Objective To explore the effect of different ventilation modes during laparoscopic radical resection of colorectal cancer(LRRCC)on respiratory function in patients with complicated mild obstructive ventilatory disorder(OVD).Methods 68 patients with mild OVD who underwent elective LRRCC from June 2022 to March 2024 were randomly divided into a volume controlled ventilation(VCV)group(n=34,with intraoperative VCV)and a pressure controlled ventilation-volume guaranteed(PCV-VG)mode group(n=34,with intraoperative PCV-VG).Changes in hemodynamics[mean arterial pressure(MAP)and heart rate(HR)],blood gas indicators[partial pressure of carbon dioxide in arterial blood(PaCO2)and arterial partial pressure of oxygen(PaO2)],lung exchange function indicators[oxygenation index(OI),alveolar-arterial oxygen partial pressure difference(PA-aO2)],respiratory mechanics indicators[tidal volume,end-tidal carbon dioxide partial pressure(PetCO2),peak airway pressure(Ppeak),and dynamic lung compliance(Cldyn)]before pneumoperitoneum(T1),30 min after establishing pneumoperitoneum(T2),1 h after pneumoperitoneum(T3),and 20 min after the end of pneumoperitoneum(T4)were observed in both groups.And incidence of intraoperative complications and the positive rate of postoperative pulmonary complication(PPC)in both groups were counted.Results There were no statistically significant differences in MAP and HR between the two groups at T1,T2,T3 and T4 time points(P>0.05).The PaCO2 level in both groups at T2,T3,and T4 time points was higher than that at T1 time point,but the PCV-VG group was lower than that in the VCV group,the differences were statistically significant(P<0.05).The PaO2,OI,and Cldyn in the two groups at T2 and T3 time points were lower than those at T1 time point,but the PCV-VG group was higher than that in the VCV group,the differences were statistically significant(P<0.05).The PA-aO2,tidal volume,PetCO2 and Ppeak of the two groups of patients at T2 and T3 time points were significantly higher than those at time point T1,and the differences were statistically significant(P<0.05).At T2 and T3,the PA-aO2 and Ppeak in the PCV-VG group were significantly lower than those in the VCV group,and the differences were statistically significant(P<0.05).The incidence of intraoperative complications and PPC positivity rate in the PCV-VG group were 8.82%and 2.94%,respectively,which were lower than 29.41%and 23.53%in the VCV group,the differences were statistically significant(P<0.05).Conclusion Compared with VCV,implementing PCV-VG mode during LRRCC surgery is more conducive to reducing the impacts of pneumoperitoneum on blood gas analysis,lung ventilation function,and respiratory mechanics,and reducing the incidence of complications such as hypoxemia and hypercapnia rate.It is worthy for clinical application.

The underlying cause of low response rates to existing immunotherapies is that tumor cells dominate tumor immune escape through surface antigen deficiency and inducing tumor immunosuppressive microenvironment (TIME). Here, we proposed an in situ tumor cell engineering strategy to disrupt tumor immune escape at the root by restoring tumor cell MHC-I/tumor-specific antigen complex (MHC-I/TSA) expression to promote T-cell recognition and by silencing tumor cell CD55 to increase the ICOSL⁺ B-cell proportion and reverse the TIME. A doxorubicin (DOX) and dual-gene plasmid (MAC pDNA, encoding both MHC-I/ASMTNMELM and CD55-shRNA) coloaded drug delivery system (LCPN@ACD) with tumor targeting and charge/size dual-conversion properties was prepared. LCPN@ACD-induced ICD promoted DC maturation and enhanced T-cell activation and infiltration. LCPN@ACD enabled effective expression of MHC-I/TSA on tumor cells, increasing the ability of tumor cell recognition and killing. LCPN@ACD downregulated tumor cell CD55 expression, increased the proportion of ICOSL⁺ B cells and CTLs, and reversed the TIME, thus greatly improving the efficacy of αPD-1 and CAR-T therapies. The application of this in situ tumor cell engineering strategy eliminated the source of tumor immune escape, providing new ideas for solving the challenges of clinical immunotherapy.

Objective To explore the effect of different ventilation modes during laparoscopic radical resection of colorectal cancer(LRRCC)on respiratory function in patients with complicated mild obstructive ventilatory disorder(OVD).Methods 68 patients with mild OVD who underwent elective LRRCC from June 2022 to March 2024 were randomly divided into a volume controlled ventilation(VCV)group(n=34,with intraoperative VCV)and a pressure controlled ventilation-volume guaranteed(PCV-VG)mode group(n=34,with intraoperative PCV-VG).Changes in hemodynamics[mean arterial pressure(MAP)and heart rate(HR)],blood gas indicators[partial pressure of carbon dioxide in arterial blood(PaCO2)and arterial partial pressure of oxygen(PaO2)],lung exchange function indicators[oxygenation index(OI),alveolar-arterial oxygen partial pressure difference(PA-aO2)],respiratory mechanics indicators[tidal volume,end-tidal carbon dioxide partial pressure(PetCO2),peak airway pressure(Ppeak),and dynamic lung compliance(Cldyn)]before pneumoperitoneum(T1),30 min after establishing pneumoperitoneum(T2),1 h after pneumoperitoneum(T3),and 20 min after the end of pneumoperitoneum(T4)were observed in both groups.And incidence of intraoperative complications and the positive rate of postoperative pulmonary complication(PPC)in both groups were counted.Results There were no statistically significant differences in MAP and HR between the two groups at T1,T2,T3 and T4 time points(P>0.05).The PaCO2 level in both groups at T2,T3,and T4 time points was higher than that at T1 time point,but the PCV-VG group was lower than that in the VCV group,the differences were statistically significant(P<0.05).The PaO2,OI,and Cldyn in the two groups at T2 and T3 time points were lower than those at T1 time point,but the PCV-VG group was higher than that in the VCV group,the differences were statistically significant(P<0.05).The PA-aO2,tidal volume,PetCO2 and Ppeak of the two groups of patients at T2 and T3 time points were significantly higher than those at time point T1,and the differences were statistically significant(P<0.05).At T2 and T3,the PA-aO2 and Ppeak in the PCV-VG group were significantly lower than those in the VCV group,and the differences were statistically significant(P<0.05).The incidence of intraoperative complications and PPC positivity rate in the PCV-VG group were 8.82%and 2.94%,respectively,which were lower than 29.41%and 23.53%in the VCV group,the differences were statistically significant(P<0.05).Conclusion Compared with VCV,implementing PCV-VG mode during LRRCC surgery is more conducive to reducing the impacts of pneumoperitoneum on blood gas analysis,lung ventilation function,and respiratory mechanics,and reducing the incidence of complications such as hypoxemia and hypercapnia rate.It is worthy for clinical application.

Cytopharmaceutical based on macrophages is a breakthrough in the field of targeted drug delivery. However, it remains a challenge to localize and control drug release while retaining macrophage activity and exerting its immunotherapeutic effect. Herein, a localized light-triggered release macrophage cytopharmaceutical (USIP@M) was proposed, which could utilize the tumor targeting and immunotherapy effects of macrophages to reverse the immune suppression of tumor microenvironment (TME). Amphiphilic block copolymers with ultraviolet (UV)-responsive o-nitrobenzyl groups were synthesized and co-loaded with sorafenib (SF), IMD-0354 (IMD), and upconverting nanoparticles (UCNPs), which were then taken up by macrophages, and the targeted delivery of drugs was realized by using the tumor tropism of macrophages. UCNPs converted near-infrared light with strong penetrability and high safety into UV light, which promoted the photoresponsive depolymerization of block copolymers and production of exosomes from USIP@M, accelerated drug efflux and maintained the activity of macrophages. IMD simultaneously polarized carrier macrophages and tumor-associated macrophages to exert the antitumor effect of macrophages, enhance T cell immunity, and alleviate the immunosuppressive state of TME. Synergistically with the chemotherapeutic effect of SF, it could effectively kill tumors. In conclusion, based on the localized light-triggered release strategy, this study constructed a novel macrophage cytopharmaceutical that could localize and control drug release while retaining the activity of macrophages and exerting its immunotherapeutic effect, which could effectively treat solid tumors.

Objective To study the preparation method and analytical technique of hyperoside from Flos Abelmoschus manihot.Methods Hyperoside was isolated and purified by solvent extract and chromatography, whose structure was determined by 1H-NMR and 13C-NMR. The purity was analyzed by TLC and HPLC.Results The TLC showed that the hyperoside had no impurity spot. The HPLC indicated that the purity reached more than 98.5%.Conclusions The mothod of isolation and purification for hyperoside reported in this paper was simple and economical.

Objective To investigate whether miR-200a suppresses cell proliferation by targeting AP-2γexpression, and reveal molecular mechanism that miR-200a functions as a tumor-suppressor in neuroblastoma cells. Methods Dual-luciferase reporter gene assay was employed to examine the effect of miR-200a on AP-2γpromotor luciferase activity. Neu-roblastoma cells were transfected with miR-200a mimics, and the expressions of AP-2γmRNA and protein were detected by RT-PCR and Western blot assay. The effects of AP-2γdown-regulation on cell proliferation were observed after AP-2γshRNA was transfected into neuroblastoma cells. Neuroblastoma cell proliferation was detected by MTS assay after being co-transfected with miR-200a mimics and AP-2γplasmid. Results Results showed that miR-200a could inhibit proliferation of neuroblastoma cells at cell viability (66.33 ± 5.13) compared with that of control group (100 ± 0), and also miR-200a can bind to the 3'untranslated region of AP-2γpromotor and inhibit its luciferase activity with an inhibit ratio at (0.624±0.051). AP-2γmRNA and protein expressions were significantly down-regulated when miR-200a was over-expressed in neuroblas-toma cells. Furthermore, results showed that shRNA-mediated down-regulation of AP-2γthat suppressed the cell prolifera-tion of neuroblastoma at (62.5±2.4) by comparing with the control group (100±0). Moreover, restoring AP-2γexpression re-versed the effect of miR-200a with a cell viability suppression at (92.4±1.4). Conclusion miR-200a suppresses cell prolif-eration by targeting AP-2γexpression in neuroblastoma cells.

Objective To compare the benefits and harms of cervical disc arthroplasty ( CDA) with anterior cervical discectomy and fusion( ACDF) for symptomatic cervical disc disease at mid? to long?term follow?up? Methods Electronic searches were made in PubMed,EMBASE,and the Cochrane Library for randomized controlled trials with at least 48 moths follow?up?Outcomes were reported as relative risk or standardized mean difference?Meta?analysis was carried out using Revman version 5?3 and Stata version 12?0. Results Seven trials were included, involving 2 302 participants?The results of this meta?analysis indicated that CDA brought about fewer secondary surgical procedures,lower neck disability index (NDI) scores,lower neck and arm pain scores,greater SF?36 Physical Component Summary (PCS) and Mental Component Summary( MCS) scores,greater range of motion ( ROM) at the operative level and less superior adjacent?segment degeneration ( P<0?05 ) than ACDF?CDA was not statistically different from ACDF in inferior adjacent?segment degeneration,neurological success,and adverse events (P>0?05)? Conclusions CDA can significantly reduce the rates of secondary surgical procedures compared with ACDF?Meanwhile, CDA is superior or equivalent to ACDF in other aspects?As some studies without double?blind are included and some potential biases exites,more randomized controlled trials with high quality are required to get more reliable conclusions.

Objective To compare the benefits and harms of cervical disc arthroplasty ( CDA) with anterior cervical discectomy and fusion( ACDF) for symptomatic cervical disc disease at mid? to long?term follow?up? Methods Electronic searches were made in PubMed,EMBASE,and the Cochrane Library for randomized controlled trials with at least 48 moths follow?up?Outcomes were reported as relative risk or standardized mean difference?Meta?analysis was carried out using Revman version 5?3 and Stata version 12?0. Results Seven trials were included, involving 2 302 participants?The results of this meta?analysis indicated that CDA brought about fewer secondary surgical procedures,lower neck disability index (NDI) scores,lower neck and arm pain scores,greater SF?36 Physical Component Summary (PCS) and Mental Component Summary( MCS) scores,greater range of motion ( ROM) at the operative level and less superior adjacent?segment degeneration ( P<0?05 ) than ACDF?CDA was not statistically different from ACDF in inferior adjacent?segment degeneration,neurological success,and adverse events (P>0?05)? Conclusions CDA can significantly reduce the rates of secondary surgical procedures compared with ACDF?Meanwhile, CDA is superior or equivalent to ACDF in other aspects?As some studies without double?blind are included and some potential biases exites,more randomized controlled trials with high quality are required to get more reliable conclusions.

Objective To explore the expression and clinical signiifcance of microRNA-200a in childhood B-cell acute lymphoblastic leukemia (ALL). Methods Bone marrow samples were collected from 45 children with B-cell ALL and 18 chil-dren without hematology disease as control. Total RNA was acquired from bone marrow. qRT-PCR was performed to detect the expression level of miR-200a. Results The relative expression level of miR-200a in B-cell ALL group was signiifcantly lower than that in control group (P<0.05);the expression of miR-200a in children over 10 years old was signiifcantly lower than those in children under 10 years old (P<0.05);the expression of miR-200a in newly diagnosed samples was lower than those in those samples taken on Day 33 and at Week 12, respectively (P<0.05, P<0.01). In addition, the expression of miR-200a in low-risk group was higher than those in mid-risk and high-risk group, respectively (P<0.05). Conclusions Low level of miR-200a had a close correlation with the development and prognosis of childhood B cell ALL, which could be used as a potential target of thera-py and a biomarker of childhood B cell ALL in the future.

Objective To explore the role of interleukin-23 (IL-23)/interleukin-17 (IL-17) signaling pathway in viral myocarditis (VMC) and evaluate the intervention effect of Aastragaloside. Methods Seventy-five male BALB/c mice were randomly divided into 4 groups, control group (n=15), model group (n=20), low-dose intervention group (n=20) and high-dose intervention group (n=20). Mice in control group were inoculated with 0.1 ml virus cultivation solution intraperitoneally while mice in the other 3 groups were treated with 0.1ml virus cultivation solution containing 1×102 TCID50 coxsackievirus B3 (CVB3) to establish VMC model. On the day of inoculation, mice in low- and high-dose intervention groups were intra-gastrically administered with 0.1 ml of 1% and 9%Astragaloside solution respectively, whereas those in control and model groups were treated with 0.1 ml carboxymethycellulose solution. Astragaloside or carboxymethycellulose was given once a day and continued 15 days. The number of mice death and the performance of mice were recorded in experimental period. All mice were sacrificed on day 15. The heart and blood sample were obtained. Histological cross sections of heart were stained with hematoxylin-eosin and scored for myocardial histopathologic changes under optical microscope. Th17 cells were analyzed by flow cytometry. The mRNA and protein expression levels of myocardial IL-23 and IL-17 were detected by real-time quantitative PCR and Western blotting, respectively. Results The mortality was statistically significant differ-ences among the four groups (P= 0.013), which was the lowest in the control group. The myocardial histopathologic scores, the percen-tage of Th17 cells, as well as expression levels of myocardial IL-23 and IL-17 mRNA and protein were significantly lower in high-dose intervention group than those in model group and low-dose intervention group, but higher than those in control group (P < 0.05). The myocardial histopathologic scores, the percentage of Th17 cells, as well as ex-pression levels of myocardial IL-23 and IL-17 mRNA and protein were significantly higher in model group and low-dose in-tervention group (P < 0.05). There were no significant difference in the above mentioned indicators between low-dose inter-vention group and model group (P > 0.05). Conclusions Astragaloside may dose-dependently protect against VMC by in-hibiting IL-23/IL-17 signaling pathway.