Nutritional risk is present in a large proportion of infants with congenital heart disease,which is associated with various factors including malnutrition,pulmonary hypertension,and hemodynamic instability.Standard perioperative nutrition support may effectively decrease nutritional risk and has become an essential part in clinical treatment of congenital heart disease.Understanding the rules of perioperative energy metabolism is key to nutrition support.This article reviews the progress of research on the energy metabolism in infants with congenital heart disease in perioperative period,aiming to provide evidence for clinical nutrition support in this group of patients.

Objective To discuss the rescuing process and the selection of operating method of 9 cases of patients with carot-id artery injury .Methods 9 patients received positive anti -shock treatment after admission .Anterior sternocleidomastoid incision was made in the upper and middle section , and cervicothoracic incision was made in the lower section .Then ligature of external carot-id artery and repair and danastomosis of common carotid artery and internal carotid artery were examined .Results Among the 9 ca-ses, 2 were dead, 1 had hemiplegic paralysis and aphasia , 1 had hoarseness and drink cough and 5 others were cured.Conclusion Early diagnosis , effective haemostasis , reconstruction of carotid artery and necessary brain protection are the key to reducing the mor -tality and decreasing the morbidity of neurological deficit .

Objective To develop autosomal SNP fluorescent-multiplex PCR system,and investigate the allele frequencies of these 13 SNP loci in Southern Liaoning Han population.Methods After selected 13 autosomal SNP loci,SNP fluorescent-multiplex system was developed based on the principle of fragment length discrepant allele specific PCR,and the allele frequencies of these SNP loci in Southern Liaoning Han population were investigated using the established system.Results For the same SNP locus,the homozygote showed a single product peak,and the heterozygote showed two product peaks with different length.For the different SNP loci,the lengths of their PCR products were different.Therefore,we could genotype the 13 SNP loci simultaneously according to the length of products and the amount of product peaks,and the results were in accordance with that of direct sequencing.In the meanwhile,the allelic frequencies of these 13 SNP loci in Southern Liaoning Han population were obtained.Conclusion The SNP fluorescent-multiplex system based on the fragment length discrepant allele specific PCR strategy is simple and economical,and is of a high application value in forensic medicine.

Objective:To establish the core competency index system for emergency rescue of infectious diseases among military advance nurses, so as to provide a reference for evaluating the core emergency capability of military advanced nursing staff.Methods:The index system of emergency core competence of military advanced nursing staff in the emergency of infectious diseases was preliminarily formulated. Based on the evidence-based theory, the improved Delphi correspondence method was used to issue two rounds of questionnaires to 20 authoritative experts. After sorting out and analyzing, the effective questionnaire was formed, and the weight of each index was calculated by AHP.Results:The recovery rates of the two rounds of expert questionnaire were 100%, and the expert authority coefficients were 0.792 and 0.846, respectively; the Kendall ′s W was close to 1, which was statistically significant ( P < 0.01). Finally, three first-class indicators, 12 second-class indicators and 52 third-class indicators were determined, including knowledge related to the prevention of sudden infectious diseases, professional nursing skills and medical support capacity. Conclusion:The results show that the index content of the core emergency rescue capability system of military advanced nursing staff is centralized, the weight distribution is reasonable and has high practicability, which is conducive to improve the practical technical ability and core emergency ability of the military advanced nursing staff, improve the emergency rescue level of infectious disease emergencies and the overall medical support level of military hospitals

BACKGROUND:Genetic studies have shown that there may be association between osteoprotegerin gene G1181C polymorphism and bone mineral density in postmenopausal women, but there are some differences in the conclusions.
OBJECTIVE:To study the association between osteoprotegerin gene G1181C polymorphism and bone mineral density in postmenopausal women through Meta-analysis.
METHODS:The PubMed database, Embase database, CNKI database and Wanfang database were searched for the observational studies about the association between osteoprotegerin gene G1181C polymorphism and bone mineral density in postmenopausal women. The standardized mean difference was considered as the effect indicator and calculated with random or fixed effect models according to the significance of heterogeneity.
RESULTS AND CONCLUSION:A total of 9 articles were included with a total of 8 799 and 9 365 participants for which vertebral and spine bone mineral density had been measured, respectively. The analysis results showed that the bone mineral density of the postmenopausal women with the G al ele of G1181C was significantly lower than that of the postmenopausal women with the C al ele. Similar results were obtained in Caucasian population subgroup analysis. The Caucasian population subgroup analysis showed that the bone mineral density of the postmenopausal women with GG genotype of G1181C was lower than that of the postmenopausal women with GC and CC genotype. The results indicate that there is association between osteoprotegerin gene G1181C polymorphism and bone mineral density in postmenopausal women, and G al ele is a risk factor for lower bone mineral density.

Objective:The purpose of this study was to investigate the clinical value of CT-guided localization of pulmonary nodules with soft wire hook-wire by trailing technique.Methods:The clinical data of 211 pulmonary nodules of 185 patients from November 2020 to March 2022 in Beijing Aerospace General Hospital were retrospectively analyzed. The pulmonary nodules were localized with soft wire hook-wire by trailing technique before video-assisted thoracic surgery (VATS). The success rate, complications, pathological results and localization operations related data were statistically analyzed.Results:The success rate of localization was 97.63% (206/211), and the success rate of VATS removal was 99.53% (210/211). The average operation time was (7.19 ± 2.62) min, and the average time required for resection of lesions was 27 min (10 to 126 min). During the surgery, the soft wire hook-wire of two patient was found to be dislocated and retracted into the chest wall. The pulmonary nodules were successfully located and removed according traces left by puncture points on the lung surface. It was found that the hook-wire was located in the interlobar fissure in 3 patients. The pulmonary nodules were successfully removed by the hook-wire position and appropriately expanding the resection range. A minor pneumothorax occurred in 49 patients, but no closed drainage was needed; 12 patients developed intrapulmonary hematoma; 15 patients with chest pain were treated with analgesia.Conclusions:For small pulmonary nodules requiring thoracoscopic surgery, the computed tomography-guided pulmonary nodule localization with soft wire hook-wire by trailing technique is more convenient, safe and effective, and is worthy of promotion to use.

Conservation of Natural Resources ; Hypocreales ; isolation & purification ; Medicine, Chinese Traditional ; Natural Resources ; Species Specificity ; Tibet

Venous thromboembolism (VTE) is a preventable perioperative complication of malignant tumor in thoracic surgery. At present, low molecular weight heparin anticoagulants are the first choices for perioperative drug prevention of malignant tumors, and direct oral anticoagulants are not recommended for perioperative use of malignant tumors in thoracic surgery, but their application in other related fields is relatively mature. This article will introduce direct oral anticoagulants and analyze the prospect of their perioperative application in patients with thoracic malignant tumors. It is helpful to better understand the relevant contents of "perioperative VTE prophylaxis in thoracic cancer patients: Chinese experts consensus (2018 edition)".

Objective:To establish an animal model of acute systemic cold injury in mice.Methods:There were 98 C57BL/6 mice, half male and half female, with body weight of 22-27 g and age of 10 weeks. The mice were randomly divided into 7 groups ( n=14) according to the changes of anal temperature in cold environment, namely, group A (38.5 ± 1) ℃, group B (35 ± 1) ℃, group C (30 ± 1) ℃, group D (25 ± 1) ℃, group E (20 ± 1) ℃, group F (15 ± 1) ℃, and group G (10 ± 1) ℃, among which, group A was the blank control group, and the rest groups were the experimental group. The mice in the blank control group were placed in the normal environment (20 ± 5) ℃, and the mice in the experimental group were placed in the low temperature artificial climate box at - 20℃. The anal temperature of the mice was measured intermittently (as the core temperature), and the time required for the core temperature of the mice to drop to groups B, C, D, E, F and G was recorded. The righting reflex was used to evaluate the consciousness state, the action ability and the general state of each organ of mice were observed, and the blood routine and HE staining of each organ were detected. Results:The lower the core temperature of the experimental group, the longer the time required. The consciousness state, action ability, general state of organs, blood routine, and HE staining of organs in groups B, C, and D were basically the same as those in group A, and there was no acute systemic cold injury. Therefore, the blood routine, general observation of organs, and HE staining of organs in groups B, C, and D were no longer displayed compared with those in group A. Compared with group A, mice in group E began to suffer from disturbance of consciousness and action ability. With the decrease of core body temperature, the damage was aggravated, and mice in group G died. Compared with group A, the indices of blood routine test (WBC, RBC, HGB, PLT) of mice in group E began to decrease, and the univariate variance calculation showed that only WBC changes had statistical significance ( P<0.05). Compared with groups A and E, the indices of blood routine test (WBC, RBC, HGB, PLT) of mice in group F were further reduced, and the changes of each index in univariate variance calculation were statistically significant ( P<0.05). The general observation results showed that compared with group A, the lung, liver and spleen surfaces of mice in group E began to darken, and compared with groups A and E, the lung, liver, spleen, kidney and heart of mice in group F were further deepened and darkened, with irregular edges. HE staining results of various organs showed that compared with group A, the mice in group E began to have partial alveolar structure destruction and a small amount of inflammatory cell infiltration, the central vein of the liver was slightly congested, and the red and white pulp of the spleen were indistinct. Compared with groups A and E, the pathological structure damage of the lung, liver, spleen, kidney, heart and brain tissues of the mice in group F was further aggravated. Conclusions:Detection of consciousness state, action ability, general state of organs, blood routine and HE staining indices of organs in mice under low temperature can simulate the progress of clinical acute cold injury, and the animal model of acute systemic cold injury was successfully prepared.

Objective:To investigate the differential expression of microRNA (miR)-214-3p in plasma exosomes in different types of uveal melanoma (UM) and evaluate whether miR-214-3p is a potential molecular biomarker for the diagnosis and prognosis of UM.Methods:Twenty-five UM in situ patients who received the enucleation of eyeball were enrolled at Beijing Tongren Hospital from December 2015 to October 2019, including 10 with epithelioid cell melanoma and 10 with spindle cell melanoma as well as 5 metastatic UM patients (1 with spindle cell-like melanoma and 4 with epithelioid cell-like melanoma) and 10 healthy subjects were enrolled during the same period.Blood sample was collected from all the subjects for the isolation of plasma exosomes.The morphology of exosomes was examined under the electron microscope.The exsomal marker proteins were identified by Western blot.The expression level of miR-214-3p in plasma exosomes was detected by real-time fluorescence quantitative PCR.The differential expression of miR-214-3p among different types of UM patients and healthy controls was compared.The diagnostic and classification performance of exosomal miR-214-3p was evaluated using receiver operating characteristic curve.Written informed consent was obtained from each subject prior to entering the study cohort.This study protocol was approved by an Ethics Committee of Capital Medical Univeristy (No.TRECKY2018-056).Results:The isolated exosomes were hemispherical in shape with a concavity on one side.The diameter of the exosomes was about 100 nm and the particle diameter of vesicles from samples was (82.0±2.7) nm.TSG101 protein was detectable and Calnexin protein was not found in the exosomes.The relative expression levels of plasma exosomal miR-214-3p in healthy control group, in situ UM group and metastatic UM group were 0.86(0.57, 1.49), 0.24(0.10, 0.67), and 0.43(0.23, 0.56), respectively.The miR-214-3p relative expression level in plasma exosomes of in situ UM patients and metastatic UM patients was significantly lower than that of healthy controls, and the differences were statistically significant ( Z=2.62, P<0.01; Z=2.08, P<0.05). The relative expression levels of exosomal miR-214-3p in spindle cell-like UM group and epithelioid cell-like UM group were 0.11(0.07, 0.64) and 0.46(0.14, 0.91), respectively, and no significant difference was found in the expression level of plasma exosomal miR-214-3p among different types of UM (all at P>0.05). The area under the curve of plasma exosomal miR-214-3p for UM diagnosis was 0.795. Conclusions:Plasma exosomal miR-214-3p level is significantly reduced in both in situ UM patients and metastatic UM patients.Plasma exosomal miR-214-3p is a new potential diagnostic biomarker for UM, but the exosomal miR-214-3p appears to not be able to distinguish the types of UM.