Objective To investigate the pathological characteristics of lymph nodes,liver and bone morrow in adult-onset still' s disease (AOSD).Methods The clinical data of three AOSD patients were collected and their biopsy of enlarged lymph nodes,liver and bone marrow were analyzed by histology and immunohistochemistry.Results In AOSD lymphadenopathy,there were high lymph node hyperplasia,partial architecture damage and an intense paracortical hyperplasia along with diffused infiltration of large immunoblasts,activated lymphocytes,Langerhans cells,histocytes,neutrophils and chronic inflammatory cells.Bone marrow biopsy showed a significant increase in the proportion of granulocytes and erythrocytes,with apparently increased segmented neutrophils.Hepatic biopsy showed hepatocellular spotty necrosis.Meanwhile,there was some infiltration of lymphocytes and neutrophils in the periportal fibrosis area.Immunohistochemical staining showed CD21 expression in lymphoid follicle remnants and B cell markers with few T markers in most of immunoblasts.Conclusion The pathological characterizations of lymph nodes,liver and bone marrow provide important clues to the diagnosis of AOSD as well as its differential diagnosis.

Objective To study the effect of DNA methylation regulation on the toxic effect of paraquat on the sensitized V79 cells t pretreated with 5-aza-2'-deoxycytidine.Methods V79 cells were treated by 5-aza-2'-deoxycytidine (5-Aza-2'-dc) for 12h,which is a DNA methylation inhibitor,and then treated with paraquat for 12h.The morphological changes of V79 cells were observed by microscopy and the cell viability was determined by MTT assay and trypan blue staining method.Results Microscopic examination showed that the combination of 5-Aza-2'-dc and paraquat had stronger effect in inhibiting the growth of V79 cells(the cells became smaller and poorer adhensive ability) than single 5-Aza-2'-dc or paraquat.MTT assay showed that cell viability in the combination group (54.47 ± 3.04) ％ was significantly lower than the 5-Aza-2'-dc group (95.52 ± 0.90) ％ and paraquat group (89.68 ± 4.26) ％ (P＜0.05).Trypan blue staining assay showed that the death rate of ceils in the combination group (53.58 ± 1.57) ％ was significantly higher than the 5-Aza-2'-dc group (7.44 ± 2.31) ％ and paraquat group (12.90 ± 1.21) ％ (P＜0.05) Conclusion 5-Aza-2'-dc promotes V79 cells damage caused by paraquat.

Objective To study the reactive oxygen level and the expression of anti-apoptotic protein Bcl-2 and pro-apoptotic protein Bax after treatment of DNA methyltransferase inhibitor 5-aza-2'-deoxycytidine (5-Aza-2'-dc) and paraquat in V79 cells.Methods Cultured V79 cells were divided into 5-Aza-2'-dc treatment group (group A),paraquat treatment group (group B),5-Aza-2'-dc and paraquat treatment group (group C,V79 cells were pretreated with 5-Aza-2'-dc for 12h followed by exposure to paraquat for 12h) and control group (group D).Reactive oxygen level in V79 cells was measured by DCFH-DA flow cytometry and expression of Bcl-2 and Bax was detected by Western blot.Results Reactive oxygen levels and expression levels of Bcl-2 and Bax in V79 cells were significantly different (P＜0.05) in 5-Aza-2'-dc and paraquat treatment group (group C),compared with 5-Aza-2'-dc treatment group (group A),paraquat treatment group (group B) and control group (group D).Expression levels of Bcl-2 and the ratio of Bcl-2 and Bax were lower while reactive oxygen levels and expression levels of Bax were higher in group C than in groups A,B and D.Conclusion 5-Aza-2'-dc regulates DNA methylation by the imbalancing the reactive oxygen metabolism and apoptosis,thus up-regulating the toxic effect of paraquat on V79 cells.

Objective To explore the effect of Enhanced Recovery after Surgery in patients undergoing thoracoscopic lobectomy with pain management. Methods A total of 160 patients with lung cancer admitted from September 20 to July 2017 at the Affiliated Chest Hospital of Shanghai Jiaotong University were randomly divided into observation group and control group. The observation group was treated with enhanced recovery care and the control group was treated with routine care. Results The incidence of postoperative complications, hospitalization time and hospitalization decreased, the difference was not statistically significant (P>0.05). The early postoperative ambulation time, postoperative exhaust time, postoperative nausea and vomiting, postoperative pain intensity at 6h, postoperative pain intensity at 12 h, postoperative pain intensity at 24 h and postoperative pain intensity at 48 h were (18.35 ± 7.18) h, 28.75％,(1.17 ± 0.84) points, (1.79 ± 1.36) points, (2.45 ± 1.12) points and (2.14 ± 1.26) points in research group,(28.11 ± 9.07) h, (36.35 ± 16.95) h, 45.00％(36/80), (1.91 ± 0.88) points, (3.05 ± 1.33) points, (4.20 ± 1.31) points and (3.89 ± 1.20) points in controlled group. There was significant difference between the two groups (t=-7.36-78.34,χ2=4.54, P<0.05). Conclusions The idea of Enhanced Recovery after Surgery for thoracoscopic lobectomy has a good clinical effect. It can reduce the perioperative stress, shorten the hospital stay and reduce the hospital cost, and have the clinical value.

Objective To evaluate the efficacy of preoperative pulmonary rehabilitation in patients with lung cancer. Methods We searched Cochrane Library, Web of Science, Pubmed, Embase, CNKI, Wan Fang Date, Vip Date and CBM to collect randomized controlled trials (RCTs) or quasi-experimental study about perioperative pulmonary rehabilitation applied in lung cancer patients, the retrieval time was from 1990 to 2017. The data was analyzed by RevMan 5.3 software after two researchers independently screened the literature, extracted the data, and evaluated the biased risk of inclusion studies. Results A total of 16 studies were included, including 904 patients, and 8 of them were RCT, and 8 quasi-experimental studies. The results of meta-analysis showed that patients after preoperative pulmonary rehabilitation their the first-second forced expiratory volume (FEV1) was increased (MD=0.20, 95%CI: 0.02-0.37, P=0.03), preoperative forced vital capacity (FVC) was increased (MD=0.22,95%CI:0.05-0.38,P=0.009), preoperative distance of 6-minute walking test (6MWT) was increased (MD=44.07, 95%CI: 33.88-54.27, P<0.001), the postoperative hospital stay in the preoperative pulmonary rehabilitation group was shortened (MD=-2.28, 95%CI: -2.77-1.79, P<0.001) and the incidence of postoperative pulmonary complications was reduced (OR=0.32,95%CI:0.22-0.49, P< 0.001). Conclusions Preoperative pulmonary rehabilitation can improve lung function of patients with lung cancer, shorten the time of postoperative hospitalization and reduce the incidence of postoperative pulmonary complications.

Objective: To examine mental health problems among adolescents in Taiyuan City and its relationship to chronotype, so as to give a scientific basis for supporting mental health of middle school students. Methods: From October to November 2021, a total of 2 621 pupils were enrolled from three junior high schools and two senior high schools in Taiyuan by using a multi stage stratified cluster random sampling method to investigate demographic characteristics, mental health status, and chronotype. Chi squared test, Spearman correlation analysis and Logistic regression were used to analyze the relationship between sleep patterns and mental health problems in middle school students. Results: The proportion of morning, intermediate and evening types of middle school students sleep were 17.9%, 65.6%, and 16.4%, respectively. The overall detection rate of mental health problems was 13.8 %, which was statistically significant among middle school students in different grades, self perceived family economic status, the number of friends and sleep patterns ( χ 2=42.69, 29.15, 46.02, 93.99, P <0.05). After adjusting for grade, self perceived family economic status and the number of friends, Logistic regression analysis revealed that mental health problems were positively associated with evening type ( OR =2.84) and negatively associated with morning type ( OR =0.61)( P ＜0.05). Conclusion Chronotype is associated with mental health problems among middle school students, with a higher risk for evening type and a lower risk for morning type. Mental health of middle school students can be enhanced by changing their chronotype.