[Objective]To investigate the expression and the clinical significance of macrophage migration inhibitory factor (MIF)in the serum and lung tissues of the patients with non-small cell lung cancer(NSCLC).[Methods]Eighty-eight eligible inpatients were confirmed by pathology of lung tissues ,including 66 patients with NSCLC and 22 patients with benign lung lesions. ELISA was performed to measure serum concentration of MIF of these patients ,which was compared with 30 healthy individuals. Meanwhile,immunohistochemistry(IHC)was performed to examine the expression of MIF in the lung tissues of the two groups. MIF expression level was compared between two groups and among different subgroups of NSCLC. The correlationship between serum MIF level and high expression rate in lung tissues was also analyzed. All the data were analyzed by SPSS17.0.[Results]The serum concentration of MIF in NSCLC group was significantly higher than that in healthy control(14.79 ng/mL vs 10.69 ng/mL,P=0.001), and was slightly higher but not significantly different from benign lung lesions group(14.79 ng/mL vs 13.68 ng/mL,P=0.580). The comparison among subgroups of NSCLC showed that the serum MIF level was not only correlated with the histological grade and clini?cal stage of the cancer,but also correlated with the gender and smoking history of the host. Immunohistochemistry showed that the MIF high expression rate in the lung tissues of NSCLC was markedly higher than that of benign lung lesions group(30.3%vs 4.5%, P=0.014). Among the subgroups of NSCLC,IHC showed MIF high expression rate was correlated with the histopathologic types and clinical stage of the cancer. Simultaneously ,the serum MIF level showed a positive correlation with MIF expression rate in the lung tissues in all patients and NSCLC group(P<0.05).[Conclusion]MIF was strongly related to the clinicopathological characteristics of NSCLC. It could be helpful for the diagnosis and clinical evaluation of NSCLC.

ObjectiveToestablisharatmodelofincreasedbloodflow-inducedpulmonaryarterialhypertension generatedbyanastomosisoftheleftcommoncarotidarterytoleftexternaljugularvein.Methods 45maleSDratswere divided into three groups:the shunt group , the ligation group and the sham group .At twelve weeks after the procedure , the general status of the rats was observed . Heart conditions , cardiac output and shunt patency were measured by echocardiography .Right ventricular systolic pressure ( RVSP ) and Qp/Qs were checked by catheterization . Right ventricular hypertrophy index ( RVHI) was calculated and lung tissues were examined by pathology using hematoxylin -eosin and elastin Van Gieson staining .All data were analyzed statistically by one-way ANOVA test using SPSS 16.0.Results There was no significant difference in body weight gains between the groups .The patency rate of shunt was 84.6%.The heart was enlarged in the group shunt .Cardiac output increased significantly in the shunt group than that in the other two groups [(309.8 ±33.1) mL/min?kg vs.(245.6 ±31.9) mL/min?kg, (240.8 ±30.9)mL/min?kg, respectively, P<0.05].In the shunt group Qp/Qs was 2.16 ±0.38 and RVSP increased to (35.8 ±4.9) mmHg, RVHI was 0.3263 ± 0.0342, significantly higher than that of the other groups .The pulmonary arteriolar wall was evidently thickened in contrast to that in the sham group [ ( 22.3 ±1.7 )% vs.( 10.6 ±1.7 )%, P <0.05 ) .Conclusions Anastomosis of the left common carotid artery to left external jugular vein can successfully establish pulmonary arterial hypertension model induced by high blood flow in rats .

OBJECTIVE: To evaluate and summarize the relevant evidence of anticoagulation and bleeding risk management in patients with extracorporeal membrane oxygenation (ECMO), and provide the evidence-based basis for the management of anticoagulation and bleeding during ECMO treatment. METHODS: According to the evidence "6S" pyramid model, all evidence on ECMO anticoagulation management and bleeding risk was searched in relevant databases, organizations and guideline websites at home and abroad. Evidence types included guidelines, expert consensus, systematic evaluation, Meta-analysis and original study. The search time limit was from May 31, 2012 to May 31, 2022. Two researchers with evidence-based research background conducted independent literature quality evaluation of the retrieved evidence, and the evidence that met the quality standards was extracted and summarized based on the opinions of industry experts. RESULTS: A total of 315 articles were retrieved, and 13 articles were included, including 3 guidelines, 6 expert consensus, and 4 Meta-analysis. A total of 27 best evidences were summarized from 7 aspects, including the selection of ECMO anticoagulation, anticoagulation in priming, anticoagulation in operation, anticoagulation monitoring, bleeding and treatment, thrombosis and treatment, and prevention and management of terminal limb ischemia. CONCLUSIONS This study provides evidence-based basis for bleeding prevention and anticoagulant management in ECMO patients. It is recommended to selectively apply the best evidence after evaluating the clinical environmental conditions of medical institutions, so as to improve the prognosis of ECMO patients.
Humans ; Extracorporeal Membrane Oxygenation/adverse effects* ; Blood Coagulation ; Hemorrhage/etiology* ; Anticoagulants/adverse effects* ; Thrombosis/prevention & control* ; Retrospective Studies

OBJECTIVETo improve the diagnosis and treatment of testicular torsion.

METHODSThe clinical data of 9 cases of suspected testicular torsion were restrospectively analyzed to summarize the diagnostic experiences.

RESULTSThe 9 patients were 12-27 (mean 15) years old, 8 treated by surgery and 1 by spontaneous detorsion under anesthesia. Among them, 7 cases were proved to be testicular torsion and 1 case was acute epididymitis. Of the 7 cases of testicular torsion, 6 were found to have 180-720-degree torsion around the spermatic cord and 1 case 180-degree around the verticality of the spermatic cord. The accuracy rate of color ultrasonic examination was 87.5%.

CONCLUSIONPatients with acute scrotum pain should have color ultrasonic examination. Not all cases of the disease had testicular torsion around the spermatic cord. Emergency operation should be performed on any suspected case of testicular torsion.

Adolescent ; Adult ; Child ; Humans ; Male ; Spermatic Cord Torsion ; etiology ; therapy

Objective:To evaluate and summarize the best evidence for early rehabilitation of adults with veno-venous extracorporeal membrane oxygenation (VV-ECMO).Methods:Evidence on early rehabilitation of adult VV-ECMO patients was searched by computer from 7 English literature databases [PubMed database, cumulative index to nursing and allied health literature (CINAHL), Embase database, Cochrane library database, UpToDate clinical consultant, BMJ best clinical practice, JBI database], 5 Chinese literature databases (China biomedical literature database, China Yimai Tong, China national knowledge infrastructure, Wanfang data, VIP database), 5 guideline networks [National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), China Guide Network] and 2 professional association websites [Extracorporeal Life Support Organization (ELSO), Chinese Association of Rehabilitation Medicine]. The search period is from January 2011 to December 2021. The appraisal of guidelines for research and evaluation Ⅱ (AGREE ) and JBI 2014 quality assessment tools were used to evaluate the quality of inclusion guidelines, systematic reviews, expert consensus and original studies, respectively, and to extract and summarize the best evidence for early rehabilitation of adults with VV-ECMO.Results:A total of 2 guidelines, 2 expert consensuses, 2 systematic reviews and 8 original studies [including 1 randomized controlled trial (RCT), 1 non-randomized controlled study, 3 cohort studies and 3 case reports] were included. The evidence was summarized from 9 aspects including the necessity of early rehabilitation, rehabilitation initiation time, rehabilitation location, pre-rehabilitation preparation, pre-rehabilitation assessment, rehabilitation method, rehabilitation frequency and duration, rehabilitation process monitoring and effect evaluation,and finally 24 pieces of the best evidence were summarized.Conclusion:Early rehabilitation of adults with VV-ECMO is safe and feasible. The summary of the best evidence can provide evidence-based guidance for clinical medical staff to reasonably carry out early rehabilitation.

Objective To develop a new type of blast injury simulator to establish a mouse model of brain blast injury and study its damage mechanism. Methods Thirty healthy Kunming mice were randomly(random number) divided into the normal control group and brain blast injury model (TBI) group. A mouse model of traumatic brain injury was prepared by a self-developed explosive injury simulator. Morris water maze, Evans blue experiment and HE staining were used to observe the effects of shockwave exposure on spatial memory, blood-brain barrier, and pathological changes of brain tissues. T test was used for statistical analysis. Western blot method was used for detecting expression of brain injury markers Tau, S100β, Choline, inflammatory factors IL-1β, IL-4, IL-6, IL-10, NF-κB, apoptosis factors Bcl-2, Bax, Caspase3, and oxide protein stress-related factors IREα, MDA5, COX2 SOD1, and SOD2. Results Compared with the normal control group, (11.2±2.1) s, the time of searching platform in the TBI group was (54.6±8.4) s, was significantly longer (t=-19.330, P<0.05), and the EB exudation in the TBI group was 3.22 times (t=-13.903, P<0.05). Pathological staining revealed neuronal damage in the hippocampus, and TBI induced brain injury markers Tau(0.26±0.03 vs 0.46±0.04,t=-9.788, P<0.05), S100β(0.54±0.03 vs 0.74±0.02,t=-12.433, P<0.05) and Choline(0.54±0.05 vs 0.80±0.04, t=-7.970, P<0.05), inflammatory cytokines IL-1β(0.22±0.04 vs 0.31±0.05,t=-3.431, P<0.05), IL-4(0.65±0.02 vs 0.97±0.03, t=-18.927, P<0.05), IL-6(0.88±0.05 vs 1.07±0.08, t=-9.488, P<0.05) and NF-κB(0.80±0.06 vs 1.03±0.07,t=-4.507, P<0.05), and pro-apoptotic cytokines Bax(0.66±0.04 vs 0.78±0.04, t=-13.007, P<0.05) and Caspase3(0.44±0.03 vs 0.60±0.05, t=-4.472, P<0.05), oxidative stress-related factor pro IREα(0.72±0.06 vs 1.07±0.04, t=-9.665, P<0.05), MDA5(0.47±0.02 vs 0.77±0.02, t=-23.678, P<0.05) and expression of COX2(0.70±0.07 vs 0.86±0.02, t=-6.421, P<0.05), inhibition of inflammation inhibitory factor IL-10(1.14±0.06 vs 0.74±0.07, t=13.729, P<0.05), inhibition of apoptosis factors Bcl-2(0.72±0.05 vs 0.46±0.02, t=11.491, P<0.05) and inhibition of oxidative stress factors SOD1(1.17±0.05 vs 0.99±0.01, t=7.731, P<0.05) and SOD2(0.81±0.05 vs 0.61±0.04, t=10.257, P<0.05) expression. Conclusions The brain injury induced by blast exposure can induce spatial learning and memory loss, blood brain barrier disruption, neuronal damage hippocampus in mice, and promote the expression of brain injury markers, induce inflammation, oxidative stress and apoptosis. The self-developed explosive shock simulator successfully establishes a mouse brain blast injury model.

Objective To investigate the effect of CareDose 4D combined with Care kV on CT pulmonary ground glass nodule ( GGN) with respect to quality and radiation dose. Methods The thoracic model containing 6 GGN was performed by using 7 low-dose schemes. The CareDose 4D + Care kV was adopted in scheme 1. In schemes 2, 3 and 4, the tube voltage was 120 kV, and the tube current 30, 20 and 10 mAs respectively. In schemes 5, 6 and 7, the tube voltage was 100 kV, and the tube current was 30, 20 and 10 mAs, respectively. The image quality [ CT value, contrast noise ratio ( CNR) , noise value (SD) and subjective score] and effective dose (E) were compared. Results There was no statistically significant difference in CT value of GGN among different schemes (P>0. 05). The SD of scheme 1 was higher than those of schemes 2, 3 and 5, but lower than those f scheme 7, while the CNR of scheme 1 was lower than those of schemes 2, 3 and 5, but higher than that of scheme 7 ( t=13. 020, 9. 560, 8. 120,-5. 720, -7. 849, -5. 192, -4. 130, 1. 361,P<0. 05). SD and CNR of scheme 1 were not significantly different from those of scheme 4 and 6 ( P>0. 05) . The subjective scores of each GGN of schemes 1, 2, 3, 5 and 6 was over 3 points, but and the subjective scores of one GGN of each of schemes 4 and 7 were below 3 points. The value E of the scheme 1 was reduced by 63. 0％, 44. 4％, 38. 8％, and 9. 1％, compared with the schemes 2, 3, 5 and 6, respectively. Conclusions CareDose 4D combined with Care kV in low-dose lung CT scan can ensure the image quality of GGN and reduce the radiation dose effectively.