Objective To observe the effect of civelestat sodium combined with low tidal volume lung protective ventilation on oxygenation level and inflammatory reaction in patients with acute respiratory distress syndrome(ARDS). Methods From January 2021 to March 2022, 96 patients with ARDS were selected from the Department of Critical Medicine of Hainan Cancer Hospital. They were divided into control group and observation group according to the method of random number table, with 48 patients in each group. The control group was treated with low tidal volume lung protective ventilation, while the observation group was treated with civelestat sodium combined with low tidal volume lung protective ventilation. Compare the mechanical ventilation, admission to ICU, hospitalization time, blood gas index(PaO2), partial pressure of carbon dioxide(PaCO2), oxygenation index(PaO2/FiO2), hemodynamic index(HR), mean arterial pressure(MAP), central venous pressure(CVP), pulmonary function index(FVC), forced expiratory volume(FEV1), FEV1/FVC) Inflammatory factors [interleukin-6(IL-6), C-reactive protein(CRP), white blood cell count(WBC)], and the incidence of adverse reactions. Results The time of mechanical ventilation, admission to ICU and hospitalization in the observation group was shorter than that in the control group(t/P=6.414/<0.001, 3.881/<0.001, 5.290/<0.001). At 24 and 72 hours after treatment, the PaO2, PaO2/FiO2 in the observation group were higher than those in the control group, and PaCO2 was lower than those in the control group(F/P=8.451/<0.001, 9.785/<0.001, 10.265/<0.001). At 24 hours and 72 hours after treatment, HR in the two groups showed a downward trend, while MAP and CVP showed an upward trend, and the observation group decreased/increased more significantly at the same time point(F/P=18.621/<0.001, 25.786/<0.001, 26.105/<0.001).The FVC, FEV1, FEV1/FVC in the observation group were higher than those in the control group 72 hours after treatment(t/P=5.971/<0.001、8.649/<0.001、10.404/<0.001). The levels of serum IL-6, CRP and WBC in the observation group were lower than those in the control group 72 hours after treatment(t/P=7.887/<0.001, 6.168/<0.001, .="" there="" was="" no="" significant="" difference="" in="" the="" incidence="" of="" adverse="" reactions="" between="" two="" p="">0.05). Conclusion Civelestat sodium combined with low tidal volume lung protective ventilation can improve the blood gas index of ARDS patients, stabilize hemodynamics, reduce lung injury and inflammatory reaction of the body, thus improving lung function, shortening mechanical ventilation, staying in ICU, and hospitalization time, and has high safety.

Objective To investigate the therapeutic effect of immunomodulator combined with budesonide on chronic obstructive pulmonary disease(COPD) and its influence on airway mucus hypersecretion and prognosis.Methods From September 2019 to September 2021, 80 patients with COPD were selected from the Department of Respiratory and Critical Care Medicine of Sinopharm Tongmei General Hospital. They were randomly divided into control group and research group, with 40 patients in each group. The control group was treated with budesonide, while the study group was treated with budesonide plus immunomodulator. To compare the clinical efficacy of the two groups, pulmonary function indexes [forced expiratory volume in the first second/forced vital capacity(FEV1/FVC), FEV1% of the estimated value(FEV1%), residual volume/total lung volume(RV/TLC)], Treg/Th17 cytokines [interleukin-17(IL-17), transforming growth factor) before and after treatment-β1(TGF-β1), IL-10], airway mucus hypersecretion related indicators [Toll like receptor 4(TLR4), mucin 5AC(MUC5ac), dry/wet proportion of sputum], adverse reactions and prognosis.Results After 4 weeks of treatment, the total effective rate of the study group was higher than that of the control group(95.00% vs.65.00%,χ2=11.250,P=0.001). FEV1/FVC, FEV1% in the study group were higher than those in the control group(t/P=2.498/0.015, 3.177/0.002), and RV/TLC were lower than those in the control group(t=4.557, P<0.001). Study group sputum IL-10, TGF-β1. TLR4 was higher than that in the control group(t=4.514, 9.407, 3.575, P<0.001). The dry/wet specific gravity of IL-17, MUC5ac and sputum in the control group was lower than that in the control group(t=6.232, 4.046, 8.771, P<0.001). there="" was="" no="" significant="" difference="" in="" the="" incidence="" of="" adverse="" reactions="" between="" two="" p="">0.05). Follow up after 12 weeks of treatment showed that the number of acute exacerbations in the study group was less than that in the control group(t=10.849, P<0.001), and the readmission rate was lower than that in the control group(χ2=4.451, P=0.034).Conclusion The combination of immunomodulator and budesonide in the treatment of COPD has a significant effect, which can alleviate the airway mucus hypersecretion, alleviate clinical symptoms, improve immune function, and further improve the prognosis.

Objective To observe the therapeutic effect of Bailing capsule combined with azithromycin on mycoplasma pneumonia in children and its influence on the levels of serum soluble programmed death receptor 1(sPD-1) and cytokine like protein 1(CYTL1). Methods From March 2018 to September 2021, 140 children with mycoplasma pneumonia diagnosed and treated in Pediatric Division II of the Second Affiliated Hospital of Hainan Medical College were selected and divided into the control group and the observation group by random number table method, with 70 cases in each group. The control group was treated with azithromycin, and the observation group was treated with Bailing capsule on the basis of the control group. The total effective rate, symptom improvement time, pulmonary function indexes(FEV1, FVC, FEV1/FVC), blood gas analysis(PaO2, PaCO2, pH, SaO2), inflammatory factors(CRP, IL-6, IL-10, TNF-α) before and after treatment were compared between the two groups-α, immune function indicators [CD4+, CD4+/CD8+, CD3+, immunoglobulin G(IgG)], serum sPD-1, CYTL1 levels, and adverse reactions. Results The total effective rate of the observation group was higher than that of the control group, the difference was statistically significant(82.86% vs.67.14%, χ2=4.809,P=0.028). The cough relief time, blood picture recovery time, antipyretic time and rale disappearance time in the observation group were significantly lower than those in the control group(t=23.253, 14.382, 33.859, 14.960, P<0.001). After 2 weeks of treatment, the levels of FEV1 and FEV1/FVC in the observation group were significantly higher than those in the control group(t=17.305, 8.743, P<0.001). PaO2, pH, SaO2 levels were significantly higher than those in the control group, and PaCO2 levels were significantly lower than those in the control group(t=10.717, 5.435, 7.513, 6.426, all P<0.001). Serum CRP, IL-6, IL-10, TNF-α The level was significantly lower than that of the control group(t=24.031, 7.203, 8.499, 7.743, P<0.001). The levels of CD4+, CD4+/CD8+, CD3+ and IgG in the control group were higher than those in the control group(t=7.130, 4.830, 7.298, 5.698, P<0.001). The level of serum sPD-1 was significantly lower than that of the control group, and the level of CYTL1 was significantly higher than that of the control group(t=10.292, 7.787, P<0.001). there="" was="" no="" significant="" difference="" in="" the="" incidence="" of="" adverse="" reactions="" between="" two="" p="">0.05). Conclusion Bailing capsule combined with azithromycin can significantly improve the clinical efficacy of children with mycoplasma pneumonia, shorten the time for symptom improvement, enhance lung function, improve blood gas analysis indicators, reduce the level of inflammatory factors, improve immune function, reduce the level of serum sPD-1, and increase the level of CYTL1, with good safety.

Objective To analyze the changes of serum myeloid differentiation protein-2(MD-2), eosinophil percentage(EOS%) and their relationship with the characteristics of respiratory tract flora in patients with acute attack of bronchial asthma(AEBA).Methods From August 2020 to February 2022, 94 patients with AEBA admitted to the Department of Respiratory Medicine of the Central Hospital of Eastern Hubei Medical Group/Affiliated Hospital of Hubei Institute of Technology were selected as the observation group, and 94 patients with physical examination in the same period were selected as the health control group. The distribution characteristics of bacteria were determined by sputum culture. Compare the clinical data of patients with gram-negative and gram-positive bacterial infections, compare the levels of serum MD-2 and EOS% in the two groups and AEBA patients with different degrees of illness, analyze the correlation between serum MD-2 and EOS% and the degree of illness by Spearman method, analyze the risk factors of different types of bacterial infections by logistic regression, and evaluate the value of serum MD-2 and EOS% to identify the types of bacterial infections by using the working characteristic curve(ROC) of subjects. Results Among the AEBA patients, 63 were infected with gram-negative bacteria, 26 with gram-positive bacteria, and 5 with gram-negative bacteria and gram-positive bacteria. The proportion of patients with gram-negative bacterial infection and the levels of serum MD-2, EOS% and procalcitonin(PCT) were higher than those with gram-positive bacterial infection, and the score of control was lower than those with gram-positive bacterial infection [χ2(t)/P=1.996/0.046, 4.329/<0.001, 3.663/<0.001, 16.714/<0.001, 3.371/<0.001]. The serum MD-2 and EOS% in the observation group were higher than those in the healthy control group(t/P=21.161/<0.001, 19.288/<0.001). The more severe the condition of AEBA patients, the higher the level of serum MD-2 and EOS%(F/P=21.601/<0.001, 23.783/<0.001). Serum MD-2 and EOS% were positively correlated with the severity of AEBA patients(r/P=0.842/<0.001, 0.846/<0.001). The increase of serum MD-2 and EOS% was a risk factor for postoperative infection of gram-negative bacteria in AEBA patients [OR(95% CI)=2.973(1.268-5.443), 3.411(1.752-6.097)]. The ROC curve analysis showed that the area under the curve(AUC) of serum MD-2, EOS% and their combination to identify the type of bacterial infection in AEBA patients were 0.778, 0.772 and 0.877, respectively. The combined detection of the two indicators was greater than the identification efficiency of individual indicators(Z/P=2.118/0.034, 2.366/0.018). Conclusion The levels of serum MD-2 and EOS% in AEBA patients increased abnormally, and the more severe the disease was, the more obvious the changes were. At the same time, the type of bacterial infection could be identified.

Objective To analyze the effect of antisense RNA 1(lncRNA ROR1-AS1) targeting microRNA-504(miR-504) on the proliferation, migration and invasion of human hepatoma cell line MHCC97H by long chain non-coding RNA tyrosine protein kinase transmembrane receptor 1.Methods The cancer tissues and adjacent tissues of 32 patients with liver cancer were collected from the Department of Hepatobiliary Surgery of the Affiliated Hospital of Inner Mongolia Medical University from June 2019 to May 2021. MHCC97H cells were divided into si-ROR1-AS1 group, si-NC group, miR-504 mimics group, miR-NC group, si-ROR1-AS1+anti-miR-504 group and si-ROR1-AS1+anti-miR-NC group, and the corresponding plasmids were transfected. The expression of ROR1-AS1 and miR-504 in tissue samples and cells was detected by qRT-PCR. Cell proliferation was detected by clonogenic assay and MTT assay. Transwell detected cell migration and invasion. The levels of cyclin-dependent kinase inhibitor 1A(p21), matrix metalloproteinase-2(MMP-2), MMP-9 and E-cadherin were detected by Western-blot method. The regulatory relationship between ROR1-AS1 and miR-504 was detected by double luciferase report experiment. Results The level of ROR1-AS1 in cancer tissue of patients with liver cancer was higher than that in paracancerous tissue, and the level of miR-504 was lower than that in paracancerous tissue(t=11.544, 10.905, P<0.001). Compared with si-NC group, the number of MHCC97H cell clones, cell survival rate, number of migrating cells, number of invasive cells, and levels of MMP-2 and MMP-9 in si-ROR1-AS1 group decreased(t=8.978, 9.647, 8.444, 13.282, 10.026, 12.006, P<0.001), and the levels of miR-504, p21, E-cadherin increased(t=10.527, 9.722, 12.901, P<0.001). Compared with the miR-NC group, the number of MHCC97H cell clones, cell survival rate, number of migrating cells, number of invasive cells and the level of MMP-2 and MMP-9 in the miR-504 mimics group decreased(t=8.831, 9.680, 8.187, 12.480, 10.026, 10.954, P<0.001), and the level of p21 and E-cadherin protein increased(t=9.418, 12.614, P<0.001). The double luciferase report experiment showed that ROR1-AS1 could target the regulation of miR-504. Compared with si-ROR1-AS1+anti-miR-NC group, si-ROR1-AS1+anti-miR-504 group increased the number of cell clones, cell survival rate, number of migrating cells, number of invasive cells, and levels of MMP-2 and MMP-9(t=7.064, 7.012, 6.746, 10.222, 7.213, 7.982, P<0.001), while p21 and E-cadherin protein levels decreased(t=4.841, 7.120, P<0.001).Conclusion Interference with the expression of ROR1-AS1 can inhibit the proliferation, migration and invasion of hepatoma MHCC97H cells. The specific mechanism may be related to the targeted miR-504 level.