Impact of non-alcoholic fatty liver disease on coronavirus disease 2019: A systematic review

BACKGROUND Many studies have revealed a link between non-alcoholic fatty liver disease(NA-FLD)and coronavirus disease 2019(COVID-19),making understanding the relationship between these two conditions an absolute requirement.AIM To provide a qualitative synthesis on the currently present data evaluating COVID-19 and NAFLD.METHODS This systematic review was conducted in accordance with the guidelines pro-vided by preferred reporting items for systematic reviews and meta-analyses and the questionnaire utilized the population,intervention,comparison,and outcome framework.The search strategy was run on three separate databases,PubMed/MEDLINE,Scopus,and Cochrane Central,which were systematically searched from inception until March 2024 to select all relevant studies.In addition,ClinicalTrials.gov,Medrxiv.org,and Google Scholar were searched to identify grey literature.RESULTS After retrieval of 11 studies,a total of 39282 patients data were pooled.Mortality was found in 11.5%and 9.4%of people in NAFLD and non-NAFLD groups.In all,23.2%of NAFLD patients and 22%of non-NAFLD admissions diagnosed with COVID-19 were admitted to the intensive care unit,with days of stay varying.Ventilatory support ranged from 5%to 40.5%in the NAFLD cohort and from 3.1%to 20%in the non-NAFLD cohort.The incidence of acute liver injury showed significance.Clinical improvement on days 7 and 14 between the two classifications was significant.Hospitalization stay ranged from 9.6 days to 18.8 days and 7.3 days to 16.4 days in the aforementioned cohorts respectively,with 73.3%and 76.3%of patients being discharged.Readmission rates varied.CONCLUSION Clinical outcomes except mortality consistently showed a worsening trend in patients with NAFLD and concomitant COVID-19.Further research in conducting prospective longitudinal studies is essential for a more powerful conclusion.

Application Effect of Stratified Nursing Intervention for ICU Mechanically Ventilated Patients in the Context of Aspiration Risk Assessment

Objective:To explore the application effect of stratified nursing intervention based on the background of misinspiration risk assessment in mechanically ventilated patients in intensive care unit(ICU).Methods:100 cases of mechanically ventilated patients who were admitted to the ICU of our hospital from March 2022 to March 2023 were selected and divided into an observation group and a control group according to the random number table method,with 50 cases in each of the two groups.The control group was given routine care in ICU,and the observation group was given stratified nursing interventions based on the background of the risk of aspiration assessment on the basis of the control group,and both groups were cared for until they were transferred out of the ICU,and the mechanical ventilation time,ICU stay time,muscle strength score,complication rate,adherence,and satisfaction were observed and compared between the two groups.Results:The mechanical ventilation time and ICU stay time of the observation group were shorter than that of the control group after the intervention;the muscle strength score,compliance and satisfaction of the observation group were higher than that of the control group after the intervention;and the complication rate of the observation group was lower than that of the control group after the intervention,all of which were P<0.05.Conclusion:The application of stratified nursing intervention based on the background of misaspiration risk assessment in ICU mechanically ventilated patients can improve the patient's muscle strength,shorten the time of mechanical ventilation,promote the patient's recovery,reduce the occurrence of complications,and improve the patient's compliance and satisfaction.

Analysis on the Effect of Yiqi Huoxue Decoction Combined with Neuromuscular Electrical Stimulation in Improving ICU-Acquired Debility in Mechanically Ventilated Patients

Objective:To investigate the effect of Yiqi Huoxue decoction combined with neuromuscular electrical stimulation on improving intensive care unit(ICU)acquired debility in mechanically ventilated patients.Methods:50 patients who were admitted to the ICU and received mechanical ventilation treatment in our hospital from June 2022 to June 2023 and were complicated with ICU-acquired neurasthenia were selected,and randomly grouped using the randomized envelope method into two groups:control group with 25 patients who received neuromuscular electrical stimulation alone;observation group with 25 patients who received the traditional Chinese medicine Yiqi Huoxue decoction.Comparison indexes:treatment efficiency,degree of emotional recovery(APACHEⅡscore),muscle strength status(MRC score),motor status(FAC rating),and self-care ability(BI index score).Results:The treatment efficiency of patients in the observation group patients was higher as compared to those in the control group(P<0.05).There was no significant difference in the comparison of the results of the scores(ratings)of each index between the two groups before treatment(P>0.05).After the treatment,the APACHEⅡscores of patients in the observation group were significantly lower as compared to those in the control group,while the MRC scores,FAC ratings,and BI index scores were higher in the observation group than those of the control group patients(P<0.05).Conclusion:The combined application of Yiqi Huoxue decoction and neuromuscular electrical stimulation in the treatment of patients with ICU-acquired neurasthenia complicated by mechanical ventilation significantly enhanced the clinical efficacy,the patient’s muscle strength,motor status,and ability of self-care.Hence,it has high application value and is worthy to be popularized.

Early mobilization for mechanically ventilated patients in the intensive care unit:a systematic review and meta-analysis

Background: Early mobilization(EM) is a regimen that was carried out by physiotherapists in a relatively early stage. It has been investigated by an increasing number of researchers. However, there has not been a meta-analysis concerning whether EM could benefit the clinical outcomes of critically ill patients requiring mechanical ventilation(MV). The present systematic review aims to evaluate the effect of EM compared with immobilization for mechanically ventilated patients.Methods: A computerized literature search was performed in six databases for related articles from inception to June 2017. We included randomized controlled trials and controlled clinical trials and used the Physiotherapy Evidence Database scale to assess the quality of included studies. Primary outcomes were measures of muscle function, duration of MV, and incidence of mortality.Secondary outcomes were adverse effects and length of stay(LOS) in intensive care unit(ICU) and hospital.Results: Eight trials were included; of those, only one study without standard EM reported that the intervention was invalid to improve the outcomes. The result of meta-analysis indicated that EM shortened the duration of MV; however, it had no positive effect on mortality and LOS in ICU.Conclusions: This review suggests that EM improves the muscle function and ventilation duration. Further research highlighting standard intervention and specific groups is needed.

Cooling System Design Optimization of an Enclosed PM Traction Motor for Subway Propulsion Systems

This paper presents the design optimization of a self-circulated ventilation system for an enclosed permanent magnet(PM)traction motor utilized in the propulsion systems for subway trains.In order to analyze accurately the machine's inherent cooling capacity when the train is running,the ambient airflow and the related heat transfer coefficient(HTC)are numerically investigated considering synchronously the bogie installation structure.The machine is preliminary cooled with air ducts set on the motor shell,and the fluidic-thermal field distributions with only the shell air duct cooling are numerically calculated.During simulations,the HTC obtained in the former steps is applied to the external surface of the machine to model the inherent cooling characteristic caused by the train movement.To reduce the temperature rise and thus guarantee the motor's working reliability,an internal self-circulated air cooling system is proposed according to the machine temperature distribution.The air enclosed in the end-caps is driven by the blades mounted on both sides of the rotor core and forms two air circuits to bring the excessive power losses generated in the heating components to cool regions.The fluid flow and temperature rise distributions of the cooling system's structural parameters are further improved by the Taguchi method in order to confirm the efficacy of the internal air cooling system.

Systematic review on the risk-benefit ratio of morphine for acute heart failure

Objective:To evaluate morphine's risk-benefit profile in the treatment of acute heart failure.Method:Different electronic databases,including PubMed,MEDLINE,Cochrane Library,and Google Scholar,as well as clinicaltrails.gov,were searched for articles published between 2012 and 2022.The risk of bias in the present study was evaluated by employing randomized controlled trials(RCTs)checklist that assesses the effectiveness of new interventions through random assignment of participants to different treatment groups.The two-part tool was used to address the five specific domains such as selection bias,performance bias,detection bias,attrition bias,and selective reporting bias.Evaluation of the quality of diagnostic accuracy studies was conducted using the RevMan software(version 5.4),a quality assessment tool.Results:A total of 13 studies were included in the present review,in which there were 5 retrospective studies,3 randomized-control studies,2 prospective studies,1 multicenter pharmacodynamics study,1 multicenter cardiac magnetic resonance imaging study,and 1 open-label,cross-over study.The mortality of acute heart failure patients treated with morphine was higher compared to those without morphine.Conclusions:Acute heart failure patients who do not receive morphine have a lower mortality rate compared to those who receive morphine.Considering the adverse effects,including mortality associated with morphine,there is a pressing need for further research to explore alternative and effective treatment options in acute heart failure.

Effect of preoperative inspiratory muscle training on postoperative outcomes in patients undergoing cardiac surgery:A systematic review and meta-analysis

BACKGROUND Cardiovascular disease is the most prevalent disease worldwide and places a great burden on the health and economic welfare of patients.Cardiac surgery is an important way to treat cardiovascular disease,but it can prolong mechanical ventilation time,intensive care unit(ICU)stay,and postoperative hospitalization for patients.Previous studies have demonstrated that preoperative inspiratory muscle training could decrease the incidence of postoperative pulmonary complications.AIM To explore the effect of preoperative inspiratory muscle training on mechanical ventilation time,length of ICU stay,and duration of postoperative hospitalization after cardiac surgery.METHODS A literature search of PubMed,Web of Science,Cochrane Library,EMBASE,China National Knowledge Infrastructure,WanFang,and the China Science and Technology journal VIP database was performed on April 13,2022.The data was independently extracted by two authors.The inclusion criteria were:(1)Randomized controlled trial;(2)Accessible as a full paper;(3)Patients who received cardiac surgery;(4)Preoperative inspiratory muscle training was implemented in these patients;(5)The study reported at least one of the following:Mechanical ventilation time,length of ICU stay,and/or duration of postoperative hospitalization;and(6)In English language.RESULTS We analyzed six randomized controlled trials with a total of 925 participants.The pooled mean difference of mechanical ventilation time was-0.45 h[95%confidence interval(CI):-1.59-0.69],which was not statistically significant between the intervention group and the control group.The pooled mean difference of length of ICU stay was 0.44 h(95%CI:-0.58-1.45).The pooled mean difference of postoperative hospitalization was-1.77 d in the intervention group vs the control group[95%CI:-2.41-(-1.12)].CONCLUSION Preoperative inspiratory muscle training may decrease the duration of postoperative hospitalization for patients undergoing cardiac surgery.More high-quality studies are needed to confirm our conclusion.

Wind-Thermal Environmental Characteristic of Multi-Variable Passive Enhanced Natural Ventilation System for High and Large Space Building

Natural ventilation effects in high and large space buildings of tropical areas greatlya ffect the air conditioning energy consumption.Aiming at nearly zero energy building design,thisp aper mainly contributes to provide theoretical basis and reference for thermal comfortable air conditioning system design of high and large space buildings.Taking a theatre in Hainan as study object,a newly composite enhanced natural ventilation system is proposed by integrating theu nderground tunnel-based earth to air heat exchange system and the solar chimney.Ventilationq uantity,air velocity and air temperature field,human vertical temperature gradient differenceu nder24simulation working conditions are considered and analyzed by using ANSYS Fluent.Fort he underground tunnel,results show that Group Two with double underground tunnels and side airs upply location shows its advantages in cooling effects and air supply uniformity.Then for the solar chimney,results show that the solar radiation intensity contributes to larger difference int ransmission power and leads to different cooling effects.On the whole,the system under workingc ondition No.7with120m long,side air supply,double underground tunnel and20m high,1mw ide,0.6°absorber plate angle solar chimney shows its priority in better comprehensive performance.

Determination of Effectiveness of Energy Management System in Buildings

Building Energy Management Systems(BEMS)are computer-based systems that aid in managing,controlling,and monitoring the building technical services and energy consumption by equipment used in the building.The effectiveness of BEMS is dependent upon numerous factors,among which the operational characteristics of the building and the BEMS control parameters also play an essential role.This research develops a user-driven simulation tool where users can input the building parameters and BEMS controls to determine the effectiveness of their BEMS.The simulation tool gives the user the flexibility to understand the potential energy savings by employing specific BEMS control and help in making intelligent decisions.The simulation is developed using Visual Basic Application(VBA)in Microsoft Excel,based on discrete-event Monte Carlo Simulation(MCS).The simulation works by initially calculating the energy required for space cooling and heating based on current building parameters input by the user in the model.Further,during the second simulation,the user selects all the BEMS controls and improved building envelope to determine the energy required for space cooling and heating during that case.The model compares the energy consumption from the first simulation and the second simulation.Then the simulation model will provide the rating of the effectiveness of BEMS on a continuous scale of 1 to 5(1 being poor effectiveness and 5 being excellent effectiveness of BEMS).This work is intended to facilitate building owner/energy managers to analyze the building energy performance concerning the efficacy of their energy management system.

Comparison of the Effectiveness of Marked Suction Tubes vs. Plain Suction Tubes in Pediatric Mechanically Ventilated Patients

Introduction: Endotracheal suction plays a crucial role in the management of mechanically ventilated patients. This study aims to evaluate the clinical effectiveness and safety of suction tubes with markings in mechanically ventilated pediatric patients. Materials and Methods: A randomized assignment was carried out on a cohort of 52 pediatric patients who underwent mechanical ventilation in the Pediatric Intensive Care Unit at the Third Affiliated Hospital of Sun Yat-sen University, covering the period from January 2022 to December 2022. These patients were divided into two groups: an improved group (n = 26) utilizing marked suction tubes, and a regular group (n = 26) employing conventional suction tubes. The objective of our study was to evaluate the clinical effectiveness of marked suction tubes. Results: The effects of the improved group on the vital signs of children undergoing mechanical ventilation were small and statistically significant compared with the regular group (p < 0.05). Additionally, the improved group exhibited a reduced frequency of sputum suction, shorter mechanical ventilation duration, and fewer days of hospitalization in the PICU compared to the regular group during the ventilation period. Notably, the difference in the duration of PICU hospitalization was statistically significant (p < 0.05). Moreover, the incidence of adverse reactions in the improved group was notably lower, with statistically significant differences observed in airway mucous membrane damage and irritating cough when compared to the regular group (p < 0.05). Conclusion: The utilization of marked suction tubes provides clinical nurses with clear guidance for performing suctioning with ease, efficiency and safety. Consequently, advocating for the widespread implementation of marked suction tubes in clinical practice is a commendable pursuit.

Driving pressure in mechanical ventilation:A review

Driving pressure(ΔP)is a core therapeutic component of mechanical ventilation(MV).Varying levels ofΔP have been employed during MV depending on the type of underlying pathology and severity of injury.However,ΔP levels have also been shown to closely impact hard endpoints such as mortality.Considering this,conducting an in-depth review ofΔP as a unique,outcome-impacting therapeutic modality is extremely important.There is a need to understand the subtleties involved in making sureΔP levels are optimized to enhance outcomes and minimize harm.We performed this narrative review to further explore the various uses ofΔP,the different parameters that can affect its use,and how outcomes vary in different patient populations at different pressure levels.To better utilizeΔP in MV-requiring patients,additional large-scale clinical studies are needed.

Practice and analysis of recycling non-drinking water from air-condition and reverse-osmosis system into rainwater collection system

This paper is based on the rainwater collection project in the retrofit of the Dongyi teaching block in Zhejiang University Xixi Campus.The analysis incorporates the local meteorological data, recycling water utilization, and precipitation adjustment.The rainwater collection system in this program also adds the condensation water from the heating, ventilation and air conditioning （ HVAC） system and the concentration from the reverse-osmosis system used for watering greens and supplying waterscapes.By calculating, the quantity of the HVAC condensation water in summer is 3.48 m3/d, and the quantity of the reverse-osmosis concentrated water is 198 to 396 L/d.This method solves the water shortage caused by high evaporation in summer and low precipitation in winter.Supported by empirical monitoring data, the proposed method significantly increases the economic efficiency of the system during the summer period.

Smoke distribution in naturally ventilated urban transportation tunnels with multiple shafts

The smoke spreading law of urban transportation tunnels with multiple shafts under natural ventilation is studied.A full-scale burning experiment is conducted in an actual tunnel.The study shows that smoke temperatures below the tunnel ceiling reduce rapidly along the longitudinal towards the tunnel exits. A noticeable temperature stratification is observed near the fire source.Most fire smoke is exhausted out of the shafts while the number of the smoke shafts in the downstream is more than that in the upstream.Large eddy simulation LES based on computational fluid dynamics CFD is carried out using the fire dynamics simulator FDS software with parallel processing in which the grid size of the fire-domain is set to be 0.083 m.The simulation results of temperatures under the ceiling the smoke fronts and the shafts＇smoke exhaust or air supply agree reasonably with the experimental data. Further simulations indicate that the decreasing ambient temperature or shaft spacing might reduce smoke temperatures under the tunnel ceiling and increase mass flow rates out of the shafts.This study provides technical scientific evidence and supports for the design and construction of such kinds of tunnels.

A hybrid ventilation scheme applied to bidirectional excavation tunnel construction with a long inclined shaft

The breakage and bending of ducts result in a difficulty to cope with ventilation issues in bidirectional excavation tunnels with a long inclined shaft using a single ventilation method based on ducts.To discuss the hybrid ventilation system applied in bidirectional excavation tunnels with a long inclined shaft,this study has established a full-scale computational fluid dynamics model based on field tests,the Poly-Hexcore method,and the sliding mesh technique.The distribution of wind speed,temperature field,and CO in the tunnel are taken as indices to compare the ventilation efficiency of three ventilation systems(duct,duct-ventilation shaft,duct–ventilated shaft-axial fan).The results show that the hybrid ventilation scheme based on duct-ventilation shaft–axial fan performs the best among the three ventilation systems.Compared to the duct,the wind speed and cooling rate in the tunnel are enhanced by 7.5%–30.6%and 14.1%–17.7%,respectively,for the duct-vent shaft-axial fan condition,and the volume fractions of CO are reduced by 26.9%–73.9%.This contributes to the effective design of combined ventilation for bidirectional excavation tunnels with an inclined shaft,ultimately improving the air quality within the tunnel.

Experimental and numerical simulation study on forced ventilation and dust removal of coal mine heading surface

In order to study the problems of unreasonable airflow distribution and serious dust pollution in a heading surface,an experimental platform for forced ventilation and dust removal was built based on the similar principles.Through the similar experiment and numerical simulation,the distribution of airflow field in the roadway and the spatial and temporal evolution of dust pollution under the conditions of forced ventilation were determined.The airflow field in the roadway can be divided into three zones:jet zone,vortex zone and reflux zone.The dust concentration gradually decreases from the head to the rear of the roadway.Under the forced ventilation conditions,there is a unilateral accumulation of dust,with higher dust concentrations away from the ducts.The position of the equipment has an interception effect on the dust.The maximum error between the test value and the simulation result is 12.9%,which verifies the accuracy of the experimental results.The research results can provide theoretical guidance for the application of dust removal technology in coal mine.

Energy Design and Optimization of Greenhouse by Natural Convection

This study addresses the pressing need for energy-efficient greenhouse management by focusing on the innovative application of natural ventilation.The primary objective of this study is to evaluate various ventilation strategies to enhance energy efficiency and optimize crop production in agricultural greenhouses.Employing advanced numerical simulation tools,the study conducts a comprehensive assessment of natural ventilation’s effectiveness under real-world conditions.The results underscore the crucial role of the stack effect and strategic window positioning in greenhouse cooling,providing valuable insights for greenhouse designers.Our findings shed light on the significant benefits of optimized ventilation and also offer practical implications for improving greenhouse design,ensuring sustainable and efficient agricultural practices.The study demonstrated energy savings in cooling from November to April,with a maximum saving of 680 kWh in March,indicating the effectiveness of strategically positioning windows to leverage the stack effect.This approach enhances plant growth and reduces the need for costly cooling systems,thereby improving overall energy efficiency and lowering operational expenses.

Prevention of ventilator-associated pneumonia with inhaled antibiotics

The direct delivery of inhaled antibiotics to the respiratory tract has been a subject of enduring interest among medical practitioners and researchers due to the associated favorable pharmacokinetics.This interest has been particularly pronounced in the context of critically illpatients,wherehealthcare-associatedpulmonary infections represent a significant challenge,driving continued exploration of inhaled antibiotics for intubated patients.Recent high-level evidence has shown a very promising application in the field of ventilator-associated pneumonia (VAP) prevention.^([1]).

Influences of the Fresh Air Volume on the Removal of Cough-Released Droplets in a Passenger Car of a High-Speed Train Using CFD

The spread and removal of pollution sources,namely,cough-released droplets in three different areas(front,middle,and rear areas)of a fully-loaded passenger car in a high-speed train under different fresh air flow volume were studied using computational fluid dynamics(CFD)method.In addition,the structure of indoor flow fields was also analysed.The results show that the large eddies are more stable and flow faster in the air supply under Mode 2(fresh air volume:2200m3/h)compared to Mode 1(fresh air volume:1100m3/h).By analysing the spreading process of droplets sprayed at different locations in the passenger car and with different particle sizes,the removal trends for droplets are found to be similar under the two air supply modes.However,when increasing the fresh air flow volume,the droplets in the middle and front areas of the passenger car are removed faster.When the droplets had dispersed for 60s,Mode 2 exhibited a removal rate approximately 1%–3%higher than Mode 1 for small and medium-sized droplets with diameters of 10 and 50μm.While those in the rear area,the situation is reversed,with Mode 1 slightly surpassing Mode 2 by 1%–3%.For large droplets with a diameter of 100μm,both modes achieved a removal rate of over 96%in all three regions at the 60 s.The results can provide guidance for air supply modes of passenger cars of high-speed trains,thus suppressing the spread of virus-carrying droplets and reducing the risk of viral infection among passengers.

Nomogram to predict severe retinopathy of prematurity in Southeast China

AIM:To define the predictive factors of severe retinopathy of prematurity(ROP)and develop a nomogram for predicting severe ROP in southeast China.METHODS:Totally 554 infants diagnosed with ROP hospitalized in the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University and hospitalized in Taizhou Women and Children’s Hospital were included.Clinical data and 43 candidate predictive factors of ROP infants were collected retrospectively.Logistic regression model was used to identify predictive factors of severe ROP and to propose a nomogram for individual risk prediction,which was compared with WINROP model and Digirop-Birth model.RESULTS:Infants from the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University(n=478)were randomly allocated into training(n=402)and internal validation group(n=76).Infants from Taizhou Women and Children’s Hospital were set as external validation group(n=76).Severe ROP were found in 52 of 402 infants,12 of 76 infants,and 7 of 76 infants in training group,internal validation group,and external validation group,respectively.Birth weight[odds ratio(OR),0.997;95%confidence interval(CI),0.996-0.999;P<0.001],multiple births(OR,1.885;95%CI,1.013-3.506;P=0.045),and non-invasive ventilation(OR,0.288;95%CI,0.146-0.570;P<0.001)were identified as predictive factors for the prediction of severe ROP,by univariate analysis and multivariate analysis.For predicting severe ROP based on the internal validation group,the areas under receiver operating characteristic curve(AUC)was 78.1(95%CI,64.2-92.0)for the nomogram,32.9(95%CI,15.3-50.5)for WINROP model,70.2(95%CI,55.8-84.6)for Digirop-Birth model.In external validation group,AUC of the nomogram was also higher than that of WINROP model and Digirop-Birth model(80.2 versus 51.1 and 63.4).The decision curve analysis of the nomogram demonstrated better clinical efficacy than that of WINROP model and Digirop-Birth model.The calibration curves demonstrated a good consistency between the actual severe ROP incidence and the predicted probability.CONCLUSION:Birth weight,multiple births,and noninvasive ventilation are independent predictors of severe ROP.The nomogram has a good ability to predict severe ROP and performed well on internal validation and external validation in southeast China.

Lung ultrasound score evaluation of the effect of pressure-controlled ventilation volume-guaranteed on patients undergoing laparoscopicassisted radical gastrectomy

BACKGROUND Laparoscopic-assisted radical gastrectomy(LARG)is the standard treatment for early-stage gastric carcinoma(GC).However,the negative impact of this proce-dure on respiratory function requires the optimized intraoperative management of patients in terms of ventilation.AIM To investigate the influence of pressure-controlled ventilation volume-guaranteed(PCV-VG)and volume-controlled ventilation(VCV)on blood gas analysis and pulmonary ventilation in patients undergoing LARG for GC based on the lung ultrasound score(LUS).METHODS The study included 103 patients with GC undergoing LARG from May 2020 to May 2023,with 52 cases undergoing PCV-VG(research group)and 51 cases undergoing VCV(control group).LUS were recorded at the time of entering the operating room(T0),20 minutes after anesthesia with endotracheal intubation(T1),30 minutes after artificial pneumoperitoneum(PP)establishment(T2),and 15 minutes after endotracheal tube removal(T5).For blood gas analysis,arterial partial pressure of oxygen(PaO_(2))and partial pressure of carbon dioxide(PaCO_(2))were observed.Peak airway pressure(P_(peak)),plateau pressure(Pplat),mean airway pressure(P_(mean)),and dynamic pulmonary compliance(C_(dyn))were recorded at T1 and T2,1 hour after PP establishment(T3),and at the end of the operation(T4).Postoperative pulmonary complications(PPCs)were recorded.Pre-and postoperative serum interleukin(IL)-1β,IL-6,and tumor necrosis factor-α(TNF-α)were measured by enzyme-linked immunosorbent assay.RESULTS Compared with those at T0,the whole,anterior,lateral,posterior,upper,lower,left,and right lung LUS of the research group were significantly reduced at T1,T2,and T5;in the control group,the LUS of the whole and partial lung regions(posterior,lower,and right lung)decreased significantly at T2,while at T5,the LUS of the whole and some regions(lateral,lower,and left lung)increased significantly.In comparison with the control group,the whole and regional LUS of the research group were reduced at T1,T2,and T5,with an increase in PaO_(2),decrease in PaCO_(2),reduction in P_(peak) at T1 to T4,increase in P_(mean) and C_(dyn),and decrease in Pplat at T4,all significant.The research group showed a significantly lower incidence of PPCs than the control group within 3 days postoperatively.Postoperative IL-1β,IL-6,and TNF-αsignificantly increased in both groups,with even higher levels in the control group.CONCLUSION LUS can indicate intraoperative non-uniformity and postural changes in pulmonary ventilation under PCV-VG and VCV.Under the lung protective ventilation strategy,the PCV-VG mode more significantly improved intraop-erative lung ventilation in patients undergoing LARG for GC and reduced lung injury-related cytokine production,thereby alleviating lung injury.