nutritional status of patients.

ObjectiveTo investigate the synergistic mechanism of vinegar-processed Olibanum on ulcerative colitis（UC） via the bile acids regulating "gut-liver" crosstalk. MethodRats were randomly divided into normal group， model group， Olibanum group and vinegar-processed Olibanum group. UC model of rats was induced by intracolonic instillation of 2，4，6-trinitrobenzenesulfonic acid（TNBS）. Ultra high performance liquid chromatography-triple quadrupole-mass spectrometry（UPLC-QQQ-MS） was used to perform the qualitative analysis of 30 bile acids in the colon of rats. Real-time fluorescence quantitative polymerase chain reaction（Real-time PCR） and Western blot were used to detect changes in the expression of farnesoid X receptor（FXR）， fibroblast growth factor 15（FGF15） and FGF receptor 4（FGFR4） in "gut-liver" crosstalk at mRNA and protein levels. And with the help of HcoEpiC cell model intervened by conjugated bile acids， simulating the UC state， and according to the different modes of intervention， they were divided into the blank group， conjugated bile acid group， Olibanum group， vinegar-processed Olibanum group and 3-O-acetyl-9，11-dehydro-β-boswellic acid（ADHBA） group. The effect of Olibanum before and after processing with vinegar and the main differential component ADHBA on the mRNA expression of FXR and FGF19 were explored by Real-time PCR. ResultCompared with the normal group， the levels of conjugated bile acids in the model group increased significantly（P<0.01）， and the mRNA and protein expressions of "gut-liver" crosstalk factors FXR， FGF15 and FGFR4 decreased significantly（P<0.05， P<0.01）. Compared with the model group， the content of conjugated bile acids in the Olibanum group and vinegar-processed Olibanum group was significantly decreased（P<0.01）， the mRNA and protein expressions of FXR， FGF15 and FGFR4 were significantly elevated（P<0.05， P<0.01）， and vinegar-processed Olibanum exhibited superior effects than Olibanum. In cellular experiments， a significant decrease in mRNA expression of FXR and FGF19 was observed in the conjugated bile acid group when compared with the blank group（P<0.01）. Compared with the conjugated bile acid group， the mRNA expressions of FXR and FGF19 were significantly higher in the Olibanum， vinegar-processed Olibanum and ADHBA groups（P<0.05， P<0.01）， and the effect of vinegar-processed Olibanum was more favorable. ConclusionVinegar-processed Olibanum may enhance the ameliorating effect on UC by enhancing the down-regulation of conjugated bile acids in the colon and the up-regulation of FXR-FGF15/19-FGFR4 "gut-liver" crosstalk pathway， and ADHBA may be the main material basis for the synergy.

The aim of this study was to produce recombinant porcine interferon gamma (rPoIFN-γ) by Chinese hamster ovarian (CHO) cells expression system and to analyze its antiviral activity. Firstly, we constructed the recombinant eukaryotic expression plasmid pcDNA3.1-PoIFN-γ and transfected into suspension cultured CHO cells for secretory expression of rPoIFN-γ. The rPoIFN-γ was purified by affinity chromatography and identified with SDS-PAGE and Western blotting. Subsequently, the cytotoxicity of rPoIFN-γ was analyzed by CCK-8 test, and the antiviral activity of rPoIFN-γ was evaluated using standard procedures in VSV/PK-15 (virus/cell) test system. Finally the anti-Seneca virus A (SVA) of rPoIFN-γ activity and the induction of interferon-stimulated genes (ISGs) and cytokines were also analyzed. The results showed that rPoIFN-γ could successfully expressed in the supernatant of CHO cells. CCK-8 assays indicated that rPoIFN-γ did not show cytotoxicity on IBRS-2 cells. The biological activity of rPoIFN-γ was 5.59×10⁷ U/mg in VSV/PK-15 system. Moreover, rPoIFN-γ could induced the expression of ISGs and cytokines, and significantly inhibited the replication of SVA. In conclusion, the high activity of rPoIFN-γ was successfully prepared by CHO cells expression system, which showed strong antiviral activity on SVA. This study may facilitate the investigation of rPoIFN-γ function and the development of novel genetically engineered antiviral drugs.
Swine ; Animals ; Cricetinae ; Interferon-gamma/pharmacology* ; Cricetulus ; CHO Cells ; Sincalide ; Recombinant Proteins/pharmacology* ; Antiviral Agents/pharmacology*

Objective:To observe the effect of esketamine on cardiac index in patients undergoing lumbar surgery in prone position under general anesthesia.Methods:Forty-five patients with prone lumbar surgery after general anesthesia in Hunan Provincial People′s Hospital from March to July 2021 were divided into observation group (24 cases, group A) and control group (21 cases, group B) according to random number table method. Group A received 0.5 mg/kg esketamine intravenously during induction, and 0.15 mg/(kg·h) esketamine intravenously for 2 h after prone position. Group B received the same amount of normal saline. Both groups were given sevoflurane and remifentanil during operation to maintain anesthesia, and sufentanil was given intermittently during operation. The mean arterial pressure (MAP), systolic blood pressure (SBP), diastolic pressure (DBP), cardiac index (CI), and heart rate (HR) before induction (T 0), during endotracheal intubation (T 1), 5 minutes after intubation (T 2), 5 minutes after prone position (T 3), 10 minutes after prone position (T 4), 30 minutes after prone position (T 5), 45 minutes after prone position (T 6), 60 minutes after prone position (T 7), 90 minutes after prone position (T 8), and 120 minutes after prone position (T 9) were recorded; The total dosage of norepinephrine 2 hours after anesthesia to prone position and extubation time after operation were also recorded. The Visual Analogue Scale (VAS) was performed 15 minutes after extubation, 6 and 24 hours after operation. Results:There was no significant difference in CI between T 3-T 9 and T 2 in group A ( P>0.05); the CI of group B at T 3-T 7 was significantly lower than that at T 2 (all P<0.05); there was no significant difference in CI between T 8-T 9 and T 2 in group B (all P>0.05); There was no significant difference in CI between group A and group B at T 0-T 2 (all P>0.05). The CI of group A at T 3-T 9 was significantly higher than that of group B (all P<0.05); The dosage of norepinephrine in group A was significantly lower than that in group B ( P<0.05); There was no significant difference in HR, MAP, SBP and DBP between the two groups at different time points (all P>0.05); there was also no significant difference in extubation time and VAS scores at 15 minutes, 6 hours and 24 hours after extubation between the two groups (all P>0.05). Conclusions:Intraoperative application of esketamine can increase CI after prone position and reduce the amount of norepinephrine during lumbar surgery.

OBJECTIVE: To analyze the clinical and genetic features of a patient with mevalonate kinase deficiency (MKD). METHODS: Whole exome sequencing was carried out for the proband. Candidate variant was verified by Sanger sequencing. RESULTS: The proband was found to harbor compound heterozygous variants of the MVK gene, including a c.248C>T (p.Phe83Cys) variant derived from his father and a c.971C>T (p.Ala324Val) variant from his mother. Based on the guidelines of the American College of Medical Genetics and Genomics, both variations were predicted to be likely pathogenic (PM1 + PM2 + PM3 + PP3). CONCLUSION The compound heterozygous variants of the MVK gene probably underlay the MKD in the proband. Above findings have enriched the mutational spectrum of the MVK gene.
Child ; Genomics ; Humans ; Immunoglobulin D/genetics* ; Mevalonate Kinase Deficiency/genetics* ; Mutation ; Whole Exome Sequencing

Hepatic sinusoidal obstruction syndrome (HSOS) is the most common early complication in patients with hematopoietic stem cell transplantation (HSCT). According to reports, the average incidence of HSOS post-HSCT is 13.7% (0~62%). HSOS may be accompanied by multiple organ failure, and the mortality rate can exceed 80% at 100 days of onset. Defibrotide is currently the safest and most effective drug used to prevent and treat HSOS post-HSCT. It is currently the only drug approved in the United States for the treatment of HSOS with lung/renal dysfunction post-HSCT. In addition, it has been approved in the European Union for the treatment of severe HSOS cases post-HSCT. This article briefly describes and summarizes the research progress, clinical application, pharmacokinetics, efficacy, safety, dose and treatment of defibrotide in HSOS post-HSCT.

Objective:To explore the application of ArcCheck system in the validation of Helical and Direct tomotherapy plans for esophageal cancer and summarize relevant experience.Methods:The Helical and Direct tomotherapy verification plans were established for 32 patients with esophageal cancer at different positions according to the doctor′s instructions, which were verified by the ArcCHECK system to compare the passing rate of the results.The correlation between the volume of the target area and the passing rate of the planned verification was analyzed. The therapeutic verification plan with a small target volume was made. The target area was placed at the center of ArcCHECK phantom and the area of detectors to statistically compare the verification passing rates.Results:Helical plan showed a significantly higher passing rate than the Direct plan ( P<0.01). The correlation coefficients between the target volume and the passing rate of the Helical and Direct plans were -0.364 and -0.042, and the P values were 0.041 and 0.819, respectively. For the Helical plan, when the 3%/2mm criterion was adopted, there was significant difference between placing the high-dose area at the center of the phantom and the area of detectors ( P=0.005), and the passing rate of the latter was higher. There was no significant difference in the other cases (all P>0.05). Conclusions:The passing rate of the Helical plan is generally higher than that of the Direct plan, which may be related to the angular response of the ArcCHECK detector and the fact that more reference points are not included for calculation due to low-dose radiation. In addition, it may also be related to the higher requirements of Direct plan for tomotherapy dose control system. In the Helical verification plan, when the 3%/3mm criterion is adopted, the larger the target volume, the higher the possibility of lower passing rate, whereas the correlation coefficient between them is relatively low. The high-dose area can be verified by the plans at the center of the phantom or the detection point. With the comprehensive consideration, we suggest putting it at the center of the phantom.