Objective To investigate the risk factors of radiation-induced oral mucositis (ROM) and to provide evidence for the prevention of ROM. Methods The severity of ROM was observed and recorded in 56 patients with nasopharyngeal carcinoma. The association of the severity of mucositis with age , sex, clinical stage, concurrent chemoradiotherapy, white blood cell count,BMI index, smoking, alcohol intake, and history of diabetes were assessed by using multivariate logistic regression analysis. Results The severity of ROM was significantly associated with a decrease in leucocyte count (P<0.05), and it was not markedly correlated with the other eight factors (P>0.05). Conclusions Leukopenia was one of the risk factors for the development of ROM. In clinical pratice,leukopenia should be corrected in patients with bone marrow depression due to radiotherapy in a timely manner.

Objective: Rumination is a maladaptive emotional-regulation strategy that is strongly associated with depression. Impaired executive function can lead to difficulties in disengaging from rumination, thus exacerbating depression. In this study, we inspect an electroencephalograph neurofeedback protocol that enhance the target peak alpha frequency (PAF) activation in the prefrontal region. We examine the protocol’s effects on depression and rumination. Methods: We randomly assigned 30 dysphoric participants into either the neurofeedback training group or the control group. We then evaluated their depression, rumination, and executive function at pre- and posttraining so as to examine the effects of the neurofeedback. Results: The results show that this neurofeedback protocol can specifically enhance participants’ target PAF. The participants’ executive function performances significantly improved after undergoing 20 neurofeedback sessions. Compared with those in the control group, those in the neurofeedback group had significantly fewer depressive symptoms and significantly reduced rumination. Moreover, as target PAF and executive function improved, depression and rumination both declined. Conclusion Our data are in line with those of previous studies that indicated a relationship between upper-band alpha activity and executive function. This PAF neurofeedback can effectively enhance participants’ executive function, which can reduce rumination and ameliorate depression. This neurofeedback training is based on basic cognitive neuroscience, so it sheds light on depression’s pathological factors and etiology.

The fatality rate of liver failure caused by fatal amanita poisoning is high, and there are no effective antidote drugs in China. On July 30, 2020, the department of infectious diseases and liver diseases of the First People's Hospital of Yunnan Province admitted a 67-year-old female patient with liver failure caused by fatal amanita poisoning. The patient went to the emergency department for treatment due to abdominal pain, vomiting and diarrhea after eating 350-400 g of amanita mushroom for 2 days, accompanied by fatigue for 1 day. There was no abnormality in physical examination. Laboratory indexes: alanine aminotransferase (ALT) 4 798 U/L, aspartate aminotransferase (AST) 10 030 U/L, activated partial thromboplastin time (APTT) 57.5 s, prothrombin time (PT) 72.1 s, international normalized ratio (INR) 8.66, prothrombinactivity (PA) 10%. Based on the patient's medical history, clinical manifestations and laboratory data, the diagnosis was amanita peptide mushroom poisoning and acute liver failure. According to the mechanism of amanita toxin poisoning as enterohepatic circulation, endoscopic retrograde cholangiopancreatography and ultrasound-guided gallbladder puncture and drainage for drainage of bile to discharge toxins were performed to interrupt the enterohepatic circulation of toxins. However, both methods failed, so open cholecystostomy was performed. Because the patient's coagulation function was very poor, artificial hepatic plasma exchange was given to improve coagulation function before open cholecystostomy, and eventually bile was drained successfully. After a total of 19 days of comprehensive medical treatment, the patient was cured and discharged from the hospital, and no sequelae was found after 1 year of follow-up. For such patients, early identification of the disease is required, and blocking the enterohepatic circulation of toxins as soon as possible according to the characteristics and toxicological mechanism of toxins may be the key treatment for rescuing patients with liver failure poisoned by amanita toxin, and it is necessary to combine comprehensive treatments such as active fluid replacement and blood purification to further improve the survival rate.

Objective To investigate the effects and potential mechanisms of ultrasound-guided thoracic paravertebral block(TPVB)combined with general anesthesia in patients undergoing thoraco-scopic surgery.Methods A total of 122 patients undergoing thoracoscopic surgery were selected and randomly divided into control group and tudy group,with 61 patients in each group.The control group received general anesthesia,while the study group received ultrasound-guided TPVB combined with general anesthesia.Clinical data and perioperative indicators were recorded and compared between the two groups.Mean arterial pressure(MAP),heart rate(HR),Visual Analogue Scale(VAS)scores before surgery,24 hours and 72 hours after surgery,and inflammatory factors[interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)],oxidative stress indicators[malondialde-hyde(MDA),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)]levels before surgery and 72 hours after surgery were compared between the two groups.Postoperative adverse reactions were recorded.Real-time fluorescence quantitative polymerase chain reaction was used to detect the expression of key molecules mRNA in the Nrf2/Keap1/ARE pathway in the peripheral blood of pa-tients in the two groups.Results There were no statistically significant differences in operative time and intraoperative blood loss between the two groups(P＞0.05).The study group had shorter extu-bation time and indwelling time of drainage tube,less total drainage volume,and less total PCIA drug consumption within 36 hours after surgery and times of patient controlled intravenous analgesia(PCIA)effective compression compared to the control group(P＜0.05).At 24 and 72 hours after surgery,MAP,HR,and VAS scores were higher than preoperative levels in the control group,while VAS scores were higher than preoperative levels in the study group,but MAP,HR,and VAS scores were lower in the study group compared to the control group(P＜0.05).At 72 hours after surgery,serum levels of IL-6,IL-10,TNF-α,and MDA were higher than preoperative levels,while SOD and GSH-Px levels were lower than preoperative levels in both groups.Additionally,the study group had lower serum levels of IL-6,TNF-α,and MDA and higher levels of IL-10,SOD,and GSH-Px compared to the control group(P＜0.05).The total incidence of postoperative adverse re-actions was 4.92％(3/61)in the study group,which was lower than 21.31％(13/61)in the con-trol group(P＜0.05).At 72 hours after surgery,the expression levels of Nrf2 mRNA and ARE mRNA in the peripheral blood of patients in the study group were lower than those in the control group,while the expression level of Keap1 mRNA was higher(P＜0.05).Conclusion Compared with general anesthesia,ultrasound-guided TPVB combined with general anesthesia can significantly improve hemodynamic stability and analgesic effects in patients with early-stage lung cancer after thoracoscopic surgery,relieve inflammatory and oxidative stress responses,and decrease the inci-dence of postoperative adverse reactions.The molecular mechanism may be related to the inhibition of Nrf2/Keap1/ARE signaling pathway activation.

Objective To investigate the effects and potential mechanisms of ultrasound-guided thoracic paravertebral block(TPVB)combined with general anesthesia in patients undergoing thoraco-scopic surgery.Methods A total of 122 patients undergoing thoracoscopic surgery were selected and randomly divided into control group and tudy group,with 61 patients in each group.The control group received general anesthesia,while the study group received ultrasound-guided TPVB combined with general anesthesia.Clinical data and perioperative indicators were recorded and compared between the two groups.Mean arterial pressure(MAP),heart rate(HR),Visual Analogue Scale(VAS)scores before surgery,24 hours and 72 hours after surgery,and inflammatory factors[interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)],oxidative stress indicators[malondialde-hyde(MDA),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)]levels before surgery and 72 hours after surgery were compared between the two groups.Postoperative adverse reactions were recorded.Real-time fluorescence quantitative polymerase chain reaction was used to detect the expression of key molecules mRNA in the Nrf2/Keap1/ARE pathway in the peripheral blood of pa-tients in the two groups.Results There were no statistically significant differences in operative time and intraoperative blood loss between the two groups(P＞0.05).The study group had shorter extu-bation time and indwelling time of drainage tube,less total drainage volume,and less total PCIA drug consumption within 36 hours after surgery and times of patient controlled intravenous analgesia(PCIA)effective compression compared to the control group(P＜0.05).At 24 and 72 hours after surgery,MAP,HR,and VAS scores were higher than preoperative levels in the control group,while VAS scores were higher than preoperative levels in the study group,but MAP,HR,and VAS scores were lower in the study group compared to the control group(P＜0.05).At 72 hours after surgery,serum levels of IL-6,IL-10,TNF-α,and MDA were higher than preoperative levels,while SOD and GSH-Px levels were lower than preoperative levels in both groups.Additionally,the study group had lower serum levels of IL-6,TNF-α,and MDA and higher levels of IL-10,SOD,and GSH-Px compared to the control group(P＜0.05).The total incidence of postoperative adverse re-actions was 4.92％(3/61)in the study group,which was lower than 21.31％(13/61)in the con-trol group(P＜0.05).At 72 hours after surgery,the expression levels of Nrf2 mRNA and ARE mRNA in the peripheral blood of patients in the study group were lower than those in the control group,while the expression level of Keap1 mRNA was higher(P＜0.05).Conclusion Compared with general anesthesia,ultrasound-guided TPVB combined with general anesthesia can significantly improve hemodynamic stability and analgesic effects in patients with early-stage lung cancer after thoracoscopic surgery,relieve inflammatory and oxidative stress responses,and decrease the inci-dence of postoperative adverse reactions.The molecular mechanism may be related to the inhibition of Nrf2/Keap1/ARE signaling pathway activation.