Thoracic anesthesia with spontaneous respiration represents a form of precision anesthesia meticulously customized to individual patients.Considering the more stringent requirements this anesthesia approach imposes on the regulation of respiratory function,the writing group of the"Consensus of Experts on the Management of Thoracic Anesthesia with Spontaneous Respiration"has formulated elaborate guidelines regarding indications and contraindications,preoperative evaluation,anesthesia implementation,common complications,and treatment strategies.This was accomplished by referencing relevant domestic and international literature and integrating it with actual clinical requirements.The objective is to standardize the rational application of this anesthesia method.

Objective: To understand the influence of the concept of movement education on the fundamental motor skills of preschool children aged 3-6, so as to provide a reference for improving the quality of preschool education and promoting the all round development of preschool children. Methods: From August 2022 to June 2023, 592 normally developing preschool children aged 3- 6 in a certain kindergarten in Qingdao were selected as the research objects by convenience sampling. They were randomly divided into the intervention group (physical education activities designed based on the concept of movement education) and the control group (original teaching plan). The intervention lasted for 24 weeks (twice a week, 40 minutes each time). Test of Gross Motor Development-2 (TGMD-2) was used to evaluate the children s gross motor skills, and repeated measures analysis of variance was used to analyze the data of the two groups before and after the intervention. Results: Except for running and kicking, the group main effects ( F group =18.78-104.77), time main effects( F time =243.23-3 003.19), and other interactive effects between group and time ( F group×time =14.01-322.91) were of statistical significances for gross motor, movement motor, manipulative motor and each sub indicator between intervention group and control group. Further simple effect analysis results showed that, before intervention, there were no statistically significant differences in the total scores of gross motor (48.95±10.65,45.87±10.98), movement motor ( 25.93± 7.31,23.46±7.32) and manipulative motor (23.15±4.40,22.40±4.69) between the intervention group and the control group ( F=3.69, 2.94, 1.90, P >0.05); and two goups were also found of no statistical significance in the each sub indicator of movement and manipulative motor ( F=0.01-3.58, P >0.05); after intervention, the total scores of gross motor, movement motor, and manipulative motor in the intervention group (75.92±9.48, 38.12±5.40, 37.80±4.92) were all better than those in the control group ( 59.52± 12.12, 30.71±7.47, 28.81±5.54) ( F =168.15, 97.58, 210.71), and the total indicators of both goups had better scores than those before the intervention ( F intervention = 3 498.90 , 1 438.27, 2 431.24; F control =545.58, 309.18, 283.29)(all P <0.01); after intervention, the intervention group had better scores in all sub indicators (except for running and kicking) than the control group ( F =43.57-297.71), and the each sub indicator of both goups had better scores than those before the intervention ( F intervention = 300.58-858.65; F control =12.28-135.64)(all P <0.01). Conclusion Physical education activities designed based on the concept of movement education could better promote the development of children s fundamental motor skills.

Thoracic anesthesia with spontaneous respiration represents a form of precision anesthesia meticulously customized to individual patients.Considering the more stringent requirements this anesthesia approach imposes on the regulation of respiratory function,the writing group of the"Consensus of Experts on the Management of Thoracic Anesthesia with Spontaneous Respiration"has formulated elaborate guidelines regarding indications and contraindications,preoperative evaluation,anesthesia implementation,common complications,and treatment strategies.This was accomplished by referencing relevant domestic and international literature and integrating it with actual clinical requirements.The objective is to standardize the rational application of this anesthesia method.

[Objective]To explore how hyperthyroidism induces ventricular remodeling via activating β-catenin/FoxO1 in rat cardiomyocytes.[Methods]Hyperthyroidism-induced ventricular remodeling rat models were established by intraperitoneal injection of levothyroxine(T4)at 0.1 mg/kg for 30 days.β-catenin inhibitor MSAB(14 mg/kg)was admin-istrated for 30 days.We used western blot to detect the expression of myocardial hypertrophy marker ANP,β-catenin and FoxO1;immunofluorescence to examine the expression and intracellular distribution of β-catenin and FoxO1.Hyperthy-roidism-induced cardiomyocyte hypertrophy rat models were established by treatment of triiodothyronine(T3)into cul-tured primary neonatal rat cardiomyocytes for 24 hours.β-catenin siRNA(30 nmol/L)was used to down-regulate β-catenin expression in cardiomyocytes.Western blot and immunofluorescence were used to analyze the effects of β-catenin inhibition on the hyperthyroidism-induced cardiomyocyte hypertrophy.[Results]Following Wnt/β-catenin activation,β-catenin was found increased nuclear expression,to bind to the nuclear transcriptional factors and regulate the gene ex-pression.β-catenin nuclear expression was significantly increased in the hyperthyroidism-induced ventricular remodeling rats,but no change was found in the expression of typical transcriptional factor TCF7l2.Our results revealed that inhibiting β-catenin by MSAB attenuated the hyperthyroidism-induced rat ventricular remodeling.Further analysis indicated that β-catenin/FoxO1 expression was significantly increased in hyperthyroidism-induced myocardial hypertrophy which could be attenuated by suppressing β-catenin/FoxO1 in cardiomyocytes.[Conclusions]β-catenin/FoxO1 is activated in hyperthy-roidism-induced myocardial hypertrophy and β-catenin/FoxO1 inhibition attenuates hyperthyroidism-induced cardiomyo-cyte hypertrophy.

Objective To explore the effect of Naikan cognitive-music reminiscence therapy on coping style in female patients with chronic schizophrenia.Methods In May, 2020, 72 female patients with chronic schizophrenia from Beijing Huilongguan Hospital were assigned into control group (n = 48) and music group (n = 24) after trait matching. Both groups accepted routine medicine, while the control group accepted Naikan cognitive therapy, and the music group accepted Naikan cognitive therapy combined music reminiscence, for twelve weeks. They were blind assessed with Simplified Coping Style Questionnaire, Self-rating Depression Scale and Self-rating Anxiety Scale before and after intervention.Results There were five cases in the control group removed for erroneous response. The main effects of group were not significant for all the assessments (F < 0.567, P > 0.05). The main effect of time was significant for negative coping style score (F = 6.968, P = 0.01), and the interaction effects were significant for positive coping style score and Self-rating Depression Scale score (F > 4.227, P < 0.05).Conclusion Combining with music reminiscence, Naikan cognitive therapy may be advantageous for the coping style of female patients with chronic schizophrenia.

Objective:To explore the relationship between soft markers found in the first trimester (11-13 + 6 gestational weeks) ultrasound screening and fetal adverse pregnancy outcomes. Methods:Single pregnancy fetuses were selected from the Multicenter Clinical Study of First Trimester Screening in China during August 2017 to August 2020. The types and detection rate of soft markers during the first trimester were compared. The correlation between positive soft markers and adverse pregnancy outcomes was analyzed by binary Logistics regression.Results:A total of 16 625 fetuses with complete follow-up outcomes were included in the group. Six hundred and seven ultrasonic soft markers were detected in 556 fetuses with positive soft markers during the first trimester, and the first four most frequently occurred were increased nuchal translucency (NT) (2.08%, 345/16 625), echogenic intracardiac focus (EIF) (0.94%, 156/16 625), hypoplasia of fetal nasal bone (0.20%, 34/16 625), single umbilical artery (SUA) (0.19%, 31/16 625). Among 556 fetuses, the incidence of adverse pregnancy outcome in fetuses with two or more positive soft markers was 32.50% (13/40), which was significantly higher than fetuses with single positive soft marker (11.05%, 57/516), and the difference was statistically significant (χ 2=5.055, P<0.001). The incidence of adverse pregnancy outcome in positive soft markers fetus associated with structural abnormalities was 80.77% (21/26), which was significantly higher than fetuses with isolated positive soft marker (12.08%, 64/530), and the difference was statistically significant (χ 2=90.310, P<0.001). Binary logistic regression analysis showed choroid plexus cyst (CPC), SUA, echogenic bowel (EB), absent/reversed a-wave of ductus venosus, hypoplasia of fetal nasal bone, increased NT, and EIF were closely related to the adverse pregnancy outcomes (all P<0.05). However, there were no significant correlations between tricuspid regurgitation (TR), pyelectasis (PYE) and fetal adverse pregnancy outcomes (all P>0.05). Conclusions:The ultrasonic soft markers during the first trimester are of great significance in predicting fetal adverse pregnancy outcomes. For multiple positive soft markers or positive soft markers combined with structural abnormalities, more attention should be paid to them and comprehensive evaluation is required to be carried out.

Clinical data, nutrition support and 6-year follow-up results of a patient with Tricho-hepato-enteric syndrome (THES) diagnosed in the Children′s Hospital of Nanjing Medical University in December 2013 were analyzed.The patient suffered severe malnutrition, growth retardation, hypophosphatemia, hypoglobulinemia, high nutritional risk status and significant intestinal dysfunction.The genetic testing revealed SKIV2 L gene variation in this case of THES.During the acute exacerbation of diarrhea, enteral nutrition and periodical short-term parenteral nutrition were given as nutrition support.Deep-hydrolyzed formula by oral and low-fat, low-residue, high-quality-protein diet was given during the remission phase.At last, the diarrhea and nutritional status of the patient improved gradually.The growth and development, including neuromotor development of the case also caught up to children with the same age, and he was capable of schooling.It is suggested that rational individualized nutrition support can significantly improve intestinal function and nutritional status of children with THES, which overcome the dangerous period, improve the quality of life and prolong the survival time.

OBJECTIVE:To observe the efficacy and safety of amiodarone combined with valsartan in the treatment of paroxys-mal atrial fibrillation in elderly patients. METHODS:130 elderly patients with paroxysmal atrial fibrillation were randomly divided into observation and control group. Control group was orally given Amiodarone tablet 0.6 g in the first week,3 times a day,0.4 g in the second week,twice a day,0.2 g in the third week,twice a day;observation group was additionally given valsartan capsule 0.4 g in the first 1-3 day(s),once a day,the dose was increased to 0.8 g if patients showed no hypotension,once a day,and then decreased to 0.4 g if the pressure was lower than 100/60 mm Hg,once a day. The treatment course for both groups was 12 weeks. Clinical efficacy,and left atrium(LA),left ventricular end-diastolic volume(LVEDV),left ventricular systolic volume(LVESV), left ventricular ejection fraction (LVEF),heart rate,cardiothoracic ratio,systolic blood pressure,diastolic blood pressure before and after treatment,and incidence of adverse reactions in 2 groups were observed. RESULTS:Total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P<0.05). After treatment,LA, LVEDV and LVESV,heart rate,cardiothoracic ratio,systolic blood pressure,diastolic blood pressure in 2 groups were significant-ly lower than before,and observation group was lower than control group,LVEF was significantly higher than before,and observa-tion group was higher than control group,the differences were statistically significant(P<0.05). There was no significant differ-ence in the incidence of adverse reactions(P>0.05). CONCLUSIONS:The efficacy of amiodarone combined with valsartan is more obvious than only amiodarone in the treatment of paroxysmal atrial fibrillation in elderly patients,with similar safety.

Objective:To evaluate the clinical efficacy and safety of Danhong injections in the adjuvant therapy for angina pecto-ris. Methods:According to a random number table,totally 120 cases of patients with angina pectoris were randomly divided into the observation group and the control group. The control group was treated with the conventional therapy,such as oxygen uptake,anti-in-flammation,expectoration and relieving asthma,and the observation group was treated with Danhong injections(30ml added in 250ml glucose infusions,ivd,qd)additionally. The treatment course was 2 weeks. The hemorheology and blood lipid changes before and af-ter the treatment were recorded,the ECG was analyzed and the clinical symptom improvement was evaluated in the two groups. Re-sults:After the treatment,the hemorheological indices of the two groups were significantly reduced(P<0. 01),and the improvement of the observation group was much better than that of the control group(P<0. 01). After the treatment,the TC,TG and LDL were significantly lower and the HDL was notably higher than those before the treatment in the two groups(P<0. 01),and the improvement of the observation group was significantly better than that in the control group(P<0. 01). The total efficiency of ECG and clinical symptom improvement in the observation group was significantly higher than that in the control group(P<0. 05). Conclusion:Dan-hong injections in the treatment of angina pectoris can significantly improve the hemorheology and blood lipid to enhance the clinical ef-ficacy,which are worthy of promoted application.

AIM: To investigate the effect of 17?-estradiol(E2) on myocardial hypertrophy induced by endothelin-1(ET-1) and the related mechanism.METHODS: Myocardial cells from neonate rats were cultured in vitro and myocardial hypertrophy model was established with ET-1.The effects of 17?-estradiol on myocardial hypertrophy were observed.The role of ERK1/2 in the effects of 17?-estradiol was also detected.RESULTS: Compared with control group,ET-1 increased cell protein content,cell surface area and -Leucine(-Leu) incorporation.Pretreatment with E2 for 24 h could inhibit the increase in cell protein content,cell surface area and -Leu incorporation induced by ET-1.ET-1 significantly stimulated ERK1/2 activity,which was prevented by pretreatment with E2.Tamoxifen,estradiol receptor antagonist,partially inhibited the effect of E2.The ability of ET-1 to stimulate -Leu incorporation was significantly blocked by PD98059,which could enhance the inhibitory effect of E2 on the increase of -Leu incorporation in cardiomyocytes induced by ET-1.CONCLUSION: E2 can inhibit cardiomyocyte hypertrophy induced by ET-1.This effect is mediated by estrogen receptor.ERK1/2 signal pathway is closely correlated with the inhibitory effect of E2 on cardiomyocyte hypertrophy induced by ET-1.