Humans ; HIV Infections/drug therapy* ; HIV-1/genetics* ; Tenofovir/therapeutic use* ; Anti-HIV Agents/therapeutic use* ; RNA ; Drug Combinations

Objective To explore the value of PLR in peripheral blood in the efficacy and prognosis of targeted therapy for NSCLC with EGFR-mutated. Methods Ninety patients with EGFR-mutant of NSCLC were selected, and the PLR was calculated before targeted therapy. The PLR median was used as a cut-off point for grouping, and they were assigned to group A (low PLR group) and group B (high PLR group). All patients were treated with EGFR-TKIs. Relationship between PLR and clinicopathological features was analyzed. Objective efficacy, ORR, DCR, PFS and OS between the two groups were compared. Results Before EGFR-TKIs therapy, median PLR was 139, and there were 44 patients in group A, and 46 in group B. There were statistical differences regarding smoking, tumor location, histological differentiation, T staging, and clinical staging between group A and B (P <0.05). The rates of PR, ORR and DCR in group A were higher than those in group B, and the PD rate was lower than that in group B (P < 0.05). Log-rank test showed that median OS and median PFS in group A were longer than those in group B (P= 0.001). Conclusions PLR in peripheral blood has certain reference value for therapeutic effect and prognosis evaluation on NSCLC with EGFR-mutation. Low PLR of NSCLC patients with EGFR-mutation has higher efficacy and longer survival time after targeted therapy, and it is an independent and prognostic factor.

To obtain specific antibodies against nsp4 protein of porcine reproductive and respiratory syndrome virus (PRRSV), nsp4 gene was amplified by RT-PCR and cloned into pET-28a(+) vector, designated pET28a-nsp4. pET28a-nsp4 was transformed into Escherichia coli Trasseta (DE3) cells and expressed after induction of IPTG. SDS-PAGE analysis showed that the recombinant protein was expressed in soluble form with the molecular weight of 26 kDa. The soluble fusion protein in the supernatant was purified using Ni+-NTA affinity chromatography. New Zealand rabbits were immunized by the purified nsp4 and anti-sera against nsp4 were obtained. The titer of polyclonal antibodies was about 106 and showed good specificity and sensitivity in the immunofluorescence assay and Western blotting analysis. The polyclonal antibodies also recognized native nsp4 form PRRSV infected Marc-145 cells, providing a useful tool in PRRSV replication mechanism study.

Objective Ticagrelor-related dyspnea may affect the medication adherence of patients with coronary artery disease.This study aims to assess the impact of ticagrelor adherence on 1-year cardiovascular outcomes in pateints with stable coronary artery diseases (SCAD).Methods This study includes the patients with SCAD from Fuwai hospital who discharged with ticagrelor between Jan.2015 to Jun.2015.We collected data of clinical characteristics and ticagrelor adherence from these patients by reviewing the electronic medical records and personnel interview.Follow-up was performed at 6 and 12 months by telephone interview or office visits.Results A total of 155 patients with SCAD were enrolled,of whom 122 (78.7％) were males with a mean age (57.0 ± 10.0) years.Among them,50 (32.3％) patients have a history of myocardial infraction and 106 (68.4％) patients had angiographic confirmed left main and/or multivessel disease.Forty-six patients (29.7％) with SCAD prematurely stopped ticagrelor within 12 months,while 25 (16.1％) patients switched from ticagrelor to clopidogrel.Hemorrhagic events and locally unavailable ticagrelor were the major reasons causes of the premature discontinuation of ticagrelor.Univariate analysis showed age,body mass index (BMI),hypertention and locally unavailable ticagrelor as relative factors for early ticagrelor discontinuation after discharge.Multivariate analysis revealed unavailable drug locally (OR 0.25,95％ CI 0.09-0.69) and elderly patients (OR 4.13,95％ CI 1.40-12.19) were risk factors for low persientence or premature ticagrelor discontinuation.Conclusion This study showed poor ticagrelor adherence in patients with SCAD after discharge.Locally unavailable ticagrelor and elderly patients were strong predictors of poor ticagrelor adherence.Discontinuation to ticagrelor prematurely may not have impact on adverse cardiovascular outcomes.

Objective To explore the effect of electroacupuncture (EA) at tusanli (ST36) on regulation of stress response under different doses of etomidate anesthesia in rats.Methods Sixty male Sprague-Dawley rats, weighing 280-310 g, were randomly divided into control group (group C), model group (group M), etomidate 60 mg/kg group (group E1), etomidate 30 mg/kg group (group E2), etomidate 60 mg/kg combined with EA group (group EA1) and etomidate 30 mg/kg combined with EA group (group EA2), n=10 in each group.All groups received inferior caudal trunk transection at the level between sacral spinal nerve 3 and 4 (S3, S4) to prepare acute stress response model except group C.Group M received no others treatment.The rats in group E1, group EA1, group E2 and group EA2 were intraperitoneally injected with 60, 60, 30 and 30 mg/kg etomidate, respectively.Group EA1 and group EA2 received EA ST36.The points were stimulated at a frequency of 2/100 Hz with 1 mA output and a dilatational wave, which lasted for 30 min.ACTH and Cor levels were measured by ELISA.The c-fos protein expression in hypothalamic tissue was examined by Western blot.Results Compared with group C, ACTH and Cor levels, and hypothalamic expression of c-fos protein in group M were significantly increased (P<0.05).Compared with group M, serum ACTH and Cor levels, and hypothalamic expression of c-fos protein in groups E1, E2, EA1 and EA2 were significantly decreased (P<0.05).Compared with group E1, serum ACTH and Cor levels, and hypothalamic expression of c-fos protein were significantly higher in groups E2 and EA1 (P<0.05).Compared with group E2, serum ACTH level and hypothalamic expression of c-fos protein were significantly lower in group EA2 (P<0.05).Conclusion EA at ST36 regulating stress response under etomidate anesthesia in rats is effective and two-way, and the mechanism may be due to the release of neurotransmitters induced c-fos protein in hypothalamus.

Objective To compare three rat models of acute stress response and to explore an ideal experimental rat model for research of acute stress response .Methods A total of 40 clean grade male SD rats were randomly ( by random number ) divided into 4 groups ( n=10 each ):Normal group ( group I ) , caudal trunk transection group ( group II), burn group (group III), and amputation group (group IV).The group I received no special treatment , the group II received inferior caudal trunk transection at the level between sacral spinal nerve 3 and 4 (S3, S4), the group III was inflicted with 30%total body surface area ( TBSA) grade 3 burn on the back , and the group IV had an amputation of the left lower limb as severe traumatic stress .Rats in each group were killed at 30 minutes after treatment and blood samples were collected for measuring serum adrenocorticotropic hormone (ACTH) and corticosterone (CORT) levels by ELISA. The c-fos protein expression in hypothalamic tissue was examined by immunohistochemistry .Results Compared with the group I, serum ACTH and CORT levels , and hypothalamic expression of c-fos protein in the group II , III, IV were significantly increased ( P <0.05 ) .Compared with the group III , serum ACTH and CORT levels , and hypothalamic expression of c-fos protein were significantly higher in the group II and IV ( P <0.05 ) , while there was no significant difference between the group II and IV (P>0.05).Conclusions The preparation of acute stress response model induced by inferior caudal trunk transection has simple operation steps and produces a traumatic injury to a similar degree , and quite well reflects the acute stress response in humans caused by sudden accident .Therefore it is a quite good method to establish acute stress response and deserves further investigation .

Objective To investigate the effect of acupoint massage combined with foot bathing in hot water on sleep quality of patients after gynecological operation. Methods Ninety-nine gynecological patients were divided into the control group (n=49) and the observation group (n = 50) after gynecological operation according to time of admission. The control group received the routine nursing and the observation group was treated with acupoint massage and foot bathing in hot water besides routine nursing. Pittsburgh sleep quality index was used to investigate the sleep quality at the day before operation 1 and 8 days after operation. Result The sleep quality of postoperative patients in the observation group was significantly better than that of the control group (P < 0.05). Conclusions The acupoint massage with hot bathing in hot water can improve the quality of sleep of the patients after gynecological operations. For its convenience in manipulation, it is popular among patients and their families.

Objective To assess the application of Chinese children's intelligence equation (CCIE) and Bayley Scales of infant and toddler development-Ⅲ (BSID-Ⅲ) in screening of postoperative cognitive dysfunction (POCD) in children after general anesthesia.Methods The study group (Group A),including 50 ASA-Ⅰ participants of 1-3 years old who would undergo hernia repair laparoscopic surgery,was assessed on one day (1 d) before and three days (3d) after the surgery respectively by both of CCIE and BSID-Ⅲ according to their ages of month.The control group (Group C),including 50 healthy participants with the matched age,was assessed in the same period by the same method.Both of Group A and C were assessed by the Z score method to diagnose POCD and both scales were used to analyze the results of POCD screening and their agreement.Results (1) Compared with preoperative 1 d,the CCIE score of Group A on 3d after surgery was relatively decreased (21.22±4.96 vs 18.65±4.74,P＜0.05) and the POCD rate was 12.0％.While in Group C,the CCIE score and the POCD rate had no statistical significance (20.83±4.97 vs 21.22±5.21,P＞0.05).(2) Compared with preoperative 1d,the scores of cognition,language,motion,social-emotion and adaptive behaviors in BSID-Ⅲ of Group A decreased (100.00±4.58 vs 96.44± 4.20,103.22±4.99 vs 96.24± 5.75,102.06±4.01 vs 95.28±4.27,101.22±7.38 vs 91.06±7.10,98.52±9.11 vs 90.5±8.47,P＜0.05) and the POCD incidence was 20.0％.While in group C,the BSID-Ⅲ score and the POCD rate had no statistical significance (104.61±5.48 vs 103.79±5.38,107.68±5.60 vs 107.11 ±6.05,108.29±5.91 vs 108.29±4.21,101.11±7.61 vs 101.86±6.99,99.00±7.99 vs 100.82±7.36,P＞0.05).(3)Reasonable agreement of the CCIE and BSID-Ⅲ was observed (Kappa value was 0.70;P＜ 0.05).Conclusion There is considerable agreement between BSID-Ⅲ and CCIE.While BSID-Ⅲ is relatively more sensitive to the POCD and more efficient in the diagnosis of POCD than the CCIE.Thus,BSID-Ⅲ is more likely to provide better evaluation of the postoperative cognitive functions of children within 1-3 years old and should be recommended to the health professionals in China.

Objective There is a lack objective methods for the diagnosis of postoperative cognitive dysfunction (POCD).This study aimed to investigate the influence of propofol or etomidate anes-thesia on the postoperative cognitive function and serum S 100βprotein level in infants . Methods This study included 100 hernia infants aged 1-3 years treated by laparoscopic herniorrhaphy under propofol (n=50) or etomidate anesthesia (n=50).At 1 day before and 3 days after surgery, we assessed the cognitive function of the patients using Bayley Scales of Infant and Toddler Development ( BSID-Ⅲ) and further divided each group into a POCD and a non-POCD sub-group based on the results of diagnosis made according to the Z-scores.Using ELISA, we measured the levels of the serum S100βpro-tein in the iliac venous blood drawn preoperatively ( T0 ) and before PACU ( T1 ) and compared them between the POCD and non-POCD groups. Results At 3 days after operation, POCD was observed in 10 cases (20.0%) in the propofol group and 9 cases (18.0%) in the etomidate group, with no statistically significant differences between the two (P>0.05).The level of the serum S100βprotein was markedly elevated in both the propofol and etomidate groups at T 1 as compared with that at T0(P<0.05), and so was it in the POCD in comparison with that in the non-POCD group (P<0.05), with no statistically significant differences between the two groups at T1(P>0.05).A significant correlation was found between the postoperative S 100βlevel and POCD at 3 days after surgery in both the propofol (r=0.842, P=0.001) and the etomidate group (r=0.821, P=0.001). Conclusion Propofol and etomidate anes-thesia can induce different degrees of postoperative decline of cognitive function in 1-3 years old infants .The post-anesthesia elevation of the serum S100βprotein level is positively correlated with early postoperative POCD and indicates various degrees of brain damage .

Objective To investigate the influence of electroacupuncture(EA) in different points combined with spinal anesthesia on acute stress response and mechanisms related with expression of spinal c-fos protein. Methods Fifty adult male Sprague-Dawley rats were randomly divided into 5 groups:groupⅠwere normal rats receiving only 50μL saline intrathecal IT injection;groupⅡwere docked rats receiving IT with 50 μL saline;groupⅢ were docked rats receiving IT injection of 50 μL, 2.5 μg fentanyl; group Ⅳwere docked rats receiving IT injection of fentanyl 50μL and EA at′zu-san-li′;groupⅤwere docked rats receiving EA at′er xue′and IT fentanyl. Serum corticosterone (CORT) and adrenocorticotropic hormone (ACTH) levels were measured by ELISA. Determined the c-fos protein expression levels of L4-6 spinal by western blotting. Result GroupⅡACTH, CORT levels and c-fos expression was significantly higher than those in groupⅠ(P<0.01). Compared with groupⅡ, groupⅢ,ⅣandⅤhad higher ACTH and CORT levels (P<0.05). However, c-fos expression in the spinal cord between groupⅡandⅢshowed no difference (P>0.05). Between groupⅢandⅣ, no differences in serum hormone levels (P > 0.05) were detected. In group Ⅴ the c-fos expression was lower than that of the Ⅳ group (P < 0.01). Conclusion Body acupuncture and auricular electrical stimulation combined with intrathecal anesthesia were effective to reduce pain in rats with acute stress reactions. Under intrathecal anesthesia, auricular stimulation played a better role of non-nerve block region, and the mechanism may be due to the release of neurotransmitters induced c-fos protein in spinal cord.