Objective To investigate the application value and effect of lung vascular and lesion positioning guided by Doppler ultrasound in the operation of thoracoscopic lobectomy. Methods Thirty cases of experimental pigs were randomly divided into A, B and C three groups. The group A was operated by conventional thoracoscope for upper right lobectomy, and group B was operated by thoracoscope for upper right lobectomy which guided by Doppler ultrasound cavity prober. Then, the operation time, blood loss and materials costs were compared between the two groups. The group C was used to establish the model of lung cancer and CT scanning was used to indicate the lung lesions. During operation, lesions were positioned by Doppler ultrasound and wedge resections were performed under thoracoscope. Then, the pulmonary lobectomy guided by ultrasound and mediastinal lymph nodes dissection were performed. At last, the coincidence rate of intraoperative ultrasound and CT location was analyzed statistically. Results There were significant differences in operation time between Groups A and B ( < 0.01), while no significant differences in blood loss and material costs ( >0.05) . In group C, lesion location positioning guided by ultrasound during the operation was completely consistent with guided by CT before the operation. No significant differences in the lesion diameter were observed between ultrasound and CT methods ( > 0.05) . Conclusion With the application of Doppler ultrasound, the invisible and untouchable blood vessel can become visible and can be positioned in precise to shorten the time of thoracoscopic lobectomy. In addition, the accurate positioning of tiny lesions in the lung can solve the problem of lung small lesion positioning which is difficult in the operation under thoracoscope. Therefore, it can be promoted in clinical applications in a wide range.

Objective To investigate the feasibility of pig lung cancer model induced by bronchial perfusion of 3,4-benzopyrene. Methods 24 experimental pig were randomly divided into model group and control group, each containing 12 cases. Experimental pigs were under the anaesthetic state, pigs in the model group were given endobronchial infusion of 3,4 - benzopyrene - corn oil mixture, pigs in control group were injected with equal capacity of corn oil.Perfusion 1 times a week for 16 weeks.In week 16,32 and 48,all experimental pig were given lung CT scans, then the lung lesions were observed.After 48 weeks, the pig lung, esophagus, and gastrointestinal tract, liver and brain and other organs were dissected, the presence of tumor formation was observed, and the mass, and experimental pig lung biopsy were given hematoxylin and eosin staining analysis. Results Lung cancers were not found in control group by both CT lung cancers and anatomy. In the model group, pulmonary CT showed space-occupying lesions with different location and size in lungs of 8 pigs, and the space-occupying lesions were confirmed as malignant tumors by pathology, including 3 cases of moderately differentiated adenocarcinoma, 2 cases of highly differentiated squamous cell carcinoma, 1 case of alveolar cell carcinoma,2 cases of adenosquamous carcinoma. Three other pigs and pigs in the control group were not found with tumor by both lung CT and anatomy. Pigs in model group were induced successfully to malignant tumor in 1 year , the total tumor formation rate was 75%,lung tumor formation rate was 66.66%. Conclusion The trachea bronchial perfusion of 3,4- benzopyrene is a simple,safe and reliable way to construct animal models of lung cancer.

Objective:To evaluate the efficacy and safety of belimumab in the treatment of systemic lupus erythematosus (SLE).Methods:Retrospective analysis was made in 41 patients with SLE who were treated with belimumab in our hospital. The demographic data, clinical features, laboratory test results and treatment-related adverse events (AE) were collected and analyzed. Paired sample t test and Wilcoxon test were used to compare and analyze the changes of laboratory indexes before and after treatment. Results:The follow-up time of the 41 patients was (3.0±1.0) months, and 19 patients stopped belimumab because of the Covid-19 pandemic, the duration for belimumab withdrawal was (2.6±0.9) months. The most common clinical manifestation was impaired renal function (63.4%, 26 cases), followed by musculoskeletal impairment (58.5%, 24 cases). Before and after treatment, the dose of glucocorticoid was significantly decreased [15(9, 35) mg/d vs 13(8, 25) mg/d, Z=-3.573, P<0.01], the systemic lupus erythematosus disease activity index (SLEDAI)-2000 was significantly decreased [5(4, 8) vs 2(2, 4), Z=-4.446, P<0.01], the anti-double-stranded DNA (dsDNA) antibody [enzyme-linked immune-sorbent assay (ELISA)] level was significantly decreased [96(26, 300) vs 36(10, 139), Z=-3.436, P<0.01], the complement C3 level was significantly increased [(0.62±0.22) g/L vs (0.74±0.20) g/L, t=-5.454, P<0.01], the complement C4 level was significantly increased [(0.13±0.07) g/L vs (0.17±0.07) g/L, t=-5.851, P<0.01), the hemoglobin level was significantly increased [(117±15) g/L vs (125±16) g/L, t=-4.236, P<0.01) and A/G level was significantly increased [(1.30±1.36) vs (1.49±0.29), t=-5.174, P<0.01]. Four patients (13.8%) had adverse events during treatment with belimumab, including 1 case of upper respiratory tract infection, 2 cases of urinary tract bacterial infections and 1 case of herpes zoster. Conclusion:Belimumab is safe and effective in the treatment of SLE. It can significantly reduce the dosage of glucocorticoid and improve anemia, but the specific mechanism needs to be further studied.

Objective:To evaluate the efficacy and safety of oral anisodine hydrobromide tablets in the treatment of nonarteritic anterior ischemic optic neuropathy (NAION).Methods:A multicenter nonrandomized controlled trial was conducted.A total of 282 acute NAION patients (282 eyes) were recruited from 16 hospitals in China from July 2020 to May 2021.Patients were divided into two groups according to treatment methods, which were control group (124 cases, 124 eyes) receiving regular treatment including citicoline sodium plus Ginkgo biloba leaf liquid extract or Ginkgo biloba leaf extract tablets plus mecobalamin, and experimental group (158 cases, 158 eyes) receiving treatment in control group plus oral anisodine hydrobromide tablets 1 mg, twice daily for 2 to 3 months.Best corrected visual acuity (BCVA), visual field index (VFI), peripapillary retinal nerve fiber layer (pRNFL) and radial peripapillary capillary vessel density (RPC) were assessed at 1, 2, 3, and 6 months after enrollment using the standard decimal visual acuity chart, 750i Humphery visual field analyzer, Cirrus HD-OCT 4000/Cirrus HD-OCT 5000, RTVue-XR optical coherence tomography respectively.The primary outcomes were BCVA and VFI, and the secondary outcomes were pRNFL, RPC, and the side effects during the follow-up.The study adhered to the Declaration of Helsinki.All patients were fully informed about the treatment and purpose of this study and voluntarily signed the informed consent form.The study protocol was approved by Chinese PLA General Hospital (No.S2020-021-01). Results:In all, 242 patients (242 eyes) completed the follow-up of BCVA, and 98 patients (98 eyes) completed the VFI follow-up.In terms of visual function, BCVA and VFI improved significantly over time in the two groups, and BCVA and VFI were better in experimental group than in control group at various follow-up time points (all at P<0.05). In terms of structure, pRNFL gradually decreased in both groups with the extension of treatment, and pRNFL was significanthy thinner in experimental group than in control group at various follow-up time points (all at P<0.05). There was no significant difference in RPC between the two groups at the last follow-up ( P>0.05). There were two cases with side effects and one case was discontinued due to side effects 25 days after enrollment. Conclusions:Oral anisodine hydrobromide can improve visual acuity and visual field in NAION and accelerate the regression of optic disc edema, with good safety.