Objective To compare the effects of different extracts of Rheum palmatum on weight and tissue structure of hypothalamusand and pituitary of adult female rats,and screen the main reproductive toxicity extract.Methods The water,chloroform,ethyl acetate,and n-butanol extracts and water-soluble substance of R.palmatum were prepared by polarity gradient extraction method.Female adult rats were randomly divided into blank control group,rhubarb water extract group,and different extracts groups.The dosage of all the groups was equivalent to 4.00 g/kg crude rhubarb.Rats were administered with extracts by gavage for 60 d.Body mass growth rate of rats were calculated before and after administration.The pathological changes of hypothalamic arcuate nucleus neurons and pituitary gonadal cell were observed with light microscope.Results Compared with the blank control group,the body mass growth rate of rhubarb water extract group was decreased (P ＜ 0.05),while those in the different extracts groups were increased (P ＜ 0.01);The hypothalamic arcuate nucleus neurons of rhubarb water extract group showed chromatin marginalization,nissl substance dissolving,fuzzy boundary of nuclear membrane,as well as hell cells,and the total number of adenohypophysis cells reduced and the cells arranged in irregular.However,there were no apparent pathologic changes in different extracts groups.Conclusion Rhubarb water extract administration by long-term dose can reduce weight growth rate and result in pathologic changes of hypothalamic arcuate nucleus and adenohypophysis,while the different extracts can increase weight growth rate significantly and have little effects on the organizational structure ofhypothalamic arcuate nucleus and adenohypophysis.

Objective To compare the clinical efficacy and the complications of two ventilation modes in the premature infants with neonatal respiratory distress syndrome(NRDS).Two different noninva-sive ventilation methods,synchronized nasal intermittent positive pressure ventilation(SNIPPV) and nasal continuous positive airway pressure(NCPAP) combined with Curosurf were used in the treatment of patients with NRDS.Methods A retrospective study was conducted in 46 infants with NRDS admitted to our hospi-tal during January 2016 to December 2017. The subjects were divided into SNIPPV group(n =24) and NCPAP group(n =22),respectively combined with Curosurf treatment. PaO2,PaCO2,oxygenation index (OI)(PaO2/FiO2),duration of oxygen therapy,noninvasive ventilation time,reintubation cases for the use of pulmonary surfactant,starting time of feeding,length of hospital stay,incidence of abdominal distention, intracranial hemorrhage,air leakage and other complications were compared between the two groups before and after treatment.Results After treatment,the blood gas indexes of PaO2and OI at 24 h both in the two groups were significantly higher than those before the treatment(P<0.05).After treatment,PaCO2was lower in both SNIPPV group and NCPAP group,but there was no statistical difference between the two groups(P>0.05).The OI at 24 h[(219 ± 23)mmHg,1 mmHg=0.133 kPa] was significantly higher in SNIPPV group than that in NCPAP group[(199 ± 26)mmHg](P<0.05).There was no difference in PaO2,PaCO2and OI between the two groups before treatment.Duration of oxygen therapy,starting time of feeding,the time of using noninvasive ventilation,length of hospital stay were shorter in SNIPPV group[(82.8 ± 11.7)h vs. (107.6 ± 20.3)h,(32.0 ± 8.0)h vs.(47.0 ± 7.2)h,(62.3 ± 10.8)h vs.(99.6 ± 17.1)h,(12.0 ± 3.5)d vs.(15.0 ± 3.8)d] than those in NCPAP group,the differences were statistically significant(P <0.05). Reintubation cases for the use of pulmonary surfactant and the incidence rate of abdominal distension, intracranial hemorrhage,air leakage showed no statistical significance between the two groups(P>0.05). Conclusion SNIPPV and NCPAP combined with Curosurf treatment have similar clinical effects in premature infants with NRDS. While SNIPPV can reduce the starting time of feeding,the time of using noninvasive ventilation,duration of oxygen therapy,length of hospital stay in the patients with NRDS,and the clinical effect is more significant.

Objective To investigate the significance of permissive hypercapnia( PHC) in the treat-ment of neonates with respiratory failure using synchronized nasal intermittent positive pressure ventilation. Methods A retrospective study was conducted in 47 neonates with respiratory failure admitted to our NICU during January 2015 to December 2017. The subjects were divided into PHC group ( n =27, PaCO245 ～70 mmHg,1 mmHg=0. 133 kPa) and non-permissive hypercapnia( non-PHC) group( n=20,PaCO235～45 mmHg),respectively. The blood gas indicators(PaO2,PaCO2,PaO2/FiO2) before and after non-invasive ventilation treatment were compared;Ventilator parameters of the two groups ( PIP, PEEP, PiO2 , Ti ) were compared. Duration of oxygen therapy,non-invasive ventilation time,starting time of feeding,length of hospi-tal stay,the incidence of intracranial hemorrhage,air leakage,ventilation induced lung injury,and reintubation rate were compared between the two groups. Results After treatment,the blood gas indexes of PaO2 and OI at 24h in two groups were significantly higher than those before the treatment(P<0. 05). There was no sig-nificant difference on PaO2 and OI between two groups both before and after treatment. PaCO2 was lower in non-PHC group after treatment than that before the treatment(P<0. 05),but it showed no difference in PHC group (P>0. 05). The PIP value of the ventilator parameters in PHC group[(19. 9 ± 2. 7) mmHg] was sig-nificantly lower than that in the non-PHC group[(21. 7 ± 2. 3) mmHg](P<0. 05),and there was no statisti-cally significant difference between the two groups in the other ventilator parameters(P>0. 05). Duration of oxygen therapy,starting time of feeding,the time of using noninvasive ventilation,length of hospital stay in PHC group were shorter obviously than those in non-PHC group [ ( 79. 5 ± 10. 8 ) h vs. ( 92. 7 ± 19. 1 ) h;(34.3±8.8)hvs.(47.1±10.8)h;(67.4±12.3)hvs.(97.6±17.3)h;(11.0±4.6)dvs.(14.0±3.9) d](P<0. 05). The incidences of air leakage,and intracranial hemorrhage showed no significant difference between PHC group and non-PHC group(3/27 cases vs. 4/20 cases;3/27 cases vs. 2/20 cases)(P>0. 05). There was no significant difference between the two groups in the rate of reintubation of invasive ventilation after non-invasive ventilation failure ( 2/27 cases vs. 3/20 cases, P > 0. 05 ) . The incidence of ventilator induced lung injury was significantly lower in PHC group than that in non-PHC group ( 2/27 cases vs. 7/20 cases) ( P<0. 05 ) . Conclusion The effects of treating respiratory failure were similar in PHC group and non-PHC group. However,the PHC treatment could shorten the time of oxygen therapy,non-invasive ventila-tion time and hospitalization time,reduce the incidence of lung injury associated with ventilator. The clinical efficacy of PHC was more significant.

Acute Pain ; etiology ; prevention & control ; Chronic Pain ; etiology ; prevention & control ; Humans ; Lung Neoplasms ; surgery ; Pneumonectomy ; adverse effects ; methods ; Thoracic Surgery, Video-Assisted

Objective To investigate the effects of alveolar epithelial cells (AEC) on bronchopulmonary dysplasis(BPD) induced by hyperoxia in newborn rats.Methods The model of BPD induced by hyperoxia in neonatal rats was established.HE staining was used to observe the alveolar septum and alveoli development.The expression of the specific surfactant protein C (SPC) on type Ⅱ alveolar epithelial cells (AEC Ⅱ) and the expression of specific aquaporin 5 (aquaporin5 AQP5) on type Ⅰ alveolar epithelial cells (type Ⅰ alveolar epithelialcells,AECⅠ) were measured by immunohistochemistry.Results There was no significant difference of AQP5 between experimental groups and control group at 1 d,but significantly lower expression of AQP5 could be seen in experimental group1 on day3 (P ＜ 0.05).And then,the AQP5 level of lung tissue of newborn rats at 5,7,14d after experiment in groupl was significantly lower than that of in air control group (P ＜ 0.05).The expression of SPC protein had no significant difference between experimental groups and control group at 1 d,but the SPC level of lung tissue of newborn rats at 3,7,14d after experiment in group1 was significant lower than that of in air control group (P ＜ 0.05).Conclusion Hyperoxia exposure leads to the expression of SP-C and AQP5 decreased,which may be key points for the development of BPD.AECⅡ may play an important role in the repairation of alveolar epithelial cells in neonatal rats with BPD induced by hyperoxia.

Objective To investigate the distribution of pathogenic bacteria characteristics and antimicrobial susceptibility results in children with positive urine culture specimen in order to provide some references for the clinical rational use of antimicrobial agents.Methods The pathogenic data of children in our hospital in 2017 with positive urine culture specimen were collected and statistical analyzed.Results A total of 364 strains of 23 pathogens have been isolated,which the Escherichia coli was dominant,accounting for 41.21％ (150strains).followed by Enterococcus faecium (18.41％),Klebsiella pneumoniae (14.29％) and Enterococcus faecalis (7.15％).Different pathogenic bacterias have varying degrees of drug resistance to commonly used antibiotics.The drug resistance rates of Escherichia coli to ampicillin,piperacillin,cefmenorr and cefazolin were 88.36％,85.71％,81.58％ and 81.16％.The drug resistance rates of Enterococcus faecium to ampicillin,clindamycin and penicillin G were 100％;the drug resistance rates of Klebsiella pneumoniae to ampicillin,tetracycline,cefazolin and cefuroxime axetil were 96.08％,92.31％,82.98％ and 80％;All Enterococcus faecalis detected were sensitive to qulnupristin/dalfopristin and clindamycin.Conclusion Escherichia coil,Enterococcus faecium,Klebsiella pneumoniae and Enterococcus faecalis ate common pathogens in positive urine culture of children.Clinicians should use antibiotics reasonably according to the pathogenic characteristics.

OBJECTIVE: To investigate the association of myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) with troponin level and left ventricle (LV) function in patients with ST-segment elevated myocardial infarction (STEMI). MATERIALS AND METHODS: Thirty-five STEMI patients who successfully had undergone reperfusion treatment within 1 week of their infarction were consecutively enrolled. All patients were referred for dynamic CT-MPI. Serial high-sensitivity troponin T (hs-TnT) levels and left ventricular ejection fraction (LVEF) measured by echocardiography were recorded. Twenty-six patients with 427 segments were included for analysis. Various quantitative parameters derived from dynamic CT-MPI were analyzed to determine if there was a correlation between hs-TnT levels and LVEF on admission and again at the 6-month mark. RESULTS: The mean radiation dose for dynamic CT-MPI was 3.2 ± 1.1 mSv. Infarcted territories had significantly lower MBF (30.5 ± 7.4 mL/min/100 mL versus 73.4 ± 8.1 mL/min/100 mL, p < 0.001) and myocardial blood volume (MBV) (2.8 ± 0.9 mL/100 mL versus 4.2 ± 1.1 mL/100 mL, p = 0.044) compared with those of reference territories. MBF showed the best correlation with the level of peak hs-TnT (r = −0.682, p < 0.001), and MBV showed a moderate correlation with the level of peak hs-TnT (r = −0.437, p = 0.026); however, the other parameters did not show any significant correlation with hs-TnT levels. As for the association with LV function, only MBF was significantly correlated with LVEF at the time of admission (r = 0.469, p = 0.016) and at 6 months (r = 0.585, p = 0.001). CONCLUSION: MBF quantified by dynamic CT-MPI is significantly inversely correlated with the level of peak hs-TnT. In addition, patients with lower MBF tended to have impaired LV function at the time of their admission and at 6 months.
Blood Volume ; Echocardiography ; Heart Ventricles ; Humans ; Infarction ; Myocardial Infarction ; Myocardial Perfusion Imaging ; Reperfusion ; Stroke Volume ; Troponin T ; Troponin

The National Comprehensive Cancer Network (NCCN) released the latest version 1, 2022 of "NCCN guidelines for the clinical diagnosis and treatment of small cell lung cancer" (hereinafter referred to as "guideline"). Based on high-quality evidence-based medicine, this guideline provides references of clinical diagnosis and treatment for clinicians around the world. Compared with the version 3, 2021 of the "guideline", updates and revisions mainly focused on the progress of radiotherapy and systemic treatment. This article will interpret the updated therapy content in this new version of the "guideline".

Based on new clinical evidence, the National Comprehensive Cancer Network (NCCN) annually updates and releases the "NCCN Guidelines for the Clinical Diagnosis and Treatment of Non-Small Cell Lung Cancer" which has become the reference for clinical diagnosis and treatment approved and complied by clinicians worldwide. On November 25, 2020, the latest 2021 V1 version of "NCCN Clinical Diagnosis and Treatment Guidelines for Non-Small Cell Lung Cancer" (hereinafter referred to as "Guidelines") was released. Compared with the 8th edition of the "Guidelines" in 2020, many updates focused on the progress of targeted and immunotherapy. This article will provide the interpretations of the updated therapy content of this edition of the guidelines.

Segmentectomy is the removal of certain segments of the lung with lesions and retaining the normal lung tissue of the lobe. Lung segmentectomy is considered difficult due to the lack of clear anatomical boundaries between lung segments. Segmentectomy has a variety of indications, such as lung cancer, metastatic lung tumors, and many non-malignant diseases. In the treatment of early stage lung cancer, segmentectomy was initially considered only as a treatment option for patients not suitable for conventional lobectomy. As more evidence emerged, the indications for segmentectomy have continued to change over time, and segmentectomy has been widely performed in patients with early stage lung cancer. Theoretically, segmentectomy leads to better preservation of lung function than lobectomy, but the risk of incomplete tumor resection is higher, so the indication of segmentectomy has become a focus of debate. This article will introduce the surgical techniques of segmentectomy and summarize the published and unpublished clinical studies on segmentectomy for the treatment of early stage lung cancer.