Objective To evaluate the efficacy of pressure-controlled volume-guaranteed (PCVVG) mode for lung protective ventilation in patients requiring one-lung ventilation (OLV) during thoracoscopic surgery.Methods Sixty patients,aged 50-70 yr,with body mass index of 18-26 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective radical resection of esophageal cancer performed via video-assisted thoracoscope under general anesthesia,were divided into 2 groups (n=30 each) using a random number table:volume-controlled ventilation group (group V) and PCV-VG group (group P).The ventilator settings were adjusted,with a tidal volume 10 ml/kg and respiratory rate 10-12 breaths/min during two-lung ventilation,and with a tidal volume 6 ml/kg and respiratory rate 12-16 breaths/min during OLV.The inspiratory/expiratory ratio was 1 ∶ 2,pressure restriction was 35 cmH2O,and 33％ oxygen was inhaled at 2 L/min.The end-tidal pressure of carbon dioxide was maintained at 35-40 mmHg.Visual analog scale score was maintained ≤ 3 after operation.After admission to the operation room (T0) and at 1,3 and 7 days after operation (T1-3),forced vital capacity (FVC),forced expiratory volume in first second (FEV1),and maximal mid-expiratory flow (MMEF) were measured,arterial blood samples were collected for blood gas analysis,arterial carbon dioxide partial pressure and arterial oxygen partial pressure (PaO2) were recorded,and alveolar-arterial oxygen tension difference (PA-a O2) was calculated.Clinical Pulmonary Infection Score was assessed at T1,T2 and T3.The chest tube removal time and length of postoperative hospital stay were recorded.Results Compared with the baseline at T0,FVC,FEV1,MMEF and PaO2 were significantly decreased,and PA-aO2 was increased at T1-3 in the two groups (P＜0.05).Compared with group V,FVC,FEV1,MMEF and PaO2 were significantly increased,PA-aO2 and Clinical Pulmonary Infection Score were decreased,and the chest tube removal time and length of postoperative hospital stay were shortened at T1-3 in group P (P＜0.05).Conclusion PCV-VG mode can achieve lung protective ventilation,which is helpful in improving outcomes in the patients requiring OLV during thoracoscopic surgery.

The individual variability should be considered in precision medicine-prevention and treatment strategies.Medical research using genomics, proteomics, metabolomics, systems analyses, and other modern tools has made big progress.In 2002, the members of the Complex-Trait Consortium proposed to develop a new mouse genetics resource called the Collaborative Cross (CC).The CC is a genetic reference panel of recombinant inbred lines of mice, designed for the dissection of complex traits and gene networks.It will provide a powerful measure for functional studies of biological networks, which will be essential to understand the intricacies of disease processes.

Objective To establish a sensitive and specific LC-MS/MS method for measurement of notoginsenoside R1, ginsenoside Rg1, ginsenoside Re, ginsenoside Rb1, ginsenoside Rd, tanshinone Ⅰ, astragaloside Ⅳ and harpagosidein of Fufang Xueshuantong Capsule in rat plasma. Methods The HPLC separation was performed on Thermo Hypersil GOLD column (2.1 mm× 100mm, 5 μm) at 30 ℃, injecting 10 μL and using acetonitrile-water (0.1% formic acid) as the mobile phrase (B was acetonitrile, A was 0.1%formic acid;0-10 min, 25%-55%B;10-20 min, 55%-70%B) with the flow rate of 0.2 mL/min. Detection was performed on a tandem quadrapole mass spectrometer using positive electrospray ionization, SRM scan mode. Results The eight compounds showed good linearity in wide ranges (notoginsenoside R1 1.00-800 ng/mL, ginsenoside Rg1 0.950-760 ng/mL, ginsenoside Re 1.44-1440 ng/mL, ginsenoside Rb1 1.33-1330 ng/mL, ginsenoside Rd 9.90-990 ng/mL, harpagosidein 1.01-1010 ng/mL, astragaloside Ⅳ 1.16-928 ng/mL, tanshinone Ⅰ 10.0-800 ng/mL). In addition, the accuracy and recovery were around 85%-115%and 50%-70%. The RSD of intra and inter day precision were lower than 15%. Conclusion The method is specific, rapid and sensitive. Therefore, it can be applied to pharmacokinetic study of eight effective compounds in Fufang Xueshuantong Capsule.

Objective To explore the role of portal venous pressure changes in the liver dysfunction caused by hepatic congestion after extended liver resection.Methods The experimental study was adopted.According to the random number table,90 Sprague-Dawley rats were divided into 3 groups,30 in each group:30 rats in the non-congestion group received 70％ of liver resection (median lobe + left lobe),30 rats in the congestion group received 70％ of liver resection (median lobe + left lobe) with whole caudal lobe congestion by ligation of veins and 30 rats in the congestion + splenectomy group received 70％ of liver resection (median lobe + left lobe) with whole caudal lobe congestion by ligation of veins and splenectomy.(1) Twenty rats in each group were used to make postoperative survival analysis.Ten rats in each group were used for related experiments.The portal venous pressures (PVPs) of 5 rats in each group were detected at postoperative 12 hours and 24 hours,and then blood and liver specimens were collected.(2) PVP changes were detected at postoperative 12 hours and 24 hours.(3) Clinical and biochemical test:level of total bilirubin (TBil) was tested at postoperative 12 hours and 24 hours.(4) Pathological examination:liver pathological damage was detected by HE staining.(5) The expression of CD68 macrophagocyte was detected by immunohistochemical staining.(6) The relative expressions of Cleaved Casepase-3 and hypoxia inducible factor-1α (HIF-1α) proteins at postoperative 24 hours were detected by Westein blot.(7) The relative expressions of mRNA of vascular regulation related genes (ET-1/eNOS) and inflammatory factors (TNF-α and IL-6) were detected by real-time polymerase chain reaction (RT-PCR).(8)The hyaluronic acid (HA) was measured by enzyme-linked immuno-sorbent assay (ELISA).Measurement data with normal distribution were represented as （x） ± s.Comparison among 3 groups was done using the ANOVA,and pairwise comparison was done by the LSD test.The postoperative 5-day survival curve was drawn by the KaplanMeier method,and the survival was compared using the Log-rank test.Results (1) Survival analysis:5-day survival rate in the non-congestion group,congestion group and congestion + splenectomy group were respectively 75％,10％ and 55％,with a statistically significant difference among the 3 groups (x2=18.21,P ＜0.05).(2)Changes of PVPs and TBil:levels of PVP and TBil in the non-congestion group,congestion group and congestion + splenectomy group were respectively (15.77 ±0.67)cmH2O,(18.33 ±0.28) cmH2O,(14.87 ± 0.58) cmH2O,(1.48 ±0.10)μmol/L,(1.76±0.15) μ mol/L,(1.62 ±0.11) μmol/L at postoperative 12 hours and (13.49 ± 0.45) cmH2 O,(16.96 ± 0.82) cmH2 O,(15.69 ± 0.85) cmH2 O,(1.47 ± 0.11) μmol/L,(1.94 ± 0.07) μmol/L,(1.67 ± 0.11) μmol/L at postoperative 24 hours,showing statistically significant differences among 3 groups (F =56.53,29.01,6.81,27.85,P ＜ 0.05).(3) Results of pathological examination:compared with noncongestion group,there were a lot of vacuolar cells with degeneration appearing in non-congestion liver tissues,severe liver cell swelling and hepatic sinus congestion in the congestion group at postoperative 24 hours.Compared with congestion group,vacuolar degeneration appearing in non-congestion liver tissues have some improvement in the congestion + splenectomy group.(4) Immunohistochemical staining:compared with non-congestion group and congestion + splenectomy group,the positive CD68 marked macrophages in the congestion group were increased at postoperative 24 hours.(5) Western blot assay:the relative expressions of Cleaved Casepase-3 and HIF-1α proteins in the non-congestion group,congestion group and congestion + splenectomy group were 0.63 ± 0.05,1.17 ± O.18,0.95 ± 0.17 and 0.63 ± 0.14,1.48 ± 0.08,1.13 ± 0.17,respectively,showing statistically significant differences among 3 groups (F =17.42,50.58,P ＜ 0.05).(6) Results of RT-PCR:the relative expression of mRNA of ET-1/eNOS in the non-congestion group,congestion group and congestion + splenectomy group was respectively 1.01 ± 0.63,2.09 ± 0.27,0.82 ± 0.12 at postoperative 12 hours and 0.73 ± 0.17,2.16 ± 0.94,0.80 ± 0.24 at postoperative 24 hours,showing statistically significant differences among 3 groups (F =62.91,10.65,P ＜0.05).The relative expression of mRNA of TNF-α in the non-congestion group,congestion group and congestion + splenectomy group was respectively 0.99 ± 0.08,127.80 ± 13.15,7.34 ± 1.56 at postoperative 12 hours and 0.99 ± 0.06,116.62 ± 13.32,58.62 ± 12.12 at postoperative 24 hours,showing statistically significant differences among 3 groups (F =436.77,154.54,P ＜ 0.05).The relative expression of mRNA of IL-6 in the non-congestion group,congestion group and congestion + splenectomy group was respectively 0.98 ±0.06,1.87 ±0.34,1.54 ±0.15 at postoperative 12 hours and 0.99 ±0.05,2.02 ±0.27,1.51 ±0.11at postoperative 24 hours,with statistically significant differences among 3 groups (F =22.08,46.71,P ＜ 0.05).(7) Results of ELISA:the level of HA in the non-congestion group,congestion group and congestion + splenectomy group was respectively (149 ± 9) ng/L,(200 ± 19) ng/L,(174 ± 9) ng/L at postoperative 12 hours and (136 ± 16) ng/L,(202 ± 13) ng/L,(91 ± 11) ng/L at postoperative 24 hours,with statistically significant differences among 3 groups (F =19.23,34.68,P＜0.05).Conclusions On the basis of extended liver resection,a wide range of liver congestion through increasing PVP causes hepatic microcirculation disorders,hypoxia,inflammation,vacuoles degeneration cells,increased cells apoptosis,aggravated damage of liver function and increased mortality of rats.Splenectomy could reduce PVP and then improve the liver tissues damage caused by liver congestion,meanwhile,increase the survival rate of rats.

Objective To summarize our experiences in the diagnosis and prognosis of different subtypes of primary thyroid lymphoma (PTL). Methods The clinical data of 27 PTL patients who were treated in our hospital from January 1998 to December 2014 were retrospectively analyzed. The pathological types of these patients included B cell lymphoma unclassifiable (BCLU) (n=5),mucosa-associated lymphiod tissue lymphoma (MALT) (n=9),diffuse large B cell lymphoma (DLBCL) (n=12),and T cell lymphoma (n=1). Results Of all these 27 cases,the most common clinical symptom was painless swelling of the neck (n=21,77.8%). Of 7 patients who had received preoperative fine needle biopsy,lymphoma was suspected in 2 cases (28.6%). Among these 7 cases,the positive rate of suspicious lymphoma was 66.7% in 3 DLBCL patients,0 in 3 MALT patients,and 0 in 1 BCLU paitent. Also,25 patients underwent intraoperative frozen pathological examination,which revealed lymphoma or suspicious lymphoma in 16 cases (64.0%); in these patients,the positive rate was 66.7% for BCLU,77.8% for MALT,58.3% for DLBCL,and 0 for T-cell lymphomas. The overall survival was (89.3±12.4) months,and the overall 5-year survival rate was 61.6%. The estimated survival in symptomatic group was 31.6 months,which was significantly shorter than that in asymptomatic group (97.9 months) (P=0.032). Other factors including age,sex,tumor size,tumor stage,international prognostic index,tracheal compression,lactate dehydrogenase,residual tumor,and pathological type showed no significant effect on survival(all P>0.05). Conclusions DLBCL has the highest fine needle biopsy positive rate,MALT has the highest frozen pathological positive rate,and intraoperative frozen pathology has more malignant results than the preoperative fine needle biopsy in the diagnosis. The accompanying lymphoma symptoms may be an adverse prognostic factor.

AIM:To investigate the effect of signal transducer and activator of transcription 1 ( STAT 1 ) on proliferation and interferon-β(IFN-β) sensitivity of human non-small-cell lung cancer H1299 cells.METHODS:STAT1 or EGFP gene was transfected into H1299 cells by the lentiviral vectors system.The cell number was counted under a mi-croscope and cell proliferation was tested by MTT assay.In addition, the cells transfected with STAT1 and EGFP were trea-ted with IFN-βand cell viability was measured by MTT assay.The protein levels of p-STAT1, ICAM-1 and PCNA were de-tected by Western blot.RESULTS: Over-expression of STAT1 inhibited H1299 cell proliferation (P<0.05).H1299 cells transfected with STAT1 gene had a higher sensitivity to IFN-βthan the control cells transfected with EGFP ( P <0.05).Overexpression of STAT1 increased the protein level of p-STAT1, and reduced IACM-1 expression in H1299 cells. Moreover, STAT1 enhanced STAT1 phosphorylation and downregulated the expression of PCNA in H1299 cells treated with IFN-β.CONCLUSION:STAT1 inhibits the proliferation and enhances the IFN-βsensitivity of non-small-cell lung cancer H1299 cells.

ObjectiveTo analyze therapeutic efficiency of 125 iodine brachytherapy seeds implantation guided by flexible fiber-optic bronchoscopy(FFB)image in terminal central non-small cell lung carcinoma (NSCLC).MethodsUnder therapy planning system (TPS) and guided by flexible fiber-optic bronchoscopy image,125 iodine seeds were implanted in 66 Confirmed terrainal cases with NSCLC and its posology Was validated and rechecked regularly.Remlts Complete remission (CR) was observed in 15 cases and partial remission (PR) in 36 cases during the first-year follow-up,with an overall efficiency rate (CR+PR) of 77.3 percent and one-year survival of 80.3 percent.Complete remission (CR) was observed in seven cases,partial remission (PR) in 22 cases,stable condition (SC) in three cases.and no progression was found during the second-year follow-up,respectively,with an overall efficiency rate (CR+PR) of 90.6 percent and two-year survival of 43.8 percent No radioactive damage were observed in the early and late stages of therapy.ConclusionsTherapy with radioactive 125 iodine seeds implantation guided by flexible fiber-optic bronchoscopy image could relieve airway obstruction effectively in terminal lung cancer and control progression of bronchiogenic carcinoma.

Objective To explore the expression of miR-221/222 in non-small cell lung cancer (NSCLC) and its correlation with clinical pathological parameters. Methods The clinical pathological data and formalin fixed-paraffin embedded (FFPE) tissues of 55 NSCLC patients and 10 benign lesion patients who underwent surgery in the First Affiliated Hospital of Nanhua University from February 2012 to May 2014 were collected and followed. The relationship between miR-221/222 expression detected by real-time PCR and clinical pathological parameters and progression-free survival (PFS) were analyzed. The differential survival between the high expression group and the low expression group of miR-221/222 were compared. A Cox proportional hazard regression model was utilized to examine the prognostic factors of NSCLC. Results The expression level of miR-221/222 was significantly higher in tumor tissues than that in corresponding benign lesion tissues (Fold change=3.52, P=0.000;Fold change=2.01, P=0.000). There was a negative correlation between miR-221/222 expression and pathological grades (r=-0.732, P=0.000;r=-0.451, P=0.001). The relative expression of miR-221 showed a positive correlation with miR-222 (r=0.376, P=0.000). Patients with higher levels of miR-221/222 were closely associated with a shorter PFS (miR-221: 55.43 weeks vs. 81.29 weeks, P=0.028; miR-222: 45.00 weeks vs. 87.04 weeks, P=0.008). Finally, multivariate analysis demonstrated that miR-222 expression was independently associated with poor PFS (RR=2.808, P=0.033). Conclusions miR-221/222 is highly expressed in NSCLC tumor tissues with a positive correlation. A negative correlation is observed between the expression of miR-221/222 and tumor differentiation. The potential high expression of miR-221/222 is considered as tumor biomarkers for the prognosis of NSCLC patients.

Objective:To explore the incidence and occurrence time of gallstone disease after bariatric surgery.Methods:Retrospectively analyzed the clinical data of 187 patients with morbid obesity who underwent bariatric surgery in the Department of General Surgery, Beijing Friendship Hospital, Capital Medical University from Dec. 2017 to Aug. 2019. All patients did not receive prophylactic ursodeoxycholic acid. All patients were underwent abdominal ultrasound and MRI examination preoperatively, and at least one abdominal ultrasound, MRI examination postoperatively. The incidence and occurrence time of gallstones and biliary sludge in patients with different bariatric surgery were analyzed respectively. Measurement data conforming to the normal distribution were described as mean ± standard deviation ( Mean± SD). Measurement data consistent with skewed distribution were described as median (lower quartile, upper quartile). Counting data were described as a percentage (%). Kruskal-Wallis test was used for comparison among groups, and then Bonferroni correction was used for pairwise comparison. Results:The follow-up time was up to Dec. 31, 2020, with a median follow-up time of 27.0 (22.0, 31.0) months. Thirty-four patients (18.2%, 34/187) developed gallstones after bariatric surgery. Individually, it was 18.0%(30/167) in LSG group, 22.2%(2/9) in LRYGB group, 11.1%(1/9) in LOAGB group and 50.0%(1/2) in LOAGB revisional surgery group. Eighteen patients (9.6%, 18/187) were found biliary sludge formation, among which 8.4% (14/167), 22.2% (2/9), and 22.2% (2/9) underwent LSG, LRYGB, and LOAGB, respectively. The rates of weight loss and BMI loss in patients with postoperative gallstone-formation were 21.4 (18.7, 23.6)% and 21.4 (18.6, 23.5) %, respectively. Three patients (1.6%, 3/187) had newly developed symptomatic gallstones, and all of them underwent LSG. The mean occurrence time for biliary sludge and gallstone was 85.5 (28.8, 98.8) and 103.5 (93.0, 179.3) days, respectively. Statistical difference in occurrence time was only found between postoperative gallstone and biliary sludge formation ( P=0.009). Conclusion:Without drug intervention, the incidence of gallstone after bariatric surgery was about 18.2% (34/187), which requires close clinical attention. Abdominal ultrasonography and the T2WI sequence of upper abdominal MRI can help to diagnose gallstone and monitor its changes.

Objective:To summarize the best evidence of post-stroke insomnia nursing and provide basis for clinical practice.Methods:According to the "6S" pyramid model, the system searched UpToDate, Scottish Interhospital Guidelines Network, US National Guidelines Network, JBI Evidence Based Health Care Center Database, BMJ Best Clinical Practice, NICE Guidelines Network, China Medical Pulse Communication Guidelines Network, Ontario Registered Nurses Network, The Cochrane Library, PubMed, Web of Science, Medline, Embase, CINAHL, CNKI, Wanfang, VIP and Chinese Biomedical Literature Database and related association websites. Evidence on the post-stroke insomnia nursing, including guidelines, systematic evaluations, expert consensus, etc. The retrieval period was from the database construction to February 19, 2022. The quality of the literature was evaluated by the corresponding articles evaluation criteria.Results:A total of 24 articles were selected, including 6 guidelines, 16 systematic reviews and 2 expert consensus. Totally 26 pieces of the best evidence on 5 aspects including the evaluation of sleep quality, the diagnosis of post-stroke insomnia, the development of individual plan, non-pharmaceutical intervention, and traditional Chinese medicine nursing intervention were finally summarized.Conclusions:The summarized evidence of post-stroke insomnia nursing, for can be used to provides scientific and effective evidence-based basis for nursing staff to carry out clinical practice. It is suggested that the specific evidence should be selected according to the specific situation of patients in clinical application.