贝伐珠单抗致过敏性休克1例

分析1例贝伐珠单抗致过敏性休克的临床特点和相关因素,为临床安全用药提供参考。1例右肺腺癌患者第10次使用贝伐珠单抗进行单药化疗,出现心慌、气短、口唇发绀、指脉氧饱和度降低、心率加快、血压测不出、短暂全身抽搐和一过性心跳停止,经抢救后患者痊愈,并终止了贝伐珠单抗对原发病的治疗。贝伐珠单抗为低敏性药物,但多疗程治疗的肿瘤患者应警惕严重的/罕见的过敏反应,建议在具备抢救设施的环境中在使用。

Clinical significance of episcleral venous fluid wave in gonioscopy-assisted transluminal trabeculotomy

AIM:To evaluate the clinical significance of checking episcleral venous fluid wave(EVFW)during gonioscopyassisted transluminal trabeculotomy(GATT)in patients with open angle glaucoma(OAG).METHODS:This retrospective case series study comprised 30 patients(45 eyes)with OAG underwent GATT.The location and extent of EVFW were examined and graded after intraoperative compression flushing of the anterior chamber angle during the operation.Patients were followed up for 1y.A complete success for surgery is defined as a postoperative intraocular pressure(IOP)<18 mm Hg without any anti-glaucoma medication.IOP<18 mm Hg with less than two anti-glaucoma medications is defined as qualified success,while the control of IOP requiring three anti-glaucoma medications is considered as unsuccess.RESULTS:The mean IOP was 35.38±7.16 mm Hg before surgery and 15.52±4.22 mm Hg 1y after surgery(P<0.01).The average number of anti-glaucoma medication was 2.8±1.2(2-4)preoperation and 0.6±1.3(0-3)1y postoperation(P<0.01).The success rate of the operation was 93.33%.Complete success rate was 66.67%,qualified success rate was 26.67%,and 6.66%of unsuccessful cases required reoperation.EVFW of all cases was grade 2-4,and the percentages of grade 2,3 and 4 were 33.33%,40.0%and 26.67%,respectively.The distribution and percentage of EVFW were inferior(36%),nasal(28%),superior(20%),and temporal(16%).The EVFW grade of complete success patients was 3.4±0.6(3-4),and that of qualified success patients was 2.6±1.0(2-4).The larger the range of EVFW,the lower the IOP,and the better the IOP reduction effect.CONCLUSION:During GATT surgery,pressurized irrigation of anterior chamber to check EVFW can reduce the outflow resistance of aqueous humor and increase the effect of postoperative IOP.The range of EVFW is negatively correlated with postoperative IOP.Therefore,EVFW may be a valuable prognostic indicator for the success of GATT surgery.

荆州地区真菌性角膜炎176例临床分析

目的:分析荆州地区真菌性角膜炎(FK)患者的感染特征和临床治疗转归等,为本地区FK的临床诊疗提供依据。方法:收集2015-01/2020-07在荆州市中心医院眼科就诊并病原学确诊为FK的176例患者资料,对患者的流行病学特征、真菌菌种鉴定结果、药物敏感性及临床治疗经过及转归等进行分析。结果:FK患者176例中,男118例,女58例,男女比例为2.03∶1。发病年龄以50~59岁及60~69年龄段的患者人数最多,发病高峰季节为4~6月及10~12月。危险因素包括外伤及可能外伤史、眼表疾病、眼科术后、配戴角膜接触镜及长期局部药物使用。主要致病菌为镰刀菌属(39.8%)、曲霉菌属(30.7%)、链格孢菌属(15.9%)和念珠菌属(5.1%),药敏结果示伏立康唑和两性霉素B均比较敏感,而氟康唑的耐药率非常高。125眼经药物保守治疗后病情好转或治愈,12眼行角膜基质内注药,15眼行结膜瓣遮盖或羊膜移植,21眼行角膜移植术,8眼行眼内容物剜除术,包括5眼行结膜瓣遮盖后严重眼内炎的患者。结论:荆州地区FK的发病人群多为中老年男性,多为农业劳动过程中角膜外伤后导致,以镰刀菌及曲霉菌多见,根据药敏结果选择合理的抗真菌药物及治疗方式非常重要。

一步双修饰策略提高富镍层状氧化物正极材料的电化学性能

提出一种从表面到体相的一步整体改性策略,同步合成Nb掺杂和LiNbO_(3)包覆的LiNi_(0.83)Co_(0.12)Mn_(0.05)O_(2)(NCM)正极材料。LiNbO_(3)包覆层可以调控界面并促进锂离子扩散;更强的Nb—O键能有效抑制Li^(+)/Ni^(2+)阳离子混排,提高晶体结构稳定性,从而有助于缓解Li^(+)脱出/嵌入过程中晶格参数的各向异性变化。结果表明:双修饰材料表现出较好的结构稳定性和优异的电化学性能。最佳样品NCM-Nb2在2.7~4.3 V之间以1C循环100次后,容量保持率为90.78%,而原始样品容量保持率仅为67.90%;同时,在10C下具有149.1 mA·h/g的更高倍率性能,这些结果突显了一步双修饰策略协同提高富镍层状氧化物正极材料电化学性能的可行性。

原发性闭角型青光眼的发病机制研究新进展

原发性闭角型青光眼(PACG)是临床上最常见的一种青光眼类型,全球发病率高且致盲性大,具有进行性不可逆发展的特点。PACG的发病机制复杂多样,不仅与眼部解剖结构的异常有关,如前房结构出现角膜小、短眼轴和浅前房等特征,近年研究还发现晶状体、虹膜、睫状体及脉络膜异常均与PACG的发病有关。另外PACG的发生与遗传因素和心理应激因素亦有较紧密的关系,本文结合文献报道较为全面地从解剖特征、遗传因素、心理应激三个方面对PACG的发病机制做了简要论述,希望籍此为青光眼的早期诊断和治疗提供有益的理论支撑。

A/B超联合造影自发荧光在YAG激光玻璃体消融术中的应用

目的:A/B超联合造影自发荧光观察YAG激光治疗生理性玻璃体混浊的临床效果。方法:筛选2018-08/2019-01在汉口爱尔眼科医院诊断为生理性玻璃体混浊患者30例30眼,术前A/B超定位玻璃体混浊位置,距离晶状体2~3mm、视网膜3~4mm范围外为安全距离。检查患者术前最佳矫正视力、非接触眼压、扫描激光眼底照相、A/B超、造影自发荧光,由同一位操作熟练的医生应用YAG激光消融机对生理性玻璃体混浊进行激光消融治疗。激光治疗后随访1d,1wk,1mo,术后检查最佳矫正视力、非接触眼压、扫描激光眼底照相、造影自发荧光检查,采用Image-J软件测量治疗前后玻璃体混浊大小。结果:治疗前,治疗后1d,1wk,1mo最佳矫正视力、眼压均无差异(P>0.05)。30眼中,28眼一次激光消融治疗,2眼2次激光消融治疗,平均治疗次数1.06次。治疗后造影自发荧光显示玻璃体混浊明显减小或消失,前后对比有差异(P<0.01)。术中及术后均无并发症发生。结论:A/B超联合造影自发荧光证实YAG激光治疗生理性玻璃体混浊安全有效。

黄芪含药血清对氯化钴诱导ARPE-19细胞缺氧损伤的保护作用

目的:研究黄芪含药血清对氯化钴(CoCl_(2))诱导人视网膜色素上皮(ARPE-19)细胞缺氧损伤的保护作用,从而探讨黄芪是否通过抗氧化应激来改善糖尿病视网膜病变(DR)。方法:建立CoCl_(2)诱导ARPE-19细胞缺氧模型,并分为以下5组:正常组(细胞正常培养,不加任何处理)、缺氧模型组(200μmol/L CoCl_(2))、空白血清组(200μmol/L CoCl_(2)+空白血清)、低剂量含药血清组(200μmol/L CoCl_(2)+10%含药血清)、高剂量含药血清组(200μmol/L CoCl_(2)+20%含药血清)。CCK-8检测细胞活性;试剂盒检测细胞上清液中还原型谷胱甘肽(GSH)、丙二醛(MDA)水平;ELISA检测细胞培养基中缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)的含量;实时荧光定量PCR(qPCR)检测VEGF、HIF-1α和脯氨酰羟化酶-2(PHD-2)的mRNA水平;Western Blot法检测VEGF、HIF-1α和PHD-2的表达情况。结果:采用200μmol/L的CoCl_(2)浓度可成功建立ARPE-19细胞缺氧模型。低剂量和高剂量黄芪含药血清可抑制缺氧诱导的ARPE-19细胞增殖(P<0.05),升高ARPE-19细胞缺氧损伤中GSH水平,降低MDA含量(P<0.05)。低剂量和高剂量黄芪含药血清可抑制ARPE-19细胞缺氧损伤上清液中HIF-1α和VEGF的表达(P<0.05),以及ARPE-19细胞中VEGF、HIF-1α、PHD-2的mRNA表达和蛋白表达(P<0.05)。结论:低剂量和高剂量黄芪含药血清通过抗氧化作用减轻CoCl_(2)诱导ARPE-19细胞缺氧损伤。

Review of salt consumption and stomach cancer risk:Epidemiological and biological evidence

Stomach cancer is still the fourth most common cancer;thus,it remains an important public health burden worldwide,especially in developing countries.The remarkable geographic variations in the rates of stomach cancer indicate that dietary factors,including a range of food groups to which salt and/or nitrates have been added,may affect stomach cancer risk.In this paper,we review the results from ecologic,case-control and cohort studies on the relationship between salt or salted foods and stomach cancer risk.The majority of ecological studies indicated that the average salt intake in each population was closely correlated with gastric cancer mortality.Most case-control studies showed similar results,indicating a moderate to high increase in risk for the highest level of salt or salted food consumption.The overall results from cohort studies are not totally consistent,but are suggestive of a moderate direct association.Since salt intake has been correlated with Helicobacter pylori(H pylori) infection,it is possible that these two factors may synergize to promote the development of stomach cancer.Additionally,salt may also cause stomach cancer through directly damaging gastric mucus,improving temporary epithelial proliferation and the incidence of endogenous mutations,and inducing hypergastrinemia that leads to eventual parietal cell loss and progression to gastric cancer.Based on the considerable evidence from ecological,case-control and cohort studies worldwide and the mechanistic plausibility,limitation on salt and salted food consumption is a practical strategy for preventing gastric cancer.

Serum calcium,albumin,globulin and matrix metalloproteinase-9 levels in acute cerebral infarction patients

BACKGROUND Hemorrhagic transformation(HT)is a common complication in patients with cerebral infarction.However,its pathogenesis is poorly understood.The knowledge of factors that may increase risk for HT may help in improving the safety of thrombolytic therapy.AIM To investigate the predictive value of serum calcium,albumin,globulin and matrix metalloproteinase-9(MMP-9)levels for HT after intravenous thrombolysis(IVT)in patients with acute cerebral infarction.METHODS Five hundred patients with acute cerebral infarction who received IVT with alteplase within 4.5 h after the onset of disease between January 2018 and January 2021 at our hospital were selected as the study subjects.They were divided into groups based on computed tomography scan results of the brain made within 36 h after thrombolysis.Forty patients with HT were enrolled in an observation group and 460 patients without HT were enrolled in a control group.Serum calcium,albumin,globulin and MMP-9 levels were compared between the two groups.Regression analysis was used to discuss the relationship between these indices and HT.RESULTS The previous history of hypertension,diabetes,atrial fibrillation,cerebrovascular diseases,smoking and alcohol intake were not associated with HT after IVT in patients with acute cerebral infarction(all P>0.05).The National Institutes of Health stroke scale(NHISS)score was associated with HT after IVT in patients with acute cerebral infarction(P<0.05).The serum calcium and albumin levels were lower in the observation group than in the control group(all P<0.05).The levels of globulin and MMP-9 were significantly higher in the observation group than in the control group(all P<0.05).Logistic regression analysis showed that NHISS score,serum calcium,albumin,globulins and MMP-9 were independent factors influencing the occurrence of HT following IVT in patients with cerebral infarction(P<0.05).CONCLUSION Serum calcium,albumin,globulin and MMP-9 levels are risk factors for HT after IVT in patients with acute cerebral infarction.Moreover,NHISS score can be used as a predictor of post-thrombolytic HT.

Interactions between CagA and smoking in gastric cancer

AIM: To examine the interactions between cytotoxinassociated gene (CagA) positive Helicobacter pylori infection and smoking in non-cardiac gastric cancer.METHODS: A case-control study (257 cases and 514 frequency-matched controls) was conducted from September 2008 to July 2010 in Xi’an,China.Cases were newly diagnosed,histologically confirmed non-cardiac cancer.Controls were randomly selected from similar communities to the cases and were further matched by sex and age (± 5 years).A face-to-face interview was performed by the investigators for each participant.Data were obtained using a standardized questionnaire that included questions regarding known or suspected lifestyle and environmental risk factors of gastric cancer.A 5 mL sample of fasting venous blood was taken.CagA infection was serologically detected by enzymelinked immunosorbent assays.RESULTS: Smoking and CagA infection were statistically significant risk factors of non-cardiac cancer.CagA was categorized in tertiles,and the odds ratio (OR) was 12.4 (95% CI: 6.1-20.3,P = 0.003) for CagA after being adjusted for confounding factors when the highexposure category was compared with the low-exposure category.Smokers had an OR of 5.4 compared with subjects who never smoked (95% CI: 2.3-9.0,P = 0.002).The OR of non-cardiac cancer was 3.5 (95% CI: 1.8-5.3) for non-smokers with CagA infection,3.5 (95% CI: 1.9-5.1) for smokers without CagA infection,and 8.7 (95% CI: 5.1-11.9) for smokers with CagA infection compared with subjects without these risk factors.After adjusting for confounding factors,the corresponding ORs of non-cardiac cancer were 3.2 (95% CI: 1.5-6.8),2.7 (95% CI: 1.3-4.9) and 19.5 (95% CI: 10.3-42.2),respectively.There was a multiplicative interaction between smoking and CagA,with a synergistic factor of 2.257 (Z = 2.315,P = 0.021).CONCLUSION: These findings support a meaningful interaction between CagA and smoking for the risk of gastric cancer which may have implications for its early detection.

A dysfunction of CD4^+ T lymphocytes in peripheral immune system of Parkinson's disease model mice

Objective Parkinson's disease(PD),a neurodegenerative disorder,has been reported to be associated with brain neuroinflammation in its pathogenesis.Herein,changes in peripheral immune system were determined to better understand PD pathogenesis and provide possible target for treatment of PD through improvement of immune disorder.Methods l-methyl-4-phenyl-l,2,3,6-tetrahydropyridine(MPTP) was intraperitoneally injected into mice to prepare PD model.Expression levels of pro-inflammatory and anti-inflammatory cytokines and transcription factors of CD4^+ T lymphocyte subsets in spleen and mesenteric lymph nodes and concentrations of the cytokines in serum were examined on day 7 after MPTP injection.Percentages of CD4^+ T lymphocyte subsets were measured by flow cytometry.Results MPTP induced PD-like changes such as motor and behavioral deficits and nigrostriatal impairment.Expression levels of the pro-inflammatory cytokines including interferon(IFN)-γ,interleukin(IL)-2,IL-17 and IL-22,in spleen and mesenteric lymph nodes were upregulated and their concentrations in serum were elevated in PD progression.But,the concentrations of the anti-inflammatory cytokines including IL-4,IL-10 and transforming growth factor(TGF)-β were not altered in the two lymphoid tissues or serum of PD mice.In addition,expression of T-box in T cells(T-bet),the specific transcription factor of helper T(Th) 1 cells,was downregulated,but expression of transcription factor forkhead box p3(Foxp3),the transcription factor of regulatory T(Treg) cells,was upregulated.In support of the results,the numbers of IFN-γ^+-producing CD4^+cells(Th1 cells) were reduced but CD4^+CD25^+ cells(Treg cells) were elevated in both the lymphoid tissues of PD mice.Conclusion PD has a dysfunction of peripheral immune system.It manifests enhancement of proinflammatory response and CD4^+T cell differentiation bias towards Treg cells away from Thl cells.

Association of XPG rs2094258 polymorphism with gastric cancer prognosis

BACKGROUND The xeroderma pigmentosum group G(XPG)gene at chromosome 13q33 consists of 15 exons,which may be related to the occurrence and development of gastric cancer(GC).AIM To examine the association of several common single nucleotide polymorphisms(SNPs)of the XPG gene with GC risk and survival.METHODS Five SNPs of XPG(rs2094258,rs751402,rs873601,rs2296147,and rs1047768)were genotyped by PCR restriction fragment length polymorphism in 956 histologically confirmed GC cases and 1012 controls in North China.GC patients were followed for survival status and,if deceased,cause of death.Logistic regression and Cox regression were used for analysing associations of XPG SNPs with risk of GC and prognosis,respectively.For rs2094258,heterozygous model(CT vs CC),homozygous model(TT vs CC),recessive model(TT vs CT+CC),and dominant model(TT+CT vs CC)were analyzed.RESULTS None of the examined loci were statistically associated with GC risk,although rs2296147 was marginally associated with GC risk(P=0.050).GC patients with the rs2094258 CT+CC genotype showed worse survival than those with the TT genotype(log-rank test,P=0.028),and patients with the CC genotype had a tendency of unfavourable prognosis compared with those with the TT+CT genotype(log-rank test,P=0.039).The increase in C alleles of rs2094258[hazard ratio(HR)=1.19,95%confidence interval(CI):1.02-1.45,P=0.037]were associated with the long-term survival of GC cases.Other risk factors for survival included tumor differentiation(HR=4.51,95%CI:1.99-8.23,P<0.001),lymphovascular invasion(HR=1.97,95%CI:1.44-3.01,P<0.001),and use of chemotherapy(HR=0.81,95%CI:0.63-0.98,P=0.041).CONCLUSION The XPG rs2094258 polymorphism may be associated with overall survival in GC patients.

Endovascular treatment vs drug therapy alone in patients with mild ischemic stroke and large infarct cores

BACKGROUND Treatment decision making is strictly associated with the outcomes in patients with ischemic stroke who show a large core infarct.Medical care alone may result in suboptimal treatment efficacy,and endovascular treatment may be accompanied by safety issues.Whether endovascular treatment is superior to medical care is not well investigated in the clinical studies.AIM To investigate the efficacy of endovascular treatment and drug therapy alone in mild ischemic stroke patients with large infarct cores.METHODS Fifty patients with mild ischemic stroke and 50 patients with acute ischemic stroke caused by anterior large vessel occlusion were selected at the First Affiliated Hospital of Hebei North University between January 2021 and December 2021.Patients were divided into an endovascular therapy group and a drug therapy group according to different treatment methods.In the endovascular therapy group,there were 28 patients with minor stroke and 22 patients with large infarct cores.The drug therapy group had 22 patients with minor stroke and 28 patients with large infarct cores.The National Institutes of Health Stroke Scale(NIHSS) scores were collected and compared between the two groups immediately after the operation and 24 h and 7 d after the operation.The modified Rankin scale(m RS) and/or activity of daily living were assessed at hospital discharge.RESULTS There was no significant difference in NIHSS scores between the two groups before the operation(P > 0.05).NIHSS scores were lower in the endovascular therapy group than in the drug therapy group at 24 h and 7 d after the operation and at hospital discharge(all P < 0.05).The incidence of early neurologic deterioration was significantly lower in the endovascular therapy group than in the drug therapy group(P < 0.05).At hospital discharge,the m RS score was lower in the endovascular treatment group than in the drug therapy group,and the activity of daily living score was better in the endovascular treatment group than in the drug therapy group(all P < 0.05).During a follow-up of 3 mo,17 patients(34.0%) had good prognosis(m RS ≤ 2),33 patients(66.0%) had poor prognosis(m RS > 2),and 11 patients(22.0%) died.In the medical treatment group,16 patients(m RS ≤ 2) had good prognosis(32.0%),34 patients(m RS > 2) had poor prognosis(68.0%),and 14 patients(28.0%) died.There was no significant difference in prognosis and mortality between the two groups(P > 0.05).CONCLUSION Endovascular therapy can improve NIHSS score and m RS score in patients with mild ischemic stroke and large infarct cores.It is suitable for clinical application.

Incomplete Kawasaki disease complicated with acute abdomen: A case report

Kawasaki disease(KD)is an acute systemic vasculitis characterized by unknown etiology.CASE SUMMARY A 4.5-year-old boy developed an acute abdomen during the onset of incomplete KD.He still had persistent abdominal pain after undergoing exploratory laparotomy and appendectomy.Ultrasound examination at early onset revealed a giant coronary artery aneurysm.The patient developed a myocardial infarction and heart failure accompanied by respiratory and cardiac arrest.He underwent coronary artery revascularization and coronary artery bypass graft using an autologous internal mammary artery.After the operation,the cardiac output increased,and the symptoms of heart failure resolved.Follow-up evaluation at 1 mo after operation showed that the patient's cardiac function had restored to New York Heart Association standard Grade I heart failure,and normal growth was obtained.CONCLUSION Coronary artery revascularization and coronary artery bypass graft is an effective method for treating myocardial ischemia in children with KD complicated with giant coronary artery aneurysm.Nevertheless,some issues still need specific attention.

Interactions between pork consumption,CagA status and IL-1B-31 genotypes in gastric cancer

AIM: To explore potential interactions among Helicobacter pylori(H. pylori), CagA status, interleukin(IL)-1B-31 genotypes, and non-cardiac gastric cancer(GC) risk.METHODS: A case-control study of non-cardia GCwas performed at 3 hospitals located in Xi'an, China, between September 2008 and July 2010. We included 171 patients with histologically diagnosed primary noncardia GC and 367 population based controls(matched by sex, age and city of residence). A standardized questionnaire was used to obtain information regarding potential risk factors, including pork consumption. H. pylori CagA status was assessed by enzyme-linked immunosorbent assay, and IL-1B-31 genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism. Multivariate unconditional logistic regression was used to explore potential interactions among the factors.RESULTS: The CagA appeared to confer an increased risk of GC(OR = 1.81, 95%CI: 1.25-2.61). The main associations with IL-1B-31C allele here were 0.98(95%CI: 0.59-1.63) for CC vs TT and 0.99(95%CI: 0.64-1.51) for C Carriers vs TT. However, no associations were observed for CagA or IL-1B-31 genotype status among subjects who reported low pork consumption(P for interaction = 0.11). In contrast, high pork consumption and IL-1B-31C genotypes appeared to synergistically increase GC risk(P for interaction = 0.048) after adjusting for confounding factors, particularly among subjects with CagA(OR = 3.07, 95%CI: 1.17-10.79). We did not observe effect modification of pork consumption by H. pylori CagA status, or between H. pylori CagA status and IL-1B-31 genotypes after adjustment for pork consumption and other factors.CONCLUSION: These interaction relationships among CagA, IL-1B-31 and pork consumption may have implications for development of the preventive strategies for the early detection of non-cardiac GC.

Association between interleukin-21 gene rs907715 polymorphism and gastric precancerous lesions in a Chinese population

BACKGROUND The single nucleotide polymorphisms of interleukin-21(IL-21)gene were confirmed to be related to various diseases,but no studies have examined the possible role of IL-21 single nucleotide polymorphisms(SNPs)(rs907715,rs2221903,and rs12508721)in gastric precancerous lesions.AIM To explore the associations between SNPs of IL-21 gene(rs907715,rs2221903,and rs12508721)and gastric precancerous lesions in a Chinese population.METHODS Three SNPs of IL-21 were genotyped using polymerase chain reaction–ligase detection reaction in 588 cases and 290 healthy controls from May 2013 to December 2016 in northwestern China.Gastric precancerous lesions were confirmed by endoscopic examination and categorized as non-atrophic gastritis,atrophic gastritis,and intestinal metaplasia.Descriptive statistic and logistic regression were used for data analyses.RESULTS IL-21 rs907715 genotype CC and C frequencies were higher in in patients with gastric precancerous lesions than in the controls(OR=1.59,95%CI:1.06-2.38,P=0.013;OR=1.28,95%CI:1.01-2.22,P=0.044,respectively)after adjusting for confounding factors.For SNP rs907715 in intestinal metaplasia patients,significant differences between cases and controls were observed in the frequencies of genotype CC and C(OR=1.92,95%CI:1.24-2.98,P=0.004;OR=1.53,95%CI:1.04-2.24,P=0.028,respectively);for non-atrophic gastritis and atrophic gastritis patients,the CC and C genotypes showed no significant association with risk in all models.No association between either rs2221903 or rs12508721 and gastric precancerous lesions was found in the present study.In the haplotype analysis,the TC haplotype(rs907715 and rs12508721)and TT haplotype(rs2221903 and rs907715)were more frequent in the case group than control group(P<0.05).CONCLUSION Our findings indicate that SNP rs907715 of IL-21 gene is associated with gastric precancerous lesions.The TC haplotype(rs907715 and rs12508721)and TT haplotype(rs2221903 and rs907715)increased the risk of gastric precancerous lesions.If confirmed,these findings will shed light on the etiology of precancerous lesions.

Effect of sufentanil combined with propofol and scoline on stress response and immune response in fiberoptic bronchoscopy

Objective: To explore the effect of sufentanil combined with propofol and scoline on stress response and immune response in fiberoptic bronchoscopy. Methods: A total of 138 patients with fiberoptic bronchoscopy in the hospital between March 2015 and April 2017 were collected and divided into routine group and scoline group by random number table, 69 cases in each group. Routine group received sufentanil combined with propofol anesthesia, and scoline group received sufentanil, propofol combined with scoline anesthesia. The differences in the levels of stress hormones in serum and immune indexes in alveolar lavage fluid were compared between the two groups before and after examination. Results: Before examination, the differences in the levels of Th1/Th2 cytokines in serum as well as Th1/Th2 cytokines and Th17/Treg cytokines in alveolar lavage fluid were not statistically significant between the two groups;immediately after examination, serum stress hormones Cor, E and NE levels of scoline group were lower than those of routine group;Th1 cytokines IL-2 and IFN-γ levels in alveolar lavage fluid were higher than those of routine group while Th2 cytokines IL-10 and IL-13 levels were lower than those of routine group;Th17 cytokine IL-17 level in alveolar lavage fluid was lower than that of routine group while Treg cytokine IL-23 level was higher than that of routine group. Conclusion: Small-dose scoline for fiberoptic bronchoscopy anesthesia can effectively relieve the systemic stress state and avoid the acute injury of immune response function.

To investigate the effects of butylphthalide on reducing neuronal apoptosis in rats with cerebral infarction by inhibiting the JNK/P38 MAPK signaling pathway

Objective:To investigate the effects of butylphthalide on reducing neuronal apoptosis in rats with cerebral infarction by inhibiting the JNK/P38 MAPK signaling pathway.Methods:Forty-eight SD male rats were divided into DZ group(control group),CI group(model group)and NBP group(butylphthalide group).Rats in CI group and NBP group were used to establish cerebral infarction models.NBP group used NBP.The solution(80 mg/(kg?d))was administered orally,and the remaining two groups were administered with the same volume of peanut oil.After 14 consecutive days of treatment,the Zea Longa score was used to evaluate the neurological function of DZ,CI and NBP rats.Scoring,TTC staining was used to observe the cerebral infarction volume of rats in DZ group,CI group and NBP group,HE staining was used to observe the pathological morphology of brain tissue in DZ group,CI group and NBP group.Neuronal apoptosis,Western blot was used to detect the expression of p-JNK and p-p38MAPK in brain tissues of DZ group,CI group and NBP group.Results:The neurological function of the rats in the CI group was higher than that in the DZ group,and the difference was statistically significant(P<0.05).The neurological function score of the rats in the NBP group was reduced compared with the CI group,and the difference was statistically significant(P<0.05).The cerebral infarction volume in the group was 35.56%higher than that in the DZ group,and the difference was statistically significant(P<0.05).The minor infarct volume in the NBP group was 21.59%,which was less than that in the CI group,and the difference was statistically significant(P<0.05).Nerve cells are neatly sorted,with a large number.The gap between blood vessels and interstitial tissue in the CI group is enlarged,the cells are severely contracted,and the neuron structure is incomplete.Compared with the CI group,the NBP group has reduced neuron contraction and increased number;The dead nerve cells were brown.The apoptosis rate of nerve cells in the CI group was 79.65%higher than that in the DZ group was 5.82%.The difference was statistically significant(P<0.05).The nerve cell apoptosis rate in the NBP group was 30.23%.Compared with CI group,the difference was statistically significant(P<0.05);Western blot results showed that p-JNK and p-p38MAPK protein expression in CI group was higher than that in DZ group,and the difference was statistically significant(P<0.05).The levels of p-JNK and p-p38MAPK proteins in the NBP group were lower than those in the CI group.There was statistically significant(P<0.05).Conclusion:Butylphthalide can improve neurological damage,reduce apoptotic nerve cells,and reduce infarct volume in rats with cerebral infarction,which is related to the inhibition of JNK/P38 MAPK pathway expression.

Effect of circuit exercise training combined with drug therapy on glucose lipid metabolism and microinflammatory state in T2DM patients

Objective: To study the effect of circuit exercise training combined with drug therapy on glucose lipid metabolism and microinflammatory state in T2DM patients. Methods: Patients with newly diagnosed T2DM who were treated in Dazhou Integrated Traditional Chinese and Western Medicine Hospital between June 2014 and October 2016 were selected and randomly divided into training intervention group and routine intervention group who received circuit exercise training intervention and routine exercise intervention respectively. The contents of glucose lipid metabolism indexes and inflammatory cytokines in serum as well as the contents of inflammatory cells in peripheral blood were determined before intervention and 8 weeks after intervention. Results: Serum FBG, F-Ins, HbA1c%, FFA, TC, LDL-C, ox-LDL, Chemerin, Resistin, IL-6, MCP-1 and CRP contents as well as peripheral blood CD14+CD16+ cell contents of both groups of patients after intervention were lower than those before intervention while HDL-C, ADP and Vaspin contents were higher than those before intervention, and serum FBG, F-Ins, HbA1c%, FFA, TC, LDL-C, ox-LDL, Chemerin, Resistin, IL-6, MCP-1 and CRP contents as well as peripheral blood CD14+CD16+ cell content of training intervention group after intervention were lower than those of routine intervention group while HDL-C, ADP and Vaspin contents were higher than those of routine intervention group. Conclusion: Circuit exercise training for T2DM can be more effective in improving glucose lipid metabolism and inhibiting inflammatory response.

Changes and significance of inflammatory reaction and immune function in children with infectious pneumonia

Objective: To investigate the changes of inflammatory factors and immune function indexes in children with infectious pneumonia, to analyze the relationship between the level of indicators and the severity of the disease. Methods: A total of 160 children with infectious pneumonia were selected as the observation group included bacterial pneumonia group (n=98), mycoplasma pneumonia group (n=32) and viral pneumonia group (n=30), according to the severity of the disease, they were divided into mild group (n=105) and severe group (n=55), at the same time 100 cases of healthy children in the same period were selected as control group, the levels of inflammatory factors and the indexes of immune function were compared between the groups and different courses of disease. Results: Compared with the control group, the levels of hs-CRP and PCT in the observation group were significantly increased, and in the observation group, the bacterial pneumonia group of hs-CRP and PCT levels were significantly higher than those in mycoplasma pneumonia group and viral pneumonia group, compared with the viral pneumonia group hs-CRP level ,the level in the mycoplasma pneumonia group was significantly increased;The comparison of immune function index, the observation group CD3+, CD4+ and CD4+/CD8+ levels [(66.32±8.61)%, (36.51±6.26), (1.21±0.29)] were significantly lower than those of the control group, the level of CD8+ (26.34±5.11)% was significantly higher than the control group (22.75±3.88)%, but the levels of CD3+, CD4+, CD8+and CD4+/CD8+ in each group of the observation group were not statistically significant;The severe group hs-CRP, PCT and CD8+ levels were significantly higher than the mild group, and the levels of CD3+, CD4+ and CD4+/CD8+ were significantly decreased. Conclusion: There is a marked inflammatory response and abnormal cellular immune function in children with infectious pneumonia, and its level detection is of great value in the diagnosis of disease and the assessment of the severity of the disease.