ObjectiveTo explore the surgical methods and its efficacy on severe chronic obstructive pneumonia disease (COPD) with spontaneous pneumothorax.MethodsClinical features and surgical efficacies of 16 cases of severe COPD were analyzed.Results No death occurred and all patients recovered and discharged.The lung function index including subjective symptoms,motor ability and endurance in 14 cases showed obvious improvement compared with those before combination of pneumothorax.Two patients improved to the level before surgery.ConclusionThe lung function index of patients with severe COPD and pnumothorax can be relatively less restricted and open-chest surgery should be performed as soon as possible.Linear nailing and simple lung volume reduction surgery are recommended to improve lung function,shorten operation time and reduce surgical risks.

To explore the effects of Western medicine including Ca(2+) channel antagonist and angiotensin-receptor antagonist combined with Songling Xuemaikang Capsule (SXC), a compound traditional Chinese herbal medicine for calming liver and suppressing liver yang, on blood pressure indexes derived from 24-hour ambulatory blood pressure monitoring (ABPM), and to evaluate the effects and stability of SXC in lowering blood pressure.

BACKGROUND:Slow growth of peripheral nerve, muscle denervation atrophy and fossilization of motor end plate fol owing sciatic nerve injury cause irreversible limb function disorders. Umbilical cord mesenchymal stem cells have been widely used in multi-disciplinary research, but studies concerning umbilical cord mesenchymal stem cells delaying denervated muscle atrophy in rats fol owing peripheral nerve injury are rarely reported.
OBJECTIVE:To observe the value of human umbilical cord mesenchymal stem cells transplantation to delay denervated muscle atrophy of rats after sciatic nerve injury.
METHODS:Umbilical cord blood was col ected from healthy parturient woman after ful-term delivery. In the experimental group, the rat’s Sunderland IV degree sciatic nerve injury model was established by 5 mm denervation, epineurial repair, and 5 mm smal gap transplantation of umbilical cord mesenchymal stem cells. In the control group, after modeling, the same volume of normal saline was injected into the smal gap. The main outcome measures included the sciatic nerve function index, the wet weight of triceps surae,sciatic nerve latency, action potential conduction velocity and amplitude,and skeletal muscle fiber cross section area maintenance rate.
RESULTS AND CONCLUSION:After 4, 8 and 12 weeks of modeling, the sciatic nerve function index values, the wet weight of triceps surae and skeletal muscle fiber cross section area maintenance rates in the experimental group were significantly higher than those in the control group (P<0.05). After 12 weeks of modeling, electromyography results showed sciatic nerve latency was significantly lower, but action potential conduction velocity and amplitude were dramatical y higher in the experimental group than the control group (P<0.05, P<0.001). Human umbilical cord mesenchymal stem cells transplantation in denervated muscle atrophy rats after sciatic nerve promotes nerve growth, delays denervated muscle atrophy, maintains the denervatied neuromusle’s morphology and function.

Objective To investigate the acceptability and related factors of an "on-demand"pre-exposure prophylaxis (PrEP) to prevent HIV transmission among MSM in Shenyang.Methods MSM recruited by non-probability sampling method and questionnaire survey conducted by investigators to collect information on social and behavioral characteristics,awareness of PrEP,Truvada and the acceptability of two different PrEP-based trials.Multivariate logistic regression was employed for statistical analysis.Results Among the 292 respondents,34.2％ had heard of PrEP and 58.2％ (170/292) reported were interested in participating a PrEP trial-"on-demand" use or 48.3％ (141/292) interested on "daily" use (x2=5.785,P=0.02).Factors independently associated with those "on-demand" would include:having more than 2 male sexual partners during the past 6 month (aOR=1.7,95％CI:1.1-2.7),concerning on the positive effect of PrEP (vs.side effects) (aOR=6.4,95％CI:2.2-18.9),having an HIV-infected sexual partners (aOR=8.1,95％ CI:1.0-63.3) and self-reported high risk for HIV (aOR=2.6,95％CI:1.2-6.0).The last two factors were only associated with the "on-demand" group.Conclusions "On-demand" PrEP (as opposed to daily) seemed a more feasible prevention strategy on HIV and particularly in those having high risk behavior of HIV.For those who could not follow the daily medication or having HIV risk perception,"On-demand" basis PrEP trial should be recommended for them to follow.

The purpose of this study was to explore the reasonable dose of low molecular weight heparin (LMWH) in hemodialysis (HD) and the strategy of preventing extracorporeal circuit coagulation (ECC). A retrospective case-control study included patients who used LMWH for anticoagulation during maintenance hemodialysis (MHD) in the Hemodialysis Center of Beijing Hospital from December 2020 to January 2021. Basic data such as weight, height, basic kidney disease, dialysis age and anti-Ⅹa factor activity before, during and after dialysis were collected. A total of 46 patients were enrolled in this study, including 5 patients in coagulation group (10.9%) and 41 patients in non-coagulation group (89.1%). The anti-Ⅹa factor activity reached its peak at 0.5 h after the start of HD. The level of anti-Ⅹa factor was incorporated into the receiver operating characteristic curve (ROC curve). The results showed that the area under the ROC curve (AUC) was 0.802 (95% confidence interval: 0.651-0.54, P=0.029), and the cutoff was 0.31 IU/ml (sensitivity 1, specificity 0.683). It is suggested that the body surface area should be used as the basis to estimate the anticoagulant dose of LMWH in HD, and the activity of HD 4 h anti-Ⅹa factor ≤0.31 IU/ml, which is of diagnostic value for ECC. In addition, the results of binary logistic regression analysis showed that dialysis age was an independent risk factor for ECC ( OR value 1.319, 95% CI 1.052-1.654, P=0.017). In summary, this study reveals that dialysis age may be a risk factor for ECC and that the activity of HD 4 h anti-Ⅹa factor ≤0.31 IU/ml can be used as a potential diagnostic cut-off point for ECC in HD patients, which provides a scientific basis for monitoring strategies to prevent blood coagulation in HD filters.

Objective To establish a nomogram model for efficiently predicting overall survival(OS)and cancer-specific survival(CSS)in patients with CRCHBM.Method 2239 patients from 2010 to 2019 were retrospectively analyzed from the Surveillance,Epidemiology,and End Results Program(SEER)databases and Wuhan Union Hospital Cancer Center.SEER is randomly assigned to the training and internal validation cohorts,and the Wuhan database serves as the external validation.Cox regression analyses were used to determine the independent clinicopathological prognosis factors affecting OS and CSS,and a nomogram was constructed to predict OS and CSS.The clinical utility of columnar plots was assessed using calibration curves,area under the curve(AUC),and decision curve analysis(DCA).Result OS column line graphs were constructed based on nine independent predictors:age,tumor location,degree of differentiation,tumor size,TNM stage,chemotherapy,primary focus surgery,number of lymph nodes sampled,and serum carcinoembryonic antigen(CEA)level.The C-index of the nomogram to predict the 1-,3-,and 5-year OS were 0.764,0.790,and 0.805 in the training group,0.754,0.760,and 0.801 in the internal validation group,and 0.822,0.874,and 0.906 in the external validation group.CSS column line graphs were constructed based on 3 independent predictors of TNM staging,radiotherapy and chemotherapy.The 1-,3-,and 5-year CSS AUROC values of the training group were 0.791,0.757,and 0.782,respectively.0.682,0.709,0.625 in the internal validation group and 0.759,0.702,0.755 in the external validation group,respectively.The results of receiver operating characteristic curve(ROC),ROC and DCA showed that the use of our model was more effective in predicting OS and CSS than other single clinicopathological features.Conclusion In summary,the nomogram based on significant clinicopathological features can be conveniently used to predict OS and CSS individually in patients with CRCHBM.

Objective:To establish a predictive model for coagulation in the extracorporeal circuit in elderly hemodialysis(HD)patients.Methods:The retrospective case-control study included 196 elderly patients with chronic renal failure receiving 4-h hemodialysis for the first time at the blood purification center of our hospital between March 1, 2019 and January 30, 2022.All enrolled patients were treated with heparin or related drugs for anticoagulation(including unfractionated heparin and low molecular weight heparin), with 14 cases(7.1%)in the coagulation group with a coagulation grade ≥1.There were 182 cases(92.9%)in the non-coagulation group.Demographic data, vital signs in a sitting position and the resting state before dialysis and laboratory tests before dialysis were collected.After the prediction model was developed, it was validated in elderly patients with chronic renal failure aged ≥60 years receiving 4-hour hemodialysis for the first time at our hospital between February 1, 2022 and February 1, 2023.Results:There were significant differences in heart rate[(82.6±12.3)times/min vs.(74.4±11.1)times/min]and total cholesterol[(4.3±1.2)mmol/L vs.(3.2±1.2)mmol/L]between the coagulation group and the non-coagulation group( t=2.231, 2.012, P<0.05).Multivariate logistic analysis showed that the heart rate( OR=0.930, 95% CI: 0.871-0.993, P<0.05)and cholesterol( OR=0.623, 95% CI: 0.391-0.992, P<0.05)had an effect on blood coagulation in cardiopulmonary bypass.The area under the curve(AUC)for predicting cardiopulmonary bypass clotting by heart rate was 0.639(the optimal cutoff value was 71 beats/min), the AUC for predicting clotting by total cholesterol was 0.708(the optimal cutoff value: 4.275 mmol/L), and the prediction using the combination of heart rate and total cholesterol was more effective(AUC=0.735).The model was verified in 98 patients with good results(AUC=0.895). Conclusions:The initial coagulation risk of the extracorporeal circuit in elderly patients undergoing initial HD can be preliminarily estimated based on the nomogram.

The purpose of this study was to explore the reasonable dose of low molecular weight heparin (LMWH) in hemodialysis (HD) and the strategy of preventing extracorporeal circuit coagulation (ECC). A retrospective case-control study included patients who used LMWH for anticoagulation during maintenance hemodialysis (MHD) in the Hemodialysis Center of Beijing Hospital from December 2020 to January 2021. Basic data such as weight, height, basic kidney disease, dialysis age and anti-Ⅹa factor activity before, during and after dialysis were collected. A total of 46 patients were enrolled in this study, including 5 patients in coagulation group (10.9%) and 41 patients in non-coagulation group (89.1%). The anti-Ⅹa factor activity reached its peak at 0.5 h after the start of HD. The level of anti-Ⅹa factor was incorporated into the receiver operating characteristic curve (ROC curve). The results showed that the area under the ROC curve (AUC) was 0.802 (95% confidence interval: 0.651-0.54, P=0.029), and the cutoff was 0.31 IU/ml (sensitivity 1, specificity 0.683). It is suggested that the body surface area should be used as the basis to estimate the anticoagulant dose of LMWH in HD, and the activity of HD 4 h anti-Ⅹa factor ≤0.31 IU/ml, which is of diagnostic value for ECC. In addition, the results of binary logistic regression analysis showed that dialysis age was an independent risk factor for ECC ( OR value 1.319, 95% CI 1.052-1.654, P=0.017). In summary, this study reveals that dialysis age may be a risk factor for ECC and that the activity of HD 4 h anti-Ⅹa factor ≤0.31 IU/ml can be used as a potential diagnostic cut-off point for ECC in HD patients, which provides a scientific basis for monitoring strategies to prevent blood coagulation in HD filters.