Objective To investigate the changes in tumor necrosis factor-alpha ( TNF-a) and interleukin-8 (IL-8) mRNA in skeletal muscle during open heart surgery with cardiopulmonary bypass (CPB) . Methods Ten patients (4 male, 6 female) aged 35-62 yr undergoing valve replacement under CPB were enrolled in this study. Anesthesia was induced with midazolam, fentanyl and pancuronium and maintained with isoflurane-fentanyl and pancuronium. A specimen of rectus muscle of abdomen (2g) was taken while chest was being opened (baseline) and closed. Blood samples were obtained before anesthesia (T0), while chest was being opened (T1), 15 min after initiation of CPB (T2), 5 min after aortic unclampmg (T3) and while chest was being closed (T4) for determination of plasma TNF-a and IL-8 level using enzyme-linked immunosorbent assay technique. Results TNF-a and IL-8 mRNA expression in skeletal muscle were significantly increased while chest was being closed as compared with the baseline ( P

Objective To investigate the therapeutic effect of stereotactic surgical treatment and postoperative cognitive functions in patients with treat-resistant obsessive compulsive disorder(TRO). Methods Twelve patients with TRO receiving MRI stereotactic bilateral anterior capsulotomy was retrospectively studied. The evaluation was conducted using the Yale-Brown obsessive compulsive rating scale (Y-BOCS),Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC),Wechsler Memory Scale-Revised in China(WMS-R), Modified Version of Wisconsin Card Sorting Tests (M-WCST) before and 6 months after the operation. Results The scores of Y-BOCS was 5.00(1.00,12.25) and 25.00 (20.25,32.00) after and before surgery, respectively. The scores of Y-BOCS were significantly lower after surgery than before (P<0.05). Most of cognitive function tests were not significantly different in TRO between pre-operation and 6 month post-operation (P>0.05).There were significant improvements in several cognitive tests after surgery including im-mediately logical memory 20.00(12.50,24.00),delayed logical memory16.50(11.50,21.75),immediately visual reproduc- tion 12.00(11.00,14.00),delayed visual reproduction11.00(8.50,14.00) and block design test scores 36.50(29.75,46.75), immediately logical memory14.00(13.00,18.75),delayed logical memory 14.50 (8.75,17.00),immediately visual reproduc-tion 11.00(6.50,11.75),delayed visual reproduction 8.50(6.25,10.00) and block design test scores 30.50(21.00,41.50) (P<0.05). Conclusions MRI-guided bilateral anterior internal capsulotomy is effective and safe treatment for patients with TRO and can improve their cognitive function.

Purpose: The human epidermal growth factor receptor 2 (HER2) is an established therapeutic target for various kinds of solid tumors. HER2 amplification occurs in approximately 1% to 6% of colorectal cancer. In this study, we aimed to assess the efficacy and safety of trastuzumab in combination with chemotherapy in HER2-positive metastatic colorectal cancer (mCRC). Materials and Methods: An open-label, phase II trial (Clinicaltrials.gov: NCT03185988) was designed to evaluate the antitumor activity of trastuzumab and chemotherapy in HER2-positive digestive cancers excluding gastric cancer in 2017. Patients from this trial with HER2-positive, KRAS/BRAF wild-type, unresectable mCRC were analyzed in this manuscript. Eligible patients were treated with trastuzumab (8 mg/kg loading dose and then 6 mg/kg every 3 weeks) and irinotecan (120 mg/m2 days 1 and 8 every 3 weeks). The primary endpoint was the objective response rate. Results: Twenty-one HER2-positive mCRC patients were enrolled in this study. Seven patients (33.3%) achieved an objective res-ponse, and 11 patients (52.4%) had stable disease as their best response. The median progression-free survival (PFS) was 4.3 months (95% confidence interval, 2.7 to 5.9). Four of the 21 patients (19.0%) had grade 3 adverse events, including leukopenia, neutropenia, urinary tract infection, and diarrhea. No treatment-related death was reported. Exploratory analyses revealed that high tumor tissue HER2 copy number was associated with better therapeutic response and PFS. Alterations in the mitogen-activated protein kinase pathway, HER2 gene, phosphoinositide 3-kinase/AKT pathway, and cell cycle control genes were potential drivers of trastuzumab resistance in mCRC. Conclusion Trastuzumab combined with chemotherapy is a potentially effective and well-tolerated therapeutic regimen in mCRC with a high HER2 copy number.

The end of the COVID-19 infection peak in 2022 prompts a backlog of cardiovascular surgical patients to gradually return to the hospital, resulting in a surge in cardiovascular surgeries. However, against the backdrop of the COVID-19 pandemic, the clinical practice of cardiovascular surgery faces many problems. Therefore, organized by Beijing Anzhen Hospital, experts in cardiovascular surgery and related fields have formulated hospital expert experience on perioperative treatment principles of cardiovascular surgery for patients infected with COVID-19. This article summarizes the clinical decision-making of patients requiring cardiovascular surgery after COVID-19 infection, and advises on the corresponding recommendations according to the existing evidence-based medical evidence as well as the actual clinical practice experience of relevant experts. The main content of the article includes special requirements for cardiovascular surgical treatment indications in patients with COVID-19 infection, selection of surgical timing, special requirements of preoperative, intraoperative and postoperative management, etc., which aims to provide COVID-19-infected patients with guidance on rational decision-making when receiving cardiovascular surgery.