Nuclear factor kappa B(NF-?B) is an important transcription factor in the expression of many inflammatory media. With the recent progress of molecular biological technique, the modulated mechanism of NF-?B in immunity, stress, inflammatory responses, and the differentiation and growth of lymphocyte has been the focus. This review presents the role of NF-?B in ischemia-reperfusion and cardiopulmonary bypass, and the research progression of intervention therapy in inhibition of the activation of NF-?B is also introduced herein after.

Objective To evaluate the therapeutic effect of mini-incision surgery for the treatment of varicose vein of lower extremities. Methods 106 limbs of 95 paitnets with varicose vein underwent saphenectomy combined with ligation of communicating veins by way of mini-incision from November 1997 to April 2001. The ascending venography and StethoDoppler examination were performed preoperatively in all of the patients. Results Venous reflux in deep vein of lower extremities were at grade 0 in 62 limbs, at grade Ⅰ in 28 limbs and at grade Ⅱ in 16 limbs demonstrated by ascending venography with Valsalva test. StethoDoppler examination showed that valve insufficiency of great saphenous vein at saphenofemoral junction was in 99 limbs, the insufficiency of small saphenous vein at saphenopopliteal in 5 limbs and incompetent perforating vein in all of the limbs. Postoperative course was uneventful, the average hospitalization days after operation were 2.8 days and no recurrent varicose veins occurred in all the patients during the follow-up period lasting 1-30 months. Conclusions With the help of preoperative StehoDoppler examination, the mini-incision surgery for the treatment of varicose vein of lower extremities is safe, simple, effective and lower costs.

Objective: To seek the direct evidence of myocardial inflammatory activation in a cohort of patient undergoing surgery on cardiopulmonary bypass (CPB). Methods: Twenty patients undergoing surgery on CPB had plasma samples obtained for tumor necrosis factor-? (TNF-?), perioperatively. Myocardial tissue samples were obtained intraoperatively, both pre-and post-CPB. Myocardial nuclear factor ?B (NF-?B) nuclear translocation and plasma TNF-? concentrations were analyzed by standard enzyme-linked immunosorbent assay (ELISA). Cross clamp times, CPB times and the time to extubation were recorded. The change of myocardial NF-?B nuclear translocation and plasma TNF-? concentrations was assessed by analysis of variance (ANOVA). The regression analysis was utilized to define the correlations among the optical densities of NF-?B, concentrations of plasma TNF-?, influencing factors and heart function. Results: (1) Seventeen patients had NF-?B nuclear translocation before initiation of CPB, the optical density (OD) of myocardial NF-?B was significantly increased at the end of CPB in nineteen patients. (2) The correlation between the activity of NF-?B and concentration of TNF-? was signi ficant. (3) The correlation between the activity of NF-?B and clinic outcomes and other influencing factors was not significant. Conclusion: Myocardial inflammatory activation may be present in the patients before CPB. CPB could increase the activity of myocardial NF-?B.

Objective To investigate the clinical effect and immunologic function of Moxifloxacin combined with small dose of hormone in the treatment of Ventilator pneumonia in elder.Methods 64 cases of Ventilator pneumonia in our hospital were collected and randomly divided into experiment group and control group, 32 cases each.Two groups were given conventional treatment, the control group received Methylprednisolone Sodium Succinate 1 mg/kg qd, the experiment group was given Methylprednisolone Sodium Succinate 1 mg/kg qd, and Moxifloxacin Hydrochloride and Sodium Chloride Injection 400 mg qd.Two groups of patients were continuous treated for 10 days.After treatment,T lymphocyte subsets, NK cells, white blood cell count, C reactive protein, clinical symptoms disappeared time, mechanical ventilation time, ICU length of stay and mortality rate were compared. Results After treatment, the total effective rate in the experiment group 75% was higher than the control group 50%( P <0.05 ).The levels CD3 +, CD4 +, CD4 +/CD8 +and NK cell in two groups increased(P<0.05), levels of CD8 +decreased(P<0.05),levels of WBC, CPR and PCT decreased in the two groups(P<0.05), and compared with the control group, the levels CD3 +, CD4 +, CD4 +/CD8 +and NK cell in the experiment group were higher(P<0.05), levels of CD8 + were lower(P<0.05),levels of WBC,CPR and PCT were lower(P <0.05), the rales disappeared time, cough disappeared time, fever disappeared time were significantly shorter than the control group(P <0.05), the duration of mechanical ventilation and the length of hospital stay were significantly shorter(P<0.05).Conclusion Moxifloxacin combined with small dose of hormone in the treatment of Ventilator pneumonia in elder was significantly effective, and it can relieve inflammation, prevention of infection control, enhance immune function.

N-terminal pro-brain natriuretic peptide(NT-proBNP) with no biological activity is the best cardiac marker in the diagnosis,risk stratification,prognosis and therapeutic monitoring of the patients with cardiac dysfunction,and is one of the natriuretic peptides.In this review,we aim to the latest progress of NT-proBNP study on its change during peri-cardiopulmonary bypass,and its applications in the diagnosis of preoperative cardiac function and in the guidance of heart failure therapy.

Objective To discuss the surgical interference of chronic suppurative otitis media and it's long-term results.Methods In 113 cases of mastoidectomy with tympanoplasty followed up for 3 years,We discuss the results of recurrence and hearing levle of the open-mastoidectomy with tympanoplasty(OMT)and combined approach tympanoplasty(CAT).Results There is no significant difference between OMT(improved 12 dB HL)and CAT(improved 9.5 dB HL)in the improved hearing threshold leve.The recurrence rate of OMT was 5.8%,but the CAT was 24.4%,the difference is significant.Conclusion The effect of OMT is better than that of CAT for the long-term resulls in these cases.

Objective: To investigate the proportion of physical examinations among patients with severe mental disorders and its influencing factors in Shaoxing City, Zhejiang Province, so as to provide the evidence for improving the proportion of physical examinations among patients with severe mental disorders. Methods : The epidemiological and clinical features of patients with severe mental disorders included in community management in Shaoxing City in 2022 were collected from Zhejiang Provincial Severe Mental Disorder Management Information System, including demographics, disease diagnosis and treatment, physical examination, and rescue and assistance. Factors affecting the physical examination were identified among patients with severe mental disorders using a multivariable logistic regression model. Results: A total of 25 468 patients with severe mental disorders were enrolled in Shaoxing City in 2022, including 12 151 males and 13 317 females, with a male to female ratio of 0.91∶1, and the participants had a mean age of (54.34±14.71) years. Schizophrenia was the predominant type of severe mental disorders (15 419 cases, 60.54%), and 21 374 subjects participating in the physical examinations in 2022 (83.92%). Multivariable logistic regression analysis showed that female (OR=0.901, 95%CI: 0.832-0.975), urban areas (OR=0.506, 95%CI: 0.468-0.547), mental disorders due to epilepsy (OR=1.779, 95%CI: 1.104-2.866), hospitalized treatment (6 to 10 times, OR=0.523, 95%CI: 0.401-0.681; 11 times and more, OR=0.177, 95%CI: 0.108-0.288), special diseases in outpatient (OR=1.738, 95%CI: 1.597-1.891), receiving medical assistance (OR=2.851, 95%CI: 2.616-3.107), targets of the community care and assistance groups (OR=1.653, 95%CI: 1.471-1.857) and guardian (spouse, OR=1.777, 95%CI: 1.513-2.086; children, OR=1.277, 95%CI: 1.069-1.526; parents, OR=1.342, 95%CI: 1.143-1.576) were statistically associated with the proportion of physical examinations. Conclusions The proportion of health examinations was 83.92% among patients with severe mental disorders in Shaoxing City in 2022. Gender, residence, guardian, disease diagnosis, times of hospitalized treatment, medical assistance, special diseases in outpatients and target of community care and assistance groups were factors affecting health examinations among patients with severe mental disorders.

Objective To investigate the difference in normal tissue complication probability (NTCP) of lower cranial nerves (LCNs) between target volumes recommended by Radiation Therapy Oncology Group (RTOG) and China in intensity-modulated radiotherapy (IMRT) for T1-2 nasopharyngeal carcinoma (NPC),and to provide the evidence of dose-volume effect for the protection of LCNs in IMRT for NPC.Methods A total of 20 patients with T1-2 NPC who were treated from 2013 to 2015 were enrolled,and LCNs were delineated on CT images.Target volume delineation and treatment plan designing were performed according to the method recommended by RTOG0225 (RTOG target volume delineation method) or the Chinese Working Committee for Clinical Staging of NPC in 2010 (Chinese target volume delineation method),and the differences in the dose to LCNs and NTCP were calculated.Results In the RTOG and Chinese methods for target volume delineation,Dmax to the left and right LCNs was 7 450±273 cGy/7294±309 cGy and 7 361± 160 cGy/7 190±395 cGy,respectively (P=0.018 and 0.042),Dmean was 6735±285 cGy/6 660±333 cGy and 6 446±429 cGy/6 299±467 cGy,respectively (both P=0.000),and the NTCP was 60％±10％/57％±13％ and 51％±15％/45％±17％,respectively (both P=0.000).Conclusions It is feasible to precisely delineate target volume with the LCNs as a routine OAR and predict NTCP in IMRT for T1-2 NPC.The NTCP of the LCNs is closely associated with target volume dose and irradiated volume.The dose to the LCNs and NTCP determined by the Chinese target volume delineation method are significantly lower than those determined by the RTOG method.

Objective To study three contouring approaches of the bowel and evaluate the bowel dose volume with cervical cancer patient.Methods Twelve patients were selected,prescribed dose 45 Gy/ 25f.For each patient we contoured the bowel according to three different definitions:bowel loops,bowel bag and peritoneal space.Then we generated three rival plans each considering a different bowel definition and to evaluate dose differences of the HI,CI of PTV and D D V5-V45 of bowel loops with paired t-test.Results Comparison between BL and BB plan,Dmax,HI and CI of PTV,V5-V45 of bowel loops were not significantly different (P =0.171,0.076,0.192,P =0.315-0.855),D of PTV and Dmax of bowel loops had difference (P=0.017,0.038).Comparison between BL and PS plan,Dmax,D HI and CI of PTV and Dmax of bowel loops had differences (P=0.033,0.044,0.046,0.041,0.013),V5-V45 of bowel loops were not significantly different (P=0.416-0.977).If the bowel loops V40 ≤ 15％,and bowel bag and peritoneal space V40≤20％.Conclusions All definitions provided a very similar dose volume of bowel loops.Taking into account HI and CI of PTV and max dose of bowel loops,BB seems better than PS.

Objective To investigate the natural history and growth pattern of hepatic hemangioma in adults.Methods From April 2010 to March 2013, adult patients with hepatic hemangioma who had no prior treatment were enrolled.A routine follow-up was performed to observe the natural history and complications of these lesions.Results 236 patients were enrolled in the study.The median size of the hemangiomas was 4.5 cm (range 0.6 ～ 19.2 cm).During a median follow-up of 48 months (range 3 ～ 266 months), the hemangiomas increased in size in 61.0％ of patients, remained stable in size in 23.7％, decreased in size in 8.5％.The peak growth period was in patients ＜ 30 years age (0.46 ± 0.41 cm/year) and the growth rate decreased significantly after 50 years of age (0.21 ±0.40 cm/year).Hemangiomas with a size ＜2.0 cm had the lowest growth rate (0.16 ± 0.42 cm/year).The peak growth rate was in hemangiomas 8.0 ～ 10.0 cm (0.80 ± 0.62 cm/year) , but for hemangiomas ＞ 10.0 cm, the growth rate was only (0.47 ±0.91)cm per year.Only 9 patients had severe symptoms caused by the hemangioma.No patients presented with hemangioma-related complications.Conclusions The majority of hepatic hemangiomas have the tendency to increase in size but they rarely caused complications.All the hemangiomas could be safely managed by observation, and surgery should only be considered in patients with complications.