Objective To observe the effect of gefitinib on expression of epidermal growth factor receptor (EGFR) in bile duct epithelial cells, and the feasibility of inhibiting hyperplasia of bile duct epithelial cells with gefitinib. Methods Sixty-one patients with hepatolithiasis having to be in hospital for surgery from the First People’s Hospital of Shuangliu county were selected, with 25-65 years old, average 46.92 years. The patients were randomly divided into therapy group and control group. There were 30 cases in therapy group, in which fine duct was placed on lesion bile duct during operation, and through whom gefitinib solution was perfused after operation. There were 31 cases in control group with only T tube drainage after operation. The bile duct sample was obtained respectively during the operation and 6 weeks and 12 weeks after operation. The histology and expression change of EGFR were observed by HE staining, immunohistochemistry and RT-PCR method respectively. Results There were no significant differences in pathohistology changes of bile duct and the EGFR protein and mRNA expression between therapy group and control group during operation. The hyperplasia of epithelium mucosae and submucosal gland in the therapy group were obviously decreased as compared with those in control group, the EGFR mRNA and protein expression in therapy group were weaker than those of control group （Plt;0.05） 6 weeks and 12 weeks after gefitinib treatment. Conclusion EGFR is overexpressed in the chronic proliferative cholangitis, and continuously local application of gefitinib after operation can specifically interrupt the activation and expression of EFGR and then effectively inhibit the hyperplasia of bile duct epithelial cells.
Objective To explore the predictive value of superoxide dismutase (SOD) and serum amyloid A (SAA) in short-term poor prognosis in patients with lacunar infarction. Methods The clinical data of 185 patients who were diagnosed with lacunar infarction in the Second Affiliated Hospital of Wannan Medical College between January 1st and December 31st, 2021 were analyzed retrospectively. According to the modified Rankin Scale (mRS) score 3 months after discharge, the patients were divided into the good prognostic group (mRS≤2) and the poor prognostic group (mRS>2). Multiple logistic regression was used to analyze the independent risk factors of the short-term adverse prognosis of patients with lacunar infarction, and a risk prediction model (nomograph) was constructed. The predictive efficacy of SOD, SAA and nomograph for poor prognosis was analyzed by using the receiver operating characteristic curve. Calibration curve and decision curve analysis were used to evaluate the differentiation and clinical application value of the model. Results A total of 185 lacunar cerebral infarction patients with a mean age of (68.26±10.77) years were enrolled in this study, among whom 80 (43.2%) were males and 39 (21.1%) had adverse prognosis. Multiple logistic regression analysis showed that systolic blood pressure [odds ratio (OR)=1.028, 95% confidence interval (CI) (1.004, 1.052), P=0.021], diabetes [OR=4.939, 95%CI (1.703, 14.320), P=0.003], SAA [OR=1.089, 95%CI (1.052, 1.128), P<0.001], apolipoprotein B [OR=7.647, 95%CI (2.186, 26.753), P=0.001] were independent risk factors for poor prognosis in lacunar infarction patients, while the level of SOD [OR=0.979, 95%CI (0.965, 0.994), P=0.006] was a protective factor. The area under the curve of the nomograph for predicting the short term poor prognosis was 0.874 [95%CI (0.812, 0.936), P<0.001]. The goodness-of-fit test with the calibration curve indicated that the prediction probability was consistent with the actual occurrence probability (Hosmer-Lemeshow test P=0.295), and the decision curve indicated that the nomograph had good clinical application value. Conclusion SAA and SOD have good predictive value for short-term adverse prognosis of lacunar cerebral infarction patients, and the nomograph constructed based on them has a good differentiation and consistency, which can provide a basis for clinicians to evaluate the prognosis of lacunar cerebral infarction patients.
Chronic obstructive pulmonary disease is often accompanied by anxiety or depression. The exacerbation of anxiety and depression can lead to the deterioration of chronic obstructive pulmonary disease, reduce patients’ quality of life, worsen poor prognosis, and increase the risk of death. Anxiety and depression are one of the important causes of death in patients with chronic obstructive pulmonary disease, but the complexity of their risk factors and pathogenesis often lead to clinicians being unable to make accurate diagnosis and treatment in a timely manner. Based on existing research, this article elaborates on the risk factors and pathogenesis of chronic obstructive pulmonary disease complicated with anxiety or depression, aiming to improve the diagnosis and treatment ability of clinical physicians for chronic obstructive pulmonary disease complicated with anxiety or depression, achieve timely diagnosis and treatment, improve patients’ prognosis, and improve quality of life.