A network pharmacology approach to explore the mechanism of action of Yiqi Fumai lyophilized injection in the treatment of novel coronavirus disease

Background:Shengmai decoction,which has been included in the diagnosis and treatment of coronavirus disease 2019(COVID-19),is effective in the early treatment of patients with severe COVID-19.Yiqi Fumai lyophilized injection(YQFM)is a modern Chinese medicine preparation of the Shengmai decoction.The mechanism of its intervention at the molecular level in the severe stage of COVID-19 remains unclear.Therefore,it is necessary to investigate the mechanism of YQFM in the treatment of patients with severe COVID-19.Methods:The corresponding target genes of the main active ingredients in YQFM and COVID-19 were obtained by using multiple databases and literature retrieval.A protein-protein interaction network was constructed,and enrichment analysis of the target was performed using Cytoscape 3.8.1.Lastly,the docking of all the identified compounds with angiotensin-converting enzyme II was confirmed by applying molecular docking technology.Results:YQFM has anti-inflammatory effects on RAW267.4 macrophages.The main active compounds of YQFM are all effective anti-inflammatory agents,and these active compounds also show beneficial physiological functions,such as anti-oxidation,anti-bacterial,and anticancer activities.Gene Ontology analysis showed enrichment in the following pathways:lipopolysaccharides,interleukins,NF-kappa B,interleukin-2 and others,revealing that YQFM may play a role in the treatment of patients with severe COVID-19 through these pathways.Conclusion:YQFM has multicomponent and multitarget characteristics,and it could reduce lung injury by inhibiting inflammatory reactions,promoting antiviral activities,and regulating immunity,among other functions,to treat patients with severe COVID-19.

广州女性低剂量CT肺癌筛查结果及高危因素探索

背景与目的肺癌高居中国恶性肿瘤发病率和死亡率之首。既往肺癌筛查试验大多为针对吸烟者等高危人群的选择性筛查,然而亚洲肺癌病例非吸烟女性占相当比例。本研究旨在评估广州市社区女性的肺癌患病率并探究肺癌高危因素。方法采用胸部低剂量计算机断层扫描(low-dose computed tomography,LDCT)对广州市40-74岁女性居民行肺癌筛查,并根据2018版《中国肺癌低剂量螺旋CT筛查指南》对肺结节进行分类管理及计算阳性结节和肺癌检出率。筛查对象在行检查前均须完成“肺癌危险因素调研问卷”,后对问卷危险因素进行最小绝对收缩和选择算子惩罚Logistic回归分析。结果分析共纳入6256名女性,发现阳性结节1228例(19.63%),确诊肺癌117例(1.87%),其中原位癌6例,I期103例(占肺癌比例88.03%)。根据问卷变量行最小绝对收缩和选择算子(Least absolute shrinkage and selection operator,LASSO)惩罚Logistic回归分析发现,年龄≥50岁(OR=1.07,95%CI:1.06-1.07)、个人恶性肿瘤史(OR=3.29,95%CI:3.22-3.37)、纺织职业(OR=1.10,95%CI:1.08-1.13)、小时候使用煤为燃料(OR=1.14,95%CI:1.13-1.16)以及食物过敏史(OR=1.10,95%CI:1.07-1.13)是该地区女性肺癌的高危因素。结论胸部LDCT可以发现大量早期肺癌,可用于女性肺癌筛查。年龄≥50岁、个人恶性肿瘤史、纺织职业、小时候使用煤为燃料和食物过敏史是该地区女性人群肺癌的高危因素,需提高该群体对肺癌早筛的重视程度。

喷雾干燥结合紫外交联制备甲基丙烯酸缩水甘油酯改性丝胶中空微球及其性能

为了制备高耐水性光固化丝胶蛋白(SS)微球,采用喷雾干燥与紫外交联相结合的方法,以丝胶为原料制备了甲基丙烯酸缩水甘油酯(GMA)交联SS中空微球(GMA-g-SS),该法赋予了其良好的耐水稳定性和紫外光固化性能。优化的喷雾干燥工艺参数包括:SS浓度、进风温度及进液速度;研究了GMA浓度、二苯甲酮(BP)用量及紫外辐照时间对接枝率的影响。借助扫描电镜、红外光谱及热分析对微球表面形貌结构及稳定性进行了表征与分析。结果表明,喷雾干燥SS微球呈单分散空心结构,直径约5~20μm;GMA-g-SS微球红外光谱在1152 cm^(-1)和764 cm^(-1)处出现环氧基的吸收峰,表明GMA与SS交联成功。交联后微球呈黏连聚集状态,具有较高的紫外光固化性能且耐水稳定性大幅提升,溶失率仅为17.1%。所制备的GMA-g-SS微球具有可调的耐水稳定性和紫外光固化性,是一种有潜力的光固化3D打印生物材料。

Small extracellular vesicles derived from cerebral endothelial cells with elevated microRNA 27a promote ischemic stroke recovery

Axonal remodeling is a critical aspect of ischemic brain repair processes and contributes to spontaneous functional recovery.Our previous in vitro study demonstrated that exosomes/small extracellular vesicles(sEVs)isolated from cerebral endothelial cells(CEC-sEVs)of ischemic brain promote axonal growth of embryonic cortical neurons and that microRNA 27a(miR-27a)is an elevated miRNA in ischemic CEC-sEVs.In the present study,we investigated whether normal CEC-sEVs engineered to enrich their levels of miR-27a(27a-sEVs)further enhance axonal growth and improve neurological outcomes after ischemic stroke when compared with treatment with non-engineered CEC-sEVs.27a-sEVs were isolated from the conditioned medium of healthy mouse CECs transfected with a lentiviral miR-27a expression vector.Small EVs isolated from CECs transfected with a scramble vector(Scra-sEVs)were used as a control.Adult male mice were subjected to permanent middle cerebral artery occlusion and then were randomly treated with 27a-sEVs or Scra-sEVs.An array of behavior assays was used to measure neurological function.Compared with treatment of ischemic stroke with Scra-sEVs,treatment with 27a-sEVs significantly augmented axons and spines in the peri-infarct zone and in the corticospinal tract of the spinal grey matter of the denervated side,and significantly improved neurological outcomes.In vitro studies demonstrated that CEC-sEVs carrying reduced miR-27a abolished 27a-sEV-augmented axonal growth.Ultrastructural analysis revealed that 27a-sEVs systemically administered preferentially localized to the pre-synaptic active zone,while quantitative reverse transcription-polymerase chain reaction and Western Blot analysis showed elevated miR-27a,and reduced axonal inhibitory proteins Semaphorin 6A and Ras Homolog Family Member A in the peri-infarct zone.Blockage of the Clathrin-dependent endocytosis pathway substantially reduced neuronal internalization of 27a-sEVs.Our data provide evidence that 27a-sEVs have a therapeutic effect on stroke recovery by promoting axonal remodeling and improving neurological outcomes.Our findings also suggest that suppression of axonal inhibitory proteins such as Semaphorin 6A may contribute to the beneficial effect of 27a-sEVs on axonal remodeling.

Experimental investigation of engineered geopolymer composite for structural strengthening against blast loads

The recent increase in blast/bombing incidents all over the world has pushed the development of effective strengthening approaches to enhance the blast resistance of existing civil infrastructures.Engineered geopolymer composite(EGC)is a promising material featured by eco-friendly,fast-setting and strain-hardening characteristics for emergent strengthening and construction.However,the fiber optimization for preparing EGC and its protective effect on structural elements under blast scenarios are uncertain.In this study,laboratory tests were firstly conducted to evaluate the effects of fiber types on the properties of EGC in terms of workability,dry shrinkage,and mechanical properties in compression,tension and flexure.The experimental results showed that EGC containing PE fiber exhibited suitable workability,acceptable dry shrinkage and superior mechanical properties compared with other types of fibers.After that,a series of field tests were carried out to evaluate the effectiveness of EGC retrofitting layer on the enhancement of blast performance of typical elements.The tests include autoclaved aerated concrete(AAC)masonry walls subjected to vented gas explosion,reinforced AAC panels subjected to TNT explosion and plain concrete slabs subjected to contact explosion.It was found that EGC could effectively enhance the blast resistance of structural elements in different scenarios.For AAC masonry walls and panels,with the existence of EGC,the integrity of specimens could be maintained,and their deflections and damage were significantly reduced.For plain concrete slabs,the EGC overlay could reduce the diameter and depth of the crater and spallation of specimens.

Assessing recent recurrence after hepatectomy for hepatitis Brelated hepatocellular carcinoma by a predictive model based on sarcopenia

BACKGROUND Sarcopenia may be associated with hepatocellular carcinoma(HCC)following hepatectomy.But traditional single clinical variables are still insufficient to predict recurrence.We still lack effective prediction models for recent recurrence(time to recurrence<2 years)after hepatectomy for HCC.AIM To establish an interventable prediction model to estimate recurrence-free survival(RFS)after hepatectomy for HCC based on sarcopenia.METHODS We retrospectively analyzed 283 hepatitis B-related HCC patients who underwent curative hepatectomy for the first time,and the skeletal muscle index at the third lumbar spine was measured by preoperative computed tomography.94 of these patients were enrolled for external validation.Cox multivariate analysis was per-formed to identify the risk factors of postoperative recurrence in training cohort.A nomogram model was developed to predict the RFS of HCC patients,and its predictive performance was validated.The predictive efficacy of this model was evaluated using the receiver operating characteristic curve.RESULTS Multivariate analysis showed that sarcopenia[Hazard ratio(HR)=1.767,95%CI:1.166-2.678,P<0.05],alpha-fetoprotein≥40 ng/mL(HR=1.984,95%CI:1.307-3.011,P<0.05),the maximum diameter of tumor>5 cm(HR=2.222,95%CI:1.285-3.842,P<0.05),and hepatitis B virus DNA level≥2000 IU/mL(HR=2.1,95%CI:1.407-3.135,P<0.05)were independent risk factors associated with postoperative recurrence of HCC.Based on the sarcopenia to assess the RFS model of hepatectomy with hepatitis B-related liver cancer disease(SAMD)was established combined with other the above risk factors.The area under the curve of the SAMD model was 0.782(95%CI:0.705-0.858)in the training cohort(sensitivity 81%,specificity 63%)and 0.773(95%CI:0.707-0.838)in the validation cohort.Besides,a SAMD score≥110 was better to distinguish the high-risk group of postoperative recurrence of HCC.CONCLUSION Sarcopenia is associated with recent recurrence after hepatectomy for hepatitis B-related HCC.A nutritional status-based prediction model is first established for postoperative recurrence of hepatitis B-related HCC,which is superior to other models and contributes to prognosis prediction.

Stratigraphic framework and sedimentary evolution during the Cryogenian-Ediacaran transition in northeastern Sichuan Basin,South China

The northeastern Sichuan area in the northern Yangtze margin has unique Ediacaran geological records,especially the Doushantuo Formation(DST),and become a hot research area in recent years.However,the Cryogenian-Ediacaran(C-E)boundary has not been precisely identified,which restricts the in-depth study of geological information during this crucial transitional period and is unfavorable for a systematic and complete understanding of the Yangtze Block and even the global paleogeographic pattern.This study conducted stratigraphy,sedimentology,and chronostratigraphy to establish the stratigraphic framework and sedimentary evolution of the C-E transition strata in northeastern Sichuan.The results showed that the Ediacaran sediments,without the cap dolomite,unconformably overlaid the Cryogenian sediments in the studied area.The Member II of the DST,characterized by 50-160 m of red-green sandstone(approximately equivalent to the original Chengkou“Guanyinya Formation”),directly overlaid the Cryogenian sediments and displayed a 623±2.3 Ma maximum depositional age from the detrital zircon U-Pb dating.Regional stratigraphic correlations indicate that the C-E transition strata in northeastern Sichuan had a consistent lithological association and sedimentary sequence characteristics but differed from the Three Gorges.Typically,the upper Nantuo massive glacial diamictites transition to the icebergs rafted lonestone-bearing mudstones at the top,then change upward to DST barrier coast sandstones.The proposed DST of the northeastern Sichuan Basin was divided into three lithostratigraphic members without the regional Member I cap dolomite:(i)Member II purple-red,gray-green sandstone strata,(ii)MemberⅢblack mudstone strata,and(iii)Member IV P-Mn bearing strata.During the C-E transition,the study area experienced(i)the global deglaciation stage in the terminal Marinoan glaciation and(ii)the filling-leveling up stage with clastic rocks in the early Ediacaran.Overall,the early Ediacaran of northeastern Sichuan succeeded the paleogeographic features of the late Cryogenian.

Strain‑Induced Surface Interface Dual Polarization Constructs PML‑Cu/Bi_(12)O_(17)Br_(2) High‑Density Active Sites for CO_(2) Photoreduction

The insufficient active sites and slow interfacial charge trans-fer of photocatalysts restrict the efficiency of CO_(2) photoreduction.The synchronized modulation of the above key issues is demanding and chal-lenging.Herein,strain-induced strategy is developed to construct the Bi–O-bonded interface in Cu porphyrin-based monoatomic layer(PML-Cu)and Bi_(12)O_(17)Br_(2)(BOB),which triggers the surface interface dual polarization of PML-Cu/BOB(PBOB).In this multi-step polarization,the built-in electric field formed between the interfaces induces the electron transfer from con-duction band(CB)of BOB to CB of PML-Cu and suppresses its reverse migration.Moreover,the surface polarization of PML-Cu further promotes the electron converge in Cu atoms.The introduction of PML-Cu endows a high density of dispersed Cu active sites on the surface of PBOB,significantly promoting the adsorption and activation of CO_(2) and CO desorption.The conversion rate of CO_(2) photoreduction to CO for PBOB can reach 584.3μmol g-1,which is 7.83 times higher than BOB and 20.01 times than PML-Cu.This work offers valuable insights into multi-step polarization regulation and active site design for catalysts.

Amino-functionalized UiO-66-doped mixed matrix membranes with high permeation performance and fouling resistance

For the reduction of bovine serum proteins from wastewater,a novel mixed matrix membrane was prepared by functionalizing the substrate material polyaryletherketone(PAEK),followed by carboxyl groups(C-SPAEKS),and then adding amino-functionalized UiO-66-NH_(2)(Am-UiO-66-NH_(2)).Aminofunctionalization of UiO-66 was accomplished by melamine,followed by an amidation reaction to immobilize Am-UiO-66-NH_(2),which was immobilized on the surface of the membrane as well as in the pore channels,which enhanced the hydrophilicity of the membrane surface while increasing the negative potential of the membrane surface.This nanoparticle-loaded ultrafiltration membrane has good permeation performance,with a pure water flux of up to 482.3 L·m^(-2)·h^(-1) for C-SPAEKS/AmUiO-66-NH_(2) and a retention rate of up to 98.7%for bovine serum albumin(BSA)-contaminated solutions.Meanwhile,after several hydrophilic modifications,the flux recovery of BSA contaminants by this series of membranes increased from 56.2%to 80.55%of pure membranes.The results of ultra-filtration flux time tests performed at room temperature showed that the series of ultrafiltration membranes remained relatively stable over a test time of 300 min.Thus,the newly developed mixed matrix membrane showed potential for high efficiency and stability in wastewater treatment containing bovine serum proteins.

Adhesion strength of tetrahydrofuran hydrates is dictated by substrate stiffness

Understanding the hydrate adhesion is important to tackling hydrate accretion in petro-pipelines.Herein,the relationship between the Tetrahydrofuran(THF)hydrate adhesion strength(AS)and surface stiffness on elastic coatings is systemically examined by experimental shear force measurements and theoretical methods.The mechanical factor-elastic modulus of the coatings greatly dictates the hydrate AS,which is explained by the adhesion mechanics theory,beyond the usual factors such as wettability and structural roughness.Moreover,the hydrate AS increases with reducing the thickness of the elastic coatings,resulted from the decrease of the apparent surface elastic modulus.The effect of critical thickness for the elastic materials with variable elastic modulus on the hydrate AS is also revealed.This study provides deep perspectives on the regulation of the hydrate AS by the elastic modulus of elastic materials,which is of significance to design anti-hydrate surfaces for mitigation of hydrate accretion in petro-pipelines.

Manufacturing CAR-NK against tumors: Who is the ideal supplier?

Chimeric antigen receptor-natural killer(CAR-NK) cells have emerged as another prominent player in the realm of tumor immunotherapy following CAR-T cells. The unique features of CAR-NK cells make it possible to compensate for deficiencies in CAR-T therapy, such as the complexity of the manufacturing process, clinical adverse events, and solid tumor challenges. To date, CAR-NK products from different allogeneic sources have exhibited remarkable anti-tumor effects on preclinical studies and have gradually been applied in clinical practice.However, each source has advantages and disadvantages. Selecting a suitable source may help maximize CAR-NK cell efficacy and increase the feasibility of clinical transformation. Therefore, this review discusses the development and challenges of CAR-NK cells from different sources to provide a reference for future exploration.

Application of deep learning methods combined with physical background in wide field of view imaging atmospheric Cherenkov telescopes

The High Altitude Detection of Astronomical Radiation(HADAR)experiment,which was constructed in Tibet,China,combines the wide-angle advantages of traditional EAS array detectors with the high-sensitivity advantages of focused Cherenkov detectors.Its objective is to observe transient sources such as gamma-ray bursts and the counterparts of gravitational waves.This study aims to utilize the latest AI technology to enhance the sensitivity of HADAR experiments.Training datasets and models with distinctive creativity were constructed by incorporating the relevant physical theories for various applications.These models can determine the type,energy,and direction of the incident particles after careful design.We obtained a background identification accuracy of 98.6%,a relative energy reconstruction error of 10.0%,and an angular resolution of 0.22°in a test dataset at 10 TeV.These findings demonstrate the significant potential for enhancing the precision and dependability of detector data analysis in astrophysical research.By using deep learning techniques,the HADAR experiment’s observational sensitivity to the Crab Nebula has surpassed that of MAGIC and H.E.S.S.at energies below 0.5 TeV and remains competitive with conventional narrow-field Cherenkov telescopes at higher energies.In addition,our experiment offers a new approach for dealing with strongly connected,scattered data.

Oral administration of Bacillus coagulans TQ-35 alleviates allergic responses in OVA-sensitive BALB/c mice

Bacillus coagulans has been extensively studied so far,but there has been a lack of research on its usage in allergy.In this study,we designed to assess the effect of different concentrations of B.coagulans on food allergy in a BALB/c mouse model of ovalbumin(OVA)-induced food allergy and its effect on gut microbes.The assessment of symptoms,specific immunoglobulin E(IgE),T-cell differentiation,and related gene expression levels in sensitized mice by assay indicated that high doses of oral B.coagulans could alleviate allergic symptoms.Treatment with B.coagulans,in the high-dose group,significantly reduced IgE and IgG1 levels and modulated the balance of T helper type 1 cell(Th1)and Th2 and the expression of relevant genes in the spleen.16S rRNA analysis showed that probiotics improved the structure of the microbiota,in particular by boosting the percentage of Clostridia,Bacteroides vulgatus and Enterococcus faecium,and by increasing the abundance of microbial species,thereby modulating the immune system.Therefore,this study can provide insights into the practical application of B.coagulans doses to alleviate OVA allergy.

Error field penetration in J-TEXT tokamak based on two-fluid drift-MHD model

An externally generated resonant magnetic perturbation can induce complex non-ideal MHD responses in their resonant surfaces.We have studied the plasma responses using Fitzpatrick's improved two-fluid model and program LAYER.We calculated the error field penetration threshold for J-TEXT.In addition,we find that the island width increases slightly as the error field amplitude increases when the error field amplitude is below the critical penetration value.However,the island width suddenly jumps to a large value because the shielding effect of the plasma against the error field disappears after the penetration.By scanning the natural mode frequency,we find that the shielding effect of the plasma decreases as the natural mode frequency decreases.Finally,we obtain the m/n=2/1 penetration threshold scaling on density and temperature.

NOX4 promotes tumor progression through the MAPK-MEK1/2-ERK1/2 axis in colorectal cancer

BACKGROUND Metabolic reprogramming plays a key role in cancer progression and clinical outcomes;however,the patterns and primary regulators of metabolic reprogramming in colorectal cancer(CRC)are not well understood.AIM To explore the role of nicotinamide adenine dinucleotide phosphate oxidase 4(NOX4)in promoting progression of CRC.METHODS We evaluated the expression and function of dysregulated and survival-related metabolic genes using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes.Consensus clustering was used to cluster CRC based on dysregulated metabolic genes.A prediction model was constructed based on survival-related metabolic genes.Sphere formation,migration,invasion,proliferation,apoptosis and clone formation was used to evaluate the biological function of NOX4 in CRC.mRNA sequencing was utilized to explore the alterations of gene expression NOX4 over-expression tumor cells.In vivo subcutaneous and lung metastasis mouse tumor model was used to explore the effect of NOX4 on tumor growth.RESULTS We comprehensively analyzed 3341 metabolic genes in CRC and identified three clusters based on dysregulated metabolic genes.Among these genes,NOX4 was highly expressed in tumor tissues and correlated with worse survival.In vitro,NOX4 overexpression induced clone formation,migration,invasion,and stemness in CRC cells.Furthermore,RNA-sequencing analysis revealed that NOX4 overexpression activated the mitogen-activated protein kinase-MEK1/2-ERK1/2 signaling pathway.Trametinib,a MEK1/2 inhibitor,abolished the NOX4-mediated tumor progression.In vivo,NOX4 overexpression promoted subcutaneous tumor growth and lung metastasis,whereas trametinib treatment can reversed the metastasis.CONCLUSION Our study comprehensively analyzed metabolic gene expression and highlighted the importance of NOX4 in promoting CRC metastasis,suggesting that trametinib could be a potential therapeutic drugs of CRC clinical therapy targeting NOX4.

Application of Fusobacterium nucleatum as a biomarker in gastrointestinal malignancies

The morbidity and mortality of gastrointestinal(GI)malignancies are among the highest in the world,posing a serious threat to human health.Because of the insidious onset of the cancer,it is difficult for patients to be diagnosed at an early stage,and it rapidly progresses to an advanced stage,resulting in poor treatment and prognosis.Fusobacterium nucleatum(F.nucleatum)is a gram-negative,sporefree anaerobic bacterium that primarily colonizes the oral cavity and is implicated in the development of colorectal,esophageal,gastric,and pancreatic cancers via various intricate mechanisms.Recent development in novel research suggests that F.nucleatum may function as a biomarker in GI malignancies.Detecting the abundance of F.nucleatum in stool,saliva,and serum samples of patients may aid in the diagnosis,risk assessment,and prognosis monitoring of GI malignancies.This editorial systematically describes the biological roles and mechanisms of F.nucleatum in GI malignancies focusing on the application of F.nucleatum as a biomarker in the diagnosis and prognosis of GI malignancies to promote the clinical translation of F.nucleatum and GI tumors-related research.

领导包联制:基层疑难事项的跨层级治理——概念缘起、实践类型及制度逻辑

领导包联制作为领导下沉参与基层治理的制度通道,在基层疑难、重点事项的治理中广泛应用,是具有本土特色的中国之治。论文溯及领导包联制的缘起,归纳了其当前典型实践样态,探讨了其何以推动基层疑难事项治理的制度逻辑。研究发现,第一,领导包联制是对党的领导干部“蹲点调研”工作方法的创新性传承,其由党的工作制度逐步发展为一项社会治理制度,在实践中取得了良好的治理成效。第二,领导包联制在实践中存在“中央领导联系点”“省级领导包县联市”和“市县领导包联事项”三种典型实践样态。第三,领导包联制通过对传统科层责任关系、组织关系、治理关系以及治理导向的重构,推动了基层疑难事项的跨层级治理。领导包联制是具有鲜明中国特色的上级领导参与基层微观事项治理的制度通道。上级领导介入基层治理工作在一定程度上减轻了基层在面对疑难治理事项时的压力,为观察和理解跨层级协作治理提供了新的视角。

4%,达成还是超越?——从国际比较的视角观照我国财政性教育经费支出占GDP比重的适切性

教育经费充足是教育事业发展的有力保障,2012年我国财政性教育经费占国内生产总值的比例达到4.28%,其后十年该比例均保持在4%以上,给予教育事业极大的信心与保障。通过检视国内教育经费投入数据发现,我国财政性教育经费支出已显乏力,难以满足教育强国建设高质量教育体系的需求。通过国际数据比较发现,我国与经济发展水平相近的俄罗斯和墨西哥相比,无论是公共教育支出占GDP的比例还是生均教育投入,均处于中间水平,与OECD部分国家相比,尚存在较大差距。在结合国际比较分析后推断:未来我国人均GDP突破2万美元时,财政性教育经费支出比例至少提高到4.8%才能达到OECD平均的教育财政投入水平,倘若人均GDP达到3万美元的经济发展水平,财政性教育经费支出比例应至少达到5%。

Clinical application of reserved gastric tube in neuroendoscopic endonasal surgery for pituitary tumor

BACKGROUND The neuroendoscopic approach has the advantages of a clear operative field,convenient tumor removal,and less damage,and is the development direction of modern neurosurgery.At present,transnasal surgery for sphenoidal pituitary tumor is widely used.But it has been found in clinical practice that some patients with this type of surgery may experience post-operative nausea and vomiting and other discomforts.AIM To explore the effect of reserved gastric tube application in the neuroendoscopic endonasal resection of pituitary tumors.METHODS A total of 60 patients who underwent pituitary adenoma resection via the endoscopic endonasal approach were selected and randomly divided into the experimental and control groups,with 30 in each group.Experimental group:After anesthesia,a gastric tube was placed through the mouth under direct vision using a visual laryngoscope,and the fluid accumulated in the oropharynx was suctioned intermittently with low negative pressure throughout the whole process after nasal disinfection,during the operation,and when the patient recovered from anesthesia.Control group:Given the routine intraoperative care,no gastric tube was left.The number of cases of nausea/vomiting/aspiration within 24 h post-operation was counted and compared between the two groups;the scores of pharyngalgia after waking up,6 h post-operation,and 24 h postoperation.The frequency of postoperative cerebrospinal fluid leakage and intracranial infection were compared.The hospitalization days of the two groups were statistically compared.RESULTS The times of postoperative nausea and vomiting in the experimental group were lower than that in the control group,and the difference in the incidence of nausea was statistically significant(P<0.05).After the patient woke up,the scores of sore throat 6 h after the operation and 24 h after operation were lower than those in the control group,and the difference was statistically significant(P<0.05).The number of cases of postoperative cerebrospinal fluid leakage and intracranial infection was higher than that of the control group,but there was no statistically significant difference from the control group(P>0.05).The hospitalization days of the experimental group was lower than that of the control group,and the difference was statistically significant(P<0.05).CONCLUSION Reserving a gastric tube in the endoscopic endonasal resection of pituitary tumors,combined with intraoperative and postoperative gastrointestinal decompression,can effectively reduce the incidence of nausea,reduce the number of vomiting and aspiration in patients,and reduce the complications of sore throat The incidence rate shortened the hospitalization days of the patients.

3D-CTBA结合灌注区识别技术在单孔胸腔镜复杂肺段切除术中的应用

背景与目的随着肺段切除术在早期肺癌治疗中的广泛应用,如何更加精准和微创地完成肺段切除成为研究热点。本研究旨在探讨三维计算机断层支气管血管成像(three-dimensional computed tomography bronchography and angiography,3D-CTBA)结合灌注区识别技术在单孔胸腔镜复杂肺段切除术中的应用价值。方法回顾性分析2021年1月-2022年1月首都医科大学宣武医院胸外科单诊疗组连续112例单孔胸腔镜复杂肺段切除术患者的资料,总结采用三维重建结合灌注区识别技术完成手术并分析其临床数据。结果本组病例平均手术时间为(141.1±35.4)min,段间界显示初始时间为(12.5±1.7)s,段间界维持时间为(114.3±10.9)s,肺段间界均清晰显示(100%),出血量为[10(10,20)]m L,术后总引流量为(380.5±139.7)m L,术后拔管时间为(3.9±1.2)d,术后住院时间为(5.2±1.6)d。8例出现术后并发症。结论3D-CTBA结合灌注区识别技术在单孔胸腔镜复杂肺段切除术中对段间界识别具有快速、准确和安全的优点,为精准切除肿瘤、减少手术时间及降低手术并发症提供指导。