Objective: To analyze the influencing factors for hospitalization costs among stroke patients with different subtypes, so as to provide the reference for reducing the economic burden of patients. Methods: Data of patients with hemorrhagic or ischemic stroke who were discharged from hospitals in Nanshan District, Shenzhen City from January 1, 2016 to December 31, 2021 were collected through Hospital Information System. Hospitalization costs were analyzed between hemorrhagic and ischemic stroke patients, and factors affecting hospitalization costs among stroke patients with different subtypes were identified using a structural equation model. Results: A total of 10 298 patients with stroke were recruited, including 2 820 patients with hemorrhagic stroke (27.38%) and 7 478 patients with ischemic stroke (72.62%). The patients with hemorrhagic stroke had a median duration of hospital stay of 19.00 (interquartile range, 18.00) d, and a median hospitalization cost of 26 759.48 (interquartile range, 51 000.87) Yuan. The patients with ischemic stroke had a median duration of hospital stay of 12.00 (interquartile range, 10.00) d, and a median hospitalization cost of 12 199.87 (interquartile range, 13 290.20) Yuan. Structural equation model analysis showed that department of hospitalization, discharge status, ways of leaving hospital, surgery and hypertension had direct effects on hospitalization costs and indirect effects on hospitalization costs through duration of hospital stay among hemorrhagic stroke patients, and duration of hospital stay had the highest total effect (0.684), followed by surgery (0.632). Employment status, admission route, department of hospitalization, ways of leaving hospital, payment mode, surgery and dyslipidemia had direct effects on hospitalization costs and indirect effects on hospitalization costs through duration of hospital stay among ischemic stroke patients, and duration of hospital stay (0.746), surgery (0.424) and department of hospitalization (0.151) ranked the top three in total effects. Conclusion The hospitalization cost is relatively high among stroke patients in Nanshan District, and duration of hospital stay and surgery have great influence on hospitalization costs among stroke patients with different subtypes.

Objective To investigate the benefits of using a stapler tractor in the treatment of segmental bronchus during lung segmentectomy through detailed video replay analysis of surgical procedures. Methods We collected data from patients who underwent segmentectomy performed by the same surgical team in the Department of Thoracic Surgery, the First Affiliated Hospital of Nanjing Medical University, from November 2020 to August 2023. After excluding data that lacked analysis parameters, the remaining patients were divided into four groups based on the methods used for dissociating segmental bronchus: a stapler tractor group (group A), a stapler with bronchial stretching group (group B), a stapler only group (group C), and a silk ligature group (group D). Then, we compared baseline data and videotaped surgical details across all groups. Surgical details included the success rate of one-time segmental bronchus dissociation and severance, the time taken for successful one-time dissociation and severance of the segmental bronchus, the incidence of bleeding during bronchus dissociation, the conversion rate to thoracotomy during surgery, and surgical outcomes such as total operative time, postoperative hospitalization days, postoperative thoracic drainage volume, and pulmonary air leakage rate. Results The study included 325 patients (203 in the group A, 62 in the group B, 29 in the group C, and 31 in the group D). There was no statistically significant difference in baseline data among the four groups. However, significant differences were found in terms of total operation time, postoperative hospitalization days, intraoperative blood loss, segmental bronchial stump length, postoperative air leakage rate, hemorrhage rate during segmental bronchial dissociation, and conversion to thoracotomy rate among the four groups (P<0.05). Conclusion Using a stapler tractor for dissociating segmental bronchus in lung segmentectomy results in shorter operative time, less risk of intraoperative bleeding, and less surgical complications. This study provides valuable evaluation methodologies through the analysis of video replay surgical details, contributing to the improvement of lung segmentectomy quality.

Objective: To investigate the trend in incidence of stroke in Nanshan District, Shenzhen City from 2010 to 2021, so as to provide the evidence for formulating the integrated strategy for stroke control. Methods: The data of stroke morbidity in Nanshan District from 2010 to 2021 were collected through Shenzhen Chronic Disease Prevention and Control Management System. The incidence of stroke was calculated, and standardized by the population of the Chinese Sixth National Census in 2010. The trends in stroke incidence were evaluated in Nanshan District from 2010 to 2021 using annual percent change (APC) and average annual percent change (AAPC), and gender-, age- and subtype-specific incidence of stroke was descriptively analyzed. Results: A total of 30 377 cases with stroke were reported in Nanshan District from 2010 to 2021, with a crude incidence rate of 190.45/105 and a standardized incidence rate of 405.65/105. The crude incidence rate of stroke appeared a tendency towards a rise in Nanshan District from 2010 to 2021 (APC=5.38%, t=4.678, P=0.001), and a higher crude incidence rate of stroke was seen among men than among women (227.57/105 vs. 148.40/105; χ2=1 309.580, P<0.001). The incidence of stroke appeared a tendency towards a rise with age (χ2trend =435.717, P<0.001), and there was a tendency towards a rise in stroke incidence among residents under 40 years of age (APC=2.89%, t=2.538, P=0.029). The crude incidence of ischemic stroke was 151.24/105, which was higher than that of hemorrhagic stroke (39.21/105) (χ2=10 521.000, P<0.001). Conclusions The incidence of stroke appeared a tendency towards a rise in Nanshan District from 2010 to 2021, with ischemic stroke as the predominant subtype of stroke. Males and middle-aged and elderly residents should be given a high priority for stroke prevention and treatment.

Objective: To investigate the prevalence of current smoking and smoking cessation, and identify the influencing factors among hypertensive patients in Nanshan District, Shenzhen City, so as to provide insights into smoking control among hypertensive patients. Methods: The demographic features, life style, status of smoking and smoking cessation in hypertensive patients were collected from 69 community health centers in Nanshan District from 2017 to 2019. The gender- and age-specific prevalence of smoking and smoking cessation was estimated among hypertensive patients, and the factors affecting hypertensive patients&#39; smoking and smoking cessation were identified using a multivariable logistic regression model. Results: Totally 4 385 patients with hypertension were enrolled, with a mean age of (58.41±11.19) years, and the participants included 2 265 men (51.65%) and 2 120 women (48.35%). There were 724 current smokers, and the prevalence of current smoking was 16.51%, with 29.71% prevalence in males and 2.41% in females. There were 424 hypertensive patients quitting smoking, and the prevalence of smoking cessation was 36.93%, with 38.20% prevalence in males. Multivariable logistic regression analysis identified male ( OR=12.885, 95%CI: 9.567-17.354 ) and drinking ( OR=2.567, 95%CI: 2.118-3.111 ) as facilitating factors for current smoking among hypertensive patients, and increasing age (OR=0.723, 95%CI: 0.642-0.815) and high exercise frequency (OR=0.881, 95%CI: 0.817-0.950) as barrier factors, while male ( OR=7.309, 95%CI: 3.304-16.165), increasing age ( OR=1.381, 95%CI: 1.120-1.703 ), unmarried ( OR=1.819, 95%CI: 1.329-2.490 ), divorced ( OR=7.837, 95%CI: 1.254-48.975 ), retired ( OR=1.545, 95%CI: 1.095-2.180 ), unemployed (OR=1.801, 95%CI: 1.057-3.066), and high exercise frequency ( OR=1.221, 95%CI: 1.096-1.360 ) were identified as facilitating factors for smoking cessation among hypertensive patients and widowed ( OR=0.285, 95%CI: 0.089-0.906 ), high educational level ( OR=0.766, 95%CI: 0.619-0.949 ), and drinking ( OR=0.488, 95%CI: 0.368-0.647 ) as barrier factors. Conclusions The prevalence of smoking is lower, and the prevalence of smoking cessation is higher among hypertensive patients than among general populations in Nanshan District. Young and middle-aged, employed, widowed men with a high educational level are key populations for tobacco control, and alcohol consumption control and intensified exercises are important measures to reduce the prevalence of smoking and improve the prevalence of smoking cessation.

Objective To understand the application effect of community chronic disease health management in elderly patients with diabetes, and to provide health management basis for the prevention and treatment of elderly patients with diabetes in community. Methods A total of 200 community type 2 diabetes patients were selected from July 2019 to December 2019, and were divided into two groups with 100 patients in each group by randomized control method. The control group was managed by conventional way, and the observation group was managed by community chronic disease health management. The two groups agreed to follow up patients monthly. Life behavior factors and clinical metabolic indicators of patients were obtained and recorded, and the effects of the two groups were evaluated after a 6-month cycle. Results After intervention, the levels of serum FPG, 2hPG and HbA1c in the two groups were significantly lower than those before treatment (P<0.05). The serum levels of FPG, 2hPG and HbA1c in observation group were significantly lower than those in control group (P<0.05). After intervention, diet control, movement dependence, foot care, test compliance score and SDSCA total score in both groups were significantly increased compared with those before treatment (P<0.05). The observation group was significantly higher than the control group (P<0.05). After intervention, the scores of physiological, psychological, environmental and social relationship in the two groups were significantly lower than those before treatment (P<0.05). The observation group was significantly lower than the control group (P<0.05) . Conclusion Community chronic disease health management has a good effect on elderly diabetes patients in community, which is worth long-term implementation and promotion in social health centers.

Objective     To evaluate the association between anesthesia regimen (volatile or intravenous anesthetics) and postoperative infection in adult cardiac patients undergoing cardiac surgery. Methods    The clinical data of 496 elective adults undergoing cardiac surgery under cardiopulmonary bypass from June 2019 to June 2020 in West China Hospital of Sichuan University were retrospectively analyzed, including 251 females and 245 males with an average age of 54.1±11.4 years. American Society of Anesthesiologists grade was Ⅰ-Ⅲ. There were 243 patients in a volatile group with sevoflurane or desflurane, and 253 patients in an intravenous anesthesia group with propofol. The primary outcome was the incidence of infection within 30 days after cardiac surgery, including pulmonary infection, surgical site infection, sepsis, and urinary tract infection. The secondary outcomes were duration of mechanical ventilation, incidence of reintubation, ICU stay, postoperative length of hospital stay and total hospitalization cost. Results     A total of 155 (31.3%) patients developed postoperative infection within 30 days, with an incidence of 32.9% in the volatile group and 29.6% in the intravenous anesthesia group. There was no statistical difference in the incidence of infection (RR=1.111, 95%CI 0.855 to 1.442, P=0.431) or the secondary outcomes (P>0.05) between the two groups. Conclusion     The anesthesia regimen (volatile or intravenous anesthetics) has no association with the risk of occurrence of postoperative infection in adult  patients undergoing elective cardiac surgery with cardiopulmonary bypass.

Objective    To compare the clinical effects of segmentectomy and lobectomy for ≤2 cm lung adenocarcinoma with micropapillary and solid subtype negative by intraoperative frozen sections. Methods    The patients with adenocarcinoma who received segmentectomy or lobectomy in multicenter from June 2020 to March 2021 were included. They were divided into two groups according to a random number table, including a segmentectomy group (n=119, 44 males and 75 females with an average age of 56.6±8.9 years) and a lobectomy group (n=115, 43 males and 72 females with an average of 56.2±9.5 years). The clinical data of the patients were analyzed. Results    There was no significant difference in the baseline data between the two groups (P>0.05). No perioperative death was found. There was no statistical difference in the operation time (111.2±30.0 min vs. 107.3±34.3 min), blood loss (54.2±83.5 mL vs. 40.0±16.4 mL), drainage duration (2.8±0.6 d vs. 2.6±0.6 d), hospital stay time (3.9±2.3 d vs. 3.7±1.1 d) or pathology staging (P>0.05) between the two groups. The postoperative pulmonary function analysis revealed that the mean decreased values of forced vital capacity and forced expiratory volume in one second percent predicted in the segmentectomy group were significantly better than those in the lobectomy group (0.2±0.3 L vs. 0.4±0.3 L, P=0.005; 0.3%±8.1% vs. 2.9%±7.4%, P=0.041). Conclusion    Segmentectomy is effective in protecting lungs function, which is expected to improve life quality of patients.

[摘 要] 目的：探讨lncRNA FAM95B1对胶质瘤细胞增殖和迁移能力的影响并探究其相关作用机制。方法： 选取2018年1月至2020年8月于合肥市第三人民医院行手术治疗的38例胶质瘤患者的胶质瘤组织及癌旁组织标本，利用qPCR检测胶质瘤组织与4种细胞系中FAM95B1的表达水平，以表达最低的胶质瘤LN382细胞为研究对象，转染空载质粒（对照组）或pcDNA3.1-FAM95B1质粒（实验组）。MTT法和划痕实验检测FAM95B1对LN382细胞增殖和迁移能力的影响。生物信息学分析技术和双荧光素酶基因报告实验预测并验证FAM95B1与miR-26a-5p及PTEN之间的相互作用机制，应用qPCR和WB法检测FAM95B1对miR-26a-5p和PTEN表达的影响。结果： FAM95B1在胶质瘤组织中的表达明显低于癌旁组织（P<0.01）。FAM95B1在多种胶质瘤细胞系中的表达均明显低于正常脑胶质细胞（均P<0.01）。过表达FAM95B1可以下调LN382细胞的增殖（P<0.05）和迁移能力（P<0.01）。FAM95B1能够靶向结合miR-26a-5p（P<0.01），miR-26a-5p能够靶向结合PTEN mRNA（P<0.01）。过表达FAM95B1可下调LN382细胞中miR-26a-5p的表达（P<0.01），促进PTEN mRNA的表达（P<0.01）。结论：在胶质瘤组织和细胞系中异常低表达的FAM95B1通过发挥竞争性内源RNA的功能抑制miR-26a-5p的表达而增强PTEN蛋白表达，抑制胶质瘤细胞系LN382的增殖和迁移。

[Abstract] Objective: To investigate the effect of HMGB1 gene on the growth of human epithelial ovarian cancer xenografts in nude mice, and to lay a foundation for finding new targets for the treatment of ovarian cancer. Methods: Human epithelial ovarian cancer SKOV3 cells in logarithmic growth phase were selected to establish a human epithelial ovarian cancer xenograft model in nude mice. Nude mice with successful model establishment were randomly divided into control group and HMGB1-siRNA group. On the 7th, 9th, 11th, 14th, and 16th days after cell inoculation, the same amount of saline and HMGB1-siRNA were respectively injected into two groups of mice under the armpit.After 3 weeks, the nude mice were sacrificed by cervical dislocation, the tumor tissues were separated, and the volume of the tumor was measured. The apoptosis of transplanted tumor cells was detected by Tunnel staining. The expressions of HMGB1, STAT3 and p-STAT3 were detected by Western blotting. The expression of vascular endothelial growth factorA(VEGF-A) and microvascularization were detected by immunohistochemistry. Results: Compared with the control group, the growth of tumor volume slowed down in HMGB1 siRNA group, and on the 21st day, the tumor volume of HMGB1-siRNA group was significantly smaller than that of the control group (P<0.05). HMGB1-siRNA successfully knocked down the expression of HMGB1 mRNA in transplanted tumor tissue. The apoptosis rate of tissue cells in HMGB1-siRNA group was significantly increased ([34±8]% vs [6±2]%, P=0.04), and the expressions of HMGB1 and p-STAT3 were significantly reduced (P<0.05). The expression of VEGF-Aand the number of microvessels were significantly lower than those of the control group (both P<0.05). Conclusion: Knockdown of HMGB1 gene reduces the expression of VEGF-A and microvessel formation possibly by inhibiting the HMGB1/STAT3 signaling pathway, thereby promoting the apoptosis of tumor tissues and slowing the growth of xenografts.

Objective: To explore the effect of miR-195/TLR4 axis on the proliferation, invasion and migration of liver cancer cells via regulating NF-κB pathway. Methods: Twenty-five pairs of liver cancer tissues and corresponding adjacent tissues surgically resected at the Second Affiliated Hospital of Kunming Medical University from March 2016 to January 2017 were collected for this study. Liver cancer HepG2 cells were cultured and then randomly divided into four groups: control group (NC), miR-195 mimic group (miR-195), TLR4 knockdown group (si-TLR4), and miR-195 inhibitor combined with TRL4 knockdown group (si-TLR4+miR-195 inhibitor). qRTPCR was used to detect the expression of miR-195 in liver cancer tissues and cell lines. CCK-8 assay was used to evaluate the cell viability of each group. Transwell and Wound healing assay were applied to detect the invasion and migration ability of HepG2 cells, respectively. Dual-luciferase reporter gene assay was used to verify the targeted regulation of TLR4 by miR-195. WB was applied to analyze the protein expressions of TLR4 and NF-κB p65. Results: miR-195 was down-regulated in the liver cancer tissues compared with adjacent tissues (P<0.01). Compared with human hepatic epithelial cells (THLE-3), the expression of miR-193 in liver cancer cell lines (HepG2 and Huh-7) was down-regulated (P<0.01), and the expression level in HepG2 cells was the lowest. The proliferation, invasion and migration of HepG2 cells was significantly suppressed after over-expression of miR-195 (all P<0.01). Moreover, over-expression of miR-195 significantly down-regulated TLR4 protein expression (P<0.05), and TLR4 was negatively correlated with miR-195 (R2= 0.602, P<0.0001). Furthermore, miR-195 over-expression inhibited proliferation, invasion and migration of HepG2 cells by targeting TLR4 expression and blocking NF-κB pathway (P<0.05 or P<0.01). Conclusion: miR-195 over-expression can inhibit the proliferation, invasion and migration of HepG2 cells. The mechanism may be related with targeting TLR4 and blocking the NF-κB pathway to affect cell biological behaviors.