Recent Advances in Bronchopulmonary Dysplasia Protection and Therapy

For preterm infants, bronchopulmonary dysplasia (BPD) is usually caused by abnormal lung development due to various factors during prenatal and postnatal process. One of the reasons for death and bad prognosis of preterm infants is to have BPD. Up to now, there are no unified strategies or drugs to treat BPD. In clinical, many intervention treatments have been applied to achieve BPD therapy, mainly including preterm protection, protective ventilation strategies, and delivery of corticosteroids, pulmonary vasodilators, and antioxidants. This review summarizes the current advances in BPD protection and treatment, and notes that gut microbiota and mesenchymal stem cells (MSCs) can be the promising strategy for protecting and treating BPD in the future.

Molecular Epidemiology and Clinical Characteristics of Hand, Foot and Mouth Disease in North Sichuan Region, China, 2018-2023: A Descriptive Study

Background: Hand, foot and mouth disease (HFMD) remains an important public health problem in China. Many studies on the epidemiological characteristics of HFMD have been reported, but studies in North Sichuan region have been neglected. Methods: HFMD-related enterovirus infected cases were clinically confirmed and underwent real-time RT-PCR (rRT-PCR) from May 2018 to October 2023 in Guangyuan Central Hospital. Results: During 2018-2023, other EV (437 cases, 81.08%) was the most predominant serotype followed by CV-A16 (94 cases, 17.44%), EV-A71 (8 cases, 1.48%) was the least predominant serotype. Peak infections occurred in July and October. There were no significant differences in gender, age and serotypes. HFMD was concentrated in children under 47 months of age, with the highest incidence in children aged 12 - 23 months and the highest proportion of other EV infections in the whole age group. COVID-19 did not cause significant changes in gender, age and serotype. Overall, there was a significant increase in the proportion of children aged 12 - 23 months infected with CV-A16, and an increase in the proportion of children aged over 36 months infected with other EVs. Conclusions: The incidence of HFMD caused by EV-A71 has decreased significantly, and other EVs have become the main pathogens of HFMD in North Sichuan region in recent years. In the prevention and control of CV-A16, more attention should be paid to children aged 12 - 23 months and the dominant serotype should be closely monitored. Our study highlights the importance of developing of new diagnostic reagents and vaccines for the prevention and control of enterovirus infection. This study for the first time provides insights into district interventions to local conditions.

Boron-doped high-entropy oxide toward high-rate and long-cycle layered cathodes for wide-temperature sodium-ion batteries

03-type layered metal oxides hold great promise for sodium-ion batteries cathodes owing to their energy density advantage.However,the severe irreversible phase transition and sluggish Na^(+)diffusion kinetics pose significant challenges to achieve high-performance layered cathodes.Herein,a boron-doped03-type high entropy oxide Na(Fe_(0.2)Co_(0.15)Cu_(0.05)Ni_(0.2)Mn_(0.2)Ti_(0.2))B_(0.02)O_(2)(NFCCNMT-B_(0.02))is designed and the covalent B-O bonds with high entropy configuration ensure a robust layered structure.The obtained cathode NFCCNMT-B_(0.02)exhibits impressive cycling performance(capacity retention of 95%and 82%after100 cycles and 300 cycles at 1 and 10 C,respectively)and outstanding rate capability(capacity of 83 mAh g^(-1)at 10 C).Furthermore,the NFCCNMT-B_(0.02)demonstrates a superior wide-temperature performance,maintaining the same capacity level(113,4 mAh g^(-1)@-20℃,121 mAh g^(-1)@25℃,and 119 mAh g^(-1)@60℃)and superior cycle stability(90%capacity retention after 100 cycles at 1 C at-20℃).The high-entropy configuration design with boron doping strategy contributes to the excellent sodium-ion storage performance.The high-entropy configuration design effectively suppresses irreversible phase transitions accompanied by small volume changes(ΔV=0.65 A3).B ions doping expands the Na layer distance and enlarges the P3 phase region,thereby enhancing Na^(+)diffusion kinetics.This work offers valuable insights into design of high-performance layered cathodes for sodium-ion batteries operating across a wide temperature.

Development and performance evaluation of high temperature resistant strong adsorption rigid blocking agent

As drilling wells continue to move into deep ultra-deep layers,the requirements for temperature resistance of drilling fluid treatments are getting higher and higher.Among them,blocking agent,as one of the key treatment agents,has also become a hot spot of research.In this study,a high temperature resistant strong adsorption rigid blocking agent(QW-1)was prepared using KH570 modified silica,acrylamide(AM)and allyltrimethylammonium chloride(TMAAC).QW-1 has good thermal stability,average particle size of 1.46μm,water contact angle of 10.5.,has a strong hydrophilicity,can be well dispersed in water.The experimental results showed that when 2 wt%QW-1 was added to recipe A(4 wt%bentonite slurry+0.5 wt%DSP-1(filtration loss depressant)),the API filtration loss decreased from 7.8to 6.4 m L.After aging at 240.C,the API loss of filtration was reduced from 21 to 14 m L,which has certain performance of high temperature loss of filtration.At the same time,it is effective in sealing 80-100mesh and 100-120 mesh sand beds as well as 3 and 5μm ceramic sand discs.Under the same conditions,the blocking performance was superior to silica(5μm)and calcium carbonate(2.6μm).In addition,the mechanism of action of QW-1 was further investigated.The results show that QW-1 with amide and quaternary ammonium groups on the molecular chain can be adsorbed onto the surface of clay particles through hydrogen bonding and electrostatic interaction to form a dense blocking layer,thus preventing further intrusion of drilling fluid into the formation.

Predictors of Adverse Pregnancy Outcomes Following Traumatic Injuries

Objective After traumatic injury in pregnant women,providing timely and appropriate management for high-risk patients is crucial for both pregnant women and fetuses.This study aimed to identify risk factors that predict adverse pregnancy outcomes after traumatic injury.Methods A retrospective cohort study including 317 pregnant patients who experienced trauma was conducted.The collected data included general demographics,injury mechanisms and adverse pregnancy outcomes.Patients were divided into two subgroups based on the absence or presence of trauma-related adverse pregnancy outcomes.Univariate and multivariate logistic regressions were conducted to estimate the associations between clinical variables and adverse pregnancy outcomes.Results A total of 41(12.93%)patients experienced adverse pregnancy outcomes within the first 24 h post-trauma.This study revealed that age>35 years(OR=14.995,95%CI:5.024–44.755,P<0.001),third trimester trauma(OR=3.878,95%CI:1.343–11.204,P=0.012),abdominal pain(OR=3.032,95%CI:1.221–7.527,P=0.017),vaginal bleeding(OR=3.226,95%CI:1.093–9.523,P=0.034),positive scan in focused assessment with sonography for trauma(FAST)positive(OR=8.496,95%CI:2.825–25.555,P<0.001),9≤injury severity score(ISS)<16(OR=3.039,95%CI:1.046–8.835,P=0.041)and ISS≥16(OR=5.553,95%CI:1.387–22.225,P=0.015)increased the probability of posttraumatic adverse pregnancy outcomes.Maternal age,gestational age at delivery,vaginal bleeding and positive FAST results were risk factors for abnormal delivery.Conclusion Advanced maternal age,third trimester,and positive FAST results should alert multidisciplinary trauma teams to closely monitor patients to prevent adverse pregnancy outcomes.

Risk factors,prognostic factors,and nomograms for distant metastasis in patients with diagnosed duodenal cancer:A population-based study

BACKGROUND Duodenal cancer is one of the most common subtypes of small intestinal cancer,and distant metastasis(DM)in this type of cancer still leads to poor prognosis.Although nomograms have recently been used in tumor areas,no studies have focused on the diagnostic and prognostic evaluation of DM in patients with primary duodenal cancer.AIM To develop and evaluate nomograms for predicting the risk of DM and person-alized prognosis in patients with duodenal cancer.METHODS Data on duodenal cancer patients diagnosed between 2010 and 2019 were extracted from the Surveillance,Epidemiology,and End Results database.Univariate and multivariate logistic regression analyses were used to identify independent risk factors for DM in patients with duodenal cancer,and univariate and multivariate Cox proportional hazards regression analyses were used to determine independent prognostic factors in duodenal cancer patients with DM.Two novel nomograms were established,and the results were evaluated by receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA).RESULTS A total of 2603 patients with duodenal cancer were included,of whom 457 cases(17.56%)had DM at the time of diagnosis.Logistic analysis revealed independent risk factors for DM in duodenal cancer patients,including gender,grade,tumor size,T stage,and N stage(P<0.05).Univariate and multivariate COX analyses further identified independent prognostic factors for duodenal cancer patients with DM,including age,histological type,T stage,tumor grade,tumor size,bone metastasis,chemotherapy,and surgery(P<0.05).The accuracy of the nomograms was validated in the training set,validation set,and expanded testing set using ROC curves,calibration curves,and DCA curves.The results of Kaplan-Meier survival curves(P<0.001)indicated that both nomograms accurately predicted the occurrence and prognosis of DM in patients with duodenal cancer.CONCLUSION The two nomograms are expected as effective tools for predicting DM risk in duodenal cancer patients and offering personalized prognosis predictions for those with DM,potentially enhancing clinical decision-making.

Utility of real-time 3D visualization system in the early stage of phacoemulsification training

●AIM:To determine the teaching effects of a real-time three dimensional(3D)visualization system in the operating room for early-stage phacoemulsification training.●METHODS:A total of 10 ophthalmology residents of the first-year postgraduate were included.All the residents were novices to cataract surgery.Real-time cataract surgical observations were performed using a custom-built 3D visualization system.The training lasted 4wk(32h)in all.A modified International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubric(ICO-OSCAR)containing 4 specific steps of cataract surgery was applied.The self-assessment(self)and expert-assessment(expert)were performed through the microsurgical attempts in the wet lab for each participant.●RESULTS:Compared with pre-training assessments(self 3.2±0.8,expert 2.5±0.6),the overall mean scores of posttraining(self 5.2±0.4,expert 4.7±0.6)were significantly improved after real-time observation training of 3D visualization system(P<0.05).Scores of 4 surgical items were significantly improved both self and expert assessment after training(P<0.05).●CONCLUSION:The 3D observation training provides novice ophthalmic residents with a better understanding of intraocular microsurgical techniques.It is a useful tool to improve teaching efficiency of surgical education.

The basic core traditional C hinese medicine for the prevention and treatment of COVID-19 and its active mechanisms

Background:COVID-19 has had a dramatic impact on human health,economies,societies,and livelihoods around the world.Traditional Chinese medicine(TCM)formulae have played an important role in the prevention and treatment of COVID-19.WHO evaluated the role of TCM in treating of COVID-19 and encouraged other countries to promote the use of TCM formulae.However,the key is to find the basic core traditional Chinese medicine(BC-TCM)among those formulae.Methods:For the first time,we mined the data of TCM formulae in CNIPA and analyzed herb characteristics and association rules.We then determined the BC-TCM and screened main compounds and therapeutic targets.Finally,the potential molecular mechanisms were explored by using enrichment analyses and molecular docking.Results:This study screened 123 patented TCM formulae,including 312 herbs.According to frequency statistics and association rules,nine herbs(Gan Cao,Jin Yinhua,Guang Huoxiang,Fu Ling,Huang Qi,Jie Geng,Lian Qiao,Cang Zhu,Ku Xingren)were selected as the BC-TCM.The BC-TCM involved 166 main compounds and 48 therapeutic targets.The active compounds Hederagenin,Spinasterol,Beta-sitosterol,and Liquiritin had high binding activity to the COVID-19 targets 3CL,ACE2,and core targets RELA,HSP90AA1,STAT3,MAPK3,and TP53 according to molecular docking results.Interestingly,Hederagenin might be a potential compound for the prevention and treatment of COVID-19.Conclusion:Our research predicted and confirmed the preventive therapeutic effect of BC-TCM on COVID-19.This has the potential to broaden the scope of TCM,guide people in using clinical formulae,and provide valuable insights for future TCM discovery research.

Synthesis and mechanism of environmentally friendly high temperature and high salt resistant lubricants

With the exploration and development of deep and ultra-deep oil and gas,high torque and high friction during the drilling of deep and ultra-deep wells become one of the key issues affecting drilling safety and drilling speed.Meanwhile,the high temperature and high salt problem in deep formations is prominent,which poses a major challenge to the lubricity of drilling fluids under high temperature and high salt.This paper reports an organic borate ester SOP as an environmentally friendly drilling fluid lubricant.The performance evaluation results show that when 1%lubricant SOP is added to the fresh water-based mud,the lubrication coefficient decreases from 0.631 to 0.046,and the reduction rate of lubrication coefficient is 92.7%.Under the conditions of 210℃ and 30%NaCl,the reduction rate of lubricating coefficient of the base slurry with 1%SOP was still remain 81.5%.After adding 1%SOP,the wear volume decreased by 94.11%compared with the base slurry.The contact resistance experiment during the friction process shows that SOP can form a thick adsorption film on the friction surface under high temperature and high salt conditions,thus effectively reducing the friction resistance.Molecular dynamics simulation shows that lubricant SOP can be physically adsorbed on the surface of drilling tool and borehole wall through hydrogen bond and van der Waals force.XPS analysis further shows that SOP adsorbs on the friction surface and reacts with metal atoms on the friction surface to form a chemically reactive film.Therefore,under high temperature and high salt conditions,the synergistic effect of physical adsorption film and chemical reaction film effectively reduces the frictional resistance and wear of the friction surface.In addition,SOP is non-toxic and easy to degrade.Therefore,SOP is a highly effective and environmentally friendly lubricant in high temperature and high salt drilling fluid.

The Decay Process of an α-configuration Sunspot

The decay of sunspot plays a key role in magnetic flux transportation in solar active regions(ARs).To better understand the physical mechanism of the entire decay process of a sunspot,an α-configuration sunspot in AR NOAA 12411 was studied.Based on the continuum intensity images and vector magnetic field data with stray light correction from Solar Dynamics Observatory/Helioseismic and Magnetic Imager,the area,vector magnetic field and magnetic flux in the umbra and penumbra are calculated with time,respectively.Our main results are as follows:(1) The decay curves of the sunspot area in its umbra,penumbra,and whole sunspot take the appearance of Gaussian profiles.The area decay rates of the umbra,penumbra and whole sunspot are-1.56 MSH day^(-1),-12.61 MSH day^(-1) and-14.04 MSH day^(-1),respectively;(2) With the decay of the sunspot,the total magnetic field strength and the vertical component of the penumbra increase,and the magnetic field of the penumbra becomes more vertical.Meanwhile,the total magnetic field strength and vertical magnetic field strength for the umbra decrease,and the inclination angle changes slightly with an average value of about 20°;(3) The magnetic flux decay curves of the sunspot in its umbra,penumbra,and whole sunspot exhibit quadratic patterns,their magnetic flux decay rates of the umbra,penumbra and whole sunspot are-9.84 × 10^(19)Mx day^(-1),-1.59 × 10^(20)Mx day^(-1) and -2.60 × 10^(20)Mx day^(-1),respectively.The observation suggests that the penumbra may be transformed into the umbra,resulting in the increase of the average vertical magnetic field strength and the reduction of the inclination angle in the penumbra during the decay of the sunspot.

Analysis of nutritional risk,skeletal muscle depletion,and lipid metabolism phenotype in acute radiation enteritis

BACKGROUND Radiation enteritis,which often occurs during radiation-induced acute intestinal symptoms(RIAIS),is the most common and important complication during radiotherapy for cervical cancer.RIAIS caused by abdominal and pelvic radiotherapy will affect nutrient intake,digestion,absorption,and metabolism,leading to malnutrition or poorer nutritional status.In patients with malignant tumors,malnutrition can adversely affect the curative effect and response of radiotherapy by reducing radiosensitivity,affecting the precision of radiotherapy placement and increasing the incidence of radiotherapy-related adverse reactions.AIM To analyze nutritional risk,skeletal muscle depletion,and lipid metabolism phenotype in acute radiation enteritis.METHODS Fifty patients with cervical cancer received external beam radiotherapy,and 15 patients received brachytherapy after external beam radiotherapy.Body weight,body composition parameters,nutritional risk screening(NRS)2002 score,and blood biochemical indices of patients with cervical cancer during periradiation were tested by a one-way repeated measures analysis of variance.Metabolomics analysis was used to identify characteristic lipid metabolism pathways.Clinical factors that affect linoleic acid changes were screened using the generalized evaluation equation.RESULTS Among the 50 patients,37 had RIAIS,including 34 patients with grade 1-2 RIAIS and 3 patients with grade 3 RIAIS.The NRS 2002 score of patients who underwent cervical cancer radiotherapy continued to increase during the periradiation period,and 42 patients who underwent cancer radiotherapy had nutritional deficits(NRS 2002 score≥3 points)at the end of radiotherapy.Correlation analyses revealed that body weight and body mass index changes were closely associated with body fat content(R2=0.64/0.51).The results of the univariate analysis showed that radiotherapy time,percentage reduction of serum albumin,and percentage reduction of serum prealbumin were the key factors affecting skeletal muscle exhaustion(P<0.05).Metabolomic analysis of fecal supernatants of cervical cancer patients during the periradiation period revealed the involvement of linoleic acid,cholic acid,arachidonic acid,and N-acetyl-L-benzene alanine in the metabolic pathway of linoleic acid.CONCLUSION Cervical cancer radiotherapy patients faced nutritional risks,decreased serum albumin synthesis,and increased risk of skeletal muscle exhaustion.Linoleic acid was a biomarker of high nutritional risk.

Study on the mechanism of Wuzi Yanzong pill in treating osteoporosis based on network pharmacology and molecular docking

Background:Based on network pharmacology and molecular docking,our study discussed the mechanism of Wuzi Yanzong pill in treating Osteoporosis(OP),which lays the foundation for drug development of OP.Methods:The chemical compounds and potential targets of Wuzi Yanzong pill were explored through TCMSP,PubChem,Swiss ADME and other databases.GeneCards,OMIM and Drugbank databases were used to obtain OP related targets.The intersection between the targets of Wuzi Yanzong pill and the related targets of OP was found by drawing a Venn diagram.PPI network was constructed with the STRING database and core targets were screened.The TCM-compound-action target-disease network was drawn using the Cytoscape software.The Metascape platform was used to find the pathways and functions for core target enrichment.Molecular docking validation of action compounds and core targets is completed by software such as Auto Dock Vina.Results:59 compounds and 707 action targets of Wuzi Yanzong pill were found.603 disease targets were selected,106 intersection targets were found using a Venn diagram,and 37 core targets were screened.By enrichment analysis,143 KEGG pathways,1026 GO biological processes,23 GO cell compositions and 60 GO molecular functions were obtained.The results of molecular docking showed that the effective compounds of Wuzi Yanzong pill,such as stigmasterol,quercetin,kaempferol andβ-sitosterol,had high binding activity with STAT3,TNF and IL6 core target proteins.Conclusion:Wuzi Yanzong Pill may play a role in treating OP by regulating STAT3,TNF,IL-6,TP53,VEGFA,JUN,AKT1,IL-1B,SRC,MMP9 and other pathways,as well as cancer-correlation,rheumatoid arthritis-correlation,MAPK,Th17 cell differentiation,IL-17,TNF signaling pathway and so on,to interpret Wuzi Yanzong pill’s clinic.

“Astragali Radix−Salviae Miltiorrhizae Radix Et Rhizoma”herb pair in the treatment of liver cirrhosis and its pharmacological mechanisms

Objective:Liver cirrhosis is a disease that seriously damages human health.Traditional Chinese Medicine(TCM)formulae have a good therapeutic effect on cirrhosis,and the herb pair is the smallest unit in formula compatibility,which is important for improving the therapeutic effect.Therefore,identifying core herb pairs among TCM formulae is key.Methods:We mined the data of TCM formulae for the treatment of cirrhosis in the China National Intellectual Property Administration for the first time and analyzed their herb characteristics and association rules.We screened 405 patented TCM formulae,including 953 herbs.Based on frequency statistics and association rules,we determined“Astragali Radix-Salviae Miltiorrhizae Radix Et Rhizoma”as the core herb pair.Results:Six active compounds,Isorhamnetin,Formononetin,Calycosin,Cryptotanshinone,Dihydrotanshinone I,and Tanshinone II A,were screened out based on previous studies and network pharmacology.We found that SRC,TP53,HSP90AA1,MAPK3,MAPK1,and STAT3 played pivotal roles in treating cirrhosis.Interestingly,molecular docking indicated that MAPK3 might be a potential pharmacological target for cirrhosis.Conclusion:We preliminarily predicted and verified the pharmacological and molecular mechanism of“Astragali Radix-Salviae Miltiorrhizae Radix Et Rhizoma”in treating cirrhosis.This can expand the scope of TCM in the treatment of cirrhosis,guide people to use clinical formulae,and provide valuable insights for further drug discovery studies.

曲唑酮治疗阿尔茨海默病伴睡眠障碍患者的疗效及对患者认知功能的影响

目的探讨曲唑酮治疗阿尔茨海默病(AD)伴睡眠障碍患者的疗效及其对患者认知功能、海马体积、日常生活能力的影响。方法选取2018年10月—2019年10月在湖州市第三人民医院就诊的AD伴随睡眠障碍患者70例为研究对象。将70例患者随机分为观察组(口服多奈哌齐+曲唑酮)和对照组(口服多奈哌齐+唑吡坦),每组35例。用MRI扫描并计算海马体积。采用简易精神状态检查(MMSE)量表、蒙特利尔认知评估(MoCA)量表、日常生活活动(ADL)量表评估患者认知水平及日常生活能力。采用多导睡眠图(PSG)、匹兹堡睡眠治疗指数(PSQI)量表评估患者睡眠质量及疗效。结果观察组治疗前后总睡眠时间及睡眠效率提高的水平高于对照组(P<0.05),睡眠潜伏期、觉醒次数降低的水平高于对照组(P<0.05)。观察组左测海马头部体积降低的差值大于对照组(P<0.05)。两组治疗前后左侧海马体部、尾部及右侧海马头部、体部、尾部体积的差值比较,差异无统计学意义(P>0.05)。观察组患者治疗前后MMSE、MoCA及ADL评分提高的水平高于对照组(P<0.05)。观察组睡眠障碍临床疗效优于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论曲唑酮联合多奈哌齐治疗AD伴睡眠障碍可显著改善患者睡眠质量,提高疗效、认知功能,改善患者左侧海马头部萎缩,并具有良好的耐受性,值得进一步临床推广应用。

Efficacy and safety of Banxia Xiexin Decoction in the treatment of gastric ulcer:a systematic review and meta-analysis of twenty-seven randomized controlled trials

Background:Banxia XieXin Decoction(BXD)is a traditional Chinese medicine decoction commonly used in the Chinese clinical treatment of gastric ulcer(GU).Although some people believe that it may have some advantages in this regard,There is no reliable evidence-based study demonstrating its effectiveness.This study aims to systematically evaluate the healing effect and security of BXD in the treatment of GU.Methods:PubMed,Cochrane Library,EMBASE,ScienceNet,China National Knowledge Infrastructure(CNKI),Wanfang database,Weipu database,and China biomedical literature service(CBM)database were systematically searched to obtain all randomized controlled trials(RCTs)evaluating the treatment GU of BXD published as of April 2022.Two researchers independently screened and extracted all research data,finally evaluated the bias risk of inclusion in the study using revman 5.4.Results:This meta-analysis included 27 randomized controlled trials and 1411 patients.The clinical effective rate,recurrence rate,HP eradication rate,adverse reaction rate,and visual analog score(VAS)of BXD combined treatment and standard treatment alone were compared.The results of the meta-analysis showed that BXD combined treatment improve the symptoms related to the gastric ulcers and reduce drug-related adverse reactions.Due to the low quality of the research included in this analysis,in-depth high-quality research is crucial for verifying these results.

胸外科术后急性肺栓塞的诊断与治疗——附37例胸外术后急性肺栓塞病例的诊治经验

背景与目的肺栓塞(pulmonary embolism, PE)是胸外科术后最严重的并发症之一,因此充分了解胸外科术后急性PE患者所具有的临床特点具有重要意义。本研究通过总结37例胸外科术后急性PE患者的临床特点及诊治体会,从而提高胸外科术后急性PE的预防及诊治水平。方法对37例胸外科术后急性PE患者进行回顾性分析,对性别、年龄、体重指数(body mass index, BMI)、诊断及手术术式及术后发生PE时间、临床表现、诊断及治疗过程进行综合分析。结果 37例患者中男16例(43.2%),女21例(56.8%),平均年龄为(65.64±6.29)岁(53岁-82岁),32例患者年龄超过60岁(86.5%)。BMI范围位于17.1 kg/m2-30.8 kg/m^2之间,中位BMI为26.3 kg/m2,27例(73.0%)患者的BMI超过25.0 kg/m2。恶性肿瘤34例(91.9%)。中位发病时间为术后第4天,其中发生在术后第3天的患者有11例,所占比例(29.7%)最高。上午9点至晚上9点发生PE的比例可达77.8%。术后D二聚体(D-dimer,D-D)波动在1.0μg/mL-20.0μg/mL(FEU)之间,平均值为(7.09±4.45)μg/mL(FEU),其中32例(86.5%)患者的术后D-D高于3.00μg/mL(FEU)。结论充分掌握胸外科术后急性PE患者的临床特点,及早发现诊断并采取多学科治疗能大大提高疾病生存率。

Prognosis after resection for hepatitis B virus-associated intrahepatic cholangiocarcinoma

AIM:To investigate the prognostic factors after resection for hepatitis B virus(HBV)-associated intrahepatic cholangiocarcinoma(ICC) and to assess the impact of different extents of lymphadenectomy on patient survival.METHODS:A total of 85 patients with HBV-associated ICC who underwent curative resection from January 2005 to December 2006 were analyzed.The patients were classified into groups according to the extent of lymphadenectomy(no lymph node dissection,sampling lymph node dissection and regional lymph node dissection).Clinicopathological characteristics and survival were reviewed retrospectively.RESULTS:The cumulative 1-,3-,and 5-year survival rates were found to be 60 %,18 %,and 13 %,respectively.Multivariate analysis revealed that liver cirrhosis(HR = 1.875,95%CI:1.197-3.278,P = 0.008) and multiple tumors(HR = 2.653,95%CI:1.562-4.508,P < 0.001) were independent prognostic factors for survival.Recurrence occurred in 70 patients.The 1-,3-,and 5-year disease-free survival rates were 36%,3% and 0%,respectively.Liver cirrhosis(HR = 1.919,P = 0.012),advanced TNM stage(stage Ⅲ/Ⅳ)(HR = 2.027,P < 0.001),and vascular invasion(HR = 3.779,P = 0.02) were independent prognostic factors for disease-free survival.Patients with regional lymph node dissection demonstrated a similar survival rate to patients with sampling lymph node dissection.Lymphadenectomy did not significantly improve the survival rate of patients with negative lymph node status.CONCLUSION:The extent of lymphadenectomy does not seem to have influence on the survival of patients with HBV-associated ICC,and routine lymph nodedissection is not recommended,particularly for those without lymph node metastasis.

Multivariate predictive model for asymptomatic spontaneous bacterial peritonitis in patients with liver cirrhosis

BACKGROUNDSpontaneous bacterial peritonitis (SBP) is a detrimental infection of the asciticfluid in liver cirrhosis patients, with high mortality and morbidity. Earlydiagnosis and timely antibiotic administration have successfully decreased themortality rate to 20%-25%. However, many patients cannot be diagnosed in theearly stages due to the absence of classical SBP symptoms. Early diagnosis ofasymptomatic SBP remains a great challenge in the clinic.AIMTo establish a multivariate predictive model for early diagnosis of asymptomaticSBP using positive microbial cultures from liver cirrhosis patients with ascites.METHODSA total of 98 asymptomatic SBP patients and 98 ascites liver cirrhosis patients withnegative microbial cultures were included in the case and control groups,respectively. Multiple linear stepwise regression analysis was performed toidentify potential indicators for asymptomatic SBP diagnosis. The diagnosticperformance of the model was estimated using the receiver operatingcharacteristic curve.RESULTSPatients in the case group were more likely to have advanced disease stages,cirrhosis related-complications, worsened hematology and ascites, and higher mortality. Based on multivariate analysis, the predictive model was as follows: y (P) = 0.018 + 0.312 × MELD (model of end-stage liver disease) + 0.263 × PMN(ascites polymorphonuclear) + 0.184 × N (blood neutrophil percentage) + 0.233 ×HCC (hepatocellular carcinoma) + 0.189 × renal dysfunction. The area under thecurve value of the established model was 0.872, revealing its high diagnosticpotential. The diagnostic sensitivity was 73.5% (72/98), the specificity was 86.7%(85/98), and the diagnostic efficacy was 80.1%.CONCLUSIONOur predictive model is based on the MELD score, polymorphonuclear cells,blood N, hepatocellular carcinoma, and renal dysfunction. This model mayimprove the early diagnosis of asymptomatic SBP.

Insulin-like growth factor receptor-1 overexpression is associated with poor response of rectal cancers to radiotherapy

AIM: To explore the potential correlation between insulin-like growth factor receptor-1 (IGF-1R) expression and rectal cancer radiosensitivity.

腕踝针在老年无痛胃镜检查中对丙泊酚用量的影响

目的探讨腕踝针灸法对老年患者无痛胃镜检查中丙泊酚用量的影响。方法收集胃镜检查患者120例,年龄70~85岁,美国麻醉医师协会(ASA)分级Ⅱ级或病情稳定Ⅲ级,按随机数字表法分为对照组和腕踝针组,各60例。腕踝针组入室前在相应区域穿刺留针,入室后两组静脉给予纳布啡0.1 mg/kg,静脉靶控输注丙泊酚,待睫毛反应消失、呼之不应时进行胃镜操作,根据术中体动情况,酌情追加丙泊酚。记录丙泊酚总用量、胃镜操作时间、唤醒时间、离室时间、呼吸抑制、低血压和恶心呕吐等不良反应情况。结果腕踝针组丙泊酚用量、唤醒时间和离室时间明显低于对照组(P<0.05),呼吸抑制、低血压和术后恶心呕吐的发生率低于对照组(P<0.05)。结论腕踝针在丙泊酚无痛胃镜检查中,可有效减少丙泊酚用量,降低不良反应,缩短恢复时间。