Objective To observe the feasibility and safety of self-made extended endobronchial tube applicated in one-lung ventilation for radical resection of esophageal cancer.Methods 80 patients were randomly divided into two groups:self-made extended endobronchial tube group (group A) and double-lumen endobronchial tube group (group B).The degree of lung collapse,systolic blood pressure,diastolic blood pressure,heart rate,airway pressure (Paw),arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),arterial oxygen saturation (SaO2) were monitored.The time for insertion,rate of successfully intubation for single time,incidence of postoperative hoarseness and sore throat were recorded.Results There were no significant differences in degree of lung collapse,systolic blood pressure,diastolic blood pressure and heart rate,SaO2 in the two groups(all P＞0.05).The comparison of the time for insertion between the two groups:(1.5±0.4)min vs.(2.6±0.8)min(t=4.78,P＜0.05);rates of successfully intubation for single time:95.0％ vs.80.0％(χ2=5.19,P＜0.05).The comparison of Paw between the two groups:T1:(17.3±1.1)cmH2O vs.(22.5±0.9)cmH2O,t=4.613,P＜0.05;T2:(17.9±0.5)cmH2O vs.(23.6±1.4)cmH2O(t=5.438,P＜0.05);T3:(18.1±0.8)cmH2O vs.(24.6±1.2)cmH2O(t=3.741,P＜0.05).The comparison of blood gas during one-lung ventilation between the two groups:PaO2(281.5±53.4)mmHg vs.(187.6±48.8)mmHg(t=5.28,P＜0.05);SaO2(98.1±6.3)％ vs.(94.5±5.7)％(t=3.46,P＜0.05);PaCO2(31.2±3.6)mmHg vs.(37.6±4.1)mmHg(t=6.32,P＜0.05).The comparison of incidence of postoperative hoarseness:1case vs.6cases(χ2=5.91,P＜0.05);The comparison of incidence of sore throat:4cases vs.13cases(χ2=6.13,P＜0.05).Conclusion Single-lung ventilation has achieved via either the double lumen tube or the self-made extended endobronchial tube.However,the self-made extended endobronchial tube is recommended for single-lung ventilation because of the advantages of its easy intubation and position,full oxygenation,low Paw,less incidence of postoperative hoarseness and sore throat.Self-made extended endobronchial tube can be used as a one-lung ventilation method in its indications.

Objective To observe the morphology changes in articular cartilage of knee osteoarthritis ( KOA) model rats after intervention with Shudi Jisheng Zhuanggu Decoction (SJZD). Methods SD rats were randomized into 7 groups, namely blank control group, model group, Paracetamol group ( 0.270 g/kg) , Zhuangu Guanjie Pills group ( 1.08 g/kg) , and high-, middle- and low-dosage SJZD groups ( 27.450, 13.725, 6.863 g/kg, respectively). Rats were injected with papain solution into the right knee joint to build models of KOA before administration of drugs. Thickness of right knee joint was measured to evaluate the effect of SJZD on the swelling degree of knee joint. Histological changes of knee cartilage were evaluated by Mankin scoring method after the cartilage sections being stained with hematoxylin-eosin (HE). Results Swelling degree of knee joint and Mankin scores were significantly increased in the model group compared to the blank control group ( P<0.01). In comparison with the model group, the swelling degree of knee joint and Mankin scores of SJZD groups were significantly decreased (P<0.05 or P<0.01), and the pathological changes were relieved. Conclusion SJZD can ameliorate the pathological changes of knee articular cartilage in rats with KOA, so as to delay cartilage degeneration and protect the cartilage.

Gallbladder carcinoma is the most common malignancy in biliary tract.Early dissemination,rapid and silent progression and delayed diagnose could portend a dismal prognosis.The 5-year survival rate is less than 10％.Clarifying the etiological feature can improve the early diagnosis.Comprehending surgical indications of benign lesions can provide the methods for rational prophylactic resections.Standardized treatment of accident gallbladder carcinoma could improve the patients' prognosis.Efficient serologic markers could be used for early diagnosis and screening.

This article discussed on the continuing medical education for general practitioners within a nonprofit multihospital system.Literature review,statistical analysis and survey results were employed.Training situation for general practitioner at home and aboard was reviewed.Statistics on population,disease spectrum,present situation of community doctors in Luwan branch of Ruijin hospital was also analyzed.Results showed that current education system for general practitioners cannot catch up the increasing demand yet.Meanwhile patients expected well qualified and skillful physicians in the community healthcare centers.Reinforcement of continuing medical education for general practitioners was the stepping stone of a nonprofit multihospital system.Improving skills and qualifications of physician played an essential role in the urban network of medical services.

Objective To observe and analyze the difference of serum immunoglobulin IgA, IgG, IgM, β2-microglobulin and transferrin in pre-eclampsia (PE) and pregnancies complicated with chronic kidney disease.Methods Totally 46(40.0%)pregnancies with PE(PE group),36(31.3%)pregnancies with chronic kidney disease(chronic kidney disease group)and 33(28.7%)normal pregnancies with normal blood pressure and proteinuria without any complication(control group)delivered in Renji Hospital were recruicted in this study from February 2017 to July 2017.Serum IgA,IgG,IgM,β2-microglobulin and transferrin levels were detected. Correlation tests were conducted between these indicators and blood pressure, 24 hours proteinuria value and delivery weeks. Results (1) Comparison of general situation of pregnancies in the 3 groups:there were no significant difference in the age and child bearing history between the 3 groups(all P>0.05),while there was a significant difference in the blood pressure and deliver week(all P<0.01).There was no significant difference in 24 hours proteinuria values between PE group and chronic kidney disease group (Z=-0.187, P=0.852). (2) Comparison of serum immunoglobulin, β2-microglobulin and transferrin levels in pregnant women with three groups: serum IgA level in chronic kidney disease group was significantly higher than those in PE and control groups[(2.4±0.9)vs(1.8±0.9)vs(1.6±0.6)g/L;F=9.959,P<0.01].The serum IgG and IgM values had no significant difference between the 3 groups(all P>0.05).Serum β2-microglobulin in chronic kidney disease group was significantly higher than those in PE and control groups[(4.0±2.6)vs(2.7±0.7)vs(2.0±0.5)mg/L;F=15.892,P<0.01].Serum transferrin in chronic kidney disease group was significantly lower than those in PE and control groups[(3.0±0.8)vs(3.7±1.1)vs(3.6±0.6) g/L; F=6.284, P<0.01]. (3) The correlation between serum immunoglobulin, β2-microglobulin, transferrin and blood pressure, proteinuria value and delivery weeks in PE group: the blood pressure level was not correlated with serum IgA,β2-microglobulin and transferrin values in PE group(all P>0.05).So,24 hours proteinuria value was positively correlated with β2-microglobulin (r=0.557, P<0.01), which was negatively correlated with transferrin (r=-0.442, P<0.01) and was not correlated with IgA(r=0.089, P=0.556). There was a negative correlation between delivery weeks and β2-microglobulin(r=-0.328,P=0.026),and positive correlation with transferrin (r=0.315, P=0.035) and no correlation with IgA (r=-0.169, P=0.260). (4) The correlation between serum immunoglobulin, β2-microglobulin, transferrin and blood pressure, proteinuria value and delivery weeks in chronic kidney disease group:the blood pressure level was positively correlated with β2-microglobulin(systolic pressure: r=0.598,P<0.01;diastolic pressure:r=0.557,P<0.01),which was not correlated with IgA and transferrin in chronic kidney disease group (all P>0.05). So,24 hours proteinuria value was positively correlated with β2-microglobulin and IgA(r=0.568,r=0.330,both P<0.05), and not correlated with transferrin (r=0.255, P=0.133). Delivery weeks had a negative correlation with β2-microglobulin(r=-0.574,P<0.01),while it had a positive correlation with transferrin(r=0.369,P=0.027). No correlation was found between delivery weeks and IgA values (r=-0.257, P=0.131). Conclusion The serum levels of IgA,β2-microglobulin and transferrin in PE and pregnancies with chronic kidney disease are significantly different,which may provide clinical value for the diagnosis of PE and pregnancies with chronic kidney disease in future.

OBJECTIVE: To analyze the indications of the therapies for rheumatoid arthritis (RA) with neural network model analysis. METHODS: Three hundred and ninety-seven patients were included in the clinical trial from 9 clinical centers. They were randomly divided into Western medicine (WM) treated group, 194 cases; and traditional Chinese herbal medicine (CM) treated group, 203 cases. A complete physical examination and 18 common clinical manifestations were prepared before the randomization and after the treatment. The WM therapy included voltaren extended action tablet, methotrexate and sulfasalazine. The CM therapy included Glucosidorum Tripterygii Totorum Tablet and syndrome differentiation treatment. The American College of Rheumatology 20 (ACR20) was taken as efficacy evaluation. All data were analyzed on SAS 8.2 statistical package. The relationships between each variable and efficacy were analyzed, and the variables with P<0.2 were included for the data mining analysis with neural network model. All data were classified into training set (75%) and verification set (25%) for further verification on the data-mining model. RESULTS: Eighteen variables in CM and 24 variables in WM were included in the data-mining model. In CM, morning stiffness, swollen joint number, peripheral immunoglobulin M (IgM) level, tenderness joint number, tenderness, rheumatoid factor (RF), C-reactive protein (CRP) and joint pain were positively related to the efficacy, and disease duration and more urination at night negatively related to the efficacy. In WM, erythrocyte sedimentation rate (ESR), weak waist, white fur in tongue, joint pain, joint stiffness and swollen joint were positively related to the efficacy, and yellow fur in tongue, red tongue, white blood negatively related to the efficacy. In the analysis with the neural network model in the patients of verification set, the predictive response rates of 20% patients would be 100% and 90% in the treatment with CM and WM, respectively. CONCLUSION: Neural network model analysis, based on the full clinical trial data with collection of both traditional Chinese medicine and modern medicine diagnostic information, shows a good predictive role for the information in the efficacy in rheumatoid arthritis.

Mindfulness training has shown beneficial effects on cognitive functions in older adults.Howev-er,the studies on this topic have used different methods and populations,and their results were inconsistent.No sys-tematic review has synthesized and evaluated these findings.This review aims to address this gap by categorizing the studies based on the training methods and cohorts of older adults,and summarizing the effects of mindfulness training on cognitive function.The review finds that mindfulness training had different effects depending on the lev-el of cognitive decline and the training method.Both standardized and unstandardized training methods improved cognitive performance in older adults with normal or subjective cognitive decline.However,the effect of mindful-ness training diminished as cognitive decline worsened,being inconsistent in mild cognitive impairment and non-sig-nificant in dementia.The review also discusses the possible mechanisms and suggested directions for future re-search.

Objective:To investigate the efficacy of sacubitril/valsartan in the treatment of cancer therapy-related cardiac dysfunction(CTRCD).Methods:A comprehensive analysis of all the literature on sacubitril/valsartan therapy for CTRCD published in Pubmed,Web of Science,Cochrane Library,Medline,and Embase from the inception of the database up to March 2023 was conducted,summarizing the tim-ing of drug administration,dosage,and efficacy,and further systematically summarizing the clinical studies on the use of the drug for the prevention of CTRCD.Results:After 3-12 months of treatment with sacubitril/valsartan for CTRCD,NYHA in cancer patients improved from grade Ⅱ-Ⅳ to grade Ⅰ-Ⅱ,LVEF increased by 3.0%to 37.0%,and NT-proBNP decreased by 280.0-65 498.0 pg/mL.Conclusions:The sacu-bitril/valsartan demonstrates efficacy in managing CTRCD and holds significant clinical utility in enhancing LVEF,GLS,and other patient indic-ators,thereby enabling the continuation of anti-tumor therapy and prolonging survival for cancer patients.

Objective:To construct a prognostic risk model for hepatocellular carcinoma(HCC),and elucidate the immune characteristics and immunotherapy response in patients with different prognostic stratification.Methods:RNA-seq data of TCGA-LIHC and ICGC(LIRI-JP),and gene microarray data of GSE14520 and GSE54236 in hepatocellular carcinoma,as well as clinical informa-tion of the corresponding samples were downloaded.First,screening of differentially expressed genes in tumor and non-tumor tissue samples from TCGA-LIHC,GSE14520 and GSE54236.For the common differential genes,univariate cox regression analysis was per-formed using TCGA-LIHC data to obtain HCC prognosis-related genes.Five genes were randomly selected as a panel,and the optimal prognostic marker panel was screened among 10 000 panels using Lasso-cox regression analysis combined with a five-fold cross-valida-tion method.TCGA-LIHC data were used as training set to construct the prognostic risk model,and ICGC data were used as validation set to test the model performance.Tumor immune dysfunction and exclusion(TIDE)algorithm and Immunophenotypic score(IPS)were used to predict immunotherapy efficacy in patients in different prognostic groups.Results:Overall survival was significantly lon-ger in low-risk group of HCC patients compared with high-risk group.Tumor proliferation rate,Treg and Th2 cell chemotaxis,stromal remodeling,and pro-tumor cytokines were significantly increased in high-risk patients,while NK cells,Th1 cells,effector cells and endothelial cells were significantly increased in low-risk patients.Immune checkpoint analysis showed that PDCD1,CTLA4 and CD276 were up-regulated in high-risk patients,while PDCD1LG2 was upregulated in low-risk patients.TIDE score and IPS results predicted that patients in low-risk group had better efficacy to immunotherapy.Conclusion:This study constructed a prognostic risk model containing three genes,DNASE1L3,RDH16 and DLGAP5,which can effectively predict the prognosis of HCC patients and assist in clinical decision making for individualized immunotherapy.

OBJECTIVE: To explore the inhibitory role of spermatogenesis-associated gene 12 (SPATA12) on tumor cell proliferation and its possible mechanism. METHODS: The expression pattern of SPATA12 in testicular tumors was investigated by in situ hybridization analysis using tissue microarrays. The effects of SPATA12 on tumor cell proliferation and colony formation was detected by 3-(4.5-dimethylthiazol-2- yl)-2,5-diphenyl tetrazolium bromide (MTT) assay and colonyforming assays, respectively. The changes of expression level of cell cycle genes in tumor cells were detected by reverse transcription polymerase chain reaction(RTPCR). RESULTS: In situ hybridization analysis showed that the SPATA12 was highly expressed in normal adult testis, but lacking in testicular tumors such as seminoma. MTT assay and colony-forming assay indicated that the exogenous expression of SPATA12 could suppress both tumor cell proliferation and colony formation. RT-PCR showed that the expression of cyclin A1 gene was markedly suppressed and the level of cyclin D1 was somewhat reduced following SPATA12 transfection. However, no obvious changes were observed in mRNA expression of cyclin B1 or cyclin E1 after SPATA12 transfection. CONCLUSION SPATA12 could be an inhibitor during the development of tumor via regulation of cell cycle genes.
Cell Line, Tumor ; Cell Proliferation ; Genes, Tumor Suppressor ; Genes, cdc ; HeLa Cells ; Homeodomain Proteins ; genetics ; metabolism ; Humans ; Male ; Testicular Neoplasms ; genetics ; pathology ; Transfection