摘要：Immune evasion behavior and immunosuppressive characteristics of tumor extensively impedethe immune initiation effect of therapy triggered immunogeniccell death (ICD). In this work, a carrier-adjuvantedimmunostimulator (designated as CoCeC) is developed toboost photodynamic immunotherapy by downregulatingprogrammed death ligand 1 (PD-L1) and impairing adenosinetriphosphate (ATP) hydrolysis. Among these, the crosslinkedchitosan oligosaccharide is applied as the drug carrier fordelivery of Ce6 and Ceritinib, which also serves as an immuneadjuvant to downregulate PD-L1. Meanwhile, the robustphotodynamic therapy (PDT) of CoCeC exhibits lethal toxicityagainst tumor cells to induce ICD and release damage-associated molecular patterns (DAMPs), which can also impairATP hydrolysis by blocking CD39. In vitro and in vivo resultsdemonstrate the robust therapeutic efficacy of CoCeC tosuppress primary tumor growth and activate a superior immune elimination against lung metastasis by amplifying theimmune initiation of ICD with the assistance of immune *** work provides a self-adjuvanted strategy to enhance the immune response of therapy induced ICD, which ispromising to activate systemic antitumor immunity in consideration of the complicated immunosuppressive factors.

摘要：Cough is a defensive behavior that protects the respiratory system from infection and clears airway *** airflow dynamics have been analyzed by a variety of mathematical and experimental *** this paper,the cough airflow dynamics of 42 subjects were obtained and *** identification model based on piecewise Gauss function for cough airflow dynamics is proposed through the dimensionless method,which could achieve over 90%identification ***,an assisted cough system based on pneumatic flow servo system is *** vacuum situation and feedback control are used to increase the simulated peak cough flow rate,which are important for airway secretion clearance and to avoid airway collapse,*** simulated cough peak flow could reach 5 L/s without the external assistance such as manual pressing,patient cooperation and other ***,the backstepping control is developed to generate a simulated cough airflow that closely mimics the natural cough airflow of *** assisted cough system opens up wide opportunities of practical application in airway secretion clearance for critically ill patients with COVID 2019 and other pulmonary diseases.

摘要：Background Chronic obstructive pulmonary disease(COPD)is a severe public health *** smoke(CS)is a risk factor for COPD and lung *** underlying molecular mechanisms of CS-induced malignant transformation of bronchial epithelial cells remain *** this study,we describe a lung-on-a-chip to explore the possible mechanistic link between cigarette smoke extract(CSE)-associated COPD and lung *** An in vitro lung-on-a-chip model was used to simulate pulmonary epithelial cells and vascular endothelial cells with *** levels of IL-6 and TNF-αwere tested as indicators of inflammation using an enzyme-linked immune sorbent *** junction complex mRNA expression was detected with qRT-PCR as the index of epithelial-to-mesenchymal transition(EMT).The effects of CSE on the phosphorylation of signal transduction and transcriptional activator 3(STAT3)were detected by Western *** cytometry was performed to investigate the effects of this proto-oncogene on cell cycle *** Inflammation caused by CSE was achieved in a lung-on-a-chip model with a mimetic *** exposure induced the degradation of intercellular connections and triggered the EMT *** exposure also activated the phosphorylation of proto-oncogene STAT3,while these effects were inhibited with *** CSE exposure in the lung-on-a-chip model caused activation of STAT3 in epithelial cells and endothelial ***0152,an inhibitor of activated STAT3,could be a potential treatment for CS-associated COPD and lung cancer.

摘要：背景:海地一家自服药结核病诊所。 目的:探讨在发展中国家,是否只有采用直接观察下的治疗才能帮助解决服药顺从性问题。 设计:把病人随机分为3组:A组:从药品监察器取药品,并在监察记录上给予忠告;B组:从药品监察器取药品,在记录上未得到忠告;C组:从简单的容器中取药。 结果:在前11周,监察记录良好是已经预料到的,治疗丢失者很少(P<0.01),并且在后9个月中,顺从性很好(P<0.01)。研究表明,在监察记录上给予忠告可使放弃治疗者减少约一半。 结论:本研究提示,在不能全程实行直接观察下治疗的地区,对自服药的药品监察是有效的,特别是在农村地区。其用处为:1)明确地鉴定出治疗顺从性差的病人;2)减少诊所对服药监察记录良好,居住远离诊所病人的访视频度;3)把监察记录告知病人,以改善治疗顺从性;4)当发现不合作时,可以延长其治疗期。

摘要：目的确定皮质激素是否可有效预防成年危重症患者拔管后喉部水肿，并降低因喉部水肿导致的再插管。设计荟萃分析。数据来源：检索数据库PubMed，Cochrane Controlled Trials Register，Web of Science，and Embase，对语言、研究时间和发表状态没有限制。选择标准关于静脉使用皮质激素预防成年患者拔管后并发症的随机、安慰剂对照研究。回顾方法检索并根据纳入和排除标准选择文献、提取数据、评估方法学的可靠性，然后进行独立分析并重复。汇总分析数据得到优势比和95％可信区间，风险差异和需治数。研究终点：主要终点：拔管后发生喉部水肿。次要终点：由于喉部水肿导致的再插管。结果6项临床研究纳入分析（n=1923）。与安慰剂组相比，拔管前应用激素可降低喉部水肿（OR=0．38，95％可信区间为0．17～0．85）和再插管（OR=0．29，95％可信区间为0．15～0．58）的发生率，相应的风险差异分别为-0．10（-0．12～-0．07；需治数为10）和-0．02（-0．04～-0．01;需治数为50）。亚组分析显示，多次给药可明显降低喉部水肿（OR=0．14，95％可信区间为0．08～0．23）和再插管（OR=0．19，95％可信区间为0．07～0．50）的发生率，相应的风险差异分别为-0．19（-0．24--0．15；需治数为5）和-0．04（-0．07--0．02；需治数为25）。单次给药只发现有降低喉部水肿和再插管发生率的趋势，可信区间包含1。没有报道激素相关的副作用。结论成年患者拔管前预防性多次给予皮质激素可降低拔管后喉部水肿和因其所致再插管的发生率，且很少引发不良事件。