Objective To compare the clinical value of chest CT and Magnetic Resonance Imaging (MRI) in the diagnosis of lymph node metastasis of thoracic esophageal cancer. Methods A retrospective analysis of 90 patients with thoracic esophageal cancer lymph node metastasis diagnosed and treated in our hospital from July 2015 to June 2019. All patients underwent chest CT and MRI scans after admission, and the lesion tissue samples were taken for pathological examination after surgery. Physical examination, with pathological diagnosis results as the gold standard, analyze the sensitivity and specificity of chest CT and MRI. Results The sensitivity, specificity, positive predictive value, and negative predictive value of MRI scan was 88.73%, 94.74%, 98.44%, and 69.23%, respectively, which were higher than 69.01%, 52.63%, 84.48%, and 31.25% of the chest CT scan. In the distribution of lymph node metastasis, the middle of the thorax was the largest, and the proportions of the upper, middle, and lower thoraxes were 26.67%, 60.00%, and 13.33%, respectively. The uppermost mediastinal and paratracheal lymph nodes had the largest metastases in the upper thorax, the paratracheal and subcarinal lymph nodes in the middle thoracic segment had the most metastasis, and the next to the cardia and left gastric artery lymph nodes in the lower thorax had the largest metastases. The accuracy of MRI diagnosis is higher than that of chest CT. Conclusion Both chest CT and MRI can diagnose lymph node metastasis of thoracic esophageal cancer. The diagnostic value of MRI in diagnosing lymph node metastasis of thoracic esophageal cancer is better than chest CT. The diagnostic accuracy of MRI in each part of the lymph node is higher than that of chest CT, which can show the lymph nodes more clearly in transfer situation.

This study investigated the characteristics and frequency of perioperative anaphylactic shock induced by cefuroxime, so as to provide a reference for the safe and rational use of cefuroxime in the perioperative period. Cases of perioperative anaphylactic shock caused by cefuroxime in our hospital from 2011 to 2021 were extracted from the Adverse Drug Reaction Monitoring System. Literature reporting adverse drug reactions (ADR) including cefuroxime-induced anaphylactic shock in perioperative settings was collected from the CNKI, VIP, Wanfang, PubMed, and Web of Science databases from their respective inception to May 2022. Statistical analysis was performed for all cases of cefuroxime-induced perioperative anaphylactic shock. A total of 31 patients were included [13 men (48.1%) and 14 women (51.9%)], most of whom were over 60 years old ( n=16, 59.3%); 9 (29.0%) patients had a history of drug allergy; 5 (16.1%) patients had received skin tests, but with negative results; 28 (90.3%) patients received treatment intravenously; 22 (71.0%) patients were treated after anesthesia. For 20 (64.5%) patients the ADR occurred within 10 minutes after anesthesia. The main manifestations were hypotension, dyspnea, rash, and tachycardia. For all patients, symptoms resolved after withdrawal of the drug and active rescue, and there were no deaths. A history of allergy and skin test findings may have limitations in predicting perioperative anaphylactic shock caused by cefuroxime; greater vigilance should be exercised when using cefuroxime in the perioperative period. Close monitoring is recommended for patients undergoing treatment with cefuroxime. Rescue therapy should be administered for allergic shock, and suitable response measures must be taken in a timely manner to ensure the safety of patients.

Objective　To detect the location of pathogens in myocardium using in situ RT-PCR technique in order to study the pathogenetic course of the myocardial lesion induced by CoxB3m virus infection in mice. Methods　(1) Thirty and fifty Balb/c mice were used respectively to establish the acute and chronic CoxB3m infected models, with another 25 healthy mice as the controls; (2) KS400 image analysis system (Germany) was used to measure the cardiac chamber area and the left ventricular wall thickness of the chronic infected mice and the controls; (3) CoxB3m virus in myocardial tissue was detected using in situ RT-PCR by direct incorporated technique which employed nucleotide labeling by anti-digoxin antibody and bonded with alkaline phosphatase (anti-dig-AKP method). Results　Picture analysis indicated that the left ventricular chamber area was enlarged and the left ventricular wall was thinner in the chronic repeated virus infected models than those of the controls. With in situ RT-PCR, positive signals for Coxsackie virus B3m RNA were detected not only in the myocardium of the acute Balb/c mice models but also in the myocardium of the chronic mice models. Conclusion　Coxsackie virus B3m is able to induce pathologic lesions by exhibiting positive CVB-RNA signals in both acute and chronic models in mice. In the chronic experimental models, the cardiac chamber is enlarged while the ventricular wall is thinned which demonstrates the association with persistent infection of Coxsackie virus B3m virus.

were no significant differences in the detection rate of recto-sigmoid colon,mid colon,right colon and total detection of polyps among the 3 groups (P >0.05).Conclusion 4-L split-dose PEG is better than the oth-er 2 regimens in the colon cleansing quality,so it can better reach the intestinal cleaning standards before enteroscopy,which is a more suitable regimen for bowel preparation.

Objective:To investigate the pathogen distribution and antimicrobial resistance among lower respiratory tract infections in patients with hematological malignancies.Methods:Sputum samples were collected from 967 patients with hematological malignancies and lower respiratory tract infections in Department of Hematology,the Second Hospital of Shanxi Medical University from January 2017 to July 2020. The pathogens and drug sensitivity reports were carried out by automatic bacterial identification instruments. WHONET 5.6 and SPSS 20.0 softwares were used for statistical analysis.Results:A total of 961 strains of pathogens were isolated, 516 (53.7%) pathogens were Gram-negative bacteria, mainly 118 strains of Klebsiella pneumonia (12.3%), 68 strains of Pseudomonas aeruginosa (7.1%), 67 strains of Acinetobacter baumannii (7.0%),52 strains of Stenotrophomonas maltophilia (5.4%), 43 strains of Escherichia coli (4.5%), and 42 strains of Enterbacter cloacae (4.4%). There were 171 (17.8%) strains of Gram-positive bacteria and 274 (28.5%) fungi. The drug resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to carbapenem were 22.1%-31.3%. Stenotrophomonas maltophilia was sensitive to levofloxacin, compound sulfamethoxazole and minocycline. The antimicrobial resistance rates of these three enterobacteria to carbapenems, cefoperazone/sulbactam, piperacillin/tazobactam were low (<10%). The resistant Gram-positive bacteria to ticoplanin, vancomycin and linazolamide were not detected.Conclusion:The major pathogens related to lower respiratory tract infections in patients with hematological malignancies are gram-negative bacteria in our centre. Different pathogens appear different characteristics of antimicrobial resistance.

Objective: To compare and analyze the epidemiological characteristics of hospitalized elderly, young and middle-aged patients with severe burn in recent years, so as to provide reference for the prevention and treatment of elderly patients with severe burn. Methods: Relying on the entry system of epidemiological case data and biological sample of severe burn from multicenter in clinic, medical records of patients with severe burn, aged above 18, hospitalized in 8 burn wards from January 2012 to December 2015 were collected. Six hundred and fifteen patients who were more than 18 years old and less than or equal to 65 years old were included in young and middle-aged group (YM). Eighty-two patients aged more than 65 years old were included in elderly group (E). Data of age, gender, residence, education level, cause of injury, location of injury, season of injury, total burn area, occurrence and area of full-thickness burn injury, wound site, inhalation injury incidence and severity, post burn admission time, proportion of delayed resuscitation, proportion of escharectomy or tangential excision and skin grafting, preinjury systemic disease, system complication during hospitalization, length of hospital stay, outcome of treatment, and reason of abandoning treatment of patients were analyzed. Data were processed with chi-square test and Mann-Whitney U test. The odds ratios of preinjury systemic disease, system complication during hospitalization, and adverse outcome of patients in group YM were compared with those in group E. Results: (1) The majority of patients in the two groups were male, but the proportion of male patients in group YM was higher. There was statistically significant difference in gender distribution of patients between the two groups (χ²=18.727, P<0.001). The majority of patients in the two groups were from rural areas, but the proportion of rural patients in group E was higher. There was statistically significant difference in residence distribution of patients between the two groups (χ²=9.306, P=0.002). Patients in group YM mainly had secondary education, while patients in group E mainly had primary education. There was statistically significant difference in distribution of education level of patients between the two groups (χ²=146.797, P<0.001). (2) The most common causes of injury of patients in the two groups were both flame, but the proportion of patients with flame burn injury in group E was higher. There was statistically significant difference in distribution of cause of injury of patients between the two groups (χ²=25.063, P<0.001). The main locations of injury of patients in groups YM and E were respectively public place and private residence. There was statistically significant difference in location distribution of injury of patients between the two groups (χ²=46.313, P<0.001). The main seasons of injury of patients in groups YM and E were respectively summer and winter. There was statistically significant difference in season distribution of patients between the two groups (χ²=23.143, P<0.001). There was statistically significant difference in distribution of total burn area of patients between the two groups (χ²=25.799, P=0.002). The occurrences of full-thickness burn injury of patients in the two groups were similar (χ²=2.685, P=0.101), while there was statistically significant difference in area of full-thickness burn injury of patients between the two groups (χ²=26.702, P=0.002). There was no statistically significant difference in distribution of wound site of patients between the two groups (χ²=3.954, P=0.785). There were no statistically significant differences in incidence and severity distribution of inhalation injury of patients between the two groups (with χ² values respectively 0.425 and 0.672, P values above 0.05). (3) There was statistically significant difference in distribution of admission time of patients between the two groups (χ²=6.632, P=0.036), but there was no statistically significant difference in proportion of delayed resuscitation of patients between the two groups (χ²=1.261, P=0.261). The proportion of escharectomy or tangential excision and skin grafting of patients in group YM was 72.0% (443/615), which was significantly higher than 35.4% (29/82) of group E (χ²=44.498, P<0.001). The incidence of preinjury systemic disease of patients in group YM was 13.2% (81/615), which was significantly lower than 61.0% (50/82) of group E (χ²=108.337, P<0.001). The risk of preinjury systemic disease of patients in group E was 10.30 times of that of patients in group YM [with 95% confidence interval (CI) of 6.24-17.01, P<0.001]. During hospitalization, 59.8% (49/82) of patients in group E suffered from system complications, which was significantly higher than 36.6% (225/615) of group YM (χ²=16.282, P<0.001). The risk of system complication of patients in group E was 2.57 times of patients in group YM (with 95% CI of 1.61-4.12, P<0.001). The length of hospital stay of patients in group E was significantly shorter than that of group YM (U=36 735, P<0.001). There was statistically significant difference in treatment outcome of patients between the two groups (χ²=106.251, P<0.001). The risk of adverse outcome of patients in group E was 7.52 times of group YM (with 95% CI of 4.40-12.88, χ²=67.709, P<0.001). The proportion of abandoning treatment of patients in group E was significantly higher than that of group YM (χ²=150.670, P<0.001). The risk of abandoning treatment of patients in group E was 15.86 times of that of group YM (with 95% CI of 9.36-26.88, P<0.001). There was no statistically significant difference in distribution of reason of abandoning treatment of patients between the two groups (χ²=4.178, P=0.243). Conclusions There were significant differences in the epidemiological characteristics of patients in groups E and YM. In elderly burn patients, the proportion of rural population was higher and the education level was lower. Flame burn was common and burns mostly occurred in private residences and in winter. The total burn area was slightly lower but the area of full-thickness burn injury was larger. The length of hospital stay was shorter and the proportion of surgical treatment was lower. The incidences of preinjury systemic disease and system complication during hospitalization were higher, and therefore the risks of adverse outcome and abandoning treatment were higher.

ObjectiveTo explore the molecular mechanism of modified Shengjiangsan in alleviating endoplasmic reticulum （ER） stress and reducing urinary protein in the rat model of diabetic nephropathy （DN）. MethodSeventy-five SD rats were randomized into normal， model， low-， medium-， and high-dose （4.37， 8.73， 17.46 g·kg^-1， respectively） modified Shengjiangsan， and irbesartan （0.014 g·kg^-1） groups， with 10 rats in each group. Rats were administrated with corresponding doses of medications or distilled water by gavage， once a day， for 8 consecutive weeks. After the last administration， the levels of glucose （GLU） in the blood， 24-hour urinary protein （24 h-UTP）， and superoxide dismutase （SOD）， malondialdehyde （MDA）， and glutathione peroxidase （GSH-Px） in the renal tissue were measured. Hematoxylin-eosin staining， periodic acid-Schiff staining， and transmission electron microscopy were employed to observe the pathological changes in rat kidneys. Immunohistochemistry was employed to measure the expression levels of nephrin， podocin， glucose-regulated protein 78 （GRP78）， C/EBP homologous protein （CHOP）， and activating transcription factor 4 （ATF4） in the kidneys of rats. Western blot was employed to measure the protein levels of silent information regulator 1 （Sirt1）， phosphorylated （p）-protein kinase RNA-like endoplasmic reticulum kinase （PERK）， and p-eukaryotic translation initiation factor 2 alpha （eIF2α） in rat kidneys. ResultCompared with the normal group， the modeling caused pathological damage to the kidneys， elevated the levels of GLU and 24 h-UTP （P<0.05）， up-regulated the protein levels of GRP78， CHOP， ATF4， p-PERK， and p-eIF2α （P<0.05）， and down-regulated the protein level of Sirt1 （P<0.05） in rat kidneys. Compared with the model group， modified Shengjiangsan and irbesartan lowered the GLU and 24 h-UTP levels （P<0.05）， alleviated the pathological damage in the renal tissue， down-regulated the protein levels of GRP78， CHOP， ATF4， p-PERK， and p-eIF2α （P<0.05）， and up-regulated the protein level of Sirt1 （P<0.05）. ConclusionModified Shengjiangsan up-regulates Sirt1 expression and inhibits phosphorylation of proteins in the PERK/eIF2α pathway to reduce ER stress and oxidative stress in the renal tissue， thus alleviating the pathological damage in the renal tissue and reducing urinary protein in DN rats.

ObjectiveTo observe the effect of Dahuang Xiezhuo prescription on the changes in renal pathology and reactive oxygen species （ROS）/thioredoxin-interacting protein （TXNIP）/NOD-like receptor protein 3 （NLRP3） pathway expression in the kidney tissues of rats with 5/6 nephrectomy， and to explore the mechanism of Dahuang Xiezhuo prescription in protecting renal function and delaying renal interstitial fibrosis and the possibility. MethodNinety healthy male SD rats were randomly divided into a sham operation group， a model group， low， medium， and high-dose （6.825， 13.65， 27.30 g·kg^-1） Dahuang Xiezhuo prescription groups， and a Niaoduqing granule group （2.60 g·kg^-1）. Except the sham operation group， 5/6 nephrectomy was used to replicate the rat model of chronic renal failure （CRF）. After modeling， each administration group was given the corresponding dose of drug suspension by intragastric administration， once a day for consecutive 8 weeks. After administration， serum creatinine （SCr） and urea nitrogen （BUN） levels and 24 h urinary protein quantification （UTP） levels were detected. Western blot assay was used to detect the protein expressions of thioredoxin （TRX）， TXNIP， and NLRP3. The protein expressions of TRX， TXNIP， NLRP3， apoptosis-associated speck-like protein containing a CARD （ASC）， transformation growth factor-β （TGF-β）， Collagen Ⅳ， α-smooth muscle actin （α-SMA）， and fibronectin （FN） were detected by immunohistochemistry. ResultAs compared with the sham operation group， serum levels of SCr， BUN， and UTP in the model group were increased （P<0.05）， TRX， TXNIP， NLRP3， ASC， TGF-β， Collagen Ⅳ， α-SMA， and FN proteins were increased （P<0.01）， and renal interstitial fibrosis significantly occurred. As compared with the model group， the levels of SCr， 24 h BUN， and UTP in the low， medium， and high-dose Dahuang Xiezhuo prescription groups and the Niaoduqing granule group were decreased to varying degrees （P<0.05）， TRX， TXNIP， NLRP3， ASC， TGF-β， Collagen Ⅳ， α-SMA， and FN were decreased （P<0.01）， and renal interstitial fibrosis was improved to varying degrees. ConclusionDahuang Xiezhuo prescription can protect renal function and delay renal interstitial fibrosis in rats with CRF.

As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.

As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.