Objective To assess the effectiveness of carotid endarterectomy(CEA) in the surgical treatment of stenosis of carotid artery.Methods From December 2003 to June 2006,28 patients of carotid arteriosclerotic stenosis received CEA and vascular repair or plasty(VP).Before and after operation,the hemodynamic parameters including inner diameter of internal carotid canal,blood flow rate,blood flow and blood flow rate of middle cerebral artery of 28 patients were measured by color Doppler flow imaging(CDFI) and transcranial Doppler(TCD).Results The inner diameter of internal carotid canal in all patients recovered to normal range.Blood flow rate and blood flow after operation were improved.No postoperative complications occurred,and no aneurysms formed.Conclusion CEA is one of the effective ways to manage carotid stenosis and angioplasty can improve the long-term efficiency.

ObjectiveTo explore the effects of hemofiltration on serum enzyme (SE),endotoxin (ET) and malonaldehyde (MDA) of dogs with heat stroke caused shock.MethodsSixteen healthy male hybrid dogs were randomly divided into 2 groups,8 for each:as heat stroke group (HS group ) and hemofiltration group (HF group).Severe heat stroke model was induced with high temperature.The dogs were taken out of the heating cabin when it reached heat stroke level,and then observed under normal temperature without treatment.The dogs in HF group was immediately treated with hemofiltration.The changes of SE,ET,MDA of two groups of dogs were observed and the survival time between two groups was compared,ResultsThe time from heat exposure to shock was ( 107.00 ± 28.52 ) and ( 111.38 ± 22.24 )minutes in HS group and HF group respectively ( t =- 0.354,P =0.729 ).The SE ( CK,LDH,ALT,AST) of the dogs were all higher after heat stroke,and the dogs of two groups showed no siginificant difference (P ＞ 0.05).At three hours after heat stroke,the SE increased apparently in HS group and HF group,but the level was significantly lower in HF group. Before heat stroke,the serum ET showed no siginificant difference between two groups ( P ＞ 0.05 ).After heat stroke,the serm ET was much higher than before ( P ＜0.01 ),but there was still no siginificant difference between two groups ( P ＞0.05 ).At three hours after heat stroke,the ET increased both in HF group and HS group,but the level was lower in HF group.Before heat stroke,the serm MDA had no siginificant difference between two groups ( P ＞ 0.05 ).After heat stroke,the serm MDA was much higher than before ( P ＜ 0.0l ),but there was still no siginificant difference between two groups (P ＞ 0.05 ).After heat stroke in three hours,the MDA of HS group rose apparently while HF group slowly declined.The median survival time of HF group was 180 min while HS group was 75 min,the survival rate showed siginificant difference (P ＜ 0.01 ).Conc4usions HF can improve the prognosis of dogs with heat stroke caused shock,prolong its survival time,reduce mortality.The mechanism is probably that HF clear serum MDA,partially clear serum ET and then eventually reduce cell and tissue injury and reduce SE.

Objective To study the diagnostic value of Sox2 mRNA transcription level in bronchoscopic biopsy specimens from lung cancer patients. Methods The expression of Sox2 mRNA was detected using RT-PCR from 100 hu-man lung cancer biopsy and 18 non-cancer lung biopsy through bronchoscopy. The expression of Sox2 protein was examined by immunohistochemistry from 50 cases of lung cancer biopsy, 32 cases of benign lung lesions and 18 cases of pericarcino-matous normal lung tissues. Then the relationships between Sox2 mRNA transcription level and lung cancer clinical patho-logical parameters were analyzed to test the diagnostic value of Sox2 transcription level. Results The transcription of Sox2 mRNA and its protein expression level were significantly higher in lung cancer than that in benign pulmonary disease tissues (P＜0.05). The transcription of Sox2 mRNA was not correlated with age, gender, histology, lymph node metastasis, TNM stage and differentiation of lung cancer patients (P>0.05). The Sox2 mRNA yielded an area of 0.748 under the ROC curve with the sensitivity of 85.0%and the specificity of 61.1%, taking the cut-off value of 0.513. Conclusion The Sox2 mRNA might be a useful diagnostic marker for lung cancer.

Objective To study the operative technique and effect of temporary balloon occlusion of the abdominal aorta for preventing intraoperative bleeding during cesarean for patients with pernicious placenta previa and placenta accreta. Methods Retrospective analysis was conducted on the intraoperative situation of forty-one cases and information of follow-up twenty-nine cases, which were pernicious placenta previa and placenta accreta and delivered in the First Affiliated Hospital of Zhengzhou University from May 1, 2013 to June 30, 2014. Diagnosis was confirmed by line of color Doppler ultrasound and MRI for all patients before operations. An interventional physician performed right femoral artery puncture and preset the abdominal aortic balloon catheter in the digital subtraction angiography operation room before cesarean. At the same time of fetal delivery, 10 ml normal saline was injected into the balloon immediately, which results in filling of the balloon and blocking of the aorta. According to the area and depth of placenta implantation and implantation or penetration of the posterior bladder wall, placenta separation, partial resection of the uterine wall and partial bladder resection and repair were performed correspondingly. Meanwhile, saline in the balloon was pumped out gradually until empty. Condition of placenta implantation, blood loss and blood transfusion volume during the operation, intraoperative and postoperative complications, the duration and dose of fetal radiation exposure, and Apgar score of neonates were analyzed. Results Among the 41 cases, penetrative placenta and implanted placenta were observed in five cases and 36 cases, respectively. The latter 36 cases including 28 cases of bladder posterior wall accreta and eight cases of bladder posterior wall penetration. For all cases, the average operation time was (68.5±15.3) min, the mean blood loss in the operation was (1 058±960) ml, among which eight received blood transfusion with an average of (600±400) ml, and the mean hospital stay was (8.2±2.3) d. Uteruses were reserved in all cases. The mean duration and dose of fetal radiation exposure was (8.1±3.6) s and (5.2±2.9) mGy, and the Apgar score of neonates was 8.7±0.5 at 1 min and 9.5±0.3 at 5 min, respectively. The patients were followed up until October 31, 2014. Among them, six were lost, six were still in puerperium, 18 were breast-feeding, and the menses of 11 had returned. Conclusion Preset abdominal aortic balloon catheter in pernicious placenta previa and placenta accrete patients might effectively reduce the blood loss during cesarean section as well as the risk of hysterectomy through temporary occlusion of the abdominal aorta.

OBJECTIVE:To study the effects of combined decoctions of alismatis rhizoma and curcumae radix and rehmanniae radix praeparata on the decoction amount of acteoside in rehmanniae radix praeparata,and provide reference for studying the effec-tive ingredients of three-drug effect. METHODS:Single decoction-1(rehmanniae radix praeparata 20 g),single decoction-2(alis-matis rhizoma 20 g),single decoction-3(curcumae radix 20 g),combined decoction-1(rehmanniae radix praeparata 20 g,alisma-tis rhizoma 20 g),combined decoction-2(rehmanniae radix praeparata 20 g,curcumae radix 20 g),combined decoction-3(alisma-tis rhizoma 20 g,curcumae radix 20 g)and combined decoction-4(rehmanniae radix praeparata 20 g,alismatis rhizoma 20 g,cur-cumae radix 20 g)were respectively taken to prepare dry extracts after extracting by refluxing,HPLC was used to detect the acteo-side content and calculate its decoction amount in sample. RESULTS:The decoction amounts of acteoside in single decoction-1, combined decoction-1,combined decoction-2 and combined decoction-4 dry extracts were 0.0354,0.0223,0.0228,0.0110 mg/g,respectively. Compared with single decoction-1 group,the last 3 groups had statistical significances(P<0.01);combined decoc-tion-4 showed lowest decoction amount in three-drug combined decoction group. Acteoside was not detected in the negative control groups(single decoction-2,single decoction-3 and combined decoction-3). CONCLUSIONS:The decoction amount of acteoside is reduced when alismatis rhizoma,curcumae radix and rehmanniae radix praeparata were decocted together,indicating that it may not be the main ingredient of playing effects in three-drug combined decoction liquid.

Objective :To construct hepatocarcinoma specific IL-1? anti-sense RNA expression vector and to explore its effect on the growth of implanted hepatocarcinoma H22 cells in mice and the possible mechanism. Methods:Murine IL-1? anti-sense RNA expression vectors pafpIRES2-antiIL-1?1 and pafpIRES2-antiIL-1?2 under the regulation of minimal alpha-feto protein (AFP) promoter and CMV enhancer were constructed,and further verified by PCR,restriction endonuclease analysis and DNA sequencing. H22 cells transfected with pafpIRES2-antiIL-1? 1 or pafpIRES2-antiIL-1? 2 were divided into 3 groups:H22/mock,H22/antiIL-1?1 and H22/antiIL-1?2 group. Expression of IL-1? was detected by RT-PCR. Transfected H22 cells were subcutaneously injected into mice to establish tumor implanted mouse model. Tumor volume was measured; the cytotocixity of spleen NK against H22 cells was detected by MTT. Results:Hepatocarcinoma specific IL-1? anti-sense RNA expression vectors pafpIRES2-antiIL-1?1 and pafpIRES2-antiIL-1?2 were successfully constructed and were verified by PCR,restriction endonuclease analysis and DNA sequencing. IL-1? expression in H22 cells was down-regulated after transfected with IL-1? anti-sense RNA expression vectors,especially with the pafpIRES2-antiIL-1?2 vector. Hepatocarcinoma cells implanted mouse model was successfully established. Tumor volume and growth of tumor in H22/antiIL-1?2 mice was obviously smaller than that in H22/mock mice,and the cytotocixity of spleen NK against H22 cells in H22/antiIL-1?1 and H22/antiIL-1?2 mice was also greatly enhanced. Conclusion:Hepatocarcinoma specific IL-1? anti-sense RNA expression vector pafpIRES2-antiIL-1? was successfully constructed. It effectively inhibits the growth of implanted hepatocarcinoma in mice probably through specifically blocking expression of IL-1? and increasing cytotocixity of spleen NK.

Objective To detect the expressions and clinical significance of Nanog and CD44 protein in lung cancer. Methods The expressions of Nanog and CD44 were detected by immunohistochemistry in 50 cases of lung cancer, 32 cases of benign lesion lung tissue and 18 cases of paraneoplastic normal lung tissue. Then their relationships with clinicopathological factors were analyzed. Results The expression of Nanog in lung cancer was significantly higher than those in benign lesion lung tissue and paraneoplastic normal lung tissue (P < 0.05). There was no significant difference of the expression of CD44 among the three groups (P > 0.05). The expressions of Nanog and CD44 in squamous cell carcinomas were higher than those in adenocarcinomas and small cell lung carcinomas (P < 0.05). The expressions of Nanog and CD44 were significantly correlated with lymph node metastasis (P < 0.05), but were not correlated with age, gender, tumour size, TNM stage and differentiation of lung cancer (P>0.05). The positive correlation was also noted between the expressions of Nanog and CD44 in lung cancer (r = 0.564, P < 0.05). Conclusion Nanog and CD44 proteins may participate in the genesis and progression of lung cancer. Nanog protein is a potential diagnostic marker and therapeutic target for lung cancer.

OBJECTIVE:To investigate the decoction amount changes of verbascoside,gallic acid in single decoction and com-bined decoction of rehmanniae radix preparata,corni fructus and poria,and provide scientific basis for further study of effective substance basis. METHODS:The single decoction,combined decoction with each 2 medicine and combined decoction with the 3 medicines of rehmanniae radix preparata,corni fructus and poria,were respectively prepared. HPLC was adopted to detect and com-pare the decoction amount of active component verbascoside in rehmanniae radix preparata and active component gallic acid in cor-ni fructus in each group. RESULTS:Compared with single decoction of rehmanniae radix preparata,the decoction amount of ver-bascoside was decreased in combined decoction of poria+rehmanniae radix preparata(P<0.01),decoction amount of verbascoside was increased in combined decoction of corni fructus+rehmanniae radix preparata or combined decoction with the 3 medicines(P<0.01). Compared with single decoction of corni fructus,the decoction amount of gallic acid in each combined decoction was de-creased (P<0.01). CONCLUSIONS:The combined decoction of rehmanniae radix preparata,corni fructus and poria has certain promotion and inhibition effects on the decoction of verbascoside in rehmanniae radix preparata and inhibition effect on the decoc-tion of gallic acid in corni fructus. It is speculated verbascoside may be one of the main components in combined decoction playing the role of effectiveness.

Objective:To construct and validate a risk prediction model for immune checkpoint inhibitor-associated pneumonia (CIP) using machine learning algorithms and the nomogram, aiming to provide an accurate and intuitive method to assist nurses in screening people at high risk of developing CIP.Methods:This was a retrospective case -control study. A total of 230 oncology patients treated with immune checkpoint inhibitors attending Zhujiang Hospital of Southern Medical University from January 2019 to February 2022 were collected using the hospital's electronic medical record system. The prediction models were built using five machine learning algorithms and nomogram. The models were then validated on a separate test set, and their differentiation and stability were assessed using evaluation indices like AUC and accuracy rate.Results:Underlying lung disease, smoking history, serum albumin≤35 g/L and radiotherapy history were identified as important influencing factors of CIP in all six models. The AUC of K nearest neighbor, support vetor machines (SVM), naive Bayesian, decision tree and random forest models predicted CIP were 0.647, 0.696, 0.930, 0.870, and 0.934, respectively. The AUC of the model created by the nomogram was 0.813, which was lower than the best random forest model in the machine learning algorithm, but with good predictive performance (AUC=0.934).Conclusions:The nomogram model can assess the patient′s risk more intuitively, but the risk prediction model of CIP based on a machine learning algorithm has a higher diagnostic value. It is suggested that the accuracy and usefulness of the prediction model can be increased by combining the nomogram's foundation with the machine learning algorithm.

Objective:To explore the potential categories of return-to-work self-efficacy of postoperative patients with thyroid cancer and analyze the influencing factors, so as to provide theoretical basis for implementing precise interventions of occupational rehabilitation.Methods:This was a cross-sectional study. A convenient sampling method was used to select 257 postoperative patients with thyroid cancer in Zhujiang Hospital of Southern Medical University from May 2022 to July 2023. The General Information Questionnaire, Return-To-Work Self-Efficacy Questionnaire and Cancer Fatigue Scale were used for investigation. Latent profile analysis was used to explore the potential categories of return-to-work self-efficacy of postoperative patients with thyroid cancer. Logistic regression and decision tree were used to analyze the influencing factors of different potential categories.Results:Finally, 250 postoperative patients with thyroid cancer were included. There were 76 males and 174 females, aged (37.91 ± 8.04) years old. The return-to-work self-efficacy of postoperative patients with thyroid cancer was divided into 2 potential categories: low return-to-work self-efficacy group (72.0%, 180/250) and high return-to-work self-efficacy group (28.0%, 70/250). Logistic regression showed education, thyrotropin suppressive therapy, cancer-related fatigue and age were factors influencing the potential categories of return-to-work self-efficacy of postoperative patients with thyroid cancer ( OR values were 0.951 - 19.820, all P<0.05). Decision tree model showed education level and cancer-related fatigue were the most important factors ( χ2 = 31.40, 16.95, both P<0.05). Conclusions:There were two potential categories of return-to-work self-efficacy of postoperative patients with thyroid cancer. Most of them had low levels of return-to-work self-efficacy. Health care professionals should focus on patients who are less educated and having cancer-related fatigue, meanwhile, should not ignore patients who are substandard thyrotropin suppressive therapy, and older. Implement precise interventions of occupational rehabilitation to improve the return-to-work self-efficacy of postoperative patients with thyroid cancer so as to help them reintegrate into society.