Objective:To investigate the value of preoperative slight decline of the pulmonary function in predicting postoperative cardiopulmonary complications (PCC) after left total pneumonectomy of lung cancer patients to guide the clinical surgery of lung can-cer. Methods:Clinical data of 200 lung cancer patients after left total pneumonectomy were retrospectively analyzed. These patients were divided into two groups (PCC and non-PCC) based on the incidence of postoperative cardiopulmonary complications within 1 month after the cancer resection. The relationship between the preoperative slight or moderate to severe reduction of pulmonary func-tion and postoperative complications was explored. The correlation between the preoperative slight decline of the pulmonary function index and PCC was also analyzed. Results:Among the 200 patients, 35, 45, and 120 demonstrated normal, slightly, and moderately to severely reduced pulmonary functions, and 28.6%, 53.3%, and 62.5% showed PCC within 1 month after the surgical resection (χ2=12.611, P=0.002). Significant differences in the slightly reduced pulmonary function parameters MVV% (70% ≤ MVV<80%) and FEV1%(70%≤FEV 1%<80%) were observed between those without and with complications (P=0.028 and 0.014). Further analysis indicated no significant difference between the patients with preoperative slight reduction of FEV1%only or of MVV%only (P>0.05). However, statistically significant differences were observed when both FEV1%and MVV%were slightly reduced (χ2=6.598, P=0.010). Conclusion:The preoperative slight reduction values of FEV1%and MVV%were the risk factors in predicting PCC after left pneumo-nectomy in lung cancer patients. The slightly reduced FEV1%or MVV%alone cannot influence PCC. Both slightly reduced FEV1%and MVV%were the risk factors of PCC. Perioperative management should be strengthened for these patients to lower the incidence of PCC.

Objective The purpose of this study was to explore the effect of FVIII(factor VIII,FVIII)and VWF (von Willebrand factor,VWF)elevation on the severity, prognosis and inpatient complications such as infections and neuroworsening in patients with acute ischemic stroke. Methods Ninety patients with acute ischemic stroke and 50 pa?tients without ischemic stroke were recruited from affiliated Shengjing hospital of China Medical University between De?cember 2014 and March 2015 . We tested FVIII and VWF levels of all the patients. Patients with acute ischemic stroke were divided into 4 groups:both FVIII and VWF within normal range(FVIII-/VWF-);elevated FVIII, but normal VWF (FVIII↑/VWF-); FVIII within normal range, but elevated VWF(FVIII-/VWF↑); and elevation of both FVIII and VWF(FVIII↑/VWF↑). Results The median of VWF was higher in the case group (1521.88 U/L) than in the control group (1281.77U/L)(P=0.023). Compared with patients with both FVIII and VWF within normal range, patients with ele? vation of both FVIII and VWF had more severe neurological dysfunction(NIHSS at admission>5)(OR=3.643,95%CI:1.258~10.549,P=0.017)and poorer prognosis(mRS>2 at the point of 3 months after stroke)(OR=7,95%CI:2.304~21.266,P=0.001), higher proportion of mRS>2 at discharge(OR=3.797,95%CI:1.346~10.713,P=0.012),and more in?patient complications such as infections(OR=3.913,95%CI:1.115~13.729,P=0.033)and neuroworsening(OR=5.538, 95%CI:1.099~27.908,P=0.038). After additional adjustment for various confounding factors, elevation of both FVIII and VWF was an independent predictor of poor prognosis in patients with acute ischemic stroke(OR=4.495,95%CI 1.012~19.957,P=0.048). Conclusions The elevation of FVIII and VWF is positively associated with the severity and prognosis in patients with acute ischemic stroke, which may serve as an independent predictor of poor prognosis.

Objective To investigate the effect of the exogenous fragile hisdidine triad(FHIT) gene on the proliferation and the apoptosis of cutaneous carcinoma cell line A431,and to explore the mechanism of tumor suppression by the FHIT gene.Methods The plasmids pcDNA3-FHIT and pcDNA3-vector were transfected into the cutaneous carcinoma cell line A431 without FHIT gene expression,and then the transfected cells were screened by G418 and the expression of FHIT was determined by the immunocytochemical staining technique.The effect of FHIT on the growth characteristics of cutaneous carcinoma cell line A431 was observed by MTT,colony forming test and flow cytometry.Results Stable FHIT gene expressing A431 cells were produced,the proliferation activity and colony forming capability of A431FHIT were suppressed,whereas the apoptosis was increased.All these differences between A431-FHIT cells and the two control groups of cutaneous carcinoma cells had statistical significance.Conclusion Transfecting the exogenous FHIT gene into cutaneous carcinoma cells line A431can suppress the proliferation of tumor cells,and can also induce apoptosis and cell cycle arrest.

Objective To explore the indications and clinical effects of simultaneous mandibular angleplasty on the unaffected side, performed using preformed titanium mesh combined with mandibular angle bone graft, for the treatment of hemifacial microsomia (HFM). Methods The study group included 11 patients between 2013 and 2021 with HFM who underwent simultaneous mandibular angle reduction of the unaffected side and augmentation of the affected side using resected bone scaffolds within the titanium mesh. A series of mandibular linear measurements such as ramus height(RH)and mandibular body length(BL), angular measurements, and asymmetry index combined with clinical photographs and postoperative complications were used to assess the therapeutic effect. Results Postoperatively, all patients were satisfied. Significant improvement in mandibular contour was shown, with no obvious complications. Postoperative data, such as BL and angular measurements, showed no statistically significant differences(P>0.05) between the affected and unaffected sides with improvement in symmetry, except for RH(P<0.05). The preoperative and postoperative asymmetry index were (17.11±4.56)% and (4.81±1.73)%, respectively, with significant improvement(P=0.002). Conclusion This approach provides satisfactory results and significantly improves facial asymmetries for unilateral HFM with hypertrophy of the contralateral mandibular angle.

Pathogenic Candida albicans has a high degree of adaptability to environment,which is evidenced by its a-daptability to various conditions,including its symbiosis with the host,growth in host tissues during invasion,and survival un-der antifungal treatment.The growth and reproduction of C.albicans is accompanied with metabolism process.C.albicans can use a wide range of carbon and nitrogen sources,and it is sensitive to the alteration of nutrition.Recent studies reveal that the environment affects the metabolism of C.albicans,whilst C.albicans regulates its metabolism to adapt to the environment. Therefore,further study on the relationship between metabolism and high adaptability of C.albicans is helpful to discover no-vel antifungal targets.

Objective To understand patient pathway and clinical characteristics of chronic diseases in urban areas of Shanghai. Methods A total of 10 002 residents were enrolled and assigned to the chronic disease group (including hypertension, diabetes, coronary heart disease, myocardial infarction, and ischemic stroke) and the non-chronic disease group. Body mass index,fasting blood glucose, triglyceride,total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol were tested.Difference of patient pathway and clinical characteristics of those chronic diseases was compared. Results Above chronic diseases were observed in 37.7% participants. About 2/3 diseases were confirmed and 80% patients were followed up in healthcare units not far away from home. Patients with coronary heart disease and myocardial infarction showed more outpatient visit to tertiary hospitals (P＜0. 05 ). However, patients with ischemic stroke had health check, rehabilitation and pharmacy done mainly in local healthcare centers (P＜0. 05 ). Diastolic blood pressure of patients visiting local doctors was significantly decreased (P＜0. 05). Conclusion Some differences in patient pathway were found in this study. Communication and cooperation between medical institutions should be intensified for effective chronic disease control.

Objective To evaluate the position of the fetal conus medullaris during pregnancy and its value in detecting tethered cord syndrome(TCS). Methods Nine hundred and seventy-four normal fetuses and 46 fetuses with TCS between 15 and 41 weeks gestation were involved in the study.Parameters D 1 (the distance between the end of the conus medullaris and the caudal edge of last vertebral body ossification center) and D2 (the distance from the end of the conus medullaris to the caudal skin namely the intersection point of the extending line of D1 and the skin) were measured in the caudal midsagittal plane of the spine. Sixty normal fetuses were chosed randomly for interobserver variability.Correlation analysis between these two parameters and gestational age(GA) were conducted and the normal reference value of these parameters were calculated in normal group. The ratios of growth parameters ( Biparietal diameter, Head circumference,Abdominal circumference,Femur length) to D1 and D2 were calculated separately to observe the difference of the ratios between two groups. All the parameters and ratios of normal fetuses were compared with that of TCS cases.Results There was no significant difference in D1 and D2 between two observers.A significant linear correlation between the parameters and GA was found in normal group,linear regression equations were D1=0.251 GA -2.265 cm (R2=0.926,P <0.01) and D2=0.267 GA -1.812 cm(R2=0.928,P <0.01),respectively.D1 and D2 were much lower in normal group than in abnormal group (all P <0.01). The ratios of the growth parameters to D1 and D2 were relatively stable and had statistically differences between two groups in different gestational age. Conclusions The methods that determination of D1 and D2 are simple and feasible,and could help to the prenatal diagnosis of TCS.

OBJECTIVE: To investigate the differentially expressed proteins in the cerebrospinal fluid (CSF) of patients with amyotrophic lateral sclerosis (ALS) at the proteomics level using tandem mass spectrometry label (TMT) technique and explore the pathogenic mechanism and related pathways of ALS. METHODS: Between November, 2017 and April, 2018, 5 patients with medulla oblongata onset ALS and 5 patients with limb onset ALS were selected from the Departments of Neurology of 928 Hospital of Army Joint Logistics Support Force of PLA and Xiangya Hospital of Central South University, with 5 patients with migraine and low intracranial pressure headache serving as the healthy controls.CSF samples were obtained from all the participants, and the differentially expressed proteins in the CSF were identified using tandem mass spectrometry (TMT) technique with bioinformatics analysis. RESULTS: A total of 1530 proteins were identified and quantified in the CSF samples.The expression of 48 proteins was up-regulated and 6 proteins were down-regulated in medulla oblongata onset ALS patients; 16 proteins were up-regulated and 19 were down-regulated in limb onset ALS patients.GO analysis showed that these proteins, which were distributed both within and outside the cells, were involved in cell physiological process, single organ process and biological regulation and had binding function, catalytic activity, and receptor activity.KEGG pathway analysis showed that the up-regulated proteins in the CSF from patients with medulla oblongata onset ALS participated in 3 pathways involving the lysosomes, metabolism, and measles.The down-regulated proteins in the CSF from patients with limb onset ALS participated in 7 pathways involving the complement and coagulation cascade, infection and herpes simplex infection, and all the pathways contained complement components. CONCLUSIONS The CSF samples of ALS patients with medullary onset and limb onset have differentially expressed proteins.The lysosomal pathway is involved in the occurrence and progression of ALS with medullary onset, and the immune responses are involved in the occurrence and progression of ALS with limb onset.
Amyotrophic Lateral Sclerosis ; Biomarkers ; Cerebrospinal Fluid ; Humans ; Proteome ; Proteomics ; Tandem Mass Spectrometry

BackgroundSchizophrenia patients often face high level of stigma and low level of self-esteem， significantly hindering their recovery. Mindfulness-based intervention has proven be effective in reducing stigma and improving self-esteem. However， traditional mindfulness intervention typically involve high costs and require long-term professional involvement. ObjectiveTo explore the effects of blended mindfulness interventions on stigma and self-esteem in patients with stable schizophrenia， so as to provide references for reducing stigma， enhancing self-esteem and promoting recovery. MethodsPatients receiving outpatient treatment at the Third Hospital of Daqing from June 2022 to January 2023， who met the diagnostic criteria for schizophrenia in the International Classification of Diseases， tenth edition （ICD-10） and were in a stable phase， were recruited for the study （n=84）. According to the random number table method， participants were randomly assigned to study group and control group， with 42 cases in each group. Both groups received treatment with the second-generation antipsychotic medications， while the study group additionally received blended mindfulness intervention for 8 weeks， with sessions lasting 45~60 minutes， three times a week. Both groups were evaluated with Five Facet Mindfulness Questionnaire （FFMQ）， Internalized Stigma of Mental Illness Inventory （ISMI） and Rosenberg Self-Esteem Scale （RSES） at baseline and after 8-week intervention. Covariance analysis was used to compare the FFMQ， ISMI and SES scores between two groups after 8-week intervention. ResultsAfter 8-week intervention， there were statistically significant differences between two groups in total FFMQ scores， as well as in the observation， acting with awareness， non-judgment and non-reactivity subscale scores （F=50.680， 12.952， 13.567， 22.799， 14.043， P<0.01）. Statistically significant differences were observed in total ISMI scores， and in the alienation， stereotype endorsement， discrimination experience， stigma resistance and social withdrawal subscale scores （F=513.125， 148.990， 125.055， 75.996， 154.850， 54.125， P<0.01）. The difference in RSES scores between two groups was also statistically significant （F=19.478， P<0.01）. ConclusionBlended mindfulness intervention may help improve the mindfulness and self-esteem in stable schizophrenia patients while reducing stigma. ［Funded by Research Project of Heilongjiang Provincial Health Commission （number， 20220303090993）］

OBJECTIVETo explore the application of immediate recurrent laryngeal nerve reconstruction in the treatment of thyroid cancer invading the recurrent laryngeal nerve.

METHODSTen patients with thyroid cancer invading unilateral recurrent laryngeal nerve underwent radical surgery and immediate recurrent laryngeal nerve reconstruction. The reconstructive surgical approach included recurrent laryngeal nerve decompression surgery, end-to-end anastomosis of the recurrent laryngeal nerve, anastomosis of ansa cervicalis nerve to the recurrent laryngeal nerve, and nerve-muscle pedicle (NMP) technique. Among the ten patients, one underwent nerve decompression, one underwent end-to-end anastomosis of the recurrent laryngeal nerve, seven had anastomosis of ansa cervicalis to recurrent laryngeal nerve, and one case had anastomosis of ansa cervicalis to recurrent laryngeal nerve combined with nerve-muscle pedicle (NMP) technique. The effect of surgery was evaluated by videolaryngoscopy, maximum phonation time (MPT), phonation efficiency index (PEI) and voice assessment. T-test was used in the statistical analysis.

RESULTSAll of the 10 patients had no complications including tumor recurrence and hypoparathyroidism after the surgery. Their hoarseness symptoms were improved, and the patients returned to normal or near-normal voice. Postoperative videolaryngoscopy showed that paralyzed vocal cord returned to normal muscle tone and volume, and the vocal cord vibration and mucosal wave were symmetric and the patients got good glottal closure. The pre- and post-operative maximum phone times of the patients were (4.52 ± 0.89) s and (11.91 ± 1.87) s, respectively (P < 0.01). The pre- and post-operative phonation efficiency indices were (1.37 ± 0.43) s/L and (4.02 ± 1.33) s/L, respectively (P < 0.05).

CONCLUSIONSIn patients with thyroid cancer invading unilateral recurrent laryngeal nerve, immediate recurrent laryngeal nerve reconstruction following radical surgery of thyroid cancer can effectively achieve recovery in phonation function and improve the quality of life of the patients.

Anastomosis, Surgical ; Humans ; Neoplasm Recurrence, Local ; surgery ; Neurosurgical Procedures ; Phonation ; Postoperative Complications ; Quality of Life ; Reconstructive Surgical Procedures ; Recurrent Laryngeal Nerve ; pathology ; surgery ; Thyroid Neoplasms ; surgery ; Vocal Cord Paralysis ; Vocal Cords