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.

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.