Objective: lung cancer significantly increases VTE. And VTE increased the risk of perioperative death of lung cancer. This study aimed to explore new risk factors for VTE and establish a staking machine learning model to predict VTE much more precisely. Nine machine learning models were developed.Methods: We retrospectively analyzed patients received surgery with non-small cell lung cancer between January 2018 and November 2022 in our hospital. Patients with complete clinical and pathological data, which can provide analyzable VTE data and factors and epidermal growth factor receptor (EGFR) mutation status were enrolled and randomly divided into training group and test group at a ratio of 7:3. Feature selection was performed using logistic regression. Three most predictive machine learning Classifier were chosen as the first layer of the stacking machine learning model，and logistic regression was chosen as the second layer meta-learning model. Score of the stacking machine learning model by histograms in both testing group and training group. ROC-AUC and Decision curve analysis (DCA) was used to calculate the clinical impact of the stacking machine learning model.Results: PLT count, level of D- Dimers, level of albumin, smoking history and mutation in EGFR 20exon were independent predictive factors for VTE. Based on the multivariable logistic regression analysis, age, PLT count, level of D- Dimers, level of albumin, smoking history and mutation in EGFR 20exon were used to develop the machine learning models, and nine machine learning models were constructed. LGBM Classifier, RandomForest Classifier and GNB were the chosen as the first layer of the stacking machine learning model，and logistic regression was chosen as the second layer meta-learning model. ROC-AUC, accuracy, sensitivity and specificity of the stacking machine learning model in the training set and testing set was 0.984&0.979, 0.949&0.954, 0.935&1.000 and 0.958&0.887, respectively. In the validation test, the final model demonstrated an ROC-AUC 0.983, accuracy of 0.937, and a sensitivity 0.978 with a specificity of 0.947. The decision curve analyses furtherly revealed that the net benefits of the stacking machine learning model for predicting postoperative VTE was very high. And Brier Score of the stacking machine learning model was 0.032.Conclusion: Mutation in EGFR 21exon significantly increase the risk of VTE. And The stacking machine learning model based on EGFR mutation status and clinical characters had a powerful predictive value for postoperative VTE in patients with NSCLC.

目的 研究孤立性肺部小结节病变患者采用CT引导下带钩钢丝定位术实施胸腔镜治疗的临床效果.方法 选择2018年3月-2021年3月在我院进行治疗的60例孤立性肺部小结节病变患者,根据治疗方式的差异,分成对照组和治疗组.对照组中的30例患者单纯实施电视胸腔镜治疗,治疗组中的30例患者接受CT引导下带钩钢丝定位术胸腔镜治疗.对比两组手术操作、术后疼痛消失、术后住院时间、操作期间出血量、术后不良反应、中转开胸情况.结果 治疗组患者手术操作、术后疼痛消失、术后住院时间短于对照组;操作期间出血量低于对照组;术后不良反

目的 探讨食管癌术后肺部感染患者血浆肿瘤坏死因子(TNF)基因微卫星多态性及其与预后的关系.方法 选取2018年1月-2020年9月邢台市人民医院食管癌术后继发肺部感染患者115例为感染组,系统抽样选取同期食管癌根治术未发生感染患者148例为对照组.根据肺部感染患者预后情况分为生存组88例和病死组27例.采用聚合酶链式反应进行DNA扩增,聚丙烯酰胺凝胶电泳-银染技术进行微卫星分型.结果 感染组携带TNF c 1/1基因型的频率为39.13％ 高于对照组(P<0.05),携带TNF c 1等位基因的频率为63.04％ 高于对照组(P<0.05);肺部感染患者中病死组携带TNF c 1/1基因型的频率为59.26％ 高于生存组(P<0.05),携带TNF c 1等位基因的频率为75.93％ 高于生存组(P<0.05);低蛋白血症、血液高凝状态、携带TNF c 1/1基因型是导致患者预后不良的危险因素(P<0.05).TNF c 1/1基因型患者住院时间长于TNF c 1/2基因型、TNF c 2/2基因型(P<0.05).结论 TNF基因微卫星多态性与食管癌术后肺部感染及其预后有关,TNF c 1/1基因型可能增加肺部感染易感性,并且导致不良预后.

目的 探讨胸腔镜辅助肋骨骨折内固定手术时机对术后呼吸衰竭的影响.方法 回顾性分析2008年10月—2017年6月我院收治的221例多发肋骨骨折患者的临床资料.根据患者伤后进行手术的时间分为A组82例、B组74例和C组65例,A组伤后<72 h进行手术,B组伤后72～120 h进行手术,C组伤后≥120 h进行手术.观察3组术后呼吸衰竭发生率的差异,并分析术后发生呼吸衰竭的相关影响因素.结果 A组术后呼吸衰竭的发生率高于B组和C组(P<0.01),B组和C组比较差异无统计学意义(P>0.05).年龄、手术时间、肋骨骨折根数、胸部简略创伤量表评分、损伤严重程度评分、手术时机、肺挫伤简易评分为多发肋骨骨折患者术后发生呼吸衰竭的独立影响因素(P<0.05).结论 受伤72 h后手术可显著降低肋骨骨折内固定术后呼吸衰竭的发生率,手术时机是术后发生呼吸衰竭的独立影响因素.

目的 探讨血清载脂蛋白E(apolipoprotein E,ApoE)、降钙素原(procalcitonin,PCT)及脑钠肽(brain natriuretic peptide,BNP)对医院获得性肺炎(hospital acquired pneumonia,HAP)诊断及预后评估的价值.方法 选取2015年7月—2018年4月我院ICU收治的144例患者为研究对象,根据在入住ICU期间是否发生HAP分为HAP组(79例)与非HAP组(65例),对比2组患者ApoE、PCT及BNP水平.根据肺炎严重指数(pneumonia severity index,PSI)评分将79例HAP患者分为低危组、中危组及高危组;根据HAP患者30 d存活情况分为存活组与死亡组,然后对不同病情程度、不同预后患者的ApoE、PCT及BNP水平进行对比.结果 HAP组的ApoE、PCT及BNP水平显著高于非HAP组(P均<0.05);不同病情程度HAP患者之间ApoE、PCT、BNP水平及PSI评分对比存在显著差异(P均<0.05),其中高危组高于中危组与低危组,中危组高于低危组;死亡组的ApoE、PCT及BNP水平显著高于存活组(P均<0.05).结论 ApoE、PCT及BNP在HAP患者中的水平高于非HAP患者,且随着患者病情的加重而升高,对HAP患者的病情判断及预后评估具有一定的参考价值.

目的 探讨丹参川芎嗪联合泼尼松在肺间质纤维化患者中的应用效果及对炎症因子的影响.方法 选取2016年2月-2018年4月我院收治的肺间质纤维化患者81例,随机分为对照组与研究组.对照组40例,应用泼尼松治疗;研究组41例,应用丹参川芎嗪联合泼尼松治疗.1周为1个疗程,2组均连续治疗8个疗程.比较2组患者临床疗效、炎性因子TGF-β1(转移生长因子)、IL-18(白细胞介素-18)、IL-13(白细胞介素-13)浓度、肺功能、抗氧化因子CAT(过氧化氢酶)、LPO(脂质过氧化物)、GSH-PX(谷胱甘肽过氧化酶)浓度、血气指标PaO2(血氧分压)、PaCO2(动脉血二氧化碳分压)、pH.结果 研究组有效率为95.2％,优于对照组的67.5％(P<0.05);治疗后研究组炎性因子TGF-β1、IL-18、IL-13浓度低于对照组(P<0.05);治疗后研究组肺功能优于对照组(P<0.05);治疗后研究组抗氧化因子CAT、GSH-PX浓度高于对照组(P<0.05),LPO抗氧化因子浓度低于对照组(P<0.05);治疗后研究组血气指标PaO2、pH高于对照组(P<0.05);PaCO2低于对照组(P<0.05).结论 在肺间质纤维化患者的治疗过程中,泼尼松降低了患者炎性因子浓度、抑制巨噬细胞的产生、降低免疫应答反应与气道炎性反应,丹参川芎嗪提高了患者的血氧分压,改善低氧,缓解呼吸困难,恢复肺部功能,减轻炎性反应,控制病情发展.

目的:探讨沙美特罗替卡松粉吸入剂联合丹参川芎嗪注射液治疗肺间质纤维化的疗效及对患者生活质量的影响.方法:选取2016年5月至2018年3月邢台市人民医院收治的肺间质纤维化患者98例,按照随机数字表法分为观察组和对照组,每组49例.对照组患者给予沙美特罗替卡松粉吸入剂治疗,观察组患者在对照组的基础上加用丹参川芎嗪注射液.观察两组患者的临床疗效,治疗前后的肺功能指标改善情况、血气指标[血氧分压(PaO2)、血二氧化碳分压(PaCO2)]水平、肿瘤坏死因子α(TNF-α)水平、转化生长因子-β1(TGF-β)水平及生活质量评分.结果:观察组患者的总有效率为85.7％(42/49),明显优于对照组的71.4％(35/49),差异有统计学意义(P<0.05);治疗后,观察组患者肺功能指标水平改善情况明显优于对照组;PaO2水平明显高于对照组,PaCO2水平明显低于对照组;血清TNF-α、TGF-β1水平明显低于对照组;心理状况、活动受限及症状评分明显低于对照组,上述差异均有统计学意义(P<0.05).结论:沙美特罗替卡松粉吸入剂联合丹参川芎嗪注射液治疗肺间质纤维化的疗效理想,可改善患者生活质量.

Objective To study the application of regional localization method in the thoracoscopic resection of small pulmonary nodule.Methods Sixty-eight cases of small pulmonary nodules were located by applying the small pulmonary nodules regional localization method,and the clinical effect was intraoperatively observed.The ROC curve was used to find the best node for the nodule maximum diameter and minimum distance from the pleural.Results The once successful localization was obtained in 65 cases with the success rate of 95.6％.The best node of the maximum diameter of small pulmonary nodules was 1.0 cm,and the shortest distance from the pleura was 1.3 cm.Conclusion The regional localization method in the thoracoscopic resection of small pulmonary nodule has high accuracy.

Objective To investigate the effect of selective cyclooxygenase (COX-2) inhibitor celecoxib on the expression of COX-2,motor function and learning and memory after traumatic brain injury in rats.Methods The mice were divided into control group,sham operation group,model group and experimental group.The model of closed craniocerebral trauma was established by Marmarou method,the control group did not receive any treatment.The experimental group was given 250 mg· kg-1 celecoxib,intraperitoneal injection immediately after injury,and every 6 h a time.The control group,sham operation group and model group were injected intraperitoneally with the same amount of 0.9％ NaC1.Real-time quantitative polymerase chain reaction (qPCR) was used to detect the expression of COX-2 mRNA,Western blot and immunohistochemical staining were used to detect the expression of COX-2 protein,the neurological impairment score (NSS) was used to measure motor function after trauma in rats,Morris water maze test to test the learning and memory function.Results The relative expression of COX-2 mRNA in control group,sham operation group,model group and experimental group were 1.10 ±6.96,1.27 ±2.10,2.18 ±5.24 and 1.69 ±4.62,there was significant difference between model group and experimental group (P ＜ 0.05).Western blotting showed that the expression of COX-2 protein in control group,sham operation group,model group and experimental group were 0.88 ± 3.26,0.93 ± 2.25,2.26 ± 1.43 and 1.65 ± 4.62,there was significant difference between model group and experimental group (P ＜ 0.05).Immunohistochemical staining showed that the expression of COX-2 in control group,sham operation group,model group and experimental group were 68.53 ±2.66,70.05 ±3.10,97.38 ±6.14,80.40 ±7.32,there was significant difference between model group and experimental group (P ＜ 0.05).The NSS of control group,sham operation group,model group and experimental group were 0.96 ± 0.37,1.13 ± 0.24,16.26 ± 4.56,7.97 ±3.49,there was significant difference between model group and experimental group (P ＜0.05).The time required for the search platform in control group,sham operation group,model group and experimental group on 11 d after traumatic brain injury were (28.25 ±9.10),(27.35 ± 10.32),(57.36 ± 18.20),(57.21 ±20.38) s.There was significant difference between model group and experimental group (P ＜ 0.05).Conclusion Celecoxib can reduce the inflammatory response after craniocerebral injury by specific inhibition of COX-2,and further improve the motor and learning and memory dysfunction after craniocerebral trauma in rats.

目的 研究塞来昔布对大鼠颅脑创伤后Fas表达及认知功能的影响,探讨其对颅脑创伤后神经的保护作用及其机制.方法 96只Wistar大鼠随机分为对照组、假手术组、模型组和药物组,参照Marmarou方法构建大鼠闭合型脑创伤模型,采用实时荧光定量PCR和免疫组织化学法分别检测Fas、Caspase-8的mRNA和蛋白表达,TUNEL法检测神经细胞凋亡情况,Y型迷宫实验检测大鼠认知功能.结果 模型组较对照组、假手术组Fas、Caspase-8的mRNA和蛋白表达均显著增高(P＜0.05);药物组较模型组Fas、Caspase-8的mRNA和蛋白表达均显著降低(P＜0.05),但仍高于对照组和假手术组(P＜0.05).模型组较对照组、假手术组凋亡细胞显著增多(P＜0.05);药物组较模型组凋亡细胞数显著减少(P＜0.05),但仍高于对照组和假手术组(P＜0.05).模型组较对照组、假手术组大鼠记忆成绩次数明显减少(P＜0.05),药物组较模型组大鼠记忆成绩次数明显增加(P＜0.05),但仍低于对照组与假手术组(P＜0.05).结论 塞来昔布通过下调颅脑创伤后Fas介导的凋亡程序,以发挥对大鼠颅脑创伤后神经元的保护作用,并改善大鼠的认知功能.

Objective To investigate effect of thoracoscope-assisted internal fixation in treatment of multiple rib fractures. Methods A total of 96 patients with multiple rib fractures during January 2013 and December 2016 were di-vided into observation group(n=52) and control group(n=44) according to operative methods. Observation group was given thoracoscope-assisted internal fixation,while control group was given traditional open chest of internal fixation. In two groups,changes of intraoperative and postoperative conditions and high sensitivity C reaction protein(hs-CRP) levels were observed,and incidence rate of complications was compared. Results In observation group,intraoperative blood loss volume and postoperative drainage volume were less(P<0.01),and operative time,pain time,out-of-bed activity time and hospitalization time were shorter,and values of hospitalization expenses and hs-CRP level were lower than those in control group (P<0.05, P<0.01). Incidence rate of postoperative complications in observation group was signifi-cantly lower than that in control group (P<0.05). Conclusion Thoracoscope-assisted internal fixation in treatment of multiple rib fractures can reduce intraoperative injury and incidence rate of postoperative complications.

目的 探讨术前外周血血小板/淋巴细胞比值(PLR)对食管癌患者预后的影响.方法 回顾性分析该院胸外科142例行食管癌根治术患者的临床资料,根据患者术前外周血血小板/淋巴细胞比值分为低PLR组(PLR＜250)和高PLR组(PLR≥250),采用单因素和COX回归模型分析两组患者的PLR及其他临床病理因素与5年生存率的关系.结果 低PLR组患者的5年生存率高于高PLR组(68.6％ vs.46.7％;P＝0.031);在晚期食管癌患者中,低PLR组5年生存率高于高PLR组(47.4％ vs.25.1％,P=0.016),而早期食管癌中两组差异无统计学意义(P＞0.05).单因素分析显示肿瘤位置、肿瘤浸润深度、淋巴结转移、肿瘤分期、术前PLR对食管癌患者5年生存率有影响;多因素分析显示PLR是影响食管癌预后的独立危险因素(RR:2.214;95％ CI:1.006～4.862;P=0.047).结论 术前PLR对食管癌预后具有一定预测作用,可能作为一项食管癌预后的预测指标.

目的 探讨电视胸腔镜手术(VATS)在胸部刀刺伤中的应用价值.方法 回顾性分析我院2012 ～ 2015年22例胸部刀刺伤行VATS诊治的临床资料.其中男20例、女2例,年龄26.5 (17～48)岁.结果 行VATS 18例,肺破裂修补12例,出血血管钛夹、电凝止血4例,肺破裂及膈肌破裂修补2例;辅助小切口手术2例,肋间动脉缝扎止血1例,膈肌修补1例;中转开胸行心室壁修补术1例,胸腔镜下膈肌破裂修补合并开腹行肝破裂修补术1例.全组无手术死亡,无术后严重并发症.结论 VATS安全、有效、创伤小,早期应用有助于降低胸部刀刺伤患者的死亡风险.

Aim To investigate the effects of celecoxib on cyclooxygenase-2(COX-2) and caspase-9 expression and motor function after traumatic brain injury in rats.Methods The rats were divided into control group, sham operation group, trauma group and treatment group.The model of closed craniocerebral trauma was established by Marmarou method, the gene expression of COX-2 and Caspase-9 was detected by real-time quantitative PCR(qPCR), the protein expressions of COX-2 and Caspase-9 were detected by immunohistochemical staining, and the motor function of the rats was evaluated by the neurological impairment score(NSS).Results The gene and protein expression of COX-2 and Caspase-9 in traumatic group was significantly higher than in other three groups (P<0.05), the expression of COX-2 and Caspase-9 in treatment group was significantly lower than in traumatic group(P<0.05), but still higher than the sham operation group and the normal group(P<0.05);compared with the trauma group, the motor function of the treatment group could be effectively improve (P<0.05), but compared with the control group and the sham operation group, the difference was statistically significant(P<0.05).Conclusion Celecoxib can reduce the inflammatory response after craniocerebral injury by specific inhibition of COX-2, and further reduce the expression of Caspase-9, thereby reducing the apoptosis of nerve cells, and improving motor function after traumatic brain injury in rats.

Objective To study the effect of celecoxib on learning and memory function,cyclooxygenase(COX-2) and the apoptotic protease-activating factor-1(Apaf-1) protein expression after traumatic brain injury in rat.Methods A total of 72 adult male Wistar rats were equally and randomly divided into the normal control group,sham operation group,trauma group and Celecoxib treatment group.Postoperative 72 h-reperfusion was performed for taking brain specimens.The immunohistochemical method and Western blot were used to respectively detect COX-2 and Apaf-1 protein expression change;the Morris water maze test was adopted to detect the learning and memory function on preoperative 5 d and at postoperative 72 h.Results The COX-2 and Apaf-1 protein expression in the trauma group was significantly higher than that in other groups (P＜0.05),and the protein expression in the treatment group and trauma group was decreased,but still higher than that in the sham operation group and normal group(P＜ 0.05);in the Morris water maze test,the prolongation of escape latency time in the trauma group was maximal among 4 groups (P ＜0.05),but the treatment group had a shorter time compared with the trauma group (P＜0.05).Conclusion Craniocerebral trauma can cause different degrees of learning and memory dysfunction,and COX-2 inhibitor celecoxib can downregulate the expression of COX-2 and Apaf-1 protein,inhibit inflammation reaction and cellular apoptosis,and improve the learning and memory dysfunction after traumatic brain injury.

Objective To investigate the effects of celecoxib (selective cyclooxygenase-2 inhibitor) on the expression of Bcl-2 and Bax in rat brain after severe craniocerebral injury in rats.Methods SD rats were randomly divided into four groups:experimental group,model group,sham operation group and control group.The rats in experimental group and model group were established with closed craniocerebral injury model.In the experimental group,intraperitoneal injection of celecoxib (250 mg · kg-1) was performed immediately after the craniocerebral injury model was established.The rats in sham operation group and the control group were given the same amount of 0.9％ NaCl intraperitoneally.The expressions of Bcl-2 and Bax mRNA and protein were detected by immunohistochemical staining.Results The expression of Bcl-2 protein in the experimental group,model group,sham-operated group and control group were 68.75 ± 0.62,45.40 ± 0.36,81.08 ± 0.65,78.12 ±0.05.The expression of Bcl-2 in the model group was significantly lower than in sham-operated group and control group with significantly (P ＜ 0.05).Compared with the model group,the expression of Bcl-2 in the experimental group decreased with significantly (P ＜ 0.05).The expression of Bax protein in experimental group,model group,sham operation group and control group respectively were 68.28 ±0.35,92.48 ±0.16,65.06 ±0.63,63.15 ±0.10.The expression of Bax in model group was significandy higher than in sham-operated group and control group with significantly (P ＜ 0.05).Compared with the model group,the expression of Bax in the experimental group decreased with significantly(P ＜ 0.05).Conclusion Celecoxib can increasing the expression of Bcl-2,decreasing the expression of Bax,inhibiting the apoptosis of neurons after raniocerebral injury,has a protective effect on the traumatic brain injury in rats.

Objective To investigate the expression of MT-3 gene in esophageal squamous cell carcinoma and its relationship with postoperative pathology and patient's prognosis.Methods A retrospective study was performed in 96 patients with esophageal squamous cell carcinoma who received surgical resection in our hospital from 2009 to 2011.Immunohistochemical staining was used to detect the expression of MT-3 gene in tumor tissues.The χ2 test was used to evaluate the correlation, and Kaplan-meier method was used to analyze survival rate,moreover,Log-rank test was used to determine survival difference.The Cox regression analysis was performed to determine the independent prognostic risk factors.Results Among 96 specimens,there were 41 cases of positive expression of MT-3 gene,accounting for 41.28%.The negative expression of MT-3 in esophageal squamous cell carcinoma was closely correlated with tumor differentiation,T staging and lymph node metastasis (P<0.05 or P<0.01).Among 96 patients,the 3-year survival rate accounted for 45.9%,in which the patients with negative expression of MT-3 gene accounted for 20.1%,and the patients with positive expression of MT-3 gene accounted for 52.6%,there was a significant difference between them (P<0.05).Cox regression analysis showed that tumor differentiation degree,lymph node metastasis and negative expression of MT-3 gene were prognostic risk factors in patients with esophageal carcinoma in middle thoracic esophagus after surgery.Conclusion The expression levels of MT-3 gene are decreased in middle thoracic esophageal carcinoma,which is correlated with tumor differentiation degree, T staging and lymph node metastasis.The 3-year survival rate in patients with positive expression of MT-3 gene is significantly higher than that of patients with negative expression of MT-3 gene.Therefor MT-3 gene may be used as a molecular marker for evaluating the postoperative prognosis of patients with esophageal squamous cell carcinoma.

Objectve To investigate the effect of celecoxib on the expression of Survivin and neuronal apoptosis after traumatic brain injury in rats,and to explore its brain protection mechanism.Methods The 64 SD rats were randomly divided into four groups:normal group,sham operation group,model group and experimental group.The rats in experimental group and model group were established with closed craniocerebral injury model by free falling method.In the experimental group,intraperitoneal injection of celecoxib (250 mg · kg-1) was performed immediately after the craniocerebral injury model was established.The rats in sham operation group and the normal group were given the same amount of 0.9％ NaC1 intraperitoneally.The expressions of Survivin and Caspase-3 were detected by immunohistochemistry.The neuronal apoptosis was detected by TdT-mediated dUTP-biotin nick end labeling(TUNEL) method.Results The expression of Survivin protein in the normal group,sham-operated group,model group,and experimental group were 3.19 ± 1.43,5.34 ± 1.26,14.17 ±0.54,27.76 ±0.70.The expression of Casepse-3 protein in above four groups were 1.19 ±0.51,3.19 ±0.71,11.17 ±3.74,6.30 ±2.80.The expression of Survivin in the model group was significantly higher than in normal group and sham-operated group with significantly (all P ＜ 0.05).Compared with the model group,the expression of Survivin and Caspase-3 in the experimental group increased with significantly (all P ＜0.05).The number of apoptotic cells in 6,12,24,72 h in the sham-operated group,model group,and experimental group were 2.84 ± 0.56,12.17 ± 1.74,5.36 ± 0.80;3.19 ± 0.71,33.17 ± 3.74,26.30 ± 2.80;5.34 ± 0.83,72.57 ± 6.74,58.48 ± 4.50;2.44 ± 0.83,61.28 ± 5.36,42.56 ± 4.63.The number of apoptotic cells in the model group was significantly higher than in sham-operated group with significantly (all P ＜ 0.05).Compared with the model group,the number of apoptotic cells in the experimental group decreased with significantly (all P ＜ 0.05).Conclusion Celecoxib may inhibit Caspase-3 activation-mediated apoptosis by increasing the expression of anti-apoptotic Survivin protein.In order to reduce the neuronal apoptosis after traumatic brain injury,and play a protective role in the brain.

Objective To investigate the effect of selective cyclooxygenase (COX-2) inhibitor celecoxib on the expression of Bcl-2 and learning and memory function after traumatic brain injury in rats.Methods The experiment was divided into control group,sham operation group,brain trauma group and treatment group.Marmarou method was used to establish the closed craniocerebral trauma model in rats.Real-time quantitative PCR(qPCR) was used to detect mRNA expression,the protein expression was detected by immunohistochemistry,TUNEL staining was used to detect cells apoptosis,Morris water maze test was used to test learning and memory function.Results The expression of COX-2 in brain trauma group was significantly higher than in other three groups (P ＜ 0.05).Compared with brain trauma group,the treatment group can effectively reduce the expression of COX-2 (P ＜ 0.05).The expression of Bcl-2 in brain trauma group was significantly lower than that in other three groups (P ＜ 0.05).Compared with the brain trauma group,the treatment group can effective increased the expression of COX-2 (P ＜ 0.05).The number of TUNEL positive cells in brain trauma group was significantly higher than other groups(P ＜ 0.05),and the number of positive cells in the treatment group was significantly lower than the brain trauma group (P ＜ 0.05).Brain trauma group search platform time was longer than other groups (P ＜ 0.05).Compared with the traumatic group,the time required for the search platform to be effectively reduced in treatment group(P ＜ 0.05).Conclusion Celecoxib,as a specific inhibitior of COX-2,reduce the inflammatory response after craniocerebral trauma,increase the expression of Bcl-2,thereby inhibiting cell apoptosis,play a protective role in the brain,and improve its learning and memory dysfunction after trauma.

Objective To investigate effects of celecoxib on the expression of cyclooxygenase-2 (COX-2), apoptotic protease activation factor-1 (Apaf-1) and function of mobility in rat model of severe craniocerebral trauma. Methods For?ty-eight adult male Wistar rats were randomly divided by random number table into four groups. Normal group was given no manipulation. Sham group was given scalp incision and sutured. The severe closed craniocerebral injury model was estab?lished via Foda method in rats of injury group. Treatment group was given intraperitoneal injection of celecoxib [ 250 mg/(kg·6 h)] on the basis of injury group. The intraperitoneal injection of same volume of normal saline was given in the other three groups. Samples were taken altogether after 72 hours. Changes of COX-2 and Apaf-1 were detected by immunohistochemis?try and Western blot assay. Ten days after the restoration, six rats were taken from each group for assessing neurological im?pairment scale (NSS). Results The expression levels of COX-2 and Apaf-1 were significantly higher in injury group than those of other groups. The expression levels of COX-2 and Apaf-1 were significantly lower in treatment group than those of injury group but the levels were significantly higher than those of sham group and normal group (P < 0.05). NSS scores showed that rats in treatment group improved mobility compared with that of injury group (P<0.05), but there was difference compared with Sham group and control group (P<0.05). Conclusion Celecoxib, with its specific inhibitoty effect on pro?tein COX-2, can effectively reduce inflammatory reactions lower the expression of Apaf-1 and reduce apoptosis of neurons, improving the prognosis of dysfunction of mobility after craniocerebral injury.