Objective To investigate the efficacy of early, short-term, low-dose corticosteroid administration for the prevention and treatment of early acute lung injury (EALI) in patients undergoing thoracoscopic lobectomy. Methods A retrospective analysis was conducted on the clinical data of patients who underwent thoracoscopic lobectomy at the Department of Thoracic and Cardiovascular Surgery, Taihe Hospital, Hubei University of Medicine, from January 2019 to January 2022. Patients were divided into an early steroid therapy group and an observation group based on whether they received corticosteroids in the early postoperative period. In the early steroid therapy group, in addition to standard postoperative care, patients received a low-dose intravenous push of methylprednisolone (80-120 mg/d) for 3 consecutive days. In the observation group, patients received standard postoperative care without intravenous corticosteroids for the first 3 days. Chest plain CT scans were performed on postoperative day (POD) 1 and POD 3 or 4 to evaluate lung injury. CT scores and the incidence of postoperative EALI were recorded. Results A total of 521 patients were included (268 males, 253 females; age range: 11-80 years). There were 318 patients in the observation group and 203 in the early steroid therapy group. On POD 1, the incidence of EALI was 16.0% in the observation group and 13.8% in the early steroid therapy group, with no statistical difference (P=0.486). Correspondingly, there was no statistical difference in chest CT scores among EALI-positive patients between the two groups (P=0.927). On POD 3-4, the incidence of EALI was significantly lower in the early steroid therapy group (22.7%) compared to the observation group (33.6%) (P=0.007). Although chest CT scores among EALI-positive patients were lower in the early steroid therapy group, the difference was not statistically significant (P=0.377). The overall incidence of EALI within the first 4 postoperative days was significantly lower in the early steroid therapy group (26.1%) than in the observation group (37.4%) (P=0.007). Radiological progression (defined as new-onset EALI or progression of existing EALI) occurred in 14.8% of the early steroid therapy group, significantly lower than the 28.9% in the observation group (P<0.001). The early steroid therapy group had a shorter postoperative length of stay (P<0.001), while there was no statistical difference in the incidence of poor wound healing between the groups (P=0.762). Conclusion Early postoperative corticosteroid use effectively reduces the incidence of EALI on POD 3-4, lowers the risk of radiological progression, and decreases the overall incidence of postoperative EALI. This is achieved without prolonging the length of stay or increasing the risk of poor wound healing. Therefore, early administration of low-dose corticosteroids is beneficial in suppressing the occurrence and progression of EALI. Its early use is recommended for patients at high risk for postoperative EALI.

Objective To explore the recognition capabilities of electronic nose combined with machine learning in identifying the breath odor map of benign and malignant pulmonary nodules and Traditional Chinese Medicine (TCM) syndrome elements. Methods The study design was a single-center observational study. General data and four diagnostic information were collected from 108 patients with pulmonary nodules admitted to the Department of Cardiothoracic Surgery of Hospital of Chengdu University of TCM from April 2023 to March 2024. The patients' TCM disease location and nature distribution characteristics were analyzed using the syndrome differentiation method. The Cyranose 320 electronic nose was used to collect the odor profiles of oral exhalation, and five machine learning algorithms including random forest (RF), K-nearest neighbor (KNN), logistic regression (LR), support vector machine (SVM), and eXtreme gradient boosting (XGBoost) were employed to identify the exhaled breath profiles of benign and malignant pulmonary nodules and different TCM syndromes. Results (1) The common disease locations in pulmonary nodules were ranked in descending order as liver, lung, and kidney; the common disease natures were ranked in descending order as Yin deficiency, phlegm, dampness, Qi stagnation, and blood deficiency. (2) The electronic nose combined with the RF algorithm had the best efficacy in identifying the exhaled breath profiles of benign and malignant pulmonary nodules, with an AUC of 0.91, accuracy of 86.36%, specificity of 75.00%, and sensitivity of 92.85%. (3) The electronic nose combined with RF, LR, or XGBoost algorithms could effectively identify the different TCM disease locations and natures of pulmonary nodules, with classification accuracy, specificity, and sensitivity generally exceeding 80.00%.Conclusion Electronic nose combined with machine learning not only has the potential capabilities to differentiate the benign and malignant pulmonary nodules, but also provides new technologies and methods for the objective diagnosis of TCM syndromes in pulmonary nodules.

Objective:To explore common characteristics and core challenges in the family parenting process of preschool children, identify key issues in parenting practices in rural revitalization areas, and provide a reference for developing localized family intervention strategies in China.Methods:Using purposive sampling, caregivers of preschool children ( n=26) were recruited from a kindergarten in Shuangbai County, Chuxiong Yi Autonomous Prefecture, Yunnan Province, from May to August 2024. A descriptive qualitative research method was adopted. Directed content analysis and conventional content analysis were combined to analyze interview transcripts and family parenting records, extracting core themes and characteristic issues in parenting practices. Results:A total of 881 minutes of interviews were conducted, resulting in approximately 260 000 words of transcripts and text materials. A total of five core themes and 13 sub-themes were summarized, covering access to health information and scientific parenting knowledge, imbalance between parenting needs and objective resource supply, safety care, responsive care, and weak family collaboration systems.Conclusions:Families in rural revitalization areas currently face problems such as limited access to information, insufficient scientific parenting resources, and weak family collaboration functions. It is recommended to optimize parenting practices by deepening the integration of medical and educational resources, strengthening health information channels, and building an integrated "family-school-community" intervention framework.

Objective:To explore common characteristics and core challenges in the family parenting process of preschool children, identify key issues in parenting practices in rural revitalization areas, and provide a reference for developing localized family intervention strategies in China.Methods:Using purposive sampling, caregivers of preschool children ( n=26) were recruited from a kindergarten in Shuangbai County, Chuxiong Yi Autonomous Prefecture, Yunnan Province, from May to August 2024. A descriptive qualitative research method was adopted. Directed content analysis and conventional content analysis were combined to analyze interview transcripts and family parenting records, extracting core themes and characteristic issues in parenting practices. Results:A total of 881 minutes of interviews were conducted, resulting in approximately 260 000 words of transcripts and text materials. A total of five core themes and 13 sub-themes were summarized, covering access to health information and scientific parenting knowledge, imbalance between parenting needs and objective resource supply, safety care, responsive care, and weak family collaboration systems.Conclusions:Families in rural revitalization areas currently face problems such as limited access to information, insufficient scientific parenting resources, and weak family collaboration functions. It is recommended to optimize parenting practices by deepening the integration of medical and educational resources, strengthening health information channels, and building an integrated "family-school-community" intervention framework.

Objective To uncover and identify the differences in salivary microbiota profiles and their potential roles between patients with pulmonary nodules(PN)and healthy controls,and to propose new candidate biomarkers for the early warning of PN.Methods 16S rRNA amplicon sequencing was performed with the saliva samples of 173 PN patients,or the PN group,and 40 health controls,or the HC group,to compare the characteristics,including diversity,community composition,differential species,and functional changes of salivary microbiota in the two groups.Random forest algorithm was used to identify salivary microbial markers of PN and their predictive value for PN was assessed by area under the curve(AUC).Finally,the biological functions and potential mechanisms of differentially-expressed genes in saliva samples were preliminarily investigated on the basis of predictive functional profiling of Phylogenetic Investigation of Communities by Reconstruction of Unobserved States(PICRUSt2).Results The α diversity and βdiversity of salivary microbiota in the PN group were higher than those in the HC group(P＜0.05).Furthermore,there were significant differences in the community composition and the abundance of oral microorganisms between the PN and the HC groups(P＜0.05).Random forest algorithm was applied to identify differential microbial species.Porphyromonas,Haemophilus,and Fusobacterium constituted the optimal marker sets(AUC=0.79,95％confidence interval:0.71-0.86),which can be used to effectively identify patients with PN.Bioinformatics analysis of the differentially-expressed genes revealed that patients with PN showed significant enrichment in protein/molecular functions involved in immune deficiency and redox homeostasis.Conclusion Changes in salivary microbiota are closely associated with PN and may induce the development of PN or malignant transformation of PN,which indicates the potential of salivary microbiota to be used as a new non-invasive humoral marker for the early diagnosis of PN.

Objective: To investigate the correlation between serum lysosomal-associated membrane protein 2 (LAMP-2), LAMP-2 antibody levels and the progression of renal function in patients with chronic kidney disease (CKD). Methods: A total of 80 patients with CKD 3 to 5 stage (CKD group) and 50 healthy controls (control group) from August 2016 to August 2017 in Affiliated Dongfeng Hospital, Hubei University of Medicine were enrolled. The levels of hemoglobin, creatinine, urea, albumin, LAMP-2 and LAMP-2 antibody in fasting elbow venous blood of 2 groups were detected, and the estimate glomerular filtration rate (eGFR) was calculated. The CKD patients were followed up for 1 year, and renal function deterioration was defined as eGFR declined more than average value; the follow-up was over when the patients started dialysis or died, and those patients also defined as renal function deterioration. The patients were divided into high level group and low level group according to the serum LAMP-2 and LAMP-2 antibody levels. Results: The eGFR, hemoglobin and albumin in CKD group were significantly lower than those in control group: (24.60 ± 5.79) ml/min vs. (119.20 ± 9.52) ml/min, (111.36 ± 24.41) g/L vs. (144.60 ± 17.85) g/L and (36.83 ± 3.84) g/L vs. (45.92 ± 6.37) g/L, the creatinine, urea, LAMP-2 and LAMP-2 antibody were significantly higher than those in control group: (306.17 ± 49.24) μmol/L vs. (83.24 ± 5.55) μmol/L, (15.17 ± 3.39) mmol/L vs. (5.57 ± 1.33) mmol/L, (24.76 ± 5.47) μg/L vs. (12.93 ± 4.43) μg/L and (20.33 ± 4.89) μg/L vs. (9.98 ± 2.20) μg/L, and there were statistical differences (P<0.01). All 80 patients with CKD patients completed follow-up, and the follow-up time was 3 to 12 (8.14 ± 1.95) months. The eGFR at the end of followed-up was significantly lower than that at enrolment: (19.38 ± 7.30) ml/min vs. (24.60 ± 5.79) ml/min, the creatinine and LAMP-2 antibody at the end of followed-up were significantly higher than those at enrolment: (397.56 ± 52.32) μmol/L vs. (306.17 ± 49.24) μmol/L and (22.35 ± 4.74) μg/L vs. (20.33 ± 4.89) μg/L, and there were statistical differences (P<0.01); there were no statistical differences in hemoglobin, albumin, urea and LAMP-2 between the end of follow-up and enrollment (P>0.05). Among the 80 patients with CKD, renal function deterioration was in 42 cases, and renal function stability was in 38 cases. In renal function deterioration patients, the eGFR and urea at the end of followed up were significantly lower than those at enrolment: (18.28 ± 6.92) ml/min vs. (24.46 ± 5.76) ml/min and (13.51 ± 1.92) mmol/L vs. (14.81 ± 3.32) mmol/L, the creatinine, LAMP-2 and LAMP-2 antibody at the end of followed up were significantly higher than those at enrolment: (412.47 ± 53.21) μmol/L vs. (303.16 ± 47.87) μmol/L, (29.07 ± 5.42) μg/L vs. (25.89 ± 5.39) μg/L and (25.03 ± 3.30) μg/L vs. (20.95 ± 4.86) μg/L, and there were statistical differences (P<0.01 or <0.05); there were no statistical differences in hemoglobin and albumin between the end of follow-up and enrolment (P>0.05). In renal function stability patients, the eGFR at the end of follow-up was significantly lower than that at enrolment: (20.38 ± 7.58) ml/min vs. (24.73 ± 5.89) ml/min, the creatinine at the end of follow-up was significantly higher than that at enrolment: (381.07 ± 46.64) μmol/L vs. (309.49 ± 51.15) μmol/L, and there were statistical differences (P<0.01); there were no statistical differences in hemoglobin, albumin urea, LAMP-2 and LAMP-2 antibody between the end of follow-up and enrolment (P>0.05). In CKD patients, 38 cases were in LAMP-2 high level group (≥ 24.75 μg/L), and 42 cases were in LAMP-2 low level group (<24.75 μg/L); 38 cases were in LAMP-2 antibody high level group (≥ 20.33 μg/L), and 42 cases were in LAMP-2 antibody low level group (<20.33 μg/L). Kaplan-Meier curve analysis result showed that the renal function deterioration risk in LAMP-2 high level group was significantly higher than that in LAMP-2 low level group, LAMP-2 antibody high level group was significantly higher than that in LAMP-2 antibody low level group, and there were statistical differences (P<0.01). Conclusions Serum LAMP-2, LAMP-2 antibody levels are increased in patients with CKD, and higher serum LAMP-2 and LAMP-2 antibody levels may be associated with high risk of adverse kidney outcomes and become a promising marker to predict CKD progression.

Objective To observe the effect and the skin flap necrosis situation of low concentration methylene blue dye in sentinel lymph node biopsy of breast cancer compared with normal concentration methylene blue dye.Methods One hundred and thirty-eight cases patients with early breast cancer who were treat by sentinel lymph node biopsy surgery in Breast surgery Department of Sichuan ProvincialTumor Hospital from June 2016 to February were selected,and randomly divided into low concentration methylene blue dye group (n =69) and common concentration methylene blue dye group (n =69).Observed and recorded the sentinel lymph node detection and skin flap necrosis of relevance ratio(1％ and 0.1％ concentration methylene blue dye) concentration methylene blue dye in both two groups.Results There were no significant differences in terms of number of sentinel lymph node detection,the detection rate and false negative rate in two groups,while the rate of cutaneous necrosis in low concentration methylene blue dye group was lower (5.8％ vs.0％,P =0.025).Conclusion The effect of low concentration methylene blue dye in sentinel lymph node biopsy of breast cancer is the same as that of common concentration while the low concentration group with fewer side effects.

BACKGROUNDThe objective of this study was to analyze the trend in the publication of systematic reviews on hip fractures through a bibliometric approach.

METHODSLiterature including systematic reviews or meta-analyses on hip fractures was searched from the ISI Web of Science citation database. The search results were analyzed in terms of geographical authorship and frequency of citation by country, institution, author, and periodical distribution.

RESULTSA total of 654 published systematic reviews from 1995 to 2013 in 48 countries or regions were retrieved. The United States (171) was the predominant country in terms of the number of total publications, followed by the United Kingdom (149), Canada (120), Australia (76), and China (54). The number of systematic reviews significantly increased during the last 6 years, especially in China. The production ranking changed in 2012, at which time the United States and China were the leaders in the yearly production of systematic reviews on hip fractures. The amount of literature (27 publications) from China contributed almost one-quarter of the total literature (109 publications) in 2012. However, the average number of citations of each article from China was still low (6.70), while the highest number of citations of each article was from Sweden (193.36). The references were published in 239 different journals, with 15 journals contributing to 41.3% of the systematic reviews on hip fractures. The two journals that contributed the most were Osteoporosis International (10.6%) and the Cochrane Database of Systematic Reviews (7.6%). The predominant institution in terms of the number of publications was McMaster University (36) in Canada.

CONCLUSIONSThe best evidence in the field of hip fractures has attracted increasing attention. Systematic reviews on hip fractures from China have been increasingly more frequent during the past 6 years, particularly in 2012.

Bibliometrics ; Hip Fractures ; Humans ; Publications

OBJECTIVETo investigate the therapeutic efficacy and safety of salbutamol and dexamethasone added into large-volume whole lung lavage (WLL) fluid in patients with pneumoconiosis.

METHODSA total of 176 patients with pneumoconiosis were randomly divided into control group (n=86) and treatment group (n=90). The control group received WLL with 0.9% sodium chloride solution, while for the treatment group, salbutamol and dexamethasone were added into the WLL fluid for both lungs at the 1st and 4th WLLs.Before and after WLL, the pulmonary wheezing, arterial partial pressure of oxygen (Pa02), peak airway pressure(Pa peak), amount of intrapulmonary residual fluid, forced expiratory volume in one second (FEVw) (72 h later),diffusion capacity for carbon monoxide (DLCO ), and forced vital capacity (FVC) were measured for comparison between the two groups.

RESULTSAfter WLL, the treatment group had a significantly lower detection rate of pulmonary wheezing than the control group ( 13.3% vs 29.1 %, x2=5.028, ?=0.025), and the control group had a significantly higher incidence rate of pulmonary wheezing than the treatment group (21.8% vs 3.7%, 0R=5.423,95%CI 2.036-9.568 ). Compared with the control group, the treatment group had significantly higher Pa02 and significantly lower Pa peak and amount of intrapulmonary residual fluid (t =2.163 -4.132, P<0.05) and significantly higher FEV1, DLCO, and FVC (t=1.986-2.345, P<0.05) after WLL.

CONCLUSIONSalbutamol and dexamethasone added into large-volume WLL fluid may effectively alleviate bronchial spasm, reduce hypoxemia, and decrease Pa peak in patients with pneumoconiosis, thus promoting lung function recovery after WLL.

Adult ; Albuterol ; administration & dosage ; Bronchoalveolar Lavage ; Bronchoalveolar Lavage Fluid ; Dexamethasone ; administration & dosage ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; therapy ; Young Adult