BACKGROUND:One-lung ventilation is wildly applied in cardiothoracic surgery including general surgery and lung transplantation surgery.There have been much more researches of one-lung ventilation in recent years.OBJECTIVE:To analyze and conclude the research progress of one-lung ventilation with a view to improve the effectiveness of one-lung ventilation and reduce complications during and after one-lung ventilation.RETRIEVAL STRATEGY:A computer-based search of Medline was undertaken to identify the articles about one-lung ventilation published from January 1980 to October 2007 with the keywords "one-lung ventilation,hypoxemia,lung transplantation",and the language was limited to English.Chinese articles about one-lung ventilation punished from January 2000 to October 2007 were searched in China National Knowledge Infrastructure(CNKI),with the keywords "one-lung ventilation,hypoxemia,lung transplantation" and the language was limited to Chinese.The materials were selected firstly and full texts were searched.Inclusion criteria:①the basic and clinical study on one-lung ventilation;②the clinical study on anesthesia of lung transplantation.Exclusion criteria:①repetitive study;②reviews.Over 300 articles on one-lung ventilation were collected,in which 28 were accordant with inclusion criteria.LITERATURE EVALUATION:Of the 28 articles,15 were about the study of the management during one-lung ventilation,and 13 were the hypoxemia study of one-lung ventilation.DATA SYNTHESIS:After the selected literatures were analyzed and arranged,the management of one-lung ventilation including the selection of ventilation mode,the settings of tidal volume and respiratory frequency,fraction of inspired oxygen,fluid management was analyzed.Hypoxemia is the biggest challenge during one-lung ventilation.We may improve arterial oxygenation and reduce the occurrence of hypoxemia by various ways.However,the management of one-lung ventilation is still controversial and needs further study.CONCLUSION:With the study on the management of one-lung ventilation and the handling of common matters deepens continuously,the application of one-lung ventilation will be more widespread and more safe.

Objective:Stephania tetrandra is widely used in traditional Chinese medication.In present study,we studied the resource status of it in Anhui and Jiangxi Province.Methods:We inspected relevant documents to confirm which counties we would investigate;and then,we interviewed many relative local people and carried out sample-plot survey.Results:The resource of wild Stephania tetrandra in the two provinces were both seriously damaged.Conclusion:Large-scale promotion of artificial cultivation was required to ensure the supply and to realize the reasonable and sustainable utility of this medicinal material.

Objective:To explore the relationship between atrial fibrillation stroke risk score (CHA2DS2-VASc score) and short-term prognosis of aged patients with nonvalvular atrial fibrillation (NVAF)complicated ischemic cerebral stroke (ICS).Methods:A total of 206 aged NVAF+ ICS patients who hospitalized in our hosipital from Jun 2011 to Aug 2013 were selected.CHA2DS2-VASc score was used to perform stroke risk stratification,and patients were di- vided into low risk group (n=24,0 score),medium risk group (n=78,1 score)and high risk group (n=104,2~9 scores).Modified Rankin scale (mRS)was used to assess patients'prognosis on three months after onset.According to mRS score,patients were divided into good prognosis group (n=89,0~2 scores)and poor prognosis group (n=117,3~6 scores).Independent predictors for poor prognosis in three months were analyzed.Results:Compared with low risk group,there were significant rise in age,percentages of hypertension,diabetes mellitus (DM),heart failure,stroke and vascular disease history,scores of United States national institutes of health stroke score (NIHSS) in medium and high risk groups (P<0.05 or <0.01).Compared with good prognosis group,there were significant rise in age [(72.81±7.68)years vs.(81.56±8.03)years],percentages of hypertension (58.4% vs.71.8%)and stroke history (9.0% vs.29.9%),scores of NIHSS [(2.97±1.42)scores vs.(7.67±3.92)scores]and CHA2DS2- VASc [(1.70±1.63)scores vs.(4.03±2.53)scores]in poor prognosis group,P<0.05 or <0.01. Multi-factor Logistic regression analysis indicated NIHSS score (high risk:OR=1.78,95%CI:1.27~2.56,P=0.001 ), CHA2DS2-VASc scores (high risk:OR=3.24,95%CI:1.32~6.98,P=0.001)and age (high risk:OR=1.23, 95%CI:1.07~1.54,P=0.01)were independent predictors for poor prognosis on three months in aged NVAF +ICS patients.Conclusion:CHA2DS2-VASc score is related to early improvement of patients with NVAF + ICS;age,scores of NIHSS and CHA2DS2-VASc are independent predictors for poor short-term prognosis.

OBJECTIVETo analyze the correlation between content of glycyrrhizic acid and the single nucleotide polymorphism of beta-amyrin synthase (bAS) in Glycyrrhiza uralensis.

METHODglycyrrhizic acid content in 80 samples of the cultivated G. uralensis were determined by HPLC; According to the very significant level (P < 0.000 1), 80 samples in accordance with glycyrrhizic acid will be grouped by SAS 9.0; Using RT-PCR strategy to amplification the Open Reading Frame of beta-amyrin synthase with the template of total RNA extracted from roots of G. uralensis and then using DNAman to analyze the relationship between glycyrrhizic acid content and the single nucleotide polymorphism of beta-amyrin synthase (bAS).

RESULTThere exited two mutation sites 94 bp and 254 bp, G/A conversion occurred at 94 bp site, which belonged to a missense mutation. G/A conversion led to the corresponding amino acid conversion (Gly --> Asp); C/T conversion occurred at 254 bp site, which belonged to a synonymous mutation. According to sequence variation, the samples were divided into four genotypes: G-T genotype, A-T genotype, G/A-C genotype and G-T genotype.

CONCLUSIONA-T genotype, G/A-C genotype and G-T genotype are correlated with the high content of glycyrrhizic acid.

Genotype ; Glycyrrhiza uralensis ; enzymology ; genetics ; metabolism ; Glycyrrhizic Acid ; metabolism ; Intramolecular Transferases ; genetics ; Polymorphism, Single Nucleotide ; Reproducibility of Results

Objective To investigate the expression of ferroptosis-related proteins in the hippocampus in AD mice. Methods AD mice were created by knocking in PSEN1 p.G378E gene in C57BL/6 mice. The expression of ferroptosis-related proteins, glutathione peroxidase 4 (GPX4), cystine-glutamate exchanger (SLC7A11), long-chain fattyacyl-CoA synthetase 4 (ACSL4) and phosphatidylethanolamine-binding protein1 (PEBP1) in the hippocampus were compared among PSEN1 p.G378E-/-、 PSEN1 p.G378E-/+and WT mice. Results The expression levels of GPX4, PEBP1, SLC7A11 and ACSL4 proteins in the hippocampus were significantly increased in PSEN1 p.G378E-/-mice than in either PSEN1 p.G378E-/+or WT mice (P<0.05). Meanwhile, the expression levels of GPX4 and PSEN1 proteins were higher in PSEN1 p.G378E-/+mice than in WT mice (P<0.05). However, there were no significant differences in expression levels of SLC7A11 and ACSL4 proteins between PSEN1 p.G378E-/+mice and WT mice (P>0.05). Conclusion Expression levels of ferroptosis-related proteins are significantly increased in the hippocampus of PSEN1 p.G378E knock-in mice.

This study was aimed to assess the agreement between pulse pulmonary arterial oxygen saturation (StO2) by oximetry in trachea and the mixed venous oxygen saturation (SvO2) by fiberoptic pulmonary arterial catheter, and to evaluate the accuracy of StO2 monitoring during hypoxia. 10 mongred dog's were used. After anesthesia was induced and thorax was opened, we placed a fiberoptic pulmonary artery catheter directly through the dog's right ventricular outlet. Then, we placed and adjusted the trachea catheter, attached the oximetry probe to trachea carina till the high quality StO2 PPG signal was obtained, and till the readings were stable at about +/-2% from fiberoptic catheter. The pair readings of StO2 and SvO2 were recorded at every minute interval in 10 minutes when circulation was stable. Decreasing the inhaled oxygen concentration till the tongue's SpO2 decreased to 60%; recording the changes of StO2 and SvO2 in every 5% drop of tongue's SpO2 when the tongue's SpO2 decreased from 100% to 50%. The results showed that there was a good agreement between the two methods for pulmonary arterial oxygen saturation measurement. However, the difference between the two methods was great and unacceptable during the presence of hypoxia.
Animals ; Catheterization, Swan-Ganz ; methods ; Dogs ; Female ; Hypoxia ; blood ; Male ; Monitoring, Physiologic ; methods ; Oximetry ; instrumentation ; methods ; Oxygen ; blood ; Pulmonary Artery ; Trachea

Sarcopenia is becoming one of the challenges that is associated with worse quality of life and death.Accurate evaluation of skeletal muscle quantity and quality is the most important for the screening and diagnosing sarcopenia.Compared with other imaging evaluation methods, ultrasound examination is a portable, no-ionizing radiation and inexpensive technique, and especially has a high repeatability.After a comprehensive overview of the imaging tests assessing skeletal muscle, this review summarized ultrasound examination requirements for assessing skeletal muscle, measurement parameters, and future perspectives.

Objective:To develop a Beijing norm of Memory and Executive Screening (MES) scale to facilitate its further promotion and application in the future.Methods:Study subjects were selected based on the inclusion and exclusion criteria, including patients who visited the memory clinic of Xuanwu Hospital of Capital Medical University from March 20, 2017 to January 6, 2021, and normal people recruited simultaneously from community, and trained and qualified investigators conducted questionnaire surveys through face-to-face interviews. Then strict quality control, data collection and statistical analysis were performed.Results:A total of 607 participants were included, including 239 normal people, 293 individuals with subjective cognitive decline (SCD), and 75 individuals with mild cognitive impairment (MCI). There was a negative correlation between the scores of MES and age ( r=-0.19, P<0.001), but a positive correlation between scores of MES and education level ( r=0.29, P<0.001). The optimal cut-off value of this scale in Beijing was 86 points, the area under curve (AUC) of the cut-off value to distinguish MCI was 0.847 (normal people vs MCI) and 0.826 (SCD vs MCI), and after adding demographic variables, AUC showed slight increase (0.847 to 0.850 and 0.826 to 0.847), whereas the differences were not statistically significant ( Znormal peoplevsMCI=0.49, ZSCDvsMCI=1.21, P>0.05). And there was no statistically significant difference between MES and Montreal Cognitive Assessment scales in diagnostic power for normal people and people with MCI ( Zscale alone=1.03, Zafter adding demographic variables=1.13, P>0.05). Conclusions:The MES scale has a better distinguishing power for MCI, and its optimal cut-off value in Beijing is 86 points, which is different from previous studies. In the future, the sample size needs to be further expanded to verify this norm.

Objective:To investigate the clinical features and prognosis of male with anti-melanoma differentiation-associated gene 5 (MDA5) autoantibody.Methods:The clinical data of 246 patients with DM and anti-MDA5 autoantibodies hospitalized by Jiangsu Myositis Cooperation Group from 2017 to 2020 were collected and retrospectively analyzed. Chi-square test was performed to compared between counting data groups; Quantitative data were expressed by M ( Q1, Q3), and rank sum test was used for comparison between groups; Single factor survival analysis was performed by Kaplan-Meier method and Log rank test; Cox regression analysis were used for multivariate survival analysis. Results:①The male group had a higher proportion of rash at the sun exposure area [67.1%(47/70) vs 52.8%(93/176), χ2=4.18, P=0.041] and V-sign [50.0%(35/70) vs 30.7%(54/176), χ2=8.09, P=0.004] than the female group. The male group had higher levels of creatine kinase [112(18, 981)U/L vs 57 (13.6, 1 433)U/L, Z=-3.50, P<0.001] and ferritin [1 500 (166, 32 716)ng/ml vs 569 (18, 14 839)ng/ml, Z=-5.85, P<0.001] than the female group. The proportion of ILD [40.0%(28/70) vs 59.7%(105/176), χ2=7.82, P=0.020] patients and the red blood cell sedimentation rate[31.0(4.0, 101.5)mm/1 h vs 43.4(5.0, 126.5)mm/1 h, Z=-2.22, P=0.026] in the male group was lower than that of the female group, but the proportion of rapidly progressive interstitial lung disease (PR-ILD) [47.1%(33/70) vs 31.3%(55/176), χ2=5.51, P=0.019] was higher than that of the female group. ②In male patients with positive anti-MDA5 antibodies,the death group had a shorter course of disease[1.0(1.0, 3.0) month vs 2.5(0.5,84) month, Z=-3.07, P=0.002], the incidence of arthritis [16.7%(4/24) vs 42.2%(19/45), χ2=4.60, P=0.032] were low than those in survival group,while aspartate aminotransferase (AST)[64(22.1, 565)U/L vs 51(14,601)U/L, Z=-2.42, P=0.016], lactate dehydrogenase (LDH) [485(24,1 464)U/L vs 352(170, 1 213)U/L, Z=-3.38, P=0.001], C-reactive protein (CRP) [11.6(2.9, 61.7) mg/L vs 4.95(0.6, 86.4) mg/L, Z=-1.96, P=0.050], and ferritin levels [2 000(681, 7 676) vs 1 125 (166, 32 716)ng/ml, Z=-3.18, P=0.001] were higher than those in the survival group, and RP-ILD [95.8%(23/24) vs 22.2%(10/45), χ2=33.99, P<0.001] occurred at a significantly higher rate. ③Cox regression analysis indicated that the course of disease LDH level, and RP-ILD were related factors for the prognosis of male anti-MDA5 antibodies [ HR (95% CI)=0.203(0.077, 0.534), P=0.001; HR (95% CI)=1.002(1.001, 1.004), P=0.003; HR (95% CI)=95.674 (10.872, 841.904), P<0.001]. Conclusion:The clinical manifestations of male anti-MDA5 antibody-positive patients are different from those of female. The incidence of ILD is low, but the proportion of PR-ILD is high. The course of disease, serum LDH level, and RP-ILD are prognostic factors of male anti-MDA5 antibody-positive patients.

BACKGROUNDLupus nephritis (LN) is one of the most serious manifestations of systemic lupus erythematosus. Although there have been substantial improvements in LN treatment over the last decade, the outcome remains unoptimistic in a considerable percentage of patients. The aim of this study was to evaluate the efficacy and safety of mizoribine (MZR), a novel selective inhibitor of inosine monophosphate dehydrogenase, as induction treatment for active LN in comparison with mycophenolate mofetil (MMF) and intravenous cyclophosphamide (CYC).

METHODSNinety patients with active LN were observed. Thirty patients were given MZR orally at the dose of 300 mg every other day. Thirty patients took MMF at 2 g per day in two divided doses. Thirty patients received CYC intravenously 0.5 g every 2 weeks. Therapeutic effects and adverse events (AEs) were evaluated at the end of 24-week treatment. One-way analysis of variance (ANOVA) followed by Dunn's test was applied to compare the difference among the groups. For comparing categorical data between two groups, χ(2) test was employed.

RESULTSEarly responses at week 12 were achieved by 73.3%, 90.0%, and 96.7% in MZR, MMF, and CYC groups, respectively. There was no significant difference in the complete remission rates (22.7%, 24.0%, and 25.0%, respectively) or overall response rates (68.2%, 72.0%, and 75.0%, respectively) among the three groups at week 24. The most prominent drop-down of Systemic Lupus Erythematosus Disease Activity Index scores was observed in MMF or CYC group, and the decline of health assessment questionnaire scores in MZR or MMF group was more prominent than that in the CYC group at week 12. Serum complement 3 (C3) or C4 levels were elevated in all groups after the treatments. CYC was more effective in inhibiting anti-double-stranded DNA antibody, while MZR was more effective in inhibiting antinuclear antibody. The incidences of AEs in patients treated with CYC were significantly higher than those in patients treated with MZR or MMF (24.2% for CYC vs. 3.3% for MZR, and 2.6% for MMF, P = 0.01).

CONCLUSIONSMZR is well tolerated and has an effect similar to MMF in the induction therapy of active LN. MZR may serve as an alternative approach for LN patients.

Administration, Intravenous ; Adolescent ; Adult ; Aged ; Cyclophosphamide ; administration & dosage ; therapeutic use ; Enzyme Inhibitors ; administration & dosage ; therapeutic use ; Female ; Humans ; Immunosuppressive Agents ; administration & dosage ; therapeutic use ; Lupus Nephritis ; drug therapy ; Male ; Middle Aged ; Mycophenolic Acid ; administration & dosage ; therapeutic use ; Ribonucleosides ; administration & dosage ; therapeutic use ; Treatment Outcome ; Young Adult