Objective To study the diagnostic value of flexible bronchoscope in location and causes of atelectasis.Methods Flexible bronchoscopy examination was carried out on seventy-nine cases of apneumatosis to observe lobar bronchus and segmental bronchus.Lung biopsy and bronchoalveolar lavage were carried out.Results Thirty-two cases were lung cancer,covering 40.5%.Seven cases were pulmonary tuberculosis,covering 8.8%.Thirty-eight cases were inflammation,covering 48.1%.Two cases had foreign matter,covering 2.5%.Conclusions Flexible bronchoscopy is of important clinical value in the location,diagnosis and treatment of atelectasis.

Objective To explore the changes of the white matter integrity in paranoid schizophrenia.Methods Diffusion weighted images of the 19 patients' with paranoid schizophrenia and 30 healthy controls'whole brains were acquired with a single-shot echo planar imaging ( EPI ) sequence aligned to the straight axial plane. After preprocessed with DTI-studio and SPM5 software, the fractional anisotropy (FA) images of the two groups were compared by two-sample t-test with SPM5 software. Results Subjects of paranoid schizophrenia demonstrated reduced FA in the right thalamus white matter(x = 18 ,y = - 10,z = 14,cluster = 194, t= -3.27, P=0.000 ) and demonstrated increased FA in the right insula white matter ( x = 34, y = -10, z = 12, cluster = 113, t =4.50, P = 0.004 ). Conclusion Schizophrenia has conflicting changes of white matter integrity in some brain areas.

Objective To study the change of immune factor in COPD rats after intravenous injection of regulatory T cells.Methods Twenty-one SPF rats was divided into three groups at random,rat COPD model was built by smoking.We used magnetic bead isolation technic to separate CD4+CD25+ regulatory T cells.Regulatory T cells were cultured and injected into rats though rats' caudal vein according to different dose,5 × 104/mL,5 × 105/mL,5 × 106/mL respectively.Flow cytometry was used to analyze cell factors.ELISA was used to analyze IL-6 and CRP.Restlts Adding JJ316 or IL-2 into medium benefited the proliferation of CD4+CD25+ regulatory T cells.On the 20 th day,regulatory T cells CD4+CD25+ proliferation stopped by adding JJ316 or IL-2 respectively.Regulatory T cells were cultured and injected into rats though rat caudal vein according to different dose.The levels of CRP and IL-6 were decreased when rats were injected by CD4+CD25+regulatory T cell after one week.Conclusions Injection of regulatory T cells is helpful to control inflammation progression of COPD,so the increase of regulatory T cells of patients with COPD may decrease inflammation progression of COPD.

Objective To analyze the characteristics of papers published in Organ Transplantation in the past ten years. Methods The academic papers published in Organ Transplantation from January 2010 to December 2019 were retrieved from China National Knowledge Infrastructure (CNKI). The publication volume, the funded paper ratio, authors, research institutions and keywords were analyzed by information visualization software CiteSpace 5.3 and VOSviewer 1.6. Results From 2010 to 2019, a total of 919 academic papers were published in Organ Transplantation, with an average annual publication volume of 92, showing an overall stable trend. The funded paper ratio and the ratio of papers with funding support at the provincial level or above increased year by year, reaching 100% in 2019. High-yield authors mainly formed two research teams led by Shi Bingyi and Chen Guihua respectively. The first authors were distributed across China. In recent years, as many as 58 programmatic papers were published by national academic institutions, especially signed by Branch of Organ Transplantation of Chinese Medical Association. The average number of authors per paper was 4.94 in Organ Transplantation, and the proportion of papers contributed by two or more authors remained above 90% in recent years. According to the analysis of research institutions, the average number of institutions per paper was 1.60 in Organ Transplantation. Keyword co-occurrence network analysis demonstrated that liver transplantation, renal transplantation and organ transplantation were the research hotspots in the field of organ transplantation. Keyword cluster analysis showed that research mainly focused on 9 fields, such as liver transplantation, renal transplantation, organ transplantation, organ donation, posttransplantation complications, transplantation immunity, end-stage liver disease, xenotransplantation and stem cell transplantation. Keyword burst analysis showed that xenotransplantation, α-1, 3-galactose, transplantation immunity, apoptosis, donor specific antibody (DSA), antibody-mediated rejection (AMR) and flow cytometry were the research hotspots. Conclusions The authors that publish academic papers in Organ Transplantation come from major transplantation centers all over the country. The papers of Organ Transplantation cover the research hotspots of each branch in the field of organ transplantation, and include a large quantity of programmatic papers signed and published by national academic institutions, which show the frontier hotspots and the highest level of research in the field of organ transplantation in China, making Organ Transplantation an excellent academic journal.

Objective:To investigate the effect of homogeneous management combined with staged teaching on physicians receiving standardized training of hepatobiliary surgery.Methods:A total of 46 physicians who received standardized training in Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, from January to March 2020 were selected as control group and were given conventional teaching, and 50 physicians who received standardized training from April to June 2020 were selected as observation group and were given homogeneous management combined with staged teaching. The two groups were compared in terms of professional level, clinical ability, and the degree of satisfaction with teaching before and after teaching. SPSS 24.0 was used to perform the independent samples t-test, the paired t-test, the chi-square test, and the rank sum test. Results:After teaching, both groups had significant increases in the scores of theoretical examination and operation skill examination, and compared with the control group, the observation group had significantly higher scores of theoretical examination (94.57±3.28 vs. 90.32±2.12) and operation skill examination (94.37±4.18 vs. 91.25±3.46). After teaching, both groups had significant increases in the scores of clinical consultation, physical examination, humanistic concern, clinical diagnosis, communication ability, organizational ability, and overall evaluation, and the observation group had significantly higher scores of the above seven aspects than the control group (6.98±0.94/6.45±0.14/6.95±0.88/6.65±0.93/6.53±0.26/6.84±0.92/6.58±0.35 vs. 6.13±0.31/6.21±0.76/6.21±0.42/6.18±0.35/6.32±0.61/6.33±0.24/6.25±0.71). The observation group had a significantly higher overall satisfaction rate than the control group [94.00% (47/50) vs. 78.26% (36/46)].Conclusion:In the standardized training and teaching of hepatobiliary surgery, homogeneous management combined with staged teaching can improve the professional level and clinical ability of physicians and enhance the degree of satisfaction with teaching.

Objective To systematically review the effect of enteral nutrition via a naso-gastric (intestinal) tube (NG) vs a percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) after liver transplantation,and provide support for the selection of proper nutrition.Methods Pub Med,web of science,Cochrane Library (Jan,2018),CNKI,VIP and Wanfang Date were search until Jan,2018.Two authors independently assessed the trials for inclusion and extracted the data.Discrepancies were resolved in consultation with a third reviewer,about the research of retrospective study for the effects of enteral nutrition via NG vs PEG/PEJ after liver transplantation was performed and supplemented.Publication bias were evaluated,and Meta-analyses were conducted with RevMan5.3.Results 4 studies were collected,involving 430 patients.The Meta-analysis showed that starting time of enteral nutrition of PEG/PEJ was earlier than NG (MD =-1.77,95％ CI-1.83 to-1.70,P＜0.05).The average hospitalization time of PEG/PEJ was shorter than NG (MD=-2.88,95％CI-5.19 to-0.56,P＜0.05).The diarrhea incidence of PEG/PEJ was higher than NG (OR=1.66,95％CI 1.04 to 2.65,P＜0.05),and gastroesophageal reflux incidence of PEG/PEJ was lower than NG (OR=0.29,95％CI 0.12 to 0.66,P＜0.05).The gastric retention rate of PEG/PEJ was lower than NG (OR =0.26,95％ CI 0.14 to 0.41,P＜0.05).Dislocation incidence of PEG/PEJ was lower than NG (OR =0.06,95％CI 0.01 to 0.46,P＜0.05).The pneumonia incidence of PEG/PEJ tube was lower than NG (OR=0.59,95％CI 0.36 to 0.99,P＜0.05).There were no significant differences between PEG/PEJ and NG on indwelling time,occlusion,abdominal infection,acute renal insufficiency,and acute rejection reaction.Conclusion PEG/PEJ had earlier starting time of enteral nutrition,shorter hospitalization time,lower nutrition tube placement related complications such as gastric esophagus reflux,gastric retention,dislocation rate and lower incidence of pneumonia,but the incidence of diarrhea was higher.NG is the first choice after liver transplantation,and for patients with serious basic diseases,weak digestive function or digestive system disorders PEG/PEJ can be chosen.

Critical care medicine-related treatment is an interdisciplinary and multi-professional process,often leading to secondary or concomitant mental disorders in clinical practice.Currently,there is no consensus on the pharmacological treatment of related mental illnesses in China.The Chinese Society of Psychosomatic Medicine collaborated with the Critical Care Medicine expert group to form a consensus writing expert group.After a systematic review of relevant literature,summarizing published domestic and foreign literature,and extensive discussions,the consensus was developed.The consensus elaborates on the principles and processes of the standardized use of psychotropic drugs in critical care medicine,as well as the clinical indications,precautions,and specific drug selection of various psychiatric medications,providing feasible suggestions and guidance for the clinical application of psychiatric medications in the intensive care unit.