Objective To investigate the microstructure and ultrastructure changes of cardiac muscle, pallium, lung, liver and kidney tissue and hemodynamic effects after the success of cardiac arrest (CA)-cardiopulmonary resuscitation(CPR) of swine. Method A total of 16 Beijing swine(weight 29 ～ 35 kg)were randomly (random number) divided into normal-control group ( n = 8) and standard CPR group ( n = 8). The swine of the former group were only given anesthetized and intubated, without ventricular fibrillation and CPR. The swine of the latter group were given standard CPR after 4 min of untreated VF, from 10 min after restoration of spontaneous cirkg) and keep for 6 h. And cardiac output (CO), left ventricular maximal rate of systolic pressure ( + dp/dtmax),maximum reduction of left ventricular diastolic velocity ( - dp/dtmax), heart rate (HR) and mean arterial pressure (MAP) of these animals before ventricular fibrillation and 0.5 h, 2 h, 4 h, 6 h after ROSC have been monitored.All swine were put to death after 6 h,and got their cardiac apex, pallium, left lung, right lobe of liver and upper pole of left kidney quickly for microstructure and ultrastructure studies. Statistical analysis was performed using two paired samples t test. Results At different time points after restoration of spontaneous circulation, the cardiac output (CO),left ventricular maximal rate of systolic pressure ( + dp/dtmax), maximum reduction of left ventricular diastolic velocity (- dp/dtmax) were significantly lower than before ventricular fibrillation, with significant difference ( P ＜ 0.05). And HR of different time points were increased significantly ( P ＜ 0.05), with no significantly difference between MAP of each time points ( P ＞ 0.05). Compared with the normal-control group, the cardiac muscle, pallium, lung, liver and kidney tissue of the swine in standard CPR group were found different degree of damages in their microstructure and ultrastructure sections. The damages of the cardiac muscle, pallium, and lung tissue were more obviously. Conclusions Sudden cardiac arrest(CA)-cardiopulmonary resuscitation(CPR) could cause different degree of damages and hemodynamic effects on the body, through our ROSC 6 h model, the damages of the cardiac muscle, pallium and lung were more severity, the damages of liver and kidney were lighter.

Objective To observe the effects of two rehabilitation programs to staff in office with cervical spondylosis,and to explore the appropriate rehabilitation program for this group of people.Methods There were 37 office personnel with cervical spondylosis were selected by the inclusion criteria.They were randomly divided into treatment group A(once a week,n=17) and treatment group B (once a week,n=20) according to the random number table method.The treatment group A took middle frequency electrotherapy and infrared therapy,while the treatment group B took tuina manipulation.The changes of visual analogue scale (VAS) and cervical range of movement (ROM) were observed after 10 weeks of treatment.Results Compared with before treatment,the VAS scores of the two treatment groups decreased with statistically significant difference after 10 weeks of treatment(tA=12.91,tB=13.88,all P<0.05).There was no significant difference in VAS score between the two treatment groups after treatment(t=0.22,P>0.05).Compared with before treatment,the cervical ROM of the two groups increased significantly after treatment(tA anteflexion=-4.59,tA posterior extension=-5.13,tA left flexion=-4.24,tA right flexion=-3.25,tA left circumflexion=-7.13,tA right circumflexion=-7.47,tB anteflexion=-5.85,tB posterior extension=-7.28,tB left flexion=-8.64,tB right flexion=-8.38,tB left circumflexion=-11.72,tB right circumflexion=-11.95,all P<0.05).There were significant differences in the increase range of flexion,left flexion and left circumflexion between the two treatment groups after treatment(tflexion=-2.29,tleft flexion=-2.77,tleft circumflexion=-2.32,all P<0.05),but posterior extension,right flexion and right circumflexion had no statistically significant diffferences(tposterior extension=-1.97,tright flexion=-1.97,tright circumflexion=-1.97,all P>0.05).Conclusion The two kinds of rehabilitation programs can relieve the neck pain of the office personnel,but treatment group B is better than treatment group A in increasing cervical ROM.

Objective:To observe the influence of methylprednisolone in the respiratory mechanical parameters in the elderly patients undergoing major surgeries with general anesthesia intubation after mechanical ventilation,and to investigate whether methylprednisolone can improve the respiratory system degenerative diseases and benefit the mechanical ventilation. Methods:Sixty patients undergoing elective line laparotomy were divided into experimental group and conrol group (n=30) according to their wishes.The patients in experimental group receieved intravenous injection of methylprednisolone 1 mL (40 mg) after endotracheal intubation,and the patients in control group receieved 1 mL intravenous saline water injection.The airway peak pressure (Ppeak), airway platform (Pplat), lung compliance (Compl), and airway resistance (Raw) of the patients in two groups were recorded at the time of immediately before administration and 10,20,30,40 min after administration.The arterial blood oxygen partial pressure(PaO2),arterial blood CO2 partial pressure(PaCO2),CO2 partial pressure at the end of breathe out(PetCO2) of the patients were detected at the time of immediately before administration and 20 min after administration.Results:Compared with before administration, the respiratory mechanics parameters of the patients in control group 10,20,30,40 min after administration had no statistically significant differences (P>0.05);the Comple of the patients in experimental group was singnificantly increased (P<0.05), and the Ppeak, Pplat,and Raw were significantly decreased (P<0.05).Compared with control group, the Compl of the patients in experiment group 10,20,30,and 40 min after administration were significantly increased (P<0.05),and the Ppeak, Pplat, and Raw were decreased (P<0.05).Compared with before administration,the PaO2,PaCO2,and PetCO2 of the patients in control group 20 min after administration had no significant differences(P>0.05);the PaCO2 and PetCO2 of the patients in experimental group 20 min after administration were decreased(P<0.05),and the PaO2 was increased(P<0.05).Compared with control group,the PaCO2 and PetCO2 of the patients in experimental group 20 min after administration were decreased(P<0.05),and the PaO2 was increased(P<0.05).Conclusion:Methylprednisolone can obviously reduce PaCO2,Peak, and Pplat and increase PaO2 and Compl;methylprednisolone has possibility in improving the adverse effects of degenerative disease of respiratory system on general anesthesia in the elderly patients.

Objective To explore the effect of latissimus dorsi musculocutaneous flap for repairing severe soft tissue defect of the elbow.Methods Seventeen patients with severe soft tissue defect of the elbow were repaired by latissimus dorsi musculocutaneous flap.Ten patients were performed transfer of skin flap for functional reconstruction,9 patients reconstructed elbow flexion,and 1 patient reconstructed elbow extension.Seven patients' tissue defect were repaired by cover type musculocutaneous flap,and the areas of these flaps ranged from 6 cm × 10 cm-12 cm × 27 cm.Results All the musculocutaneous flaps kept alive.After an average postoperative follow-up for 12-40(22.0 ± 9.6) months,the color and luster of the flaps were satisfying.There were no scar contracture of the flap and no bulkiness of the elbow.Ten patients performed transfer of skin flap for functional reconstruction,and the range of motion was 100°-140° of flexion and-20°-0° of extension.Muscle power was M3-M5.Hand function was near normal.Conclusion Latissimus dorsi musculocutaneous flap is an ideal surgical method to repair the severe soft tissue defect of the elbow.

Objective To explore the clinical value and safety of early enteral nutrition support in patients after liver transplantation.Methods We retrospectively analyzed the clinical data of 86 cases who used early enteral nutrition support therapy after liver transplantation between January 2008and October 2011.All of patients were uproot the gastric tube at the first day after the operation,and gradual to the normal diet.The patients who used parenteral nutrition support therapy were as the control group(n＝112).Then we compared the data of patients in the two groups.Results The early enteral nutrition is more useful to the patients after liver transplantation than intravenous nutrition [In the seventh day after the operation,the control group's ALT was (45.2 ± 12.9) U/L,AST was (40.2±9.4) U/L,ALBwas (35.6±2.5) g/L,P＜0.05].The early enteral nutrition also can decrease hospital stay and hospital costs [(14.2±3.4) d,P＜0.05].Conclusion The early enteral nutrition is useful and safe to the patients after liver transplantation.

Objective To evaluate the feasibility,safety and efficacy of laparoscopic radiofrequency ablation (RFA) therapy for hepatocellular carcinoma (HCC).Methods Sixty-eight cases of liver cancer lesions were underwent laparoscopic radiofrequency ablation,and their postoperative recovery state,focal necrosis rate were observed.Results All the 68 cases were successfully performed operation,114 lesions were treated including 20 missed lesions at preoperative imaging diagnosis.There were no serious postoperative complications,the average hospital stay was (2.5 ± 1.2) days,focal necrosis rate 3 months after operation was 85.9％,lesion recurrence rate 6 months after operation was 12.2％,the 1-year survival rate was 76.47％.Conclusions Laparoscopic radiofrequency ablation in treatment of hepatocellular carcinoma has high security,few complications,short hospital stay and remarkable clinical effects.It's well worth clinical outreach.

Objective: To investigate the Effects of entinostat on the expression of NKG2D ligands in the non-small cell lung cancer (NSCLC) cell lines, A549 and HCC-827, and to detect the effect of entinostat-mediated NK cell killing of A549 and HCC-827 cells. Meth-ods: The effect of entinostat on A549 and HCC-827 cell proliferation was measured by MTT assay. Flow cytometry was used to detect the expression of NKG2D ligands. mRNA levels of the ligands were detected by RT-PCR . The level of soluble MICA in cell culture super-natant was evaluated by ELISA. The cytotoxicity of NK cells against A549 and HCC-827 cell lines (treated with entinostat) was assessed using lactate dehydrogenase release assay. Results: Entinostat showed a time-and dose-dependent inhibition effect on the prolifera-tion of A549 and HCC-827 cell lines. The expression of NKG2D ligands and mRNA transcription levels of MICA and MICB were en-hanced after treatment with 0.5, 1μmol/L entinostat for 48 h. The soluble MICA level in A549 cell culture supernatant was increased by 1μmol/L entinostat. The sensitivity of HCC-827 cells to NK cells was enhanced upon treatment with 0.5, 1μmol/L entinostat. Con-clusions: entinostat enhanced the killing effect of NK cells on non-small cell lung cancer cells by up-regulating the expression of NKG2D ligands. This provides a new method and theory for the treatment of NSCLC.

ObjectiveTo evaluate the efficacy and safety of 7 atypical antipsychotics combined with selective serotonin reuptake inhibitors（SSRIs） in the treatment of refractory obsessive-compulsive disorder by network Meta-analysis. MethodsRandomized controlled trials （RCTs） about atypical antipsychotics and SSRIs in the treatment of refractory obsessive-compulsive disorder were searched in CNKI， Wanfang Data， VIP， CBM， PubMed， Embase and Cochrane Library databases from inception to June 2020. Based on inclusion and exclusion criteria， the literature screening， date extraction and assessing risk of bias were performed by two researchers independently. Then all statistical analyses were performed using Stata 15.0 software. ResultsA total of 36 RCTs covering 7 atypical antipsychotics and 2 362 patients were included. Network Meta-analysis showed that the surface under the cumulative ranking （SUCAR） of total response rate was the largest in Olanzapine + SSRIs， followed by Paliperidone + SSRIs， Amisulpride + SSRIs， Risperidone + SSRIs， Quetiapine + SSRIs， Ziprasidone + SSRIs， Aripiprazole + SSRIs， SSRIs， and Placebo + SSRIs in turn. In terms of Hamilton Anxiety Scale （HAMA） score， the SUCAR was the largest in Amisulpride + SSRIs， followed by Aripiprazole + SSRIs， Quetiapine + SSRIs， Risperidone + SSRIs， and SSRIs in turn. In terms of Treatment Emergent Symptom Scale （TESS） score， the SUCAR was the largest in Amisulpride + SSRIs， followed by SSRIs， Paliperidone + SSRIs， Quetiapine + SSRIs， Ziprasidone + SSRIs， Risperidone + SSRIs， Aripiprazole + SSRIs， and Placebo + SSRIs in turn. ConclusionCompared with single application of SSRIs， its combination with atypical antipsychotics achieves better efficacy and higher safety in treating refractory obsessive-compulsive disorder， with Olanzapine+SSRIs being the most effective and Amisulpride+SSRIs the safest.

Objective To analyze the chemical compounds of Shenqi Dihuang decoction by the ultraperformance liquid chromatography coupled with linear quadrupole ion trap-orbitrap mass spectrometry (UPLC-LTQ-Orbitrap-MS). Methods Warters ACQUITY UPLC HSS T3 (2.1 mm ×100 mm, 1.8 μm) was used as chromatographic column with mobile phase: 0.1% formic acid water (A)-0.1% formic acid acetonitrile (B) with gradient elution, and flow rate was 0.3 ml/min. Electrospray ion source (ESI) and an electrostatic field orbital ion trap mass analyzer were adopted, which was used to collect mass spectrometry fragment information with positive and negative ion modes, by comparing with the relative retention time of the reference substance. In addition, the fragment information of the mass spectrum was used to identify the compounds. The accurate identification of the chemical components in Shenqi Dihuang decoction was confirmed with literature. Results The study found that UPLC-LTQ-Orbitrap-MS technology could be used to identify 62 chemical components, including 13 aromatic acids, 9 flavonoids, 8 saponins, and 5 aromatic amines, 3 keto acids, 2 phenols, 1 aromatic quinone and other ingredients in Shenqi Dihuang decoction. Conclusion The identification analysis method in this study was efficient and accurate, which could be applied to the identification and analysis of chemical components in Shenqi Dihuang decoction and provided the important experimental data for the research on the material basis and mechanism.

Objective To analyze the clinical outcomes of early invasive fungal disease(IFD)in patients after allogenetic hematopoietic stem cell transplantation(allo-HCST)with metagenomic next-generation sequencing(mNGS).Methods A retrospective analysis was conducted on patients undergoing allo-HCST in our Bone Marrow Transplantation Center between July 2021 and October 2022.These patients experienced one of the following conditions within 100 d after transplantation:① Patients with persistent fever and negative blood culture after empiric antimicrobial therapy for 72 h or longer;② Hyperpyrexia of unknown origin occurred again after effective anti-infection in the past;③ Symptoms in lower respiratory tract associated with lung lesions on CT scan,and empiric anti-infective therapy was ineffective.Peripheral blood or bronchoscopic alveolar lavage fluid were tested with mNGS,and overall survival(OS)and non-relapse mortality(NRM)were analyzed.Results There were 60 patients enrolled in this study.For the peripheral blood samples of 47 cases and bronchoalveolar lavage fluid samples of 13 cases,mNGS found that 19 cases were negative to pathogens,30 cases were non-fungal positive,and 11 case were fungal positive,including 3 cases of aspergillus,5 cases of mucor,2 cases of Candida tropicalis,and 1 case of Trichosporon asahii.Of the 11 patients with fungal positive,8 achieved complete remission after antifungal therapy according to the mNGS results.The 1-year OS and NRM of the 60 patients were 70.0％(95％CI:64.1％～75.9％)and 20.0％(95％CI:11.9％～32.5％),respectively,while those of the fungal infection patients were 54.5％(95％CI:49.5％～69.5％)and 36.4％(95％ CI:15.5％～70.3％),respectively.No significant differences were seen in 1-year OS(P=0.487)and 1-year NRM(P=0.358)among the negative,fungal infection and non-fungal infection patients,neither OS(P=0.238)and NRM(P=0.154)between the fungal infection and the non-fungal infection patients.Conclusion mNGS can rapidly diagnose the early IFD after allo-HSCT,which is helpful for timely and effective treatment and improves the prognosis of patients.