Objective To evaluate the clinical characteristics of human immunodeficiency virus (HIV) infected patients with peripheral lung masses (PLMs), and to assess the diagnostic utility of contrast-enhanced ultrasound (CEUS) in differentiating benign and malignant PLMs. Methods A retrospective analysis was performed on the clinical data of 69 patients with PLM treated in Shanghai Public Health Clinical Center from January 2020 to December 2023. All patients underwent percutaneous biopsy, and were categorized into benign group (n＝36) and malignant group (n＝33). 25 patients were HIV-positive and 44 patients were HIV-negative. The clinical features and CEUS parameters in patients were compared across these groups. Results Patients with malignant masses were significantly older than those with benign masses (P＜0.05). In the malignant group, HIV-negative patients exhibited significantly larger tumor diameters compared to HIV-positive patients (P＜0.05); in the HIV-positive patients, no significant difference in tumor size was observed between benign and malignant masses. 19 patients underwent CEUS. 10 malignant masses, irrespective of HIV status (10 positive and 9 negative), commonly presented with indistinct margins, delayed enhancement, heterogeneous perfusion, and delayed peak enhancement on CEUS. 9 benign masses showed earlier peak enhancement compared to 10 malignant masses (P＜0.05); no significant differences were observed in the initiation and washout time of enhancement between benign and malignant masses. In HIV-positive patients, 5 benign masses frequently demonstrated discrepancies between CEUS findings and pathological results. Conclusions The clinical and CEUS characteristics were different between benign and malignant PLMs. However, CEUS shows limited accuracy in distinguishing benign and malignant PLMs, underscoring the need for pathological confirmation.

Objective To explore the mechanism of Glaucocalyxin A(GLA)in inhibiting ovalbumin(OVA)-induced airway remodeling in asthmatic mice through the topoisomerase Ⅱ α(TOP2A)/cyclin-dependent kinase 1(CDK1)signaling pathway.Methods Forty Balb/c mice were randomly divided into 5 groups:the control group,the model group,the low-dose GLA group,the high-dose GLA group and the Dexamethasone group,with 8 mice in each group.The effect of GLA on airway remodeling was examined by immunohistochemical staining,ELISA and other methods,and bioinformatics methods were used to predict new targets of GLA.The action targets of TOP2A were screened using the STRING database,and the interaction relationship between the two was verified by co-immunoprecipitation.In vitro,GLA and siRNA were used to interfere with interleukin-4(IL-4)-stimulated human airway epithelial cells BEAS-2B.The expressions of TOP2A,epidermal growth factor receptor(EGFR),Integrin β1,focal adhesion kinase(FAK),β-catenin,CDK1 and DRP1 were detected by Western Blot.Results GLA intervention could significantly reduce OVA-induced asthma airway remodeling,airway smooth muscle thickening,collagen deposition around the airway,the number of eosinophils in alveolar lavage fluid,the expression of pro-inflammatory cytokines such as IL-4,and the level of serum IgE.The new target of GLA screened out was TOP2A,which was highly expressed in the lung tissue of the asthma airway remodeling model.GLA intervention could down-regulate its expression.In vitro,intervention with GLA and si-TOP2A could significantly down-regulate the expressions of IL-4-induced TOP2A,EGFR,Integrin β1,FAK and β-catenin.Further studies have found that TOP2A had an interaction relationship with CDK1.si-TOP2A could downregulate the expression of CDK1,and knockdown of CDK1 could significantly down-regulate the expression of phosphorylated DRP1.Conclusion GLA may alleviate asthma airway remodeling by targeting the TOP2A/CDK1 signaling pathway,providing experimental evidence for the clinical diagnosis and treatment of asthma airway remodeling in asthma.

Objective:To explore the effects of medication interval on the quality of split-dose bowel preparation and analyze the independent risk factors affecting the quality of bowel preparation.Methods:This pilot study involved two centers. Adult outpatients who underwent screening, surveillance, and diagnostic colonoscopy in the First Affiliated Hospital of Naval Medical University ( n=46) and the Fifth Hospital of Zhangjiakou ( n=20) between April and June 2023 were enrolled. Bowel preparation was conducted based on the guideline. Patients were divided into the short-interval group (4-<10 hours, n=45) and the long-interval group (10-16 hours, n=21) based on the time between the two administrations of polyethylene glycol during bowel preparation. Differences in terms of patient-reported outcome measurements (patient-reported willingness to repeat the bowel preparation regimen, satisfaction with bowel preparation, satisfaction with sleep), defecation frequency, Boston bowel preparation scale scores, bowel preparation bubble scores, bowel preparation qualified rates, polyp detection rates and incidence of adverse events were compared. Relevant factors influencing bowel preparation quality were analyzed by univariate logistic regression. Results:There were no significant differences in patient-reported willingness to repeat the bowel preparation regimen [88.9% (40/45) VS 85.7% (18/21), χ2<0.001, P>0.999], the satisfaction with bowel preparation [65.9% (29/45) VS 57.1% (12/21), χ2=0.469, P=0.493], or the satisfaction with sleep quality [35.6% (16/45) VS 28.6% (6/21), χ2=0.314, P=0.575] between the short-interval and long-interval groups. Similarly, no significant differences were observed between the groups in defecation frequency (11.3±4.8 VS 10.2±4.4, t=0.861, P=0.395), Boston bowel preparation scale scores (8.2±1.4 scores VS 7.9±1.2 scores, t=1.024, P=0.311), bowel preparation bubble scores (8.6±1.0 scores VS 8.4±1.5 scores, t=0.672, P=0.506), bowel preparation qualified rates [88.9% (40/45) VS 90.5% (19/21), χ2<0.001, P>0.999], polyp detection rates [33.3% (15/45) VS 47.6% (10/21), χ2=1.242, P=0.265], or incidence of adverse events [24.4% (11/45) VS 14.3% (3/21), χ2=0.381, P=0.537]. Univariate logistic analysis suggested that a low-fiber diet ( OR=8.100, 95% CI:1.400-46.849, P=0.019) was an influencing factor for qualified bowel preparation. Conclusion:Medication interval of the two doses of polyethylene glycol in a split-dose bowel preparation regimen for colonoscopy has no significant impact on bowel preparation quality. Notably, preoperative low-fiber diet emerges as an independent protective factor for qualified bowel preparation.

Objective To explore the mechanism of Glaucocalyxin A(GLA)in inhibiting ovalbumin(OVA)-induced airway remodeling in asthmatic mice through the topoisomerase Ⅱ α(TOP2A)/cyclin-dependent kinase 1(CDK1)signaling pathway.Methods Forty Balb/c mice were randomly divided into 5 groups:the control group,the model group,the low-dose GLA group,the high-dose GLA group and the Dexamethasone group,with 8 mice in each group.The effect of GLA on airway remodeling was examined by immunohistochemical staining,ELISA and other methods,and bioinformatics methods were used to predict new targets of GLA.The action targets of TOP2A were screened using the STRING database,and the interaction relationship between the two was verified by co-immunoprecipitation.In vitro,GLA and siRNA were used to interfere with interleukin-4(IL-4)-stimulated human airway epithelial cells BEAS-2B.The expressions of TOP2A,epidermal growth factor receptor(EGFR),Integrin β1,focal adhesion kinase(FAK),β-catenin,CDK1 and DRP1 were detected by Western Blot.Results GLA intervention could significantly reduce OVA-induced asthma airway remodeling,airway smooth muscle thickening,collagen deposition around the airway,the number of eosinophils in alveolar lavage fluid,the expression of pro-inflammatory cytokines such as IL-4,and the level of serum IgE.The new target of GLA screened out was TOP2A,which was highly expressed in the lung tissue of the asthma airway remodeling model.GLA intervention could down-regulate its expression.In vitro,intervention with GLA and si-TOP2A could significantly down-regulate the expressions of IL-4-induced TOP2A,EGFR,Integrin β1,FAK and β-catenin.Further studies have found that TOP2A had an interaction relationship with CDK1.si-TOP2A could downregulate the expression of CDK1,and knockdown of CDK1 could significantly down-regulate the expression of phosphorylated DRP1.Conclusion GLA may alleviate asthma airway remodeling by targeting the TOP2A/CDK1 signaling pathway,providing experimental evidence for the clinical diagnosis and treatment of asthma airway remodeling in asthma.

Objective:To explore the effects of medication interval on the quality of split-dose bowel preparation and analyze the independent risk factors affecting the quality of bowel preparation.Methods:This pilot study involved two centers. Adult outpatients who underwent screening, surveillance, and diagnostic colonoscopy in the First Affiliated Hospital of Naval Medical University ( n=46) and the Fifth Hospital of Zhangjiakou ( n=20) between April and June 2023 were enrolled. Bowel preparation was conducted based on the guideline. Patients were divided into the short-interval group (4-<10 hours, n=45) and the long-interval group (10-16 hours, n=21) based on the time between the two administrations of polyethylene glycol during bowel preparation. Differences in terms of patient-reported outcome measurements (patient-reported willingness to repeat the bowel preparation regimen, satisfaction with bowel preparation, satisfaction with sleep), defecation frequency, Boston bowel preparation scale scores, bowel preparation bubble scores, bowel preparation qualified rates, polyp detection rates and incidence of adverse events were compared. Relevant factors influencing bowel preparation quality were analyzed by univariate logistic regression. Results:There were no significant differences in patient-reported willingness to repeat the bowel preparation regimen [88.9% (40/45) VS 85.7% (18/21), χ2<0.001, P>0.999], the satisfaction with bowel preparation [65.9% (29/45) VS 57.1% (12/21), χ2=0.469, P=0.493], or the satisfaction with sleep quality [35.6% (16/45) VS 28.6% (6/21), χ2=0.314, P=0.575] between the short-interval and long-interval groups. Similarly, no significant differences were observed between the groups in defecation frequency (11.3±4.8 VS 10.2±4.4, t=0.861, P=0.395), Boston bowel preparation scale scores (8.2±1.4 scores VS 7.9±1.2 scores, t=1.024, P=0.311), bowel preparation bubble scores (8.6±1.0 scores VS 8.4±1.5 scores, t=0.672, P=0.506), bowel preparation qualified rates [88.9% (40/45) VS 90.5% (19/21), χ2<0.001, P>0.999], polyp detection rates [33.3% (15/45) VS 47.6% (10/21), χ2=1.242, P=0.265], or incidence of adverse events [24.4% (11/45) VS 14.3% (3/21), χ2=0.381, P=0.537]. Univariate logistic analysis suggested that a low-fiber diet ( OR=8.100, 95% CI:1.400-46.849, P=0.019) was an influencing factor for qualified bowel preparation. Conclusion:Medication interval of the two doses of polyethylene glycol in a split-dose bowel preparation regimen for colonoscopy has no significant impact on bowel preparation quality. Notably, preoperative low-fiber diet emerges as an independent protective factor for qualified bowel preparation.

Objective To identify the risk factors for postoperative cognitive dysfunction (POCD) in elderly patients undergoing total knee arthroplasty (TKA).Methods Ninety-six American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients,aged 65-80 yr,with body mass index of 18-25 kg/m2,undergoing elective TKA under total Ⅳ anesthesia,were divided into POCD group and non-POCD group according to whether POCD occurred on 7th day after surgery.The patient baseline characteristics in the perioperative period,plasma concentrations of interleukin-1beta (IL-1β),tumor necrosis factor-alpha (TNFα),neuron-specific enolase (NSE) and S-100β protein,and visual analogue scale (VAS) scores at 1 and 2 days after operation were recorded.Logistic regression analysis was used to identify the risk factors for POCD.Results Thirty-eight patients developed POCD at 7 days after operation,and the incidence was 39％.The results of logistic regression analysis showed that the number of operations,VAS score during activity at 1 day after operation,and concentrations of TNF-α,IL-1β,NSE and S-100β protein in plasma were risk factors for POCD (P＜0.05).Conclusion The number of operations,VAS score during activity at 1 day after operation,and concentrations of TNF-α,IL-1β,NSE and S-100β protein in plasma are risk factors for POCD in elderly patients undergoing TKA.

Objective To explore the application effects of three-dimensional teaching mode for clinical anesthesiology. Methods 43 students were selected into control group, who were from class one, grade 2010 in the Department of Anesthesiology, Ningxia Medical University. 42 students were selected into observation group, who were from class two, grade 2010 in the Department of Anesthesiology, Ningxia Medical University. The traditional teaching mode were used for the students in control group during the teaching of clinical anesthesiology, while three-dimensional teaching mode were used for the students in observation group during the teaching. At the end of teaching, the teaching results were compared between the control group and the observation group, mainly including the usual scores evaluated from an anaesthesia plan plus an anaesthesia case discussion, and the final scores. The teaching satisfaction questionnaire were used to assess the effects of two teaching methods on the students' interest in learning, the capacity of clin-ical practice, the abilities of exploring, analyzing and solving problems, etc. SPSS 17.0 software was used in statistical analysis. The students' teaching results were tested by using two independent samples t-test. The satisfactions of these teaching effects were tested by using the Chi-square test. Results The usual and final scores in the observation group were significantly higher than those in the control group [(88.1±5.1) vs. (75.3±4.2), (82.1±3.3) vs. (75.7±3.9); P<0.05]. Compared with the control group, the satisfactions of teaching effects in the observation group were higher such as to stimulate interest in learning (60.5% vs. 90.5%), to improve the abilities of self-study (30.2% vs. 83.3%) and clinical practice (51.2% vs. 85.7%), to widen the scope of knowledge (46.5% vs. 88.1%) and to cultivate the spirits of innovation (55.8% vs. 83.3%), etc (P<0.05). Conclusion During the teaching of clinical anesthesiology, the three-dimensional teaching mode has more advantages than the traditional one, which is good for improving the students' innovation and practice abilities.

Objective To evaluate the significance of serum 8-hydroxy-deoxyguanosine acid ( 8-OHdG) in the diagnosis of nonalcoholic steatohepatitis ( NASH).Methods Patients or healthy subjects were enrolled at the Second Hospital of Tianjin Medical University and the Second People ′s Hospital of Tianjin from May 2013 to December 2015.A total of 41 patients with nonalcoholic fatty liver disease were enrolled in the study , including 20 nonalcoholic simple fatty liver ( NAFL) patients and 21 NASH patients whose diagnosis were proven by liver biopsy.The other 32 healthy subjects were studied as controls.Serum 8-OHdG, ALT, AST and GGT were tested.Nonalcoholic fatty liver disease activity score ( NAS ) and expression of 8-OHdG in liver was investigated between NAFL patients and NASH patients.The correlations between serum 8-OHdG and serum ALT , AST, GGT, and 8-OHdG in liver tissue in NASH group were investigated.In addition , the receiver operating characteristic ( ROC) curve analyses for ALT and 8-OHdG levels were performed in NAFL patients and NASH patients , and the cut-off value was determined.Results Serum 8-OHdG values in healthy controls , NAFL and NASH patients were (0.19 ±0.16) μg/L, (0.22 ±0.16) μg/L, (0.42 ±0.21) μg/L respectively.The serum 8-OHdG and serum ALT, GGT and 8-OHdG in liver tissue were all positively correlated in NASH group with respective correlation coefficient r values as 0.454 7, 0.382 9, and 0.497 6.AUC of 8-OHdG was 0.901 with cut-off value 0.39 μg/L.Its sensitivity was 88.3%and specificity was 81.5%, which were higher than those of ALT.Conclusion The value of serum 8-OHdG would be used as a marker for the diagnosis of NASH.

Objective To compare the effects of propofol-based anesthesia versus sevoflurane-based anesthesia on postoperative cognitive dysfunction (POCD) in elderly patients with metabolic syndrome.Methods Ninety-four patients of both sexes,aged 65-80 yr,weighing 60-95 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective orthopedic surgery or gastrointestinal surgery under general anesthesia,were assigned to either propofol-based anesthesia group (group P,n =47) or sevoflurane-based anesthesia group (group S,n =47) using a random number table.Anesthesia was maintained by Ⅳ infusion of propofol 4-6 mg · kg-1 · h-1 in group P and by inhalation of 1％-2％ sevoflurane in group S.The bispectral index value was maintained between 40-60 during surgery.Cognitive function was evaluated using the Mini-Mental State Examination,trial making test and Digit Span Tests Forward and Backward at 1 day before surgery and 3 and 7 days after surgery.The occurrence of POCD was recorded at 3 and 7 days after surgery.Results There were no significant differences in Mini-Mental State Examination scores,trial making test time,Digit Span Tests Forward and Backward scores or incidence of POCD between group S and group P (P＞0.05).Conclusion The effects of propofol-based anesthesia and sevoflurane-based anesthesia on POCD are comparable in elderly patients with metabolic syndrome.

Objective To evaluate the role of spinal κ-opioid receptors in remifentanil-induced postoperative central sensitization in a rat model of incisional pain by in vivo electrophysiology.Methods Sixty adult male Sprague-Dawley rats in which intrathecal catheters were successfully implanted,weighing 230-270 g,were divided into 5 groups (n=12 each) using a random number table:control group (group C),incisional pain group (group I),remifentanil group (group R),remifentanil plus incisional pain group (group R+I),and κ-opioid receptor agonist U50488H group (group U).A 1 cm longitudinal incision was made through skin,fascia and muscle of the plantar aspect of the right hind paw in isofiurane-anesthetized rats to establish the model of incisional pain.Remifentanil was intravenously infused for 1 h at a rate of 10 μg · kg 1 · min-1 in group R.In group R+I,remifentanil was intravenously infused for 1 h at a rate of 10 μg · kg-1 · min 1,and the model of incisional pain was established at the same time.In group U,U50488H 10 μg/10μl was injected intrathecally,30 min later remifentanil was intravenously infused for 1 h at a rate of 10 μg · kg-1 · min-1,and the model of incisional pain was established.Six rats in each group were randomly selected,the mechanical pain threshold (MPT) was measured in bilateral hind paws before implanting intrathecal catheter (T0),before operation (T1),and at 1 h,4 h and 1,2 and 3 clays after operation (T2-6).Six rats in each group were randomly selected to record the C fiber-evoked filed potentials in the spinal dorsal horn from 60 min before administration or operation to 180 min after administration or operation,the long-term potentiation (LTP) induced was also recorded,and the area under the curve (AUC) of C-fiber-evoked field potentials was calculated.Results No LTP was recorded in C,I and U groups,and the LTP was recorded in R and R+I groups.Compared with group C,the MPT in bilateral hind paws at T5,6 was significantly decreased in group R,the MPT in ipsilateral hind paws at T2 6 was decreased in group I,the MPT in ipsilateral hind paws at T2-6 and in contralateral hind paws at T5,6 was decreased in group R+I,the MPT in ipsilateral hind paws at T2-4 was decreased in group U,and the AUC of C-fiber-evoked field potentials was increased in R and R+I groups (P＜0.05).Compared with group Ⅰ,the MPT in ipsilateral hind paws at T4-6 and in contralateral hind paws at T5,6 was significantly decreased,and the AUC of C-fiber-evoked field potentials was increased in group R+I (P＜0.05).Compared with group R+ I,the MPT in ipsilateral hind paws at T2-6 and in contralateral hind paws at T5,6 was significantly increased,and the AUC of C-fiber-evoked field potentials was decreased in group U (P＜0.05).Conclusion The results of in vivo electrophysiology confirm that inhibition of spinal κ-opioid receptor function mav be involved in the mechanism by which remifentanil induces postoperative central sensitization in a rat model of incisional pain.