Objective Classification of non-small cell lung lymph (NSCLC) node (N) is one of the key factors influencing treatment, however, the cilinical noninvasive and invasive approaches to N classification have their limitations.This study aimed to investigate the risk factors of lymph node metastasis of peripheral lungadenocarcinoma by using CT and PET / CT scans.Methods Retrospective analysis had been done on a total of 248 patients who underwent surgical resection from February 2010 to November 2015 in our hospital.All of them underwent chest CT and 80 patients underwent PET/CT examination.Univariate analysis was applied in the relation of lymph node metastasis to gender, age, smoking situation, CEA, SUV, cancer size, pathological variants, and the degree of differentiation.Multivariable logistic regression analysiss were performed in the prediction of risk factors for lymph node metastasis.ResultsSeventy-four patients (29.8%) had regional lymph node metastases.Univariate analysis showed that lymph node metastasis was related to the serum CEA level, degree of differentiation, SUVmax, tumor size, lobulation/spiculation, pleural retraction, mediastinal or hilar lymphadenopathy (P<0.05).In the multivariable analysis of risk factors, including serum CEA, SUVmax and CT features, for predicting lymph node metastasis, the most important and significantly independent risk factors identified were SUVmax, CEA level, mediastinal or hilar lymphadenopathy, cavitation/bubble-likelucency and pleural retraction (P<0.05).Conclusion The lymph node metastasis is associated with SUVmax of primary tumor, serum CEA level, mediastinal or hilar lymphadenopathy, cavitation/bubble-likelucency and pleural retraction.The combination of radiographic features and serum CEA can help to predict more accurately the risk of lymph node metastasis in patients with peripheral lung adenocarcinoma.

Objective To investigate the consistency of the results detected by different types of blood cell analyzer in the blood center .Methods On the basis of the calibration in each analyzer ,with the analyzer obtaining the excellent result in participating the external laboratory quality assessment hosted by the Ministry of Health as the reference ,the fresh blood samples were adopted to analyze other analyzers .Results For the analyzers after conducting the comparison ,the consistency and accuracy of the detection results were ensured .Conclusion After calibration in different types of blood cell analyzer ,the differences exist in the detection re‐sults .Periodically conducting the comparison among different types of instrument has very practical significance .

Objective To discuss the methods of the heat preservation performance monitoring of the blood transport case and to provide the technical support for the safety of blood transportation.Methods At the different environment temperature,the amount of the cold resource was decided by the mass ratio of cold resource to blood and the temperature was automatically recorded by the intelligent temperature chip continuously,to monitor the changes of each monitoring point in the blood transport case.Results When the mass ratio of cold resource to blood was fixed at 1∶6,the cold chain of the blood transport case could keep the tempera-ture of 2-10 ℃ for 8 hours at the environment temperature of 12 ℃,It could keep the temperature of 2-10 ℃ for 4.5 hours at the environment temperature of 25 ℃,and it could keep the temperature of 2-10 ℃ for 2 hours at the environment temperature of 44℃.Conclusion When the mass ratio of cold resource to blood is fixed,as the environment temperature changes,the available time that the blood transport case keeps with the cold-chain requirement varies according to the results of the heat preservation per-formance monitoring of the blood transport case.

Aim To investigate the roles of chloride channels in the apoptosis and apoptotic volume de-crease (AVD)induced by adriamycin in nasopharyn-geal carcinoma CNE-2Z cells.Methods Apoptotic rates were detected by flow cytometry,and the volume changes were measured by the time-lapse live cell ima-ging technique.The patch clamp technique was used to record whole-cell chloride currents.Results Adria-mycin induced apoptosis of CNE-2Z cells.An early ap-optotic volume decrease was observed in the cell trea-ted with adriamycin.The cell volume was decreased by about 10% in 2 h.Adriamycin activated a chloride current which showed outward rectification.The chlo-ride channel blocker 5-nitro-2-(3-phenylpropylamino)-benzoate (NPPB ) could inhibit the adriamycin-in-duced chloride currents,apoptosis and prevent cell shrinkage.Conclusions Our findings suggest that ad-riamycin causes cell apoptosis by activation of chloride channels.Chloride channels may be involved in the apoptosis and apoptotic volume decrease induced by adriamycin in CNE-2Z cells.

Objective To clarify the relationship between clinical manifestation and pathological features of IgA nephropathy (IgAN) patients with mild proteinuria and/or hematuria.Methods Clinicopathological data from 316 biopsy-proven IgAN cases (proteinuria＜1 g/24 h and/or hematuria, and Scr＜133 μmol/L) from our hospital between January 1993 and October 2009 were studied retrospectively. The renal histopathology was quantified according to Lee's grading and Katafuchi's semi-quantitative standard, and the risk factors for renal pathological lesions were evaluated using multifactor logistic regression analysis. Results Among these 316 patients, 123 were male and 193 patients were female. The mean age at the time of renal biopsy was (33.10±10.69) years old. Clinical features were found as follows: hematuria with proteinuria was found in 267 patients (84.5%), isolated hematuria in 24 patients (7.6%), and isolated proteinuria in 25 patients (7.9%). 16.5% of patients had hypertension. The percentages of CKD stage Ⅰ, Ⅱ, Ⅲ were 76.9%, 20.9% and 2.2%, respectively. 31.3% of patients presented Lee's grade Ⅲ or more severe.52.8% of patients had various degrees of glomerulosclerosis. Crescent formation was observed in 20.3% of patients. 22.5% of patients showed tubular atrophy;16.8% showed interstitial fibrosis and 24.7% also had renal vascular lesions. The extent of glomerulosclerosis was negatively correlated with eGFR levels, but positively correlated with the amount of proteinuria and mean arterial pressure (MAP) level (P＜0.05). The score of tubulointerstitial lesion was positively correlated with the amount of proteinuria and negatively correlated with eGFR and hemoglobin (Hb)level (P＜0.05). The degree of renal vascular lesion was also correlated to MAP level positively and eGFR level negatively (P＜0.05). Multifactor logistic regression analysis revealed that proteinuria, Scr and Hb at the time of renal biopsy were independent risk factors for severe renal pathological lesions (Lee's grade Ⅲ or more severe) with odds ratio of 8.564, 1.031 and 0.975 respectively (all P＜0.01). Conclusions Severe renal histological lesions and decrease of renal function may be seen in some IgAN patients with mild proteinuria and/or hematuria. The levels of proteinuria,Scr and Hb are the independent risk factors for severe renal pathological lesions. Renal biopsy is important in these patients in order to make diagnosis and individual treatment.

ObjectiveTo conduct a systematic review of systematic reviews of the effect of preoperative prerehabilitation training on postoperative function of patients after total knee arthroplasty. MethodsThe systematic reviews and meta-analysis about the application of preoperative prerehabilitation training after total knee arthroplasty were retrieved from Cochrane Library, Embase, PubMed, Web of Science, Wanfang Data, CNKI and VIP database, from establishment to March 10th, 2023. The methodological quality was evaluated using AMSTAR. The meta-analysis of the reseaches without repetitive content was performed using RevMan 5.3. ResultsA total of ten systematic reviews/meta analyses were included. Compared with the routine rehabilitation, preoperative prerehabilitation training might decrease the scores of Western Ontario and McMaster Universities Osteoarthritis Index (MD = -1.34, 95%CI -1.94 to -0.74, P < 0.001), and Hospital for Special Surgery Knee Score (MD = -1.04, 95%CI -1.69 to -0.40, P = 0.001), shorten the length of hospital stay (MD = -1.01, 95%CI -1.66 to -0.36, P = 0.002), and enhance muscle strength three months after operation (SMD = 0.63, 95%CI 0.30 to 0.97, P < 0.001). ConclusionPreoperative prerehabilitation training can improve postoperative knee function, enhance muscle strength three months after operation, and shorten length of hospital stay for the patients after total knee arthroplasty.

Objective     To investigate the effect and prognosis of patients with ventricular septal rupture after myocardial infarction treated by surgical repair combining an occluder and a patch. Methods     Clinical data of 42 patients with myocardial infarction complicated with ventricular septal rupture admitted to the First Affiliated Hospital of Zhengzhou University from January 2010 to September 2021 were retrospectively analyzed. According to the surgical methods, 27 patients were divided into a traditional group, including 17 males and 10 females, with an average age of 62.81±6.81 years, who were repaired by patch only, and 15 patients were divided into a modified group, including 11 males and 4 females, with an average age of 64.27±9.24 years, who were repaired by surgery combining an occluder and a patch. Perioperative and follow-up data of the two groups were compared and analyzed. Results     There were statistical differences between the two groups in preoperative Killip grading, rate of intra-aortic balloon pump use, interval from myocardial infarction to operation, and the number of culprit artery (P<0.05). There was no statistical difference in other preoperative data, the cardiopulmonary bypass time, aortic cross-clamping time, postoperative hospital stay or in-hospital death rate between the two groups (P>0.05). No residual shunt occurred in the modified group, and the difference was statistically significant compared with the traditional group (P=0.038). There was no statistical difference in other complications between the two groups (P>0.05). The median follow-up time was 4 years. Two patients in the traditional group and one in the modified group died during follow-up. The follow-up cardiac function grading of patients in the modified group was statistically different from that in the traditional group (P=0.023). Conclusion     The perioperative  mortality of ventricular septal rupture after myocardial infarction is high, but the long-term effect is satisfactory. Surgical repair combining an occluder and a patch is a safe and effective treatment for ventricular septal rupture, which can effectively reduce postoperative residual shunt.

ObjectiveTo investigate the effect and mechanism of Yiyi Fuzi Baijiangsan （YYFZBJ） on the apoptosis of colon cancer cell line HCT116. MethodYYFZBJ at different concentrations （0.5， 1， 2， 4， 6， 8， 10， 12， 14， 16 g·L^-1） was used to intervene in HCT116 cells for 24， 48， 72 h. The cell counting kit-8 （CCK-8） method was used to determine the effect of YYFZBJ on cell proliferation in vitro. The cells were divided into a blank group， a capecitabine group（1.8 g·L^-1）， and low-， medium-， and high-dose YYFZBJ groups （6， 10， and 14 g·L^-1） and treated for 48 hours. Flow cytometry was used to detect the apoptosis. Hoechst 33342 staining was used to observe the apoptotic morphology of cells. Mitochondrial membrane potential （MMP） was analyzed by a mitochondrial-targeted deep-red fluorescent probe （Mito-Tracker Red CMXRos）. The expression of proteins related to the mitochondrial apoptosis pathway， such as B-cell lymphoma-2 （Bcl-2）， Bcl-2-associated X protein （Bax）， cytochrome C （Cyt C）， cysteinyl aspartate-specific protease （Caspase）-9， Caspase-3， cleaved Caspase-9， and cleaved Caspase-3 was detected by Western blot. The mRNA levels of Bcl-2， Bax， Cyt C， Caspase-9， and Caspase-3 were determined by real-time polymerase chain reaction （Real-time PCR）. ResultCompared with the blank group， YYFZBJ （8， 10， 12， 14， 16 g·L^-1） significantly inhibited the proliferation of HCT116 cells in vitro （P<0.05） in a dose-dependent manner. Compared with the blank group， the medium- and high-dose YYFZBJ groups and the capecitabine group showed increased apoptosis rates of colon cancer cells （P<0.05）. The YYFZBJ groups and the capecitabine group showed reduced number of colon cancer cells with significantly changed cellular morphology and cell apoptosis manifestations， such as strong dark blue fluorescence， nucleus concentration， shrinkage， and fragmentation. With the increase in the mass concentration of YYFZBJ， the blue fluorescence intensity was significantly enhanced. Compared with the blank group， the YYFZBJ groups and the capecitabine group showed reduced MMP in a dose-dependent manner， decreased protein and mRNA levels of Bcl-2， and increased protein expression of Bax， Cyt C， Caspase-9， Caspase-3， cleaved Caspase-9， and cleaved Caspase-3 and mRNA expression of Bax， Cyt C， Caspase-9， and Caspase-3 （P<0.05）. ConclusionYYFZBJ can induce the apoptosis of colon cancer HCT116 cells through the mitochondrial apoptosis pathway.