Objective:To investigate the prevalence of sarcopenia as defined by the third lumbar skeletal muscle index (L3-SMI) and explore its impact on drug therapy in patients with inflammatory bowel disease (IBD).Methods:The baseline abdominal CT images of 230 patients with IBD hospitalized in the First Hospital of Shanxi Medical University from December 2018 to December 2022 were retrospectively analyzed to obtain L3-SMI. The optimal cut-off value of L3-SMI to define sarcopenia was determined using receiver operating characteristic curve analysis. The IBD group included 164 cases of ulcerative colitis (UC) and 66 cases of Crohn's disease (CD), compared with 100 cases of the normal control. The clinical data and biochemical indicators, such as body mass index (BMI), albumin (ALB), pre-albumin (PA), disease activity and therapeutic drugs, were collected. Outcomes were followed up, including the optimization of baseline drug therapy, the initiation of additional biological agents or combined drug therapy. Multivariate logistic regression analysis was used to identify risk factors for the escalation of drug therapy, and the nomogram was constructed and evaluated for the prediction of drug regimen escalation in patients with IBD.Results:The prevalence of sarcopenia in the IBD population in this study was 39.6%, among whom 36.0% were with ulcerative colitis and 48.5% with Crohn's disease. The prevalence of malnutrition (BMI<18.5) in IBD patients was 18.7%, whereas 69.2% of patients with concurrent IBD and sarcopenia had a BMI≥18.5 . The median L3-SMI of IBD patients was significantly lower than that of normal controls (36.30 cm 2/m 2vs. 39.37 cm 2/m 2, P=0.004). Sarcopenia ( OR=3.33, 95% CI: 1.06 to 10.50, P=0.040) was associated with the escalation of drug therapy in patients with IBD. Based on the patient's age, presence or absence of sarcopenia, albumin and BMI, the nomogram prediction model was established, with the area under the curve (AUC) of 0.762 (95% CI: 0.691 to 0.834), showing good discriminating performance. The calibration curve and Hosmer-Lemeshow goodness-of-fit test demonstrated good consistency between the predicted and observed data ( χ2 =11.906, P=0.156). Decision curve analysis showed potential benefits of the prediction model in clinical settings. Conclusion:Sarcopenia is common in patients with IBD, which is related to the escalation of drug therapy in patients with IBD.

This article introduced TCM master Zhang Zhen's experience of using theory of"one body with two wings,regulating qi movement"in the treatment of thyroid nodules.The onset of thyroid nodules is due to liver depression and qi stagnation,and the booster of the onset is spleen and kidney dysfunction.The main pathogenesis is liver depression and qi stagnation,spleen deficiency and phlegm coagulation,kidney deficiency and blood stasis.The disease is located in the liver,spleen,and kidney.The general principle for treating thyroid nodules is to regulate the liver to regulate"the body",while the key points for treating thyroid nodules are to supplement the spleen and kidneys to supplement"the two wings".The combination of promoting blood circulation and dispersing nodules is the target for treating thyroid nodules.The clinical treatment of thyroid nodules with Shutiao Xiaohe Decoction has a significant therapeutic effect.

Humans ; Asthma/drug therapy* ; Biological Therapy

Objective:To develop the Self-management Scale for Patients with Lower Extremity Peripheral Artery Disease based on Chronic Disease Self-Management Program (CDSMP) and test its reliability and validity.Methods:Using CDSMP as the theoretical framework, a scale was formed through literature review, research group discussions, semi-structured interviews and Delphi expert inquiries. From October 2021 to March 2022, a total of 200 patients with lower extremity peripheral artery disease in the ward of Department of the Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were investigated by the convenient sampling to test the reliability and validity of the scale. A total of 200 questionnaires were distributed, and 183 valid questionnaires were recovered, with an effective recovery rate of 91.50%.Results:Cronbach's α coefficient of the overall scale was 0.935; the content validity indexes at the item level of the scale were 0.825-1.000, the content validity index at the scale level was 0.964. The first exploratory factor analysis was conducted without limiting the number of factors, and 5 common factors were obtained, with a cumulative variance contribution rate of 82.330%. According to the gravel map, 4 common factors were limited and extracted from the second exploratory factor analysis, with a cumulative variance contribution rate of 78.856%. The formal scale formed after screening included 4 dimensions and 26 items.Conclusions:The Self-management Scale for Patients with Lower Extremity Peripheral Artery Disease has good reliability and validity, which can be used as a tool for nursing staff to investigate the self-management level of patients with lower extremity peripheral arterial disease.

ObjectiveTo investigate the mechanism of gamma-chain (γC) cytokines in regulating the expression of T-cell immunoglobulin and mucin domain-containing molecule 3 (TIM-3) in CD8+ T cells of chronic hepatitis B (CHB) patients. MethodsA total of 23 CHB patients who attended Tangdu Hospital, Fourth Military Medical University, from January to May, 2017, were enrolled. Peripheral blood was collected from all patients, and Ficoll density gradient centrifugation was used to isolate peripheral blood mononuclear cells (PBMCs). PBMCs were stimulated with interleukin-7 (IL-7), interleukin-15 (IL-15), and interleukin-21, respectively, and then anti-γC antibody and/or anti-IL-7Rα, anti-IL-2Rβ, and anti-IL-21R were added to the culture solution. After 96 hours of culture, flow cytometry was used to measure the expression of TIM-3, interleukin-2 (IL-2), interleukin-10 (IL-10), and interferon-γ (IFNγ) and the phosphorylation level of signal transducer and activator of transcription (STAT) in CD8+ T cells. A one-way analysis of variance and the least significant difference t-test were used for comparison of continuous data. ResultsThe CD8+ T cells stimulated by IL-7 and IL-15 had a significantly higher percentage of TIM-3-positive CD8+ T cells than those without stimulation (t=9.966 and 9074, P＜0.05), as well as significantly higher expression levels of IL-2, IL-10, and IFN-γ and phosphorylation levels of STAT-5 and STAT-1 (all P＜0.05). Stimulation with anti-IL-7Rα and anti-γC antibody significantly reduced the elevated expression levels of TIM-3, IL-2, and IL-10 in the IL-7 stimulation group (t=5.537, 6.224, and 4.500, P＜0.05). Stimulation with anti-IL-2Rβ alone or in combination with anti-γC antibody significantly reduced the expression levels of TIM-3 and IL-2 and the phosphorylation level of STAT-1 in the IL-15 stimulation group (P ＜0.05). ConclusionIL-7 and IL-15 can upregulate the expression of TIM-3 in CD8+ T cells of CHB patients, possibly via the γC receptor-mediated STAT-cytokine signaling pathway.

In this study, Escherichia coli BL21 (DE3) was used as the host to construct 2 recombinant E. coli strains that co-expressed leucine dehydrogenase (LDH, Bacillus cereus)/formate dehydrogenase (FDH, Ancylobacter aquaticus), or leucine dehydrogenase (LDH, Bacillus cereus)/alcohol dehydrogenase (ADH, Rhodococcus), respectively. L-2-aminobutyric acid was then synthesized by L-threonine deaminase (L-TD) with LDH-FDH or LDH-ADH by coupling with two different NADH regeneration systems. LDH-FDH process and LDH-ADH process were optimized and compared with each other. The optimum reaction pH of LDH-FDH process was 7.5, and the optimum reaction temperature was 35 °C. After 28 h, the concentration of L-2-aminobutyric acid was 161.8 g/L with a yield of 97%, when adding L-threonine in batches for controlling 2-ketobutyric acid concentration less than 15 g/L and using 50 g/L ammonium formate, 0.3 g/L NAD+, 10% LDH-FDH crude enzyme solution (V/V) and 7 500 U/L L-TD. The optimum reaction pH of LDH-ADH process was 8.0, and the optimum reaction temperature was 35 °C. After 24 h, the concentration of L-2-aminobutyric acid was 119.6 g/L with a yield of 98%, when adding L-threonine and isopropanol (1.2 times of L-threonine) in batches for controlling 2-ketobutyric acid concentration less than 15 g/L, removing acetone in time and using 0.3 g/L NAD⁺, 10% LDH-ADH crude enzyme solution (V/V) and 7 500 U/L L-TD. The process and results used in this paper provide a reference for the industrialization of L-2-aminobutyric acid.
Aminobutyrates ; metabolism ; Escherichia coli ; genetics ; Formate Dehydrogenases ; metabolism ; Leucine Dehydrogenase ; metabolism ; NAD ; metabolism

Background and objective With the extensively application of HRCT (high resolution CT) and the popularization of early lung cancer screening, the proportion of small nodullar lung cancer to be operated increases rapidly. Identifying the focus lesions quickly and accurately in operation has shown to be a challenge. We carried out this research try-ing to make use of and evaluate a new method that localizaes and extracts small peripheral pulmonary nodules by way of simu-lating radiaotherapy combining methylene blue staining.Methods From February 2012 to January 2015, 97 patients with 100 peripheral pulmonary nodules ≤10 mm in size were simulated puncturing using a radiotherapy planning. When the anaesthesia came into use, methylene blue dye was injected to the virtually identiifed point corresponding to the surface point, according to the angle and depth previously computed by the radiotherapy planning. hTe video-assisted thoracoscopic surgery (VATS) wedge resections of the marked lesions were undertaken and the specimens were sent for frozen pathologic examination. hTe interval time from anesthesia-completing to puncture and injection, hTe interval time from methylene blue injection to iden-tifying the stained area and the distances between the centre point of the stains and edge of coloured lesion were recorded. Results Our preoperative localization procedure was successful in 96 of 100 (96%) nodules. hTe interval time from anesthesia-completing to puncture and injection of methylene blue were (4.85±1.25) min. hTe interval time from methylene blue injec-tion to identifying the stained area was (16.36±2.36) min. hTe distances between the centre point of the stains and edge of coloured lesion were (4.78±2.51) mm. No complication was observed in all participants.Conclusion hTe new method of locating peripheral pulmonary nodules by simulating simulating radiaotherapy combining methylene blue staining has a high success rate and no complication for localizing small peripheral pulmonary lesions, avoiding the fear and pain of the patients untaken puncture without anaesthesia reducing radial damage.

Objective To study the relationship between monoeyte chemoattractant protein 1 (MCP-1)-2518A/G polymorphism and lung cancer in Han nationality of North China. Methods One hun-dred and thirty-four unrelated consecutive patients with lung cancer(112 with NSCLC, 22 with SCLC)and 82 healthy individuals were studied. The polymorphisms of MCP-1-2518A/G were detected with polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP). Results The distribution of AA, AG and GG genotypes of MCP-1-2518 was significantly different in lung cancer patients compared with controls (X~2=8. 486,P=0. 014). There was a significant increase in the frequency of the AA genotype (OR=2. 645, X~2=6. 532, P=0.011) and a significant decrease in the frequency of the GG genotype (OR=0.519, X~2=4.929, P=0. 026)in the lung cancer patients, compared with controls. In the NSCLC patients the fre-quency of the AA genotype was higher than controls(OR=3. 138, X~2=8. 905, P=0.003) and the frequency of the GG genotype was lower than controls(OR=0. 516 ,X~2=4. 613, P=0. 032). The frequencies of AA, AG and GG genotypes in SCLC patients and controls had no difference. Conclusion This preliminary study showed that MCP-1-2518A/G polymorphism was associated with NSCLC but not SCLC.

BACKGROUND AND OBJECTIVESerum tumor markers play important roles in diagnosis, response and prognosis monitoring for lung cancer. The clinical significance of serum level of tissue polypeptide specific antigen (TPS) was investigated in diagnosis, response monitoring and prognosis in patients with lung cancer, compared with carcinoembryonic antigen (CEA), precursor of gastrin-releasing peptide (Pro-GRP) and cytokeratin-19-fragments (CYFRA21-1).

METHODSBlood samples of eighty-two patients with lung cancer before treatment and some after chemotherapy were measured by ELISA for four tumor markers.

RESULTSCompared with lung benign diseases group and health control group, the positive rates and levels of TPS, CEA and Pro-GRP in patients with lung cancer were higher, with statistically significant difference. TPS in extensive-small cell lung cancer was significant higher than that in limited-small cell lung cancer. The positive rates and levels of TPS, CEA and Pro-GRP in patients after treatment had significant decreases compared with before treatment. TPS was an independent prognostic factor of non-small cell lung cancer.

CONCLUSIONTPS is valuable to diagnosis, response monitoring for patients with lung cancer, moreover, it maybe a useful factor of prognosis of non-small cell lung cancer.

Adult ; Aged ; Aged, 80 and over ; Antigens, Neoplasm ; blood ; Biomarkers, Tumor ; blood ; Carcinoembryonic Antigen ; blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Keratin-19 ; blood ; Lung Neoplasms ; blood ; diagnosis ; Male ; Middle Aged ; Peptides ; blood ; Prognosis ; Protein Precursors ; blood ; ROC Curve

Clinical data of 53 patients with lower caliceal stone during August 2005 and March2007 were analyzed retrospectively.The stones were 11-35 mm in diameter.Under the guidance of X-ray.single renal tract parallel to the lower caliceal for percutaneous nephrolithotomy was established.The procedures were successful in all the patients.Fifty patients were stone free after first minimally invasive pereutaneous nephrolithotomy(MPCNL),2 were stone free following second MPCNL,1 saw residual small stones clear off spontaneously during the follow-up period.Operative time was 65-162 minutes.and blood loss was 10-200 ml.No severe complications or death occurred.MPCNL may be related with minimal invasion and fewer complications,thus provides an effective and safe way of lower caliceal stone treatment.