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ObjectiveTo identify the relationship between tumor tissue interleukins （ILs） and non-small cell lung cancer （NSCLC） patients with poor response to immune checkpoint blockade （ICB） therapy， and to investigate the differential expression of ILs in tumor of NSCLC patients as well as its effect on ICB response and prognosis. MethodsA total of 61 patients diagnosed with NSCLC and treated with ICB were retrospectively collected from the data of a previous study. We obtained transcriptome sequencing data from tumor tissues and survival data of the patients before ICB treatment. Using bioinformatics methods， we screened for ILs that significantly affected the efficacy and prognosis of ICB treatment. We evaluated the efficacy of ICB treatment using progressive-free survival （PFS） and assessed the prognosis using overall survival （OS）. The Kaplan-Meier survival curve and ROC curve were used to analyze the predictive effect and efficacy of ILs on the efficacy and prognosis of ICB in NSCLC patients. ResultsThe results of the univariate Cox regression analysis in our study showed that nine ILs were found to be associated with OS of NSCLC patients treated with ICB at a significance level of P < 0.1. Further multivariate analysis revealed that high expression of IL-11， IL-17D， and IL-36A was significantly associated with poor prognosis in these patients （P < 0.05）. The results from the Kaplan-Meier survival curve analysis revealed a significant negative correlation between the high expression of IL-17D and both PFS and OS in NSCLC patients. Specifically， patients with IL-17D high expression had a median PFS of 3.1 months compared with 6.5 months in low expression patients ［95% confidence interval （CI） （1.178， 3.655）， P = 0.009］. Similarly， the median OS was 9.8 months in the high expression group versus 21.8 months in the low expression group ［95%CI （1.116， 4.392）， P = 0.018］. ROC curve showed that the prediction performance was favorable ［AUCPFS = 0.702，95%CI （0.562， 0.842）， P = 0.027； AUCOS = 0.684， 95%CI （0.550， 0.818）， P = 0.014］. Although IL-11 and IL-36A alone were not significant predictors of PFS and OS in NSCLC patients， the median PFS and OS were notably shortened to 2.2 months （P = 0.003） and 3.0 months （P < 0.001）， respectively， when high expression of IL-11 and IL-36A was combined with high expression of IL-17D. The ROC curve analysis demonstrated an improvement in prediction efficiency for both PFS and OS in NSCLC patients ［AUCPFS = 0.748， 95%CI （0.615， 0.880）， P = 0.007； AUCOS = 0.703， 95%CI （0.573， 0.833）， P = 0.007］. ConclusionThe results suggest that high expression of IL-11， IL-17D， and IL-36A is associated with a higher risk of disease progression which correlates to poor PFS and OS in NSCLC patients.
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Objective:To establish two differential gene expression profiles of qi-deficiency and blood stasis syndrome before or after safflower injection treatment by using gene chip technology;compared and analyzed to ensure the effective genes that are responsible for the therapeutic effects of safflower injection against qi-deficiency and blood stasis syndrome in rats.Furthermore,speculated the effect mechanism of the therapeutic genes.Methods:Fifteen SD rats were randomly divided into 3 groups (n=5):control group,model group,and medication group.Qi-deficiency and blood stasis model was established by subjecting the rats to hunger and fatigue for two weeks.After a week of the modeling,safflower injection (100 mg/kg/d) was administered daily via the tail vein for 7 days in medication group,and the rats in model group were injected with saline of the same volume.Control group received normal feeding.At the end of the experiment,rats were killed and whole blood was collected to evaluate the blood stream change and extract mRNAs in blood samples.Qualified mRNAs were reverse transcribed into cDNA which was then used in gene chip hybridization.The genes regulated by safflower injection were determined by the fluorescence signal and the functional mechanisms of safflower injection were confirmed by further querying genealogy databases and reviewing literatures.Results:After two weeks of the modeling,the whole blood viscosity under various shear rates was significantly increased in the model rats which showed faint,blood stasis and weight loss,indicating that the model is made successfully.The increased whole blood viscosity and qi-deficiency and blood stasis syndrome were obviously reversed by safflower injection treatment.Compared with the control group,252 genes up-regulated while 54 genes down-regulated in model group;compared with the model group,196 genes up-regulated while 32 genes down-regulated.Among these,16 differentially expressed genes were involved in inflammation and immune response.Conclusions:Safflower injection was effective in treating qi deficiency and blood stasis syndrome,which was achieved by regulating inflammation related genes.
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Objective To investigate the rationality of prophylactic use of anti‐bacterial in 251 type Ⅰ incision opera‐tions .Methods The anti‐bacterial use of 251 type Ⅰ incision operations sampled randomly from May 2012 to May 2013 were retrospectively analyzed .Results The prophylactic antibiotics rate was 98 .41% in the 251 cases of the type Ⅰ incision;among the 247 cases used anti‐bacterial ,the utility rate of first generation cephalosporin antibiotic was 28 .57% after surgery and the rate of prophylactic antibiotic use within 0 .5‐2 h before operation was 61 .94% .14 .17% of antibiotic treatment was finished within 48 h after surgical operation .Conclusion There was the unreasonable situation in the prophylactic use of anti‐bacterial , w hich need to be improved .