Objective To analyze the correlation between emphysema extent measured by high resolution computed tomography (HRCT) and pulmonary function tests, symptom score in patients with chronic obstructive pulmonary disease ( COPD ) , and to study the value of HRCT in the emphysema quantification in the clinical evaluation of COPD patients. Methods 78 patients with stable COPD were recruited to take the HRCT scan , and emphysema extent was qualified by measuring the proportion of low attenuation area in the whole lung (LAA%). Correlations between LAA% and indices of pulmonary function test, bronchial dilation test, mMRC scale, CAT score and six minutes walking distance (6MWD) were assessed. Results LAA% was negatively correlated with FEV1/FVC and DLCO%pred, and the correlation coefficients were -0.759 and -0.589 (P <0.01), respectively. LAA% was positively related to mMRC score (r = 0.342, P < 0.01), and negatively asso-ciated with 6MWD (r = -0.365,P< 0.01). There was no association between LAA% and indices of bronchodila-tion test (⊿FVC, ⊿FVC%, ⊿FEV1, ⊿FEV1%) (P > 0.05). Conclusions The severity of emphysema measured by HRCT is well correlated with the clinical symptoms , pulmonary function tests and exercise capacity in COPD patients. It can be used to diagnose emphysema early and to evaluate the severity of the disease com-prehensively. Thus, the risk factors of COPD can be controlled and the prognosis of the patients can be im-proved.

Objective: To investigate the predictive value of protein C(PC) for long-term mortality of patients with community-acquired pneumonia(CAP). Methods: A total of 657 patients with CAP were enrolled in Taian Central Hospital from January 2011 to December 2011.The patients were divided into short-term group(≤30 days), medium-term group(>30~90 days) and long-term group(>90 days). PC, high sensitivity C-reactive protein(hs-CRP), procalcitonin(PCT), pneumonia severity index(PSI) score and CURB-65 score were measured at the time of admission.The ROC curve was used to evaluate the independent risk factors.The Kaplan-Meier survival function curve was used to analyze the difference of mortality between the short-term group and long-term group.Independent risk factors for CAP risk were analyzed by COX regression. Results: A total of 597 cases were followed up, there were 49 cases(8.09%) in the short-term group, 11 cases(1.84%) in the medium-term group, and 537 cases(89.93%) in the long-term group.The PC levels in the short-term group, medium-term group and long-term group were (32.2±10.6)%, (43.1±9.9)%, (69.6±23.0)%, respectively.The level of PC was significantly increased in the short-term group compared with the medium-term group and long-term group (short-term group vs.medium-term group, q=6.18, P<0.05, short-term group vs.long-term group, q=9.87, P<0.05). The hs-CRP levels in the short-term group, medium-term group and long-term group were (108.1±22.4)mg/L, (68.2±12.9)mg/L, (25.1±17.1)mg/L, respectively.The level of hs-CRP was significantly increased in the short-term group compared with the medium-term group and long-term group (short-term group vs.medium-term group, q=5.23, P<0.05, short-term group vs.long-term group, q=12.95, P<0.05). Meanwhile, PC showed higher accuracy(AUC, 0.889) than CURB-65(AUC, 0.828) and hs-CRP(AUC, 0.711) in the long-term group.The Kaplan-Meier survival function curve showed that the mortality rate was significantly higher in the high-value group compared with the low-value group(F=17.10, P<0.01). PC was an independent factor for long-term mortality and was associated with poorer survival by the COX regression analysis. Conclusion PC has a high predictive value for long-term mortality in CAP patients.

Objective:To explore the mental health level of Chinese adults aged 20~79 years and its association with exercise based on the surveillance data.Methods:A cross-sectional study was conducted in a total of 161 901 samples from the Fifth National Physical Fitness Surveillance, including 121 928 adults aged 20-59 years and 39 973 elderly aged 60-79 years. The mental health status was assessed by a comprehensive questionnaire, and the participation in frequency and duration of exercise were investigated. Chi-square test and Logistic regression were applied to test the relationship between exercise and mental health using SPSS 26.0 software.Results:The rate of depressive symptoms among residents aged 20-79 years in China was 16.6%(26 311/158 518). In the adults aged 20-59 years, the rates of depression and anxiety symptoms were 18.0%(21 465/119 409) and 13.8%(16 435/119 444), respectively, and the proportion of those who often or always felt stressed was 15.3%(18 373/120 444). In the elderly aged 60-79 years, the rate of depression symptoms was 12.4%(4 846/39 109), the proportion of those with loneliness scale scores higher than 25 was 32.8%(12 650/38 525), and 4.0%(1 587/39 395) elderly often or always felt stressed. Compared with the non-exercisers, the risk of depression symptoms in the exercisers was reduced by 20% ( β=-0.22, OR=0.80, 95% CI: 0.78-0.82). With increased frequency and intensity of physical exercise, the mental health condition improved significantly. For those who exercised at least 3 days a week and had moderate intensity or above, the detection rate of depression symptoms decreased by 35% ( β=-0.39, OR=0.65, 95% CI: 0.63-0.67).The negative associations between exercise and depression were found in different ages, genders and resident subgroups. The risk of anxiety was 6% lower in the adults who participated in physical activity ( β=-0.06, OR=0.94, 95% CI: 0.91-0.97) and 15% lower in those who exercised over 3 days per week at moderate-to-vigorous intensity ( β=-0.16, OR=0.85, 95% CI: 0.81-0.89). No association between exercise and risk of stress was observed ( P>0.05), but the positive effect was also found as exercise frequency and intensity increased. Older adults with exercise had a reduced risk of high loneliness scores by 50% ( β=-0.70, OR=0.50, 95% CI: 0.47-0.52) and a 35% lower detection of stress risk ( β=-0.43, OR=0.65, 95% CI: 0.59-0.72). Conclusion:Exercise was significantly and meaningfully associated with self-reported mental health.Exercise can actively and effectively prevent and improve mental health.

Objective This study aims to investigate the feasibility and safety of Da Vinci robotic-assisted thoracoscopy for resecting mediastinal tumors in pediatric patients.Methods From November 2020 to June 2023,a total of 80 pediatric patients undergoing mediastinal tumor resection at Wuhan Children's Hospital were randomly assigned into two groups,with each group consisting of 40 participants.The control group underwent conventional thoracoscopy,while the observation group underwent Da Vinci robotic-assisted thoracoscopy.This study aimed to compare perioperative indicators between the two groups and establish learning curves based on surgical duration and intraoperative blood loss.Additionally,it assessed levels of pain mediators and stress response markers before surgery and at 24 hours post-surgery,as well as postoperative complications.Inflammatory marker levels were evaluated one month after surgery,and the children's quality of life was measured using the Pediatric Quality of Life Inventory(PedsQL)Generic Core Scales before surgery and one month post-surgery.Results The surgical duration for the observation group and the control group was(1.76±0.33)hours and(2.82±0.62)hours,respectively,and the intraoperative blood loss was(49.83±6.39)mL and(71.55±8.19)mL,respectively.Furthermore,the post-operative drainage time,drainage volume,and hospital stay for the observation group were all lower than those for the control group(P<0.05).After surgery,the levels of BK,5-HT,NPY,and PGE2 in the observation group were(8.06±1.06)mg/L,(170.20±13.21)ng/L,(201.82±13.52)mg/L,and(241.82±15.32)ng/L,respectively,indicating lower levels of pain mediators,stress response markers,and inflammatory factors compared to the control group(P<0.05).he overall incidence of complications was 2.50%in the observation group as opposed to 20.00%in the control group.Moreover,there was a statistically significant improvement in quality of life after surgery within the observation group when compared to that within the control group(P<0.05).Conclusion Da Vinci robotic-assisted thoracoscopy demonstrates enhanced feasibility and safety in pediatric mediastinal tumor resection,thereby justifying its clinical promotion.

Objective To investigate the effect of different concentrations of Echinococcus multilocularis secretion antigen (Em-sAg) on the phenotype and function of mouse bone marrow-derived dendritic cells (BMDCs) induced by lipopolysaccharide (LPS). Methods The bone marrow precursor cells isolated from the mouse bone marrow cavity were stimulated by mouse recombinant granulocyte-macrophage colony-stimulating factor (GM-CSF) to form BMDCs, and then cell morphology was observed under an inverted microscope. After the purity of BMDCs was identified by flow cytometry, BMDCs were divided into control group, positive control group (LPS 1 μg/ml), LPS+3 mg/ml Em-sAg group, LPS+1.5 mg/ml Em-sAg group, LPS+0.75 mg/ml Em-sAg group, and LPS+0.375 mg/ml Em-sAg group. Flow cytometry was used to measure the expression of BMDC surface molecules (CD80, CD86, and MHC-Ⅱ molecules) in each group, and ELISA was used to measure the expression level of the cytokine IL-12p70. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups. Results Observation under an inverted microscope showed that after 8-10 days of culture, the cells had burr-like protrusions and were in a state of complete suspension. Flow cytometry showed that the positive rate of CD11c was above 70% and most of the cultured cells were identified as BMDCs based on this. Flow cytometry further showed that compared with the control group, the LPS group had significant increases in the cell molecules CD80, CD86, and MHC-Ⅱ on surface (all P < 0.05); compared with the LPS group, the LPS+3 mg/ml Em-sAg group, the LPS+1.5 mg/ml Em-sAg group, the LPS+0.75 mg/ml Em-sAg group, and the LPS+0.375 mg/ml Em-sAg group had a significant reduction in CD80 ( F =34.870, P < 0.001), while there were no significant reductions in CD86 and MHC-Ⅱ( P > 0.05). ELISA showed that there was a significant difference in the level of IL-12 p70 between groups ( F =73.140, P < 0.05); compared with the control group, the LPS group had a significant increase in the expression level of IL-12p70 after stimulation ( P < 0.05); compared with the positive control group, the LPS+3 mg/ml Em-sAg group, the LPS+1.5 mg/ml Em-sAg group, the LPS+0.75 mg/ml Em-sAg group, and the LPS+0.375 mg/ml Em-sAg group had a significant reduction in the expression level of IL-12p70 ( P < 0.05), and the degree of reduction in the pro-inflammatory factor IL-12p70 increased with the increase in the concentration of Em-sAg. Conclusion Different concentrations of Em-sAg can inhibit LPS-induced maturity of BMDCs and the expression of the pro-inflammatory cytokine IL-12p70.