Objective To investigate the clinical efficacy of shenfu injection combined with chemotherapy in the treatment of small cell lung cancer .Methods 100 cases of patients with small cell lung cancer were randomly di-vided into control group and observation group using the number table ,each group was 50 cases.The control group was given only gemcitabine +carboplatin treatment,and the observation group was given 60ml shenfu injection twice per day on the basis of the control group ,and it continued 10d.Two groups of a course of treatment was three weeks . Changes in lymphocyte subsets , the incidence of postoperative complications , quality of life and lung function were compared before and after treatment .Results The clinical total effective rate of control group was 54.0%,which was significantly lower than that of the observation group (86.0%),the difference existed a statistical significant difference (χ2 =8.36,P<0.05).Changes in lymphocyte subsets before and after treatment between the control group and the observation group,the differences were statistically significant (t1=5.36,5.12,4.68,5.68,4.78,t2=5.28,5.13, 5.68,4.12,4.66,all P<0.05) after treatment,the observation group than the control group ,the difference was sta-tistically significant(t=5.22,5.73,4.56,5.03,4.85,all P<0.05);The rate of postoperative complications in the contro group was 16.0%,14.0%in the observation group ,the difference existed no statistical difference (χ2 =2.13, P>0.05).According to the SGQR scoring standads ,there was a statistical difference between the two groups ( t=4.29,5.34,4.93,6.22,all P<0.05).There was a statistical difference of pulmonary function (FEV1,FEV1%,FVC and 6MWD) between the two groups(t=4.19,5.23,4.52,4.39,all P<0.05).Conclusion Shenfu injection combined with chemotherapy is applied in the treatment of small cell lung cancer ,which has a significant effect ,it can obviously improve the patient′s quality of life and lung function ,and it should be promoted and applied in clinical practice .

Objective:To study the diagnostic efficacy and prognostic evaluation value of QT interval dispersion (QTd) in children and adolescents with cardioinhibitory vasovagal syncope (VVS-CI).Methods:From July 2010 to January 2020, 80 children and adolescents who received their first visit or admission to the Pediatric Syncope Clinic of The Second Xiangya Hospital of Central South University and definite diagnosed of VVS-CI due to syncope or presyncope were selected as the VVS-CI group, meanwhile, 80 children and adolescents who had physical examination in the hospital were selected as the control group.QT interval were measured by 12-lead electrocardiogram at the baseline.Results:(1) Comparison between the two groups: Compared with the control group, the VVS-CI group had a significantly lower heart rate ( P<0.05) and significantly longer QT interval, such as the maximum QT interval (QTmax), minimum QT interval (QTmin), QTd, corrected maximum QT interval (QTcmax) and corrected QT interval dispersion (QTcd) ( P<0.05). After follow-up 84 (45, 127) days, compared with the responsive group, the non-responsive group had a significantly longer QT interval, such as QTmax, QTd, QTcmax, corrected minimum QT interval (QTcmin)and QTcd ( P<0.05). (2) Diagnostic efficiency: QTmax, QTmin, QTd, QTcmax and QTcd had a certain diagnostic value in children and adolescents with VVS-CI ( P<0.001). QTd had the largest area under the curve (AUC) (0.914), and had a sensitivity of 86.30% and a specificity of 84.95% at the optimal cut-off value of 28.50 ms for VVS-CI diagnosis.(3) Prognostic evaluation value: QTmax, QTd, QTcmax, QTcmin, QTcd had an estimated value for the prognosis of VVS-CI in children and adolescents ( P<0.05 or 0.01). QTd had the largest AUC (0.906) and the best cut-off value was 34.50 ms, the sensitivity to predict response to VVS-CI intervention was 90.00%, and the specificity was 82.35%. Conclusion:QTd of electrocardiogram has a good estimation value in the diagnosis and prognosis of VVS-CI in children and adolescents.

Objective To summarize the experience of intraoperative neuromonitoring (IONM) system for monitoring and protection of recurrent laryngeal nerve (RLN) during thyroid surgery.Methods A total of 220 cases were enrolled in this study (53 males and 167 females),with the median age of 38.2 years old.There were 85 cases of thyroid cancer,19 cases of thyroid benign tumor,90 cases of thyroid goiter,3 cases of Hashimoto's diseases,and 23 cases of hyperthyroidism.113 cases had tumors larger than 5 cm in diameter.During the procedure,2 recording needle electrodes were put in cricothyroid muscle and 1 stimulator electrode was explored in tracheoasophageal groove.If any RLN was fight there or nearby,doctors can see the electromyogram and hear the toothonk.With careful dissection,RLN can be found out till exploring into the larynx site.Results Electromyogram showed in 207 cases (278 nerves),and it didn't show in 13 cases,among whom 9 cases were false-negative because of system or annesthesia problems,4 cases didn't manage to have needle electrodes put in properly due to cricothyroid muscle being invaded.No permanent RLN paralysis occoured.Transient nerve paralysis occurred in 2 cases,who recovered in 1 month after operation.Conclusion IONM system is an effective way to avoid damage to RLN in thyroidectomy.

AIM: To study the protective effects of basic fibroblast growth factor (bFGF) on myocardial ischemia in rats and their underlying mechanism. METHODS: A rat myocardial ischemic injury model was established by left coronary artery ligation. The rats were killed at 2 h, 4 h, 8 h after coronary artery occlusion. The samples of blood and myocardium were collected for observing the expression of Bcl-2 and Bax in myocardial cells and the changes of superoxide dismutase (SOD) or myocardial enzymes. RESULTS: The amount of Bcl-2 protein expression of myocardial cells in ischemia + bFGF group was significantly higher than that in ischemia+saline group (P

Objective To evaluate the role of C-X-C chemokine receptor type 4 ( CXCR4) in the dorsal root ganglia ( DRG) in incisional pain in rats. Methods Thirty-two male Sprague-Dawley rats, aged 7-10 weeks, weighing 250-300 g, in which intrathecal catheters were successfully implanted, were divided into 4 groups (n＝8 each) using a random number table method: sham operation group (group S), CXCR4 antagonist AMD3100 plus sham operation group (group A+S), incisional pain group (group I) and CXCR4 antagonist AMD3100 plus incisional pain group (group A+I). Rats were anesthetized with sevoflu-rane. AMD3100 20 μg (in 10 μl of normal saline) was intrathecally injected, and no incision was made 30 min later in group A+S. A 1-cm longitudinal incision was made through skin, fascia and muscle of the plantar aspect of the left hindpaw in group I. AMD3100 20 μg (in 10 μl of normal saline) was intrathecally injected, and 30 min later the model of incisional pain was established in group A+I. The mechanical paw withdrawal threshold ( MWT) and thermal paw withdrawal latency ( TWL) were measured at 24 h before surgery and 2, 4, 8, 16 and 24 h after surgery. The rats were sacrificed after the last measurement of pain threshold and the DRGs of the lumbar segment (L4-6) were removed for detecting the expression of CXCR4, phosphorylated extracellular regulated protein kinase ( p-ERK) and total ERK ( t-ERK) by Western blot. Results Compared with group S, MWT was significantly decreased and TWL was shortened at T1-5in group I and group A+I, and the expression of CXCR4 and p-ERK in DRGs was significantly up-regulated (P＜0. 05), and no significant change was found in the expression of t-ERK in group I, no significant change was found in the expression of CXCR4, p-ERK and t-ERK in group A+I, and no significant change was found in the parameters mentioned above in group A+S (P＞0. 05). Compared with group I, MWT was significantly increased and TWL was prolonged at T1-5, the expression of CXCR4 and p-ERK in DRGs was down-regulated (P＜0. 05), and no significant change was found in the expression of t-ERK in group A+I (P＞0. 05). Conclusion CXCR4 in DRGs is involved in incisional pain, and the mechanism may be re-lated to activating ERK1∕2 signaling pathway in rats.

BACKGROUND:Serum-specific biomarkers between normal healthy individuals and populations with developmental cervical canal stenosis(Qi deficiency and blood stasis syndrome)have not been fully defined. OBJECTIVE:To screen and identify the potential biomarkers of developmental cervical canal stenosis with Qi deficiency and blood stasis. METHODS:Serum samples were collected from nine patients with developmental cervical canal stenosis with Qi deficiency and blood stasis and eight healthy people.Differentially expressed proteins in serum were screened and identified using isotope relative labeling and absolute quantification combined with liquid chromatography tandem mass spectrometry.Western blot was used to verify some significant differentially expressed proteins. RESULTS AND CONCLUSION:A total of 61 differentially expressed proteins(P<0.05)were identified using tandem mass spectrometry techniques.Compared with the healthy normal population group,14 differentially expressed proteins such as complement component C1q receptor,apolipoprotein A4,and C-C motif chemokine ligand 18 were significantly upregulated,while 47 differentially expressed proteins such as myosin light chain 3,mitochondrial translation elongation factor,and nucleolar phosphoprotein 1 were significantly downregulated.The results of gene ontology enrichment analysis indicated that these differentially expressed proteins might participate in molecular functions such as regulation of chromosomal tissue,mitochondrial membrane tissue,and muscle system processes.Protein-protein interaction network analysis showed that 38 common differential proteins,including complement component C1q receptor,apolipoprotein A4,C-C motif chemokine ligand 18,myosin light chain 3,mitochondrial translation elongation factor,and nucleolar phosphoprotein 1,were located at functional network nodes between healthy normal individuals and those with developmental cervical canal stenosis(Qi deficiency and blood stasis syndrome),and were closely related to the local energy metabolism of the cervical spine,the production of cervical vertebral osteocytes,and the formation of osteoclasts.The main differentially expressed protein myosin light chain 3 was validated using western blot assay,and the validation results were consistent with the proteomic results.To conclude,the preliminary discovery of differentially expressed proteins in serum between healthy normal individuals and those with developmental cervical canal stenosis(Qi deficiency and blood stasis syndrome)through absolute quantitative technology combined with liquid chromatography tandem mass spectrometry technology suggests that myosin light chain 3 may be a specific serum marker for developmental cervical canal stenosis(Qi deficiency and blood stasis syndrome).

Objective:To observe the characteristics of macular telangiectasia (MacTel) in multi-color and multi-mode fundus images.Methods:An abservational case series study was conducted.Sixteen eyes of 12 patients diagnosed with MacTel by fluorescein fundus angiography (FFA) from January to November 2019 in Shandong Eye Hospital were analyzed.There were 8 cases (8 eyes) with MacTel type Ⅰ, among which 4 cases were male and 4 cases were female, with an average age of (62.3±12.5) years.The other 4 cases (8 eyes) had MacTel type Ⅱ, all of which were female, with an average age of (58.7±10.5) years.Best corrected visual acuity, slit lamp microscopy, color fundus photography, multicolor scanning laser imaging, FFA, optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) were carried out in all the patients.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Shandong Eye Institute (No.2019S003).Results:In color fundus images of MacTel type Ⅰ eyes, annular macular exudation with macular edema occurred in 6 eyes, macular edema without hard exudates in 1 eye, and hard macular exudates without macular edema in 1 eye.However, the transparency of retina in temporal fovea in MacTel type Ⅱ eyes decreased, showing a gray color.In multi-color fundus images of MacTel type Ⅰ eyes, punctate granular yellow macular exudation and yellow-green macular edema were observed, which were clearer than those in color fundus images.Punctate exudation was seen in both the blue and green reflectance images, which was clearest in green reflectance image, followed by blue reflectance image and then the infrared reflectance image.In OCT images of MacTel type Ⅰ eyes, cystoid edema of inner retina or uneven reflection signal of outer plexiform retina were observed.Loss of inner and outer retinal structures and cavities were observable in MacTel type Ⅱ eyes, and outer retinal atrophy appeared in 2 eyes.In OCTA images, the destruction of superficial and deep capillary plexus in macular area were observed in both MacTel typeⅠand type Ⅱ eyes, and the destruction of deep capillary plexus was more obvious.In addition, more obviously increased vascular space, decreased vessel density, and increased foveal avascular zone were found in MacTel type Ⅱ eyes.In early stage of FFA, delayed capillary filling near fovea was seen in MacTel typeⅠeyes, and dilated temporal vessels in fovea, some of which showed tumor-like dilation, and the limited tumor-like dilation was enhanced in the later stage.Different degrees of dilated parafoveal blood vessels in the early stage, and the capillary in the temporal side of the macula showing diffuse strong fluorescence in the late stage of FFA was observed in MacTel type Ⅱ eyes.Conclusions:Multi-color scanning laser imaging can be used to observe the morphological characteristics of MacTel, and the imaging features of different types of MacTel are significantly different.

Objective: To screen the risk factors of patients with frequent acute exacerbation of chronic obstructive pulmonary disease (COPD) by detecting the clinical indicators of periodontitis and the level of bacterial and inflammatory markers in saliva. Methods: Thirty-eight COPD patients in their stable period were recruited and detected from Beijing Chao-Yang Hospital,Capital Medical University during December 2016 to May 2017. The periodontal index were recorded. The levels of inflammatory factors in saliva samples were examined by using enzyme linked immunosorbent assay (ELISA). The bacteria composition in the saliva samples were identified by using 16SrRNA gene pyrosequencing. All patients were followed up and monitored for acute exacerbation of COPD for 12 months. The patients were divided into frequent acute exacerbation group (≥2 times/year, n=10) and non frequent acute exacerbation group (<2 times/year, n=28). Results: In univariate analysis, the patients′ average age of frequent acute exacerbation group (69.0±7.3) was significantly older than that of non-frequent acute exacerbation group (61.8±8.3) (P=0.02). The numbers of remaining teeth ≤26 [100% (10/10)] was significantly higher and plaque index ≤2.5 (2/10) in frequent acute exacerbation group was significantly lower compared with the remaining teeth ≤26 [43% (12/28)] and the plaque index ≤2.5 [71% (21/28)] in non-frequent acute exacerbation group (P=0.02, P=0.01). The proportions of salivary inflammatory factors interleukin-6 (IL-6) level ≤60 ng/L (10%),C-reactive protein (CRP) level ≤1 550 μg/L (30%), matrix metalloproteinase-8 (MMP-8) level ≤140 μg/L (30%) and fibrinogen level ≤90 mg/L (30%) in frequent acute exacerbation group were significantly lower compared with salivary inflammatory factors IL-6 level ≤60 ng/L (71%),CRP level ≤1 550 μg/L (71%), MMP-8 level ≤140 μg/L (86%) and fibrinogen level ≤90 mg/L (71%) in non-frequent acute exacerbation group (P<0.05). The differences of relative abundances of salivary bacteria,such as species of Chloroflexi, Anaerolineae, Anaeroales, Corynebacteriales, Anaerolineaceae, Tissierellaceae, Leptotrichiaceae, Corynebacteriaceae, Leptotrichia, Moryella, Lachnoanaerobaculum and Corynebacterium between frequent acute exacerbation group and non-frequent acute exacerbation group were significantly different (P<0.05). In multivariate logistics regression analysis,the level of IL-6 >60 ng/L and the relative abundance of Corynebacteriales >0.2 had significant difference (P<0.05). Conclusions The level of IL-6 and the relative abundance of Corynebacteriales might be the markers of frequent acute exacerbation in COPD patients.

Objective    To assess the feasibility and safety of ultra-micro 5 mm single-port endoscopic thoracic sympathicotomy in selected patients with primary palmar hyperhidrosis. Methods    From March 1, 2018 to February 1, 2021, 90 patients with primary palmar hyperhidrosis who underwent ultra-micro 5 mm single-port endoscopic thoracic sympathicotomy at the Thoracic Surgery Department of the University of Hong Kong-Shenzhen Hospital. There were 47 males and 43 females, with a median age of 26.0 (22.0, 31.0) years. During the operation, T3 and/or T4 thoracic sympathetic nerve chain was transected using an ultra-micro 5 mm single-port incision near the areola or under the axilla. The surgical data of the patients were retrospectively reviewed and analyzed. Results     All patients successfully completed the operation without major bleeding during the operation and no conversion to thoracotomy. There was no death or serious complication during the perioperative period. The operation time was 43.0 (23.0, 60.0) min, and the intraoperative blood loss was 2.0 (1.0, 2.0) mL. In the perioperative period, only one patient needed a tiny chest tube indwelling. The symptoms of hyperhidrosis on the hands all disappeared after the operation. The pain score on the postoperative day was 2.0 (2.0, 2.0) points. The hospital stay after surgery was 1.0 (1.0, 1.0) d. In the first month after the operation, the symptoms of hyperhidrosis on the hands were significantly relieved compared with those before the operation. The surgical incisions healed well, the wounds were concealed, and there was no wound infection or poor healing. The patients' satisfaction with the surgical incisions was 100.0%. After the operation, 14 (15.6%) patients had mild compensatory hyperhidrosis, 5 (5.6%) patients had moderate compensatory hyperhidrosis, and no patient had severe compensatory hyperhidrosis. Overall satisfaction rate was 94.0%. Conclusion     The clinical application of ultra-micro 5 mm single-port endoscopic thoracic sympathicotomy in selected patients with primary palmar hyperhidrosis is safe and feasible. The surgical wound is extremely small and hidden, the operation time is short, the pain is very slight, and the clinical outcome is good. It can fully meet the patients' pursuit of beauty.