ObjectiveTo investigate the changes of serum myocardial enzymes and high density lipoprotein cholesterol(HDL-C) in children with septic shock.MethodsFifty-two children with septic shock in our hospital from Jan 2006 to Mar 2011 were divided into severe septic shock group( n =27 ) and mild septic shock group ( n =25 ).The serum creatine kinase-MB ( CK-MB ),α-hydroxybutyrate dehydrogenase (α-HBDH),lactic dehydrogenase(LDH) and HDL-C were analysed in both two groups on 1,2,4,7,10,15 d,and compared with 32 normal children as control group.Meanwhile,the children's condition,death cases and cured time were recorded.ResultsThe levels of serum CK-MB [ ( 32.084 ± 4.595 ) U/L,( 61.481 ±5.639) U/L],α-HBDH/LDH(0.694 ±0.080,0.884 ±0.079) in mild and severe septic shock groups were higher than those of normal control group[ (21.675 ± 3.453) U/L ] and (0.443 ± 0.065 ) ( P ＜ 0.01 ) ;the levels of serum HDL-C[ (0.646 ±0.067) mmol/L,(0.310 ± 0.124) mmol/L ] in the two septic shock groups were decreased significantly than that of control group[ ( 1.012 ±0.156) mmol/L] (P ＜0.01 ).Five cases died in the severe septic shock group while no cases died in mild septic shock group.The times of CK-MB recovered[ (9.82 ±1.76) d vs (4.68 ± 1.22) d],α-HBDH/LDH recovered[ (7.23 ± 1.38) d vs (3.76 ± 0.83 ) d] and HDL recovered[ ( 12.14 ± 2.21 ) d vs ( 6.48 ± 1.33 ) d ] were more slowly in severe septic shock group than those of mild septic shock group( P ＜ 0.01 ).ConclusionThe higher of the serum CK-MB and α-HBDH/LDH,and the lower of HDL-C in septic shock children,the disease is more severe,the recovery time is longer and a worse prognosis may occur.

Objective To detect the expressions of proliferating cell nuclear antigen (PCNA), C-erbB-2, p53, estrogen receptor (ER) and progesterone receptor (PR) in order to explore the proper margin for breast conservative surgery on Chinese women. Methods We collected 40 resection specimens from breast cancer patients who had received radical surgery. Then we divided each specimen into primary tumor group and hyperplasia and gene expression characteristics of PCNA, c-erbB-2, p53, ER and PR were measured by pathological and immunohistochemical assay in the five groups. Results With the further distance from the primary tumor, the proportions of high-risk disease and positive gene expressions of PCNA, c-erbB-2 and p53 in paracarcinoma tissues gradually decreased (P<0.05). Higher risk and more positive expressions were related to paracarcinoma was no correlation of PCNA, ER and PR expressions adjacent to breast cancer with tissue differentiation and lymph node metastasis (P>0.05). a safe and appropriater region for breast conservative surgery.

Objective To investigate the dynamic changes of lymphocyte subsets (lymphocyte count, CD3 +T,CD4 +T,CD8 +T,CD19 +B,CD56 +NK)in children with septic shock.Methods Peripheral blood lymphocyte subsets were analysed in 25 cases with severe septic shock and 24 cases with mild septic shock on day 1 ,3,8,and compared with those of 25 healthy volunteers.Children with severe septic shock were divided in-to survival group and dying group according to the outcome.The detection data were compared.Results In the first day of admission,peripheral blood lymphocyte subsets in children with septic shock decreased significantly compared with the normal children,and there was significant difference in the three groups(P <0.05 ).In the third day of admission,children with mild septic shock had statistical increase of CD4 +T,CD3 +T and lympho-cyte count(P <0.05),and children with severe septic shock had statistical decrease of lymphocyte subsets ex-cept CD56 +NK.In the eighth day of admission,children with mild septic shock had no significant difference in CD4 +T lymphocyte count compared with control group(P >0.05),but children with severe septic shock had statistical increase of CD4 +T,CD3 +T and lymphocyte count(P <0.05).There were 5 cases died who had se-vere septic shock in day 2 to day 5 after admission.The count of lymphocyte subsets were detected significantly lower in dying group than survival group in the third day of admission(P <0.05).Conclusion The continuous low level of lymphocyte subsets indicates bad outcome.The patientˊs condition improved with increase of CD4 +T,CD3 +T,lymphocyte count.CD4 +T is the most sensitive.Dynamic detection of lymphocyte subsets in the pe-ripheral blood of children with septic shock is of great clinical significance in judging the severity of disease and cura-tive effect.

Objective To investigate lymph node metastases in distal gastric cancer and its clinical significance. Methods From June 2006 to December 2007, 129 distal gastric cancer patients underwent radical gastrectomy with lymphadenectomy. Dissected lymph nodes were collected in groups, and histopathological studies were performed to detect lymph node metastasis. The relationship between lymph node metastasis and tumor parameters such as diameter, location, infiltrating depth, histological category,Borrmann typing was evaluated. Results Lymph node metastases was found in 80 out of 129 patients (62%). A total of 3295 lymph nodes were harvested with an average of 25.54 lymph nodes per patient,among those 889 lymph nodes were identified with metastasis. The metastasis rate was 18.60%, 48. 84%,37. 98%, 38. 76%, 44. 19%, 31.01%, 10. 85%, 14. 73%, 4. 65%, 1.55% and 0. 78% respectively in No. 1, No. 3, No. 4d, No. 5, No. 6, No. 7, No. 8a, No. 9, No. 11 p, No. 12a, No. 14v lymph node group.No. 3 and No. 6 group nodes were moat frequently invaded by metastasis. Conclusion This study provides the regular pattern of lymph node metastasis in distal gastric carcinoma patients undergoing radical gastrectomy and perigastric lymphadectomy which helps to guide lymphadectomy in terms of less trauma and favorite prognosis.

Objective To investigate MR findings and dynamic changes of the brain after gas explosion,and to evaluate the relationship between MR findings and post-traumatic stress disorder (PTSD).Methods Forty-nine survivors of a gas explosion (group A) were examined with brain MRI within 1 to 3 days,and serial MR follow-up examinations were also performed.Forty miners not under the ground that day were assigned as group B,and 40 staff working on the ground as group C.The signal intensity values of hippocampus and globus pallidus on T2WI were measured in the three groups and F test was performed by using SPSS 13.0.The relationship between signal intensity values of hippocampus/globns pallidus and PTSD was explored,and the relationship between ADC values of hippocampus and PTSD was also investigated.Results In group A,slight low signal on T1WI and high signal on T2WI were detected on initial MRI in hippocampus (33 cases),globus pallidus (12 cases),cortex (10 cases),and midbrain (2 cases),respectively.On follow-up MRI at 2 months,lesions in hippocampus disappeared (25 cases) or remained slight high signal on T2WI (8 cases),lesions in globus pallidus disappeared (3 cases,5 sides) or showed shrinkage and encephalomalacia (9 cases),cortical lesions resulted in encephalomalacia in 2 cases and returned normal in the others,and lesions in the midbrain showed encephalomatacia.For comparison of T2 signal intensity values in hippocampus and globus pallidus,there was significant difference between group A and group B(P <0.01),and also between group A and group C(P <0.01),but no difference was detected between group B and group C (P>0.05).In group A,the T2 signal intensities of PTSD and non-PTSD were 455±37 and 462±53 in the left hippocarnpus,and 458±36 and 460±43 in the right hippoeampus on 1 to 3 days,and the T2 signal intensities of PTSD and non-PTSD were 438±29 and 424±37 in the left hippocampns,and 442±31 and 430±32 in the right hippocampus at 2 months.The T2 signal intensities of PTSD and non-PTSD were 361 ±35 and 366±63 in the left globus pallidus,and 363 ±41 and 375±62 in the right globus pallidus on 1 to 3 days,and the T2 signal intensities of PTSD and non-PTSD were 341±24 and 337±39 in the left globns pallidus,340±26 and 332±35 in the tight glohus pallidns at 2 months.There was no difference of T2 signal intensity values in hippocampus and globus pallidus between PTSD and non-PTSD( t=0.350,0.826,0.503,0.907,P>0.05).In group A,ADC values of PTSD and nun-PTSD were (8.1±1.1)×10-4 and(8.1 ±0.9)×10-4mm2/s in the left hippocampus,and (8.2±1.0)×10-4 and(8.2±0.8)×10-4mm2/s in the tight hippocampus on 1 to 3 days,ADC values were (8.8±0.7)×10-4 and (9.0±1.0)×10-4mm2/s in the left hippocampus,and (8.5±0.9)×10-4 and (9.3±1.1)×10-4mm2/s in the tight hippocampus at 2 months.ADC values in hippocampns showed no difference between PTSD and non-PTSD(t=0.016,0.081,P>0.05)on initial MRI,but showed significant difference between PTSD and non-PTSD in tight hippocampus (t=7.407,P < 0.05) on follow-up MRI at 2 months,while no difference in left hippocampus (t =0.333,P>0.05) was observed at 2 months.Conclusion Hippocampns and globus pallidus are the most vulnerable structures in gas explosion.The occurrence of PTSD may be related to the injury of fight hippocampus,but not related to the injury of globns pallidus.

Objective To develop a hospice care attitude scale for medical workers and to test its reliability and validity. Methods The inital scale was formed by literature review, semi-structured interview and expert consultation. From September to December 2015, a total of 238 medical workers, from different departments from hospitals of different levels in Quanzhou, were selected hierarchically and randomly, and were investigated about their attitude towards hospice care, by which, reliability and validity of the scale were tested, and the final scale was formed. Results In the final scale of hospice care attitude for medi-cal workers, 7 dimensions with 26 items were included. By exploratory factor analysis, 7 common factors were extracted, with cumulative contribution of variance 62.238% . Content validity of the scale was 0.889, with Cronbach's alpha 0.891, split-half reliability 0.863 and test-retest Pearson correlation coefficient 0.867. Conclusions The hospice care attitude scale for medical workers has been proved to be reliable and valid, which can be used to assess hospice care attitude of the medical workers.

Interpreting genes of interest is essential for identifying molecular mechanisms, but acquiring such information typically involves tedious manual retrieval. To streamline this process, the fanyi package offers tools to retrieve gene information from sources like National Center for Biotechnology Information (NCBI), significantly enhancing accessibility. Additionally, understanding the latest research advancements and sharing achievements are crucial for junior researchers. However, language barriers often restrict knowledge absorption and career development. To address these challenges, we developed the fanyi package, which leverages artificial intelligence (AI)-driven online translation services to accurately translate among multiple languages. This dual functionality allows researchers to quickly capture and comprehend information, promotes a multilingual environment, and fosters innovation in academic community. Meanwhile, the translation functions are versatile and applicable beyond biomedicine research to other domains as well. The fanyi package is freely available at https://github.com/YuLab-SMU/fanyi.

AIM:This study aimed to observe the analgesic effects of Hegu acupoint catgut embedding in a rat model of labor and investigate its influence on biomarkers such as calcitonin gene-related peptide(CGRP)signals at the Hegu acupoint.METHODS:Thirty-six pregnant rats were randomly divided into three groups:control group,Hegu acu-puncture group,and Hegu catgut embedding group.Pain threshold changes were assessed using the tail immersion test and paw withdrawal thermal latency at four time points:pre-induction,before the onset of labor,at the onset of labor,and at the mid-stage of labor.Tissue samples from the Hegu acupoint were collected at the mid-stage of labor to detect the ex-pression of CGRP,substance P(SP),and mast cells using immunofluorescence.The concentrations of ATP and ade-nosine were measured using ELISA.RESULTS:Before labor induction,there was no significant difference in tail immer-sion test and paw withdrawal thermal latency among the three groups(P>0.05).Before the onset of labor,both the acu-puncture and catgut embedding groups exhibited significantly higher tail-flick times and paw withdrawal latencies com-pared to the control group(P<0.05).At labor initiation and mid-labor,the catgut embedding group had significantly higher tail-flick times and paw withdrawal latencies compared to both the control and acupuncture groups(P<0.05).During mid-labor,the expression of CGRP,SP,mast cells,ATP,and adenosine concentrations in the catgut embedding group was significantly higher than that in the control and acupuncture groups(P<0.05),with co-expression of CGRP,SP,and mast cells observed.CONCLUSION:Hegu acupoint catgut embedding effectively alleviates labor pain,and its mechanism may involve increased local expression of CGRP and SP,promoting mast cell degranulation,and increasing ATP release and its conversion to adenosine.

Objective:To investigate the learning curve for a five-step procedure, namely, a transthoracic single-port assisted laparoscopic transabdominal diaphragmatic approach, for Siewert type II adenocarcinoma of the esophagogastric junction.Methods:In this retrospective cohort study, we analyzed relevant clinical data of 66 patients with Siewert type II adenocarcinoma of the esophagogastric junction who had undergone the five-step procedure performed by the same surgeon in the Gastrointestinal Surgery Department of Guangdong Provincial Hospital of Chinese Medicine from May 2017 to April 2023. The learning curve were plotted using cumulative summation analysis and selected indicators, including intraoperative blood loss, duration of surgery, time to first flatus, time to first tolerance of liquid food, length of hospital stay, and incidence of perioperative complications at different stages were compared. The data were analyzed using SPSS 24.0 statistical software. Numerical data are presented as cases (%) and data were analyzed using the χ 2 test or Fisher's exact test. Normally distributed measurement data are presented as x±s, and independent sample t-testing was performed for inter group comparison. Non-normally distributed measurement data are presented as M( Q1, Q3) and the Mann–Whitney U test was used for inter group comparison. Results:The five-step procedure had been successfully completed without switching to open surgery in all 66 study patients. There were no perioperative deaths, blood loss was 100 (50, 200) mL and duration of surgery 329.4±87.3 minutes. The equation of optimal fit for the duration of surgery was y=0.031x 3-4.4757x 2+164.97x-264.4 ( P<0.001, R2=0.9797). The cumulative summation learning curve reached a vertex when 25 surgical procedures had accumulated. Using 25 cases as the cut-off, we divided the learning curves into learning and proficiency periods and patients into learning (25) and proficiency period groups (41). There were no statistically significant differences between the two groups of patients in sex, age, body mass index, American Society of Anesthesiologists score, history of abdominal surgery, comorbidities, preoperative neoadjuvant therapy, maximum tumor diameter, surgical procedure, or T and N stage of tumor ( P>0.05). The following factors differed significantly (all P<0.05) between the learning and proficiency stages: in the latter there was less intraoperative blood loss (100 [50, 100] ml vs. 200 [100, 200] ml, U=-3.940, P<0.001), shorter duration of surgery ([289.8±50.7] minutes vs. [394.4±96.0] minutes, t=5.034, P<0.001), more mediastinal lymph nodes removed (5 [2, 8] vs. 2 [1, 5], U=-2.518, P=0.012), earlier time to first flatus (2 [2, 3] days vs. 4 [3, 6] days, U=-4.016, P<0.001), earlier time to first tolerance of liquid food (5 [4, 6] days vs. 7 [6, 8] days, U=-2.922, P=0.003), shorter duration of hospital stay (8 [8, 10] vs. 10 [9, 12] days, U=-2.028, P=0.043). The incidence of surgical complications did not differ significantly between the two groups ( P=0.238). Conclusion:Satisfactory results can be achieved with the five-step procedure for patients with Siewert type II adenocarcinoma of the esophagogastric junction once 25 procedures have been performed.

Objective:To explore the application of anterior esophageal wall full layer fixation and gastric tube guidance in total laparoscopic overlap method for intracorporeal esophagojejunostomy.Methods:Overlap esophagojejunostomy with anterior esophageal wall full layer fixation and gastric tube guidance is suitable for patients with advanced gastric cancer (clinical stage: cT1b~4aN0~3M0) and esophageal invasion <3 cm, who underwent radical total gastrectomy+ overlap esophagojejunostomy. The main operation procedure was performed as follows: A titanium clip was used for fixation of the full anterior wall of esophagus before overlap esophagojejunostomy, and the side‐to‐side esophagojejunostomy was performed with the linear stapler under the guidance of gastric tube. Then the titanium clip was removed after confirming that the correct cavity was entered. Finally, the common outlet was closed by two barbed sutures. A descriptive case series study was conducted. The clinical data of patients who underwent laparoscopic radical gastrectomy and overlap esophagojejunostomy with anterior esophageal wall full layer fixation and gastric tube guidance in Guangdong Provincial Hospital of Chinese medicine and the First Affiliated Hospital of Guangzhou University of Chinese medicine from May 2021 to June 2023 were retrospectively analyzed.Results:A total of 42 patients were collected, and all of them were successfully completed laparoscopic total radical gastrectomy without conversion to laparotomy or perioperative death. The esophagojejunostomy time, operative time, intraoperative blood loss was 17(5‐25) minutes, (258.8±38.0) minutes and 50(20‐200) ml, respectively. The incidence of esophageal false lumen was 0%, and there were no intraoperative complications. The time of gastric tube removal, initial fluid diet intake and the duration of postoperative hospital were 2(1‐5) , 4(1‐8) and 8(4‐21) days, respectively. There were no postoperative anastomotic hemorrhage, anastomotic stenosis and other related complications. One patient (2.38%) developed a Clavien‐Dindo IIIb complication, which was abdominal hemorrhage after operation. The second surgical exploration confirmed that the patient was bleeding due to gastroduodenal artery rupture. After intraoperative suture hemostasis, fluid expansion, blood transfusion and other treatments, the patient was discharged on the 15th day after the operation. Three patients (7.14%) developed Clavien‐Dindo grade II complications, including anastomotic leakage, chylous leakage and pulmonary infection, and were discharged after conservative treatment such as anti‐infection and prolonged retention of drainage tube.Conclusions:Laparoscopic overlap method for intracorporeal esophagojejunostomy with anterior esophageal wall fixation and gastric tube guidance can shorten the time of esophagojejunostomy and prevent the occurrence of false lumen, and do not increase anastomose‐related complications.