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Objective:To investigate effects of the ROCK1 gene on proliferation and migration of and related molecular expression in keloid fibroblasts.Methods:Immunohistochemical technique was used to detect ROCK1 protein expression in human keloids and normal skin tissues, and Western blot analysis was performed to detect the expression of ROCK1, transforming growth factor β1 (TGF-β1) and E-cadherin in keloid tissues. In vitro cultured human keloid fibroblasts (HKFs) were divided into 4 groups: ROCK1 gene overexpression control group (ROCK1 NC group) transfected with ROCK1 gene overexpression control vectors, ROCK1 gene overexpression group (ROCK1 OE group) transfected with ROCK1 gene overexpression vectors, ROCK1 gene knockdown control group (sh NC group) transfected with ROCK1 gene knockdown control vectors, and ROCK1 gene knockdown group (shROCK1 group) transfected with ROCK1 gene knockdown vectors. Cell counting kit-8 (CCK8) assay was performed to evaluate the effect of ROCK1 gene on the survival rate of HKFs, Transwell assay to evaluate the effect on the migration of HKFs, and real-time fluorescence-based quantitative PCR (qRT-PCR) and Western blot analysis were conducted to determine the mRNA and protein expression of ROCK1, TGF-β1 and E-cadherin, respectively. Results:Immunohistochemical study showed that ROCK1 protein expression decreased significantly in the human keloid tissues compared with the normal tissues ( t = 6.47, P = 0.003) ; Western blot analysis showed that the expression levels of ROCK1 and E-cadherin significantly decreased ( t = 14.02, 162.20, respectively, both P < 0.001), while TGF-β1 expression significantly increased ( t = 76.01, P < 0.001) in the keloid tissues compared with the expression levels of corresponding proteins in the normal tissues. CCK8 assay showed that the cell activity was significantly lower in the ROCK1 OE group than in the ROCK1 NC group after 24-hour transfection ( t = 3.25, 3.78, P = 0.031, 0.019, respectively), and significantly higher in the shROCK1 group than in the sh NC group ( t = 3.12, 2.79, P = 0.036, 0.049, respectively). Transwell assay showed that the number of migratory cells was significantly lower in the ROCK1 OE group than in the ROCK1 NC group ( t = 5.17, P = 0.004), and significantly higher in the shROCK1 group than in the sh NC group ( t = 9.28, P < 0.001). Compared with the ROCK1 NC group, the ROCK1 OE group showed significantly increased mRNA and protein expression levels of ROCK1 and E-cadherin ( P < 0.05 or < 0.001), but decreased mRNA and protein expression levels of TGF-β1 (both P < 0.001) ; compared with the sh NC group, the shROCK1 group showed significantly decreased mRNA and protein expression levels of ROCK1 and E-cadherin ( P < 0.05 or < 0.001), but significantly increased mRNA and protein expression levels of TGF-β1 ( P = 0.005 or < 0.001) . Conclusions:The ROCK1 gene can inhibit the proliferation and migration of HKFs. Overexpression of the ROCK1 gene can down-regulate the TGF-β1 gene expression and up-regulate the E-cadherin gene expression in HKFs.
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Objective:To study the effects of different carbon dioxide (CO 2) pneumoperitoneum pressures combined general anesthesia with sevoflurane-propofol on cerebral oxygenmetabolism balance and stress response in elderly patients undergoing colorectal cancer surgery. Methods:A retrospective collection of 100 colon cancer cases from February 2020 to February 2021 in the Jiading Branch of Shanghai First People′s Hospital (Jiangqiao Hospital, Jiading District) and the Shanghai First People′s Hospital were divided into low pressure group and high pressure group according to different CO 2 pneumoperitoneum pressure values, each with 50 cases and 12 mmHg(1 mmHg = 0.133 kPa) and 18 mmHg CO 2 pneumoperitoneum pressure values were used to inflate, and the perioperative status, cerebral oxygen metabolism status, and stress response of the two groups were observed. Results:The take food time, first time out of bed in the low pressure group were lower than those in the high pressure group: (45.67 ± 7.34) h vs. (49.67 ± 8.16) h, (34.69 ± 8.26) h vs. (39.87 ± 7.16) h, there were statistical differences( P<0.05). The time of first anal exhaust and hospital stay in the two groups had no significant differences ( P>0.05). Repeated measures analysis of variance results showed that the levels of partial pressure of carbon dioxide in artery, oxyhemoglobin saturation, arterial blood lactate acid, benous blood lactic acid were different followed the time and treatment methods ( P<0.05). The levels of heart rate, mean arterial pressure, cortisol and thyroid stimulating hormone in the low pressure group were higher than those in the high pressure group: (73.68 ± 6.35) beats/min vs. (84.84 ± 6.86) beats/min, (81.67 ± 13.68) mmHg vs. (93.68 ± 14.37) mmHg, (100.24 ± 12.34) μg/L vs. (135.68 ± 13.69) μg/L, (3.12 ± 0.43) mU/L vs. (3.54 ± 0.34) mU/L, there were statistical differences ( P<0.05). Conclusions:Different CO 2 pneumoperitoneal pressures affect the brain oxygen metabolism of patients, and clinical attention should be paid to them.
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Objective:To observe the effects of ultrasound guided transversus abdominis plane block (TAPB) on pain, rehabilitation indexes and immune function of postoperative in patients undergoing laparoscopic colorectal cancer surgery.Methods:A total of 100 patients undergoing laparoscopic colorectal cancer surgery admitted to Jiading Branch of Shanghai First People′s Hospital/Jiangqiao Hospital of Jiading District and Shanghai First People′s Hospital from February 2020 to February 2021 were selected as the study subjects, including 43 patients performed epidural block (control group) and 57 patients performed TAPB (observation group). The clinical indicators, vital signs parameters, pain degree, immune function in the two groups were compared.Results:The exhausting time, defecation time, getting out of bed time and hospitalization time in observation group were shorter than those in control group: (2.71 ± 0.54) d vs. (2.99 ± 0.66) d, (3.02 ± 0.49) d vs. (3.49 ± 0.56) d, (3.20 ± 0.89) d vs. (3.85 ± 1.08) d, (6.81 ± 0.98) d vs. (7.71 ± 1.08) d, there were statistical differences ( P<0.05). The diastolic blood pressure, systolic blood pressure and heart rate at pre-anesthesia, immediate incision of the skin, end of the surgery between two groups had no significant differences ( P>0.05). The scores of visual analogue scale at 4, 24, 48 and 72 h after surgery in the observation group were significantly lower than those in the control group ( P<0.05). The levels of CD 3+, CD 4+, CD 4+/CD 8+ and IgM after surgery for 3 d in the observation group were higher than those in the control group: 0.512 ± 0.054 vs. 0.487 ± 0.051, 0.280 ± 0.036 vs. 0.222 ± 0.032, 1.36 ± 0.29 vs. 1.17 ± 0.26, (152.53 ± 34.3) kU/L vs. (138.86 ± 31.18) kU/L, there were statistical differences ( P<0.05). Conclusions:TAPB can effectively reduce the degree of postoperative pain and immunosuppression after laparoscopic colorectal cancer surgery, so as to promote postoperative rehabilitation of patients.
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Objective:To explore whether left ventricular interstitial fibrosis is associated with left atrial enlargement and left atrial dysfunction in patients of hypertrophic cardiomyopathy(HCM) with preserved ejection fraction.Methods:From October 2018 to September 2021, 59 HCM including 30 with enlarged maximal left artrial volume index (LAVI max), 29 with normal LAVI max and 28 age-and gender-matched controls were retrospectively enrolled. Imaging protocol included cine sequence, late gadolinium enhancement and T 1 mapping.The relationships between left ventricular mass index (LVMI), quantitative myocardial fibrosis and left atrial-related indexes were analyzed. One-way analysis of variance with Bonferroni post hoc correction or Kruskal-Wallis was performed for continuous variables. Categorical variables were assessed using the Chi-square test or Fisher′s exact test. Pearson or Spearman analysis was used for linear or monotonic nonlinear correlations. Results:The left ventricular end-diastolic volume index, left ventricular end-systolic volume index, left ventricular cardiac output and LVMI of HCM with enlarged LAVI max group were higher than HCM with normal LAVI max group and control group( P<0.05).Correlation analysis showed that LVMI correlated positively with LAVI max( r=0.780, P<0.001) and minimal left artrial volume index (LAVI min) ( r=0.816, P<0.001), extracellular volume correlated positively with LAVI max( r=0.462, P<0.001) and LAVI min( r=0.483, P<0.001),%LGE was correlated positively with LAVI max( r=0.311, P<0.05) and LAVI min( r=0.327, P<0.05),left ventricular index interstitial volume was correlated negatively with left atrial ejection fraction of reservoir ( r=-0.669, P<0.001),left atrial ejection fraction of conduit ( r=-0.472, P<0.001),left atrial ejection fraction of pump ( r=-0.518, P<0.001)and left atrial expansion index( r=-0.626, P<0.001). Conclusion:There is association between LVMI and fibrosis and left atrial enlargement and phases dysfunction in HCM with preserved ejection fraction.
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Objective:To explore the treatment of levator complex in conjoint fascial sheath suspension correction on severe ptosis, and to seek a reliable and less complications operation.Methods:From October 2016 to February 2020, 40 eyes of 24 patients with severe ptosis (6 males and 18 females, aged from 10 to 73 years, with an average of 34.4 years) were divided into study group and control group. 20 eyes in study group were treated with combined fascia sheath suspension and levator palpebrae muscle complex tension-free shortening correction, while 20 eyes in control group were treated with combined fascia sheath suspension and levator palpebrae muscle complex tension-free shortening correction The effects and complications of the two groups were compared.Results:Follow-up studies were conducted at 1 week, 3 month and 6 months after operation. There was no significant difference between the two methods at different time points after operation, and the incidence of complications in the study group was less than that in the control group at 1 week after operation.Conclusions:Combined with fascial sheath suspension and levator palpebrae muscle complex tension-free shortening in the treatment of severe blepharoptosis has less complications and reliable curative effect in the early postoperative period, but it still needs to be improved to obtain more lasting curative effect.
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Objective:To explore the practice effect of phased transitional care on the growth of low birth weight premature infant and parenting stress in premature mother.Methods:A total of 82 low birth weight premature infant and its mother were randomly assigned to intervention group (42 cases) and control group (40 cases), the control group were given routine outpatient care, the intervention group received phased transitional care. The physical development status in premature infants and parenting stress in premature mother were compared at discharge time and 1 month, 3 months and 6 months older.Results:The body weight, body length, head circumference of premature infant were (7 179.92±477.69) g, (64.74±6.23) cm, (42.80±5.78) cm in the intervention group, which were significantly increased compared to (6 889.43±354.46) g, (61.26±5.06) cm, (39.60±5.54) cm in the control group at 6 months after discharge, the differences were statically significant ( t values were 3.063, 2.728, 2.515, P<0.05). The total stress scale in the intervention group at 1month, 3monts, 6 months after discharge were (76.73±8.51), (68.36±6.28), (67.39±5.09) points, which were significantly decreased compared to (81.10±8.95), (77.71±6.35), (75.75±5.59) pionts in the control group, the differences was statically significant ( t values were 2.225, 6.574, 6.948, P<0.05). Conclusion:Phased transitional care can effectively promote the growth and development of low birth weight preterm infants, as well as improve the parenting stress of premature mother.
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@# The animal model of neonatal hypoxic-ischemic brain damage refers to ischemia and hypoxia conditions to duplicate the pathogenesis and pathological progress in the perinatal animals. The main modeling methods include blocking arterial vessels, clipping trachea and prenatal intrauterine anoxia and so on. The paper mainly reviewed the progress and evaluation of neonatal hypoxic-ischemic brain damage animal models.
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Objective To analyze the relationship among perceived stress, resilience and sleep quality in patients with coronary heart disease, and to examine the mediating effect of resilience between perceived stress and sleep quality. Methods Totally 231 patients with coronaryheartdisease were selected. The Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS), and 10-item Connor-Davidson Resilience Scale (CD-RISC-10) were used to assess the sleep quality, perceived stress and resilience respectively. Results The average scores of PSQI were (7.2 ± 2.8) points, and 71.4％ (165/231) of the participants had sleep problems (PSQI>5). CD-RISC-10 scores were negatively correlated with PSQI scores and PSS scores (r=-0.62,-0.43, P<0.01), and PSS scores were positively correlated with PSQI scores (r=0.33, P<0.01). Furthermore, Bootstrap-generated 95％CI was (0.130-0.319, P<0.01) and did not include 0, which indicated that resilience significantly mediated the relationship between perceived stress and sleep quality. The mediating effect size of resilience was 56.1％. Conclusion It suggests that patients with coronary heart disease have poor sleep quality. Perceived stress and resilience could affect sleep quality, and resilience could mediate the relationship between perceived stress and sleep quality.
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Objective To explore the clinicopathological characteristics,recurrence,metastasis and survival of triple negative breast cancer (TNBC),and to analyze the correlation factors affecting the prognosis.Methods Data of 378 breast cancer patients treated from Jan.2008 to Dec.2011 were retrospectively analyzed.According to immunohistochemical staining of estrogen of receptor (ER),progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2),they were divided into TNBC group (61 cases) and non-triple negative breast cancer group (non-TNBC,317 cases).The two groups were compared in terms of clinicopathological characteristics,prognosis and survival.Results Patients in TNBC group had significant differences in the following aspects:ratio of patients with newly diagnosed age ＜35 years old,patients with family history of breast cancer,the maximum diameter of tumor more than 5 cm,positive preoperative axillary lymph node status,tumor in clinical stage m,histological grade of tumor in level Ⅲ,Ki67 overexpression and P53 overexpression,while there was no statistical difference in the aspects of menstrual status,pathological type or surgical method between them.The local recurrence and distant metastasis rate were obviously higher in TNBC group than in non-TNBC group.5-year diseasefree survival (DFS) and 5-year overall survival (OS) were significantly lower in TNBC group than in non-TNBC group.Univariate analysis showed that factors related to 5-year DFS in TNBC group were:age,the maximum diameter of tumor,the preoperative axillary lymph node status,clinical staging of tumor,and P53 overexpression.The maximum diameter of tumor,the preoperative axillary lymph node status and clinical staging of tumor were recognized as the influence factors of 5-year OS.Independent factors affecting 5-year DFS in TNBC group were:the maximum diameter of tumor,and the preoperative axillary lymph node status.The maximum diameter of tumor and the preoperative axillary lymph node status were the independent factors influencing 5-year OS.Conclusions The clinicopathological characteristics of TNBC include:younger onset age,family clustering of breast cancer,the larger maximum of tumor diameter,larger portion of positive preoperative axillary lymph node,later clinical staging of tumor,higher histological grade of tumor,easier local recurrence and distant metastasis,lower 5-year DFS and 5-year OS.The factors of age,the maximum diameter of tumor,the preoperative axillary lymph node status,clinical staging of tumor,P53 overexpression especially the maximum diameter of tumor and the preoperative axillary lymph node status play the important clinical roles in judging the prognosis of TNBC.
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Objective To explore the effects of application of one-hand double-lumen simultaneous locking tech-nique on reduction of occlusion using high pressure resistant double-lumen PICCs. Methods Convenience sampling method was used to recruit 73 patients assigned into the experimental group,using one-hand double-lumen simulta-neous locking technique;66 patients were assigned into the control group,using routine locking method. The rate of PICC occlusion was recorded. Results The rate of incomplete occlusion was 8.22% in the experimental group,and 17.42% in the control group,the rate of complete occlusion in the experimental group was 0,and 0.76% in the control group,and the difference was statistically significant(P<0.05). Conclusion The one-hand double-lumen simul-taneous locking technique is easy and convenient to conduct. It can effectively reduce occlusion using high pres-sure resistant double-lumen PICCs.
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Objective To investigate the relationship between the onset of lower extremity venous thrombotic disease and seasons.Methods A retrospective study was conducted, 300 patients with lower extremity venous thrombotic disease admitted to HandanCity Hospital of Traditional Chinese Medicine (TCM) from August 2012 to February 2014 were enrolled, the incidences and TCM syndromes of patients with lower extremity venous thrombotic disease in different seasons were observed, and the pathogenesis and relationships between the types of TCM syndrome and seasons were analyzed.Results There were 142 patients with lower extremity superficial thrombophlebitis, and 158 cases with lower extremity deep venous thrombosis, the incidence of lower extremity venous thrombotic disease in spring was significantly higher than that in summer and autumn [32.8% (86/262) vs. 21.3% (54/254), 18.4% (50/272), bothP 0.01); while the incidence of lower extremity venous thrombotic disease in winter was significant higher than those in summer and autumn (allP < 0.01). The incidences of damp and heat downward flow type in autumn and summer were increased compared with those in winter and spring [55.6% (30/54), 60.0% (30/50) vs. 20.0% (22/110), 23.3% (20/86), allP < 0.01], while the incidences of lower extremity venous thrombotic disease with damp heat and stasis syndrome in winter and spring were increased compared with those in summer and autumn seasons [80.0% (88/110), 76.7% (66/86) vs. 44.4% (24/54), 40.0% (20/50)].Conclusions The incidence of lower extremity venous thrombotic disease is related to seasons, and the onset is high in winter and spring, damp heat and stasis syndrome being the main type; according to different seasons, clinical treatment can direct to different pathogenic factors to adopt different preventive measures interfering with the patient's constitution in order to eliminate or reduce the risk factors, achieving the effect of the disease prevention.
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Colorectal Cancer (CRC) is a kind of molecular diversified neoplasm.For nonmetastatic early CRC patients who received surgery based systemic treatment,the 5 years survival rate is as high as 50％-80％.However,only chemotherapy is available for majority of metastatic advanced CRC patients.The effect of chemotherapy is disappointing.Numerous studies have demonstrated that some patients with metastatic advanced CRC can benefit from anti-EGFR and anti-VEGF monoclonal antibodies.Here,we give a brief overview about the clinical research of the detection of KRAS,BRAF,MSI and HER2in guiding treatment with targeted drugs in metastatic advanced CRC
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Objective To explore the diagnosis and treatment of disseminated cryptococcosis involving the biliary tract and the central nervous system. Methods The clinical data of one child with disseminated cryptococcosis involving biliary tract and central nervous system were analyzed retrospectively. The related literatures were reviewed. Results A 6-year-old boy presented with jaundice, hepatic dysfunction and convulsions. The surgical treatment was performed. The pathological biopsy showed cryptococcal infection, cryptococcal capsular polysaccharide antigen latex agglutination test in serum and cerebrospinal fluid were positive and cerebrospinal fluid ink staining was also positive. After antifungal treatment, the symptoms were relieved and no sequelae existed during the follow-up period. Conclusion Disseminated cryptococcosis simultaneously involving the biliary tract and the central nervous system is rare in children.
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Objective To explore the diagnosis and treatment of disseminated cryptococcosis involving the biliary tract and the central nervous system. Methods The clinical data of one child with disseminated cryptococcosis involving biliary tract and central nervous system were analyzed retrospectively. The related literatures were reviewed. Results A 6-year-old boy presented with jaundice, hepatic dysfunction and convulsions. The surgical treatment was performed. The pathological biopsy showed cryptococcal infection, cryptococcal capsular polysaccharide antigen latex agglutination test in serum and cerebrospinal fluid were positive and cerebrospinal fluid ink staining was also positive. After antifungal treatment, the symptoms were relieved and no sequelae existed during the follow-up period. Conclusion Disseminated cryptococcosis simultaneously involving the biliary tract and the central nervous system is rare in children.
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Intermediate-conductance Ca2+-activated K+channel ,also known as KCa3.1,IKCa and SK4,is widely distributed in fibroblasts,proliferating smooth muscle cells,endothelial cells,T lymphocytes,plasma cells,macrophages,and epithelial cells, and involved in the pathological and physiological processes such as vascular contraction,inflammation ,calcification,tissue fibrosis, immune response,malignant tumor,internal and external secretory glands. In recent years,it has been found that blocking the KCa3.1 pathway or knockouting the gene can significantly prevent the pathophysiological process of its involvement. The recent use of the specific blocker TRAM-34 in animals and humans shows its safety and tolerability,providing a new direction for the treatment of related diseases. In this article,the research progress in KCa3.1 related diseases in recent years is reviewed.
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Objective Ischemic stroke with elevated serum immunoglobulin E ( IgE) in some young patients is regarded as cerebral vasculitis clinically though without sufficient pathological evidence .This study was to investigate the characteristics of vascular lesions in these patients by temporal artery biopsy . Methods We performed histopathologic examinations on the temporal arteries of 32 young ischemic stroke patients with unknown etiology , 16 with normal and the other 16 with elevated serum IgE .We observed inflammatory cells infiltration and mast cells by HE staining and toluidine blue stai-ning respectively and determined the expressions of matrix metalloproteinase -9 (MMP-9), monocyte chemotaxis protein -1 (MCP-1) and serum IgE by immunohistochemistry . Results Compared with the patients with normal IgE , those of the elevated IgE group showed a significantly higher rate of inflammatory cells infiltration (12.5%vs 62.5%, P0.05).Nor was any signifi-cant difference observed in the number of the mast cells between the normal and elevated IgE groups (2.8 ±1.5 vs 3.6 ±2.3, P>0.05). Conclusion The infiltration and necrosis of inflammatory cells and fibrin exudation in the temporal artery of the young pa-tient with elevated serum IgE are likely to be the manifestations of vasculitis , and MCP-1 may play a role in the pathogenesis of the disease.
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Objective To explore the experiences of family caregivers of children with tumor of PICC-line. Methods A semi- structured interview was conducted with 16 family caregivers of children with tumor of PICC- line. Data were analyzed based on Colaizzi′s phenomenological research method. Results Five themes were extracted including lack of knowledge and skills of family care, heavy psychological burden, weakness of social support system, to face calmly and respond actively, sense of achievement brought by gaining nursing experience. Conclusions Understanding the experiences and problems of family caregivers can help nurses provide professional family care education and psychological counseling to alleviate their psychological burden and satisfy their needs.
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Objective It remains to be confirmed whether tissue kallikrein has neuroprotective effect in diabetes-induced stroke.This study was to investigate the neuroprotection of tissue kallikrein against cerebral ischemia-reperfusion injury in diabetic rats. Methods Healthy male SD rats were randomly divided into a sham operation, a saline control, and a tissue kallikrein group.Diabetes mellitus was induced in the animals by intraperitoneal injection of streptozotocin and the model of focal cerebral ischemia-reperfusion was made with an intraluminal vascular occlusion method. At 24 hours after modeling, we obtained the neurological deficit score, in-farct size, and brain water content, counted Iba1-and MPO-positive cells by immunohistochemistry, and determined the expressions of ICAM-1 and VCAM-1 by real-time PCR. Results In comparison with the saline controls, the rats treated with tissue kallirein showed significant decreases in the neurological deficit score (P<0.01), the infarct size ([23.57 ±5.79] vs [47.97 ±1.19]%, P<0.01), brain edema ([81.73 ±2.10] vs [84.94 ±2.34]%, P<0.05), the counts of Iba1-and MPO-positive cells (12.33 ±4.46 vs 31.83 ±8.13 and 13.83 ±4.49 vs 37.50 ±7.64, both P<0.01), and the expressions of ICAM-1 and VCAM-1 (both P<0.05). Conclusion Tissue kallikrein has a neuroprotective effect against cerebral ischemia-reperfusion injury in diabetic rats, which may be associated with its anti-inflammation property.
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AIM:To explore the polarized distribution of M 2 macrophages in the marginal region around lung adenocarcinoma , the marginal/central ratio and their effect on the prognosis .METHODS:Double immunohistochemistry staining was used to determine the distribution and the difference of CD 163 +/CD68 +( M2 ) macrophages in the marginal and central regions in 49 cases of lung adenocarcinoma in situ ( AIS), 11 cases of minimally invasive adenocarcinoma ( MIA) and 57 cases of invasive adenocarcinoma ( IA) in order to explore the effect and mechanism of the polarized distri-bution and the marginal/central ratio on the progression of lung adenocarcinoma .Single-factor Kaplan-Meier survival curve analysis and multivariate Cox survival analysis were employed to explore the relationship between the polarized distribution of M2 macrophages and the prognosis .RESULTS:Polarized aggregation of M 2 macrophages was observed in the marginal region of lung adenocarcinoma compared with that in the central region , and the difference was significant ( P<0.01 ) . Based on the median level , they were divided into high polarized group and low polarized group .In low polarized group , M2 macrophage count in AIS was not significantly different from that in MIA or IA .However, in high polarized group, M2 macrophage count in AIS was lower than that in MIA and IA in turn and there were statistically significant differences (P<0.01).Single-factor Kaplan-Meier survival curve analysis and log-rank test result showed that the number of M2 mac-rophages in the marginal region and marginal/central ratio were negatively correlated to the survival time (χ2 =44.71, P<0.01;χ2=21.75, P<0.01).Multivariate Cox survival analysis showed that the high polarized distribution of M 2 macro-phages in the marginal region and the marginal /central ratio were independent risk factors for the prognosis ( P<0.01 ) . CONCLUSION:There is a polarization effect of M2 macrophages on the marginal region of lung adenocarcinoma .The marginal polarization and the marginal/central ratio are independent risk factors of the prognosis .Therefore , it may be an effective method for the evaluation of the prognosis to judge the marginal polarization by preoperative puncture and to deter -mine the marginal/central ratio of M2 macrophages by postoperative biopsy .
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Objective Inflammation response is involved in the whole pathological process of acute cerebral infarction ( ACI) , but few reports are seen on its clinical implication in ACI patients .The purpose of this study was to investigate the predictive value of the differential count of leukocytes for stroke severity and early clinical outcomes in the acute phase of cerebral infarction . Methods We collected the clinical and laboratory data of 635 patients diagnosed with ACI within 72 hours of symptom onset and eval-uated the association between the differential count of peripheral blood leukocytes and stroke severity at admission and within 3 days af-ter admission as well as the clinical outcomes at discharge .The neural function impairment scores of the patients were obtained with The NIH Stroke Score ( NIHSS) at admission and on the third day after admission , and the therapeutic results evaluated with the modi-fied Rankin Scale ( mRS) , mRS >2 as poor prognosis .Analyses were performed on the correlation of the differential count of leuko-cytes with NIHSS and mRS scores and its influence on the ACI patients . Results At discharge , the mRS related influencing factors included the total count of leukocytes (OR=1.147, 95% CI:1.038-1.268), count of neutrophil cells (OR=1.227, 95% CI:1.00-1.369 ), count of lymphocytes ( OR =0.508, 95% CI:0.342-0.753), and neutrophil to lymphocyte ratio (NLR) (OR=1.150, 95%CI:1.008-1.314).the NIHSSs were correlated with the counts of leucocytes (r=0.078, P=0.024), neutrophil cells (r=0.083, P=0.019), and lymphocytes (r=0.010, P=0.004) at admission, and with the counts of leucocytes ( r =0.238, P <0.001), neutrophil cells (r=0.335, P<0.001), lymphocytes (r=-0.269, P<0.001), and NLR (r=0.423, P<0.001) on the third day after admission. Conclusion In the acute phase of cer-ebral infarction , the differential count of leukocytes and NLR are valuable for predicting the severity of neurologic impairment and early poor functional outcome .