Objective To study the change of serum diamine oxidase (DAO) level in patients with severely acute pancreatitis (SAP) in order to explore the role of DAO in assessing the severity of SAP and the magnitude of gastrointestinal dysfunction.Methods From January 2012 through December 2013,56 SAP patients with 33 male and 23 female and average age (45-± 14) years admitted within 3 days after onset were enrolled for this study.At admission,serum diamine oxidase (DAO) was detected,and APACHE Ⅱ score,computed tomography severity index (CTSI) score and Balthazar grading and gastrointestinal dysfunction score were calculated.And at the corresponding time,serum procalcitonin (PCT) was detected.The correlations between serum DAO level and 4 other markers were analyzed.Results The high level of serum DAO was found at admission in SAP patients correlating positively with serum PCT concentrations (r =0.516,P＜ 0.01),APACHE Ⅱ score (r =0.631,P＜ 0.01),CTIS score (r=0.640,P ＜ 0.01),and the degree of gastrointestinal dysfunction (r =0.730,P ＜ 0.01).Conclusions The role of serum DAO in assessing the severity of SAP and magnitude of gastrointestinal dysfunction in SAP patients is really valid.

Objective To investigate the curative effect of the preoperative intervention transcatheter arterial chemoembolization and preoperative intravenous systemic simple chemotherapy for gastric cancer.Methods Retrospective analysis of 55 patients diag-nosed with gastric cancer.These patients were divided into two groups:treatment group and control group (simple chemotherapy group),with treatment group of 35 cases and control group of 20 cases,and cases of two groups all received surgical radical surgery for gastric carcinoma treatment.Preoperative and postoperative clinical symptoms were observed.Data of tumor sizes and tumor vessel changes were analyzed and compared.The difference of curative effect between two groups was observed.Results Compared with control group,degeneration and necrosis of tumor cells in gastric cancer tissue of treatment group were obvious,and tumor ves-sels significantly reduced,with nonuniformed,and became thinner.Number of tumor vessels of treatment group was obviously low-er than that of control group (P <0.05).Conclusion The interventional therapy of gastric cancer has obvious short-term therapeutic effects,and can reduce tumor vessels effectively and improve surgical resection rate.

BACKGROUNDThe prevalence of lung cancer in the elder increases gradually recently, and lung cancer has become the main cause of cancer-related death. The aim of this study is to analyse the operative indication, complication, perioperative management and surgical measures, results and specificity for lung cancer in the elderly patients.

METHODSOne hundred and thirty-seven elderly patients with lung can-cer, aged from 70 to 83 years old with mean age of 74 were analysed. Of the 137 cases, 13 patients were in the stage I, 76 in stage II, 48 in stage III. Surgical procedures included pneumonectomy for 4 patients, lobectomy for 122 patients, segmentectomy and wedge resection for 7 patients, sleeve lobectomy for 19 patients, bronchoplastic procedure and pulmonary artery reconstruction for 2 patients. Video-assisted thoracic surgery was performed in 13 cases for segmentectomy and wedge excision

RESULTSThere was no operative death. The resection rate was 97.1%, and postoperative complication rate was 29.9%. The follow-up rate was 88.3% . The 1-, 2-, 3-year survival rate was 62%, 35%, 28% respectively.

CONCLUSIONSElderly patients with lung cancer can obtain good therapeutic results and prognosis undergoing surgical therapy, but the operative indications will be limited. Exquisite surgical technique and application of respirator after operation may expand the operative indications.

Objective:To understand the current situation of research in the field of sepsis caused by Gram positive bacteria (G + bacteria) in China, to clarify the research content and analyze its general research direction, so as to find the hot topics of research in recent years. Methods:The literatures in SinoMed related to sepsis caused by G + bacteria and published in Chinese from building database to October 2019 were screened. The distribution and trend of the published year, journals, research institutions and researchers of relevant literature were analyzed, and Ucinet 6.0 software was used to draw the social network graph of the researchers and to analyze their internal relations. The subject words of related literatures were extracted. The relationship among the subject words in related literatures was arranged according to the centrality by NetDraw in Ucinet 6.0 software, the bibliographic information co-occurrence analysis system software (BICOMS2 software) was used to classify the subject words and the visualization matrix was generated. The graph clustering tool software (gCLUTO software) was used to cluster the subject words, and the visualization surface graph was generated to analyze the current research hot spot, research trend and research direction of G + bacteria-induced sepsis. Results:A total of 1 976 literatures about sepsis caused by G + bacteria were retrieved, and 26 literatures in conference summaries, news reports, research information, missing content, or inconsistent with the theme were excluded. Finally, a total of 1 950 literatures were enrolled in final analysis. The number of published literatures analysis showed that from 1979 to 1992, there were few studies about sepsis caused by G + bacteria, which increased geometrically from 2008, and the number of literatures published from 2008 to 2018 was 1 144, accounting for 58.67% (1 144/1 950). From 1979 to 2019, 23 high-yield institutions published more than 5 literatures, of which 6 were institutions with 10 or more literatures, and only one institution with more than 20 literatures. There were only 5 journals with more than 100 articles, 5 381 authors involved in the literatures, but few authors with more than 10 literatures published, and no inter-provincial or inter-municipal cooperation was found. A social network analysis of 103 high-frequency subject words that appeared more than 5 times showed that the study of sepsis caused by G + bacteria mainly focused on "sepsis", including the incidence of sepsis caused by drug resistant Staphylococcus aureus was on the rise, especially in newborns and children with weakened immune systems, the selection of therapeutic drugs gradually developed to glycopeptides with strong anti-drug resistance and synthetic oxazolidinones. The research and development of drugs for the treatment of sepsis caused by G + bacteria might become a new research direction or field in the future. Cluster analysis of 103 high-frequency subject words showed that the research hot spots of G + bacteria-induced sepsis mainly focused on five topics, namely early diagnosis of sepsis; bacterial infection pathway of sepsis, nosocomial infection and bacterial drug resistance; the basis of epidemiological prevention and treatment of sepsis; venous catheter infection-related sepsis; the treatment, nursing and prognosis of patients with sepsis. Conclusion:The studies of sepsis caused by G + bacteria are winning more and more attention, but the resources sharing and academic exchanges among hospitals need to be further improved.

AIM: To investigate the effect of tetramethylpyrazine (TMP) on doxorubicin (Dox) induced cardiotoxicity and the role of 14-3-3γ/Bcl-2 protein expression. METHODS: Primary cultured cardiomyocytes were randomly divided into Control group, Dox group, Dox+TMP group and Dox+TMP+pAD/14-3-3γ-shRNA group. After 48 hours, the cell viability was detected by MST, the activity of LDH in culture medium, the activities of Caspase-3, SOD, GSH-Px and the content of MDA were detected; the expression of 14-3-3γ and mitochondrial Bcl-2 was detected by Western blot; ROS generation, mitochondrial membrane potential and mPTP opening were detected by flow cytometry; apoptosis was detected by TUNEL method. RESULTS: After Dox exposed for 48 hours, the viability of cardiomyocytes decreased significantly, the activity of LDH in culture medium increased, the activities of SOD and GSH-Px decreased, the content of MDA increased, ROS generation increased; the mitochondrial membrane potential decreased, mPTP continued to open, caspase-3 activity and apoptosis increased. TMP pretreatment significantly upregulated the expression of 14-3-3γ and mitochondrial Bcl-2, and reversed the above changes simultaneously; pAD/14-3-3γ-shRNA not only downregulated the expression of 14-3-3γ, but also decreased the expression of Bcl-2 in mitochondria. CONCLUSION: TMP pretreatment upregulates the expression of 14-3-3γ and mitochondrial Bcl-2, inhibits oxidative stress, maintains mitochondrial function and reduces Dox induced apoptosis.

Since the outbreak of corona virus disease 2019(COVID 19), the epidemic has spread rapidly, which brings great challenge to the surgical diagnosis, treatment and management of lung neoplasm Sichuan International Medical Exchange &Promotion Association organized thoracic surgery experts to sum up experiences from experts in major hospital, and formulated the Guidance suggestion on surgical diagnosis, treatment and management of lung neoplasm during the outbreak of COVID-19 to provide references for thoracic surgeons.

Objective To survey the distribution pattern and subject domain knowledge of the literatures about ventilator-associated pneumonia (VAP). Methods Literatures about VAP published until December 2017 were identified in SinoMed database for statistics and analysis. The information of author, organization and province was extracted by BICOMS software for generating co-occurrence matrix, at the same time, the topic words were cluster analyzed by Gcluto software to generate topical visual surface maps and visualization matrices, and the current research hotspots were analyzed. NetDraw from Ucinet 6.0 software was used to arrange the relationship among topic words according to the centrality, and the social network diagrams of authors, authors' provinces and institutions were draw to analyze the current status of VAP research cooperation. Results 4 851 VAP-related literatures were retrieved preliminarily, and 43 were excluded from abstracts, news reports, information and missing literatures. Finally, a total of 4 808 articles were enrolled in the visual analysis. From 2001 to 2004, the number of VAP-related literatures published was less than 10. Since 2009, the number of VAP documents had increased steadily, from 2010 to 2017, the peak period of publications reached 91.7% (4 411/4 808). According to the analysis of the amount of publications, the top three of 34 provincial administrative regions that published VAP-related literature in China were Guangdong Province (n = 628), Jiangsu Province (n = 478) and Zhejiang Province (n = 404), the number of hospitals issued by the First Affiliated Hospital of Chongqing Medical University was the largest (n = 20); there was only one journal with more than 100 articles, and there were 154 journals with only one article, accounting for 34.8% of the total number of journals. A total of 9 921 authors participated in the VAP-related literature writing, the number of high-yielding authors was not large, and the institution could not establish an effective social network diagram, suggesting that communication and cooperation should be strengthened in hospitals and outside hospitals. The results of the topic words social network analysis showed that the VAP research field was centered around the core of "mechanical ventilation", "intensive care unit (ICU)", "risk factor analysis", "nursing", "etiological analysis", "preventive measures" and "pathogens". The current research hotspots were at the edge of the network map, such as "drug sensitivity analysis", "Acinetobacter baumannii", "bronohoalveolar lavage (BAL)" and "acute exacerbation of chronic obstructive pulmonary disease (AECOPD)". By clustering 80 high-frequency topic words, at present, VAP research hotspots were mainly focus on five topics: obstructive pulmonary disease, especially in acute exacerbation, was prone to VAP; concerned about newborns and children's VAP; types, drug resistance and selection of antimicrobial agents for VAP pathogens in ICU; clinical efficacy and prognosis of VAP through preventive measures, pulmonary supportive care and comprehensive care interventions; oral care and airway management during mechanical ventilation was also the key aspect of the treatment of VAP. Conclusions In recent years, the academics had attached great importance to the study of VAP, the number of publications had reached a historical peak, and the research direction was diverse. However, it was necessary to strengthen cooperation among research institutes, collect and count epidemiological data, improve and expand the research quality and scale of clinical diagnosis, nurse, prevention, pathogen distribution and drug resistance analysis.

Objective     To compare the effect of uniportal and multiportal thoracoscopic lobectomy, and to explore the advantages and applications of uniportal thoracoscopic lobectomy in enhanced recovery after surgery. Methods     Totally 169 patients with video-assisted thoracoscopic lobectomy in Department of Thoracic Surgery of Sichuan Cancer Hospital from January to December 2016 were enrolled. There were 99 males and 70 females with age of 60.83±7.24 years. Patients were divided into two groups: a uniportal group (78 patients) and a multiportal group (91 patients) . Patients’ clinical and pathological materials were collected. Postoperative pain, complications and hospital stay, etc of the two groups were compared. Results     All patients were successfully discharged without serious postoperative complication or death. Patients in the multiportal group had smaller surgical incisions than that in the uniportal group (3.12±0.73 cm vs. 6.38±1.50 cm, P=0.016). Pain scores at postoperative 24 and 48 hours of the uniportal group were less than those of multiportal group (4.18±1.67 vs. 6.54±1.83, 3.05±1.47 vs. 4.68±1.64, P<0.05). Operation data, postoperative complications and hospital stay were similar in both groups. Conclusion     Uniportal video-assisted thoracoscopic lobectomy makes smaller incisions and can further reduce postoperative pain and dosage of morphine. The operation is safe and worthy of wide application in enhanced recovery after surgery.