Lung transplantation is the only effective treatment for end-stage lung disease. Acute kidney injury is a common complication after lung transplantation, which is related to the occurrence of chronic kidney disease and increased postoperative fatality. The factors and mechanisms affecting the occurrence of acute kidney injury are very complex. Clinically, it has been found that various risk factors during the perioperative period of lung transplantation may lead to the occurrence of acute kidney injury, including preoperative, intraoperative and postoperative factors. Early diagnosis of acute kidney injury after lung transplantation and timely intervention are of great significance to improving patient prognosis. Therefore, this article reviews the definition of acute kidney injury, non-invasive assessment, risk factors, prognosis, and clinical management of acute kidney injury after lung transplantation, aiming to provide a reference for the diagnosis and treatment of acute kidney injury after lung transplantation in clinical practice and to improve the survival rate of lung transplant recipients.

Lung transplantation is an effective treatment for various end-stage lung diseases. Optimizing perioperative fluid management can reduce the incidence of postoperative pulmonary edema and improve the prognosis of lung transplant recipients. Excessive fluid administration may lead to pulmonary edema, ischemia-reperfusion injury of the transplant lung, and increased cardiac burden, which can induce heart failure. On the other hand, overly strict fluid restriction may lead to hypovolemia, affecting tissue perfusion and causing organ dysfunction. Therefore, precise regulation of fluid balance is crucial for the postoperative recovery of lung transplant recipients. This article reviews the physiological characteristics of lung transplant recipients, types of infused fluids, fluid therapy regimens, and hemodynamic monitoring, aiming to elucidate the particularities of perioperative fluid management in lung transplantation and provide new ideas and directions for individualized fluid management.

Objective:To investigate the impact of neferine(NEF)on the blood-brain barrier in ischemic stroke(IS)rats by regulating the CC chemokine ligand 2(CCL2)-CC chemokine receptor 2(CCR2)signal pathway.Methods:SD rats were randomly divided into model group,low-dose NEF group(NEF-L group,25 mg/kg NEF),high-dose NEF group(NEF-H group,50 mg/kg NEF),and high-dose NEF+CCR2 antagonist group(NEF-H+RS102895 group,50 mg/kg NEF+10 mg/kg RS102895),sham opera-tion group(Sham group),with 15 rats in each group.The neurological function scores of rats in each group were compared.The perme-ability of blood-brain barrier of rats in each group was evaluated by Evans blue(EB)permeation method.The water content of brain tis-sue of rats in each group was determined by dry and wet weight method.The expression levels of CCL2 and CCR2 mRNA in rat brain tissue were measured by real-time fluorescence quantitative PCR(RT-qPCR).The expression levels of CCL2,CCR2,ZO-1 and Clau-din-5 proteins in rat brain tissue were detected by Western blot.Results:Compared with Sham group,the neural function score,EB content,water content,the expression levels of CCL2,CCR2 mRNA and protein in the right brain tissue of the model group were obvi-ously higher(P<0.05),the expression levels of ZO-1 and Claudin-5 were lower(P<0.05).Compared with the model group,the neuro-logical function score,water content,EB content,the expression levels of CCL2,CCR2 mRNA and protein in the right brain tissue of rats in the NEF-H group were obviously lower(P<0.05),the expression levels of ZO-1 and Claudin-5 were obviously higher(P<0.05).RS102895 enhanced the protective effect of NEF on the blood-brain barrier in IS rats.Conclusion:NEF may protect the blood-brain barrier of IS rats by inhibiting CCL2-CCR2 signal pathway.

Humans ; Aged ; Lung Diseases ; Pneumonia/drug therapy* ; Adrenal Cortex Hormones/therapeutic use* ; Pulmonary Disease, Chronic Obstructive/drug therapy* ; Administration, Inhalation ; Community-Acquired Infections/drug therapy*

Objective:To analyze the clinical characteristics and management strategies of the patients who were injured in winter snow sports in parts of Qingdao in order to provide useful information for "300 million people participating in ice and snow sports" .Methods:A retrospective study was conducted to analyze the data of 128 patients who had been admitted to Department of Orthopaedics, Qingdao Central Hospital for skiing injuries from November 2019 to March 2021. The gender, type, location and cause of injury, and treatment method of the patients were statistically analyzed.Results:Of the 128 patients, 72 were males and 56 females with an age of (32.0±12.1) years. Single injury accounted for 97.66% (125/128) while multiple injuries 2.34% (3/128). 46 injuries (35.11%, 46/131) due to single board skiing occurred in 44 patients (34.38%, 44/128); 85 injuries (64.89%, 85/131) due to double board skiing occurred in 84 cases (65.62%, 84/128). As for injury types, there were 44 cases (34.38%, 44/128) of soft tissue injury and 84 fractures (65.62%, 84/128). The top 3 injured locations were the lower leg (24.43%, 32/131), the peri-wrist part (18.32%, 24/131), and the peri-knee part (15.27%, 20/131). The most vulnerable location was, respectively, the wrist joint (26.09%, 12/46) in single board skiing and the calf (31.76%, 27/85) in double board skiing. The top three causes of injury were accidental fall (39.06%, 50/128), being struck by someone or emergency evacuation (14.84%, 19/128), and mismatched equipment models (12.50%, 16/128). The proportion of skiing beginners was as high as 76.56% (98/128). Surgical treatment was performed in 49 cases (38.28%, 49/128), and conservative treatment in 79 cases (61.72%, 79/128).Conclusions:The clinical characteristics of the patients who were injured in winter snow sports in parts of Qingdao are high proportions of skiing beginners, falls and fractures. Special attention needs to be paid to wrist protection in single board skiing and checking the ski disengagement device before double board skiing. Most patients may need only conservative treatment because although a number of patients required surgical treatment, severe multiple injuries were rare.

OBJECTIVE To compare the contents of the instructions of domestic and imported Chinese patent medicines as well as those from Hong Kong ，Macao and Taiwan ，and to explore the feasibility of Chinese patent medicines to strengthen the use of medicine according to disease differentiation . METHODS The domestic Chinese patent medicines included in national medical insurance list as well as imported Chinese patent medicines and those from Hong Kong ，Macao and Taiwan regions publicized on the official website of National Medical Products Administration were searched to statistically analyze the information of “functions”and“indications”in the instructions of Chinese patent medicines . RESULTS Finally，1 311 instructions of domestic Chinese patent medicine and 43 of imported Chinese patent regions were screened out . In the “functions”item contained in the instructions of Chinese patent medicines ，94.04% domestic Chinese patent medicines ，87.50% imported ones and those from Hong Kong ，Macao and Taiwan regions were expressed using the terms of traditional Chinese medicine ；4.89% and 12.50% were expressed using the terms of integrated Chinese and western medicine . The “functions” item were only expressed using the terms of western medicine in 1.07% of th e instructions of domestic Chinese patent medicines . The“functions” item was mostly expressed using the terms of integrated Chinese and western medicine in the instructions of imported Chinese patent medicines and those from Hong Kong ，Macao，and Taiwan regions ，but there was no expressed using the terms of western medicine alone . Among the expressions of “functions”item containing the terms of western medicine ，anti-inflammatory medicines accounted for the highest proportion ，and domestic Chinese patent medicines ，imported Chinese patent medicines and ones from Hong Kong ，Macao and Taiwan regions accounted for 37.18% and 75.00%，respectively. In the instructions of domestic Chinese patent medicines ，the“indications”item of which contained syndrome information accounted for 72.39%，and the instructions of imported Chinese patent medicines and those from Hong Kong ，Macao and Taiwan regions which did not include syndromes information accounted for 74.42%；in the instructions of domestic Chinese patent medicines ，imported ones and those from Hong Kong，Macao and Taiwan regions ，the“indications”item of which contained disease information ，accounted for 78.34% and 41.86%，respectively，and the “indications”item of which were mainly expressed using the terms of western medicine diseases ， accounted for 64.85% and 73.68%，respectively. CONCLUSIONS Most of the domestic Chinese patent medicines included in the national medical insurance list have the basis for the use of disease differentiation ；most of the imported Chinese patent medicines and those from Hong Kong ，Macao and Taiwan regions have the basis for the use of disease differentiation .

Algae are a large group of photosynthetic organisms responsible for approximately half of the earth's total photosynthesis. In addition to their fundamental ecological roles as oxygen producers and as the food base for almost all aquatic life, algae are also a rich source of bioactive natural products, including several clinical drugs. Cytochrome P450 enzymes (P450s) are a superfamily of biocatalysts that are extensively involved in natural product biosynthesis by mediating various types of reactions. In the post-genome era, a growing number of P450 genes have been discovered from algae, indicating their important roles in algal life-cycle. However, the functional studies of algal P450s remain limited. Benefitting from the recent technical advances in algae cultivation and genetic manipulation, the researches on P450s in algal natural product biosynthesis have been approaching to a new stage. Moreover, some photoautotrophic algae have been developed into "photo-bioreactors" for heterologous P450s to produce high-value added pharmaceuticals and chemicals in a carbon-neutral or carbon-negative manner. Here, we comprehensively review these advances of P450 studies in algae from 2000 to 2021.

Objective:To evaluate the correlation of community management index of essential hypertension and type 2 diabetes with the probability of premature mortality of major chronic diseases.Methods:From 2016 to 2018, the management of essential hypertension and type 2 diabetes were obtained from annual report of comprehensive prevention and control of chronic diseases in communities of Zhejiang province. The death data of chronic diseases were obtained from Information Management System of Chronic Diseases of Zhejiang province and annual population data were obtained from Public Security Bureau of Zhejiang Province. The management of essential hypertension and type 2 diabetes in communities of Zhejiang Province from 2016 to 2018 was described. The death status of major chronic diseases, including cardiovascular diseases, malignant tumors, diabetes and chronic respiratory diseases, in the same period was also described. Spearman correlation analysis and linear regression model were used to explore the correlation of community management of essential hypertension and type 2 diabetes with the probability of premature mortality of major chronic diseases.Results:The number of essential hypertension patients under standardized management, blood pressure control and regular medication increased from 3.127 3, 2.811 5 and 3.569 7 million in 2016 to 3.355 9, 3.151 8 and 4.010 6 million in 2018, respectively. The number of type 2 diabetes patients with standardized management, blood glucose control and regular medication increased from 0.805 5, 0.687 5 and 0.913 4 million in 2016 to 0.912 6, 0.798 7 and 1.064 8 million in 2018, respectively. The standardized mortality rate of chronic diseases decreased from 403.07/100 000 in 2016 to 380.07/100 000 in 2018. The proportion of premature deaths of chronic diseases decreased from 28.39% in 2016 to 26.90% in 2018. The proportion of deaths from major chronic diseases in all chronic diseases decreased from 90.96% in 2016 to 90.69% in 2018.The probability of premature mortality decreased from 10.68% in 2016 to 9.67% in 2018. The spearman correlation analysis showed that the blood pressure control and regular drug use were negatively correlated with the probability of premature death of major chronic diseases ( r values were -0.367 and -0.392; P values were 0.035 and 0.024). According to the linear regression model analysis, with increase of 100 000 of essential hypertension control cases or regular medication use cases of type 2 diabetes, the probability of premature death of major chronic diseases decreased by 0.47% (95% CI: 0.39%, 0.54%) or 1.31% (95% CI: 1.12%, 1.50%), respectively. Conclusion:From 2016 to 2018, the community management of essential hypertension and type 2 diabetes was negatively correlated with probability of premature death of major chronic diseases in Zhejiang province.

Objective:To evaluate the correlation of community management index of essential hypertension and type 2 diabetes with the probability of premature mortality of major chronic diseases.Methods:From 2016 to 2018, the management of essential hypertension and type 2 diabetes were obtained from annual report of comprehensive prevention and control of chronic diseases in communities of Zhejiang province. The death data of chronic diseases were obtained from Information Management System of Chronic Diseases of Zhejiang province and annual population data were obtained from Public Security Bureau of Zhejiang Province. The management of essential hypertension and type 2 diabetes in communities of Zhejiang Province from 2016 to 2018 was described. The death status of major chronic diseases, including cardiovascular diseases, malignant tumors, diabetes and chronic respiratory diseases, in the same period was also described. Spearman correlation analysis and linear regression model were used to explore the correlation of community management of essential hypertension and type 2 diabetes with the probability of premature mortality of major chronic diseases.Results:The number of essential hypertension patients under standardized management, blood pressure control and regular medication increased from 3.127 3, 2.811 5 and 3.569 7 million in 2016 to 3.355 9, 3.151 8 and 4.010 6 million in 2018, respectively. The number of type 2 diabetes patients with standardized management, blood glucose control and regular medication increased from 0.805 5, 0.687 5 and 0.913 4 million in 2016 to 0.912 6, 0.798 7 and 1.064 8 million in 2018, respectively. The standardized mortality rate of chronic diseases decreased from 403.07/100 000 in 2016 to 380.07/100 000 in 2018. The proportion of premature deaths of chronic diseases decreased from 28.39% in 2016 to 26.90% in 2018. The proportion of deaths from major chronic diseases in all chronic diseases decreased from 90.96% in 2016 to 90.69% in 2018.The probability of premature mortality decreased from 10.68% in 2016 to 9.67% in 2018. The spearman correlation analysis showed that the blood pressure control and regular drug use were negatively correlated with the probability of premature death of major chronic diseases ( r values were -0.367 and -0.392; P values were 0.035 and 0.024). According to the linear regression model analysis, with increase of 100 000 of essential hypertension control cases or regular medication use cases of type 2 diabetes, the probability of premature death of major chronic diseases decreased by 0.47% (95% CI: 0.39%, 0.54%) or 1.31% (95% CI: 1.12%, 1.50%), respectively. Conclusion:From 2016 to 2018, the community management of essential hypertension and type 2 diabetes was negatively correlated with probability of premature death of major chronic diseases in Zhejiang province.

Objective To analyze the clinical value of digital breast tomosynthesis (DBT) compared with digital mammography (DM) and ultrasound for diagnosing non-calcified masses in dense breasts.Methods Images taken with DBT,DM and ultrasound of 1144 patients with non-calcified masses in dense breasts were retrospectively analyzed using breast imaging reporting and data system (BI-RADS).Taking histopathologic results as golden standards,the detection rate and diagnostic accuracy,sensitivity,specificity,false negative and BI-RADS category were evaluated and compared statistically.Results The detection rate of DBT,DM and ultrasound for non-calcified massed in dense breasts was 86.62％ (991/1 144),77.80％ (890/1 144) and 99.65％ (1 140/1 144),respectively (P＜0.05),while the diagnostic accuracy was 83.92％ (960/1 144),75.00％ (858/1 144) and 94.67％ (1 083/1 144),respectively (P＜0.01).The sensitivity of DBT,DM and ultrasound was 89.39％ (312/349),79.93％ (231/289) and 92.70％ (432/466),the specificity was 81.51％ (648/795),73.33％ (627/855) and 96.02％ (651/678),while the false negative rate was 10.60％(37/349),20.07％ (58/289) and 7.30％ (34/466),respectively.No significant difference was found for benign lesions among three examination methods (P=0.75),while there was significant difference for malignant lesions among three examination methods (P＜0.01),and the differences of ultrasonography with DM and DBT,DBT and DM in the for BI-RADS category of malignant lesions were statistically significant (all P＜0.016 7).Conclusion For suspected masses in dense breasts,DBT shows significant advantage than DM,while DBT has the similar advantage compared with ultrasound for the detection and diagnosis of non-calcified masses in dense breasts.