Sixty patients underwent surgery for malignant thoracic tumor were evenly randomized into control group (group A) and treatment group (group B).0.3 ml low-molecular-weight heparin was injected per 12 h for 3 d in group B from 24 h after surgery.Bilateral venous sonography of lower extremities were performed before and d1,d3 after operation.Blood coagulation marks PLT,PT,APTT,Fibrinogen (FIB)and D-dimer were determined at the same time.Diagnosis of calf vein thrombosis after surgery was confirmed by color Doppler sonography in 7 patients:1 in group B (3％) and 6 in group A (20％) (P ＜ 0.05 ).Thrombosis at calf intermuscular vein was found in 6 patients and thrombosis at posterior tibial vein in 1 patient.FIB and D-dimer had no significant difference on the dl ( P ＞ 0.05 ) between two groups,but significantly lower on the d3 after surgery in group B than that in group A ( P ＜ 0.05 ).Low-molecularweight heparin reduced blood hypercoagulation state and thrombosis.Color Doppler sonography can be a valuable method for detecting asymptomatic deep vein thrombosis in the early stage after surgery and monitoring the efficacy of thrombosis prevention.

Objective To screen the Doc 1R gene recombinant plasmid by use of colony PCR. Method The recombinant colonies were transfered into the PCR reaction mixture. The PCR primers were used for constructing mouse Doc 1R genomic sequence. Result Among the 5, 3 positive strips in the size of 1 500 bp were visible, which were the same as the Doc 1R gene fractions in terms of their sizes were screened as positive clones. The positive colony were further confirmed by double digestion and DNA sequencing. Conclusion Colony PCR is a simple, efficient and reliable technique for screening the recombinant.

Objective To investigate the effect of advanced oxidation protein products (AOPPs) on human renal tubular epithelial cells(HK-2) autophagy.Methods HK-2 cells were stimulated with AOPPs.RT-qPCR and Western blot were used to determine the expression of autophagy related protein LC3-Ⅱ/LC3-Ⅰ,Beclin1 and p62;Western blot was utilized to examine the activation of p38 MAPK pathway.Then p38 MAPK inhibitor (SB203580) was added and co-processed with AOPPs.The change of autophagy was observed Also,autophagy inducer rapamycin was added and co-processed with AOPPs.RT-qPCR and Western blot were used to detect the expression of cell cycle inhibitory protein p27.The cell total protein level was detected by the bicinchoninic acid (BCA) method.The hypertrophy change was observed.Results AOPPs down-regulated the expression of LC3-Ⅱ/LC3-Ⅰ and Beclin1,up-regulated expression of p62 and activated p38 MAPK pathway;in comparison with the AOPPs alone treatment group,the expression of LC3-Ⅱ/LC3-Ⅰ and Beclin in the SB203580 co-processing group was increased,while p62 was decreased;the p27 expression and cells total protein in the sirolimus co-processing group were down-regulated.Conclusion AOPPs inhibits the autophagy of HK-2 cells by activating p38 MAPK pathway and the autophagy inhibition participates in HK-2 cell hypertrophy.

Objective　To assess the diagnostic efficacy of the cell-free Mycobacterium tuberculosis DNA testing (CF-TB) in tuberculous pleurisy. Methods　A total of 71 patients diagnosed with tuberculous pleurisy and 35 patients with non-tuberculous pleurisy were selected from the Fifth People's Hospital of Wuxi between January to December 2022. The standard pleural puncture was conducted to collect pleural effusion, which was then utilized for Mycobacterium tuberculosis culture, GeneXpert Mycobacterium tuberculosis/rifampicin resistance (GeneXpert MTB/RIF), CF-TB, and adenosine deaminase (ADA) testing. Blood samples were subjected to tuberculosis infection T-cell spotting test (T-SPOT.TB) assay. The receiver operator characteristic curve (ROC) was applied to obtain the optimal cut-off value for pleural fluid CF-TB and to compare the diagnostic performance of CF-TB with other methods. Data analysis was conducted using SPSS 22.0 software, with statistical significance defined as P<0.05. Results　The ROC curve analysis determined that the optimal cycle threshold (Ct) value for diagnosing tuberculous pleurisy using CF-TB in pleural fluid was 38.489, with a sensitivity of 91.5% and specificity of 97.1%. In comparison, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of T-SPOT.TB and pleural fluid ADA in diagnosing tuberculous pleurisy were 86.0%, 71.4%, 86.0%, 71.4%, 81.1%, and 55.0%, 91.4%, 92.9%, 50.8%, 67.0%, respectively, all of which were lower than the diagnostic efficiency of CF-TB. Furthermore, the specificity of pleural fluid CF-TB in diagnosing tuberculous pleurisy (97.1%) was not significantly different from GeneXpert MTB/RIF (100%) and Mycobacterium tuberculosis culture (100%), but its sensitivity (91.5%) was significantly higher than both GeneXpert MTB/RIF (19.7%) and Mycobacterium tuberculosis culture (28.2%), with a statistically significant difference (P<0.001). Conclusions　Compared to the conventional gold standard for diagnosing tuberculous pleurisy, CF-TB exhibits a higher sensitivity and its specificity is superior to that of tuberculosis immunological test. Consequently, CF-TB can serve as a valuable complement to other traditional detection methods in aiding the diagnosis of tuberculous pleurisy.

ObjectiveTo discuss the relationship between post-traumatic stress disorder(PTSD) and self psychologieal elastic for and to provide the scientific basis early for PTSD and psychological intervention.Methods 592 students were selected with the method of random cluster sampling to be investigated with children self psychological elastic scale and post-traumatic stress disorder and screening of questionnaire.ResultsThere were 45 students were PTSD screening positive group,accounting for 7.60％ of the total number,and 15 male students,accounting for 2.53％ of the total number,there were 30 female students,accounting for 5.07％ of the total number.Male and female in psychological elastic scale score were no significant differences (P＞ 0.05 ),PTSD positive group psychological screening elastic total cent and factors points were significantly lower than negative group(P＜ 0.05),PTSD total score was a significantly negative correlation( r =- 0.454,P =0.000).ConclusionPsychology resilience can be used as predictors of incidence of PTSD.

ObjectiveThe procedure of peroral endoscopic myotomy (POEM) was practiced in porcine esophagus-stomach model and the efficacy and safety of POEM for patients with achalasia were evaluated.MethodsThe ex-vivo esophagus-stomach was obtained and the pylorus was closed by hemostatic forceps.The entrance of the esophagus was fixed to foamed plastics.To perform POEM,a submucosal tunnel was created,after which the circular muscle layer was dissected and the mucosal entry was finally closed with clips.After successful animal experiment,we performed POEM on 4 patients with achalasia.Results POEM was completed in 5 porcine training models,in which 2 procedures were successful without any complication,2 were complicated with perforation in muscularis propria layer and 1 with rupture in mucosal layer.POEM was successfully performed in 4 patients with achalasia,with a mean operation time of 110min.The mean length of the submucosal tunnel was 10.5cm ( ranging 8-11 cm) and the mean length of myotomy of circular muscle layer was 7 cm (ranging 5-8 cm).The resting pressure of lower esophageal sphincter (LES) decreased from 52.4 mm Hg before POEM to 19.9 mm Hg.Massive bleeding occurred at the gastroesophageal junction in the first case and perforation occurred in mucosal layer during endoscopic hemostasis.All patients were followed up for 1-4 months,and the symptom of dysphasia was relieved significantly.ConclusionThe ex-vivo esophagus-stomach model can be used as training model for procedure of POEM,enabling endoscopists with enough experience for its use in patients.POEM is an effective therapy for achalasia,while the long-term efficacy and managements for complications are still to be elucidated.

Objective:To detect serum immunoglobulin and interleukin-18 (IL-18) levels in patients with viral hepatitis B and investigate the clinical significance of combined detection of serum immunoglobulin and IL-18 levels.Methods:A total of 102 patients with viral hepatitis B who received treatment in Jinan 2 nd People's Hospital from September 2019 to September 2020 were included in the observation group. An additional 99 patients who concurrently underwent physical examination were included in the control group. Serum immunoglobulin and IL-18 levels were detected in each group and they were compared between the two groups. Changes in serum immunoglobulin and IL-18 levels detected after treatment relative to before treatment were analyzed in the observation group. Results:Serum levels of immunoglobulin A, immunoglobulin G, immunoglobulin M, and IL-18 in the observation group were (2.68 ± 0.74) g/L, (15.24 ± 4.17) g/L, (2.59 ± 1.03) g/L, (2.53 ± 0.21) ng/mL, respectively, which were significantly higher than those in the control group [(1.76 ± 0.63) g/L, (11.58 ± 3.46) g/L, (1.38 ± 0.49) g/L, (1.68 ± 0.34) g/L, respectively, t = 9.45, 6.74, 10.54, 21.36, all P < 0.01). In the observation group, serum levels of immunoglobulin A, immunoglobulin G, immunoglobulin M, and IL-18 were (2.03 ± 0.51) g/L, (13.12 ± 3.25) g/L, (1.93 ± 0.47) g/L, (1.74 ± 0.15) μg/L after treatment, which were significantly lower than those before the treatment [(2.68 ± 0.74) g/L, (15.24 ± 4.17) g/L, (2.59 ± 1.03) g/L, (2.53 ± 0.21) μg/L , t = 7.26, 4.02, 10.54, 5.87, all P < 0.01). Conclusion:Serum immunoglobulin and IL-18 levels in combination can reflect the condition of viral hepatitis B patients and provide scientific reference for clinical treatment. The research results are scientific and innovative and are worthy of promotion.

Objective:To search, evaluate and summarize the best evidence of intervention and management of eating behavior in children with autism, so as to provide evidence for medical staff and caregivers of children with autism to manage eating behavior problems.Methods:According to the evidence pyramid "6S" model, the clinical decisions, recommended practices, guidelines, evidence summaries, expert consensus, systematic reviews and randomized controlled trials on the intervention and management of eating behavior in children with ASD were systematically searched from domestic and foreign databases, related guide websites and professional association websites. The search period was from the establishment of the database to March 31th, 2023. The quality of the guide was independently evaluated by 4 researchers, and the remaining articles were evaluated by 2 researchers. Content extraction, evidence integration and grading of the included articles were carried out, and the level of evidence recommendation was formed through the expert meeting.Results:A total of 19 articles were included, including 3 guidelines, 1 expert consensus, 13 systematic reviews and 2 randomized controlled trials. This paper summarized 25 best evidence from 5 aspects, including the common eating behavior problems of children with autism, the assessment of eating behavior problems, causes, consequences and intervention methods.Conclusions:The best evidence summarized in this study provides a basis for the management of eating behavior problems in children with autism. It is suggested that clinical staff should fully consider the clinical context when applying the evidence, and formulate more detailed and feasible eating behavior intervention programs combined with the children and their families.

Objective: To assess the impact of viable myocardium in left ventricular aneurysm (LVA) and ventricular arrhythmia on prognosis of LVA patients.
Methods: A total of one hundred and sixty LVA patients who received99Tcm-MIBI SPECT and18F-FDG PET were enrolled, including 139 male and 21 female with the mean age of (58 ± 10) years.There were 42 (26.3%) patients combining ventricular arrhythmia. LVEDV, LVESV and LVEF were detected. Semi-quantitative analysis of myocardium perfusion imaging was conducted, viable myocardium in aneurysm was deifned as the perfusion-metabolism mismatch score (MMS) ≥ 2.0. According to myocardium viability, the patients were divided into 2 groups: No viability group,n=97 and With viability group,n=63;based on ventricular arrhythmia, the patients were divided into another 4 groups: Group①, viability-, ventricular arrhythmia-, n=68, Group②, viability-, ventricular arrhythmias+,n=29, Group③, viability+, ventricular arrhythmias-,n=50 and Group④, viability+,ventricular arrhythmias+,n=13. The average follow-up time was (50 ± 7) months, the end point was cardiac death. The survival curve was obtained by Kaplan-Meier method and survival rates were compared by Log-rank analysis.
Results: The mean LVEF in 160 patients was (34 ± 11) %, cardiac death occurred in 19 (11.9%) patients. Long-term survival rates in Groups①,② and③ were 94.1%, 89.7% and 86.0%, respectively,P>0.05; while in Group④, the survival rate was 61.5%, which was lower than the other 3 groups,P=0.004. Multivariate Cox regression analysis showed that female (HR=5.101, 95% CI 1.853-14.044, P=0.002), GPET-ESV (HR=1.009, 95% CI 1.002-1.015,P=0.013), interaction between MMS and ventricular arrhythmia (HR=1.368, 95%CI 1.113-1.681,P=0.003) were independent risk factors for cardiac death;while surgical treatment (HR=0.199, 95% CI 0.054-0.742,P=0.016) could decrease the risk of cardiac death.
Conclusion: Patients with viable aneurysm and ventricular arrhythmia had poor long-term prognosis; while early and active treatment is needed for them (surgery with anti-arrhythmic therapy).

OBJECTIVE: To assess the value of BACs-on-Beads (BoBs) technique for the detection of chromosomal abnormalities in abortus tissues from recurrent pregnancy loss. METHODS: A total of 109 abortus samples were collected and analyzed with the BoBs technique. The incidence and types of chromosomal abnormalities for different age groups and gestational weeks were compared. RESULTS: The BoBs assay has succeeded in all cases, with an incidence for chromosomal abnormalities reaching 62.39% (68/109). The major findings included trisomy 16 (12/68), trisomy 22 (9/68), trisomy 13 (9/68) and trisomy 21 (8/68). The abnormal rate was significantly higher in those above 35-year-old compared with that of the <35-year-old group (P<0.05). More aberrations were found among abortus tissues derived from 42-70 days of pregnancy albeit with no statistical significance (P>0.05). The aberration rates were similar for samples derived from second, third and fourth time abortions (P>0.05). CONCLUSION BoBs technique can detect chromosomal aberrations in miscarriages and may be routinely used for the analysis of early spontaneous abortions.
Abortion, Habitual ; Abortion, Spontaneous ; Adult ; Chromosome Disorders ; Down Syndrome ; Female ; Humans ; Karyotyping ; Pregnancy ; Prenatal Diagnosis