BACKGROUND: Perioperative treatment has become an increasingly important aspect of the management of patients with non-small cell lung cancer (NSCLC). Small-scale clinical studies performed in recent years have shown improvements in the major pathological remission rate after neoadjuvant therapy, suggesting that it will soon become an important part of NSCLC treatment. Nevertheless, neoadjuvant immunotherapy may be accompanied by serious adverse reactions that lead to delay or cancelation of surgery, additional illness, and even death, and have therefore attracted much attention. The purpose of the clinical recommendations is to form a diagnosis and treatment plan suitable for the current domestic medical situation for the immune-related adverse event (irAE). METHODS: This recommendation is composed of experts in thoracic surgery, oncologists, thoracic medicine and irAE related departments (gastroenterology, respirology, cardiology, infectious medicine, hematology, endocrinology, rheumatology, neurology, dermatology, emergency section) to jointly complete the formulation. Experts make full reference to the irAE guidelines, large-scale clinical research data published by thoracic surgery, and the clinical experience of domestic doctors and publicly published cases, and repeated discussions in multiple disciplines to form this recommendation for perioperative irAE. RESULTS: This clinical recommendation covers the whole process of prevention, evaluation, examination, treatment and monitoring related to irAE, so as to guide the clinical work comprehensively and effectively. CONCLUSIONS Perioperative irAE management is an important part of immune perioperative treatment of lung cancer. With the continuous development of immune perioperative treatment, more research is needed in the future to optimize the diagnosis and treatment of perioperative irAE.

Blood Circulation ; Coronary Disease ; diagnosis ; physiopathology ; Humans ; Integrative Medicine ; Societies, Medical

Objective To evaluate the effect of traditional Chinese medicine sputum discharge liquid on preventing ventilator-associated pneumonia(VAP).Methods A randomized double-blind,placebo-controlled study was con-ducted,according to the inclusion and exclusion criteria,patients with respiratory failure and mechanical ventilation in the intensive care unit (ICU)of a hospital in 2011 -2014 were selected and divided into treatment group and con-trol group.Treatment group received sputum discharge liquid in addition to conventional treatment,control group adopted simulation agent based on conventional treatment.The incidence,treatment effectiveness,occurrence time, and prognosis of VAP between two groups of patients were compared.Results A total of 139 patients were monitored,70 cases in treatment group and 69 in control group.The incidence of VAP in treatment group and con-trol group were 37.14% (n =26)and 57.97%(n =40)respectively;the average onset time of VAP in treatment group and control group were (76±3.2)hours and (45±8.9)hours after admission to ICU respectively;treatment effectiveness rates in treatment and control group were 88.46% and 55.00% respectively;the incidence,occurrence time,and treatment effectiveness rates of VAP between two groups of patients were both significantly different (all P <0.05).There were no significant difference in blood routine,liver and kidney function,urine routine,stool rou-tine,and electrocardiogram results between two groups of patients (all P >0.05 ).Conclusion Intervention in patients with mechanical ventilation by sputum discharge liquid can reduce the incidence of VAP,and has a positive effect on the prognosis of disease and pulmonary infection in patients.

Clinical breakpoints are used in phaseⅡorⅢclinical trials to categorize microorganisms if susceptibility to new tested antibacterial agents that means the patient infected by the pathogen will be enrolled the study or not.The role of this consensus is to define procedure and required data to setting breakpoints and how to revaluate it in clinical trials.

Objective To investigate current situation of teaching competition and to put forward some feasible suggestions for improving the teaching competition of theoretical course for young teachers. Methods Questionnaire survey was conducted for 126 teachers including the effect of teaching competi-tion on effective teaching atmosphere,comprehensive teaching results,teaching ability and recommenda-tions for improvement. SPSS software was used to do statistical analysis andχ22 test was applied. P<0 . 05 stands for statistically significant difference. Results Investigation results demonstrated that teaching competition of theoretical course was conducive to forming effective teaching atmosphere,achieving better teaching effect and improving teaching ability of teachers . A χ22 test was performed on the cognition of the cultivating of classroom management ability;results demonstrated that there were significant differ-ences between teachers with more than 10 years education age and those with less than 10 years education age(χ22=4.375,P=0.0365). Conclusions Teaching competition of theoretical course is an effective way to cultivate young teachers teaching ability. Teaching competition should be combined with training and feedback and evaluation should be more scientific and objective in order to improve young teachers' teaching ability.

OBJECTIVETo investigate the effects of short-term forest bathing on human health.

METHODSTwenty healthy male university students participated as subjects and were randomly divided into two groups of 10. One group was sent on a two-night trip to a broad-leaved evergreen forest, and the other was sent to a city area. Serum cytokine levels reflecting inflammatory and stress response, indicators reflecting oxidative stress, the distribution of leukocyte subsets, and plasma endothelin-1 (ET-1) concentrations were measured before and after the experiment to evaluate the positive health effects of forest environments. A profile of mood states (POMS) evaluation was used to assess changes in mood states.

RESULTSNo significant differences in the baseline values of the indicators were observed between the two groups before the experiment. Subjects exposed to the forest environment showed reduced oxidative stress and pro-inflammatory level, as evidenced by decreased malondialdehyde, interleukin-6, and tumor necrosis factor a levels compared with the urban group. Serum cortisol levels were also lower than in the urban group. Notably, the concentration of plasma ET-1 was much lower in subjects exposed to the forest environment. The POMS evaluation showed that after exposure to the forest environment, subjects had lower scores in the negative subscales, and the score for vigor was increased.

CONCLUSIONForest bathing is beneficial to human health, perhaps through preventive effects related to several pathological factors.

Baths ; China ; Cytokines ; metabolism ; Humans ; Hydrocortisone ; blood ; Life Style ; Lymphocyte Subsets ; Male ; Nature ; Recreation ; Stress, Physiological ; Testosterone ; blood ; Trees ; Young Adult

Objective Several studies have indicated that miR-15a,miR-15b and miR-16 may be the important regulators of apoptosis.Since attenuate apoptosis could protect myocardium and reduce infarction size,the present study was aimed to find out whether these miRNAs participate in regulating myocardial ischemia reperfusion (I/R) injury.Methods Apoptosis in mice hearts subjected to I/R was detected by TUNEL assay in vivo,while flow cytometry analysis followed by Annexin V/PI double stain in vitro was used to detect apoptosis in cultured cardiomyocytes which were subjected to hypoxia/reoxygenation (H/R).Taqman real-time quantitative PCR was used to confirm whether miR-15a/15b/16 were involved in the regulation of cardiac I/R and H/R.Results Compared to those of the controls,I/R or H/R induced apoptosis of cardiomyocytes was significantly iucreased both in vivo (24.4％ ± 9.4％ vs.2.2％ ± 1.9％,P ＜ 0.01,n =5) and in vitro (14.12％ ±0.92％ vs.2.22％ ± 0.08％).The expression of miR-15a and miR-15b,but not miR-16,was increased in the mice I/R model,and the results were consistent in the H/R model.Conclusions Our data indicate miR-15 and miR-15b are up-regulated in response to cardiac I/R injury,therefore,down-regulation of miR- 15a/b may be a promising strategy to reduce myocardial apoptosis induced by cardiac I/R injury.

OBJECTIVETo investigate the effect of NK-22 cells isolated from the synovial fluid (SF) of patients with rheumatoid arthritis (RA) on the proliferation of fibroblast-like synoviocytes and explore its possible mechanism.

METHODSThe proportions of NK-22 cells in the peripheral blood (PB) and the SF of 20 RA patients and 20 healthy individuals were determined by flow cytometry. NK-22 cells in the SF sorted by flow cytometry were cultured for two weeks followed by a 4-h stimulation with 20 ng/ml phorbol 12-myristate 13-acetate and 0.5 µ mol/L ionomycin. The culture supernatant of NK-22 cells was then harvested, in which the levels of IL-22 and TNF-α were measured by ELISA. The fibroblast-like synoviocytes were exposed to the culture supernatant for 24, 48, 72, and 96 h, and the changes in the cell proliferation were detected by MTT assay.

RESULTSRA patients showed a significantly greater proportion of NK-22 cells in both the SF and PB than the normal control subjects (P<0.05). NK-22 cells sorted by flow cytometry reached a purity exceeding 90%, and the levels of IL-22 and TNF-α in the culture supernatant of NK-22 cells cultured for two weeks were 941.16 pg/ml and 368.1 pg/ml, respectively. The culture supernatant of NK-22 cells caused a rapid proliferation of the fibroblast-like synoviocytes at 24, 48, 72, and 96 h after the exposure.

CONCLUSIONNK-22 cells in the SF of RA patients can promote the proliferation of fibroblast-like synoviocytes possibly due to the capacity of NK-22 cells to produce IL-22 and TNF-α.

Adult ; Arthritis, Rheumatoid ; pathology ; Case-Control Studies ; Cell Proliferation ; Cells, Cultured ; Female ; Fibroblasts ; cytology ; Flow Cytometry ; Humans ; Interleukins ; metabolism ; Killer Cells, Natural ; cytology ; Male ; Middle Aged ; Synovial Fluid ; cytology ; Tumor Necrosis Factor-alpha ; metabolism

Blood products are those biologicals derived from plasma or obtained by recombinant technologies. This overview covers the characteristics and classification of plasma proteins, the current status of products (albumin, immunoglobulins, coagulation factors and microcontent proteins), as well as the likely trends in the near future. Human serum albumin is one of the earliest, safest and most widely used proteins in the pharmaceutical field. The approval and development of high-purity plasma albumin, recombinant human albumin and HSA fusion proteins provide a favorable prospect for the therapeutic protein. Normal immunoglobulin contains antibodies to all the micro-organisms prevalent in the donor population. The IMIG is relatively simple to prepare and use, and the side effects are acceptable; IVIG is used mainly to treat patients with primary immunodeficiency syndromes; SCIG preparations can be used in selecting suitable patients for home therapy and have occurred fewer adverse systemic reactions; specific immunoglobulins contain concentrations of antibody to an individual organism or toxin at a higher titer than normal immunoglobulin and can not be replaced in clinical use. The plasma-derived or recombinant coagulation factors are used to treat the patients with congenital or acquired factor deficiency. The products such as Fibrinogen, FVII, FVIII, von Willebrand complex, FIX/PCC, FXI, FXIII and so on, have been widely used and proved to be effective. The development of recombinant FVIIa is now as a good bypassing product to haemophilia with inhibitors. The Fibrinogen and thrombin play a very important role in surgery hemostasis. Moreover, microcontent proteins including protein C, antithrombin, alpha 1-AT, tPA have been licensed and used in clinical treatment; a number of other small field proteins are under produced research or pre-clinical investment. The ongoing development of new recombinant plasma proteins is providing alternatives for patients, but the distinct position and the potential impact of plasma-derived preparations are unique, furthermore the development of new plasma protein is still a hot spot in global pharmaceutics. Nowadays, a relative difference exists in the development of blood products between our nation and developed countries, so the domestic manufacturers are faced with chances and challenges.
Biological Factors ; therapeutic use ; Blood ; Blood Coagulation Factors ; therapeutic use ; Blood Proteins ; therapeutic use ; China ; Humans ; Immunoglobulins ; therapeutic use ; Recombinant Proteins ; therapeutic use ; Serum Albumin ; therapeutic use

OBJECTIVETo investigate the expression levels of miR-146a and miR -16 in the peripheral blood mononuclear cells (PBMCs) of patients with rheumatoid arthritis (RA) and their correlation to the disease activity.

METHODSThe expression levels of miR-146a and miR-16 in the in PBMCs were measured using real-time RT-PCR in 40 RA patients and 16 healthy individuals. The correlations of miR-146a and miR-16 expressions to the disease activity of RA were analyzed.

RESULTSThe expression levels of miR-146a and miR-16 in the PBMCs of RA patients increased significantly compared to those in the healthy individuals (P<0.05). Their expression levels was significantly higher in active RA patients than in patients with disease remission (P<0.05) and healthy individuals (P<0.01). The expression levels of miR-146a and miR-16 were positively correlated to ESR, CRP and the disease activity scores in 28 joints (DAS28) (P<0.01), but not to RF (P>0.05).

CONCLUSIONThe elevated expression levels of miR-146a and miR-16 are correlated to RA disease activity, suggesting their value in assessment of the clinical disease activity of RA.

Adult ; Arthritis, Rheumatoid ; blood ; Biomarkers ; Female ; Humans ; Leukocytes, Mononuclear ; metabolism ; Male ; MicroRNAs ; genetics ; metabolism ; Middle Aged ; Young Adult