Objective To observe the effects of ventilation with low tidal volume and positive end-expiratory pressure (PEEP)in different periods on the postoperative pulmonary function and short-term prognosis in aged patients undergoing abdominal surgery.Methods Sixty aged patients undergoing selective open abdominal surgery scheduled for general anesthesia,21 males and 39 fe-males,were randomized into 3 groups (n =20).Patients in group A received PEEP 1 h after the be-ginning of surgery;patients in group B received PEEP 1 h before tracheal extubation;patients in group C received PEEP intraoperatively.The secretion score in preoperative,postoperative 24 h and 72 h respectively,and the arterial blood gas analysis indexes (PaCO 2 ,PaO 2 ,A-aDO 2 ,PaO 2/FiO 2 calculation)in postoperative 1 h and 24 h were recorded.Results Compared with preoperative,in postoperative 1 h,PaCO 2 increased obviously in all groups,PaO 2 decreased in group B,A-aDO 2 in-creased in group A (P <0.05);in postoperative 24 h,PaCO 2 was significantly increased in group B and C,PaO 2/FiO 2 decreased in group B (P <0.05).Compared with postoperative 1 h,in postopera-tive 24 h,PaCO 2 and A-aDO 2 decreased obviously in group A (P <0.05).There were no differences in postoperative secretions score in between the 3 groups.Conclusion Low tidal volume combined short-range PEEP in different periods of surgery may improve postoperative pulmonary oxygenation. But they had no obvious help with postoperative pulmonary complications.

Objective To investigate the biosafety-related knowledge level of teachers,technicians and graduate students of medical colleges in Jiangsu province and to explore policy for management of laboratory biosafety in medical colleges.Methods In total of 550 teachers,technicians and graduate students from 5 full-time medical colleges were enrolled using a multiple-stage stratified random sampling method.Each subject was asked to complete questionnaire consisting of laboratory biosafety rules,safety consciousness,route of transmission,waste management and biosafety training,etc.Results The general awareness rate was 54.38%.The percentage of awareness in laboratory biosafety rules,safety consciousness,route of transmission were 27.58%,27.68% and 10.23%,respectively.The awareness rate in reagents toxicity was the lowest(7.21%).However,the awareness rate in protecting rules and waste management were as high as 83.77% and 76.90%,respectively.About 96.30% of the respondents considered that it would be necessary to launch a biosafety course in medical colleges.Conclusions The results showed that the awareness in laboratory biosafety among teachers and students of medical colleges still need to be improved.Propaganda and training of laboratory biosafety should be performed regularly to improve the general awareness and strengthen management.

Mendelian randomization (MR) approach follows the Mendel′s law of inheritance, which is called "Parental alleles randomly assigned to the offspring", and refers to use genetic variants as an instrumental variable to develop causal inference between the exposure factor and the outcome from observational study. In recent years, with the rapid development of genome-wide association study (GWAS) and various omics data,the disclosure of a large number of aggregated data provides an opportunity for the wide application of MR approach in causal inference. We introduce three methods widely used in MR and then apply them to explore causal relationship between blood metabolites and depressive. The advantages and disadvantages of three methods in causal inference are compared in order to provide reference for the application of MR in observational studies.

[Objective]To explore the clinical experience of professor SHAN Zhaowei treatment of chronic atrophic gastritis(CAG). [Method] To analyze SHAN Zhaowei professor from the perspective of four different pathogenesis of syndrome differentiation of CAG. To sum up professor SHAN Zhaowei 's clinical experience in the treatment of chronic atrophic gastritis, inheritance of Meng He YiPai essence. [Result] Professor SHAN Zhaowei treats CAG in qi, deficiency, blood stasis and toxin from four different pathogenesis to syndrome differentiation of traditional Chinese medicine treatment of CAG, mediation or insufficiency of qi activity, health, and remove stasis coating, detoxification cancer, the first emphasis on TCM four diagnosis, tongue mirror each other, differentiation is exquisite, precision, protecting stomach qi, along with the differentiation to add and subtract, insipid, but with magic effect. [Conclusion] The unique pathogenesis differentiation method in the treatment of CAG and the clinical experience for CAG of Professor SHAN Zhaowei is worth learning and promotion.

OBJECTIVETo observe the clinical efficacy and safety of Tiaozhi Yanggan Decoction (TZYGD) in treating non-alcoholic fatty liver.

METHODSOne hundred and thirty-eight patients were enrolled and randomized into two groups according to the random number table in a ratio of 3:1, with 8 cases eventually dropping out. The symptoms, signs, liver function markers, blood lipids, iconographic indices and clinical comprehensive efficacy after a 12-week treatment course were assessed in 101 patients treated with TZYGD in the treated group and 29 patients treated with Thiola in the control group.

RESULTSThe total effective rate in the treated group and the control group was 81.19% and 68.97%, respectively, showing a significant difference between the two groups with the former being significantly higher than the latter (P<0.05). Moreover, the improvements in the symptoms, signs, liver function, blood lipids and iconographic indices in the treated group were favorable with no serious adverse reactions.

CONCLUSIONTZYGD is effective and highly safe in treating non-alcoholic fatty liver.

Adult ; Body Mass Index ; Body Weight ; drug effects ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Fatty Liver ; blood ; drug therapy ; physiopathology ; Female ; Humans ; Lipids ; blood ; Liver ; physiopathology ; Male ; Medicine, Chinese Traditional ; adverse effects ; methods ; Middle Aged ; Phytotherapy ; adverse effects ; Treatment Outcome

Objective: This project aimed to explore the effectiveness of estimating individual treatment effect on real data, among the heterogeneous population, with Causal Forests (CF) method, to find out the characteristics of heterogeneous population. Methods: We designed and conducted four computer simulation schemes to verify the effect of estimating on individual treatment, using the CF under four different environments of the treatment effects. Real data was then analyzed for the catheterization on right heart. Results: Results from the simulation process showed that the values on individual treatment effect that were estimated by causal forests were consistent with the population effect as well as in line with the expected distribution under the setting of four different effect values. Results of real data analysis showed that values of individual treatment effect among most patients appeared positive, so the use of RHC could cause an increase of the '180-day mortality rate’ in the sampled population. Patients with lower predicted probability of 2-mo survival and albumin were more likely to have a lower risk of death after using the RHC. Conclusion CF method could be effectively used to estimate the individual treatment effect and helping the individuals to make decision on the receipt of treatment.