Objective To investigate the effect of remote ischemic preconditioning (RIPC) combined with dexmedetomidine on the lung injury during one-lung ventilation (OLV) in the patients undergoing thoracic surgery. Methods Eighty ASA physical status I or Ⅱ patients, scheduled for elective radical operation for esophageal cancer, were randomly divided into 2 groups(40 patients each group) using a random number table: control group and RIPC combined with dexmedetomidine group (ORD group). In ORD group,10 min after endotraeheal intubation, RIPC was induced by 3 cycles of 5 min lower extremity ischemia followed by 5 min reperfusion, and at the same time a loading dose of dexmedetomidine 1.0 μg/kg was infused intravenously over 15 min and then dexmedetomidine was infused at a rate of 0.5 μg/(kg·h) until the end of operation. At 0, 30 min, 1 h and 2 h of OLV(T1-4), blood samples were obtained from the radial artery for blood gas analysis and determination of plasma concentrations of tumor necrosis factor-α (TNF-α), interleukin (IL)-1βand IL-10.Oxygenation index and respiratory index were calculated. Exhaled breath condensate was collected at T1, T3 and T4, and the pH value was measured. Results The respiratory index at T2-4 in 2 groups were significantly higher than those at T1, control group: 1.16 ±0.12, 1.02 ±0.10 and 0.97±0.12 vs. 0.49±0.06, ORD group: 0.84±0.15, 0.72±0.12 and 0.65±0.10 vs. 0.48±0.08, there were statistical differences (P<0.05). The oxygenation index at T2-4 in 2 groups were significantly lower than those at T1, control group: (287.1±21.8), (306.8±35.2) and (312.9±25.5) mmHg (1 mmHg=0.133 kPa) vs. (426.5±39.0) mmHg, ORD group: (335.0±34.7), (341.1±41.3) and (359.1±38.8) mmHg vs. (433.6±23.8) mmHg, there were statistical differences (P<0.05). Compared with control group, the respiratory index at T2-4 in ORD group were elevated, the oxygenation index at T2-4 in ORD group were depressed, there were statistical differences (P<0.05). The TNF-α and IL-1β at T3-4 in 2 groups were significantly higher than those at T1, control group: (31.4±6.7) and (38.3±7.2) μg/L vs. (16.2±5.1) μg/L, (7.2±1.6) and (12.3±4.2) μg/L vs. (3.0±0.7) μg/L, ORD group: (21.7±5.4) and (23.4±5.1) μg/L vs. (16.3±4.7) μg/L, (4.8±0.9) and (6.3±1.6) μg/L vs. (2.9±0.8) μg/L, there were statistical differences (P<0.05). The pH value of exhaled breath condensate at T3-4 in 2 groups were significantly lower than those at T1, control group: 6.41±0.23 and 6.33±0.21 vs. 6.93±0.35, ORD group: 6.79±0.30 and 6.74±0.33 vs. 7.07±0.22, there were statistical differences (P<0.05). The IL-10 at T4 in 2 groups were significantly higher than those at T1, control group:(30.6±6.3) μg/L vs. (19.2±5.3) μg/L, ORD group: (41.3±5.2) μg/L vs. (19.5±4.9) μg/L, there were statistical differences (P<0.05). Compared with control group, the TNF-α and IL-1β at T3-4 in ORD group were depressed, the pH value of exhaled breath condensate at T3-4 in ORD group were elevated, the IL-10 at T4 in ORD group was elevated, there were statistical differences (P<0.05). Conclusions RIPC combined with dexmedetomidine can inhibit inflammatory responses and reduce airway acidification, thus attenuate the lung injury during OLV in the patients undergoing thoracic surgery.

This study was aimed to observe the effect of Pediatric Long-term Cough Decoction in the treatment of long-term cough among children. A total of 96 cases were diagnosed in traditional Chinese medicine (TCM) as qi-yin deficiency, and lung-heat accumulation with constipation. The western medicine diagnosis was mycoplasma pneumoniae pneumonia (MPP) infection in the recovery period after chronic cough. All cases were randomly divided into the TCM group and control group, with 48 cases in each group. In TCM group, the Pediatric Long-term Cough Decoction was used to supplement qi and nourish yin, clear away the lung-heat and excrete feces. In the control group, montelukast was used. For both groups, clinical effect of score and CD4+ T lymphocytes, CD8+ T lymphocytes and CD4+/CD8+ ratio were observed one day before treatment and thirty days after treatment. The results showed that after thirty-day treatment, the clinical effect of score in both groups was obviously improved (P < 0.01). The TCM group was better than the control group (P< 0.01). Compared with pretreatment, the posttreatment CD4+ T lympho-cytes, CD8+ T lymphocytes and CD4+/CD8+ ratio in TCM group were obviously improved (P < 0.05). The CD4+ T lymphocytes and CD4+/CD8+ ratio in the control group were obviously improved (P < 0.05). However, there was no change on the CD8+ T lymphocytes. The regulation effect on CD4+ T lymphocytes and CD8+ T lymphocytes of TCM group was better than the control group (P< 0.01). It was concluded that the Pediatric Long-term Cough Decoction can effectively improve clinical symptoms of chronic cough in children and regulate immune function.

Objective To investigate the clinical efficacy of sildenafil in treatment of pulmonary arterial hypertension (PH),in order to provide more theory basis for clinical treatment.Methods A total of 80 PH patients was enrolled in this study.All the 80 cases were divided into conventional treatment group and sildenafil treatment group with 40 cases each.The 6-min walk test distance,Brog dyspnea score,pulmonary artery systolic pressure(SPAP),heart rate,circulation systolic blood pressure (cSBP),circulation diastolic blood pressure (cDBP),alanine aminotransferase (ALT),aspartate aminotransferase (AST),blood urea nitrogen (BUN) and serum creatinine (SCr) were recorded before and after treatment.The clinical efficacy was compared between two groups.Results The 6-min walk test distance,Brog dyspnea score and SPAP before treatment in conventional treatment group and sildenafil treatment group were (258.62 ±58.34),(260.22 ± 54.33) m; (3.2 ± 1.1),(3.3 ± 1.2) scores; (70.66 ± 6.52),(71.09 ± 6.61) mm Hg (1 mm Hg =0.133 kPa),and there was no significant difference between two groups (P ＞ 0.05).The 6-min walk test distance was (332.67 ± 63.51),(411.47 ± 75.86) m after treatment in conventional treatment group and sildenalil treatment group,which was increased compared with that before treatment (P ＜ 0.05).Brog dyspnea score and SPAP were (2.6 ± 0.8),(2.0 ± 0.6) scores and (61.43 ± 5.27),(47.84 ± 5.15) mm Hg after treatment in conventional treatment group and sildenafil treatment group,which were decreased compared with those before treatment (P ＜ 0.05).The improvement of the 6-min walk test distance,Brog dyspnea score and SPAP in sildenafil treatment group were better than those in conventional treatment group (P ＜0.05).There was no significant difference in the heart rate,cSBP,cDBP,ALT,AST,BUN,SCr before and after treatment in two groups (P ＞ 0.05).The total effective rate in sildenafil treatment group was higher than that in conventional treatment group [77.5％ (31/40) vs.57.5％ (23/40)],and there was significant difference (P ＜ 0.05).The side effects were main headache,blushing,dyspepsia.Conclusion Sildenafil has more effective clinical efficacy in treating PH patients with accepted side-effect,which is worthy to be popularized in the clinical application.

Objective To Analysis the physical fitness participation of 1243 community residents and to provide the scientific basis for developing intervention strategies. Methods The study was based on data of Physical Activity Questionnaire collected in Nutrition and Health Survey 2006 in Putuo, Shanghai. 1 243 subjects aged 6 years and above were involved. Results 43.8% of community residents had participated in physical exercise. Participation ratio was 41.4% in male, lower than that in female (45.8%). Participation ratios among aged 6yr～, 18yr～, 45yr～, 60yr～ were 48.1%, 25.2%, 22.0%, 64.9% in male and 40.8%, 22.5%, 40.1%, 67.1% in female. Participation ratios among age groups were significantly different (P=0.000). Proportion for frequent exercise of all age groups were 25.0%, 11.9%, 19.7%, 64.9% for male and 21.1%, 15.0%, 37.4%, 66.3% for female. There were difference among age groups (P= 0.000). Conclusion Specific intervention measures should be developed for different kind of people.

Recently,as the exposure of the incident of‘octuplet’in Guangdong province,China's underground surrogate market has once again surfaced and led to a wide range of discussion.In this paper,the connotation and characteristics of surrogacy were analyzed and related laws and regulations of surrogacy in foreign countries were discussed.The main types of surrogacy-related legislation and regulations abroad are autonomy of private law,governmental regulation and complete prohibition.This paper carried out thorough legal analysis on whether to prohibit strictly or establish an authoritative legal system in view of the existing and ineffectively prohibited underground surrogate market in our country.

We retrospectively analyzed clinical and imaging data of 26 children with split cord malformations (SCMs). Based on Pang's classification, 14 SCMs were defined as type Ⅰ and 12 as type Ⅱ.Neural function was markedly improved in 20 patients postoperatively. Three of 4 children who did not undergo surgical treatment had neural function deteriorated. Two children lost follow-up. We suggest that Pang's Classification of SCMs may be useful in describing pathological changes and guiding surgical procedure; imaging examine (including MRI, CT and X-ray) would play a significant role in confirmed SCMs diagnosis; and surgical operation should focus on eliminate and prevent spinal cord damnification.

Humans ; Hydroxycholecalciferols ; blood ; Pneumoconiosis ; blood

Objective To demonstrate the feasibility of DTI in human calf with body phased-array coil and surface coil of spine as receiving coil on 3 T system, and to optimize the parameters of sequence, including slice thickness and b-value. Methods Fifteen healthy volunteers were recruited in this study and randomly divided into three groups. The DTI sequence for head was performed on calf in the first group (5 cases), and the sequence parameters were optimized based on the deficits of the raw and the post-processed DTI images. Then, different slice thickness were applied in the senond group (5 eases) to optimize the slice thickness, and this optimized parameter with the highest score based on quality of the post-processed DTI images was applied in the next step. Finally, different b values were applied in the last group to optimize this parameters. The b value with the highest score based on the quality of the pest-processed was the proper one. Results Three problems existed in the raw and the pest-processed images, when the DTI sequence for brain was used for the calf. First, the SNR of raw images is extremely low. Second, the muscle were unclear on the image with parts of signal lose, especially in the anterior tibialis muscle. Finally, the artifacts due to chemical shift and ghost are quite serious. The scores for muscle display quality with slice thickness of 4 mm , 5 mm and 6 mm were (7.0±0. 0), (8.6±0. 9) and (9.0±0. 0) score respectively, the signal less scores were (5.0±0. 0) and ( 12. 8±2. 6) and ( 13. 8±2. 2) score respectively, and the general score were (22. 0±0. 0) and (30. 1±3.8) and (31.0±4. 1 ) score respectively. The differences of above scores were significant among different slice thickness (F-value were 21. 000 and 30. 544 and 12. 390 respectively, P <0. 05 ). The muscle displaying quality, signal loss and general scores were lowest in group with 4 mm slice thickness (q-value were 4. 896.6. 120,6. 327,7. 138,3. 863 and 4. 043, P < 0. 05 ) o The scores of muscle display quality, signal loss and general for b =400 s/mm2 were (9. 0±0. 0), ( 14. 0± 2. 2 ) and ( 33.0±2. 2 ) score respectively, which were lower than those with b = 800 s/ram2 [(7.0±0.0), (6.2±2.2), (21.8±3.4) score] and b=1000 s/mm2[(7.0±0.0), (5.0±0.0), (20.6±2.2) score] (q-value were 3.873,3.873,6.650,7.672,7. 101 and 5.917, P <0.05)o The scores of muscle displaying quality, signal loss and general for b =600 s/mm2 were (8.2±1.1 ), ( 13.0± 2. 3) and ( 30. 8±3. 8 ) score respectively, which were higher than those with b = 800 s/mm2 and b= 1000 s/nun2 (q-value were 3.873, 3.873, 5.797, 6.820, 5.326 and 5.917, P <0.05).There is no significant difference between b = 600 s/ram2 and 400 s/ram2 ( q-value were 2. 582 and 0. 852 and 1. 775, P > 0. 05 ). Conclusion Our preliminary findings indicate that it is feasible to perform DTI on human calf with 3 T MR. With body phased-array coil and surface coil of spine as receiving coil, the DTI sequence were optimized to acquire enough SNB with slice thickness of 5 mm and b-value of 400 s/mm2.

This paper reviews the literature about the common complications, evaluation tools and intervention measures of free flap repair for tongue cancer patients at home and abroad, summarizes the current research status, and points out that the nursing plan of free flap repair for tongue cancer patients needs to be further standardized, and needs to carry out evidence-based clinical research.

Objective:To systematic review the efficacy and safety of external application of traditional Chinese medicine on treatment of breast cancer related lymphedema.Methods:CNKI, Wanfang Data, VIP, Sino-Med, The Cochrane Library, PubMed, Web of Science were searched for related randomized controlled trials, the retrieval time was from inception to May 25, 2020. Two researchers independently screened and evaluated the included studies. Meta-analysis was performed by RevMan 5.4 software.Results:A total of 16 studies involving 1 315 patients with breast cancer related lymphedema were included, and the methodological quality of the included studies was not high. Compared with conventional treatment, external application of traditional Chinese medicine combined with conventional treatment had advantages in improving the total efficiency( P<0.01) and quality of life( P<0.01), reducing pain( P<0.01) and improving upper limb function( P<0.01), without obvious adverse reactions( P>0.05), but there was no improvement in depression( P>0.05). Compared with conventional treatment, external application of traditional Chinese medicine could improve the total efficiency( P<0.01). Compared with placebo sticker combined with conventional treatment, external application of traditional Chinese medicine combined with conventional treatment can reduce circumference( P<0.05) and reduce pain( P<0.01), without obvious adverse reactions( P>0.05). Conclusions:Available evidence suggests that external application of traditional Chinese medicine may be a potential treatment method for breast cancer related lymphedema. Due to the poor methodological quality of the included studies, high-quality randomized controlled trials are still needed.