Nuclear factor kappa B(NF-?B) is an important transcription factor in the expression of many inflammatory media. With the recent progress of molecular biological technique, the modulated mechanism of NF-?B in immunity, stress, inflammatory responses, and the differentiation and growth of lymphocyte has been the focus. This review presents the role of NF-?B in ischemia-reperfusion and cardiopulmonary bypass, and the research progression of intervention therapy in inhibition of the activation of NF-?B is also introduced herein after.

Objective To evaluate the therapeutic effect of mini-incision surgery for the treatment of varicose vein of lower extremities. Methods 106 limbs of 95 paitnets with varicose vein underwent saphenectomy combined with ligation of communicating veins by way of mini-incision from November 1997 to April 2001. The ascending venography and StethoDoppler examination were performed preoperatively in all of the patients. Results Venous reflux in deep vein of lower extremities were at grade 0 in 62 limbs, at grade Ⅰ in 28 limbs and at grade Ⅱ in 16 limbs demonstrated by ascending venography with Valsalva test. StethoDoppler examination showed that valve insufficiency of great saphenous vein at saphenofemoral junction was in 99 limbs, the insufficiency of small saphenous vein at saphenopopliteal in 5 limbs and incompetent perforating vein in all of the limbs. Postoperative course was uneventful, the average hospitalization days after operation were 2.8 days and no recurrent varicose veins occurred in all the patients during the follow-up period lasting 1-30 months. Conclusions With the help of preoperative StehoDoppler examination, the mini-incision surgery for the treatment of varicose vein of lower extremities is safe, simple, effective and lower costs.

Objective: To seek the direct evidence of myocardial inflammatory activation in a cohort of patient undergoing surgery on cardiopulmonary bypass (CPB). Methods: Twenty patients undergoing surgery on CPB had plasma samples obtained for tumor necrosis factor-? (TNF-?), perioperatively. Myocardial tissue samples were obtained intraoperatively, both pre-and post-CPB. Myocardial nuclear factor ?B (NF-?B) nuclear translocation and plasma TNF-? concentrations were analyzed by standard enzyme-linked immunosorbent assay (ELISA). Cross clamp times, CPB times and the time to extubation were recorded. The change of myocardial NF-?B nuclear translocation and plasma TNF-? concentrations was assessed by analysis of variance (ANOVA). The regression analysis was utilized to define the correlations among the optical densities of NF-?B, concentrations of plasma TNF-?, influencing factors and heart function. Results: (1) Seventeen patients had NF-?B nuclear translocation before initiation of CPB, the optical density (OD) of myocardial NF-?B was significantly increased at the end of CPB in nineteen patients. (2) The correlation between the activity of NF-?B and concentration of TNF-? was signi ficant. (3) The correlation between the activity of NF-?B and clinic outcomes and other influencing factors was not significant. Conclusion: Myocardial inflammatory activation may be present in the patients before CPB. CPB could increase the activity of myocardial NF-?B.

N-terminal pro-brain natriuretic peptide(NT-proBNP) with no biological activity is the best cardiac marker in the diagnosis,risk stratification,prognosis and therapeutic monitoring of the patients with cardiac dysfunction,and is one of the natriuretic peptides.In this review,we aim to the latest progress of NT-proBNP study on its change during peri-cardiopulmonary bypass,and its applications in the diagnosis of preoperative cardiac function and in the guidance of heart failure therapy.

Objective To investigate the clinical effect and immunologic function of Moxifloxacin combined with small dose of hormone in the treatment of Ventilator pneumonia in elder.Methods 64 cases of Ventilator pneumonia in our hospital were collected and randomly divided into experiment group and control group, 32 cases each.Two groups were given conventional treatment, the control group received Methylprednisolone Sodium Succinate 1 mg/kg qd, the experiment group was given Methylprednisolone Sodium Succinate 1 mg/kg qd, and Moxifloxacin Hydrochloride and Sodium Chloride Injection 400 mg qd.Two groups of patients were continuous treated for 10 days.After treatment,T lymphocyte subsets, NK cells, white blood cell count, C reactive protein, clinical symptoms disappeared time, mechanical ventilation time, ICU length of stay and mortality rate were compared. Results After treatment, the total effective rate in the experiment group 75% was higher than the control group 50%( P <0.05 ).The levels CD3 +, CD4 +, CD4 +/CD8 +and NK cell in two groups increased(P<0.05), levels of CD8 +decreased(P<0.05),levels of WBC, CPR and PCT decreased in the two groups(P<0.05), and compared with the control group, the levels CD3 +, CD4 +, CD4 +/CD8 +and NK cell in the experiment group were higher(P<0.05), levels of CD8 + were lower(P<0.05),levels of WBC,CPR and PCT were lower(P <0.05), the rales disappeared time, cough disappeared time, fever disappeared time were significantly shorter than the control group(P <0.05), the duration of mechanical ventilation and the length of hospital stay were significantly shorter(P<0.05).Conclusion Moxifloxacin combined with small dose of hormone in the treatment of Ventilator pneumonia in elder was significantly effective, and it can relieve inflammation, prevention of infection control, enhance immune function.

Objective To discuss the surgical interference of chronic suppurative otitis media and it's long-term results.Methods In 113 cases of mastoidectomy with tympanoplasty followed up for 3 years,We discuss the results of recurrence and hearing levle of the open-mastoidectomy with tympanoplasty(OMT)and combined approach tympanoplasty(CAT).Results There is no significant difference between OMT(improved 12 dB HL)and CAT(improved 9.5 dB HL)in the improved hearing threshold leve.The recurrence rate of OMT was 5.8%,but the CAT was 24.4%,the difference is significant.Conclusion The effect of OMT is better than that of CAT for the long-term resulls in these cases.

Objective: To investigate the proportion of physical examinations among patients with severe mental disorders and its influencing factors in Shaoxing City, Zhejiang Province, so as to provide the evidence for improving the proportion of physical examinations among patients with severe mental disorders. Methods : The epidemiological and clinical features of patients with severe mental disorders included in community management in Shaoxing City in 2022 were collected from Zhejiang Provincial Severe Mental Disorder Management Information System, including demographics, disease diagnosis and treatment, physical examination, and rescue and assistance. Factors affecting the physical examination were identified among patients with severe mental disorders using a multivariable logistic regression model. Results: A total of 25 468 patients with severe mental disorders were enrolled in Shaoxing City in 2022, including 12 151 males and 13 317 females, with a male to female ratio of 0.91∶1, and the participants had a mean age of (54.34±14.71) years. Schizophrenia was the predominant type of severe mental disorders (15 419 cases, 60.54%), and 21 374 subjects participating in the physical examinations in 2022 (83.92%). Multivariable logistic regression analysis showed that female (OR=0.901, 95%CI: 0.832-0.975), urban areas (OR=0.506, 95%CI: 0.468-0.547), mental disorders due to epilepsy (OR=1.779, 95%CI: 1.104-2.866), hospitalized treatment (6 to 10 times, OR=0.523, 95%CI: 0.401-0.681; 11 times and more, OR=0.177, 95%CI: 0.108-0.288), special diseases in outpatient (OR=1.738, 95%CI: 1.597-1.891), receiving medical assistance (OR=2.851, 95%CI: 2.616-3.107), targets of the community care and assistance groups (OR=1.653, 95%CI: 1.471-1.857) and guardian (spouse, OR=1.777, 95%CI: 1.513-2.086; children, OR=1.277, 95%CI: 1.069-1.526; parents, OR=1.342, 95%CI: 1.143-1.576) were statistically associated with the proportion of physical examinations. Conclusions The proportion of health examinations was 83.92% among patients with severe mental disorders in Shaoxing City in 2022. Gender, residence, guardian, disease diagnosis, times of hospitalized treatment, medical assistance, special diseases in outpatients and target of community care and assistance groups were factors affecting health examinations among patients with severe mental disorders.

Objective To investigate the employing units' evaluation of the importance of the pre-ventive medicine talents' competencies, Hainan province, in order to provide reference for the construction of competency model of Preventive Medicine and make suggestions for the cultivation of Preventive Medicine professionals in our province. Methods Random sampling methods were applied and a survey was conducted among 10 CDCs and Health Supervision Institutes with self-designed questionnaires through telephone interview, correspondence or field investigation. SPSS 20.0 software was used to analyze the data. Results Teamwork, responsibility, preventive medicine knowledge, ability to prevent and control the dis-eases, ability to accept new methods and new techniques were thought very important by 94.4％, 100％, 72.2％, 77.8％, 72.2％of the surveyed units, respectively. However, only 5.6％、5.6％、33.3％and 38.9％of the surveyed units, respectively, considered that the computer applications ability, English proficiency, research approval and innovation ability were very important. Conclusion Colleges should improve the work of cultivating preventive medicine specialists to meet the employing units' demands.

Objective To investigate the diagnostic efficiency of 18F-FDG PET/CT imaging for indeterminate thyroid nodules.Methods Sixty-eight patients (24 males,44 females,age:(52.8±10.58) years) with indeterminate thyroid nodules who underwent 18F-FDG PET/CT imaging from January 2006 to December 2012 were analyzed retrospectively.The imaging characteristic including clearity of boundary,uniform density,calcification,capsule,mean CT value,nodular size and SUVmax of thyroid nodules were evaluated.The gold standard was postoperative pathological results.Mann-Whitney u test,x2 test and ROC curve analysis were performed to investigate the diagnostic efficiency.Results Among 68 patients with indeterminate thyroid nodules,18 were malignant and 50 were benign according to pathological results.Uniform density,calcification,capsule (x2 =0.21,0.01,0.43,all P＞0.05) and mean CT value,nodular size (all AUCs＜0.5) could not differentiate benign from malignant thyroid nodules.However,whether the nodules had clear boundary was significant to differentiate benign from malignant nodules (x2=8.06,P＜0.05),and the sensitivity,specificity and accuracy were 55.6％ (10/ 18),80.0％ (40/50) and 73.5％ (50/68),respectively.The mean SUVmax of benign and malignant thyroid nodules was 3.16±1.84 and 8.53±7.09,respectively (u=-4.281,P＜0.01).AUC of SUVmax was 0.841 (95％ CI:0.726-0.955).According to the maximal Youden index(0.562),4.25 was chosen as the SUVmax threshold,and its sensitivity,specificity and accuracy were72.2％(13/18),84.0％(42/50) and 80.9％(55/68),respectively.Conclusion Among different characteristics of 18F-FDG PET/CT imaging,SUVmax of thyroid nodules plays an important role in the differential diagnosis of undetermined thyroid nodules,but CT image features have limited value.

Objective To investigate the appropriate cutoff point of CA19-9 in prognosis and to determine other potential prognostic factors which may affect survival of patients with hilar cholangiocarcinoma (HC) after radical surgery.Methods 168 patients who had undergone radical surgery for hilar cholangiocarcinoma with R0 and R1 resection were selected for the study.Categorized versions were used in univariate model to determine the appropriate cutoff point of CA19-9.CA19-9 and other clinicopathologic factors were analyzed for their influence on survival using multivariate methods.Results The strongest univariate predictor among the categorized preoperative CA19-9 measures was CA19-9 of less than 150 IU/L (P ＜0.001).On univariate analysis,age,differentiation,tumor size,Bismuth-Corlette classification,portal vein invasion,lymph node metastasis,hepatic artery invasion,liver invasion,preoperative biliary drainage,resection margin and preoperative CA19-9 levels were identified as significant prognostic factors.On multivariable analysis,lymph node metastasis,resection margin and preoperative CA19-9 levels were independent prognostic factors of survival.Conclusions A raised preoperative CA19-9 level was an independent prognostic factor of survival for hilar cholangiocarcinoma.The most discriminative cutoff point of CA19-9 for prognosis was at 150 kU/L.